Search results for: outcomes that matter

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: Ayuko Itsuki, Sachiyo Aburatani

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Soil neutral sugar contents in Kasuga-yama Hill Primeval Forest, which is a World Heritage Site in Nara, Japan consisting of lowland laurel-leaved forest where natural conditions have been preserved for more than 1,000 years, were examined using the two-step hydrolysis to clarify the source of the neutral sugar and relations with the neutral sugar constituted the soil organic matter and the microbial biomass. Samples were selected from the soil (L, F, H and A horizons) surrounding laurel-leaved (BB-1) and Carpinus japonica (BB-2 and PW) trees for analysis. The neutral sugars were one factor of increasing the fungal and bacterial biomass in the laurel-leaved forest soil (BB-1). The more neutral sugar contents in the Cryptomeria japonica forest soil (PW) contributed to the growth of the bacteria and fungi than those of in the Cryptomeria japonica forest soil (BB-2). The neutral sugars had higher correlation with the numbers of bacteria and fungi counted by the dilution plate count method than by the direct microscopic count method. The numbers of fungi had higher correlation with those of bacteria by the dilution plate method.

Keywords: forest soil, neutral sugars, soil organic matter, two-step hydrolysis

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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: Roya Biabani, Mentore Vaccari, Piero Ferrari

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Accumulated microplastic (MPLs) in soil pose the risk of adsorbing and transporting polychlorinated biphenyls (PCBs) into the food chain or bodies. PCBs belong to a class of man-made hydrophobic organic chemicals (HOCs) that are classified as probable human carcinogens and a hazard to biota. Therefore, to take effective action and not aggravate the already recognized problems, the knowledge of PCB remediation in the presence of MPLs needs to be complete. Due to the high efficiency and little secondary pollution production, thermal desorption (TD) has been widely used for processing a variety of pollutants, especially for removing volatile and semi-volatile organic matter from contaminated solids and sediment. This study investigates the fate of PCB compounds during the thermal remediation method. For this, the PCB-contaminated soil was collected from the earth-canal downstream Caffaro S.p.A. chemical factory, which produced PCBs and PCB mixtures between 1930 and 1984. For MPL analysis, MPLs were separated by density separation and oxidation of organic matter. An operational range for the key parameters of thermal desorption processes was experimentally evaluated. Moreover, the temperature treatment characteristics of the PCBs-contaminated soil under anaerobic and aerobic conditions were studied using the Thermogravimetric Analysis (TGA).

Keywords: contaminated soils, microplastics, polychlorinated biphenyls, thermal desorption

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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: 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: Mina Adel Shokry Fahim, Jūratė Sužiedelytė Visockienė

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With the growing concern over air pollution (AP), it is clear that this has gained more prominence than ever before. The level of consciousness has increased and a sense of knowledge now has to be forwarded as a duty by those enlightened enough to disseminate it to others. This realisation often comes after an understanding of how poor air quality indices (AQI) damage human health. The study focuses on assessing air pollution prediction models specifically for Lithuania, addressing a substantial need for empirical research within the region. Concentrating on Vilnius, it specifically examines particulate matter concentrations 10 micrometers or less in diameter (PM10). Utilizing Gaussian Process Regression (GPR) and Regression Tree Ensemble, and Regression Tree methodologies, predictive forecasting models are validated and tested using hourly data from January 2020 to December 2022. The study explores the classification of AP data into anthropogenic and natural sources, the impact of AP on human health, and its connection to cardiovascular diseases. The study revealed varying levels of accuracy among the models, with GPR achieving the highest accuracy, indicated by an RMSE of 4.14 in validation and 3.89 in testing.

Keywords: air pollution, anthropogenic and natural sources, machine learning, Gaussian process regression, tree ensemble, forecasting models, particulate matter

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Authors: Ayodele Adelusi Oyedeji

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The study was carried out under a controlled environment with the aim of examining remediation of crude oil polluted soil. The germination rate, heights and girths, number of leaves and nodulation was determined following standard procedures. Some physicochemical (organic matter, pH, nitrogen, phosphorous, potassium, calcium, magnesium and sodium) characteristics of soil used were determined using standard protocols. Results showed that at varying concentration of crude oil i.e 0 ml, 25 ml, 50 ml, 75 ml and 100 ml, Leuceana leucocephala had germination rate of 92%, 90%, 84%, 62% and 56% respectively, mean height of 73.70cm, 58.30cm, 49.50cm, 46.45cm and 41.80cm respectively after 16 weeks after planting (WAP), mean girth of 0.54mm, 0.34mm, 0.33mm, 0.21mm and 0.19mm respectively at 16 WAP, number of nodules 18, 10, 10, 6 and 2 respectively and number of leaves 24.00, 16.00, 13.00, 10.00 and 6.00 respectively. The organic matter, pH, nitrogen, phosphorous, potassium, calcium, magnesium, and sodium decreased with the increase in the concentration of crude oil. Furthermore, as the concentration of crude oil increased the germination rate, height, girth, and number of leaves and nodules decreased, suggesting the effect of crude oil on Leuceana leucocephala. The plant withstands the varying concentration of the crude oil means that it could be used for the remediation of crude oil contaminated soil in the Niger Delta region of Nigeria.

Keywords: ecosystem conservation, Leuceana leucocephala, phytoremediation, soil pollution

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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: Nastas Andrei

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Ensuring accessible and functional justice is one of the priority objectives of judicial reform, and protecting the family against any acts that may harm its existence is one of the first priorities that have determined the need to defend the social order. In this context, the correlative approach of the victim and the aggressor becomes relevant as a subject of the crime of domestic violence. Domestic violence is a threat of physical, moral, or material harm, externalized now or in the past, or its provocation, which is characterized by a constant tendency to escalate and a high probability of repetitiveness in the relationship between the social partners, regardless of their legal status or domicile.Studying the legal support to identify the particularities of the victim and the subject of the crime of domestic violence facilitates the identification of the determinants of this crime, therefore, the development of means to prevent domestic violence. The scientific research has been effectuated on the base of the proper and authentic empirical data obtained from the analysis of the judicial practice in the matter of domestic violence, as well as being based on the most recent scientific issues in the field of the Substantive Criminal Law and other branches of science (criminology, psychology, sociology, pedagogy). As a result of the study performed, there have been formulated conclusions and interpretations able to be used in the science of the Substantive Criminal law, as well as in the practice of application of the legal norm in the matter of domestic violence.

Keywords: family violence, victim, crime, violence

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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: Mohamed Amine Helali, Walid Oueslati, Ayed Added

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Sedimentation rates and total fluxes of heavy metals (Fe, Mn, Pb, Zn and Cu) was measured in three different depths (10m, 20m and 40m) during March and August 2012, offshore of the Mejerda River outlet (Gulf of Tunis, Tunisia). The sedimentation rates are estimated from the fluxes of the suspended particulate matter at 7.32, 5.45 and 4.39 mm y⁻¹ respectively at 10m, 20m and 40m depth. Heavy metals sequestration in sediments was determined by chemical speciation and the total metal contents in each core collected from 10, 20 and 40m depth. Heavy metals intake to the sediment was measured also from the suspended particulate matter, while the fluxes from the sediment to the water column was determined using the benthic chambers technique and from the diffusive fluxes in the pore water. Results shown that iron is the only metal for which the balance transfer between intake/uptake (45 to 117 / 1.8 to 5.8 g m² y⁻¹) and sequestration (277 to 378 g m² y⁻¹) was negative, at the opposite of the Lead which intake fluxes (360 to 480 mg m² y⁻¹) are more than sequestration fluxes (50 to 92 mg m² y⁻¹). The balance transfer is neutral for Mn, Zn, and Cu. These clearly indicate that the contributions of Mejerda have consistently varied over time, probably due to the migration of the River mouth and to the changes in the mining activity in the Mejerda catchment and the recent human activities which affect the delta area.

Keywords: delta, fluxes, heavy metals, sediments, sedimentation rates

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Authors: Maryam Maleki, Esther Mead, Mohammad Arani, Nitin Agarwal

Abstract:

The proliferation of social media platforms like Twitter has heightened the consequences of the spread of misinformation. To understand and model the spread of misinformation, in this paper, we leveraged the SEIZ (Susceptible, Exposed, Infected, Skeptics) epidemiological model to describe the underlying process that delineates the spread of misinformation on Twitter. Compared to the other epidemiological models, this model produces broader results because it includes the additional Skeptics (Z) compartment, wherein a user may be Exposed to an item of misinformation but not engage in any reaction to it, and the additional Exposed (E) compartment, wherein the user may need some time before deciding to spread a misinformation item. We analyzed misinformation regarding the unrest in Washington, D.C. in the month of March 2020, which was propagated by the use of the #DCblackout hashtag by different users across the U.S. on Twitter. Our analysis shows that misinformation can be modeled using the concept of epidemiology. To the best of our knowledge, this research is the first to attempt to apply the SEIZ epidemiological model to the spread of a specific item of misinformation, which is a category distinct from that of rumor and hoax on online social media platforms. Applying a mathematical model can help to understand the trends and dynamics of the spread of misinformation on Twitter and ultimately help to develop techniques to quickly identify and control it.

Keywords: Black Lives Matter, epidemiological model, mathematical modeling, misinformation, SEIZ model, Twitter

Procedia PDF Downloads 158

Authors: Derrick Mirindi, Frederic Mirindi, Oluwakemi Oshineye

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 71

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 160

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 63

Authors: Mardiati Zain, Ryanto Khasrad, I. Elihasridas, J. Juliantoni

Abstract:

The research objective was to determine the productivity of cattle fed a complete ration with ammoniated based of oil palm-frond supplemented by Rumen Microbes Growth Factor (RMGF). The research used Randomized Block Design applying 4 rations as treatment and 4 groups cattle. The treatments were: A (60% oil palm frond ammoniated + 40% concentrate + RMGF); B (50% oil palm frond ammoniated + 50% concentrate + RMGF); C (40% oil palm frond ammoniated + 60% concentrate + RMGF); and D (30% oil palm frond ammoniated + 70% concentrate + RMGF). The measured parameters were dry matter (DM) and organic matter (OM) intake, daily weight gain (DWG), feed efficiency, total digestible nutrient (TDN), and digestibility of crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF), cellulose, hemicellulose. Statistical analysis showed that the treatment had no significant effect (P > 0.05) on DM intake, OM intake, daily weight gain, feed efficiency, digestibility of DM, OM, CP, TDN, NDF, hemicellulose but had a highly significant effect (P < 0.01) on digestibility of ADF and cellulose. All treatments with different ratio (oil palm frond ammoniated: concentrate : RMGF) had no different effect on cattle productivities.

Keywords: oil palm frond ammoniated, digestibility, rumen microba growth factor, Bali cattle

Procedia PDF Downloads 377

Authors: Panpan Fan, Bo Ming, Niels P. R. Anten, Jochem B. Evers, Yaoyao Li, Shaokun Li, Ruizhi Xie

Abstract:

The reallocation of dry matter (DM) and nitrogen (N) from vegetative tissues to the grain sinks are critical for grain yield. The objective of this study was to quantify the DM and N accumulation, partition, and reallocation at the single-leaf, different-organ, and individual-plant scales and clarify the responses to different levels of N availabilities. A two-year field experiment was conducted in Jinlin province, Northeast China, with three N fertilizer rates to create the different N availability levels: N0 (N deficiency), N1(low supply), and N2 (high supply). The results showed that grain N depends more on reallocations of vegetative organs compared with grain DM. Besides, vegetative organs reallocated more DM and N to grain under lower N availability, whereas more grain DM and grain N were derived from post-silking leaf photosynthesis and post-silking N uptake from the soil under high N availability. Furthermore, the reallocation amount and reallocation efficiency of leaf DM and leaf N content differed among leaf ranks and were regulated by N availability; specifically, the DM reallocation occurs mainly on senesced leaves, whereas the leaf N reallocation was in live leaves. These results provide a theoretical basis for deriving parameters in crop models for the simulation of the demand, uptake, partition, and reallocation processes of DM and N.

Keywords: dry matter, leaf N content, leaf rank, N availability, reallocation efficiency

Procedia PDF Downloads 120

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 41

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 98

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

Abstract:

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 306