Search results for: problem-oriented medical record

Authors: Yuanping Yang, Ruolin Zhou, Xingyu Liu, Lianbin Wu

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Based on the challenges of silanization of pharmaceutical glass packaging materials, the silicone oil high-temperature baking method consumes a lot of energy; silicone oil is generally physically adsorbed on the inner surface of the medical vials, leading to protein adsorption on the surface of the silicone oil and fall off, so that the number of particles in the drug solution increases, which brings potential risks to people. In this paper, a new silanizing method is proposed. High-efficiency silanization is achieved by grafting trimethylsilyl groups to the inner surface of medical vials by chemical bond at low temperatures. The inner wall of the vial successfully obtained stable hydrophobicity, and the water contact Angle of the surface reached 100°~110°. With the increase of silicified reagent concentration, the water resistance of corresponding treatment vials increased gradually. This treatment can effectively reduce the risk of pH value increase and sodium ion leaching.

Keywords: low-temperature silanization, medical vials, chemical bonding, hydrophobicity

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Authors: Ying-Lun Tseng Chiu-Ying Chen

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Taiwan's Mental Health Act was amended at the end of 2022; they added regulations regarding refusing compulsory treatment by patients with mental illnesses. In addition, not only by an examination committee, the judge must also assess the patient's need for compulsory treatment. Additionally, the maximum of compulsory hospitalization has been reduced from an unlimited period to a maximum of 60 days. They aim to promote the healthcare autonomy of individuals with mental illnesses in Taiwan and prevent their silenced voice in medical decision-making while they still possess rationality. Furthermore, they plan to use community support and social care networks to replace the current practice of compulsory treatment in Taiwan. This study uses qualitative research methodology, utilizing interview guidelines to inquire about the experiences of Taiwanese who have undergone compulsory hospitalization, compulsory community treatment, and compulsory medical care. The interviews aimed to explore their feelings when they were subjected to compulsory medical intervention, the inside of their illness, their opinions after treatments, and whether alternative medical interventions proposed by them were considered. Additionally, participants also asked about their personal life history and their support networks in their lives. We collected 12 Taiwanese who had experienced compulsory medical interventions and were interviewed 14 times. The findings indicated that participants still possessed rationality during the onset of their illness. However, when they have other treatments to replace compulsory medical, they sometimes diverge from those of the doctors and their families. Finally, doctors prefer their professional judgment and patients' families' option. Therefore, Taiwanese mental health patients' power of decision-making still needs to improve. Because this research uses qualitative research, so difficult to find participants, and the sample size rate was smaller than Taiwan's population, it may have biases in the analysis. So, Taiwan still has significant progress in enhancing the decision-making rights of participants in the study.

Keywords: medical decision making, compulsory treatment, medical ethics, mental health act

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Authors: A. Wahid Uddin

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Obstetric anal sphincter injury carries significant morbidity for a woman and affects the quality of life to the extent of permanent damage to anal sphincter musculature. The study was undertaken in a district general hospital by retrospectively reviewing random 63 case notes of patients diagnosed with a significant third or fourth-degree perineal tear admitted between the year of 2015 to 2018. The observations were collected by a pre-designed questionnaire. All variables were expressed as percentages. The major risk factors noted were nulliparity (37%), instrumental delivery (25%), and birth weight of more than 4 kg (14%). Forceps delivery with or without episiotomy was the major contributing factor (75%). In the majority of the cases (71%), no record of any perineal protection measures undertaken. The study concluded that recommended perineal protection measures should be adopted as a routine practise.

Keywords: forceps, obstetrics, perineal, sphincter

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Authors: Amhimmid Mohammed Saffour, Abdelkader Salama

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Filtering is a part of image enhancement techniques, it is used to enhance certain details such as edges in the image that are relevant to the application. Additionally, filtering can even be used to eliminate unwanted components of noise. Medical images typically contain salt and pepper noise and Poisson noise. This noise appears to the presence of minute grey scale variations within the image. In this paper, different filters techniques namely (Median, Wiener, Rank order3, Rank order5, and Average) were applied on CT medical images (Brain and chest). We using all these filters to remove salt and pepper noise from these images. This type of noise consists of random pixels being set to black or white. Peak Signal to Noise Ratio (PSNR), Mean Square Error r(MSE) and Histogram were used to evaluated the quality of filtered images. The results, which we have achieved shows that, these filters, are more useful and they prove to be helpful for general medical practitioners to analyze the symptoms of the patients with no difficulty.

Keywords: CT imaging, median filter, adaptive filter and average filter, MATLAB

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Authors: Hend Albassam, Nouf Alrumaih

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Nowadays we are in the age of technologies and communication and there is no doubt that technologies such as the Internet can offer many advantages for many business fields, and the health field is no execution. In fact, using the Internet provide us with a new path to improve the quality of health care throughout the world. The e-healthcare offers many advantages such as: efficiency by reducing the cost and avoiding duplicate diagnostics, empowerment of patients by enabling them to access their medical records, enhancing the quality of healthcare and enabling information exchange and communication between healthcare organizations. There are many problems that result from using papers as a way of communication, for example, paper-based prescriptions. Usually, the doctor writes a prescription and gives it to the patient who in turn carries it to the pharmacy. After that, the pharmacist takes the prescription to fill it and give it to the patient. Sometimes the pharmacist might find difficulty in reading the doctor’s handwriting; the patient could change and counterfeit the prescription. These existing problems and many others heighten the need to improve the quality of the healthcare. This project is set out to develop a distributed e-healthcare system that offers some features of e-health and addresses some of the above-mentioned problems. The developed system provides an electronic health record (EHR) and enables communication between separate health care organizations such as the clinic, pharmacy and laboratory. To develop this system, the Service Oriented Architecture (SOA) is adopted as a design approach, which helps to design several independent modules that communicate by using web services. The layering design pattern is used in designing each module as it provides reusability that allows the business logic layer to be reused by different higher layers such as the web service or the website in our system. The experimental analysis has shown that the project has successfully achieved its aims toward solving the problems related to the paper-based healthcare systems and it enables different health organization to communicate effectively. It implements four independent modules including healthcare provider, pharmacy, laboratory and medication information provider. Each module provides different functionalities and is used by a different type of user. These modules interoperate with each other using a set of web services.

Keywords: e-health, services oriented architecture (SOA), web services, interoperability

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Authors: Sarp Erturk, Levent Eyigel, Cihat Celik, Muhammet Sahinoglu, Serdar Ay, Yasin Kaya, Hasan Kaya

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This paper presents a quantitative analysis on the need for automotive calibration methods for digital tachographs. Digital tachographs are mandatory for vehicles used in people and goods transport and they are an important aspect for road safety and inspection. Digital tachographs need to be calibrated for workshops in order for the digital tachograph to display and record speed and odometer values correctly. Calibration of digital tachographs can be performed either manual or automatic. It is shown in this paper that manual calibration of digital tachographs is prone to errors and there can be differences between manual and automatic calibration parameters. Therefore automatic calibration methods are imperative for digital tachograph calibration. The presented experimental results and error analysis clearly support the claims of the paper by evaluating and statistically comparing manual and automatic calibration methods.

Keywords: digital tachograph, road safety, tachograph calibration, tachograph workshops

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Authors: Hamed Tofangsaz

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In the absence of an internationally agreed definition of terrorism, the question which needs to be posed is whether there is a clear and common understanding of what constitutes terrorism, terrorist acts and terrorist groups, the financing of which needs to be stopped. That is, from a criminal law perspective, whether the Terrorist Financing Convention, as the backbone of the counter-terrorist financing regime, clarifies what types of conduct, by who, in what circumstances and when, against whom (targets or victims) and with what intention or motivation should be considered terrorism? It will be explained how and why it has been difficult to reach an agreement on the definition of terrorism. The endeavour of the drafters of the Terrorist Financing Convention and others involved in countering terrorist financing to establish a general definition of terrorism will be examined. The record of attempts to define the elements of terrorism proves that it is hardly possible to reach an agreement on a generic definition of terrorism because the concept of terrorism is elusive and subject to various understandings. Even the definition provided by the Terrorist Financing Convention, is not convincing. With regard to the findings, this paper calls for further research on the legal consequences of the implementation of the terrorist financing-counter measures while the scope of terrorism, terrorist acts and terrorist organizations have been left vague.

Keywords: terrorism, terrorist financing, crime, convention

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Authors: Nilgün Katrancı, Pınar Göv

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With the acceleration and assessment of quality and patient safety works in healthcare services in the 21st century, activities to reduce errors have gained importance. The prevention and reduction of unintended consequences related to healthcare services and errors made during the delivery of healthcare services can be achieved by understanding the causes of the errors. Communication is the basic reason most frequently seen in such cases. Nurses who communicate with patients more closely and for longer time play a more critical role in ensuring patient safety compared to other healthcare professionals. To reduce the risk of medical errors and increase the quality of care, it is important to raise the awareness of nurses about patient safety in training period. This descriptive study was conducted between February 2017 and May 2017 to assess intern students' attitudes towards and knowledge of patient safety and medical errors. The target population of the study consists of intern students at the Faculty of Nursing in Gaziantep University (N=180). The study did not apply any sample selection method, and the research group consisted of 90 female and 37 male senior students who were available and accepted to take part in the study (N=127). The study used personal information form and medical error attitude scale to collect data. The medical error attitude scale consists of 16 items and 3 sub-dimensions. The most frequently seen medical error in the clinics the interns worked at was found as ‘Failure to comply with asepsis rules’ with a rate of 67,7%. The most frequent case among reasons for not disclosing an error is ‘noticing and correcting the error before affecting the patient’ with the rate of 70,9%. The most frequently expressed implications of disclosing a serious error for the intern students participating in the study are ‘harming patient trust (78%)’ and ‘possibility of overreaction by patient (62,2%)’. According to the results of the study, the awareness of the students about the importance of medical errors and error reporting was found high (3,48 ± 0,49). Consequently, it is important to assess and positively improve the attitudes of nurses and other healthcare professionals towards medical errors for the determination of causes of medical errors and their prevention.

Keywords: healthcare service, intern student, medical error, patient safety

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Authors: Hossein Ghaedamini, Salman Farahbakhsh, Alireza Amirbeigi, Zahra Saghafi, Salman Daneshi, Alireza Ghaedamini

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Background: Assessing the challenges of clinical education of medical students is one of the most important and sensitive parts of medical education. The aim of this study was to investigate the views and experiences of Kerman medical students on the factors that facilitate and inhibit the quality of clinical education. Materials and Methods: This research was qualitative and used a phenomenological approach. The study population included medical interns of Kerman University of Medical Sciences in 1400. The method of data collection was in-depth interviews with participants. Data were encoded and analyzed by Claizey stepwise model. Results: First, about 540 primary codes were extracted in the form of two main themes (facilitators and inhibitors) and 10 sub-themes including providing motivational models and creating interest in interns, high scientific level of professors and the appropriate quality of their teaching, the use of technology in the clinical education process, delegating authority and freedom of action and more responsibilities to interns, inappropriate treatment of some officials, professors, assistants and department staff with their interns, inadequate educational programming, lack of necessary cooperation and providing inappropriate treatment by clinical training experts for interns, inadequate evaluation method in clinical training for interns, poor quality mornings, the unefficiency of grand rounds, the inappropriate way of evaluating clinical training for interns, the lack of suitable facilities and conditions with the position of a medical intern, and the hardwork of some departments were categorized. Conclusion: Clinical education is always mixed with special principles and subtleties, and special attention to facilitators and inhibitors in this process has an important role in improving its quality.

Keywords: clinical education, medical students, qualitative study, education

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Authors: Wan Aminah Hasbullah

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The knowledge of medicine in Malay society stemmed out from the need to remedy disease process. Such knowledge came from observations by looking at the signs on the plants which signify it uses, the doctrine of signature, and also observing what kind of animal and its parts that can be used to treat the disease. Prayers (jampi and doa’) play a very important role in the therapeutic processes addressing the ethereal part of the body. In Malay medicine, prayers were said in the heart of the Malay bomoh (medicine man) when they are first approaching the diseased person, seeking the help of Allah in accurately directing his mind into making the right diagnosis and subsequently the right choice of treatment. In the making of medicine, similar rituals were religiously followed, starting from gathering the materia medica to the final concoction of the medicine. Thus, all the materia medica and the prayers in Malay medicine were gathered and documented in the medical manuscript known as MSS 2999 Kitab Tibb. For this study, a collection of vegetative materia medica which is specialized for the women illness from this manuscript will be gathered and analysed. A medical and cultural interpretation will be highlighted to see the relationship between efficacy in traditional Malay medicine as practiced in the past and the recent practice of the modern medicine.

Keywords: vegetative, materia medica, woman illness, Malay medical manuscript

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Authors: Natália Botica, Luís Luís, Paulo Bernardes

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The Côa Valley, listed World Heritage since 1998, presents more than 1300 open-air engraved rock panels. The Archaeological Park of the Côa Valley recorded the rock art motifs, testing various techniques based on direct tracing processes on the rock, using natural and artificial lighting. In this work, integrated in the "Open Access Rock Art Repository" (RARAA) project, we present the methodology adopted for the vectorial drawing of the rock art motifs based on orthophotos taken from the photogrammetric survey and 3D models of the rocks. We also present the information system designed to integrate the vector drawing and the characterization data of the motifs, as well as the open access sharing, in order to promote their reuse in multiple areas. The 3D models themselves constitute a very detailed record, ensuring the digital preservation of the rock and iconography. Thus, even if a rock or motif disappears, it can continue to be studied and even recreated.

Keywords: rock art, archaeology, iron age, 3D models

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Authors: Tanapon Keatsamarn, Chuchart Pintavirooj

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Foot pressure measurement provides necessary information for diagnosis diseases, foot insole design, disorder prevention and other application. In this paper, dynamic foot pressure measurement is presented for pressure measuring with high resolution and accuracy. The dynamic foot pressure measurement system consists of hardware and software system. The hardware system uses a transparent acrylic plate and uses steel as the base. The glossy white paper is placed on the top of the transparent acrylic plate and covering with a black acrylic on the system to block external light. Lighting from LED strip entering around the transparent acrylic plate. The optical sensors, the digital cameras, are underneath the acrylic plate facing upwards. They have connected with software system to process and record foot pressure video in avi file. Visual Studio 2017 is used for software system using OpenCV library.

Keywords: foot, foot pressure, image processing, optical sensors

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Authors: Karolina Wieczorek, Sophie Wiliams

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Introduction: Patient data is often collected in Electronic Health Record Systems (EHR) for purposes such as providing care as well as reporting data. This information can be re-used to validate data models in clinical trials or in epidemiological studies. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. Mentioning a disease in a discharge letter does not necessarily mean that a patient suffers from this disease. Many of them discuss a diagnostic process, different tests, or discuss whether a patient has a certain disease. The COVID-19 dataset in this study used natural language processing (NLP), an automated algorithm which extracts information related to COVID-19 symptoms, complications, and medications prescribed within the hospital. Free-text patient clinical patient notes are rich sources of information which contain patient data not captured in a structured form, hence the use of named entity recognition (NER) to capture additional information. Methods: Patient data (discharge summary letters) were exported and screened by an algorithm to pick up relevant terms related to COVID-19. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. A list of 124 Systematized Nomenclature of Medicine (SNOMED) Clinical Terms has been provided in Excel with corresponding IDs. Two independent medical student researchers were provided with a dictionary of SNOMED list of terms to refer to when screening the notes. They worked on two separate datasets called "A” and "B”, respectively. Notes were screened to check if the correct term had been picked-up by the algorithm to ensure that negated terms were not picked up. Results: Its implementation in the hospital began on March 31, 2020, and the first EHR-derived extract was generated for use in an audit study on June 04, 2020. The dataset has contributed to large, priority clinical trials (including International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) by bulk upload to REDcap research databases) and local research and audit studies. Successful sharing of EHR-extracted datasets requires communicating the provenance and quality, including completeness and accuracy of this data. The results of the validation of the algorithm were the following: precision (0.907), recall (0.416), and F-score test (0.570). Percentage enhancement with NLP extracted terms compared to regular data extraction alone was low (0.3%) for relatively well-documented data such as previous medical history but higher (16.6%, 29.53%, 30.3%, 45.1%) for complications, presenting illness, chronic procedures, acute procedures respectively. Conclusions: This automated NLP algorithm is shown to be useful in facilitating patient data analysis and has the potential to be used in more large-scale clinical trials to assess potential study exclusion criteria for participants in the development of vaccines.

Keywords: automated, algorithm, NLP, COVID-19

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Authors: Mary L. G. S. Senna, Veruska, C. Dutra, Jr., Keity L. F. Oliveira, Patrícia A. Santos, Alana C. M. Santana

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Environmental impacts are the changes in the physical, chemical or biological properties of natural areas that are most often caused by human actions on the environment and which have consequences for human health, society and the elements of nature. The identification of the environmental impacts is important so that they are mitigated, and above all that the mitigating measures are applied in the area. This work aims to identify the environmental impacts generated in the Praia do Caju area in the city of Palmas/Brazil and show that the lack of structure on the beach intensifies the environmental impacts. The present work was carried out having as parameter, the typologies of exploratory and descriptive and quantitative research through a matrix of environmental impacts through direct observation and registration. The study took place during the holidays from August to December 2016 and photographic record of impacts. From the collected data it was possible to verify that Caju beach suffers constant degradation due to irregular deposition.

Keywords: leisure, tourism, environmental impacts, Brazil

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Authors: Yuan-lin Liu, Ye Li, Tian Xia

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There are some shortcomings in Chinese existing taxi management modes. This paper suggests to establish the third-party comprehensive information management platform and put forward an evaluation model based on credit. Four indicators are used to evaluate the drivers’ credit, they are passengers’ evaluation score, driving behavior evaluation, drivers’ average bad record number, and personal credit score. A weighted clustering method is used to achieve credit level evaluation for taxi drivers. The management of taxi industry is based on the credit level, while the grade of the drivers is accorded to their credit rating. Credit rating determines the cost, income levels, the market access, useful period of license and the level of wage and bonus, as well as violation fine. These methods can make the credit evaluation effective. In conclusion, more credit data will help to set up a more accurate and detailed classification standard library.

Keywords: credit, mobile internet, e-hailing taxi, management mode, weighted cluster

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Authors: Mingming Guo, Xiaozan Wang

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Introduction: The purpose of this study is to examine the correlation between the physical fitness of Chinese college students and their daily running habits (RH). Methods: A total of 718 college students from East China Normal University participated in this study (385 boys and 333 girls). Each participant participated in the Chinese Students’ Physical Fitness Test during the 2018-2019 school year. In addition, each student is also required to use the app to record all their running results during each run during the 2018-2019 school year. Researchers can query and export all running records through the app's management platform. Results: (1) The total number of kilometers run by the students showed a significant negative correlation with their vital capacity (VC), sitting body flexion (SBF), and long jump (LJ) (rᵥ

Keywords: college students, physical fitness, running habits, data mining

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Authors: Muyatdinova Aigul, Aitkaliyeva Madina

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The article deals with the evaluation of the quality of medical services on the basis of quality indicators. For this purpose allocated initially the features of the medical services market. The Features of the market directly affect on the evaluation process that takes a multi-level and multi-stakeholder nature. Unlike ordinary goods market assessment of medical services does not only market. Such an assessment is complemented by continuous internal and external evaluation, including experts and accrediting bodies. In the article highlighted the composition of indicators for a comprehensive evaluation

Keywords: health care market, quality of health services, indicators of care quality

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Authors: Payal Abichandani, Rishi Prakash, Paras Nath Barwal, B. K. Murthy

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Information generated from various computerization processes is a potential rich source of knowledge for its designated community. To pass this information from generation to generation without modifying the meaning is a challenging activity. To preserve and archive the data for future generations it’s very essential to prove the authenticity of the data. It can be achieved by extracting the metadata from the data which can prove the authenticity and create trust on the archived data. Subsequent challenge is the technology obsolescence. Metadata extraction and standardization can be effectively used to resolve and tackle this problem. Metadata can be categorized at two levels i.e. Technical and Domain level broadly. Technical metadata will provide the information that can be used to understand and interpret the data record, but only this level of metadata isn’t sufficient to create trustworthiness. We have developed a tool which will extract and standardize the technical as well as domain level metadata. This paper is about the different features of the tool and how we have developed this.

Keywords: digital preservation, metadata, OAIS, PDI, XML

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Authors: Yirui Wang

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In the past few decades, patient safety has been the focus of much attention in the global medical and health field. As medical standards continue to improve and develop, the demand for patient safety is also growing. As one of the important dimensions in assessing patient safety, the Patient Perception Patient Safety Assessment Tool provides unique and valuable information from the patient's own perspective and plays an important role in promoting patient safety. This article aims to summarize and analyze the assessment content, assessment methods and applications of currently commonly used patient-perceived patient safety assessment tools at home and abroad, with a view to providing a reference for medical staff to select appropriate patient-perceived patient safety assessment tools.

Keywords: patients, patient safety, perception, assessment tools, review

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Authors: Ilona Buchem, Carolin Gellner

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The call for the support of senior learners in the development of digital literacy has become prevalent in recent years, especially in view of the aging societies paired with advances in digitalization in all spheres of life, including e-health. The goal has been to create opportunities for learning that incorporate the use of context in a reflective and dialogical way. Contextual learning has focused on developing skills through the application of authentic problems. While major research efforts in supporting senior learners in developing digital literacy have been invested so far in e-learning, focusing on knowledge acquisition and cognitive tasks, little research exists in reflective mentoring and coaching with the help of pedagogical agents and addressing the contextual dimensions of learning. This paper describes an approach to creating opportunities for senior learners to improve their digital literacy in the authentic context of the electronic health record (EHR) with the support of an intelligent virtual learning coach. The paper focuses on the design of the virtual coach as part of an e-learning system, which was developed in the EPA-Coach project founded by the German Ministry of Education and Research. The paper starts with the theoretical underpinnings of contextual learning and the related design considerations for a virtual learning coach based on previous studies. Since previous research in the area was mostly designed to cater to the needs of younger audiences, the results had to be adapted to the specific needs of senior learners. Next, the paper outlines the stages in the design of the virtual coach, which included the adaptation of the design requirements, the iterative development of the prototypes, the results of the two evaluation studies and how these results were used to improve the design of the virtual coach. The paper then presents the four prototypes of a senior-friendly virtual learning coach, which were designed to represent different preferences related to the visual appearance, the communication and social interaction styles, and the pedagogical roles. The first evaluation of the virtual coach design was an exploratory, qualitative study, which was carried out in October 2020 with eight seniors aged 64 to 78 and included a range of questions about the preferences of senior learners related to the visual design, gender, age, communication and role. Based on the results of the first evaluation, the design was adapted to the preferences of the senior learners and the new versions of prototypes were created to represent two male and two female options of the virtual coach. The second evaluation followed a quantitative approach with an online questionnaire and was conducted in May 2021 with 41 seniors aged 66 to 93 years. Following three research questions, the survey asked about (1) the intention to use, (2) the perceived characteristics, and (3) the preferred communication/interaction style of the virtual coach, i. e. task-oriented, relationship-oriented, or a mix. This paper follows with the discussion of the results of the design process and ends with conclusions and next steps in the development of the virtual coach including recommendations for further research.

Keywords: virtual learning coach, virtual mentor, pedagogical agent, senior learners, digital literacy, electronic health records

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Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

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Authors: U. E. Mochalova, A. V. Demeneva, Shilkin A. G., J. Yu. Artiushina

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Objective. In medical ophthalmology OCT has been actively used in the last decade. It is a modern non-invasive method of high-precision hardware examination, which gives a detailed cross-sectional image of eye tissues structure with a high level of resolution, which provides in vivo morphological information at the microscopic level about corneal tissue, structures of the anterior segment, retina and optic nerve. The purpose of this study was to explore the possibility of using the OCT technology in complex ophthalmological examination in dogs and cats, to characterize the revealed pathological structural changes in corneal tissue in cats and dogs with some of the most common corneal diseases. Procedures. Optical coherence tomography of the cornea was performed in 112 animals: 68 dogs and 44 cats. In total, 224 eyes were examined. Pathologies of the organ of vision included: dystrophy and degeneration of the cornea, endothelial corneal dystrophy, dry eye syndrome, chronic superficial vascular keratitis, pigmented keratitis, corneal erosion, ulcerative stromal keratitis, corneal sequestration, chronic glaucoma and also postoperative period after performed keratoplasty. When performing OCT, we used certified medical devices: "Huvitz HOCT-1/1F», «Optovue iVue 80» and "SOCT Copernicus Revo (60)". Results. The results of a clinical study on the use of optical coherence tomography (OCT)of the cornea in cats and dogs, performed by the authors of the article in the complex diagnosis of keratopathies of variousorigins: endothelial corneal dystrophy, pigmented keratitis, chronic keratoconjunctivitis, chronic herpetic keratitis, ulcerative keratitis, traumatic corneal damage, sequestration of the cornea of cats, chronic keratitis, complicating the course of glaucoma. The characteristics of the OCT scans are givencorneas of cats and dogs that do not have corneal pathologies. OCT scans of various corneal pathologies in dogs and cats with a description of the revealed pathological changes are presented. Of great clinical interest are the data obtained during OCT of the cornea of animals undergoing keratoplasty operations using various forms of grafts. Conclusions. OCT makes it possible to assess the thickness and pathological structural changes of the corneal surface epithelium, corneal stroma and descemet membrane. We can measure them, determine the exact localization, and record pathological changes. Clinical observation of the dynamics of the pathological process in the cornea using OCT makes it possible to evaluate the effectiveness of drug treatment. In case of negative dynamics of corneal disease, it is necessary to determine the indications for surgical treatment (to assess the thickness of the cornea, the localization of its thinning zones, to characterize the depth and area of pathological changes). According to the OCT of the cornea, it is possible to choose the optimal surgical treatment for the patient, the technique and depth of optically constructive surgery (penetrating or anterior lamellar keratoplasty).; determine the depth and diameter of the planned microsurgical trepanation of corneal tissue, which will ensure good adaptation of the edges of the donor material.

Keywords: optical coherence tomography, corneal sequestration, optical coherence tomography of the cornea, corneal transplantation, cat, dog

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Authors: Chamtouri I., Kechida M.

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Background: Evaluation has a prominent role in medical education and graduation. This evaluation has usually done in face-to-face, by written or oral questions. Simulation is increasingly taking a part as a method of evaluation. Due to the Covid-19 pandemic, which disrupted face-to-face evaluation, simulation using serious games (SG) is emerging in the field of training and assessment of medical students. The aim of our study is to compare the results of the evaluation of medical students by virtual simulation by online serious games versus clinical case-multiple choice questions (MCQ) and to assess the degree of satisfaction from these two evaluation methods. Methods: Medical students from the same study level were voluntarily participated in this study. Groupe 1 had an evaluation by SG dealing with “diagnosis and management of ST-segment elevationmyocardialinfarction (STEMI)alreadyprepared on the website www.Mediactiv.com. Groupe 2 were evaluated by clinical case-MCQ having thes same topic as SG. Results of the two groups were compared. Satisfaction questionnaire was filled by the two groups. Satisfaction degree was compared between the two groups. Results. In this study, 64 medical students (G1:31 and G2: 33) were enrolled. Obtaining complete notes in the "questioning" and "clinical examination" parts is significantly more important in-group 1 compared to group 2. No significant difference detected between the two groups in terms of “ECG interpretation” and “diagnosis of STEMI” parts. A greater number of students of group 1 obtained the full note compared to group 2 in “the initial treatment part” (54.8% vs. 39.4%; p = 0.04). Thirty learners (96.8%) in-group 1 obtained a total score ≥ 50% versus 69.7% in-group 2 (p = 0.004). The full score of 100% was obtained in three learners in-group1, while no student scored 100% in-group2 (p = 0.027). Medical evaluation using SG was reported as more innovative, fun, and realistic compared to evaluation by clinical case-MCQ. No significant difference detected between the two methods in terms of stress. Conclusion: Simulation by SG can be considered as an innovative and effective method in evaluating medical students with a higher degree of satisfaction.

Keywords: evaluation, serious games, medical students, satisfaction

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Authors: Ábrám Zoltán

Abstract:

Introduction: Climate change is now a major health risk, and its environmental and health effects have become frequently discussed topics. The consequences of climate change are clearly visible in natural disasters and excess deaths caused by extreme weather conditions. Global warming and the increasingly frequent extreme weather events have direct, immediate effects or long-term, indirect effects on health. For this reason, it is a need to teach the health effects of climate change in medical schools. Material and methods: We looked for various surveys, studies, and reports on the main pathways through which global warming affects health. Medical schools face the challenge of teaching the health implications of climate change and integrating knowledge about the health effects of climate change into medical training. For this purpose, there were organised World Café workshops for three target groups: medical students, academic staff, and practising medical doctors. Results: Among the goals of the research is the development of a detailed curriculum for medical students, which serves to expand their knowledge in basic education. At the same time, the project promotes the increase of teacher motivation and the development of methodological guidelines for university teachers; it also provides further training for practicing doctors. The planned teaching materials will be developed in a format suitable for traditional face-to-face teaching, as well as e-learning teaching materials. CLIMATEMED is a project based on the cooperation of six universities and institutions from four countries, the aim of which is to improve the curriculum and expand knowledge about the health effects of climate change at medical universities. Conclusions: In order to assess the needs, summarize the proposals, to develop the necessary strategy, World Café type, one-and-a-half to two-hour round table discussions will take place separately for medical students, academic staff, and practicing doctors. The CLIMATEMED project can facilitate the integration of knowledge about the health effects of climate change into curricula and can promote practical use. The avoidance of the unwanted effects of global warming and climate change is not only a public matter, but it is also a challenge to change our own lifestyle. It is the responsibility of all of us to protect the Earth's ecosystem and the physical and mental health of ourselves and future generations.

Keywords: climate change, health effects, medical schools, World Café, medical students

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Authors: Elizabeth Behrens, Anne Timmermann, Alexander Yerkan, Joshua Thomas, Deborah Katz, Agne Paner, Melissa Larson, Shivi Jain, Seo-Hyun Kim, Celalettin Ustun, Ankur Varma, Parameswaran Venugopal, Jamile Shammo

Abstract:

Coronavirus Disease-2019 (COVID-19) causes persistent concern for poor outcomes in vulnerable populations. Patients with hematologic malignancies (HM) have been found to have higher COVID-19 case fatality rates compared to those without malignancy. While cytopenias are common in patients with HM, especially in those undergoing chemotherapy treatment, hemoglobin (Hgb) and platelet count have not yet been studied, to our best knowledge, as potential prognostic indicators for patients with HM and COVID-19. The goal of this study is to identify factors that may increase the risk of mortality in patients with HM and COVID-19. In this single-center, retrospective, observational study, 65 patients with HM and laboratory confirmed COVID-19 were identified between March 2020 and January 2021. Information on demographics, laboratory data the day of COVID-19 diagnosis, and prognosis was extracted from the electronic medical record (EMR), chart reviewed, and analyzed using the statistical software SAS version 9.4. Chi-square testing was used for categorical variable analyses. Risk factors associated with mortality were established by logistic regression models. Non-Hodgkin lymphoma (37%), chronic lymphocytic leukemia (20%), and plasma cell dyscrasia (15%) were the most common HM. Higher Hgb level upon COVID-19 diagnosis was related to decreased mortality, odd ratio=0.704 (95% confidence interval [CI]: 0.511-0.969; P = .0263). Platelet count the day of COVID-19 diagnosis was lower in patients who ultimately died (mean 127 ± 72K/uL, n=10) compared to patients who survived (mean 197 ±92K/uL, n=55) (P=.0258). Female sex was related to decreased mortality, odd ratio=0.143 (95% confidence interval [CI]: 0.026-0.785; P = .0353). There was no mortality difference between the patients who were on treatment for HM the day of COVID-19 diagnosis compared to those who were not (P=1.000). Lower Hgb and male sex are independent risk factors associated with increased mortality of HM patients with COVID-19. Clinicians should be especially attentive to patients with HM and COVID-19 who present with cytopenias. Larger multi-center studies are urgently needed to further investigate the impact of anemia, thrombocytopenia, and demographics on outcomes of patients with hematologic malignancies diagnosed with COVID-19.

Keywords: anemia, COVID-19, hematologic malignancy, prognosis

Procedia PDF Downloads 133

Authors: Ananda Perera

Abstract:

Computer-Assisted Medical Evaluation of Symptoms (CAMEOS) is a medical expert system designed to help General Practices (GPs) make an accurate diagnosis. CAMEOS comprises a knowledge base, user input, inference engine, reasoning module, and output statement. The knowledge base was developed by the author. User input is an Html file. The physician user collects data in the consultation. Data is sent to the inference engine at servers. CAMEOS uses set theory to simulate diagnostic reasoning. The program output is a list of differential diagnoses, the most probable diagnosis, and the diagnostic reasoning.

Keywords: CDSS, computerized decision support systems, expert systems, general practice, diagnosis, diagnostic systems, primary care diagnostic system, artificial intelligence in medicine

Procedia PDF Downloads 135

Authors: K. N. Dinesh Babu, M. V. Gopalan, G. R. Manjunatha, R. Ramaprabha, V. Rajini

Abstract:

In this paper, monitoring and control of tap changer mechanism of a transformer implementation in an intelligent electronic device (IED) is discussed. Its been a custom for decades to provide a separate panel for on load tap changer control for monitoring the tap position. However this facility cannot either record or transfer the information to remote control centers. As there is a technology shift towards the smart grid protection and control standards, the need for implementing remote control and monitoring has necessitated the implementation of this feature in numerical relays. This paper deals with the programming, settings and logic implementation which is applicable to both IEC 61850 compatible and non-compatible IEDs thereby eliminating the need for separate tap changer control equipment. The monitoring mechanism has been implemented in a 28MVA, 110 /6.9kV transformer with 16 tap position with GE make T60 IED at Ultratech cement limited Gulbarga, Karnataka and is in successful service.

Keywords: transformer protection, tap changer control, tap position monitoring, on load tap changer, intelligent electronic device (IED)

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Authors: Rabail Shafique Satti, Sidra Ejaz, Madiha Arshad, Marwa Khalid, Sadia Majeed

Abstract:

The paper presents the development of an automated security system to automate the entry of visitors, providing more flexibility of managing their record and securing homes or workplaces. Face recognition is part of this system to authenticate the visitors. A cost effective and SMS based door security module has been developed and integrated with the GSM network and made part of this system to allow communication between system and owner. This system functions in real time as when the visitor’s arrived it will detect and recognizes his face and on the result of face recognition process it will open the door for authorized visitors or notifies and allows the owner’s to take further action in case of unauthorized visitor. The proposed system is developed and it is successfully ensuring security, managing records and operating gate without physical interaction of owner.

Keywords: SMS, e-mail, GSM modem, authenticate, face recognition, authorized

Procedia PDF Downloads 760

Authors: Mohsen Shirani, Shadi Asadzandi, Micaela Demichela

Abstract:

This paper presents the results of a study to assess crucial aspects and the strength of the scientific basis of a typically interdisciplinary, applied field: food supply chain risk assessment research. Our approach is based on an advanced scientometrics analysis with novel elements to assess the influence and dissemination of research results and to measure interdisciplinary. This paper aims to describe the quantity and quality of the publication trends in food supply chain risk assessment. The population under study was composed of 266 articles from database web of science. The results were analyzed based on date of publication, type of document, language of the documents, source of publications, subject areas, authors and their affiliations, and the countries involved in developing the articles.

Keywords: food supply chain, risk assessment, scientometrics, web of science

Procedia PDF Downloads 472

Authors: Kulveer Sandhu

Abstract:

Background: In 1999, the Government of Canada legalized the use of cannabis for the therapeutic purpose (CTP); however, its users remain highly vulnerable to stigma and are judged by care providers and nonusers of cannabis. Findings from a literature review suggest health care providers (HCPs), including nurses in palliative care settings, lack knowledge about medical cannabis. For this reason, it is important to enhance HCPs’awarenessand knowledge of medical cannabis. Significance of the Project: Nurses are the first point of contact and spend more time with patients than other care providers; it is, therefore, important for them to be informed about CTPto provide quality and equitable care for medical cannabis users. Although nurses and other HCPs want information on CTP, the topic is rarely included in their educational curriculum. The purpose of this project is to create an evidence informed Package designed to increase knowledge among palliative care nurses about CTP. The information package will empower palliative nurses to help palliative patients make informed decisions about their treatment plan. Method: The information package will include a basic overview of the endocannabinoid system, common cannabis plants and products, and methods of consumption, as well as information to help nurses better understand consumption and harm reduction. The package will also include a set of cannabis fact sheets for nurses. Each fact sheet will comprise a high-level overview with graphics followed by a description of medical cannabis with links and references. At the end of the learning package, there are five self-reflection questions that allow nurses to examine their personal values, attitudes, and practices regarding medical cannabis. These questions will help each nurse understand their personal approach towards CTP and its users.

Keywords: medical cannabis, improve knowledge, cannabis for therapeutic purpose (CTP), patient experience, palliative care

Procedia PDF Downloads 202