Search results for: binary outcomes

Authors: Urwah Ali

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The aim of this study is to carry out a meta-analysis in order to establish an overall international figure and to summarize the evidence relating to the possible relationship between child sexual abuse and subsequent mental and physical health outcomes. A systematic review was conducted using the HEC Digital Library, Pub Med, PsycINFO and SAHIL databases published after 2010 containing empirical data pertaining to CSA. Out of 124 articles assessed for eligibility, 32 studies provided evidence of a relationship between sexual child maltreatment and various health outcomes for use in subsequent meta-analyses. Statistical significance associations were observed between childhood sexual victimization and psychological problems in their adulthood [odds ratio (OR) = 1.5; 95%Cl 3.07–4.43]. For most studies included for meta-analysis, the odds ratio falls above 1.00, indicating that patients having history of childhood sexual victimization were more likely to develop psychological disorders.

Keywords: abuse, sexual abuse, childhood sexual abuse, mental health

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Authors: Emily Injete Amondo, Alisher Mirzabaev, Emmanuel Rukundo

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Children in rural farming households are often vulnerable to a multitude of risks, including health risks associated with climate change and variability. Cognizant of this, this study empirically traced the relationship between climate variability and nutritional health outcomes in rural children while identifying the cause-and-effect transmission mechanisms. We combined four waves of the rich Uganda National Panel Survey (UNPS), part of the World Bank Living Standards Measurement Studies (LSMS) for the period 2009-2014, with long-term and high-frequency rainfall and temperature datasets. Self-reported drought and flood shock variables were further used in separate regressions for triangulation purposes and robustness checks. Panel fixed effects regressions were applied in the empirical analysis, accounting for a variety of causal identification issues. The results showed significant negative outcomes for children’s anthropometric measurements due to the impacts of moderate and extreme droughts, extreme wet spells, and heatwaves. On the contrary, moderate wet spells were positively linked with nutritional measures. Agricultural production and child diarrhea were the main transmission channels, with heatwaves, droughts, and high rainfall variability negatively affecting crop output. The probability of diarrhea was positively related to increases in temperature and dry spells. Results further revealed that children in households who engaged in ex-ante or anticipatory risk-reducing strategies such as savings had better health outcomes as opposed to those engaged in ex-post coping such as involuntary change of diet. These results highlight the importance of adaptation in smoothing the harmful effects of climate variability on the health of rural households and children in Uganda.

Keywords: extreme weather events, undernutrition, diarrhea, agricultural production, gridded weather data

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Authors: Abdulaziz Alsadhan, Naveed Khan

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In recent years intrusions on computer network are the major security threat. Hence, it is important to impede such intrusions. The hindrance of such intrusions entirely relies on its detection, which is primary concern of any security tool like Intrusion Detection System (IDS). Therefore, it is imperative to accurately detect network attack. Numerous intrusion detection techniques are available but the main issue is their performance. The performance of IDS can be improved by increasing the accurate detection rate and reducing false positive. The existing intrusion detection techniques have the limitation of usage of raw data set for classification. The classifier may get jumble due to redundancy, which results incorrect classification. To minimize this problem, Principle Component Analysis (PCA), Linear Discriminant Analysis (LDA), and Local Binary Pattern (LBP) can be applied to transform raw features into principle features space and select the features based on their sensitivity. Eigen values can be used to determine the sensitivity. To further classify, the selected features greedy search, back elimination, and Particle Swarm Optimization (PSO) can be used to obtain a subset of features with optimal sensitivity and highest discriminatory power. These optimal feature subset used to perform classification. For classification purpose, Support Vector Machine (SVM) and Multilayer Perceptron (MLP) used due to its proven ability in classification. The Knowledge Discovery and Data mining (KDD’99) cup dataset was considered as a benchmark for evaluating security detection mechanisms. The proposed approach can provide an optimal intrusion detection mechanism that outperforms the existing approaches and has the capability to minimize the number of features and maximize the detection rates.

Keywords: Particle Swarm Optimization (PSO), Principle Component Analysis (PCA), Linear Discriminant Analysis (LDA), Local Binary Pattern (LBP), Support Vector Machine (SVM), Multilayer Perceptron (MLP)

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Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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Authors: Ilona Krone

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Maternal smoking during pregnancy increases the risk of perinatal/postnatal negative health outcomes; however, only 1 in 5 pregnant smokers quit smoking. That is a clinical and public health problem. Pregnant smokers have negative paternal support, and higher levels of perceived stress than non-smokers and quitters return to smoking in a stressful situation. A crisis like the COVID-19 outbreak causes significant uncertainty and stress. For pregnant women, additional stress may increase due to concerns for their fetus. Strategies targeting maternal stress and isolation may be particularly useful to prevent negative outcomes for women and their fetuses. Within the post-doctoral study, cooperating with leading specialists, an innovative program for pregnant smokers will be developed. Feasibility for reducing craving, distress intolerance, Covid 19 related stress, and fear in pregnant women in Latvia will be assessed.

Keywords: COVID 19, mindfulness, motivation, pregnancy, smoking cessation

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Authors: Nir Wittenberg, Moshe Farhi

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This mixed-methods study examines the integration of artificial intelligence (AI) tools in a first-year social work course to assess their potential for enhancing professional knowledge and skills. The incorporation of digital technologies, such as AI, in social work interventions, training, and research has increased, with the expectation that AI will become as commonplace as email and mobile phones. However, policies and ethical guidelines regarding AI, as well as empirical evaluations of its usefulness, are lacking. As AI is gradually being adopted in the field, it is prudent to explore AI thoughtfully in alignment with pedagogical goals. The outcomes assessed include professional identity, course satisfaction, and motivation. AI offers unique reflective learning opportunities through personalized simulations, feedback, and queries to complement face-to-face lessons. For instance, AI simulations provide low-risk practices for situations such as client interactions, enabling students to build skills with less stress. However, it is essential to recognize that AI alone cannot ensure real-world competence or cultural sensitivity. Outcomes related to student learning, experience, and perceptions will help to elucidate the best practices for AI integration, guiding faculty, and advancing pedagogical innovation. This strategic integration of selected AI technologies is expected to diversify course methodology, improve learning outcomes, and generate new evidence on AI’s educational utility. The findings will inform faculty seeking to thoughtfully incorporate AI into teaching and learning.

Keywords: artificial intelligence (AI), social work education, students, developing a professional identity, ethical considerations

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Authors: Sonia Arradaza-Pajaron

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College students are expected to engage in an on-the-job training or internship for completion of a course requirement prior to graduation. In this scenario, they are exposed to the real world of work outside their training institution. To find out their readiness both emotionally and academically, this study has been conducted. A descriptive-correlational research design was employed and random sampling technique method was utilized among 265 randomly selected third year college students of PIT, SY 2014-15. A questionnaire on Emotional Intelligence (bearing the four components namely; emotional literacy, emotional quotient competence, values and beliefs and emotional quotient outcomes) was fielded to the respondents and GWA was extracted from the school automate. Data collected were statistically treated using percentage, weighted mean and Pearson-r for correlation. Results revealed that respondents’ emotional intelligence level is moderately high while their academic performance is good. A high significant relationship was found between the EI component; Emotional Literacy and their academic performance while only significant relationship was found between Emotional Quotient Outcomes and their academic performance. Therefore, if EI influences academic performance significantly when correlated, a possibility that their OJT performance can also be affected either positively or negatively. Thus, EI can be considered predictor of their academic and academic-related performance. Based on the result, it is then recommended that the institution would try to look deeply into the consideration of embedding emotional intelligence as part of the (especially on Emotional Literacy and Emotional Quotient Outcomes of the students) college curriculum. It can be done if the school shall have an effective Emotional Intelligence framework or program manned by qualified and competent teachers, guidance counselors in different colleges in its implementation.

Keywords: academic performance, emotional intelligence, college students, academic success

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Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker

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Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.

Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation

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Authors: Jared R. Chapman

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This study introduces a type of motivational information system called an educational engagement information system (EEIS). An EEIS draws on principles of behavioral economics, motivation theory, and learning cognition theory to design information systems that help students want to improve their performance. This study compares academic outcomes for course sections taught by part- and full-time instructors both with and without an EEIS. Without an EEIS, students in the part-time instructor's course sections demonstrated significantly higher failure rates (a 143.8% increase) and dropout rates (a 110.4% increase) with significantly fewer students scoring a B- or higher (39.8% decrease) when compared to students in the course sections taught by a full-time instructor. It is concerning that students in the part-time instructor’s course without an EEIS had significantly lower academic outcomes, suggesting less understanding of the course content. This could impact retention and continuation in a major. With an EEIS, when comparing part- and full-time instructors, there was no significant difference in failure and dropout rates or in the number of students scoring a B- or higher in the course. In fact, with an EEIS, the failure and dropout rates were statistically identical for part- and full-time instructor courses. When using an EEIS (compared with not using an EEIS), the part-time instructor showed a 62.1% decrease in failures, a 61.4% decrease in dropouts, and a 41.7% increase in the number of students scoring a B- or higher in the course. We are unaware of other interventions that yield such large improvements in academic performance. This suggests that using an EEIS such as Delphinium may compensate for part-time instructors’ limitations of expertise, time, or rewards that can have a negative impact on students’ academic outcomes. The EEIS had only a minimal impact on failure rates (7.7% decrease) and dropout rates (18.8% decrease) for the full-time instructor. This suggests there is a ceiling effect for the improvements that an EEIS can make in student performance. This may be because experienced instructors are already doing the kinds of things that an EEIS does, such as motivating students, tracking grades, and providing feedback about progress. Additionally, full-time instructors have more time to dedicate to students outside of class than part-time instructors and more rewards for doing so. Using adjunct and other types of part-time instructors will likely remain a prevalent practice in higher education management courses. Given that using part-time instructors can have a negative impact on student graduation and persistence in a field of study, it is important to identify ways we can augment part-time instructors’ performance. We demonstrated that when part-time instructors use an EEIS, it can result in significantly lower students’ failure and dropout rates and an increase in the rate of students earning a B- or above; and bring their students’ performance to parity with the performance of students taught by a full-time instructor.

Keywords: gamification, engagement, motivation, academic outcomes

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Authors: Hepinda Fajari Nuharini, Sugiarti A. Musabiq

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Background: Various and continuous pressures that exceed individual resources can cause first-year undergraduate college students to experience psychological distress. Psychological distress can occur when individuals use rumination as cognitive coping strategies. Rumination is one of the cognitive coping strategies that can be used by individuals to respond to psychological distress that causes individuals to think about the causes and consequences of events that have occurred. Rumination had two subtypes, such as brooding and reflective. Therefore, the purpose of this study was determining the role of brooding and reflective as subtypes of rumination toward psychological distress in University of Indonesia first-year undergraduate students. Methods: Participants of this study were 403 University of Indonesia first-year undergraduate students aged between 18 and 21 years old. Psychological distress measured using self reporting questionnaire (SRQ-20) and brooding and reflective as subtypes of rumination measured using Ruminative Response Scale - Short Version (RRS - Short Version). Results: Binary logistic regression analyses showed that 22.8% of the variation in psychological distress could be explained by the brooding and reflective as subtypes of rumination, while 77.2% of the variation in psychological distress could be explained by other factors (Nagelkerke R² = 0,228). The results of the binary logistic regression analysis also showed rumination subtype brooding is a significant predictor of psychological distress (b = 0,306; p < 0.05), whereas rumination subtype reflective is not a significant predictor of psychological distress (b = 0,073; p > 0.05). Conclusion: The findings of this study showed a positive relationship between brooding and psychological distress indicates that a higher level of brooding will predict higher psychological distress. Meanwhile, a negative relationship between reflective and psychological distress indicates a higher level of reflective will predict lower psychological distress in University of Indonesia first-year undergraduate students. Added Values: The psychological distress among first-year undergraduate students would then have an impact on student academic performance. Therefore, the results of this study can be used as a reference for making preventive action to reduce the percentage and impact of psychological distress among first-year undergraduate students.

Keywords: brooding as subtypes of rumination, first-year undergraduate students, psychological distress, reflective as subtypes of rumination

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Authors: F. Arıkan, Z. Karakus

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Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

Keywords: cancer patients, e-learning, nursing, web based education

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Authors: Adeyemi Adeyinka, Yemisi Ilesanmi

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This study investigated parental involvement and motivation as predictors of students’ learning outcomes in value concepts in Yoruba language in Ibadan, Nigeria. Value concepts in Yoruba language aimed at teaching moral lessons and transmitting Yoruba culture. However, feelers from schools and the society reported students’ poor achievement in examinations and negative attitude to the subject. Previous interventions focused on teaching strategies with little consideration for student-related factors. The study was anchored on psychosocial learning theory. The respondents were senior secondary II students with mean age of 15.50 ± 2.25 from 20 public schools in Ibadan, Oyo-State. In all, 1000 students were selected (486 males and 514 females) through proportionate to sample size technique. Instruments used were Students’ Motivation (r=0.79), Parental Involvement (r=0.87), and Attitude to Yoruba Value Concepts (r=0.94) scales and Yoruba Value Concepts Achievement Test (r=0.86). Data were analyzed using descriptive statistics, Pearson product moment correlation and Multiple regressions at 0.05 level of significance. Findings revealed a significant relationship between parental involvement (r=0.54) and students’ achievement in and attitude to (r=0.229) value concepts in Yoruba. The composite contribution of parental involvement and motivation to students’ achievement and attitude was significant, contributing 20.3% and 5.1% respectively. The relative contributions of parental involvement to students’ achievement (β = 0.073; t = 1.551) and attitude (β = 0.228; t = 7.313) to value concepts in Yoruba were significant. Parental involvement was the independent variable that strongly predicts students’ achievement in and attitude to Yoruba value concepts. Parents should inculcate indigenous knowledge in their children and support its learning at school.

Keywords: parental involvement, motivation, predictors, learning outcomes, value concepts in Yoruba

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Authors: D. Leibman, D. Wolf, A. Gal-On

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Viral diseases of tomato crops result in heavy yield losses and may even jeopardize the production of these crops. Classical tomato breeding for disease resistance against Tomato yellow leaf curl virus (TYLCV), leads to partial resistance associated with a number of recessive genes. To author’s best knowledge Pepino mosaic virus (PepMV) genetic resistance is not yet available. The generation of viral resistance by means of genetic engineering was reported and implemented for many crops, including tomato. Transgenic resistance against viruses is based, in most cases, on Post Transcriptional Gene Silencing (PTGS), an endogenous mechanism which destroys the virus genome. In this work, we developed immunity against PepMV and TYLCV in a tomato based on a PTGS mechanism. Tomato plants were transformed with a hairpin-construct-expressed transgene-derived double-strand-RNA (tr-dsRNA). In the case of PepMV, the binary construct harbored three consecutive fragments of the replicase gene from three different PepMV strains (Italian, Spanish and American), to provide resistance against a range of virus strains. In the case of TYLCV, the binary vector included three consecutive fragments of the IR, V2 and C2 viral genes constructed in a hairpin configuration. Selected transgenic lines (T0) showed a high accumulation of transgene siRNA of 21-24 bases, and T1 transgenic lines showed complete immunity to PepMV and TYLCV. Graft inoculation displayed immunity of the transgenic scion against PepMV and TYLCV. The study presents the engineering of resistance in tomato against two serious diseases, which will help in the production of high-quality tomato. However, unfortunately, these resistant plants have not been implemented due to public ignorance and opposition against breeding by genetic engineering.

Keywords: PepMV, PTGS, TYLCV, tr-dsRNA

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Authors: Hee-Young Song

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Background and objectives: In 2011, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations proposed a multidimensional assessment of patients’ conditions that included both functional parameters and patient-reported outcomes, with the aim to provide a comprehensive assessment of the disease, thus meeting both the needs of the patient and the role of the physician. However, few studies have evaluated patient-reported outcomes as well as objective functional assessments among individuals with chronic obstructive pulmonary disease (COPD) in clinical practice in Korea. This study was undertaken to explore the relationship between functional status assessed by the 6-minute walking distance (MWD) test and subjective health status reported by stable patients with COPD residing in community. Methods: A cross-sectional descriptive study was conducted with 118 stable COPD patients aged 69.4 years old and selected by a convenient sampling from an outpatient department of pulmonology in a tertiaryhospitals. The 6-MWD test was conducted according to standardized instructions. Participants also completed a constructed questionnaire including general characteristics, smoking history, dyspnea by modified medical research council (mMRC) scale, and health status by COPD assessment test (CAT). Anthropometric measurements were performed for body mass index (BMI). Medical records were reviewed to obtain disease-related characteristics including duration of the disease and forced expiratory volume in 1 second (FEV1). Data were analyzed using PASW statistics 20.0. Results: Mean FEV1% of participants was 63.51% and mean 6-MWD and CAT scores were 297.54m and 17.7, respectively. The 6-MWD and CAT showed significant negative correlations (r= -.280, p=.002); FEV1 and CAT did as well correlations (r= -.347, p < .001). Conclusions: Findings suggest that the better functional status an individual with COPD has, the better subjective health status is, and provide the support for using patient-reported outcomes along with functional parameters to facilitate comprehensive assessment of COPD patients in real clinical practices.

Keywords: chronic obstructive pulmonary disease, COPD assessment test, functional status, patient-reported outcomes

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Authors: Joel Mintz, Kyle Huntley, Waseem Wahood, Samuel Raine, Farzanna Haffizulla

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The effect of different state government interventions on COVID-19 health outcomes is currently unknown. Stay at home (SAH) orders, all non-essential business closures and school closures in the Northeastern US were examined. A linear correlation between the peak number of new daily COVID-19 positive tests, hospitalizations and deaths per capita and the elapsed time between government issued guidance and a fixed number of COVID-19 deaths in each state was performed. Earlier government interventions were correlated with lower peak healthcare burden. Statewide closures of schools and non-essential businesses showed significantly greater (p<.001) correlation to peak COVID-19 disease burden as compared to a statewide SAH. The implications of these findings require further study to determine the effectiveness of these interventions.

Keywords: Coronavirus, epidemiology, government intervention, public health, social distancing

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Authors: Sharon Millen, Sarah Miller, Laura Dunne, Clare McGeady, Laura Neeson

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This paper presents the findings from a randomised controlled trial (RCT) and process evaluation of the Lifestart parenting programme. Lifestart is a structured child-centred programme of information and practical activity for parents of children aged from birth to five years of age. It is delivered to parents in their own homes by trained, paid family visitors and it is offered to parents regardless of their social, economic or other circumstances. The RCT evaluated the effectiveness of the programme and the process evaluation documented programme delivery and included a qualitative exploration of parent and child outcomes. 424 parents and children participated in the RCT: 216 in the intervention group and 208 in the control group across the island of Ireland. Parent outcomes included: parental knowledge of child development, parental efficacy, stress, social support, parenting skills and embeddedness in the community. Child outcomes included cognitive, language and motor development and social-emotional and behavioural development. Both groups were tested at baseline (when children were less than 1 year old), mid-point (aged 3) and at post-test (aged 5). Data were collected during a home visit, which took two hours. The process evaluation consisted of interviews with parents (n=16 at baseline and end-point), and focus groups with Lifestart Coordinators (n=9) and Family Visitors (n=24). Quantitative findings from the RCT indicated that, compared to the control group, parents who received the Lifestart programme reported reduced parenting-related stress, increased knowledge of their child’s development, and improved confidence in their parenting role. These changes were statistically significant and consistent with the hypothesised pathway of change depicted in the logic model. There was no evidence of any change in parents’ embeddedness in the community. Although four of the five child outcomes showed small positive change for children who took part in the programme, these were not statistically significant and there is no evidence that the programme improves child cognitive and non-cognitive skills by immediate post-test. The qualitative process evaluation highlighted important challenges related to conducting trials of this magnitude and design in the general population. Parents reported that a key incentive to take part in study was receiving feedback from the developmental assessment, which formed part of the data collection. This highlights the potential importance of appropriate incentives in relation to recruitment and retention of participants. The interviews with intervention parents indicated that one of the first changes they experienced as a result of the Lifestart programme was increased knowledge and confidence in their parenting ability. The outcomes and pathways perceived by parents and described in the interviews are also consistent with the findings of the RCT and the theory of change underpinning the programme. This hypothesises that improvement in parental outcomes, arising as a consequence of the programme, mediate the change in child outcomes. Parents receiving the Lifestart programme reported great satisfaction with and commitment to the programme, with the role of the Family Visitor being identified as one of the key components of the programme.

Keywords: parent-child relationship, parental self-efficacy, parental stress, school readiness

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Authors: Jin Hun Choi, So Hyun Ahn, Seong Keun Wang, Ik-Seung Chee, Jung Lan Kim, Sun Woo Lee

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Objectives: The purpose of the study is to investigate the effects of day hospital care in hospitalized schizophrenic patients in terms of treatment adherence and treatment outcomes. Methods: Among schizophrenic patients hospitalized between 2011 and 2012, 23 day hospital care patient and 40 control subjects were included in the study. All candidates underwent Beck Cognitive Insight Scale, Drug Attitude Inventory, World Health Organization Quality of Life Assessment and Psychological Well-Being Scale when their symptoms were stabilized during hospitalization, and after being discharged, 23 patients received day hospital care for two months and then changed to out-patient care while 40 patients received out-patient care immediately after discharge. At the point of two months of out-patient care, the treatment adherence of the two groups was evaluated; tracking observation was performed until February, 2013, and survival rates were compared between the two groups. Results: Treatment adherence was higher in the day hospital care group than in the control group. Kaplan-Meier survival analysis showed a higher survival rate for the day hospital care group compared to the control group. Levels of cognitive insight and quality of life were higher after day hospital care than before day hospital care in the day hospital care group. Conclusions: Through the study, it was confirmed that when hospitalized schizophrenic patients received continuous day hospital care after being discharged, they received further out-patient care more faithfully. The study is considered to aid in the understanding regarding schizophrenic patients’ treatment adherence issues and improvement of treatment outcomes.

Keywords: schizophrenia, day hospital care, adherence, outcomes

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Authors: Husham Bayazed

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Immune responses following surgical trauma play a pivotal role in predicting postoperative outcomes from healing and recovery to postoperative complications. Postoperative complications, including infections and protracted recovery, occur in a significant number of about 300 million surgeries performed annually worldwide. Complications cause personal suffering along with a significant economic burden on the healthcare system in any community. The accurate prediction of postoperative complications and patient-targeted interventions for their prevention remain major clinical provocations. Recent Findings: Recent studies are focusing on immune dysregulation mechanisms that occur in response to surgical trauma as a key determinant of postoperative complications. Antecedent studies mainly were plunging into the detection of inflammatory plasma markers, which facilitate in providing important clues regarding their pathogenesis. However, recent Single-cell technologies, such as mass cytometry or single-cell RNA sequencing, have markedly enhanced our ability to understand the immunological basis of postoperative immunological trauma complications and to identify their prognostic biological signatures. Summary: The advent of proteomic technologies has significantly advanced our ability to predict the risk of postoperative complications. Multiomic modeling of patients' immune states holds promise for the discovery of preoperative predictive biomarkers and providing patients and surgeons with information to improve surgical outcomes. However, more studies are required to accurately predict the risk of postoperative complications in individual patients.

Keywords: immune dysregulation, postoperative complications, surgical trauma, flow cytometry

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Authors: Wynne De Jong, Robert Miller, Ross Riggs

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Beyond the number of nurses providing care for patients, having nurses with the right skills, experience and education is essential to ensure the best possible outcomes for patients. Research studies continue to link nurse staffing and skill mix with nurse-sensitive patient outcomes; numerous studies clearly show that superior patient outcomes are associated with higher levels of regulated staff. Due to the limited number of tools and processes available to assist nurse leaders with staffing models of care, nurse leaders are constantly faced with the ongoing challenge to ensure their staffing models of care best suit their patient population. In 2009, several hospitals in Ontario, Canada participated in a research study to develop and evaluate an RN/RPN utilization toolkit. The purpose of this study was to develop and evaluate a toolkit for Registered Nurses/Registered Practical Nurses Staff mix decision-making based on the College of Nurses of Ontario, Canada practice standards for the utilization of RNs and RPNs. This paper will highlight how an organization has further developed the Patient Care Needs Assessment (PCNA) questionnaire, a major component of the toolkit. Moreover, it will demonstrate how it has utilized the information from PCNA to clearly identify patient and family care needs, thus providing evidence-based results to assist leaders with matching the best staffing skill mix to their patients.

Keywords: nurse staffing models of care, skill mix, nursing health human resources, patient safety

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Authors: Regina Rahimi, Delores Liston

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The advent of COVID-19 has heightened awareness of the need for social emotional learning (SEL) throughout all educational contexts. Given this, schools (most often p12 settings) have begun to embrace practices for addressing social-emotional learning. While there is a growing body of research and literature on common practices of SEL, there is no ‘standard’ for its implementation. Our work proposed here recognizes there is no universal approach for addressing SEL and rather, seeks to explore how SEL can be approached in and through diverse contexts. We assert that left unrecognized and unaddressed by teachers, issues with social and emotional well-being profoundly negatively affect students’ academic performance and exacerbate teacher stress. They contribute to negative student-teacher relationships, poor classroom management outcomes, and compromised academic outcomes. Therefore, teachers and administrators have increasingly turned to developing pedagogical and classroom practices that support the social and emotional dimensions of students. Substantive quantitative evidence indicates professional development training to improve awareness and foster positive teacher-student relationships can provide a protective function for psycho-social outcomes and a promotive factor for improved learning outcomes for students. Our work aims to add to the growing body of literature on improving student well-being by providing a unique examination of SEL through a lens of diverse contexts. Methodology: This presentation hopes to present findings from an edited volume that will seek to highlight works that examine SEL practices in a variety of academic settings. The studies contained within the work represent varied forms of qualitative research. Conclusion: This work provides examples of SEL in higher education/postsecondary settings, a variety of P12 academic settings (public; private; rural, urban; charter, etc.), and international contexts. This work demonstrates the variety of ways educational institutions and educators have used SEL to address the needs of students, providing examples for others to adapt to their own diverse contexts. This presentation will bring together exemplar models of SEL in diverse practice settings.

Keywords: social emotional learning, teachers, classrooms, diversity

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Authors: Derrick Mirindi, Frederic Mirindi, Oluwakemi Oshineye

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The ongoing high rate of construction project failures worldwide is often blamed on the difficulties of managing stakeholders. This highlights the crucial role of strategic management (SM) in achieving project success. This study investigates how integrating digital tools into the SM framework can effectively address stakeholder-related challenges. This work specifically focuses on the impact of evolving digital tools, such as Project Management Software (PMS) (e.g., Basecamp and Wrike), Building Information Modeling (BIM) (e.g., Tekla BIMsight and Autodesk Navisworks), Virtual and Augmented Reality (VR/AR) (e.g., Microsoft HoloLens), drones and remote monitoring, and social media and Web-Based platforms, in improving stakeholder engagement and project outcomes. Through existing literature with examples of failed projects, the study highlights how the evolution of digital tools will serve as facilitators within the strategic management process. These tools offer benefits such as real-time data access, enhanced visualization, and more efficient workflows to mitigate stakeholder challenges in construction projects. The findings indicate that integrating digital tools with SM principles effectively addresses stakeholder challenges, resulting in improved project outcomes and stakeholder satisfaction. The research advocates for a combined approach that embraces both strategic management and digital innovation to navigate the complex stakeholder landscape in construction projects.

Keywords: strategic management, digital tools, virtual and augmented reality, stakeholder management, building information modeling, project management software

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Authors: Arnold M. Brener, Lesbek Tashimov, Ablakim S. Muratov

Abstract:

The paper deals with the special model for coagulation kernels which represents new control parameters in the Smoluchowski equation for binary aggregation. On the base of the model the new approach to evaluating aggregative stability of disperse systems has been submitted. With the help of this approach the simple estimates for aggregative stability of various types of hydrophilic nano-suspensions have been obtained.

Keywords: aggregative stability, coagulation kernels, disperse systems, mathematical model

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Authors: Elaine Wong Yee-Sing

Abstract:

Older adults are at high risk of chronic health conditions in Singapore. A closer examination at all facets of their aging process has revealed that they may not be necessary aging well. This demands for an increasing healthcare services brought to their home environment due to limited mobility and in the interest of time management. The home environment is an ideal setting to implement self-directed health promoting activities at their convenience and enable family’s support and motivation. This research protocol aims to explore their healthcare concerns, and creation of age appropriate interventions targeted to improve their chronic disease biomarkers. Convenience sampling of 130 families residing in private housing within five major districts in Singapore will be selected to participate in the health intervention. Statistical Package for Social Science 25 will be used to examine the pre and post screening results of their lipid, glycaemia and anthropometric outcomes. Using focus interviews, data results will be translated and transcribed to investigate on enablers, barriers and improvement on these services. Both qualitative and quantitative research outcomes are crucial to examine the impact of these services for these older adults living in private housing as they are not exposed to government subsidized community health programs. It is hypothesized that provision of relevant yet engaging health programs at their homes may mitigate the rising burden of chronic health conditions and result in successful aging outcomes among older Singaporeans.

Keywords: chronic diseases, health program, older adults, residential homes

Procedia PDF Downloads 155

Authors: Sarika Gupta, Harshika Khanna, Ajay K Verma, Surya Kant

Abstract:

Background: Drug-resistant tuberculosis (DR-TB) is a growing health challenge to global TB control efforts. Pediatric DR-TB is one of the neglected infectious diseases. In our previously published report, we have notified an increased prevalence of DR-TB in the pediatric population at a tertiary health care centre in North India which was estimated as 17.4%, 15.1%, 18.4%, and 20.3% in (%) in the year 2018, 2019, 2020, and 2021. Limited evidence exists about a pattern of drug resistance, side effect profile and programmatic outcomes of Paediatric DR-TB treatment. Therefore, this study was done to find out the pattern of resistance, side effect profile and treatment outcome. Methodology: This was a prospective cohort study conducted at the nodal drug-resistant tuberculosis centre of a tertiary care hospital in North India from January 2021 to December 2022. Subjects included children aged between 0-18 years of age with a diagnosis of DR-TB, on the basis of GeneXpert (rifampicin [RIF] resistance detected), line probe assay and drug sensitivity testing (DST) of M. tuberculosis (MTB) grown on a culture of body fluids. Children were classified as monoresistant TB, polyresistant TB (resistance to more than 1 first-line anti-TB drug, other than both INH and RIF), MDR-TB, pre-XDR-TB and XDR-TB, as per the WHO classification. All the patients were prescribed DR TB treatment as per the standard guidelines, either shorter oral DR-TB regimen or a longer all-oral MDR/XDR-TB regimen (age below five years needed modification). All the patients were followed up for side effects of treatment once per month. The patient outcomes were categorized as good outcomes if they had completed treatment and cured or were improving during the course of treatment, while bad outcomes included death or not improving during the course of treatment. Results: Of the 50 pediatric patients included in the study, 34 were females (66.7%) and 16 were male (31.4%). Around 33 patients (64.7%) were suffering from pulmonary TB, while 17 (33.3%) were suffering from extrapulmonary TB. The proportions of monoresistant TB, polyresistant TB, MDR-TB, pre-XDR-TB and XDR-TB were 2.0%, 0%, 50.0%, 30.0% and 18.0%, respectively. Good outcome was reported in 40 patients (80.0%). The 10 bad outcomes were 7 deaths (14%) and 3 (6.0%) children who were not improving. Adverse events (single or multiple) were reported in all the patients, most of which were mild in nature. The most common adverse events were metallic taste 16(31.4%), rash and allergic reaction 15(29.4%), nausea and vomiting 13(26.0%), arthralgia 11 (21.6%) and alopecia 11 (21.6%). Serious adverse event of QTc prolongation was reported in 4 cases (7.8%), but neither arrhythmias nor symptomatic cardiac side effects occurred. Vestibular toxicity was reported in 2(3.9%), and psychotic symptoms in 4(7.8%). Hepatotoxicity, hypothyroidism, peripheral neuropathy, gynaecomastia, and amenorrhea were reported in 2 (4.0%), 4 (7.8%), 2 (3.9%), 1(2.0%), and 2 (3.9%) respectively. None of the drugs needed to be withdrawn due to uncontrolled adverse events. Conclusion: Paediatric DR TB treatment achieved favorable outcomes in a large proportion of children. DR TB treatment regimen drugs were overall well tolerated in this cohort.

Keywords: pediatric, drug-resistant, tuberculosis, adverse events, treatment

Procedia PDF Downloads 56

Authors: Mirindi Derrick, Mirindi Frederic, Oluwakemi Oshineye

Abstract:

Abstract: The ongoing high rate of construction project failures worldwide is often blamed on the difficulties of managing stakeholders. This highlights the crucial role of strategic management (SM) in achieving project success. This study investigates how integrating digital tools into the SM framework can effectively address stakeholder-related challenges. This work specifically focuses on the impact of evolving digital tools, such as Project Management Software (PMS) (e.g., Basecamp and Wrike), Building Information Modeling (BIM) (e.g., Tekla BIMsight and Autodesk Navisworks), Virtual and Augmented Reality (VR/AR) (e.g., Microsoft HoloLens), drones and remote monitoring, and social media and Web-Based platforms, in improving stakeholder engagement and project outcomes. Through existing literature with examples of failed projects, the study highlights how the evolution of digital tools will serve as facilitators within the strategic management process. These tools offer benefits such as real-time data access, enhanced visualization, and more efficient workflows to mitigate stakeholder challenges in construction projects. The findings indicate that integrating digital tools with SM principles effectively addresses stakeholder challenges, resulting in improved project outcomes and stakeholder satisfaction. The research advocates for a combined approach that embraces both strategic management and digital innovation to navigate the complex stakeholder landscape in construction projects.

Keywords: strategic management, digital tools, virtual and augmented reality, stakeholder management, building information modeling, project management software

Procedia PDF Downloads 33

Authors: Tony Mann

Abstract:

This paper sets out the case for involving and engaging employees/workers/stakeholders/staff in any significant change that is being considered by the senior executives of the organization. It establishes the rationale, the approach, the methodology of engagement and the benefits of a participative approach. It challenges the new norm of imposing change for fear of resistance and instead suggests that involving people has better outcomes and a longer-lasting impact. Various strategic models are introduced and illustrated to explain how the process can be most effective. The paper highlights one model in particular (the Process Iceberg® Organizational Change model) that has proven to be instrumental in developing effective change. Its use is demonstrated in its various forms and explains why so much change fails to address the key elements and how we can be more productive in managing change. ‘Participation’ in change is too often seen as negative, expensive and unwieldy. The paper aims to show that another model: UIA=O+E, can offset the difficulties and, in fact, produce much more positive and effective change.

Keywords: facilitation, stakeholders, buy-in, digital workshops

Procedia PDF Downloads 92

Authors: Adriana C. Panayi, Riaz A. Agha, Brady A. Sieber, Dennis P. Orgill

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Background: Increased rates of both breast cancer and obesity have resulted in more women seeking breast reconstruction. These women may be at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who have undergone breast reconstruction following mastectomy. Methods: Cochrane, PUBMED and EMBASE electronic databases were screened and data was extracted from included studies. The clinical outcomes assessed were surgical complications, medical complications, length of postoperative hospital stay, reoperation rate and patient satisfaction. Results: 33 studies met the inclusion criteria for the review and 29 provided enough data to be included in the meta-analysis (71368 patients, 20061 of which were obese). Obese women were 2.3 times more likely to experience surgical complications (95 percent CI 2.19 to 2.39; P < 0.00001), 2.8 times more likely to have medical complications (95 percent CI 2.41 to 3.26; P < 0.00001) and had a 1.9 times higher risk of reoperation (95 percent CI 1.75 to 2.07; P < 0.00001). The most common complication, wound dehiscence, was 2.5 times more likely in obese women (95 percent CI 1.80 to 3.52; P < 0.00001). Sensitivity analysis confirmed that obese women were more likely to experience surgical complications (RR 2.36, 95% CI 2.22–2.52; P < 0.00001). Conclusions: This study provides evidence that obesity increases the risk of complications in both implant and autologous reconstruction. Additional prospective and observational studies are needed to determine if weight reduction prior to reconstruction reduces the perioperative risks associated with obesity.

Keywords: autologous reconstruction, breast cancer, breast reconstruction, literature review, obesity, oncology, prosthetic reconstruction

Procedia PDF Downloads 297

Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

Abstract:

Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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Authors: Pratap K. Chhotaray, Jitendriya Swain, Ashok Mishra, Ramesh L. Gardas

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Ionic liquids (ILs) are molten salts, consist predominantly of ions and found to be liquid below 100°C. The unparalleled growing interest in ILs is based upon their never ending design flexibility. The use of ILs as a co-solvent in binary as well as a ternary mixture with molecular solvents multifold it’s utility. Since polarity is one of the most widely applied solvent concepts which represents simple and straightforward means for characterizing and ranking the solvent media, its study for a binary mixture of ILs is crucial for its widespread application and development. The primary approach to the assessment of solution phase intermolecular interactions, which generally occurs on the picosecond to nanosecond time scales, is to exploit the optical response of photophysical probe. Pyrene butyric acid (PBA) is used as fluorescence probe due to its high quantum yield, longer lifetime and high solvent polarity dependence of fluorescence spectra. Propylammonium formate (PAF) is the IL used for this study. Both the UV-absorbance spectra and steady state fluorescence intensity study of PBA in different concentration of aqueous PAF, reveals that with an increase in PAF concentration, both the absorbance and fluorescence intensity increases which indicate the progressive solubilisation of PBA. Whereas, near about 50% of IL concentration, all of the PBA molecules get solubilised as there are no changes in the absorbance and fluorescence intensity. Furthermore, the ratio II/IV, where the band II corresponds to the transition from S1 (ν = 0) to S0 (ν = 0), and the band IV corresponds to transition from S1 (ν = 0) to S0 (ν = 2) of PBA, indicates that the addition of water into PAF increases the polarity of the medium. Time domain lifetime study shows an increase in lifetime of PBA towards the higher concentration of PAF. It can be attributed to the decrease in non-radiative rate constant at higher PAF concentration as the viscosity is higher. The monoexponential decay suggests that homogeneity of solvation environment whereas the uneven width at full width at half maximum (FWHM) indicates there might exist some heterogeneity around the fluorophores even in the water-IL mixed solvents.

Keywords: fluorescence, ionic liquid, lifetime, polarity, pyrene butyric acid

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Authors: Jitendra Jain, Cassandra Hidajat, Hansraj Riteesh Bookun

Abstract:

Graft patency underpins long-term prognosis after coronary artery bypass grafting surgery (CABG). The benefits of the combined use of only the left internal mammary artery and radial artery, referred to as total arterial revascularisation (TAR), on long-term clinical outcomes and quality of life are relatively unknown. The aim of this study was to identify whether there were differences in long term clinical outcomes between recipients of TAR compared to a cohort of mostly arterial revascularization involving the left internal mammary, at least one radial artery and at least one saphenous vein graft. A retrospective analysis was performed on all patients who underwent TAR or were re-vascularized with supplementary saphenous vein graft from February 1996 to December 2004. Telephone surveys were conducted to obtain clinical outcome parameters including major adverse cardiac and cerebrovascular events (MACCE) and Short Form (SF-36v2) Health Survey responses. A total of 176 patients were successfully contacted to obtain postop follow up results. The mean follow-up length from time of surgery in our study was TAR 12.4±1.8 years and conventional 12.6±2.1. PCS score was TAR 45.9±8.8 vs LIMA/Rad/ SVG 44.9±9.2 (p=0.468) and MCS score was TAR 52.0±8.9 vs LIMA/Rad/SVG 52.5±9.3 (p=0.723). There were no significant differences between groups for NYHA class 3+ TAR 9.4% vs. LIMA/Rad/SVG 6.6%; or CCS 3+ TAR 2.35% vs. LIMA/Rad/SVG 0%.

Keywords: CABG; MACCEs; quality of life; total arterial revascularisation

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