Search results for: teaching hospital of Oran

Authors: Euan Donley

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Emergency Departments (EDs) are heavily burdened as presentation rates continue to rise. To improve patient flow National Emergency Access Targets (NEAT) were introduced. NEAT implements timelines for ED presentations, such as discharging patients within four hours of arrival. Mental health patients use EDs more than the general population and are generally more complex in their presentations. The aim of this study is to examine the impact of NEAT on psychiatric risk assessment of mental health patients in the ED. Seventy-eight mental health clinicians from 7 Victoria, Australia, hospital EDs participated in a mixed method analysis via anonymous online survey. NEAT was considered helpful as mental health patients were seen quicker, were less likely to abscond, could improve teamwork amongst ED staff, and in some cases administrative processes were better streamlined. However, clinicians felt that NEAT was also responsible for less time with patients and relatives’, resulted in rushed assessments, placed undue pressure on mental health clinicians, was not conducive to training, and the emphasis on time was the wrong focus for patient treatment. The profile of a patient typically likely to be treated within NEAT timelines showed a perfect storm of luck and compliance. If a patient was sober, medically stable, referred early, did not require much collateral information and did not have distressed relatives, NEAT was more likely to be met. Organisationally participants reported no organisational change or training to meet NEAT. Poor mental health staffing, multiple ED presentations and a shortage of mental health beds also hamper meeting NEAT. Findings suggest participants were supportive of NEAT in principle, but a demanding workload and organisational barriers meant NEAT had an overall negative effect on psychiatric risk assessment of mental health patients in ED.

Keywords: assessment, emergency, risk, psychiatric

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Authors: Francesco Ceresia

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Workplace aggression is broadly recognized as a main work-related risk for healthcare organizations the world over. Scholars underlined that nonfatal workplace aggressions can be also produced by Type II workplace aggression, that occur when the aggressor has a legitimate relationship with the organization and commits an act of hostility while being served or cared for by members of the organization. Several reviews and meta-analysis highlighted the main antecedents and consequences of Type II verbal and physical workplace aggression in the healthcare sector, also focusing on its economic and psychosocial costs. However, some scholars emphasized the need for a systemic and multi-factorial approach to deeply understand and effectively respond to such kind of aggression. The main aim of the study is to propose a qualitative model of Type II workplace aggression in a health care organization in accordance with the system thinking and multi-factorial perspective. A case study research approach, conducted in an Italian non-hospital healthcare organization, is presented. Two main data collection methods have been adopted: individual and group interviews with a sample (N = 24) of physicians, nurses and clericals. A causal loop diagram (CLD) that describes the main causal relationships among the key-variables of the proposed model has been outlined. The main feedback loops and the causal link polarities have been also defined to fully describe the structure underlining the Type II workplace aggression phenomenon. The proposed qualitative model shows how the Type II workplace aggression is related with burnout, work performance, job satisfaction, turnover intentions, work motivation and emotional dissonance. Finally, strategies and policies to reduce the strength of workplace aggression’s drivers are suggested.

Keywords: healthcare, system thinking, work motivation, workplace aggression

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Authors: Maryam Borjali

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Introduction. Mortality due to noncommunicable diseases has increased in the world today with the advent of demographic shifts, growing age, and lifestyle patterns in the world, which have been affected by economic and social crises. Congenital heart defects are one of the forms of diseases that have raised infant mortality worldwide. e objective of present study was to identify nonmedical determinants related to this abnormality from the mother’s perspectives. Methods. is research was a qualitative study and the data collection method was a semistructured interview with mothers who had children with congenital heart diseases referring to the Shahid Rajaei Heart Hospital in Tehran, Iran. A thematic analysis approach was employed to analyze transcribed documents assisted by MAXQDA Plus version 12. Results. Four general themes and ten subthemes including social contexts (social harms, social interactions, and social necessities), psychological contexts (mood disorders and mental well-being), cultural contexts (unhealthy lifestyle, family culture, and poor parental health behaviors), and environmental contexts (living area and polluted air) were extracted from interviews with mothers of children with congenital heart diseases. Conclusions. Results suggest that factors such as childhood poverty, lack of parental awareness of congenital diseases, lack of proper nutrition and health facilities, education, and lack of medical supervision during pregnancy were most related with the birth of children with congenital heart disease from mothers’ prospective. In this regard, targeted and intersectorial collaborations are proposed to address nonmedical determinants related to the incidence of congenital heart diseases.

Keywords: congenital_cou, cultural, social, platform

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Authors: Brindha Senthil Kumar, Payel Chakraborty, Senthil Kumar Nachimuthu, Arindam Maitra, Prem Nath

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Gastric cancer is predominantly caused by demographic and diet factors as compared to other cancer types. The aim of the study is to predict Early Gastric Cancer (ECG) from diet and lifestyle factors using supervised machine learning algorithms. For this study, 160 healthy individual and 80 cases were selected who had been followed for 3 years (2016-2019), at Civil Hospital, Aizawl, Mizoram. A dataset containing 11 features that are core risk factors for the gastric cancer were extracted. Supervised machine algorithms: Logistic Regression, Naive Bayes, Support Vector Machine (SVM), Multilayer perceptron, and Random Forest were used to analyze the dataset using Python Jupyter Notebook Version 3. The obtained classified results had been evaluated using metrics parameters: minimum_false_positives, brier_score, accuracy, precision, recall, F1_score, and Receiver Operating Characteristics (ROC) curve. Data analysis results showed Naive Bayes - 88, 0.11; Random Forest - 83, 0.16; SVM - 77, 0.22; Logistic Regression - 75, 0.25 and Multilayer perceptron - 72, 0.27 with respect to accuracy and brier_score in percent. Naive Bayes algorithm out performs with very low false positive rates as well as brier_score and good accuracy. Naive Bayes algorithm classification results in predicting ECG showed very satisfactory results using only diet cum lifestyle factors which will be very helpful for the physicians to educate the patients and public, thereby mortality of gastric cancer can be reduced/avoided with this knowledge mining work.

Keywords: Early Gastric cancer, Machine Learning, Diet, Lifestyle Characteristics

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Authors: Eftah Bte Moh, Hj Abdullah Izazol Binti Idris, Abd. Aziz Bin Abd. Shukor

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This study aimed to identify the alignment of understanding and assessment practices among secondary school teachers. The study was carried out using quantitative descriptive study. The sample consisted of 164 teachers who taught Form 1 and 2 from 11 secondary schools in the district of North Kinta, Perak, Malaysia. Data were obtained from 164 respondents who answered Expectation Alignment Understanding and Practices of School Assessment (PEKDAPS) questionnaire. The data were analysed using SPSS 17.0 +. The Cronbach alpha value obtained through PEKDAPS questionnaire pilot study was 0.86. The results showed that teachers' performance in PEKDAPS based on the mean value was less than 3, which means that perfect alignment does not occur between the understanding and practices of school assessment. Two major PEKDAPS sub-constructs of articulation across grade and age and usability of the system were higher than the moderate alignment of the understanding and practices of school assessment (Min=2.0). The content was focused on PEKDAPs sub-constructs which showed lower than the moderate alignment of the understanding and practices of school assessment (Min=2.0). Another two PEKDAPS sub-constructs of transparency and fairness and the pedagogical implications showed moderate alignment (2.0). The implications of the study is that teachers need to fully understand the importance of alignment among components of assessment, learning and teaching and learning objectives as strategies to achieve quality assessment process.

Keywords: school based assessment, alignment, understanding, assessment practices

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Authors: Jareeluk Ratanaphan

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The purposed of this research were; 1.To survey the teacher’s needs on knowledge about special education management for special needs learner 2.To development of distance training packages on providing for learner with special needs. 3. To study the effects of using the packages on trainee’s achievement. 4. To study the effects of using the packages on trainee’s opinion on the distance training packages. The design of the experiment was research and development. The research sample for survey were 86 teachers, and 22 teachers for study the effects of using the packages on achievement and opinion. The research instrument comprised: 1) training packages on special education management for special needs learner 2) achievement test 3) questionnaire. Mean, percentage, standard deviation, t-test and content analysis were used for data analysis. The findings of the research were as follows: 1. The teacher’s needs on knowledge about teaching for learner with learning disability, mental retardation, autism, physical and health impairment and research in special education. 2. The package composed of special education management for special needs student document and manual of distance training packages. The efficiency of packages was established at 79.50/81.35. 3. The results of using the packages were the posttest average scores of trainee’s achievement were higher than pretest. 4. The trainee’s opinion on the package was at the highest level.

Keywords: distance training, training package, teacher, learner with special needs

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Authors: Clifford Irikefe Gbeyonron

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Applied linguists concur that there is low-level achievement in English language use among Nigerian secondary school students. One of the factors that exacerbate this is classroom feature of which large class size is obvious. This study investigated the impact of large classes on learning English as a second language (ESL) at junior secondary school (JSS) in Yobe State. To achieve this, Solomon four-group experimental design was used. 382 subjects were divided into four groups and taught ESL for thirteen weeks. 356 subjects wrote the post-test. Data from the systematic observation and post-test were analyzed via chi square and ANOVA. Results indicated that learners in large classes (LLC) attain lower linguistic progress than learners in small classes (LSC). Furthermore, LSC have more chances to access teacher evaluation and participate actively in classroom discourse than LLC. In consequence, large classes have adverse effects on learning ESL in Yobe State. This is inimical to English language education given that each learner of ESL has their individual peculiarity within each class. It is recommended that strategies that prioritize individualization, grouping, use of language teaching aides, and theorization of innovative models in respect of large classes be considered.

Keywords: large classes, achievement, classroom discourse

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Authors: Arvin Ludovice

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The modern way of communicating and connecting people has been in its easiest forms nowadays, one of it is blog. Blogs, nowadays, are truly relevant in informing people of different as aspects, interests, and fields through these blogs. The evidentiality and testimony of collective people are easily been accessed. However, the description of blog in the making is persuading people, choice of language is one—adverbial intensifiers. Measuring the language on a scale of its intensity subdue the intensity per se. The present study determines, scrutinizes and analyses the adverbial intensifiers used in Filipino and Malaysian. The corpus consists of 30 top travel blogs written by Filipinos and 30 top travel blogs written by Malaysian for a total of 60 travel blogs. The application AntConc was utilized to tag the necessary intensifiers. A frequency distribution of the scores is used to identify the most common intensifiers used by travel bloggers from the Philippines and Malaysia. The scale or degree of intensifier is taken from Quirk Degree of Intensifiers as the basis for the functions of intensifiers. The result found that Malaysian travel blogs are more expressive with the use of the adverbial intensifiers vis-à-vis Filipino travel bloggers, consequently, ranking of the intensifiers, boosters are most used one in expressing and utilizing the language choice a more. The conclusion states that Malaysian travel bloggers are of using the functionality of the adverbial intensifiers. The distinction on the pedagogical implications are hereunto stated as well to deepen and give its significant and importance in language teaching.

Keywords: adverbial intensifiers, blogs, Filipino and Malaysian blogs, AntConc

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Authors: Manam Hanfi

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Pakistan is a victim of terrorism since 9/11 attacks. Since then it is a home for violence and extremism. One of the major reasons behind rising violence and extremism in Pakistan is radicalization. Pakistan has seen and suffered from the modification of terrorism from old to new. In new terrorism, the terrorist organizations incorporated internet to disseminate propaganda, to recruit and train people. The study focuses on the relationship between Pakistan and new terrorism and examines how the internet is being used by terrorist organizations. The study investigates radicalization through social media by terrorist organizations in Pakistan with the help of case studies. The study suggests five ways to counter radicalization, including, counter narrative on social media, content analysis of the data on the internet, curriculum and madrassa reforms, teaching peace education in the educational institutions and use of technical software such as eGLYPH to quickly remove violent data from social media. Lastly, the research attempted to contribute in counter-radicalization by combining the media dependency model and ideas for counter-radicalization. The dependency model elaborates the impact of mass media content on the audience. If media dependency is high, it will cause cognitive, affective and behavioral changes. In order to counter radicalization through social media, it is important to make cognitive, affective and behavioral changes with the help of counter-radicalization suggestions.

Keywords: counter radicalization, extremism, social media, terrorism

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Authors: B. Kenny

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The complications associated with transfusions are well documented, with the serious hazards of transfusion (SHOT) reporting system continuing to report deaths and serious morbidity due to the transfusion of allogenic blood. Many different sources including the TRICC trial, NHMRC and Cochrane recommending similar transfusion triggers/guidelines. Recent studies found the rate of infection (deep infection, wound infection, chest infection, urinary tract infection, and others) were purely a dose response relationship, increasing the Relative Risk by 3.44. It was also noted that each transfused patient stayed in hospital for one additional day. We hypothesise that providing an approved/standardised, guideline with a graphical summary of decision pathways for anaemic patients will reduce unnecessary transfusions. We retrospectively assessed patients undergoing primary knee or hip arthroplasties over a 4 year period, 1459 patients. Of these, 339 (23.24%) patients received allogenic blood transfusions and 858 units of blood were transfused, 9.14% of patients transfused had haemoglobin levels above 100 g/L, 7.67% of patients were transfused without knowing the haemoglobin level, 24 hours prior to transfusion initiation and 4.5% had possible transfusion reactions. Overall, 17% of allogenic transfusions topatients admitted to the Orthopaedic department within a 4 year period were outside NHMRC and Cochrane guidelines/recommendations. If our transfusion frequency is compared with that of other authors/hospitals, transfusion rates are consistently being high. We subsequently implemented a simple guideline for transfusion initiation. This guideline was then assessed. We found the transfusion rate post transfusion implementation to be significantly lower, without increase in patient morbidity or mortalitiy, p <0.001). Transfusion rates and patient outcome can be optimized by a simple graphical aid for decision making.

Keywords: transfusion, morbidity, mortality, neck of femur, fracture, arthroplasty, rehabilitation

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Authors: A. Uludağ, F. G. Tufekci, N. Ceviz

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Aim: The research has been carried out in order to evaluate caregiver burden, life satisfaction and received social support level of the parents whose children have congenital heart disease; to examine the relationship between the social supports received by them and caregiver burden and life satisfaction. Material and Method: The research which is descriptive and which is searching a relationship has been carried out between the dates June 7, 2012- June 30, 2014, in Erzurum Ataturk University Research and Application Hospital, Department of Pediatrics and Children Cardiology Polyclinic. In the research, it was collaborated with the parents (N = 157) who accepted to participate in, of children who were between the ages of 3 months- 12 years. While gathering the data, a questionnaire, Zarit Caregiver Burden, Life Satisfaction and Social Support Scales have been used. The statistics of the data acquired has been produced by using percentage distribution, mean, and variance and correlation analysis. Ethical principles are followed in the research. Results: In the research, caregiver burden, life satisfaction and social support level received from family (p < 0.05), have been determined higher in the parents whose children have serious congenital heart disease than that of parents whose children have slight disease and social support received from friends has been found lower. It has been determined that there is a strong relation (p < 0.001) through negative direction between both social support levels and caregiver burden of parents; and that there is a strong relation (p < 0.001) through positive direction between both support levels and life satisfaction. Conclusion: That Social Support is in a strong relation with Caregiver Burden through a negative direction and a strong relation with Life Satisfaction through positive direction in parents of all the children who have congenital heart disease requires social support systems to be reinforced. Parents can be led or guided so as to prompt social support systems more.

Keywords: congenital heart disease, child, parents, caregiver burden, life satisfaction, social support

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Authors: Sopana Wongtawee

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Purpose: Adequate bowel cleansing is essential for a high quality, effective and safe colonoscopy. The aims of this study were to compare the efficacy of bowel preparation based on a low-residue diet before 8:00 followed by a clear-liquid diet, and a low-residue diet until 16:00 one day before colonoscopy using sodium phosphate solution (Xubil ®), the side effects of the two protocols and the patient satisfaction with them. Method: This was an endoscopist-blinded, prospective, randomized, controlled trial. A total of 224 patients (112 in each group) scheduled for outpatient colonoscopy met the criteria.They were randomized to either a low-residue diet consisting of white rice porridge with either fish, chicken or eggs before 8:00 followed by a clear-liquid diet (Group 1) or a low-residue diet consisting of the same food and drink, until 16:00 the day before colonoscopy(Group 2). All of them received 45 ml of sodium phosphate solution (Xubil ®) and three glasses of water (300 ml/glass) the evening before and the morning of the procedure. The cleansing efficacy of bowel preparation was rated according to the modified Rajawithi hospital bowel preparation score scale, patient satisfaction with bowel preparation was rated using Likert scale, and side effects of the 2 protocols was assessed using a patient questionnaire. Results: The cleansing efficacy between the two groups was significantly different (p=0.02). Satisfaction with bowel preparation and side effects were not different, except for the feeling of hunger in the first group (p=0.001). Conclusion: The low-residue diet consisting of white rice porridge with fish, chicken or eggs until 16:00 one day before colonoscopy achieved a better bowel-cleansing efficacy than the protocol consisting of clear liquid all day and rice porridge only before 8:00 one day before colonoscopy.

Keywords: bowel preparation, colonoscopy, sodium phosphate solution, nursing management

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Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

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Introduction: COVID-19 molecular diagnostic laboratory is the cornerstone of the COVID-19 disease diagnosis as the patient’s treatment and management protocol depend on the molecular results. For this purpose, it is extremely important that the laboratory conducting these results adheres to the quality management processes to increase the accuracy and validity of the reports generated. We started our own molecular diagnostic setup at the onset of the pandemic. Therefore, we conducted this study to generate our quality management data to help us in improving on our weak points. Materials and Methods: A total of 14561 samples were evaluated by the retrospective observational method. The quality variables analysed were classified into pre-analytical, analytical, and post-analytical variables, and the results were presented in percentages. Results: Among the pre-analytical variables, sample leaking was the most common cause of the rejection of samples (134/14561, 0.92%), followed by non-generation of SRF ID (76/14561, 0.52%) and non-compliance to triple packaging (44/14561, 0.3%). The other pre-analytical aspects assessed were incomplete patient identification (17/14561, 0.11%), insufficient quantity of samples (12/14561, 0.08%), missing forms/samples (7/14561, 0.04%), samples in the wrong vials/empty VTM tubes (5/14561, 0.03%) and LIMS entry not done (2/14561, 0.01%). We are unable to obtain internal quality control in 0.37% of samples (55/14561). We also experienced two incidences of cross-contamination among the samples resulting in false-positive results. Among the post-analytical factors, a total of 0.07% of samples (11/14561) could not be dispatched within the stipulated time frame. Conclusion: Adherence to quality control processes is foremost for the smooth running of any diagnostic laboratory, especially the ones involved in critical reporting. Not only do the indicators help in keeping in check the laboratory parameters but they also allow comparison with other laboratories.

Keywords: laboratory quality management, COVID-19, molecular diagnostics, healthcare

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Authors: Ashana Gupta

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Aim: In the UK, Botulinum Toxin (botox) is authorised for treating chronic myofascial pain secondary to masseter muscle hypertrophy (Fedorowicz et al. 2013). This audit aimed to ensure the Maxillofacial Unit is meeting the trust guidelines for the safe storage and disposal of botox. Method: The trust upholds a strict policy for botox handling. The audit was designed to optimise several elements including Staff awareness of regulations around botox handling A questionnaire was designed to test knowledge of advised storage temperatures, reporting of adverse events, disposal procedures and regulatory authorities. Steps taken to safely delivertoxin and eliminate unused toxin. A checklist was completed. These include marks for storagetemperature, identification checks, disposal of sharps, deactivation of toxin, and disposal. Results: All staff correctly stated storage requirements for toxin. 75% staff (n=8) were unsure about reporting and regulations. Whilst all staff knew how to dispose of vials, 0% staff showed awareness for the crucial step of deactivating toxin. All checklists (n=20) scored 100% for adequate storage, ID checks, and toxin disposal. However, there were no steps taken to deactivate toxin in any cases. Staff training took place with revision to clinical protocols. In line with Trust guidelines, an additional clinical step has been introduced including use of 0.5% sodium hypochlorite to deactivate botox. Conclusion: Deactivation is crucial to ensure residual toxin is not misused. There are cases of stolen botox within South-Tees Hospital (Woodcock, 2014). This audit was successful in increasing compliance to safe handling and disposal of botox by 100% and ensured our hospitalmeets Trust guidance.

Keywords: botulinum toxin, aesthetics, handling, disposal

Procedia PDF Downloads 187

Authors: Ephrem Mebratu Dagnew, Mohammed Biset Ayalew, Gizework Alemnew Mekonnen, Alehegn Bishaw Geremew, Ousman Abubeker Abdela

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Objective: To assess the prevalence of drug-related problems and associated factors among adult psychiatric inpatients. Method: Hospital-based multicenter cross-sectional observational study was conducted from April to July 2021 at five randomly selected hospitals in North-west Ethiopia. A total of 325 consecutively sampled patients participated in the study. Clinical pharmacists assessed the DRPs based on clinical judgment supported by updated evidence-based diseases guidelines. A Medscape drug-interactions checker was used to check drug-drug interactions. The results were summarized using descriptive statistics, including frequency, mean, and standard deviation. Odds ratio (OR) with 95% confidence interval were also computed for each variable for the corresponding P-value. The value of P ≤ 0.05 was considered statistically significant. Result : From the total of 325 study participants, more than half of them (52.9%) were females and the mean age ± (standard deviation) was 30.8±11.3 years. At least one drug-related problem was recorded from 60.9%, 95% CI (55.7-65.8) of study participants with a mean of 0.6±0.49 per patient. Need additional drug therapy was the most common DRP (22.8%), followed by non-adherence to medicine (20.6%) and adverse drug reactions (11%), respectively. Factors independently associated with drug-related problems were rural residence [AOR=1.96,95%CI:1.01-2.84, P-value=0.046], self-employed [AOR=6.0 ,95% CI: 1.0-36.9, P-value=0.035] and alcohol drinkers [AOR=6.40,95%CI:1.12-37.5, p-value=0.034]. Conclusion: The prevalence of drug-related problems among adult psychiatric patients admitted to psychiatric wards was high. Healthcare providers give more attention to tackling these problems. Being a rural residence, self-employed, and Alcohol drinkers were associated with drug-related problems.

Keywords: psychiatric patients, drug-relatedproblems, multicenter, Ethiopia

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Authors: Recep Kesli, Merih Simsek, Cengiz Demir, Onur Turkyilmaz

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Objective: Goal of this study was to determine the antibiotic resistance of Staphylococcus aureus (S. aureus) and Methicillin resistant staphylococcus aureus (MRSA) strains isolated at Medical Microbiology Laboratory of ANS Application and Research Hospital, Afyon Kocatepe University, Turkey. Methods: S. aureus strains isolated between October 2012 and September 2016, from various clinical specimens were evaluated retrospectively. S. aureus strains were identified by both the conventional methods and automated identification system -VITEK 2 (bio-Mérieux, Marcy l’etoile, France), and Meticillin resistance was verified using oxacillin disk with disk-diffusion method. Antibiotic resistance testing was performed by Kirby-Bauer disc diffusion method according to CLSI criteria, and intermediate susceptible strains were considered as resistant. Results: Seven hundred S.aureus strains which were isolated from various clinical specimens were included in this study. These strains were mostly isolated from blood culture, tissue, wounds and bronchial aspiration. All of 306 (43,7%) were oxacillin resistant. While all the S.aureus strains were found to be susceptible to vancomycin, teicoplanin, daptomycin and linezolid, 38 (9.6 %), 77 (19.5 %), 116 (29.4 %), 152 (38.6 %) and 28 (7.1 %) were found to be resistant aganist to clindamycin, erythromycin, gentamicin, tetracycline and sulfamethoxazole/trimethoprim, retrospectively. Conclusions: Comparing to the Methicillin sensitive staphylococcus aureus (MSSA) strains, increased resistance rates of, trimethoprim-sulfamethoxazole, clindamycin, erythromycin, gentamicin, and tetracycline were observed among the MRSA strains. In this study, the most effective antibiotic on the total of strains was found to be trimethoprim-sulfamethoxazole, the least effective antibiotic on the total of strains was found to be tetracycline.

Keywords: antibiotic resistance, MRSA, Staphylococcus aureus, VITEK 2

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Authors: Aleksandra Ristic

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The Coronavirus Disease – 2019 hit Europe in February 2020, and infections took place in four waves. It left consequences and demanded changes for the future. More than half of European countries responded quickly by declaring a state of emergency and introducing various containment measures that have had a major impact on individuals’ lives in recent years. Closing public lives was largely achieved by limited access and/or closing public institutions and services, including the closure of educational institutions. Teaching in classrooms converted to distance learning. In the research, we used a quantitative study to analyze various factors of distance learning that influenced pupils in different segments: teachers’ availability, family support, entire online conference learning, successful distance learning, time for themselves, reliable sources, teachers’ feedback, successful distance learning, online participation classes, motivation and teachers’ communication and theoretical review of the importance of digital skills, e-learning Index, World comparison of e-learning in the past, digital education plans for the field of Europe. We have gathered recommendations and distance learning solutions to improve the learning process by strengthening teachers and creating more tiered strategies for setting and achieving learning goals by the children.

Keywords: availability, digital skills, distance learning, resources

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Authors: Borja Bordel, Ramón Alcarria, Marina Pérez

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In March 2020, in Spain, a sanitary and unexpected crisis caused by COVID-19 was declared. All of a sudden, all degrees, classes and evaluation tests and projects had to be transformed into online activities. However, the chaotic situation generated by a complex operation like that, executed without any well-established procedure, led to very different experiences and, finally, results. In this paper, we are describing three experiences in two different Universities in Madrid. On the one hand, the Technical University of Madrid, a public university with little experience in online education. On the other hand, Alfonso X el Sabio University, a private university with more than five years of experience in online teaching. All analyzed subjects were related to computer engineering. Professors and students answered a survey and personal interviews were also carried out. Besides, the professors’ workload and the students’ academic results were also compared. From the comparative analysis of all these experiences, we are extracting the most successful strategies, methodologies, and activities. The recommendations in this paper will be useful for courses during the next months when the sanitary situation is still affecting an educational organization. While, at the same time, they will be considered as input for the upcoming digitalization process of higher education.

Keywords: educational experience, online education, higher education digitalization, COVID, Spain

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Authors: Samarpreet Singh, Gerald Giesbrecht

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Both c-section and antibiotic exposure are linked to gut microbiota imbalance in infants. Such disturbance is associated with the Hypothalamic-Pituitary-Adrenal (HPA) axis function. However, the literature only has contradicting evidence for the association between c-sections and the HPA axis. Therefore, this study aims to test if the mode of delivery and antibiotics exposure is associated with the HPA axis. Also, whether exposure to both interacts with the HPA-axis. It was hypothesized that associations and interactions would be observed. Secondary data analysis was used for this co-relational study. Data for the mode of delivery and antibiotics exposure variables were documented from hospital records or self-questionnaires. In addition, cortisol levels (Area under the curve with respect to increasing (AUCi) and Area under the curve with respect to ground (AUCg)) were based on saliva collected from three months old during the infant’s visit to the lab and after drawing blood. One-way and between-subject ANOVA analyses were run on data. No significant association between delivery mode and infant cortisol level was found, AUCi and AUCg, p > .05. Only the infant’s AUCg was found to be significantly higher if there were antibiotics exposure at delivery (p = .001) or their mothers were exposed during pregnancy (p < .05). Infants born by c-section and exposed to antibiotics at three months had higher AUCi than those born vaginally, p < .02. These results imply that antibiotic exposure before three months is associated with an infant’s stress response. The association might increase if antibiotic exposure occurs three months after a c-section birth. However, more robust and causal evidence in future studies is needed, given a variable group’s statistically weak sample size. Nevertheless, the results of this study still highlight the unintended consequences of antibiotic exposure during delivery and pregnancy.

Keywords: HPA-axis, antibiotics, c-section, gut-microbiota, development, stress

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Authors: H. Mashhady, H. A. Manzoori, M. Doosti, M. Fatollahi

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This study reports a descriptive research in the form of a genre analysis of postgraduates' theses and dissertations at three Iranian universities, including Ferdowsi, Tehran, and Tarbiat Moddares universities. The researchers sought to depict the generic structure of “statement of the problem” section of PhD dissertations and MA theses. Moreover, researchers desired to find any probable variety based on the year the dissertations belonged, to see weather genre-consciousness developed among Iranian postgraduates. To obtain data, “statement of the problem” section of 90 Ph.D. dissertations and MA theses from 2001 to 2013 in Teaching English as a Foreign Language (TEFL) at above-mentioned universities was selected. Frequency counts was employed for the quantitative method of data analysis, while genre analysis was used as the qualitative method. Inter-rater reliability was found to be about 0.93. Results revealed that students in different degrees at each of these universities used various generic structures for writing “statement of the problem”. Moreover, comparison of different time periods (2001-2006, and 2007-2013) revealed that postgraduates in the second time period, regardless of their degree and university, employed more similar generic structures which can be optimistically attributed to a general raise in genre awareness.

Keywords: genre, genre analysis, Ph.D. and MA dissertations, statement of the problem, generic structure

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Authors: Mini P. Singh, Jagat Ram, Archit Kumar, Tripti Rungta, Jasmine Khurana, Amit Gupta, R. K. Ratho

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Introduction: Human adenovirus is the most common agent involved in viral conjunctivitis. The clinical manifestations vary with different serotypes. The identification of the circulating strains followed by phylogenetic analysis can be helpful in understanding the origin and transmission of the disease. The present study aimed to carry out molecular epidemiology of the adenovirus types in the patients with conjunctivitis presenting to the eye centre of a tertiary care hospital in North India. Materials and Methods: The conjunctival swabs were collected from 23 suspected adenoviral conjunctivitis patients between April-August, 2014 and transported in viral transport media. The samples were subjected to nested PCR targeting hexon gene of human adenovirus. The band size of 956bp was eluted and 8 representative positive samples were subjected to sequencing. The sequences were analyzed by using CLUSTALX2.1 and MEGA 5.1 software. Results: The male: female ratio was found to be 3.6:1. The mean age of presenting patients was 43.95 years (+17.2). Approximately 52.1% (12/23) of patients presented with bilateral involvement while 47.8% (11/23) with unilateral involvement of the eye. Human adenovirus DNA could be detected in 65.2% (15/23) of the patients. The phylogenetic analysis revealed presence of serotype 8 in 7 patients and serotype 4 in one patient. The serotype 8 sequences showed 99-100% identity with Tunisian, Indian and Japanese strains. The adenovirus serotype 4 strains had 100% identity with strains from Tunisia, China and USA. Conclusion: Human adenovirus was found be an important etiological agent for conjunctivitis in our set up. The phylogenetic analysis showed that the predominant circulating strains in our epidemic keratoconjunctivitis were serotypes 8 and 4.

Keywords: conjunctivitis, human adenovirus, molecular epidemiology, phylogenetics

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Authors: Pagadaplly Girish, P. V. Manohar

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Introduction: Management of distal femur fractures is challenging. Recently, treatment has evolved towards indirect reduction and minimally invasive techniques. Objectives: To assess the fracture union and functional outcome following open reduction and internal fixation of distal femur fractures with locking compression plate and to achieve restoration of the anatomical alignment of fracture fragments and stable internal fixation. Methodology: Patients with distal femur fracture treated by locking compression during Oct 2011 to April 2013 were assessed prospectively. Patients below 18 years and those with neuro-vascular deficits were excluded. Age, sex of the patient, type of fracture, mechanism of injury, type of implant used, operative time and postoperative complications were analysed. The Neer’s scale was used to assess the outcome of the patients. Results: The total number of patients was 30; 28 males and 2 females; mean age was 41.53 years. Road traffic accidents were the major causes of injury followed by falls. The average duration of hospital stay was 21.3 days. The overall complication rate note was 23.33%. The mean range of movement around the knee joint after 6 months of follow-up was 114.330. The average time for the radiological union was 14 weeks. Excellent to good results were noted in 26 patients (86.6%) and average to poor results were observed in 4 (13.33%) patients. Conclusions: The locking compression plate gives a rigid fixation for the fracture. It also provides a good purchase in osteoporotic bones. LCP is simple and a reliable implant appropriate for fixation of femoral fractures with promising results.

Keywords: distal femur fractures, locking compression plate, Neer’s criteria, neuro-vascular deficits

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Authors: P. Donnelly, G. Mitchell

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Traumatic Brain Injury (TBI) is a major contributor to the global burden of disease; despite its ubiquity, there is significant variation in diagnosis, prognosis, and treatment between clinicians. This study aims to examine the spectrum of approaches that currently exist at a Level 1 Trauma Centre in Australasia by surveying Emergency Physicians and Neurosurgeons on those aspects of mTBI. A pilot survey of 17 clinicians (Neurosurgeons, Emergency Physicians, and others who manage patients with mTBI) at a Level 1 Trauma Centre in Brisbane, Australia, was conducted. The objective of this study was to examine the importance these clinicians place on various elements in their approach to the diagnosis, prognostication, and treatment of mTBI. The data were summarised, and the descriptive statistics reported. Loss of consciousness and post-traumatic amnesia were rated as the most important signs or symptoms in diagnosing mTBI (median importance of 8). MRI was the most important imaging modality in diagnosing mTBI (median importance of 7). ‘Number of the Previous TBIs’ and Intracranial Injury on Imaging’ were rated as the most important elements for prognostication (median importance of 9). Education and reassurance were rated as the most important modality for treating mTBI (median importance of 7). There was a statistically insignificant variation between the specialties as to the importance they place on each of these components. In this Australian tertiary trauma center, there appears to be variation in how clinicians approach mTBI. This study is underpowered to state whether this is between clinicians within a specialty or a trend between specialties. This variation is worthwhile in investigating as a step toward a unified approach to diagnosing, prognosticating, and treating this common pathology.

Keywords: mild traumatic brain injury, adult, clinician, survey

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Authors: Anirudh Sharma

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Introduction: The Covid-19 pandemic necessitated a change in the manner outpatient fracture clinics are conducted due to the need to reduce footfall in hospital. While studies regarding virtual fracture clinics have shown these to be useful and effective, they focus exclusively on remote consultations. However, our service was bespoke to the patient – either a face-to-face or telephone consultation depending on patient need – a ‘hybrid virtual clinic (HVC).’ We report patient satisfaction and outcomes with this novel service. Methods: Patients booked onto our fracture clinics during the first 2 weeks of national lockdown were retrospectively contacted to assess the mode of consultations (virtual, face-to-face, or hybrid), patient experience, and outcome. Patient experience was assessed using the net promoter (NPS), customer effort (CES) and customer satisfaction scores (CSS), and their likelihood of using the HVC in the absence of a pandemic. Patient outcomes were assessed using the components of the EQ5D score. Results: Of 269 possible patients, 140 patients responded to the questionnaire. Of these, 66.4% had ‘hybrid’ consultations, 27.1% had only virtual consultations, and 6.4% had only face-to-face consultations. The mean overall NPS, CES, and CSS (on a scale of 1-10) were 7.27, 7.25, and 7.37, respectively. The mean likelihood of patients using the HVC in the absence of a pandemic was 6.5/10. Patients who had ‘hybrid’ consultations showed better effort scores and greater overall satisfaction than those with virtual consultations only and also reported superior EQ5D outcomes (mean 79.27 vs. 72.7). Patients who did not require surgery reported increased satisfaction (mean 7.51 vs. 7.08) and were more likely to use the HVC in the absence of a pandemic. Conclusion: Our study indicates that a bespoke HVC has good overall patient satisfaction and outcomes and is a better format of fracture clinic service than virtual consultations alone. It may be the preferred mode for fracture clinics in similar situations in the future. Further analysis needs to be conducted in order to explore the impact on resources and clinician experience of HVC in order to appreciate this new paradigm shift.

Keywords: hybrid virtual clinic, coronavirus, COVID-19, fracture clinic, remote consultation

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Authors: Vinay Kumar, M. Kishor, Sathyanarayana Rao Ts

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Background: Growth of elderly people in the general population in recent years is termed as ‘greying of the world’ where there is a shift from high mortality & fertility to low mortality and fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio-economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. Methods: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of JSS Medical College and Hospital, Mysore, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Keywords: Geriatric, mental disorders, physical illness, psychiatry

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Authors: Danilsa Lorduy, Liliana Valle

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Assessment and evaluation are inextricable parts of the teaching learning process. Evaluation practices concerns are gaining popularity among curriculum developers an educational researchers, particularly in Colombian regions where English language is taught as a foreign language EFL. This study addressed one of those issues, which are the unbalanced in –services’ evaluation practices perceived in school classes. They present predominance on the written test among the procedures they use to evaluate; therefore, the purpose of this case study was to explore in-service teachers’ evaluation practices, their beliefs about evaluation and to establish an eventual connection between practices and beliefs. To this end, classroom observations, questionnaires, and a semi structured interview were applied to three in-service English teachers from different schools in a city in Colombia. The findings suggested that teachers’ beliefs indicate a formative inclination and they actually are using a variety of procedures different from test but they seem to have some issues regarding their appropriateness for application Moreover, it was found that teachers’ practices are being influenced by external factors such as school requirements and national policies. It could be concluded that the predominance in using tests is not only elicited by teachers’ beliefs but also by national test results 'Pruebas Saber' and law 115 demanding. It was also suggested that further quantitative research is needed to demonstrate connections between overuse of testing procedures and 'Pruebas Saber' national test.

Keywords: beliefs, evaluation, external factors, national test

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Authors: Michael Smalenberger

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Intelligent tutoring systems (ITS) are computer-based platforms which can incorporate artificial intelligence to provide step-by-step guidance as students practice problem-solving skills. ITS can replicate the benefits of one-on-one tutoring, foster transactivity in collaborative environments, and lead to substantial learning gains when used to supplement the instruction of a teacher or when used as the sole method of instruction. Developments improving the ease of ITS creation have recently increased their proliferation, leading many K-12 schools and institutions of higher education in the United States to regularly use ITS within classrooms. We investigated how students perceive their experience using an ITS. In this study, 111 undergraduate students used an ITS in a college-level introductory statistics course and were subsequently asked for feedback on their experience. Results show that their perceptions were generally favorable of the ITS, and most would seek to use an ITS both for STEM and non-STEM courses in the future. Along with detailed transaction-level data, this feedback also provides insights on the design of user-friendly interfaces, guidance on accessibility for students with impairments, the sequencing of exercises, students’ expectation of achievement, and comparisons to other tutoring experiences. We discuss how these findings are important for the creation, implementation, and evaluation of ITS as a mode and method of teaching and learning.

Keywords: college statistics course, intelligent tutoring systems, in vivo study, student perceptions of tutoring

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Authors: Sadaf Ambreen, Ayesha Bibi, Sara Rafiq

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Hypertension is a medical condition in which blood pressure in the arteries is elevated than the normal, having systolic blood pressure more than 120mmHg and diastolic blood pressure more than 80 mmHg. It leads to health complications and increase the risk of diseases such as stroke, heart failure, heart attack, and even death. The aim of the current study was to evaluate nutritional status and activity level among hypertensive early adults in District Mardan Data was collected from the subjects of Public Hospital, Mardan Medical Complex, through questionnaire. A complete information about individual sociodemographic, anthropometry and health status were collected, and physical activity was assessed by using IPAQ questionnaire. A total of 150 individuals were included in the study, in which 90% were females, and 10% were males. Data was analyzed through SPSS Version 22. Majority of the study subjects, 88%, were married, 70% having nuclear living system, 43% were having elementary education, and 43% were working as laborer. Body mass index and waist circumference in female counterpart were found to be positively associated with hypertension and was found statistically significant P=<0.01. Results showed that majority of females were fall in hypertension crisis category with mild activity, and males were having hypertension stage 1 with moderate activity. Our study concluded that non-optimal nutritional status and physical inactivity resulted in elevated blood pressure in females, therefore, lifestyle change such as optimal nutritional status and physical activity may play key role in reducing risk of hypertension.

Keywords: obesity/overwight, body mass index, waist circumference, early adulthood

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Authors: Geetha Baskaran, Andrzej Barjiela, Rong Qu

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Motivation: Nurse scheduling is a complex combinatorial optimization problem. It is also known as NP-hard. It needs an efficient re-scheduling to minimize some trade-off of the measures of violation by reducing selected constraints to soft constraints with measurements of their violations. Problem Statement: In this paper, we extend our novel approach to solve the nurse scheduling problem by transforming it through Information Granulation. Approach: This approach satisfies the rules of a typical hospital environment based on a standard benchmark problem. Generating good work schedules has a great influence on nurses' working conditions which are strongly related to the level of a quality health care. Domain transformation that combines the strengths of operation research and artificial intelligence was proposed for the solution of the problem. Compared to conventional methods, our approach involves judicious grouping (information granulation) of shifts types’ that transforms the original problem into a smaller solution domain. Later these schedules from the smaller problem domain are converted back into the original problem domain by taking into account the constraints that could not be represented in the smaller domain. An Integer Programming (IP) package is used to solve the transformed scheduling problem by expending the branch and bound algorithm. We have used the GNU Octave for Windows to solve this problem. Results: The scheduling problem has been solved in the proposed formalism resulting in a high quality schedule. Conclusion: Domain transformation represents departure from a conventional one-shift-at-a-time scheduling approach. It offers an advantage of efficient and easily understandable solutions as well as offering deterministic reproducibility of the results. We note, however, that it does not guarantee the global optimum.

Keywords: domain transformation, nurse scheduling, information granulation, artificial intelligence, simulation

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Authors: Sohil I. Alqazlan

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Introduction and Objectives: The individual educational plans (IEPs) is the cornerstone in education for students with special education need (SEN). The Saudi government supported the students’ right to have an IEP, and their education is one of the primary goals for the Ministry of Education (MoE). However, this support does not reflect the huge government investment. For example, some SEN students do not have an IEP, and poor communication was found between IEP teams and student's families. As a result, this study investigated perspectives and understandings of the IEP from the views of SEN teachers in the Saudi context. Methods: This study design utilised a qualitative approach, where in-depth semi-structured interviews were used with 8 SEN teachers in Riyadh (the capital city of Saudi Arabia) schools. In terms of analysing the interviews’ findings, the researcher used the thematic analyses approach. Results and Conclusion: The legality and the consideration of the legal document in Saudi Arabia are the main areas wherein study participants were questioned. It was observed that the IEP is not considered a legal document in the region of Saudi Arabia. As interpreted from the response of the SEN teachers, the IEP lacks the required legality with respect to its implementation in Saudi Arabia. All teachers were in agreement that the IEP is not considered to be a legal document in the Kingdom of Saudi Arabia. As a result, they did not use it for all their students with SEN. Such findings might have affected the teaching quality, and school outcomes as all SEN students must be supported individually depending on their needs.

Keywords: individual education plan, special education, IEP, teachers

Procedia PDF Downloads 152