Search results for: children care

Authors: Floriane Shala, Evangeline Wagner, Yichun Zhao

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Background: Proper educational training and support are proven to be major components of EHR (Electronic Health Record) implementation and use. However, the majority of health providers are not sufficiently trained in EHR use, leading to adverse events, errors, and decreased quality of care. In response to this, students studying Health Information Science, Public Health, Nursing, and Medicine should all gain a thorough understanding of EHR use at different levels for different purposes. The design of a usable and safe EHR system that accommodates the needs and workflows of different users, user groups, and disciplines is required for EHR learning to be efficient and effective. Objectives: This project builds several artifacts which seek to address both the educational and usability aspects of an educational EHR. The artifacts proposed are models for and examples of such an EHR with a configurable UI to be learned by students who need a background in EHR use during their degrees. Methods: Review literature and gather professional opinions from domain experts on usability, the use of workflow patterns, UI configurability and design, and the educational aspect of EHR use. Conduct interviews in a semi-casual virtual setting with open discussion in order to gain a deeper understanding of the principal aspects of EHR use in educational settings. Select a specific task and user group to illustrate how the proposed solution will function based on the current research. Develop three artifacts based on the available research, professional opinions, and prior knowledge of the topic. The artifacts capture the user task and user’s interactions with the EHR for learning. The first generic model provides a general understanding of the EHR system process. The second model is a specific example of performing the task of MRI ordering with a configurable UI. The third artifact includes UI mock-ups showcasing the models in a practical and visual way. Significance: Due to the lack of educational EHRs, medical professionals do not receive sufficient EHR training. Implementing an educational EHR with a usable and configurable interface to suit the needs of different user groups and disciplines will help facilitate EHR learning and training and ultimately improve the quality of patient care.

Keywords: education, EHR, usability, configurable

Procedia PDF Downloads 157

Authors: Fereshteh Ganjavi, Rachel Schaffer, Varsha Jorawar

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Elena’s Light is a non-profit organization focused on building brighter futures for refugees, especially women and children. Our mission is to empower refugee women and children by addressing social, legal, and public health issues that predominantly concern them. Elena’s Light offers a range of services that support refugees from structural disadvantages, cultural and social stress, marginalization, and other stressors related to migration. Using a three-pronged approach, our programs focus on legal advocacy, English language acquisition, and health and wellness. Following the Afghan humanitarian crisis, Elena’s Light has developed and intensified advocacy efforts in the legal realm to address the influx of refugees who desperately need assistance. We developed and hosted a Know Your Rights presentation with local immigration lawyers and professionals in February 2022 on the Afghan Humanitarian Parole, which was very successful with over 100 attendees. Elena’s Light is hosting the second Know Your Rights session in early August 2022 on immigration options for Afghans, including Temporary Protected Status (TPS), asylum, Special Immigrant Visa (SIV), and humanitarian parole. Lastly, EL is also leading the local initiative to develop a pro-bono committee to respond to the overwhelming need for lawyers to work on legal cases for Afghan during this crisis. Furthermore, through our other services, we provide free, in-home customizable ESL tutoring sessions to refugee women with a focus on driver’s education, facilitating acculturation, and improving employment opportunities. We also provide in-home maternal, pediatric, and mental health education and wellness services that are aimed at addressing the explicit and implicit barriers to healthcare for refugee populations. Elena’s Light’s diverse community aims to counter the structural disadvantages and anxiety-inducing emotions and experiences related to being a refugee. We would like to join this International Conference on Refugee Law since protecting refugee rights is our mission. We would like to share what we have learned from our legal initiatives for refugee rights. We would also like to listen, learn from, and discuss with experts and researchers how to better understand and advocate for refugee rights. We hope to improve our understanding of how to provide better legal aid for our clients through this conference.

Keywords: legal, advocacy, Afghan humanitarian crisis, policy, pro-bono

Procedia PDF Downloads 134

Authors: Elisabeth Unterfrauner, Christian Voigt

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Since the foundation of the first Fab Lab by the Massachusetts Institute of Technology about 17 years ago, the Maker movement has spread globally with the foundation of maker spaces and Fab Labs worldwide. In these workshops, citizens have access to digital fabrication technologies such as 3D printers and laser cutters to develop and test their own ideas and prototypes, which makes it an attractive place for start-up companies. Know-How is shared not only in the physical space but also online in diverse communities. According to the Horizon report, the Maker movement, however, will also have an impact on educational settings in the following years. The European project ‘DOIT - Entrepreneurial skills for young social innovators in an open digital world’ has incorporated key elements of making to develop an early entrepreneurial education program for children between the age of six and 16. The Maker pedagogy builds on constructive learning approaches, learning by doing principles, learning in collaborative and interdisciplinary teams and learning through trial and error where mistakes are acknowledged as learning opportunities. The DOIT program consists of seven consecutive elements. It starts with a motivation phase where students get motivated by envisioning the scope of their possibilities. The second step is about Co-design: Students are asked to collect and select potential ideas for innovations. In the Co-creation phase students gather in teams and develop first prototypes of their ideas. In the iteration phase, the prototype is continuously improved and in the next step, in the reflection phase, feedback on the prototypes is exchanged between the teams. In the last two steps, scaling and reaching out, the robustness of the prototype is tested with a bigger group of users outside of the educational setting and finally students will share their projects with a wider public. The DOIT program involves 1,000 children in two pilot phases at 11 pilot sites in ten different European countries. The comprehensive evaluation design is based on a mixed method approach with a theoretical backbone on Lackeus’ model of entrepreneurship education, which distinguishes between entrepreneurial attitudes, entrepreneurial skills and entrepreneurial knowledge. A pre-post-test with quantitative measures as well as qualitative data from interviews with facilitators, students and workshop protocols will reveal the effectiveness of the program. The evaluation results will be presented at the conference.

Keywords: early entrepreneurial education, Fab Lab, maker education, Maker movement

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Authors: Vicario Marina, Ruiz Elena, Peredo Ruben, Bustos Eduardo

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the development group of Educational Computing of the National Polytechnic (IPN) in Mexico has been developing interactive resources at preschool level in an effort to improve learning in the Child Development Centers (CENDI). This work describes both a didactic architecture and a strategy for teaching English with digital stories using interactive resources available through a Web repository designed to be used in mobile platforms. It will be accessible initially to 500 children and worldwide by the end of 2015.

Keywords: instructional design, interactive resources, digital educational resources, story based English teaching, preschool education

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Authors: Monika Jurkeviciute, Amia Enam, Johanna Torres Bonilla, Henrik Eriksson

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Introduction: Many evaluations of eHealth interventions conclude that the evidence for improved clinical outcomes is limited, especially when the intervention is short, such as one year. Often, evaluation design does not address the feasibility of achieving clinical outcomes. Evaluations are designed to reflect upon clinical goals of intervention without utilizing the opportunity to illuminate effects on organizations and cost. A comprehensive design of evaluation can better support decision-making regarding the effectiveness and potential transferability of eHealth. Hence, the purpose of this paper is to present a feasible and comprehensive design of evaluation for eHealth intervention, including the design process in different contexts. Methodology: The situation of limited feasibility of clinical outcomes was foreseen in the European Union funded project called “DECI” (“Digital Environment for Cognitive Inclusion”) that is run under the “Horizon 2020” program with an aim to define and test a digital environment platform within corresponding care models that help elderly people live independently. A complex intervention of eHealth implementation into elaborate care models in four different countries was planned for one year. To design the evaluation, a participative approach was undertaken using Pettigrew’s lens of change and transformations, including context, process, and content. Through a series of workshops, observations, interviews, and document analysis, as well as a review of scientific literature, a comprehensive design of evaluation was created. Findings: The findings indicate that in order to get evidence on clinical outcomes, eHealth interventions should last longer than one year. The content of the comprehensive evaluation design includes a collection of qualitative and quantitative methods for data gathering which illuminates non-medical aspects. Furthermore, it contains communication arrangements to discuss the results and continuously improve the evaluation design, as well as procedures for monitoring and improving the data collection during the intervention. The process of the comprehensive evaluation design consists of four stages: (1) analysis of a current state in different contexts, including measurement systems, expectations and profiles of stakeholders, organizational ambitions to change due to eHealth integration, and the organizational capacity to collect data for evaluation; (2) workshop with project partners to discuss the as-is situation in relation to the project goals; (3) development of general and customized sets of relevant performance measures, questionnaires and interview questions; (4) setting up procedures and monitoring systems for the interventions. Lastly, strategies are presented on how challenges can be handled during the design process of evaluation in four different countries. The evaluation design needs to consider contextual factors such as project limitations, and differences between pilot sites in terms of eHealth solutions, patient groups, care models, national and organizational cultures and settings. This implies a need for the flexible approach to evaluation design to enable judgment over the effectiveness and potential for adoption and transferability of eHealth. In summary, this paper provides learning opportunities for future evaluation designs of eHealth interventions in different national and organizational settings.

Keywords: ehealth, elderly, evaluation, intervention, multi-cultural

Procedia PDF Downloads 324

Authors: Priyajeet Kaur Kaleka

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Introduction: A dentist is often the first responder in the battle for a patient’s healthy body and maybe the first health professional to observe signs of child abuse, be it physical, emotional, and/or sexual mistreatment. Therefore, it is an ethical responsibility for the dental clinician to detect and report suspected cases of child abuse and neglect (CAN). The main reasons for not reporting suspected cases of CAN, with special emphasis on the third: 1) Uncertainty of the diagnosis, 2) Lack of knowledge of the reporting procedure, and 3) Child abuse and neglect somewhat remained the subject of ignorance among dental professionals because of a lack of advance clinical training. Given these epidemic proportions, there is a scope of further research about dental school curriculum design. Purpose: This study aimed to assess the knowledge and attitude of dentists in Canada regarding signs and symptoms of child abuse and neglect (CAN), reporting procedures, and whether educational strategies followed by dental schools address this sensitive issue. In pursuit of that aim, this abstract summarizes the evidence related to this question. Materials and Methods: Data was collected through a specially designed questionnaire adapted and modified from the author’s previous cross-sectional study on (CAN), which was conducted in Pune, India, in 2016 and is available on the database of PubMed. Design: A random sample was drawn from the targeted population of registered dentists and dental students in Canada regarding their knowledge, professional responsibilities, and behavior concerning child abuse. Questionnaire data were distributed to 200 members. Out of which, a total number of 157 subjects were in the final sample for statistical analysis, yielding response of 78.5%. Results: Despite having theoretical information on signs and symptoms, 55% of the participants indicated they are not confident to detect child physical abuse cases. 90% of respondents believed that recognition and handling the CAN cases should be a part of undergraduate training. Only 4.5% of the participants have correctly identified all signs of abuse due to inadequate formal training in dental schools and workplaces. Although nearly 96.3% agreed that it is a dentist’s legal responsibility to report CAN, only a small percentage of the participants reported an abuse case in the past. While 72% stated that the most common factor that might prevent a dentist from reporting a case was doubt over the diagnosis. Conclusion: The goal is to motivate dental schools to deal with this critical issue and provide their students with consummate training to strengthen their capability to care for and protect children. The educational institutions should make efforts to spread awareness among dental students regarding the management and tackling of CAN. Clinical Significance: There should be modifications in the dental school curriculum focusing on problem-based learning models to assist graduates to fulfill their legal and professional responsibilities. CAN literacy should be incorporated into the dental curriculum, which will eventually benefit future dentists to break this intergenerational cycle of violence.

Keywords: abuse, child abuse and neglect, dentist knowledge, dental school curriculum, problem-based learning

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Authors: Mili Dutta, Lokender Prashad

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Introduction: Population ageing is a phenomenon that can be observed around the globe. The health-related quality of life (HRQOL) is a measurement of health status of an individual, and it describes the effect of physical and mental health disorders on the well-being of a person. The present study is aimed to describe the influence of socio-economic characteristics of elderly on their health-related quality of life in India. Methods: EQ-5D instrument and population-based EQ-5D index score has been measured to access the HRQOL among elderly. Present study utilized the Study on Global Ageing and Adult Health (SAGE) data which was conducted in 2007 in India. Multiple Logistic Regression model and Multivariate Linear Regression model has been employed. Result: In the present study, it was found that the female are more likely to have problems in mobility (OR=1.41, 95% Cl: 1.14 to 1.74), self-care (OR=1.26, 95% Cl: 1.01 to 1.56) and pain or discomfort (OR=1.50, 95% Cl: 1.16 to 1.94). Elderly residing in rural area are more likely to have problems in pain/discomfort (OR=1.28, 95% Cl: 1.01 to 1.62). More older and non-working elderly are more likely whereas higher educated and highest wealth quintile elderly are less likely to have problems in all the dimensions of EQ-5D viz. mobility, self-care, usual activity, pain/discomfort and anxiety/depression. The present study has also shown that oldest old people, residing in rural area and currently not working elderly are more likely to report low EQ-5D index score whereas elderly with high education level and high wealth quintile are more likely to report high EQ-5D index score than their counterparts. Conclusion: The present study has found EQ-5D instrument as the valid measure for assessing the HRQOL of elderly in India. The study indicates socio-economic characteristics of elderly such as female, more older people, residing in rural area, non-educated, poor and currently non-working as the major risk groups of having poor HRQOL in India. Findings of the study will be helpful for the programmes and policy makers, researchers, academician and social workers who are working in the field of ageing.

Keywords: ageing, HRQOL, India, EQ-5D, SAGE, socio-economic characteristics

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Authors: Mengnan Sun

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It is unclear about the association between air pollution and Tourette Syndrome (TS), although people have suspected that air pollution might trigger TS. TS is a type of neural system disease usually found among children. The number of TS patients has significantly increased in recent decades, suggesting an importance and urgency to examine the possible triggers or conditions that are associated with TS. In this study, the correlation between air pollution and three allergic diseases---asthma, allergic conjunctivitis (AC), and allergic rhinitis (AR)---is examined. Then, a correlation between these allergic diseases and TS is proved. In this way, this study establishes a positive correlation between air pollution and TS. Measures the public can take to help TS patients are also analyzed at the end of this article. The article hopes to raise people’s awareness to reduce air pollution for the good of TS patients or people with other disorders that are associated with air pollution.

Keywords: air pollution, allergic diseases, climate change, Tourette Syndrome

Procedia PDF Downloads 63

Authors: Muhammad Faisal Khilji, Rana Shoaib Hamid, Asim Qureshi

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A fifty years old female presented in the emergency department of a tertiary care hospital with complaints of migraine type headache for the last few months. Her last episode of headache was severe, increasing in intensity, associated with nausea but no fever, lasting more than 24 hours and not resolving with analgesics. On examination there was no neurological deficit. CT scan of brain showed a large Pedunculated, non-expansible, non-aggressive bony lesion in the clivus with its sharp fragment impinging into the pons. Findings were further confirmed with MRI brain. Trans-sphenoidal excision biopsy was done and histopathology proved the lesion to be osteochondroma of clivus.

Keywords: osteochondroma, clivus, headache, CT scan

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Authors: Rima Mammadova

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Azerbaijan is a developing country that tries to keep its own culture and traditions. At the same time tries to get benefit from the experience and knowledge of the developed countries. After the collapse of the Soviet Union, Azerbaijan got its independence and currently, implements various programs and policy initiatives to the development of different fields, such as an education, human rights, etc. Disability related issues are also in the main priority list of the country. During the Soviet Union, children with disabilities studied in the special schools, which called boarding schools. They were isolated from the society and most of them were not able to get their higher education. As the result of this kind of tendency, they were in dependence on their parents, relatives and especially the government, as there were several kind of pensions provided by the government depending on the level of disability. Although Azerbaijan maintain different programs, the remnants of the Soviet period still exists. This paper investigates the current situation in Azerbaijan concerning the higher education of people with disabilities. Qualitative and quantitative research methods used in this paper. As a qualitative method a literature review was done on what the term “disability” is and what kind of education rights possess people with disabilities in Azerbaijan. A detailed research also was done on legislation of the Republic of Azerbaijan concerning the education rights of people with disabilities in Azerbaijan. As a quantitative method, questionnaire was used. The questionnaires were sent to the 8 Azerbaijani Higher Education Institutions (HEIs) which are located in different regions of Azerbaijan in order to assess and evaluate the situation concerning the students with disabilities. The main aims of these questionnaires were to find out how many students with disabilities study in Higher Education Institutions in 8 HEIs and what kind of obstacles and challenges Institutions face concerning the education of students with disabilities. The researches provided for the project brought up the results that people with disabilities possess all rights concerning the education rights legally. However in the practice they face various types of obstacles and challenges. The number of students with disabilities in HEIs in Azerbaijan is significantly low. There are several kind of reasons that affect the number of students with disabilities in HEIs. As was mentioned before the remnants of the Soviet period exists in Azerbaijan and children with disabilities get their education in boarding schools and in most cases, these boarding schools give education till the 9th class, but to enter the University, pupils have to finish 11 classes in Azerbaijan. As a result, pupils with disabilities automatically disqualify to enter the university. The paper comes into conclusion that to eliminate the isolation of pupils with disabilities from HEIs, the government should pay more attention to the special schools for the pupils with disabilities, the boarding schools should be cancelled and etc. By the applying these kind of changes the rights of people with disabilities will be provided not only theoretically but also practically.

Keywords: Azerbaijan, disability, students with disabilities, boarding schools

Procedia PDF Downloads 267

Authors: Rana Parween, Rob Marchant

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With the continued loss of global biodiversity despite the application of modern conservation techniques, it has become crucial to investigate non-conventional methods. Accelerated destruction of ecosystems due to altered land use, climate change, cultural and social change, necessitates the exploration of society-biodiversity attitudes and links. While the loss of species and their extinction is a well-known and well-documented process that attracts much-needed attention from researchers, academics, government and non-governmental organizations, the loss of traditional ecological knowledge and practices is more insidious and goes unnoticed. The growing availability of 'indirect experiences' such as the internet and media are leading to a disaffection towards nature and the 'Extinction of Experience'. Exacerbated by the lack of documentation of traditional practices and skills, there is the possibility for the 'extinction' of traditional practices and skills before they are fully recognized and captured. India, as a mega-biodiverse country, is also known for its historical conservation strategies entwined in traditional beliefs. Indigenous communities hold skillsets, knowledge, and traditions that have accumulated over multiple generations and may play an important role in conserving biodiversity today. This study explores the differences in knowledge and attitudes towards conserving biodiversity, of three different stakeholder groups living around Jim Corbett National Park, based on their age, traditions, and association with the protected area. A triangulation designed multi-strategy investigation collected qualitative and quantitative data through a questionnaire survey of village elders, the general public, and forest officers. Following an inductive approach to analyzing qualitative data, the thematic content analysis was followed. All coding and analysis were completed using NVivo 11. Although the village elders and some general public had vast amounts of traditional knowledge, most of it was related to animal husbandry and the medicinal value of plants. Village elders were unfamiliar with the concept of the term ‘biodiversity’ albeit their way of life and attitudes ensured that they care for the ecosystem without having the scientific basis underpinning biodiversity conservation. Inherently, village elders were keen to conserve nature; the superimposition of governmental policies without any tangible benefit or consultation was seen as detrimental. Alienating villagers and consequently the village elders who are the reservoirs of traditional knowledge would not only be damaging to the social network of the area but would also disdain years of tried and tested techniques held by the elders. Forest officers advocated for biodiversity and conservation education for women and children. Women, across all groups, when questioned about nature conservation, showed more interest in learning and participation. Biodiversity not only has an ethical and cultural value, but also plays a role in ecosystem function and, thus, provides ecosystem services and supports livelihoods. Therefore, underpinning and using traditional knowledge and incorporating them into programs of biodiversity conservation should be explored with a sense of urgency.

Keywords: biological diversity, mega-biodiverse countries, traditional ecological knowledge, society-biodiversity links

Procedia PDF Downloads 105

Authors: Dongdong Bai

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The curriculum is essential in determining the quality of early childhood education (ECE). Education policy is intricately linked to the effective execution of the preschool education curriculum. The learner-centred education (LCE) approach is a globally common educational concept. However, it is an approach that is applied variably in ECE policy-making and implementation across diverse cultural contexts. Notwithstanding its significance, limited study has investigated the ECE curriculum policies on the articulation and implementation of the LCE concept in England and Hong Kong’s non-profit-making kindergartens — two regions with intricate historical and cultural connections. Moreover, both regions have experienced significant transformations in ECE policy since 1997. This research employs a qualitative comparative approach, with discourse analysis of key policy documents and relevant literature as the primary methodology. The study develops a comparison framework grounded in Adamson and Morris' curriculum comparison theory, which evaluates curricula from the perspectives of purpose, focus, and manifestation. The paper is structured around three key elements: (1) educational objectives; (2) implementation guidance, including pedagogical strategies, learning content and assessment mechanism; and (3) influential cultural ideologies. Through this framework, the study explores the similarities and differences in the design and implementation of LCE within ECE policies in England and Hong Kong’s non-profit-making kindergartens, while examining the cultural factors that shape these policy variations. The findings indicate that both England and Hong Kong possess child-centered educational objectives focused on enhancing cognitive, skill-based, and physical development; however, Hong Kong's policies notably emphasize alleviating academic pressure in achieving these curriculum aims. England's recommendations advocate for play-based, and exploratory learning to augment children's cognitive development. Conversely, Hong Kong utilizes narrative techniques and indoor instruction to facilitate progressive education. Additionally, both areas encompass cognitive disciplines such as literacy and numeracy; however, England distinctly prioritizes citizenship education with an emphasis on cultural traits. In contrast, Hong Kong amalgamates Western educational ideas with an emphasis on traditional Chinese culture and values, encompassing the study of Chinese characters, etiquette, and moral education rooted in Confucian cultural ideologies. Ultimately, regarding assessment mechanisms, England has transitioned from government-led professional evaluation programs to a hybrid of market and governmental oversight. Conversely, Hong Kong's curriculum evaluation mechanism primarily consists of self-evaluation and public supervision, yet it is evident that the policy could benefit from greater receptiveness to public and expert input. The underlying cultural ideologies significantly influence these policy discrepancies. In England, ECE policies are guided by core concepts that viewing children as individuals, agents, and future citizens. In Hong Kong, the policies reflect Confucian traditions and cultural values, which shape their unique approach to ECE in Hong Kong societies. In conclusion, whereas both locations strive to advocate LCE for the comprehensive development of children, significant differences arise in curriculum focus and implementation policies, shaped by their respective cultural philosophies.

Keywords: curriculum policy, cultural contexts, early childhood education, learner-centred education

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Authors: Javier E. García-Gallo, Nelson J. Fonseca-Ruiz, John F. Duitama-Munoz

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Sepsis is a syndrome that occurs with physiological and biochemical abnormalities induced by severe infection and carries a high mortality and morbidity, therefore the severity of its condition must be interpreted quickly. After patient admission in an intensive care unit (ICU), it is necessary to synthesize the large volume of information that is collected from patients in a value that represents the severity of their condition. Traditional severity of illness scores seeks to be applicable to all patient populations, and usually assess in-hospital mortality. However, the use of machine learning techniques and the data of a population that shares a common characteristic could lead to the development of customized mortality prediction scores with better performance. This study presents the development of a score for the one-year mortality prediction of the patients that are admitted to an ICU with a sepsis diagnosis. 5650 ICU admissions extracted from the MIMICIII database were evaluated, divided into two groups: 70% to develop the score and 30% to validate it. Comorbidities, demographics and clinical information of the first 24 hours after the ICU admission were used to develop a mortality prediction score. LASSO (least absolute shrinkage and selection operator) and SGB (Stochastic Gradient Boosting) variable importance methodologies were used to select the set of variables that make up the developed score; each of this variables was dichotomized and a cut-off point that divides the population into two groups with different mean mortalities was found; if the patient is in the group that presents a higher mortality a one is assigned to the particular variable, otherwise a zero is assigned. These binary variables are used in a logistic regression (LR) model, and its coefficients were rounded to the nearest integer. The resulting integers are the point values that make up the score when multiplied with each binary variables and summed. The one-year mortality probability was estimated using the score as the only variable in a LR model. Predictive power of the score, was evaluated using the 1695 admissions of the validation subset obtaining an area under the receiver operating characteristic curve of 0.7528, which outperforms the results obtained with Sequential Organ Failure Assessment (SOFA), Oxford Acute Severity of Illness Score (OASIS) and Simplified Acute Physiology Score II (SAPSII) scores on the same validation subset. Observed and predicted mortality rates within estimated probabilities deciles were compared graphically and found to be similar, indicating that the risk estimate obtained with the score is close to the observed mortality, it is also observed that the number of events (deaths) is indeed increasing as the outcome go from the decile with the lowest probabilities to the decile with the highest probabilities. Sepsis is a syndrome that carries a high mortality, 43.3% for the patients included in this study; therefore, tools that help clinicians to quickly and accurately predict a worse prognosis are needed. This work demonstrates the importance of customization of mortality prediction scores since the developed score provides better performance than traditional scoring systems.

Keywords: intensive care, logistic regression model, mortality prediction, sepsis, severity of illness, stochastic gradient boosting

Procedia PDF Downloads 222

Authors: Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu

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Background & objective: Mitral valve surgeries are mainly performed by median sternotomy with conventional direct atriotomy. Good exposure to the mitral valve is challenging, especially for acute pathologies, where left atrium dilation does not occur. Other atriotomies, such as transseptal or superior septal, are used as they allow better access and visualization. Peri- and postoperative outcomes of these three different left atriotomies were compared. Methods: Patients undergoing mitral valve surgery between January 2010 and December 2020 were included and divided into three groups: group 1 (conventional direct, n=115), group 2 (transseptal, n=33) and group 3 (superior septal, n=59). To improve the sampling size, all patients underwent mitral valve surgery with or without associated procedures (CABG, aortic-tricuspid surgery, Maze procedure). The study protocol was approved by SwissEthics. Results: No difference was shown for the etiology of mitral valve disease, except endocarditis, which was more frequent in group 3 (p = 0.014). Elective surgeries and isolated mitral valve surgery were more frequent in group 1 (p = 0.008, p = 0.011) and aortic clamping and cardiopulmonary bypass were shorter (p = 0.002, p<0.001). Group 3 had more emergency procedures (p = 0.011) and longer lengths of intensive care unit and hospital stay (p = 0.000, p = 0.003). There was no difference in permanent pacemaker implantation, postoperative complications and mortality between the groups. Conclusion: Mitral valve surgeries can be safely performed using those three left atriotomies. Conventional direct may lead to shorter aortic clamping and cardiopulmonary bypass times. Superior septal is mostly used for acute pathologies, and it does not increase postoperative arrhythmias and permanent pacemaker implantation. However, intensive care unit and hospital lengths of stay were found to be longer in this group. In our opinion, this outcome is more related to the pathology and type of surgery than the incision itself.

Keywords: Mitral valve surgery, cardiac surgery, atriotomy, Operative outcomes

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Authors: M. Shemis, O. Maher, G. Casterou, F. Gauffre

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Hepatitis C virus (HCV) is a major cause of chronic liver disease with a global 170 million chronic carriers at risk of developing liver cirrhosis and/or liver cancer. Egypt reports the highest prevalence of HCV worldwide. Currently, two classes of assays are used in the diagnosis and management of HCV infection. Despite the high sensitivity and specificity of the available diagnostic assays, they are time-consuming, labor-intensive, expensive, and require specialized equipment and highly qualified personal. It is therefore important for clinical and economic terms to develop a low-tech assay for the direct detection of HCV RNA with acceptable sensitivity and specificity, short turnaround time, and cost-effectiveness. Such an assay would be critical to control HCV in developing countries with limited resources and high infection rates, such as Egypt. The unique optical and physical properties of gold nanoparticles (AuNPs) have allowed the use of these nanoparticles in developing simple and rapid colorimetric assays for clinical diagnosis offering higher sensitivity and specificity than current detection techniques. The current research aims to develop a detection assay for HCV RNA using gold nanoparticles (AuNPs). Methods: 200 anti-HCV positive samples and 50 anti-HCV negative plasma samples were collected from Egyptian patients. HCV viral load was quantified using m2000rt (Abbott Molecular Inc., Des Plaines, IL). HCV genotypes were determined using multiplex nested RT- PCR. The assay is based on the aggregation of AuNPs in presence of the target RNA. Aggregation of AuNPs causes a color shift from red to blue. AuNPs were synthesized using citrate reduction method. Different sets of probes within the 5’ UTR conserved region of the HCV genome were designed, grafted on AuNPs and optimized for the efficient detection of HCV RNA. Results: The nano-gold assay could colorimetrically detect HCV RNA down to 125 IU/ml with sensitivity and specificity of 91.1% and 93.8% respectively. The turnaround time of the assay is < 30 min. Conclusions: The assay allows sensitive and rapid detection of HCV RNA and represents an inexpensive and simple point-of-care assay for resource-limited settings.

Keywords: HCV, gold nanoparticles, point of care, viral load

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Authors: Driss Kettani

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ICT4D actors are naturally attempted to include AI in the range of enabling technologies and tools that could support and boost the Development process, and to refer to these as AI4D. But, doing so, assumes that AI complies with the very specific features of ICT4D context, including, among others, affordability, relevance, openness, and ownership. Clearly, none of these is fulfilled, and the enthusiastic posture that AI4D is a natural part of ICT4D is not grounded and, to certain extent, does not serve the purpose of Technology for Development at all. In the context of Development, it is important to emphasize and prioritize ICT4D, in the national digital transformation strategies, instead of borrowing "trendy" waves of the IT Industry that are motivated by business considerations, with no specific care/consideration to Development.

Keywords: AI, ICT4D, technology for development, position paper

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Authors: Vinodhini Elangovan, Jen Heng Pek

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Background: An ectopic pregnancy is defined as any pregnancy implanted outside of the endometrial cavity. Cornual pregnancy, a rare variety of ectopic pregnancies, is seen in about 2-4% of ectopic pregnancies. It develops in the interstitial portion of the fallopian tube and invades through the uterine wall. This case describes a third-trimester cornual pregnancy that resulted in a uterine rupture. Case: A 38-year old Chinese lady was brought to the Emergency Department (ED) as a standby case for hypotension. She was 30+6 weeks pregnant (Gravida 3, Parous 1). Her past obstetric history included a live birth delivered via lower segment Caesarean section due to non-reassuring fetal status in 2002 and a miscarriage in 2012. She developed generalized abdominal pain. There was no per vaginal bleeding or leaking liquor. There was also no fever, nausea, vomiting, constipation, diarrhea, or urinary symptoms. On arrival in the ED, she was pale, diaphoretic, and lethargic. She had generalized tenderness with guarding and rebound over her abdomen. Point of care ultrasound was performed and showed a large amount of intra-abdominal free fluid, and the fetal heart rate was 170 beats per minute. The point of care hemoglobin was 7.1 g/dL, and lactate was 6.8 mmol/L. The patient’s blood pressure dropped precipitously to 50/36 mmHg, and her heart rate went up to 141 beats per minute. The clinical impression was profound shock secondary to uterine rupture. Intra-operatively, there was extensive haemoperitoneum, and the fetus was seen in the abdominal cavity. The fetus was delivered immediately and handed to the neonatal team. On exploration of the uterus, the point of rupture was at the left cornual region where the placenta was attached to. Discussion: Cornual pregnancies are difficult to diagnose pre-operatively with low ultrasonographic sensitivity and hence are commonly confused with normal intrauterine pregnancies. They pose a higher risk of rupture and hemorrhage compared to other types of ectopic pregnancies. In very rare circumstances, interstitial pregnancies can result in a viable fetus. Uterine rupture resulting in hemorrhagic shock is a true obstetric emergency that can result in significant morbidity and mortality for the patient and the fetus, and early diagnosis in the emergency department is crucial. The patient in this case presented with known risk factors of multiparity, advanced maternal age, and previous lower segment cesarean section, which increased the suspicion of uterine rupture. Ultrasound assessment may be beneficial to any patient who presents with symptoms and a history of uterine surgery to assess the possibility of uterine dehiscence or rupture. Management of a patient suspected of uterine rupture should be systematic in the emergency department and follow an ABC approach. Conclusion: This case demonstrates the importance for an emergency physician to maintain the suspicion for ectopic pregnancy even at advanced gestational ages. It also highlights how even though all emergency physicians may not be qualified to do a detailed pelvic ultrasound, it is essential for them to be competent with a point of care ultrasound to make a prompt diagnosis of conditions such as uterine rupture.

Keywords: cornual ectopic , ectopic pregnancy, emergency medicine, obstetric emergencies

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Authors: Elachouri Mostafa, Fakchich Jamila, Lazaar Jamila, Elmadmad Mohammed, Marhom Mostafa

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Of course, there has been a great growth in scientific information about medicinal plants in recent decades, but in many ways this has proved poor compensation, because such information is accessible, in practice, only to a very few people and anyway, rather little of it is relevant to problems of management and utilization, as encountered in the field. Active compounds are used in most traditional medicines and play an important role in advancing sustainable rural livelihoods through their conservation, cultivation, propagation, marketing and commercialization. Medicinal herbs are great resources for various pharmaceutical compounds and urgent measures are required to protect these plant species from their natural destruction and disappearance. Indeed, there is a real danger of indigenous Arab medicinal practices and knowledge disappearing altogether, further weakening traditional Arab culture and creating more insecurity, as well as forsaking a resource of inestimable economic and health care importance. As scientific approach, the ethnopharmacological investigation remains the principal way to improve, evaluate, and increase the odds of finding of biologically active compounds derived from medicinal plants. As developing country, belonging to the Mediterranean basin, Morocco country is endowed with resources of medicinal and aromatic plants. These plants have been used over the millennia for human welfare, even today. Besides, Morocco has a large plant biodiversity, in fact, its medicinal flora account more than 4200 species growing on various bioclimatic zones from subhumide to arid and Saharan. Nevertheless, the human and animal pressure resulting from the increase of rural population needs has led to degradation of this patrimony. In this paper, we focus our attention on ethnopharmacological studies carried out in Morocco. The goal of this work is to clarify the importance of herbs as platform for drugs discovery and further development, to highlight the importance of ethnopharmacological study as approach on discovery of natural products in the health care field, and to discuss the limit of ethnopharmacological investigation of drug discovery in Morocco.

Keywords: Morocco, medicinal plants, ethnopharmacology, natural products, drug-discovery

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: anaemia, haemoglobinopathies, pregnancy, sickle cell disease

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Authors: Leon C. Prieto, Simone T. A. Phipps

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There is a need to promote social entrepreneurship in order to solve some of the complex problems facing various countries in Africa (poverty, unemployment, crime, HIV, etc.). For example, one possible consequence of the HIV/AIDS crisis in Zimbabwe and elsewhere is a deterioration in the educational opportunities for orphans and other vulnerable children. Given that high returns are associated with education, the loss of education for a large segment of the population would likely worsen the already dire economic consequences of the HIV/AIDS crisis. Using a systems approach, this paper argues that social entrepreneurship can be used as a vehicle to promote national human resource development, which will assist in the alleviation of societal ills on the national level as well as throughout Africa.

Keywords: human resource development, pan-african, social entrepreneurship, social enterprise

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Authors: Najmeh Hoseini

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Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.

Keywords: tDCS, stroke, case study, physical therapy

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Authors: Syed Faizan Hassan Shah

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Introduction: Burn injuries are among the most devastating of all injuries. Burns is the fourth most common type of trauma worldwide. Ap?proximately 90 percent of burns occur in low to middle-income countries. Nearly half a million Americans each year, with approximately 40,000 hospitalizations and 3,400 deaths annually, suffer burns. The survival rate for admitted burn patients has improved consistently over the past four decades, largely attributed to national decreases in burn size, improvements in burn critical care, and advancements in burn wound care. Objectives: The present study was conducted to compare the efficacy of Honey dressing versus Silver Sulfadiazine dressing for complete wound healing in the 2nd-degree thermal burn. Study Design: A Randomized controlled trial was carried out in the Department of General Surgery/burn unit of Ayub Teaching Hospital Abbottabad from July to December 2018. The study population included thermal burn patients presenting with ASA-I, ASA-II, and body surface area less than 50% of the age group above 12 to 60 years of either gender. All the patients were randomly divided into two equal groups of patients by blocked randomization using permuted block g 6. In group ‘A,’ patients underwent dressing by honey method, and patients in group ‘B’ had silver sulfadiazine dressing. The dressing was changed every 48 hours by a senior sur?geon, and the condition of the wound was observed. Time duration till complete wound healing was noted in the Proforma. Results: A total of 100 patients were selected and divided into two groups of 50 patients in each two groups. The mean age of the patients was 27.66±13.388 ran?ging from 12 to 60 years of age, and the mean duration of complete healing of wound in days was 20.20±6.251, ranging from 2 to 30 days. Mean comparison of age with both groups, age of the patients was 21.24±3.761 (n=50) in group ‘A,’ i.e., honey dressing, and 19.16±7.911 (n=50) was in group ‘B,’ i.e., silver sulfadiazine dressing. Efficacy in the honey dressing group was found effective in 48(75.0%) and ineffect? ive in 2(5.6%) out of 50 patients. Efficacy in silver sulfadiazine dressing group 16(25.0%) was three found effective and in 34(94.4%) was inef?fective out of 50 patients. There was a statistically significant difference between both groups. (P=0.000) . Conclusion: honey dressing is more effective as compared to silver sulfadiazine dressing in terms of complete wound healing in second-degree thermal burn patients; our study also concluded the same.

Keywords: efficacy, honey dressing, silver sulfadiazine dressing, wound healing

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Authors: Prasita Sooksamran, Wareerat Kaewurai

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STEM is an integrated teaching approach promoted by the Ministry of Education in Thailand. STEM Education is an integrated approach to teaching Science, Technology, Engineering, and Mathematics. It has been questioned by Thai teachers on the grounds of how to integrate STEM into the classroom. Therefore, the main objective of this study is to develop a science instructional model based on the STEM approach to enhance scientific mind and problem-solving skills for primary students. This study is participatory action research, and follows the following steps: 1) develop a model 2) seek the advice of experts regarding the teaching model. Developing the instructional model began with the collection and synthesis of information from relevant documents, related research and other sources in order to create prototype instructional model. 2) The examination of the validity and relevance of instructional model by a panel of nine experts. The findings were as follows: 1. The developed instructional model comprised of principles, objective, content, operational procedures and learning evaluation. There were 4 principles: 1) Learning based on the natural curiosity of primary school level children leading to knowledge inquiry, understanding and knowledge construction, 2) Learning based on the interrelation between people and environment, 3) Learning that is based on concrete learning experiences, exploration and the seeking of knowledge, 4) Learning based on the self-construction of knowledge, creativity, innovation and 5) relating their findings to real life and the solving of real-life problems. The objective of this construction model is to enhance scientific mind and problem-solving skills. Children will be evaluated according to their achievements. Lesson content is based on science as a core subject which is integrated with technology and mathematics at grade 6 level according to The Basic Education Core Curriculum 2008 guidelines. The operational procedures consisted of 6 steps: 1) Curiosity 2) Collection of data 3) Collaborative planning 4) Creativity and Innovation 5) Criticism and 6) Communication and Service. The learning evaluation is an authentic assessment based on continuous evaluation of all the material taught. 2. The experts agreed that the Science Instructional Model based on the STEM Education Approach had an excellent level of validity and relevance (4.67 S.D. 0.50).

Keywords: instructional model, STEM education, scientific mind, problem solving

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Authors: Evren Şar İşbilen

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As it is known, the movies and tv series are occupying a large part in the daily lives of adults and children in our era. In this connection, in the present study, the most popular historical TV series of recent years in Turkey, “Muhteşem Yüzyıl” (The Magnificent Century), was selected as the sample for the data collection in order to explore the perception of history of university students’. The data collected was analyzed bothqualitatively and quantitatively. The findings discussed in relation to the possible educative effects of historical non-educational TV series and movies on students' perceptions related to history. Additionally, suggestions were made regarding to the utilization of non-educational TV series or movies in education in a positive way.

Keywords: education, history, movies, teacher candidates

Procedia PDF Downloads 333

Authors: Yu-Ju Hsieh, Lin-Hung Lin, Wen-Hui Chang

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This study was designed as an interventional research and intended to validate whether the introduction of drinking vinegar every day can reduce and even prevent urinary tract infection in Taiwan home stayed disabilities who using indwelling catheter. The data was collected from the subjects who have received home care case at northern Taiwan, according to the questionnaire and a medical records retroactive methodology, the subjects were informed and consent to drink 15ml of table vinegar in a daily diet, and through routine urine testing and culture study. Home care nurses would assist collecting urine at the point of before and after a meal from total 35 studied subjects per month, and total collected 4 times for testing. The results showed that when the average age of study subjects was 65.46 years and catheter indwelling time was 15 years, drinking table vinegar could inhibit the activity of E. coli O157: H7 and reduce its breeding. Before drinking table vinegar daily, the subjects’ urine pH value was 7.0-8.0, and the average was 7.5, and the urine PH value dropped to 6.5 after drinking table vinegar for a month. There were two purple urine cases whose urine were changed from purple to normal color after two weeks of drinking, and the protein and bacteria values of urine gradually improved. Urine smell unpleasant before attending to this study, and the symptom improved significantly only after 1 week, and the urine smell returned to normal ammonia and became clean after 1 month later. None of these subjects received treatment in a hospital due to urinary tract infection, and there were no signs of bleeding in all cases during this study. The subjects of this study are chronic patients with a long-term bedridden catheterization; drinking cranberry juice is an economic burden for them, and also highly prohibited for diabetes patients. By adapting to use cheaper table vinegar to acidified urine and improve its smell and ease Purple Urine Syndrome, to furthermore, proven urinary tract infection, it can also to reduce the financial burden on families, the cost of social resources and the rate of re-admission.

Keywords: table vinegar, urinary tract infection, disability patients, long-term indwelling catheter

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Authors: Henok Biruk Alemayehu, Kalkidan Berhane Tsegaye, Fozia Seid Ali, Nebiyat Feleke Adimassu, Getasew Alemu Mersha

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Background: Strabismus is a visual disorder where the eyes are misaligned and point in different directions. Untreated strabismus can lead to amblyopia, loss of binocular vision, and social stigma due to its appearance. Since it is assumed that knowledge is pertinent for early screening and prevention of strabismus, the main objective of this study was to assess knowledge and attitudes toward strabismus in Woreta town, Northwest Ethiopia. Providing data in this area is important for planning health policies. Methods: A community-based cross-sectional study was done in Woreta town from April–May 2020. The sample size was determined using a single population proportion formula by taking a 50% proportion of good knowledge, 95% confidence level, 5% margin of errors, and 10% non- response rate. Accordingly, the final computed sample size was 424. All four kebeles were included in the study. There were 42,595 people in total, with 39,684 adults and 9229 house holds. A sample fraction ’’k’’ was obtained by dividing the number of the household by the calculated sample size of 424. Systematic random sampling with proportional allocation was used to select the participating households with a sampling fraction (K) of 21 i.e. each household was approached in every 21 households included in the study. One individual was selected ran- domly from each household with more than one adult, using the lottery method to obtain a final sample size. The data was collected through a face-to-face interview with a pretested and semi-structured questionnaire which was translated from English to Amharic and back to English to maintain its consistency. Data were entered using epi-data version 3.1, then processed and analyzed via SPSS version- 20. Descriptive and analytical statistics were employed to summarize the data. A p-value of less than 0.05 was used to declare statistical significance. Result: A total of 401 individuals aged over 18 years participated, with a response rate of 94.5%. Of those who responded, 56.6% were males. Of all the participants, 36.9% were illiterate. The proportion of people with poor knowledge of strabismus was 45.1%. It was shown that 53.9% of the respondents had a favorable attitude. Older age, higher educational level, having a history of eye examination, and a having a family history of strabismus were significantly associated with good knowledge of strabismus. A higher educational level, older age, and hearing about strabismus were significantly associated with a favorable attitude toward strabismus. Conclusion and recommendation: The proportion of good knowledge and favorable attitude towards strabismus were lower than previously reported in Gondar City, Northwest Ethiopia. There is a need to provide health education and promotion campaigns on strabismus to the community: what strabismus is, its’ possible treatments and the need to bring children to the eye care center for early diagnosis and treatment. it advocate for prospective research endeavors to employ qualitative study design.Additionally, it suggest the exploration of studies that investigate causal-effect relationship.

Keywords: strabismus, knowledge, attitude, Woreta

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Authors: Katalin Szöllősi, László Szabó

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Introduction and purpose: Even though female sexual dysfunctions are common among women in the postpartum period, the profile of these disturbances has not been well investigated in Hungary yet. The aim of the study was to evaluate the postpartum female sexual functions in Hungary. This research sought to investigate the possible predictor factors which can influence postpartum female sexual functions. Method and sample: This was a cross-sectional study, including patients from two maternity clinics in Budapest. 113 women were recruited into our study 3 months after their childbirth. 53 had vaginal birth, 60 had a caesarian section. Data were collected from medical reports in addition by using self-developed questions and validated questionnaires in order to measure important predictors which may be responsible for postpartum sexual dysfunctions such as mode of delivery, parity, urinary incontinence and body image. Sexual functions were evaluated by the Hungarian version of the Female Sexual Function Index (FSFI). The Hungarian version of Body Image Questionnaire-Short Form14 (BSQ-SF14) was applied for assessing body image. Results: 82,3% of the participants began to have sexual intercourse within three months postpartum. 53,98% of the participants reported sexual dysfunctions (cut-off FSFI score 26,55). According to our results mode of delivery, parity, hemorrhoids, time of intercourse, resumption was not associated with female sexual dysfunctions. We found correlation at a tendential level between urinary incontinence and sexual dysfunctions (p=0,003, R=0,26). We found a negative correlation at a tendential level between the total score of BSQ-SF14 and FSFI (p=0,03, R=-0,269). Only 32,74% of women reported discussing sexual life with health care professionals. However, 67,25% of them would have had the need to be asked about their postpartum health issues. Conclusions and recommendations: The prevalence of female sexual dysfunctions were relatively high after childbirth. We found that incontinence and body image was associated with sexual dysfunctions; other risk factors remained unknown. Despite regular contact with health care professionals, women rarely get any information about postpartum sexual health issues. The high prevalence of dysfunctions indicates the need for further investigation to address other risk factors and proper counselling of women after childbirth.

Keywords: body image, postpartum, sexual dysfunction, urinary incontinence

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Authors: Mohammad Jamalallail

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Self-esteem implies a person’s overall self-worth, self-respect, and self-value. It helps a person to maintain good mental health, personality, and achievement. Gifted students face some emotional problems, sometimes, which cause decreases in their self-esteem. Such emotional problems include loneliness, anxiety, and depression as examples. For this reason, designing a counseling program is necessary for gifted students who need a high level of self-esteem. The available counseling programs focused on developmental aspect only to the best of the writer’s knowledge. While the proposed program focuses on both clinical and developmental counseling by applying psychoanalytic play therapy. The proposed program consists of; Theoretical background such as; Behavior, and RET. It also consists of counseling procedures and therapeutic interventions.

Keywords: self-esteem, gifted, program, design

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Authors: Minhae Shim Roth

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The “Deinstitutionalization movement” refers to the spatial transition in the United States during the mid-20th century when the treatment of mental illness purportedly moved from long-term psychiatric institutions to community integrated care. Contrary to the accepted narrative of mental health care in the U.S., asylums did not close or empty. Some remained psychiatric hospitals, which came to be called forensic hospitals or state hospitals; others were converted into prisons or carceral institutions. During Deinstitutionalization, the asylum system became an appendage of the carceral system, with state hospitals becoming little more than holding centers for prisoners who were civilly committed, those incompetent to stand trial, offenders with mental health issues, and those found not guilty by reason of insanity. Psychiatric patients who became prisoners and prisoners who became patients became entangled in the phenomenon called transinstitutionalization. This paper investigates the relationship between psychiatric and criminal incarceration in 20th century California and focuses particularly on the case of Korean-American Chol Soo Lee, who fought detention in the psychiatric-prison system through the writ of habeas corpus. This study uses methodologies like critical theory, close reading, and archival research. This paper argues that during his psychiatric hospitalization at Napa State Hospital and incarceration in the California Department of Corrections, Lee underwent what sociologist Erving Goffman coined in his 1960 text Asylums as the process of “mortification.” After a burst of Asian American solidarity and legal aid that resulted in Lee’s triumphant release from Death Row in 1983 through a writ of habeas corpus, Lee struggled in the free world due to the long-lasting consequences of institutionalization, which led to alienation, recidivism, and an early death at the age of 62. This paper examines the trajectory of Lee’s trial and the legal activism behind it within the context of Goffman’s theory of total institutions and offer a nuanced reading of Lee’s case both during and after his incarceration.

Keywords: criminal justice, criminal law, law and mental capacity, habeas corpus, deinstitutionalization, mental health

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Authors: Shahla Afshar Paiman, Sedigheh Madani, Zahra Hosseininezhad

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Introduction: The most common causes of appendix luminal obstruction are fecaliths and lymphoid follicle hyperplasia. Appendicitis is a very rare Gastrointestinal complication of varicella zosterand it is mostly observed in immune-compromised patient. Case presentation: Here we reported a case of varicella zoster-related perforated appendicitis with synchronous encephalopathy as a first presentation of chickenpox in a 10-year-old boy. He had no history of immunodeficiency or predisposing factors and his diagnosis is confirmed by both serological lab tests and abdominal fluid (peritoneal secretion) PCR. Conclusion: Varicella zoster could cause appendicitis as first presentation, along with other critical complications look likes encephalopathy.

Keywords: Varicella zoster, appendicitis, encephalitis, children

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