Search results for: satisfaction of patients
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7035

Search results for: satisfaction of patients

2865 Influenza Vaccine Uptake Among Tunisian Physicians in the 2018-2019 Influenza Season

Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

Abstract:

Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.

Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake

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2864 Customer Expectation on Service Quality in Bed and Breakfast Establishments in Johannesburg Metropolitan

Authors: Chiedza Lebogang Gutu, Nester Rufaro Manuwa, Jean-Marie Mbuya

Abstract:

In Johannesburg, Metropolitan customer expectations in the hospitality industry have rapidly been increasing which has lead to the need of improving service quality to help satisfy customer expectations. Businesses need to make sure that customer expectations are met, or find ways to control customer expectations. Therefore the purpose of the study is to investigate how customer expectations of services in bed and breakfast establishments affect the perceived quality of service. A quantitative approach was used through random sampling to collect descriptive and correlation study between customer expectations and perceived quality. Findings of the study indicated that customers at bed and breakfast generally expect a clean, friendly and safe environment that has a homely feel, while they are away from home. In addition, findings of the study also emphasised that the age-groups between 20 and 35 are more likely to travel, for business and vacation purposes, staying for more or less 3, have high expectations towards modern facilities and extras in the room such as coffee machines, and are more concerned about the service being provided quickly and right, and taking extra care to deal with problems promptly.

Keywords: Customer satisfaction, Service quality, Bed and breakfast, Customer retention

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2863 [Keynote Talk]: Role of Leaders in Managing Employees’ Dysfunctional Behavior at Workplace

Authors: Aya Maher, Pakinam Youssef

Abstract:

The objective of this theoretical study is to explore in depth the role of leaders in managing employees’ dysfunctional behavior at workplace in an effort to recommend strategies and solutions for these destructive behaviors that affect employees’ performance. The significance of the study lies in the fact that dysfunctional behavior has been widely spread in almost all organizations, public and private, with its very destructive manifestations. Dysfunctional behavior may be classified into thefts, sabotage, sexual harassment, jealousy, envy, revenge, vulgarity all of which affect employees’ moral, self-esteem and satisfaction level drastically which will be reflected negatively on their performance and productivity. The main research question will focus on the role of leaders in managing employees’ dysfunctional behavior effectively at the workplace through the different strategies and control measures. In this study, the data will be collected from different academic literature and through some primary data by conducting interviews with some public and private employees from different managerial levels and fields.

Keywords: dysfunctional behavior, employees deviant behavior, employees moral, leaders role

Procedia PDF Downloads 349
2862 Clinical and Radiological Features of Adenomyosis and Its Histopathological Correlation

Authors: Surabhi Agrawal Kohli, Sunita Gupta, Esha Khanuja, Parul Garg, P. Gupta

Abstract:

Background: Adenomyosis is a common gynaecological condition that affects the menstruating women. Uterine enlargement, dysmenorrhoea, and menorrhagia are regarded as the cardinal clinical symptoms of adenomyosis. Classically it was thought, compared with ultrasonography, when adenomyosis is suspected, MRI enables more accurate diagnosis of the disease. Materials and Methods: 172 subjects were enrolled after an informed consent that had complaints of HMB, dyspareunia, dysmenorrhea, and chronic pelvic pain. Detailed history of the enrolled subjects was taken, followed by a clinical examination. These patients were then subjected to TVS where myometrial echo texture, presence of myometrial cysts, blurring of endomyometrial junction was noted. MRI was followed which noted the presence of junctional zone thickness and myometrial cysts. After hysterectomy, histopathological diagnosis was obtained. Results: 78 participants were analysed. The mean age was 44.2 years. 43.5% had parity of 4 or more. heavy menstrual bleeding (HMB) was present in 97.8% and dysmenorrhea in 93.48 % of HPE positive patient. Transvaginal sonography (TVS) and MRI had a sensitivity of 89.13% and 80.43%, specificity of 90.62% and 84.37%, positive likelihood ratio of 9.51 and 5.15, negative likelihood ratio of 0.12 and 0.23, positive predictive value of 93.18% and 88.1%, negative predictive value of 85.29% and 75% and a diagnostic accuracy of 89.74% and 82.5%. Comparison of sensitivity (p=0.289) and specificity (p=0.625) showed no statistically significant difference between TVS and MRI. Conclusion: Prevalence of 30.23%. HMB with dysmenorrhoea and chronic pelvic pain helps in diagnosis. TVS (Endomyometrial junction blurring) is both sensitive and specific in diagnosing adenomyosis without need for additional diagnostic tool. Both TVS and MRI are equally efficient, however because of certain additional advantages of TVS over MRI, it may be used as the first choice of imaging. MRI may be used additionally in difficult cases as well as in patients with existing co-pathologies.

Keywords: adenomyosis, heavy menstrual bleeding, MRI, TVS

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2861 Concepts of the Covid-19 Pandemic and the Implications of Vaccines for Health Security in Nigeria and Diasporas

Authors: Wisdom Robert Duruji

Abstract:

The outbreak of SARS-CoV-2 serotype infection was recorded in January 2020 in Wuhan City, Hubei Province, China. This study examines the concepts of the COVID-19 pandemic and the implications of vaccines for health security in Nigeria and Diasporas. It challenges the widely accepted assumption that the first case of coronavirus infection in Nigeria was recorded on February 27th, 2020, in Lagos. The study utilizes a range of research methods to achieve its objectives. These include the double-layered culture technique, literature review, website knowledge, Google search, news media information, academic journals, fieldwork, and on-site observations. These diverse methods allow for a comprehensive analysis of the concepts and the implications being studied. The study finds that coronavirus infection can be asymptomatic; it may be the antigenicity of the leukocytes (white blood cells), which produce immunogenic hapten or interferons (α, β and γ) that fight infectious parasites, was an immune response that prevented severe virulence in healthy individuals; the reason healthy patients of coronavirus infection in Nigeria naturally recovered after two to three weeks of on-set of infection and test negative. However, the fatality data from the Nigerian Centre for Disease Control (NCDC) is incorrect in this study’s finding; it perused that the fatalities were primarily due to underlying ailments, hunger, and malnutrition in debilitated, comorbid, or compromised patients. This study concluded that the kits and Polymerase Chain Reaction (PCR) machine currently used by the Nigerian Centre for Disease Control (NCDC) in testing and confirming COVID-19 in Nigeria is not ideal; it is programmed and negates separating the strain to its specific serotypes amongst its genera coronavirus, and family Coronaviridae; and might have confirmed patients with the symptoms of febrile caused by cough, catarrh, typhoid and malaria parasites as Covid-19 positive. Therefore, it is recommended that the coronavirus species infected in Nigeria are opportunistic parasites that thrive in human immuno-suppressed conditions like the herpesvirus; it cannot be eradicated by vaccines; the only virucides are interferons, immunoglobulins, and probably synthetic antiviral guanosine drugs like copegus or ribavirin. The findings emphasized that COVID-19 is not the primary pandemic disease in Nigeria; the lockdown was a mirage and not necessary; but rather, pandemic diseases in Nigeria are corruption, nepotism, hunger, and malnutrition caused by ineptitude in governance, religious dichotomy, and ethnic conflicts.

Keywords: coronavirus, corruption, Covid-19 pandemic, lock-down, Nigeria, vaccine

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2860 Effect of Various Durations of Type 2 Diabetes on Muscle Performance

Authors: Santosh Kumar Yadav, Shobha Keswani, Nishat Quddus, Sohrab Ahmad Khan, Zuheb Ahmad Shiddiqui, Varsha Chorsiya

Abstract:

Introduction: Early onset diabetes is more aggressive than the late onset diabetes. Diabetic individual has a greater spectrum of life period to suffer from its damage, complications, and long-term disability. This study aimed at assessing knee joint muscle performance under various durations of diabetes. Method and Materials: A total of 30 diabetic subjects (18 male and 12 females) without diabetic neuropathy were included for the study. They were divided into three groups with 5 years, 10 years and 15 years of duration of disease each. Muscle performance was evaluated through strength and flexibility. Peak torque for quadriceps muscle was measured using isokinetic dynamometer. Flexibility for quadriceps and hamstring muscles were measured through Ducan’s Elys test and 90/90 test. Results: The result showed significant difference in muscle strength (p<0.05), flexibility (p≤0.05) between groups. Discussion: Optimal muscle strength and flexibility are vital for musculoskeletal health and functional independence. Conclusion: The reduced muscle performance and functional impairment in nonneuropathic diabetic patients suggest that other mechanism besides neuropathy that contribute to altered biomechanics. These findings of this study project early management of these altered parameters through disease-specific physical therapy and assessment-based intervention. Clinical Relevance: Managing disability is more costly than managing disease. Prompt and timely identification and management strategy can dramatically reduce the cost of care for diabetic patients.

Keywords: muscle flexibility, muscle performance, muscle torque, type 2 diabetes

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2859 Self-Efficacy as a Predictor of Well-Being in University Students

Authors: Enes Ergün, Sedat Geli̇bolu

Abstract:

The purpose of this study is to determine the relationship between self-efficacy and subjective well-being among university students. We are aiming to determine whether self efficacy of university students predicts their subjective well-being and if there is a statistically significant difference among boys and girls in this context. Sample of this study consists of 245 university students from Çanakkale, ages ranging between 17 and 24. 72% (n=171) of the participants were girls and 28% (n=69) boys. Three different scales were utilized as data collection tools that Life Satisfaction Scale, General Self-Efficacy Scale, and Positive Negative Experiences Scale. Pearson correlation coefficient, independent sample t test and simple linear regression were used for data analyses. Results showed that well-being is significantly correlated with self-efficacy and self-efficacy is a statistically significant predictor of well-being too. In terms of gender differences, there is no significant difference between self-efficacy scores of boys and girls which shows the same case with well being scores, as well. Fostering university students' academic, social and emotional self-efficacy will increase their well-being which is very important for young adults especially their freshman years.

Keywords: positive psychology, self-efficacy, subjective well being, university students

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2858 Cultural Unconscious Believes About Couple Relationship in Married People

Authors: Saba Moghaddam

Abstract:

There is an ongoing and dynamic interplay between cultural environment and individuals’ psych, an interaction that starts at birth and continues throughout life. Cultural Unconscious affects the way people choose their partners and how they shape their relationships. The aim of this study is to identify cultural unconscious beliefs that play a decisive role in the relationship between couples. The study used the method of thematic analysis, and through purposeful sampling and semi-interviews, the themes regarding cultural unconscious in 17 married people between the ages of 24 and 40 years were identified. These themes are (1) Feminization-masculinization of post-marriage roles; (2) Subordinate Women – an intergenerational belief; (3) cultural standards affecting the choice of spouse; (4) primary family beliefs about marriage. Based on these findings, traditional beliefs continue to play a decisive function and effect on people’s unconscious, and in order to achieve a couple's relationship satisfaction, identifying their roles and becoming conscious of these unconscious cultural beliefs is very important.

Keywords: couple relationship, partner choice, thematic analysis, unconscious cultural believes

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2857 Emergence of Vancomycin Resistant and Methcillin Resistant Staphylococus aureus in Patients with Different Clinical Manifestations in Khartoum State, Sudan

Authors: Maimona A. E. Elimam, Suhair Rehan, Miskelyemen A. Elmekki, Mogahid M. Elhassan

Abstract:

Staphylococcus aureus (Staph. aureus), a major cause of potentially life-threatening infections acquired in healthcare and community settings, has developed resistance to most classes of antimicrobial agents as determined by the dramatic increase. The present study aimed to determine the prevalence of MRSA, and VRSA in patients with different clinical manifestations in Khartoum state. The study population (n, 426) were males and females with different age categories, suffering either from wound infections (105), ear infections (121), or UTI (101), in addition to nasal carriers of medical staff (100). Cultures, Gram staining, and other biochemical tests were performed for conventional identification. Modified Kirby-Bauer disk diffusion method was applied and DNA was extracted from MRSA and VRSA isolates and PCR was then performed for amplification of arc, mecA, VanA, and VanB genes. The results confirmed the existence of Staph. aureus in 49/426 (11.5%) cases among which MRSA were isolated from 34/49 (69.4%) when modified Kirby-Bauer disk diffusion method was applied. Ten out of these 34 MRSA were confirmed as VRSA by cultures on BHI agar containing 6μg/ml vancomycin according to NCCLS criteria. PCR revealed that out of the 34 MRSA isolates, 26 were mecA positive (76.5%) while 8 (23.5%) were arcC positive. No vanA or VanB genes were detected. Molecular method confirmed the results for MRSA through the presence of either arcC or mecA genes while it failed to approve the occurrence of VRSA since neither VanA or VanB genes were detected. Thus, VRSA may be attributed to other factors.

Keywords: antibiotic resistance, Staphylococcus aureus, VRSA, MRSA, Khartoum, Sudan

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2856 Medical Diagnosis of Retinal Diseases Using Artificial Intelligence Deep Learning Models

Authors: Ethan James

Abstract:

Over one billion people worldwide suffer from some level of vision loss or blindness as a result of progressive retinal diseases. Many patients, particularly in developing areas, are incorrectly diagnosed or undiagnosed whatsoever due to unconventional diagnostic tools and screening methods. Artificial intelligence (AI) based on deep learning (DL) convolutional neural networks (CNN) have recently gained a high interest in ophthalmology for its computer-imaging diagnosis, disease prognosis, and risk assessment. Optical coherence tomography (OCT) is a popular imaging technique used to capture high-resolution cross-sections of retinas. In ophthalmology, DL has been applied to fundus photographs, optical coherence tomography, and visual fields, achieving robust classification performance in the detection of various retinal diseases including macular degeneration, diabetic retinopathy, and retinitis pigmentosa. However, there is no complete diagnostic model to analyze these retinal images that provide a diagnostic accuracy above 90%. Thus, the purpose of this project was to develop an AI model that utilizes machine learning techniques to automatically diagnose specific retinal diseases from OCT scans. The algorithm consists of neural network architecture that was trained from a dataset of over 20,000 real-world OCT images to train the robust model to utilize residual neural networks with cyclic pooling. This DL model can ultimately aid ophthalmologists in diagnosing patients with these retinal diseases more quickly and more accurately, therefore facilitating earlier treatment, which results in improved post-treatment outcomes.

Keywords: artificial intelligence, deep learning, imaging, medical devices, ophthalmic devices, ophthalmology, retina

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2855 Intrinsic and Extrinsic Motivations in Organic Farming Practices and Farmers’ Subjective Well-Being: The Case of French Organic Farmers

Authors: Nguyen Thi Huong Nhai

Abstract:

This paper examines how different motivations to engage in organic farming may impact the farmers’ subjective well-being using a survey database from the French Agence Bio. Three measures representing the subjective well-being of farmers brought by their involvement in organic farming are used in this study: feelings of pride, satisfaction, and feeling of happiness. We focus on the effects of two different types of motivations: intrinsic motivations, such as preservation of human health and public health, concern about the environment, and autonomy in farming decisions; extrinsic motivations, such as fair price, income, and demand incentives. Results show that not all intrinsic motivations can increase farmers’s well-being. The intrinsic motivation relating to environment concern and aspiration seems to have the highest positive impact on the three proxies of SWB in our study. It is interesting to find out that the two extrinsic motivations (profitable price, satisfying the incentive of consumer and cooperative) are proven to have a negative influence. Some comparisons, explanations, and practical implications are also indicated in this research.

Keywords: intrinsic otivation, extrinsic motivation, subjective wellbeing, organic farmers

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2854 The Severity of Electric Bicycle Injuries Compared to Classic Bicycle Injuries in Children: A Retrospective Review

Authors: Tali Capua, Karin Hermon, Miguel Glatstein, Oren Tavor, Ayelet Rimon

Abstract:

Background: Electric bicycles (E-bikes) are one of a wide range of light electric vehicles that provide convenient local transportation and attractive recreational opportunities. Along with their growing use worldwide, the E-bike related injury rate increases. To the best of our knowledge, this study is the first to specifically compare E-bike with classic bicycle related injuries in children. Methods: Data of all pediatric ( < 16 years of age) bicycle related injuries presenting to an urban level I trauma center between 2014 and 2015 were collected and analyzed. The recorded data included age, gender, details of the accident, as well severity of injury, medical diagnosis, and the outcome. Abbreviated Injury Score (AIS) and Injury Severity Score (ISS) were calculated for each patient. Data of E-bike related injuries and classic bicycle were then compared. Results: A total of 124 bicycle related injuries and 97 E-bike related injuries presented to the emergency department. Once pedestrians and bicycle passengers were removed, the groups of riders consisted of 111 bikers and 85 E-bikers. The mean age of bikers was 9.9 years (range 3-16 years) and of E-bikers was 13.7 years (range 7.5-16 years). Injuries to the head and the extremities were common in both groups. Compared to bikers, E-bikers had significantly more injuries to intra-abdominal organs (p = 0.04). Twenty patients (16%) with bicycle related injuries were admitted, and 13 (15%) patients with E-bike related injuries, of the latter group four underwent surgical intervention. ISS scores were low overall, but the injuries of higher severity (ISS > 9) were among the E-bikers. Conclusions: This study provides unique information which suggests that injuries in E-bikers tend to be more severe than in classic bikers. There is a need for regulation regarding the use of E-bikes to enhance the safety of both bikers and other road and pavement users.

Keywords: bicycle, electric bicycle, injury, pediatric, trauma

Procedia PDF Downloads 190
2853 Advanced Mechatronic Design of Robot Manipulator Using Hardware-In-The-Loop Simulation

Authors: Reza Karami, Ali Akbar Ebrahimi

Abstract:

This paper discusses concurrent engineering of robot manipulators, based on the Holistic Concurrent Design (HCD) methodology and by using a hardware-in-the-loop simulation platform. The methodology allows for considering numerous design variables with different natures concurrently. It redefines the ultimate goal of design based on the notion of satisfaction, resulting in the simplification of the multi-objective constrained optimization process. It also formalizes the effect of designer’s subjective attitude in the process. To enhance modeling efficiency for both computation and accuracy, a hardware-in-the-loop simulation platform is used, which involves physical joint modules and the control unit in addition to the software modules. This platform is implemented in the HCD design architecture to reliably evaluate the design attributes and performance super criterion during the design process. The resulting overall architecture is applied to redesigning kinematic, dynamic and control parameters of an industrial robot manipulator.

Keywords: concurrent engineering, hardware-in-the-loop simulation, robot manipulator, multidisciplinary systems, mechatronics

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2852 Rrelationship Between Intrauterine Growth Retardation and TORCH Infections in Neonates

Authors: Seyed Saeid Nabavi

Abstract:

Background: Many infants with intrauterine growth disorder are screened for TORCH infections. This action has no economic justification in terms of the imposed costs. In this regard, due to the research gap in this field, this study aimed to investigate the relationship between intrauterine growth disorder and TORCH infection in neonates referred to Milad hospital in 2019 and 2020. Materials and Methods: In this cross-sectional study, 41IUGR newborns were selected and evaluated based on diagnostic and clinical studies in Milad Hospital in 2019 and 2020. TORCH results found in IgG and IgM antibody titer assay were tested in mother and infant. Antibody titers of toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis were determined in cases, and other variables were compared. The collected data were entered in SPSS software 25 and analyzed at a significant level of 0.05 using the statistical tests of Kolmogorov–Smirnov, Shapiro–Wilk, chi-square, and Mann–Whitney. Results: Most of the IUGR infants studied were girls (68.3%), Gravida and Parity were reported to be 68.3% and 80%, respectively, in the study. Mean weight, APGAR score, and neonatal gestational age are reported as 1710.62±334.43 g, 7.71±1.47, and 35.7+ 1.98 weeks, respectively. Most of the newborns were born by cesarean section (92.7%). TORCH infection was reported in three patients, 7.3%. The mean gestational age of IUGR infants with TORCH infection was reported to be less than other babies with IUGR. Therefore, the mean gestational age of subjects with TORCH infection was 33±1.4 weeks and in others 35.94±1.91 weeks (p-value = 0.038). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found (p-value > 0.05). Conclusion: TORCH infection was reported in 3 patients( 7.3%). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found. p-value > 0.05

Keywords: congenital infection, intrauterine growth restriction, TORCH infections, neonates

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2851 Making the Right Call for Falls: Evaluating the Efficacy of a Multi-Faceted Trust Wide Approach to Improving Patient Safety Post Falls

Authors: Jawaad Saleem, Hannah Wright, Peter Sommerville, Adrian Hopper

Abstract:

Introduction: Inpatient falls are the most commonly reported patient safety incidents, and carry a significant burden on resources, morbidity, and mortality. Ensuring adequate post falls management of patients by staff is therefore paramount to maintaining patient safety especially in out of hours and resource stretched settings. Aims: This quality improvement project aims to improve the current practice of falls management at Guys St Thomas Hospital, London as compared to our 2016 Quality Improvement Project findings. Furthermore, it looks to increase current junior doctors confidence in managing falls and their use of new guidance protocols. Methods: Multifaceted Interventions implemented included: the development of new trust wide guidelines detailing management pathways for patients post falls, available for intranet access. Furthermore, the production of 2000 lanyard cards distributed amongst junior doctors and staff which summarised these guidelines. Additionally, a ‘safety signal’ email was sent from the Trust chief medical officer to all staff raising awareness of falls and the guidelines. Formal falls teaching was also implemented for new doctors at induction. Using an established incident database, 189 consecutive falls in 2017were retrospectively analysed electronically to assess and compared to the variables measured in 2016 post interventions. A separate serious incident database was used to analyse 50 falls from May 2015 to March 2018 to ascertain the statistical significance of the impact of our interventions on serious incidents. A similar questionnaire for the 2017 cohort of foundation year one (FY1) doctors was performed and compared to 2016 results. Results: Questionnaire data demonstrated improved awareness and utility of guidelines and increased confidence as well as an increase in training. 97% of FY1 trainees felt that the interventions had increased their awareness of the impact of falls on patients in the trust. Data from the incident database demonstrated the time to review patients post fall had decreased from an average of 130 to 86 minutes. Improvement was also demonstrated in the reduced time to order and schedule X-ray and CT imaging, 3 and 5 hours respectively. Data from the serious incident database show that ‘the time from fall until harm was detected’ was statistically significantly lower (P = 0.044) post intervention. We also showed the incidence of significant delays in detecting harm ( > 10 hours) reduced post intervention. Conclusions: Our interventions have helped to significantly reduce the average time to assess, order and schedule appropriate imaging post falls. Delays of over ten hours to detect serious injuries after falls were commonplace; since the intervention, their frequency has markedly reduced. We suggest this will lead to identifying patient harm sooner, reduced clinical incidents relating to falls and thus improve overall patient safety. Our interventions have also helped increase clinical staff confidence, management, and awareness of falls in the trust. Next steps include expanding teaching sessions, improving multidisciplinary team involvement to aid this improvement.

Keywords: patient safety, quality improvement, serious incidents, falls, clinical care

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2850 The Addition of Opioids to Bupivacaine in Bilateral Infraorbital Nerve Block for Postoperative Pain Relief in Paediatric Patients for Cleft Lip Repair-Comparative Effects of Pethidine and Fentanyl: A Prospective Randomized Double Blind Study

Authors: Mrudula Kudtarkar, Rajesh Mane

Abstract:

Introduction: Cleft lip repair is one of the common surgeries performed in India and the usual method used for post-operative analgesia is perioperative opioids and NSAIDs. There has been an increase in use of regional techniques and Opioids are the common adjuvants but their efficacy and safety have not been studied extensively in children. Aim: A prospective, randomized, double-blind study was done to compare the efficacy, duration and safety of intraoral infraorbital nerve block on post-operative pain relief using bupivacaine alone or in combination with fentanyl or pethidine in paediatric cleft lip repair. Methodology: 45 children between the age group 5 – 60 months undergoing cleft lip surgery randomly allocated into 3 groups of 15 each received bilateral intraoral infraorbital nerve block with 0.75ml of solution. Group B received 0.25% bupivacaine; group P received 0.25% bupivacaine with 0.25mg/kg pethidine, group F received 0.25% bupivacaine with 0.25microgm/kg fentanyl. Sedation after recovery, post-operative pain intensity and duration of post-operative analgesia were assessed using Modified Hannallah Pain Score. Results: The mean duration of analgesia was 17.8 hrs in Group B, 23.53 hrs in Group F and 35.13 hrs in Group P. There was statistically significant difference between the means of the three groups- ANOVA (p < 0.05). Conclusion: Thus we conclude that addition of fentanyl or pethidine to bupivacaine for Bilateral Intraoral Infraorbital Nerve Block prolong the duration of analgesia with no complications and can be used safely in paediatric patients.

Keywords: cleft lip, infraorbital block, NSAIDS, Opiods

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2849 A Study of Achievement and Attitude on Learning Science in English by Using Co – Teaching Method

Authors: Sakchai Rachniyom

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Owing to the ASEAN community will formally take place in the few months; therefore, Thais should realize about the importance of English language. Since, it is regarded as a working language in the community. To promote Science students’ English proficiency, teacher should be able to teach in English language appropriately and effectively. The purposes of the quasi – experimental research are (1) to measure the learning achievement, (2) to evaluate students’ satisfaction on the teaching and learning and (3) to study the consequences of co – teaching method in order comprehend the learning achievement and improvement. The participants were 40 general science students teacher. Two types of research instruments were included; (1) an achievement test, and (2) a questionnaire. This research was conducted for 1 semester. The statistics used in this research were arithmetic mean and standard deviation. The findings of the study revealed that students’ achievement score was significantly increased at statistical level .05 and the students satisfied the teaching and learning at the highest level . The students’ involvement and teachers’ support were promoted. It was also reported students’ learning was improved by co – teaching method.

Keywords: co – teaching method, learning science in english, teacher, education

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2848 Bi-Objective Optimization for Sustainable Supply Chain Network Design in Omnichannel

Authors: Veerpaul Maan, Gaurav Mishra

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The evolution of omnichannel has revolutionized the supply chain of the organizations by enhancing customer shopping experience. For these organizations need to develop well-integrated multiple distribution channels to leverage the benefits of omnichannel. To adopt an omnichannel system in the supply chain has resulted in structuring and reconfiguring the practices of the traditional supply chain distribution network. In this paper a multiple distribution supply chain network (MDSCN) have been proposed which integrates online giants with a local retailers distribution network in uncertain environment followed by sustainability. To incorporate sustainability, an additional objective function is added to reduce the carbon content through minimizing the travel distance of the product. Through this proposed model, customers are free to access product and services as per their choice of channels which increases their convenience, reach and satisfaction. Further, a numerical illustration is being shown along with interpretation of results to validate the proposed model.

Keywords: sustainable supply chain network, omnichannel, multiple distribution supply chain network, integrate multiple distribution channels

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2847 Wearable Monitoring and Treatment System for Parkinson’s Disease

Authors: Bulcha Belay Etana, Benny Malengier, Janarthanan Krishnamoorthy, Timothy Kwa, Lieva Vanlangenhove

Abstract:

Electromyography measures the electrical activity of muscles using surface electrodes or needle electrodes to monitor various disease conditions. Recent developments in the signal acquisition of electromyograms using textile electrodes facilitate wearable devices, enabling patients to monitor and control their health status outside of healthcare facilities. Here, we have developed and tested wearable textile electrodes to acquire electromyography signals from patients suffering from Parkinson’s disease and incorporated a feedback-control system to relieve muscle cramping through thermal stimulus. In brief, the textile electrodes made of stainless steel was knitted into a textile fabric as a sleeve, and their electrical characteristic, such as signal-to-noise ratio, was compared with traditional electrodes. To relieve muscle cramping, a heating element made of stainless-steel conductive yarn sewn onto a cotton fabric, coupled with a vibration system, was developed. The system integrated a microcontroller and a Myoware muscle sensor to activate the heating element as well as the vibration motor when cramping occurred. At the same time, the element gets deactivated when the muscle cramping subsides. An optimum therapeutic temperature of 35.5°C is regulated and maintained continuously by a heating device. The textile electrode exhibited a signal-to-noise ratio of 6.38dB, comparable to that of the traditional electrode’s value of 7.05 dB. For a given 9 V power supply, the rise time for the developed heating element was about 6 minutes to reach an optimum temperature.

Keywords: smart textile system, wearable electronic textile, electromyography, heating textile, vibration therapy, Parkinson’s disease

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2846 Use of Dual-Energy CT Post Endovascular Treatment of Cerebral Aneurysm

Authors: Mitchell Stanton

Abstract:

Background: Endovascular management is well established as a mainstay treatment option for cerebral aneurysms. It is also well established that immediate post procedural imaging can be difficult to interpret due to the presence of contrast material. However, through the use of Dual-Energy computed tomography, it has become possible to differentiate contrast extravasation and intracranial haemorrhage. This case illustrates the importance of this technology following endovascular treatment of an unruptured cerebral aneurysm. Case Presentation: A 79-year-old female was found to have an unruptured large intracavernous ICA fusiform aneurysm on CT Brain Angiogram after presenting with acute ophthalmoplegia. This ophthalmoplegia was caused by mass effect from the aneurysm and subsequently the aneurysm was treated with an endovascular flow diverting stent. CT brain was performed post operatively due to a reduced level of consciousness and this showed diffuse subarachnoid hyperdensity of the left hemisphere. The use of Dual-Energy CT allowed accurate differentiation and illustrated diffuse contrast material extravasation, allowing patient to continue on dual-antiplatelets and therapeutic anticoagulation to reduce the risk of ischaemic injury post endovascular stent. Conclusion: Endovascular treatment options for management of intracranial aneurysms are constantly evolving. The use of Dual-Energy CT therefore has an integral role in accurately diagnosing any post-operative complications. Specifically, differentiating between subarachnoid haemorrhage and contrast extravasation is vital in these patients due to the significant consequences to their ongoing management in regards to continuation or cessation of antiplatelets or anticoagulation. With increasing access to this technology, its use should become standard practice in the post-operative investigation of these patients undergoing endovascular treatment.

Keywords: aneurysm, computed tomography, contrast extravasation, dual-energy CT, endovascular, subarachnoid haemorrhage

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2845 The Impact of Working Environment Condition and Lifestyle Factors in Male Infertility in South of Iran

Authors: Shabnam Etemadi

Abstract:

Background: Infertility is one of the most important issues in any society due to its psychological, medical and economic consequences that can greatly influence overall health and life. This study aims to assess the relationship between inhalation or exposing workplace pollution and dysfunction of the male reproductive system. Semen samples are male employees in south of Iran who exposed to work environmental pollutants for long hours. Method: Due to descriptive-analytical, the analysis of all interviews of all male patients of Bu Ali Medical Center and Pasteur Laboratory are conducted within 6 months. Random sampling numbered and patients signed informed consent. To analyze the data, Miller's fertility motivation questionnaires and the Miller-Smith lifestyle assessment inventory are used and Working Conditions Survey is developed. For analyzing the collecting data SPSS is used. Findings: Although sperm motility and volume had no statistically significant relationship with any of the lifestyle components, the weak relationship between sperm movement and work environment conditions (P = 0.07) lead to other factors to be investigated. * Among the factors of Working Environment Condition, smoking, work in the open environment and presence of more than 6 hours in the work environment with sperm mobility, smoking, contact with chemicals and radioactive with sperm volume at a level less than 0.05 had a statistically significant relationship. Conclusion: Finding revealed the environment pollution is one of the important factors in male infertility and strengthens this hypothesis. Working Environmental pollutants in the field of metropolitan pollution should be considered as a unifying hypothesis, possibly could interfere with male reproductive function.

Keywords: infertility, lifestyle, workplace pollution, male infertility

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2844 Association between TNF-α and Its Receptor TNFRSF1B Polymorphism with Pulmonary Tuberculosis in Tomsk, Russia Federation

Authors: K. A. Gladkova, N. P. Babushkina, E. Y. Bragina

Abstract:

Purpose: Tuberculosis (TB), caused by Mycobacterium tuberculosis, is one of the major public health problems worldwide. It is clear that the immune response to M. tuberculosis infection is a relationship between inflammatory and anti-inflammatory responses in which Tumour Necrosis Factor-α (TNF-α) plays key roles as a pro-inflammatory cytokine. TNF-α involved in various cell immune responses via binding to its two types of membrane-bound receptors, TNFRSF1A and TNFRSF1B. Importantly, some variants of the TNFRSF1B gene have been considered as possible markers of host susceptibility to TB. However, the possible impact of such TNF-α and its receptor genes polymorphism on TB cases in Tomsk is missing. Thus, the purpose of our study was to investigate polymorphism of TNF-α (rs1800629) and its receptor TNFRSF1B (rs652625 and rs525891) genes in population of Tomsk and to evaluate their possible association with the development of pulmonary TB. Materials and Methods: The population distribution features of genes polymorphisms were investigated and made case-control study based on group of people from Tomsk. Human blood was collected during routine patients examination at Tomsk Regional TB Dispensary. Altogether, 234 TB-positive patients (80 women, 154 men, average age is 28 years old) and 205 health-controls (153 women, 52 men, average age is 47 years old) were investigated. DNA was extracted from blood plasma by phenol-chloroform method. Genotyping was carried out by a single-nucleotide-specific real-time PCR assay. Results: First, interpopulational comparison was carried out between healthy individuals from Tomsk and available data from the 1000 Genomes project. It was found that polymorphism rs1800629 region demonstrated that Tomsk population was significantly different from Japanese (P = 0.0007), but it was similar with the following Europeans subpopulations: Italians (P = 0.052), Finns (P = 0.124) and British (P = 0.910). Polymorphism rs525891 clear demonstrated that group from Tomsk was significantly different from population of South Africa (P = 0.019). However, rs652625 demonstrated significant differences from Asian population: Chinese (P = 0.03) and Japanese (P = 0.004). Next, we have compared healthy individuals versus patients with TB. It was detected that no association between rs1800629, rs652625 polymorphisms, and positive TB cases. Importantly, AT genotype of polymorphism rs525891 was significantly associated with resistance to TB (odds ratio (OR) = 0.61; 95% confidence interval (CI): 0.41-0.9; P < 0.05). Conclusion: To the best of our knowledge, the polymorphism of TNFRSF1B (rs525891) was associated with TB, while genotype AT is protective [OR = 0.61] in Tomsk population. In contrast, no significant correlation was detected between polymorphism TNF-α (rs1800629) and TNFRSF1B (rs652625) genes and alveolar TB cases among population of Tomsk. In conclusion, our data expands the molecular particularities associated with TB. The study was supported by the grant of the Russia for Basic Research #15-04-05852.

Keywords: polymorphism, tuberculosis, TNF-α, TNFRSF1B gene

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2843 Using Wearable Technology to Monitor Workers’ Stress for Construction Safety: A Conceptual Framework

Authors: Namhun Lee, Seong Jin Kim

Abstract:

The construction industry represents one of the largest industries in the United States, yet it continues to face several occupational health and safety challenges. Many workers on construction sites are suffering from extended exposure to stressful situations such as poor and hazardous work environments and task complexity. Stress can be commonly defined as a feeling of emotional or physical tension, which can easily impact construction safety and result in a higher rate of job-related injuries in the construction industry. Physiological signals transmitted from wearable biosensors can be used to detect excessive stress. Therefore, workers’ stress should be detected and mitigated to prevent any type of serious incident or accident proactively. By doing this, construction productivity, as well as job satisfaction, would also be improved in the construction industry. To establish a foundation in this field of research, a conceptual framework for using wearable technology for construction safety has been developed for continuous and automatic monitoring of worker’s stress. The conceptual framework will serve as a foothold in future studies on the application of wearable technology for construction safety.

Keywords: construction safety, occupational stress, stress monitoring, wearable biosensors

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2842 The Effect of Vitamin D Supplementation on Prostate Cancer: A Systematic Review and Meta-Analysis of Clinical Trials

Authors: Simin Shahvazi, Sepideh Soltani, Seyed Mehdi Ahmadi, Russell J. De Souza, Amin Salehi-Abargouei

Abstract:

Background and Objectives: Vitamin D has received attention for its potential to disrupt cancer processes such as attenuating cell proliferation and exacerbating differentiation and apoptosis. However, whether there exists a role for vitamin D in the treatment of prostate cancer specifically remains controversial. We systematically review the literature to assess whether supplementation with vitamin D influences PSA response and overall survival in patients with prostate cancer. Methods: We searched PubMed, Scopus, ISI Web of Science and Google scholar from inception through up to 10 September 2017 for both before-and-after and randomized trials that evaluated the effect of vitamin D supplementation on the prostate specific antigen (PSA) response rate in participants with prostate cancer. The DerSimonian and Laird, inverse-weighted random-effects model was used to pool effect estimates from the studies. Heterogeneity and potential publication bias were evaluated. Subgroup analyses were also performed. Results: Twenty-two studies (16 before-after and 6 randomized controlled trials) were found and included in meta-analysis. The analysis on controlled clinical trials revealed that PSA change from baseline [weighted mean difference (WMD) = -1.66 ng/ml, 95%CI: -0.69, 0.36, P= 0.543)], PSA response (RR=1.18, 95%CI: 0.97, 1.45, P=0.104) and mortality rate (risk ratio (RR) = 1.05, 95% CI: 0.81-1.36; P=0.713) was not significantly different between vitamin D supplementation and placebo groups. Single arm trials revealed that vitamin D supplementation had had a modest effect on PSA response rate: 19% of those enrolled had at least a 50% reduction in PSA by the end of treatment (95% CI: 7% to 31%; p=0.002). Conclusion: We found that vitamin D modestly increases the PSA response rate in single arm studies. No effect on serum PSA levels, PSA response and mortality was seen in randomized controlled clinical trials. It does not seem patients with prostate cancer benefit from vitamin D supplementation.

Keywords: mortality, prostatic neoplasms, PSA response, vitamin D

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2841 Effect of a Polyherbal Gut Therapy Protocol in Changes of Gut and Behavioral Symptoms of Antibiotic Induced Dysbiosis of Autistic Babies

Authors: Dinesh K. S., D. R. C. V. Jayadevan

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Autism is the most prevalent of a subset of the disorders organized under the umbrella of pervasive developmental disorders. After the publication of Andrew Wakefield's paper in lancet, many critiques deny this connection even without looking in to the matter. The British Medical Journal even put an editorial regarding this issue. BMJ 2010; 340:c1807. But ayurveda has ample of evidences to believe this connectivity. Dysbiosis, yeast growth of the gut, nutritional deficiencies, enzyme deficiencies, essential fatty acid deficiencies, Gastro esophageal reflux disease, indigestion, inflammatory bowel, chronic constipation & its cascade are few of them to note. The purpose of this paper is to present the observed changes in the behavioural symptoms of autistic babies after a gut management protocol which is a usual programme of our autism treatment plan especially after dysbiotic changes after antibiotic administration. Is there any correlation between changes (if significant) in gut symptoms and behavioral problems of autistic babies especially after a dysbiosis induced by antibiotics. Retrospective analysis of the case sheets of autistic patients admitted in Vaidyaratnam P.S.Varier Ayurveda College hospital, kottakkal,kerala, india from September 2010 are taken for the data processing. Autistic patients are used to come to this hospital as a part of their usual course of treatment. We investigated 40 cases diagnosed as autistic by clinical psychologists from different institutions who had dysbiosis induced by antibiotics. Significant change in gut symptoms before and after treatment p<0.05 in most of its components Significant change in behavioral symptoms before and after treatments p<0.05 in most of the components Correlation between gut symptoms change and behavioral symptoms changes after treatment is + 0.86. Conclusion : Selected Polyherbal Ayurveda treatment has significant role to play to make changes abnormal behaviors in autistic babies and has a positive correlation with changes in gut symptoms induced by dysbiosis of antibiotic intake.

Keywords: ayurveda, autism, dysbiosis, antibiotic

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2840 The Exploration on the Mode of Renovation and Reconstruction of Old Factory Buildings for Cultural and Creative Industrial Parks

Authors: Yu Pan, Jing Wu, Lingwan Shen

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Since the reform and opening, China's cities have developed rapidly, and the industrial structure has been constantly adjusted and optimized. A large number of industrial plants have lost their production functions and become idle buildings. The renovation projects for the old factory buildings are important parts of the urban renewal, and most of them are the cultural and creative industrial park projects. In this paper, a statistical analysis of renovation projects of the representative cultural and creative industrial parks in recent years was conducted. According to the user's spatial experience satisfaction survey, the physical and spatial factors affecting the space regeneration of the old factory were concluded. Thus the relationship between space regeneration and material, structure, internal and external space design has been derived. Finally, we summarized the general spatial processing model in which the contradiction between ‘new’ and ‘old’ can be grafted and transformed.

Keywords: renovation of factory buildings, urban renewal, the cultural and creative industrial park, space regeneration, reconstruction mode

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2839 Comparing the Effects of Systemic Family Intervention on End Stage Renal Disease: Families of Different Modalities

Authors: Fenni Sim

Abstract:

Background: The application of systemic family therapy approaches to community health cases have not gathered traction. In National Kidney Foundation, Singapore, the belief is that community support has great potential in helping End Stage Renal Failure (ESRF) patients manage the demands of their treatment regime, whether Hemodialysis (HD) or Peritoneal Dialysis(PD) and sustain them on the treatment. However, the current community support does not include family interventions and is largely nursing based. Although nursing support is well provided to patients, and their family members in issues related to treatment and compliance, complex family issues and dynamics arising from caregiver strain or pre-dialysis relationship strain might deter efforts in managing the challenges of the treatment. Objective: The objective of the study is to understand the potential scope of work provided by a social worker who is trained in systemic family therapy and the effects of these interventions. Methodology: 3 families on HD and 3 families on PD who have been receiving family intervention for the past 6 months would be chosen for the study. A qualitative interview would be conducted to review the effectiveness for the family. Scales such as SCORE-15, PHQ-9, and Zarit Burden were used to measure family functioning, depression, and caregiver’s burden for the families. Results: The research is still in preliminary phase. Conclusion: The study highlights the importance of family intervention for families with multiple stressors on different treatment modalities who might have different needs and challenges. Nursing support needs to be complemented with family-based support to manage complex family issues in order to achieve better health outcomes and improved family coping.

Keywords: complementing nursing support, end stage renal failure, healthcare, systemic approaches

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2838 The Promotion of AI Technology to Financial Development in China

Authors: Li Yong

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Using the data of 135 financial institutions in China from 2018 to 2022, this paper deeply analyzes the underlying theoretical mechanism of artificial intelligence (AI) technology promoting financial development and examines the impact of AI technology on the digital transformation performance of financial enterprises. It is found that the level of AI technology has a significant positive impact on the development of finance. Compared with the impact on the expansion of financial scale, AI technology plays a greater role in improving the performance of financial institutions, reflecting the trend characteristics of the current AI technology to promote the evolution of financial structure. By investigating the intermediary transmission effects, we found that AI technology plays a positive role in promoting the performance of financial institutions by reducing operating costs and improving customer satisfaction, but its function in innovating financial products and mitigating financial risks is relatively limited. In addition, the promotion of AI technology in financial development has significant heterogeneity in terms of the type, scale, and attributes of financial institutions.

Keywords: artificial intelligence technology, financial development, China, heterogeneity

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2837 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

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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

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2836 Investigate the Rural Mobility and Accessibility Challenges of Seniors

Authors: Tom Ryan

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This paper investigates the rural mobility and accessibility challenges of a specific target group - Seniors. The target group is those over 66 years of age who are entitled to use the Public Transport (PT) Free Travel Scheme in rural Ireland. The paper explores at a high level some of the projected rural PT challenges and requirements over the next 10-15 years, noting that statistical predictions show that there will be a significant population demographic shift within the Senior's age profile. Using the PESTEL framework, the literature review explored existing research concerning mobility, accessibility challenges, and the opportunities Seniors face. Twenty-seven qualitative in-depth interviews with stakeholders within the ecosystem were undertaken. The stakeholders included: rural PT customers, Local-Link managers, NTA senior management, a Minister of State, and a European parliament policymaker. Tier 1 interviewee feedback spotlights that the PT network system does not exist for rural patients to access hospital facilities. There was no evidence from the Tier 2 research findings to show that health policymakers and transport planners are working to deliver a national solution to support patients getting access to hospital appointments. Several research interviewees discussed the theme of isolation and the perceived stigma of senior males utilising PT. The findings indicated that MaaS is potentially revolutionary in the PT arena. Finally, this paper suggests several short-, medium- and long-term recommendations based on the research findings. These recommendations are a potential springboard to ensure that rural PT is suitable for future Irish generations.

Keywords: accessibility, active ageing, car dependence, isolation, seniors health issues, behavioural changes, environmental challenges, internet of things, demand responsive, mobility as a service

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