Search results for: guideline adherence
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 667

Search results for: guideline adherence

277 Sustainable Urban Mobility: Rethinking the Bus Stop Infrastructures of Dhaka South

Authors: Hasnun Wara Khondker, M. Tarek Morad

Abstract:

Bangladesh is one of the most populous countries of the world in terms of density. Dhaka, the capital of Bangladesh currently has a population of approximately 15-16 million of which around 9 million people are accommodated in Dhaka South City Corporation (DSCC) within around 109 square kilometer area. Despite having various urban issues, country is at its pick of economic progress and Dhaka is the core of this economic growth. To ensure the proper economic development and citizens wellbeing, city needs an ingenious, congestion-free public transportation network. Bus stop/bus bay is an essential infrastructure for ensuring efficient public transportation flow within the city along with enhancing accessibility, user comfort, and safety through public amenities. At present, there is no established Mass Rapid Transit or Bus Rapid Transit network within the city and therefore these private owned buses are the only major mode of mass transportation of Dhaka city. DSCC has undertaken a project to re-design several bus stops and bus bays according to the universal standard for better urban mobility and user satisfaction. This paper will analyze the design approach of the bus stop/bay infrastructure within Dhaka South, putting the research lens on sustainable urban mobility with case studies of similar kind of urban context. The paper will also study the design process with setting several parameters, i.e., accessibility, passenger safety, comfort, sustainability, etc. Moreover, this research will recommend a guideline for designing a bus stop based on the analysis of the design methods.

Keywords: bus stop, Dhaka, public transportation, sustainable urban mobility, universal accessibility, user safety

Procedia PDF Downloads 349
276 Application of Scoring Rubrics by Lecturers towards Objective Assessment of Essay Questions in the Department of Social Science Education, University of Calabar, Nigeria

Authors: Donald B. Enu, Clement O. Ukpor, Abigail E. Okon

Abstract:

Unreliable scoring of students’ performance by lecturers short-chains students’ assessment in terms of underequipping the school authority with facts as intended by society through the curriculum hence, the learners, the school and the society are cheated because the usefulness of testing is defeated. This study, therefore, examined lecturers’ scoring objectivity of essay items in the Department of Social Science Education, University of Calabar, Nigeria. Specifically, it assessed lecturers’ perception of the relevance of scoring rubrics and its level of application. Data were collected from all the 36 lecturers in the Department (28 members and 8 non-members adjourned to the department), through a 20-item questionnaire and checklist instruments. A case-study design was adopted. Descriptive statistics of frequency counts, weighted means, standard deviations, and percentages were used to analyze data gathered. A mean score of 2.5 and or 60 percent and above formed the acceptance or significant level in decision taking. It was found that lecturers perceived the use of scoring rubrics as a relevant practice to ensure fairness and reliable treatment of examiners scripts particularly in marking essay items and that there is a moderately high level of adherence to the application of scoring rubrics. It was also observed that some criteria necessary for the scoring objectivity of essay items were not fully put in place in the department. It was recommended strongly that students’ identities be hidden while marking and that pre-determined marking scheme should be prepared centrally and strictly adhered to during marking and recording of scores. Conference marking should be enforced in the department.

Keywords: essay items, objective scoring, scorers reliability, scoring rubrics

Procedia PDF Downloads 152
275 The Relationship between Self-Care Behaviour and Quality of Life Among Heart Failure Patients in Jakarta, Indonesia

Authors: Shedy Maharani Nariswari, Prima Agustia Nova, I. Made Kariasa

Abstract:

Background. Heart Failure (HF) is a chronic and progressive condition associated with significant morbidity, mortality, health care expenditures, and a high readmission rate over the years. Self‐care is essential to manage chronic heart failure in the long term, and it is related to better outcomes and can enhance the quality of life. Objective. The aims of this study were to describe the relationship between self-care behavior and quality of life among heart failure patients in East Jakarta, Indonesia. Methods. This study used a correlational-descriptive design with a cross-sectional study, the sampling method used purposive sampling method. Self-care was measured using Self-care Heart Failure Index version 6.2, and quality of life was measured using The Minnesota Living with Heart Failure. Pearson correlation and Spearman-rho correlations are used to analyze the data. Results. We recruited 103 patients with HF in both outpatient and inpatient ward: mean age 59.26 ± 11.643 years, 63.1% male. Patients with higher levels of education were associated with higher self-care maintenance (p= 0.007). The patient's average quality of life is quite high, with a score of 72,07 ± 16,89. There were a significant relationship among self-care maintenance (r=0,305, p=0,001), self-care management (r=0,330, p=0,001), and self-care confidence (r=0,335, p=0,001) towards the quality of life. Most participants have inadequate self-care maintenance, self-care management, and self-care confidence (score < 70), while the score of quality of life is categorized as poor. Conclusion. The self-care behaviors were limited among patients living with HF in Indonesia yet was associated with better quality of life. It is necessary to promote health related to knowledge and adherence to self-care behavior so that it can improve the quality of life of heart failure patients. This study can be used as a reference to promote self-care among patients with heart failure, it can help to enhance their quality of life.

Keywords: heart failure, self-care maintenance, self-care management, self-care confidence, quality of life

Procedia PDF Downloads 82
274 Revisiting Domestication and Foreignisation Methods: Translating the Quran by the Hybrid Approach

Authors: Aladdin Al-Tarawneh

Abstract:

The Quran, as it is the sacred book of Islam and considered the literal word of God (Allah) in Arabic, is highly translated into many languages; however, the foreignising or the literal approach excessively stains the quality and discredits the final product in the eyes of its receptors. Such an approach fails to capture the intended meaning of the Quran and to communicate it in any language. Therefore, this study is conducted to propose a different approach that seeks involving other ones according to a hybrid model. Indeed, this study challenges the binary adherence that is highly used in Translation Studies (TS) in general and in the translation of the Quran in particular. Drawing on the genuine fact that the Quran can be communicated in any language in terms of meaning, and the translation is not sacred; this paper approaches the translation of the Quran by blending different methods like domestication or foreignisation in a systematic way, avoiding the binary choice made by many translators. To reach this aim, the paper has a conceptual part that seeks to elucidate and clarify the main methods employed in TS, and criticise and modify them to propose the new hybrid approach (the hybrid model) for translating the Quran – that is, the deductive method. To support and validate the outcome of the previous part, a comparative model is employed in order to highlight the differences between the suggested translation and other widely used ones – that is, the inductive method. By applying this methodology, the paper proves that there is a deficiency of communicating the original meaning of the Quran in light of the foreignising approach. In conclusion, the paper suggests producing a Quran translation has to take into account the adoption of many techniques to express the meaning of the Quran as understood in the original, and to offer this understanding in English in the most native-like manner to serve the intended target readers.

Keywords: Quran translation, hybrid approach, domestication, foreignization, hybrid model

Procedia PDF Downloads 133
273 Shariah Guideline on Value-Based Intermediation Implementation in the Light of Maqasid Shariah Analysis

Authors: Muhammad Izzam Bin Mohd Khazar, Ruqayyah Binti Mohamad Ali, Nurul Atiqah Binti Yusri

Abstract:

Value-based intermediation (VBI) has been introduced by Bank Negara Malaysia (BNM) as the next strategic direction and growth driver for Islamic banking institutions. The aim of VBI is to deliver the intended outcome of Shariah through practices, conducts, and offerings that generate positive and sustainable impact to the economy, community and environment which is aligned to Maqasid Shariah in preserving the common interest of society by preventing harm and maximizing benefit. Hence, upon its implementation, VBI will experiment the current Shariah compliance treatment and revolutionise new policies and systems that can meritoriously entrench and convey the objectives of Shariah. However, discussion revolving VBI in the light of Maqasid analysis is still scarce hence further research needs to be undertaken. The idea of implementation of VBI vision into quantifiable Maqasid Shariah measurement is yet to be explored due to the nature of Maqasid that is variable. The contemporary scholars also have different views on the implementation of VBI. This paper aims to discuss on the importance of Maqasid Shariah in the current Islamic finance transactions by providing Shariah index measurement in the application of VBI. This study also intends to explore basic Shariah guidelines and parameters based on the objectives of Shariah; preservation of the five pillars (religion, life, progeny, intellect and wealth) with further elaboration on preservation of wealth under five headings: rawaj (circulation and marketability); wuduh (transparency); hifz (preservation); thabat (durability and tranquillity); and ‘adl (equity and justice). In alignment with these headings, Islamic finance can be innovated for VBI implementation, particularly in Maybank Islamic being a significant leader in the IFI market.

Keywords: Islamic Financial Institutions, Maqasid Index, Maqasid Shariah, sustainability, value-based intermediation

Procedia PDF Downloads 141
272 Acoustical Comfort in Major Highway in Birnin Kebbi, Kebbi State-Nigeria

Authors: Muhammad Naziru Yahaya, Mustapha Bashir Ayinde

Abstract:

Noise has been recognized as a major source of pollution in many urban and semi-urban settlements. Noise pollution causes by vehicular movement in urban cities has reaches an alarming proportion due to continuous increases in vehicles and industrialization. This research aim to determine the geo-physical characteristics of the study area and to determine the level of noise generation and volume intensity in areas where noise levels are high within the metropolis and compare with NESREA and WHO standards. This study identified the various sources of noise, compared noise levels in various parts of the study area with recommended standards and determined the geo-physical characteristic of noise generated. A sound level meter Gm 1352, was used for the noise measurements. The study showed that the noise pollution levels measured in minimum noise level of 63.75 dBA and average maximum of 95.175 dBA, at some locations in Birnin Kebbi metropolis the noise level have exceeded the standard limits set by the World Health Organization (WHO), Federal Environment Protection Agency (FEPA). Results revealed that there was a considerable increase in noise pollution in First Bank roundabout and Haliru Abdu roundabout, attribute to high numbers of vehicular movement and road congestion within Birnin Kebbi. The study therefore concluded that there should be an enforcement and adherence to the regulation regarding noise pollution limit. The minimum average day noise level recorded was 67.225 dBA, and average maximum of 96.6 dBA is an indication that the noise level of Birnin Kebbi metropolis was highly unsatisfactory. Based on this, it is suggested that taking adequate measures and following the laid-down recommendations will reduce traffic noise to the barest minimum.

Keywords: decibel, noise level, pollution, sound level, traffic, highway

Procedia PDF Downloads 50
271 Nutritionists' Perspective on the Conception of a Telenutrition Platform for Diabetes Care: Qualitative Study

Authors: Choumous Mannoubi, Dahlia Kairy, Brigitte Vachon

Abstract:

The use of technology allows clinicians to provide an individualized approach in a cost-effective manner and to reach a broader client base more easily. Such interventions can be effective in ensuring self-management and follow-up of people with diabetes, reducing the risk of complications by improving accessibility to care services, and better adherence to health recommendations. Consideration of users' opinions and fears to inform the design and implementation stages of these telehealth services seems to be essential to improve their acceptance and usability. The objective of this study is to describe the telepractice of nutritionists supporting the therapeutic management of diabetic patients and document the functional requirements of nutritionists for the design of a tele-nutrition platform. To best identify the requirements and constraints of nutritionists, we conducted individual semi-structured interviews with 10 nutritionists who offered tele-nutrition services. Using a qualitative design with a descriptive approach based on the Nutrition Care Process Model (mNCP) framework, we explored in depth the state of nutritionists' telepractice in public and private health care settings, as well as their requirements for teleconsultation. Qualitative analyses revealed that nutritionists primarily used telephone calls during the COVID 19 pandemic to provide teleconsultations. Nutritionists identified the following important features for the design of a tele-nutrition platform: it should support interprofessional collaboration, allow for the development and monitoring of a care plan, integrate with the existing IT environment, be easy to use, accommodate different levels of patient literacy, and allow for easy sharing of educational materials to support nutrition education.

Keywords: telehealth, nutrition, diabetes, telenutrition, teleconsultation, telemonitoring

Procedia PDF Downloads 107
270 Effects of Clinical Practice Guidelines for Central Venous Catheter to Infection Rate and Nurse’s Satisfaction in Medicine Intensive Care Unit 240 Hat Yai Hospital, Thailand

Authors: Jiranun Sreecharit, Anongnat Boonrut, Kunvadee Munvaradee, Phechnoy Singchungchai

Abstract:

Hatyai Hospital as center of hospital with a capacity of 670 beds. Medicine intensive care units (MICU240) provide care for critically ill patients who are at high risk need to be monitored closely. Intravenous catheter is vital to help assess the level of water in the body fluids and medications. Potential complications such as infection. We need to have guidelines for the care of patients who received intravenous catheter used to achieve good results. The operations research in this study was intended 1) To study the effects of practice for nurses in caring for patients with central venous catheter to infection rate and 2) To assess the satisfaction of nurses and patient care practices in central venous catheterization patients in the MICU 240. The sample of the patient's central venous catheter crisis that everyone who admitted in MICU 240 during the period from October 2013 to May 2014. Samples prior to practice and 148 samples with 249 case of practice. A systematic review of the research NSWHealth Statewide Guideline for Intensive Care. Data were analyzed by statistics, percentages and frequency NON-PARAMETRICS with Mann-Whitney U. The finding revealed that: 1. Results of the practice patient care central venous catheter infection rates were found to be reduced from 35.14 percent to 25.3 percent. 2. The results of the evaluation of nurses and patients in the patient care practices central venous catheter found to be satisfied and happy to work 85 percent.

Keywords: clinical practice guidelines, central venous catheter, infection satisfaction

Procedia PDF Downloads 456
269 A Study on the Microbilogical Profile and Antibiotic Sensitivity Pattern of Bacterial Isolates Causing Urinary Tract Infection in Intensive Care Unit Patients in a Tertiary Care Hospital in Eastern India

Authors: Pampita Chakraborty, Sukumar Mukherjee

Abstract:

The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.

Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection

Procedia PDF Downloads 247
268 A Theoretical and Experimental Evaluation of a Solar-Powered Off-Grid Air Conditioning System for Residential Buildings

Authors: Adam Y. Sulaiman, Gerard I.Obasi, Roma Chang, Hussein Sayed Moghaieb, Ming J. Huang, Neil J. Hewitt

Abstract:

Residential air-conditioning units are essential for quality indoor comfort in hot climate countries. Nevertheless, because of their non-renewable energy sources and the contribution of ecologically unfriendly working fluids, these units are a major source of CO2 emissions in these countries. The utilisation of sustainable technologies nowadays is essential to reduce the adverse effects of CO2 emissions by replacing conventional technologies. This paper investigates the feasibility of running an off-grid solar-powered air-conditioning bed unit using three low GWP refrigerants (R32, R290, and R600a) to supersede conventional refrigerants.A prototype air conditioning unit was built to supply cold air to a canopy that was connected to it. The assembled unit was designed to distribute cold air to a canopy connected to it. This system is powered by two 400 W photovoltaic panels, with battery storage supplying power to the unit at night-time. Engineering Equation Solver (EES) software is used to mathematically model the vapor compression cycle (VCC) and predict the unit's energetic and exergetic performance. The TRNSYS software was used to simulate the electricity storage performance of the batteries, whereas the IES-VE was used to determine the amount of solar energy required to power the unit. The article provides an analytical design guideline, as well as a comprehensible process system. Combining a renewable energy source to power an AC based-VCC provides an excellent solution to the real problems of high-energy consumption in warm-climate countries.

Keywords: air-conditioning, refrigerants, PV panel, energy storages, VCC, exergy

Procedia PDF Downloads 153
267 An Analysis on the Appropriateness and Effectiveness of CCTV Location for Crime Prevention

Authors: Tae-Heon Moon, Sun-Young Heo, Sang-Ho Lee, Youn-Taik Leem, Kwang-Woo Nam

Abstract:

This study aims to investigate the possibility of crime prevention through CCTV by analyzing the appropriateness of the CCTV location, whether it is installed in the hotspot of crime-prone areas, and exploring the crime prevention effect and transition effect. The real crime and CCTV locations of case city were converted into the spatial data by using GIS. The data was analyzed by hotspot analysis and weighted displacement quotient(WDQ). As study methods, it analyzed existing relevant studies for identifying the trends of CCTV and crime studies based on big data from 1800 to 2014 and understanding the relation between CCTV and crime. Second, it investigated the current situation of nationwide CCTVs and analyzed the guidelines of CCTV installation and operation to draw attention to the problems and indicating points of domestic CCTV use. Third, it investigated the crime occurrence in case areas and the current situation of CCTV installation in the spatial aspects, and analyzed the appropriateness and effectiveness of CCTV installation to suggest a rational installation of CCTV and the strategic direction of crime prevention. The results demonstrate that there was no significant effect in the installation of CCTV on crime prevention. This indicates that CCTV should be installed and managed in a more scientific way reflecting local crime situations. In terms of CCTV, the methods of spatial analysis such as GIS, which can evaluate the installation effect, and the methods of economic analysis like cost-benefit analysis should be developed. In addition, these methods should be distributed to local governments across the nation for the appropriate installation of CCTV and operation. This study intended to find a design guideline of the optimum CCTV installation. In this regard, this study is meaningful in that it will contribute to the creation of a safe city.

Keywords: CCTV, safe city, crime prevention, spatial analysis

Procedia PDF Downloads 413
266 Qualitative Analysis of Current Child Custody Evaluation Practices

Authors: Carolyn J. Ortega, Stephen E. Berger

Abstract:

The role of the custody evaluator is perhaps one of the most controversial and risky endeavors in clinical practice. Complaints filed with licensing boards regarding a child-custody evaluation constitute the second most common reason for such an event. Although the evaluator is expected to answer for the family-law court what is in the “best interest of the child,” there is a lack of clarity on how to establish this in any empirically validated manner. Hence, practitioners must contend with a nebulous framework in formulating their methodological procedures that inherently places them at risk in an already litigious context. This study sought to qualitatively investigate patterns of practice among doctoral practitioners conducting child custody evaluations in the area of Southern California. Ten psychologists were interviewed who devoted between 25 and 100% of their California private practice to custody work. All held Ph.D. degrees with a range of eight to 36 years of experience in custody work. Semi-structured interviews were used to investigate assessment practices, ensure adherence to guidelines, risk management, and qualities of evaluators. Forty-three Specific Themes were identified using Interpretive Phenomenological Analysis (IPA). Seven Higher Order Themes clustered on salient factors such as use of Ethics, Law, Guidelines; Parent Variables; Child Variables; Psychologist Variables; Testing; Literature; and Trends. Evaluators were aware of the ever-present reality of a licensure complaint and thus presented idiosyncratic descriptions of risk management considerations. Ambiguity about quantifying and validly tapping parenting abilities was also reviewed. Findings from this study suggested a high reliance on unstructured and observational methods in child custody practices.

Keywords: forensic psychology, psychological testing, assessment methodology, child custody

Procedia PDF Downloads 256
265 Evaluating the Implementation of a Quality Management System in the COVID-19 Diagnostic Laboratory of a Tertiary Care Hospital in Delhi

Authors: Sukriti Sabharwal, Sonali Bhattar, Shikhar Saxena

Abstract:

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

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

Procedia PDF Downloads 130
264 Drug-related Problems and Associated Factors among Adult Psychiatric Inpatients in Northwest Ethiopia: Multicenter Cross-Sectional Study

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

Abstract:

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

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

Procedia PDF Downloads 124
263 The Impact of a Lower Health Literacy in the Self-Management of Patients with a Multiple Sclerosis: A Literature Review

Authors: Helga Martins, Idália Matias

Abstract:

Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

Procedia PDF Downloads 129
262 Application of Non-Smoking Areas in Hospitals

Authors: Nur Inayah Ismaniar, Sukri Palutturi, Ansariadi, Atjo Wahyu

Abstract:

Background: In various countries in the world, the problem of smoking is now considered something serious because of the effects of smoking which can not only lead to addiction but also have the potential to harm health. Public health authorities have concluded that one solution that can be done to protect the public from active smokers is to issue a policy that requires public facilities to be completely smoke-free. The hospital is one of the public facilities that has been designated as a smoke-free area. However, the implementation and maintenance of a successful program based on a smoke-free hospital are still considered an ongoing challenge worldwide due to the very low level of adherence. The low level of compliance with this smoke-free policy is also seen in other public facilities. The purpose of the literature review is to review the level of compliance with the application of the Non-Smoking Area policy, how this policy has succeeded in reducing smoking activity in hospitals, and what factors lead to such compliance in each country in the world. Methods: A literature review of articles was carried out on all types of research methods, both qualitative and quantitative. The sample is all subjects who are in the research location, which includes patients, staff and hospital visitors. Results: Various variations in the level of compliance were found in various kinds of literature. The literature with the highest level of compliance is 88.4%. Furthermore, several determinants that are known to affect the compliance of the Non-Smoking Area policies in hospitals include communication, information, knowledge, perceptions, interventions, attitudes and support. Obstacles to its enforcement are the absence of sanctions against violators of the Non-Smoking Area policy, the ineffectiveness of the function of policymakers in hospitals, and negative perceptions of smoking related to mental health. Conclusion: Violations of the Non-Smoking Area policy are often committed by the hospital staff themselves, which makes it difficult for this policy to be fully enforced at various points in the hospital.

Keywords: health policy, non-smoking area, hospital, implementation

Procedia PDF Downloads 65
261 Rethinking Riba in an Agency Theoretic Framework: Islamic Banking and Finance beyond Sophistry

Authors: Muhammad Arsalan

Abstract:

The efficiency of a financial intermediation system is assessed by its ability to achieve allocative efficiency, asset transformation, and the subsequent economic development. Islamic Banking and Finance (IBF) was conceived to serve as an alternate financial intermediation system adherent to the injunctions of Islam. A critical appraisal of the state of contemporary IBF reveals that it neither fulfills the aspirations of Islamic rhetoric nor is efficient in terms of asset transformation and economic development. This paper is an intuitive pursuit to explore the economic rationale of established principles of IBF, and the reasons of the persistent divergence of IBF being accused of ruses and sophistry. Disentangling the varying viewpoints, the underdevelopment of IBF has been attributed to misinterpretation of Riba, which has been explicated through a narrow fiqhi and legally deterministic approach. It presents a critical account of how incorrect conceptualization of the key injunction on Riba, steered flawed institutionalization of an Islamic Financial intermediation system. It also emphasizes on the wrong interpretation of the ontological and epistemological sources of Islamic Law (primarily Riba), that explains the perennial economic underdevelopment of the Muslim world. Deeming ‘a collaborative and dynamic Ijtihad’ as the elixir, this paper insists on the exigency of redefining Riba, i.e., a definition that incorporates the modern modes of economic cooperation and the contemporary financial intermediation ecosystem. Finally, Riba has been articulated in an agency theoretic framework to eschew expropriation of wealth, and assure protection of property rights, aimed at realizing the twin goals of a) Shari’ah adherence in true spirit, b) financial and economic development of the Muslim world.

Keywords: agency theory, financial intermediation, Islamic banking and finance, ijtihad, economic development, Riba, information asymmetry

Procedia PDF Downloads 110
260 Reliability of Social Support Measurement Modification of the BC-SSAS among Women with Breast Cancer Who Undergone Chemotherapy in Selected Hospital, Central Java, Indonesia

Authors: R. R. Dewi Rahmawaty Aktyani Putri, Earmporn Thongkrajai, Dedy Purwito

Abstract:

There were many instruments have been developed to assess social support which has the different dimension in breast cancer patients. The Issue of measurement is a challenge to determining the component of dimensional concept, defining the unit of measurement, and establishing the validity and reliability of the measurement. However, the instruments where need to know how much support which obtained and perceived among women with breast cancer who undergone chemotherapy which it can help nurses to prevent of non-adherence in chemotherapy. This study aimed to measure the reliability of BC-SSAS instrument among 30 Indonesian women with breast cancer aged 18 years and above who undergone chemotherapy for six cycles in the oncological unit of Outpatient Department (OPD), Margono Soekardjo Hospital, Central Java, Indonesia. Data were collected during October to December 2015 by using modified the Breast Cancer Social Support Assessment (BC-SSAS). The Cronbach’s alpha analysis was carried out to measure internal consistency for reliability test of BC-SSAS instrument. This study used five experts for content validity index. The results showed that for content validity, I-CVI was 0.98 and S-CVI was 0.98; Cronbach’s alpha value was 0.971 and the Cronbach’s alpha coefficients for the subscales were high, with 0.903 for emotional support, 0.865 for informational support, 0.901 for tangible support, 0.897 for appraisal support and 0.884 for positive interaction support. The results confirmed that the BC-SSAS instrument has high reliability. BC-SSAS instruments were reliable and can be used in health care services to measure the social support received and perceived among women with breast cancer who undergone chemotherapy so that preventive interventions can be developed and the quality of health services can be improved.

Keywords: BC-SSAS, women with breast cancer, chemotherapy, Indonesia

Procedia PDF Downloads 344
259 Evaluating the Management of Febrile Infants (Less than 90 Days) Presenting to Tallaght Ed- Completed Audit Cycle

Authors: Amel Osman, Stewart McKenna

Abstract:

Aim: Fever may present as the sole sign of a serious underlying infection in young infants. Febrile Infants aged less than 90 days are at an elevated susceptibility to invasive bacterial infections, thus presenting a challenge in ensuring the appropriate management of these cases. This study aims to ensure strict adherence to NICE guidelines for the management of fever in infants between 0 and 90 days presenting to Tallaght Hospital ED. A comprehensive audit, followed by a re-audit, was conducted to enhance the quality of care delivered to these patients. In accordance with NICE guidelines, all febrile infants should undergo blood tests. Additionally, LP should be performed in all neonates under 28 days, infants displaying signs of illness, and those with WCC below 5 or above 15. Method: A retrospective case review was performed, encompassing all patients aged between 0 to 90 days who presented with fever at Tallaght ED. Data retrieval was conducted from electronic records on two separate occasions, six months apart. The evaluation encompassed the assessment of body temperature as well as both partial and full septic workups. Results: Over the study period, 150 infants presented to the ED with fever in the initial audit, and 120 in the re-audit. In the first study, 81 patients warranted a full septic workup as per NICE, but only 48 received it. Conversely, 40 patients met criteria for a partial septic workup, with 12 undergoing blood tests. In the second study, 73 patients qualified for a full septic workup, of which 52 were completed. Additionally, 27 patients were indicated for a partial workup, with 20 undergoing blood tests. Conclusion: Managing febrile infants under three months of age presenting to Tallaght ED remains a persistent challenge, underscoring the need for continuous educational initiatives to guarantee that these patients receive the requisite assessments and treatments.

Keywords: infants, fever, septic workup, tallaght

Procedia PDF Downloads 27
258 Multi Universe Existence Based-On Quantum Relativity using DJV Circuit Experiment Interpretation

Authors: Muhammad Arif Jalil, Somchat Sonasang, Preecha Yupapin

Abstract:

This study hypothesizes that the universe is at the center of the universe among the white and black holes, which are the entangled pairs. The coupling between them is in terms of spacetime forming the universe and things. The birth of things is based on exchange energy between the white and black sides. That is, the transition from the white side to the black side is called wave-matter, where it has a speed faster than light with positive gravity. The transition from the black to the white side has a speed faster than light with negative gravity called a wave-particle. In the part where the speed is equal to light, the particle rest mass is formed. Things can appear to take shape here. Thus, the gravity is zero because it is the center. The gravitational force belongs to the Earth itself because it is in a position that is twisted towards the white hole. Therefore, it is negative. The coupling of black-white holes occurs directly on both sides. The mass is formed at the saturation and will create universes and other things. Therefore, it can be hundreds of thousands of universes on both sides of the B and white holes before reaching the saturation point of multi-universes. This work will use the DJV circuit that the research team made as an entangled or two-level system circuit that has been experimentally demonstrated. Therefore, this principle has the possibility for interpretation. This work explains the emergence of multiple universes and can be applied as a practical guideline for searching for universes in the future. Moreover, the results indicate that the DJV circuit can create the elementary particles according to Feynman's diagram with rest mass conditions, which will be discussed for fission and fusion applications.

Keywords: multi-universes, feynman diagram, fission, fusion

Procedia PDF Downloads 41
257 Healthy and Smart Building Projects

Authors: Ali A. Karakhan

Abstract:

Stakeholders in the architecture, engineering, and construction (AEC) industry have been always searching for strategies to develop, design, and construct healthy and smart building projects. Healthy and smart building projects require that the building process including design and construction be altered and carefully implemented in order to bring about sustainable outcomes throughout the facility lifecycle. Healthy and smart building projects are expected to positively influence organizational success and facility performance across the project lifecycle leading to superior outcomes in terms of people, economy, and the environment. The present study aims to identify potential strategies that AEC organizations can implement to achieve healthy and smart building projects. Drivers and barriers for healthy and smart building features are also examined. The study findings indicate that there are three strategies to advance the development of healthy and smart building projects: (1) the incorporation of high-quality products and low chemical-emitting materials, (2) the integration of innovative designs, methods, and practices, and (3) the adoption of smart technology throughout the facility lifecycle. Satisfying external demands, achievement of a third-party certification, obtaining financial incentives, and a desire to fulfill professional duty are identified as the key drivers for developing healthy and smart building features; whereas, lack of knowledge and training, time/cost constrains, preference for/adherence to customary practices, and unclear business case for why healthy buildings are advantageous are recognized as the primary barriers toward a wider diffusion of healthy and smart building projects. The present study grounded in previous engineering, medical, and public health research provides valuable technical and practical recommendations for facility owners and industry professionals interested in pursuing sustainable, yet healthy and smart building projects.

Keywords: healthy buildings, smart construction, innovative designs, sustainable projects

Procedia PDF Downloads 133
256 A Case Study of Response to Dual Genotype Chronic Hepatitis C/HIV Co-Infection to Fixed Dose Sofosbuvir/Ledipasvir

Authors: Tabassum Yasmin, Hamid Pahlevan

Abstract:

HIV/Hepatitis C co-infection treatments have evolved substantially and they have similar sustained virologic response rates as those of Hepatitis C monoinfected population. There are a few studies on therapy of patients with dual genotypes, especially in HIV/Hepatic C coinfected group. Most studies portrayed case reports of dual genotype chronic Hepatitis C coinfection treatment with Sofosbuvir/Ledipasvir and Ribavirin. A 79-year-old male with a history of HIV on Truvada and Isentress had chronic Hepatitis C with 1a and 2 genotypes. The patient has a history of alcohol intake for 40 years but recently stopped drinking alcohol. He has a history of intravenous drug use in the past and currently is not using any recreational drugs. Patient has Fibro score of 0.7 with Metavir score F2 to F4. AFP is 3.2. The HCV RNA is 493,034 IU/ML. The HBV viral DNA is < 1.30 (not detected). The CD4 is 687CU/MM. The FIB 4 is 3.34 with APRI index 0.717. The HIV viral load is 101 copies/ML. MRI abdomen did not show any liver abnormality. Fixed dose Sofosbuvir/Ledipasvir was used for therapy without Ribavirin. He tolerated medication except for some minor gastrointestinal side effects like abdominal bloating. He demonstrated 100% adherence rate. Patient completed 12 weeks of therapy. HCV RNA was undetectable at 4 and 12 weeks. He achieved SVR at week 12 and subsequently had undetectable RNA for 2 years. Dual genotype prevalence in chronic hepatitis C population is rare, especially in HIV/hepatic coinfection. Our case demonstrates that dual genotypic cases can still be successfully treated with Direct Acting Antiviral agents. The newer agents for therapy for pan genotypes were not available at the time the patient was being treated. We demonstrated that dual agent therapy was still able to maintain SVR in our patient.

Keywords: HIV/Hepatitis C, SVR (sustained virologic response), DAA (direct active antiviral agents, dual genotype

Procedia PDF Downloads 171
255 Honor Endorsement from the Perspective of System Justification and Regulatory Focus Orientation

Authors: Gülçin Akbas Uslu

Abstract:

Honor cultures put importance on the sexual purity of women. Women are expected to avoid acts that may spoil their honor. The emphasis on honor leads to the subordination of women and the dominance of men. In order to protect and clean honor, women are exposed to physical and psychological violence. Therefore, understanding the motivations driving people to endorse honor bears importance. For this purpose, this study aims to explore honor endorsement from the joint perspective of System Justification Theory (SJT) and Regulatory Focus Theory (RFT). SJT asserts that people have a tendency to support and rationalize the system. The motivation to maintain the system may be a factor in the endorsement of honor. RFT proposes two distinct regulatory processes, namely promotion and prevention focus. Having a dominant prevention focus, such as a deep concern for responsibilities, risk avoidance, and minimizing negative outcomes, may have a role in honor. Data were collected conveniently from 366 participants (216 women; 150 men). Participants filled out Honor Endorsement Index, Honor Based System Justification Scale and Regulatory Focus Orientation Scale Results revealed that both regulatory focus and system justification play a role in understanding honor. One-way ANOVA findings showed that individuals with a dominant prevention focus endorse honor beliefs more than individuals with a dominant promotion focus. Besides, regression analysis revealed that prevention focus and system justification significantly and positively predict honor. Results provide clarifications for why honor has an important meaning in individuals’ life and why honor-based violence is approved. These findings bear great importance in Turkey, where emphasis on honor is high and can be used in reducing people’s adherence to honor, which is based on women’s sexuality and men’s power over women.

Keywords: honor, system justification theory, regulatory focus theory, prevention focus

Procedia PDF Downloads 120
254 Establishment of Reference Interval for Serum Protein Electrophoresis of Apparently Healthy Adults in Addis Ababa, Ethiopia

Authors: Demiraw Bikila, Tadesse Lejisa, Yosef Tolcha, Chala Bashea, Mehari Meles Tigist Getahun Genet Ashebir, Wossene Habtu, Feyissa Challa, Ousman Mohammed, Melkitu Kassaw, Adisu Kebede, Letebrhan G. Egzeabher, Endalkachew Befekadu, Mistire Wolde, Aster Tsegaye

Abstract:

Background: Even though several factors affect reference intervals (RIs), the company-derived values are currently in use in many laboratories worldwide. However, little or no data is available regarding serum protein RIs, mainly in resource-limited setting countries like Ethiopia. Objective: To establish a reference interval for serum protein electrophoresis of apparently healthy adults in Addis Ababa, Ethiopia. Method: A cross-sectional study was conducted on a total of 297 apparently healthy adults from April-October 2019 in four selected sub-cities (Akaki, Kirkos, Arada, Yeka) of Addis Ababa, Ethiopia. Laboratory analysis of collected samples was performed using Capillarys 2 Flex Piercing analyzer, while statistical analysis was done using SPSS version 23 and med-cal software. Mann-Whitney test was used to check Partitions. Non-parametric method of reference range establishment was performed as per CLSI guideline EP28A3C. Result: The established RIs were: Albumin 53.83-64.59%, 52.24-63.55%; Alpha-1 globulin 3.04-5.40%, 3.44-5.60%; Alpha-2 globulin 8.0-12.67%, 8.44-12.87%; and Beta-1 globulin 5.01-7.38%, 5.14-7.86%. Moreover, Albumin to globulin ratio was 1.16-1.8, 1.09-1.74 for males and females, respectively. The combined RIs for Beta-2 globulin and Gamma globulin were 2.54-4.90% and 12.40-21.66%, respectively. Conclusion: The established reference interval for serum protein fractions revealed gender-specific differences except for Beta-2 globulin and Gamma globulin.

Keywords: serum protein electrophoresis, reference interval, Addis Ababa, Ethiopia

Procedia PDF Downloads 203
253 Integration Between Seismic Planning and Urban Planning for Improving the City Image of Tehran - Case of Tajrish

Authors: Samira Eskandari

Abstract:

The image of Tehran has been impacted in recent years due to poor urban management and fragmented governance. There is no cohesive urban beautification framework in Tehran to enforce builders take aesthetic factors seriously when design and construct new buildings. The existing guidelines merely provide people with recommendations, not regulations. Obviously, Tehran needs a more comprehensive and strict urban beautification framework to restore its image. The damaged image has impacted the city’s social, economic and environmental growth. This research aims to find and examine a solution by which the employment of urban beautification regulation would be guaranteed, and city image would be organized. The methodology is based on a qualitative approach associated with analytical methods, in-depth surveys and interviews with Tehran citizens, authorities and experts, and use of academic resources as well as simulation. As a result, one practical solution is to incorporate aesthetic guidelines into a survival-related framework like a seismic guideline. Tehran is a seismic site, and all the buildings in Tehran have to be retrofitted against earthquake during construction. Hence, by integrating seismic regulations and aesthetic disciplines, urban beautification will be somehow guaranteed. Besides, the seismic image can turn into Tehran’s brand and enhances city identity. This research is trying to increase the social, environmental, and economic interconnectedness between urban planning and seismic planning by the usage of landscape architecture methods. As a case study, the potential outcomes are simulated in Tajrish, a suburb located in the north of Tehran. The result is that, by the redefinition of the morphology of seismic retrofitting systems, used in the significant city image elements, and re-function them in accordance with the Iranian culture and traditions, the city image would become more harmonized and legible.

Keywords: earthquake, retrofitting systems, Tehran image, urban beautification

Procedia PDF Downloads 111
252 The Impact of Artificial Intelligence on Pharmacy and Pharmacology

Authors: Mamdouh Milad Adly Morkos

Abstract:

Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theoryclinical simulation, education, pharmacology, simulation, virtual learning low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

Procedia PDF Downloads 47
251 Effects of Crisis-Induced Emotions on in-Crisis Protective Behavior and Post-Crisis Perception: An Analysis of Survey Data for the 2015 Middle East Respiratory Syndrome in South Korea

Authors: Myoungsoon You, Heejung Son

Abstract:

Background: In the current study, we investigated the effects of emotions induced by an infectious disease outbreak on the various protective behaviors taken during the crisis and on the perception after the crisis. The investigation was based on two psychological theories of appraisal tendency and action tendency. Methods: A total of 900 participants in South Korea who experienced the 2015 Middle East Respiratory Syndrome outbreak were sampled by a professional survey agency. To assess the influence of the emotions fear and anger, a regression approach was used. The effect of emotions on various protective behaviors and perceptions was observed using a hierarchical regression method. Results: Fear and anger induced by the infectious disease outbreak were both associated with increased protective behaviors during the crisis. However, the differences between the emotions were observed. While protective behaviors with avoidance tendency (adherence to recommendations, self-mitigation), were raised by both fear and anger, protective behaviors with approach tendency (information-seeking) were increased by anger, but not fear. Regarding the effect of emotion on the risk perception after the crisis, only fear was associated with a higher level of risk perception. Conclusions: This study confirmed the role of emotions in crisis protective behaviors and post-crisis perceptions regarding an infectious disease outbreak. These findings could enhance understanding of the public’s protective behaviors during infectious disease outbreaks and afterward risk perception corresponding to emotions. The results also suggested strategies for communicating with the public that takes into account emotions that are prominently induced by crises associated with disease outbreaks.

Keywords: crisis communication, emotion, infectious disease outbreak, protective behavior, risk perception

Procedia PDF Downloads 251
250 A Case Report on Neonatal Conjunctivitis in Pugs

Authors: Maria L. G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

Neonatal conjunctivitis, or ophthalmia, is an infection of the conjunctiva or cornea before opening the eyelids. It is believed that immunodeficiency contributes to the development of the condition. This study aims at reporting a case of ophthalmia neonatorum in a dog, in addition to its diagnosis and treatment. A litter of five pug neonates was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, with complaints of ocular secretion. The neonates were five days old. The clinical examination revealed that three newborns presented swelling in the ocular region and a purulent secretion in the medial corner of the eye that was exerting pressure on the ocular globes, which are compatible with the description of this disease. The diagnosis was made based on the clinical signs and bacterial culture of the secretion, which revealed the presence of bacteria belonging to the genus Staphylococcus sp. The laboratory assays did not reveal any alterations. The treatment was instituted gently, opening the eyelids early and cleaning the purulent ocular secretion with saline solution. An ophthalmic ointment with retinol, amino acids, methionine, and chloramphenicol (Epitezan®) was prescribed four times a day for seven days. Blood plasma (2 mL/100 g) was administered subcutaneously because bacterial infections in neonates may represent a failure in the transference of passive immunity. A more thorough cleaning of the environment was also recommended. Neonatal conjunctivitis has a simple diagnosis and treatment. If not treated early, it can evolve to adherence of the eyelids to the cornea, ulceration, and perforation of the cornea. Therefore, the prognosis is favorable as long as the condition is diagnosed early, and the treatment is instituted quickly.

Keywords: ophthalmia neonatorum, neonatal infection, puppy, newborn

Procedia PDF Downloads 111
249 Food Bolus Obstruction: A Rural Hospital’s Experience

Authors: Davina Von Hagt, Genevieve Gibbons, Matt Henderson, Tom Bowles

Abstract:

Purpose: Food bolus obstructions are common emergency surgical presentations, but there is no established management guideline in a rural setting. Intervention usually involves endoscopic removal after initial medical management has failed. Within a rural setting, this falls upon the general surgeon. There are varied endoscopic techniques that may be used. Methodology: A review of the past fifty cases of food bolus obstruction managed at Albany Health Campus was retrospectively reviewed to assess endoscopic findings and techniques. Operation notes, histopathology, imaging, and patient notes were reviewed. Results: 50 patients underwent gastroscopy for food bolus obstruction from August 2017 to March 2021. Ages ranged from 11 months to 95 years, with the majority of patients aged between 30-70 years. 88% of patients were male. Meat was the most common bolus (20% unspecified, 20% steak, 10% chicken, 6% lamb, 4% sausage, 2% pork). At endoscopy, 12% were found not to have a food bolus obstruction. Two patients were found to have oesophageal cancer, and four patients had a stricture and required dilatation. A variety of methods were used to relieve oesophageal obstruction ranging from pushing through to stomach (24 patients), using an overtube (10 patients), raptor (13 patients), and less common instruments such as Roth net, basket, guidewire, and pronged grasper. One patient had an unsuccessful endoscopic retrieval and required theatre for laparoscopic assisted removal with rendezvous endoscopic piecemeal removal via oesophagus and gastrostomy. Conclusion: Food bolus obstruction is a common emergency presentation. Within the rural setting, management requires innovation and teamwork within the safety of the local experience.

Keywords: food bolus obstruction, regional hospital, surgical management, innovative surgical treatment

Procedia PDF Downloads 222
248 Survey on Awareness, Knowledge and Practices: Managing Osteoporosis among Practitioners in a Tertiary Hospital, Malaysia

Authors: P. H. Tee, S. M. Zamri, K. M. Kasim, S. K. Tiew

Abstract:

This study evaluates the management of osteoporosis in a tertiary care government hospital in Malaysia. As the number of admitted patients having osteoporotic fractures is on the rise, osteoporotic medications are an increasing financial burden to government hospitals because they account for half of the orthopedic budget and expenditure. Comprehensive knowledge among practitioners is important to detect early and avoid this preventable disease and its serious complications. The purpose of this study is to evaluate the awareness, knowledge, and practices in managing osteoporosis among practitioners in Hospital Tengku Ampuan Rahimah (HTAR), Klang. A questionnaire from an overseas study in managing osteoporosis among primary care physicians is adapted to Malaysia’s Clinical Practice Guideline of Osteoporosis 2012 (revised 2015) and international guidelines were distributed to all orthopedic practitioners in HTAR Klang (including surgeons, orthopedic medical officers), endocrinologists, rheumatologists and geriatricians. The participants were evaluated on their expertise in the diagnosis, prevention, treatment decision and medications for osteoporosis. Collected data were analyzed for all descriptive and statistical analyses as appropriate. All 45 participants responded to the questionnaire. Participants scored highest on expertise in prevention, followed by diagnosis, treatment decision and lastly, medication. Most practitioners stated that own-initiated continuing professional education from articles and books was the most effective way to update their knowledge, followed by attendance in conferences on osteoporosis. This study confirms the importance of comprehensive training and education regarding osteoporosis among tertiary care physicians and surgeons, predominantly in pharmacotherapy, to deliver wholesome care for osteoporotic patients.

Keywords: awareness, knowledge, osteoporosis, practices

Procedia PDF Downloads 105