Search results for: bilingual medical dictionary
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3602

Search results for: bilingual medical dictionary

3182 A Question of Ethics and Faith

Authors: Madhavi-Priya Singh, Liam Lowe, Farouk Arnaout, Ludmilla Pillay, Giordan Perez, Luke Mischker, Steve Costa

Abstract:

An Emergency Department consultant identified the failure of medical students to complete the task of clerking a patient in its entirety. As six medical students on our first clinical placement, we recognised our own failure and endeavoured to examine why this failure was consistent among all medical students that had been given this task, despite our best motivations as adult learner. Our aim is to understand and investigate the elements which impeded our ability to learn and perform as medical students in the clinical environment, with reference to the prescribed task. We also aim to generate a discussion around the delivery of medical education with potential solutions to these barriers. Six medical students gathered together to have a comprehensive reflective discussion to identify possible factors leading to the failure of the task. First, we thoroughly analysed the delivery of the instructions with reference to the literature to identify potential flaws. We then examined personal, social, ethical, and cultural factors which may have impacted our ability to complete the task in its entirety. Through collation of our shared experiences, with support from discussion in the field of medical education and ethics, we identified two major areas that impacted our ability to complete the set task. First, we experienced an ethical conflict where we believed the inconvenience and potential harm inflicted on patients did not justify the positive impact the patient interaction would have on our medical learning. Second, we identified a lack of confidence stemming from multiple factors, including the conflict between preclinical and clinical learning, perceptions of perfectionism in the culture of medicine, and the influence of upward social comparison. After discussions, we found that the various factors we identified exacerbated the fears and doubts we already had about our own abilities and that of the medical education system. This doubt led us to avoid completing certain aspects of the tasks that were prescribed and further reinforced our vulnerability and perceived incompetence. Exploration of philosophical theories identified the importance of the role of doubt in education. We propose the need for further discussion around incorporating both pedagogic and andragogic teaching styles in clinical medical education and the acceptance of doubt as a driver of our learning. Doubt will continue to permeate our thoughts and actions no matter what. The moral or psychological distress that arises from this is the key motivating factor for our avoidance of tasks. If we accept this doubt and education embraces this doubt, it will no longer linger in the shadows as a negative and restrictive emotion but fuel a brighter dialogue and positive learning experience, ultimately assisting us in achieving our full potential.

Keywords: medical education, clinical education, andragogy, pedagogy

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3181 Cyber-Med: Practical Detection Methodology of Cyber-Attacks Aimed at Medical Devices Eco-Systems

Authors: Nir Nissim, Erez Shalom, Tomer Lancewiki, Yuval Elovici, Yuval Shahar

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Background: A Medical Device (MD) is an instrument, machine, implant, or similar device that includes a component intended for the purpose of the diagnosis, cure, treatment, or prevention of disease in humans or animals. Medical devices play increasingly important roles in health services eco-systems, including: (1) Patient Diagnostics and Monitoring; Medical Treatment and Surgery; and Patient Life Support Devices and Stabilizers. MDs are part of the medical device eco-system and are connected to the network, sending vital information to the internal medical information systems of medical centers that manage this data. Wireless components (e.g. Wi-Fi) are often embedded within medical devices, enabling doctors and technicians to control and configure them remotely. All these functionalities, roles, and uses of MDs make them attractive targets of cyber-attacks launched for many malicious goals; this trend is likely to significantly increase over the next several years, with increased awareness regarding MD vulnerabilities, the enhancement of potential attackers’ skills, and expanded use of medical devices. Significance: We propose to develop and implement Cyber-Med, a unique collaborative project of Ben-Gurion University of the Negev and the Clalit Health Services Health Maintenance Organization. Cyber-Med focuses on the development of a comprehensive detection framework that relies on a critical attack repository that we aim to create. Cyber-Med will allow researchers and companies to better understand the vulnerabilities and attacks associated with medical devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The Cyber-Med detection framework will consist of two independent, but complementary detection approaches: one for known attacks, and the other for unknown attacks. These modules incorporate novel ideas and algorithms inspired by our team's domains of expertise, including cyber security, biomedical informatics, and advanced machine learning, and temporal data mining techniques. The establishment and maintenance of Cyber-Med’s up-to-date attack repository will strengthen the capabilities of Cyber-Med’s detection framework. Major Findings: Based on our initial survey, we have already found more than 15 types of vulnerabilities and possible attacks aimed at MDs and their eco-system. Many of these attacks target individual patients who use devices such pacemakers and insulin pumps. In addition, such attacks are also aimed at MDs that are widely used by medical centers such as MRIs, CTs, and dialysis engines; the information systems that store patient information; protocols such as DICOM; standards such as HL7; and medical information systems such as PACS. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched against MDs. Very little research has been conducted in order to protect these devices from cyber-attacks, since most of the development and engineering efforts are aimed at the devices’ core medical functionality, the contribution to patients’ healthcare, and the business aspects associated with the medical device.

Keywords: medical device, cyber security, attack, detection, machine learning

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3180 Interlanguage Acquisition of a Postposition ‘e’ in Korean: Analysis of the Korean Novice Learners’ Output

Authors: Eunjung Lee

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This study aims to analyze the sentences generated by the beginners who learn ‘e,’ a postposition in Korean and to find out the regularity of learners’ interlanguage upon investigating the usages of ‘e’ that appears by meanings and functions in their interlanguage, and conditions that ‘e’ is used. This study was conducted with mainly two assumptions; first, the learner’s language has the specific type of interlanguage; and second, there is the regularity of interlanguage when students produce ‘e’ under the specific conditions. Learners’ output has various values and can be used as the useful data to understand interlanguage. Therefore, all the sentences containing a postposition ‘e’ by English speaking learners were searched in ‘Learners’ corpus sharing center in The National Institute of Korean Language’ in Korea, and the data were collected upon limiting the levels of learners with Level 1 and 2. 789 sentences that were used with ‘e’ were selected as the final subjects of the analysis. First, to understand the environmental characteristics to be used with a postposition, ‘e’ after summarizing 13 meaning and functions of ‘e’ appeared in three books of Korean dictionary that summarized the Korean grammar, 1) meaning function of ‘e’ that were used in each sentence was classified; 2) the nouns that were combined with ‘e,’ keywords of the sentences, and the characteristics of modifiers, linkers, and predicates appeared in front of ‘e’ were analyzed; 3) the regularity by the novice learners’ meaning and functions were reviewed; and 4) the differences of the regularity by level 1 and 2 learners’ meaning and functions were found. Upon the study results, the novice learners showed 1) they used the nouns related to ‘time(시간), before(전), after(후), next(다음), the next(그다음), then(때), day of the week(요일), and season(계절)’ mainly in front of ‘e’ when they used ‘e’ as the meaning function of time; 2) they used mainly the verbs of ‘go(가다),’ ‘come(오다),’ and ‘go round(다니다)’ as the predicate to match with ‘e’ that was the meaning function of direction and destination; and 3) they used mainly the nouns related to ‘locations or countries’ in front of ‘e,’ a meaning function postposition of ‘place,’ used mainly the verbs ‘be(있다), not be(없다), live(살다), be many(많다)’ after ‘e,’ and ‘i(이) or ka(가)’ was combined mainly in the subject words in case of ‘be(있다), not be(없다)’ or ‘be many(많다),’ and ‘eun(은) or nun(는)’ was combined mainly in the subject words in front of ‘live at’ In addition, 4) they used ‘e’ which indicates ‘cause or reason’ in the form of ‘because( 때문에),’ and 5) used ‘e’ of the subjects as the predicates to match with the predicates such as ‘treat(대하다), like(들다), and catch(걸리다).’ From these results, ‘e’ usage patterns of the Korean novice learners demonstrated very differently by the meaning functions and the learners’ interlanguage regularity could be deducted. However, little difference was found in interlanguage regularity between level 1 and 2. This study has the meaning to try to understand the interlanguage system and regularity in the learners’ acquisition process of postposition ‘e’ and this can be utilized to lessen their errors.

Keywords: interlanguage, interlagnage anaylsis, postposition ‘e’, Korean acquisition

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3179 Role of Gender in Apparel Stores' Consumer Review: A Sentiment Analysis

Authors: Sarif Ullah Patwary, Matthew Heinrich, Brandon Payne

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The ubiquity of web 2.0 platforms, in the form of wikis, social media (e.g., Facebook, Twitter, etc.) and online review portals (e.g., Yelp), helps shape today’s apparel consumers’ purchasing decision. Online reviews play important role towards consumers’ apparel purchase decision. Each of the consumer reviews carries a sentiment (positive, negative or neutral) towards products. Commercially, apparel brands and retailers analyze sentiment of this massive amount of consumer review data to update their inventory and bring new products in the market. The purpose of this study is to analyze consumer reviews of selected apparel stores with a view to understand, 1) the difference of sentiment expressed through men’s and woman’s text reviews, 2) the difference of sentiment expressed through men’s and woman’s star-based reviews, and 3) the difference of sentiment between star-based reviews and text-based reviews. A total of 9,363 reviews (1,713 men and 7,650 women) were collected using Yelp Dataset Challenge. Sentiment analysis of collected reviews was carried out in two dimensions: star-based reviews and text-based reviews. Sentiment towards apparel stores expressed through star-based reviews was deemed: 1) positive for 3 or 4 stars 2) negative for 1 or 2 stars and 3) neutral for 3 stars. Sentiment analysis of text-based reviews was carried out using Bing Liu dictionary. The analysis was conducted in IPyhton 5.0. Space. The sentiment analysis results revealed the percentage of positive text reviews by men (80%) and women (80%) were identical. Women reviewers (12%) provided more neutral (e.g., 3 out of 5 stars) star reviews than men (6%). Star-based reviews were more negative than the text-based reviews. In other words, while 80% men and women wrote positive reviews for the stores, less than 70% ended up giving 4 or 5 stars in those reviews. One of the key takeaways of the study is that star reviews provide slightly negative sentiment of the consumer reviews. Therefore, in order to understand sentiment towards apparel products, one might need to combine both star and text aspects of consumer reviews. This study used a specific dataset consisting of selected apparel stores from particular geographical locations (the information was not given for privacy concern). Future studies need to include more data from more stores and locations to generalize the findings of the study.

Keywords: apparel, consumer review, sentiment analysis, gender

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3178 Analyzing Medical Workflows Using Market Basket Analysis

Authors: Mohit Kumar, Mayur Betharia

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Healthcare domain, with the emergence of Electronic Medical Record (EMR), collects a lot of data which have been attracting Data Mining expert’s interest. In the past, doctors have relied on their intuition while making critical clinical decisions. This paper presents the means to analyze the Medical workflows to get business insights out of huge dumped medical databases. Market Basket Analysis (MBA) which is a special data mining technique, has been widely used in marketing and e-commerce field to discover the association between products bought together by customers. It helps businesses in increasing their sales by analyzing the purchasing behavior of customers and pitching the right customer with the right product. This paper is an attempt to demonstrate Market Basket Analysis applications in healthcare. In particular, it discusses the Market Basket Analysis Algorithm ‘Apriori’ applications within healthcare in major areas such as analyzing the workflow of diagnostic procedures, Up-selling and Cross-selling of Healthcare Systems, designing healthcare systems more user-friendly. In the paper, we have demonstrated the MBA applications using Angiography Systems, but can be extrapolated to other modalities as well.

Keywords: data mining, market basket analysis, healthcare applications, knowledge discovery in healthcare databases, customer relationship management, healthcare systems

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3177 Diabetes Diagnosis Model Using Rough Set and K- Nearest Neighbor Classifier

Authors: Usiobaifo Agharese Rosemary, Osaseri Roseline Oghogho

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Diabetes is a complex group of disease with a variety of causes; it is a disorder of the body metabolism in the digestion of carbohydrates food. The application of machine learning in the field of medical diagnosis has been the focus of many researchers and the use of recognition and classification model as a decision support tools has help the medical expert in diagnosis of diseases. Considering the large volume of medical data which require special techniques, experience, and high diagnostic skill in the diagnosis of diseases, the application of an artificial intelligent system to assist medical personnel in order to enhance their efficiency and accuracy in diagnosis will be an invaluable tool. In this study will propose a diabetes diagnosis model using rough set and K-nearest Neighbor classifier algorithm. The system consists of two modules: the feature extraction module and predictor module, rough data set is used to preprocess the attributes while K-nearest neighbor classifier is used to classify the given data. The dataset used for this model was taken for University of Benin Teaching Hospital (UBTH) database. Half of the data was used in the training while the other half was used in testing the system. The proposed model was able to achieve over 80% accuracy.

Keywords: classifier algorithm, diabetes, diagnostic model, machine learning

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3176 Health Information Needs and Utilization of Information and Communication Technologies by Medical Professionals in a Northern City of India

Authors: Sonika Raj, Amarjeet Singh, Vijay Lakshmi Sharma

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Introduction: In 21st century, due to revolution in Information and Communication Technologies (ICTs), there has been phenomenal development in quality and quantity of knowledge in the field of medical science. So, the access to relevant information to physicians is critical to the delivery of effective healthcare services to patients. The study was conducted to assess the information needs and attitudes of the medical professionals; to determine the sources and channels of information used by them; to ascertain the current usage of ICTs and the barriers faced by them in utilization of ICTs in health information access. Methodology: This descriptive cross-sectional study was carried in 2015 on hundred medical professionals working in public and private sectors of Chandigarh. The study used both quantitative and qualitative method for data collection. A semi structured questionnaire and interview schedule was used to collect data on information seeking needs, access to ICTs and barriers to healthcare information access. Five Data analysis was done using SPSS-16 and qualitative data was analyzed using thematic approach. Results: The most preferred sources to access healthcare information were internet (85%), trainings (61%) and communication with colleagues (57%). They wanted information on new drug therapy and latest developments in respective fields. All had access to computer with but almost half assessed their computer knowledge as average and only 3% had received training regarding usage. Educational status (p=0.004), place of work (p=0.004), number of years in job (p=0.004) and sector of job (p=0.04) of doctors were found to be significantly associated with their active search for information. The major themes that emerged from in-views were need; types and sources of healthcare information; exchange of information among different levels of healthcare providers; usage of ICTs to obtain and share information; barriers to access of healthcare information and quality of health information materials and involvement in their development process Conclusion and Recommendations: The medical professionals need information in their in their due course of work. However, information needs of medical professionals were not being adequately met. There should be training of professional regarding internet skills and the course on bioinformatics should be incorporated in the curricula of medical students. The policy framework must be formulated that will encourage and promote the use of ICTs as tools for health information access and dissemination.

Keywords: health information, ICTs, medical professionals, qualitative

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3175 Management and Evaluation of Developing Medical Device Software in Compliance with Rules

Authors: Arash Sepehri bonab

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One of the regions of critical development in medical devices has been the part of the software - as an indispensable component of a therapeutic device, as a standalone device, and more as of late, as applications on portable gadgets. The chance related to a breakdown of the standalone computer program utilized inside healthcare is in itself not a model for its capability or not as a medical device. It is, subsequently, fundamental to clarify a few criteria for the capability of a stand-alone computer program as a medical device. The number of computer program items and therapeutic apps is persistently expanding and so as well is used in wellbeing education (e. g., in clinics and doctors' surgeries) for determination and treatment. Within the last decade, the use of information innovation in healthcare has taken a developing part. In reality, the appropriation of an expanding number of computer devices has driven several benefits related to the method of quiet care and permitted simpler get to social and health care assets. At the same time, this drift gave rise to modern challenges related to the usage of these modern innovations. The program utilized in healthcare can be classified as therapeutic gadgets depending on the way they are utilized and on their useful characteristics. In the event that they are classified as therapeutic gadgets, they must fulfill particular directions. The point of this work is to show a computer program improvement system that can permit the generation of secure and tall, quality restorative gadget computer programs and to highlight the correspondence between each program advancement stage and the fitting standard and/or regulation.

Keywords: medical devices, regulation, software, development, healthcare

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3174 A Clear Language Is Essential: A Qualitative Exploration of Doctor-Patient Health Interaction in Jordan

Authors: Etaf Khlaed Haroun Alkhlaifat

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When doctors and patients do not share the same first language, language barriers may exist, which may have negative effects on the quality of communication and care provided. Doctors’ use of medical jargon and patients’ inability to fully express their illness, to a potential loss of relevant information can often create misunderstanding. This study sought to examine the extent to which a lack of “common” language represents one of the linguistic obstacles that may adversely influence the quality of healthcare services in Jordan. Communication Accommodation Theory (CAT) was used to interpret the phenomena under study. Doctors (n=9) and patients (n=18) were observed and interviewed in natural Jordanian medical settings. A thematic qualitative approach was employed to analyse the data. The preliminary findings of the study revealed that most doctors appeared to have a good sense of appropriate ways to break through communication barriers by changing medical terminologies or jargons into lay terms. However, for some, there were two main challenges: 1) the use of medical jargon in explaining medication and side effects and 2) the lack of patients’ knowledge in providing a full explanation about their illnesses. The study revealed that language barriers adversely affect health outcomes for patients with limited fluency in the English language. It argues that it is doctors’ responsibility to guarantee mutual understanding, educate patients on their condition and improve their health outcomes.

Keywords: communication accommodation theory, doctor-patient interaction, language barrier, medical jargon, misunderstanding

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3173 A Patient-Centered Approach to Clinical Trial Development: Real-World Evidence from a Canadian Medical Cannabis Clinic

Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk

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Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.

Keywords: medical cannabis, safety, real-world data, Canada

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3172 Development and Characterization of Bio-Tribological, Nano- Multilayer Coatings for Medical Tools Application

Authors: L. Major, J. M. Lackner, M. Dyner, B. Major

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Development of new generation bio- tribological, multilayer coatings, opens an avenue for fabrication of future high- tech functional surfaces. In the presented work, nano- composite, Cr/CrN+[Cr/ a-C:H implanted by metallic nanocrystals] multilayer coatings have been developed for surface protection of medical tools. Thin films were fabricated by a hybrid Pulsed Laser Deposition technique. Complex microstructure analysis of nano- multilayer coatings, subjected to mechanical and biological tests, were performed by means of transmission electron microscopy (TEM). Microstructure characterization revealed the layered arrangement of Cr23C6 nanoparticles in multilayer structure. Influence of deposition conditions on bio- tribological properties of the coatings were studied. The bio-tests were used as a screening tool for the analyzed nano- multilayer coatings before they could be deposited on medical tools. Bio- medical tests were done using fibroblasts. The mechanical properties of the coatings were investigated by means of a ball-on-disc mechanical test. The microhardness was done using Berkovich indenter. The scratch adhesion test was done using Rockwell indenter. From the bio- tribological point of view, the optimal properties had the C106_1 material.

Keywords: bio- tribological coatings, cell- material interaction, hybrid PLD, tribology

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3171 Attraction and Retention of Newly Graduated Medical Doctors to Deprived Regions in Ghana: A Qualitative Case Study

Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah

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Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.

Keywords: attraction, retention, medical doctors, deprived regions, Ghana

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3170 One of the Missing Pieces of Inclusive Education: Sexual Orientations

Authors: Sıla Uzkul

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As a requirement of human rights and children's rights, the basic condition of inclusive education is that it covers all children. However, the reforms made in the context of education in Turkey and around the world include a limited level of inclusiveness. Generally, the inclusiveness mentioned is for individuals who need special education. Educational reforms superficially state that differences are tolerated, but these differences are extremely limited and often do not include sexual orientation. When we look at the education modules of the Ministry of National Education within the scope of inclusive education in Turkey, there are children with special needs, bilingual children, children exposed to violence, children under temporary protection, children affected by migration and terrorism, and children affected by natural disasters. No training modules or inclusion terms regarding sexual orientations could be found. This research aimed to understand the perspectives of research assistants working in the preschool education department regarding sexual orientations within the scope of inclusive education. Six research assistants working in the preschool teaching department at a public university in Ankara (Turkey) participated in this qualitative research study. Participants were determined by typical case sampling, which is one of the purposeful sampling methods. The data of this research was obtained through a "survey consisting of open-ended questions". Raw data from the surveys were analyzed and interpreted using the "content analysis technique" (Yıldırım & Şimşek, 2005). During the data analysis process, the data from the participants were first numbered, then all the data were read, and content analysis was performed, and possible themes, categories, and codes were extracted. The opinions of the participants in the research regarding sexual orientations in inclusive education are presented under three main headings within the scope of the research questions. These are: (a) their views on inclusive education, (b) their views on sexual orientations (c) their views on sexual orientations in the preschool period.

Keywords: sexual orientation, inclusive education, child rights, preschool education

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3169 Pain Management Strategies for Effective Coping with Sickle Cell Disease: The Perspective of Patients in Ghana

Authors: V. A. Adzika, D. Ayim-Aboagye, T. Gordh

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Background and aims: Prevalence of Sickle Cell Disease (SCD) is high in Ghana but not much is known in terms of research into non-medical strategies for managing and coping with the pain associated with SCD. This study was carried out to examine effective non-medical related strategies patients use to cope and manage their SCD condition. Methods: SCD patients (387) consisting of 180 males and 204 females between 18-65 years old years participated in the study. A cross-sectional research design was used in which participants completed questionnaires on pain, non-medical coping and management strategies, anxiety, and depression. Results of multiple regression analysis showed that socio-demographic characteristics contributed to the variance in the pain associated with SCD. Results: Over 90% of participants reported that pains associated with SCD were the main reason for seeking treatment in SCD crisis. In terms of non-medical related coping strategies, attending a place of worship and praying were the main coping strategies used in SCD crises, suggesting that patients’ beliefs, particularly in a supernatural being, served as a mitigating factor in the process of coping with the pain associated with SCD crisis. Also, avoidance and withdrawal from people and social activities were reported to be strategies used to cope effectively with the pain associated with SCD crisis. Conclusion: This indicates that it is imperative to incorporate non-medical related coping and management strategies, especially religious beliefs and psychosocial factors, to coping and management of the pain associated with SCD.

Keywords: anxiety, depression, sickle cell disease, quality of life, socio-demographic characteristics, Ghana

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3168 Lexicographic Rules on the Use of Technologies for Realization of the National Signs-Terms Inventory of Cultural Heritage Field in Libras

Authors: Gláucio de Castro Júnior, Daniela Prometi, Patrícia Tuxi

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The project 'Inventory Signs-terms of the cultural heritage field in Libras' provides for the establishment of an inventory of signs, terms relating to the field of cultural heritage in Libras, from the results of research in progress as the pilot project' Accessibility Communication, Translation and Interpretation to the Application Portal Libras Heritage 'and the Pilot Project' registration-signal terms for the preparation of bilingual lexicon Libras / Portuguese terms available in the Portal Heritage. The project's goal is to spread the lexicographical rules on the use of technologies in video graphic records of sign language and foster the training of undergraduate students and graduate to the registration of the linguistic diversity of Libras through social and communicative interaction with the community deaf and enable access to Deaf information relating to the field of cultural heritage in Libras. As a result, we expect the spread of the inventory of cultural heritage-signs in terms Libras in application usage 'Portal Heritage'. To achieve the proposed objectives are accomplished technical consulting and continuous training for the production of academic material through theoretical and practical meetings, taught by experts Libras LIP / UNB in partnership with some institutions. The Inventory project signals-Terms under Heritage in Libras field initially took place in Rio de Janeiro in order to allow its development in the Midwest region, due to technical, elected some cities in Brazil, including Manaus in Amazon Macapa in Amapa, Salvador Bahia, Goiás and Goiânia in Florianopolis in Santa Catarina. At the end of all this process, the assessment by preparing a technical report presenting all the advances and points achieved in the project looking for social improvement, economic, environmental and language in the use of technology will be conducted.

Keywords: signs-terms, equity-cultural accessibility, technology, sign language

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3167 Attitudes Towards Homosexuality, Bisexuality and Transgenderism among Medical Students of a Sri Lankan University

Authors: Rajapaksha J. S. R. L., Rajapaksha R. G. D. T., Ranawaka A. U. R., Rangalla R. D. M. P., Ranwala R. D. E. B., Chandratilake M. N.

Abstract:

Introduction: Lesbian, gay, bisexual, and transgender (LGBT) patients experience discrimination, insensitivity, and ignorance about LGBT-specific health needs among healthcare providers. Developing the correct attitudes among medical students towards LGBT may help provide them with optimal healthcare. Objectives: This study aimed at assessing the attitudes of medical students towards the LBGT community. Methodology: A cross-sectional descriptive study was among all the medical students in the Faculty of Medicine, University of Kelaniya, Sri Lanka, using a validated online questionnaire. The questionnaire focused on eight areas. The data were descriptively analyzed, and the demographic groups were compared. Results: 358 students completed the survey. The response rate was 34.26%. Their attitudes on traditional gender roles and comfortability in interacting with LGBT people were moderate, and they disagreed with negative LGBT social beliefs. They knew less about the origin of sexuality/gender of LGBT. Although they accepted LGBT as a part of diversity, they discouraged normalizing the social practices of LGBT people. Their acceptance and association of LGBT were moderately positive. A minority has encountered LGBT in close social circles, and the majority of them were batch-mates. Although males’ knowledge about the origin of LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of attitudes towards LGBT reflected respondents’ political ideology. Conclusion: Although medical students’ knowledge on the sexuality/gender basis of LGBT is poor, they have moderately favourable attitudes towards them. They accept LGBT as a part of social diversity but not their social practices. Poor knowledge, lack of encounters, cultural influences, and political ideology may have influenced their attitudes.

Keywords: medical students, attitude, LGBT, diversity

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3166 Meaning Interpretation of Persian Noun-Noun Compounds: A Conceptual Blending Approach

Authors: Bahareh Yousefian, Laurel Smith Stvan

Abstract:

Linguistic structures have two facades: form and meaning. These structures could have either literal meaning or figurative meaning (although it could also depend on the context in which that structure appears). The literal meaning is understandable more easily, but for the figurative meaning, a word or concept is understood from a different word or concept. In linguistic structures with a figurative meaning, it’s more difficult to relate their forms to the meanings than structures with literal meaning. In these cases, the relationship between form and figurative meaning could be studied from different perspectives. Various linguists have been curious about what happens in someone’s mind to understand figurative meaning through the forms; they have used different perspectives and theories to explain this process. It has been studied through cognitive linguistics as well, in which mind and mental activities are really important. In this viewpoint, meaning (in other words, conceptualization) is considered a mental process. In this descriptive-analytic study, 20 Persian compound nouns with figurative meanings have been collected from the Persian-language Moeen Encyclopedic Dictionary and other sources. Examples include [“Sofreh Xaneh”] (traditional restaurant) and [“Dast Yar”] (Assistant). These were studied in a cognitive semantics framework using “Conceptual Blending Theory” which hasn’t been tested on Persian compound nouns before. It was noted that “Conceptual Blending Theory” could lead to the process of understanding the figurative meanings of Persian compound nouns. Many cognitive linguists believe that “Conceptual Blending” is not only a linguistic theory but it’s also a basic human cognitive ability that plays important roles in thought, imagination, and even everyday life as well (though unconsciously). The ability to use mental spaces and conceptual blending (which is exclusive to humankind) is such a basic but unconscious ability that we are unaware of its existence and importance. What differentiates Conceptual Blending Theory from other ways of understanding figurative meaning, are arising new semantic aspects (emergent structure) that lead to a more comprehensive and precise meaning. In this study, it was found that Conceptual Blending Theory could explain reaching the figurative meanings of Persian compound nouns from their forms, such as [talkative for compound word of “Bolbol + Zabani” (nightingale + tongue)] and [wage for compound word of “Dast + Ranj” (hand + suffering)].

Keywords: cognitive linguistics, conceptual blending, figurative meaning, Persian compound nouns

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3165 A Study on the Annual Doses Received by the Workers of Some Medical Practices

Authors: Eltayeb Hamad Elneel Yousif

Abstract:

This paper describes occupational radiation doses of workers in non-destructive testing (NDT) and some medical practices during the year 2007. The annual doses received by the workers of a public hospital are presented in this report. The Department is facilitated with HARSHAW Reader model 6600 and assigned the rule of personal monitoring to contribute in controlling and reducing the doses received by radiation workers. TLD cards with two TLD chips type LiF: Mg, Ti (TLD-100) were calibrated to measure the personal dose equivalent Hp(10). Around 150 medical radiation workers were monitored throughout the year. Each worker received a single TLD card worn on the chest above lead apron and returned for laboratory reading every two months. The average annual doses received by the workers of radiotherapy, nuclear medicine and diagnostic radiology were evaluated. The annual doses for individual radiation workers ranged between 0.55-4.42 mSv, 0.48-1.86 mSv, and 0.48-0.91 mSv for the workers of radiotherapy, nuclear medicine and diagnostic radiology, respectively. The mean dose per worker was 1.29±1, 1.03±0.4, and 0.69±0.2 mSv, respectively. The results showed compliance with international dose limits. Our results reconfirm the importance of personal dosimetry service in assuring the radiation protection of medical staff in developing countries.

Keywords: radiation medicine, non-destructive testing, TLD, public hospital

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3164 Implementation of Video Education to Improve Patient’s Knowledge of Activating Emergency Medical System for Stroke Symptoms: Evidence- Based Practice Project on Inpatient Neurology Unit in the United States

Authors: V. Miller, T. Jariel, C. Cooper-Chadwick

Abstract:

Early treatment of stroke leads to higher survival and lower disability rates. Increasing knowledge to activate the emergency medical system for signs of stroke can improve outcomes for patients with stroke and decrease morbidity and mortality. Even though patients who get discharged from the hospital receive standard verbal and printed education, nearly 20% of them answer the question incorrectly when asked, “What will you do if you or someone you know have signs of stroke?” The main goal of this evidence-based project was to improve patients’ knowledge of what to do if they have signs of stroke. Evidence suggests that using video education in conjunction with verbal and printed education improves patient comprehension and retention. The percentage of patients who noted that they needed to call 911 for stroke symptoms increased from 80% to 87% in six months after project implementation. The results of this project demonstrate significant improvement in patients’ knowledge about the necessity of activation of emergency medical systems for stroke symptoms.

Keywords: emergency medical systems activation, evidence-based practice nursing, stroke education, video education

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3163 Managing the Cognitive Load of Medical Students during Anatomy Lecture

Authors: Siti Nurma Hanim Hadie, Asma’ Hassan, Zul Izhar Ismail, Ahmad Fuad Abdul Rahim, Mohd. Zarawi Mat Nor, Hairul Nizam Ismail

Abstract:

Anatomy is a medical subject, which contributes to high cognitive load during learning. Despite its complexity, anatomy remains as the most important basic sciences subject with high clinical relevancy. Although anatomy knowledge is required for safe practice, many medical students graduated without having sufficient knowledge. In fact, anatomy knowledge among the medical graduates was reported to be declining and this had led to various medico-legal problems. Applying cognitive load theory (CLT) in anatomy teaching particularly lecture would be able to address this issue since anatomy information is often perceived as cognitively challenging material. CLT identifies three types of loads which are intrinsic, extraneous and germane loads, which combine to form the total cognitive load. CLT describe that learning can only occur when the total cognitive load does not exceed human working memory capacity. Hence, managing these three types of loads with the aim of optimizing the working memory capacity would be beneficial to the students in learning anatomy and retaining the knowledge for future application.

Keywords: cognitive load theory, intrinsic load, extraneous load, germane load

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3162 An Event-Related Potential Investigation of Speech-in-Noise Recognition in Native and Nonnative Speakers of English

Authors: Zahra Fotovatnia, Jeffery A. Jones, Alexandra Gottardo

Abstract:

Speech communication often occurs in environments where noise conceals part of a message. Listeners should compensate for the lack of auditory information by picking up distinct acoustic cues and using semantic and sentential context to recreate the speaker’s intended message. This situation seems to be more challenging in a nonnative than native language. On the other hand, early bilinguals are expected to show an advantage over the late bilingual and monolingual speakers of a language due to their better executive functioning components. In this study, English monolingual speakers were compared with early and late nonnative speakers of English to understand speech in noise processing (SIN) and the underlying neurobiological features of this phenomenon. Auditory mismatch negativities (MMNs) were recorded using a double-oddball paradigm in response to a minimal pair that differed in their middle vowel (beat/bit) at Wilfrid Laurier University in Ontario, Canada. The results did not show any significant structural and electroneural differences across groups. However, vocabulary knowledge correlated positively with performance on tests that measured SIN processing in participants who learned English after age 6. Moreover, their performance on the test negatively correlated with the integral area amplitudes in the left superior temporal gyrus (STG). In addition, the STG was engaged before the inferior frontal gyrus (IFG) in noise-free and low-noise test conditions in all groups. We infer that the pre-attentive processing of words engages temporal lobes earlier than the fronto-central areas and that vocabulary knowledge helps the nonnative perception of degraded speech.

Keywords: degraded speech perception, event-related brain potentials, mismatch negativities, brain regions

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3161 GPU Accelerated Fractal Image Compression for Medical Imaging in Parallel Computing Platform

Authors: Md. Enamul Haque, Abdullah Al Kaisan, Mahmudur R. Saniat, Aminur Rahman

Abstract:

In this paper, we have implemented both sequential and parallel version of fractal image compression algorithms using CUDA (Compute Unified Device Architecture) programming model for parallelizing the program in Graphics Processing Unit for medical images, as they are highly similar within the image itself. There is several improvements in the implementation of the algorithm as well. Fractal image compression is based on the self similarity of an image, meaning an image having similarity in majority of the regions. We take this opportunity to implement the compression algorithm and monitor the effect of it using both parallel and sequential implementation. Fractal compression has the property of high compression rate and the dimensionless scheme. Compression scheme for fractal image is of two kinds, one is encoding and another is decoding. Encoding is very much computational expensive. On the other hand decoding is less computational. The application of fractal compression to medical images would allow obtaining much higher compression ratios. While the fractal magnification an inseparable feature of the fractal compression would be very useful in presenting the reconstructed image in a highly readable form. However, like all irreversible methods, the fractal compression is connected with the problem of information loss, which is especially troublesome in the medical imaging. A very time consuming encoding process, which can last even several hours, is another bothersome drawback of the fractal compression.

Keywords: accelerated GPU, CUDA, parallel computing, fractal image compression

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3160 A Multi-Agent Intelligent System for Monitoring Health Conditions of Elderly People

Authors: Ayman M. Mansour

Abstract:

In this paper, we propose a multi-agent intelligent system that is used for monitoring the health conditions of elderly people. Monitoring the health condition of elderly people is a complex problem that involves different medical units and requires continuous monitoring. Such expert system is highly needed in rural areas because of inadequate number of available specialized physicians or nurses. Such monitoring must have autonomous interactions between these medical units in order to be effective. A multi-agent system is formed by a community of agents that exchange information and proactively help one another to achieve the goal of elderly monitoring. The agents in the developed system are equipped with intelligent decision maker that arms them with the rule-based reasoning capability that can assist the physicians in making decisions regarding the medical condition of elderly people.

Keywords: fuzzy logic, inference system, monitoring system, multi-agent system

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3159 The Relationships among Learning Emotion, Major Satisfaction, Learning Flow, and Academic Achievement in Medical School Students

Authors: S. J. Yune, S. Y. Lee, S. J. Im, B. S. Kam, S. Y. Baek

Abstract:

This study explored whether academic emotion, major satisfaction, and learning flow are associated with academic achievement in medical school. We know that emotion and affective factors are important factors in students' learning and performance. Emotion has taken the stage in much of contemporary educational psychology literature, no longer relegated to secondary status behind traditionally studied cognitive constructs. Medical school students (n=164) completed academic emotion, major satisfaction, and learning flow online survey. Academic performance was operationalized as students' average grade on two semester exams. For data analysis, correlation analysis, multiple regression analysis, hierarchical multiple regression analyses and ANOVA were conducted. The results largely confirmed the hypothesized relations among academic emotion, major satisfaction, learning flow and academic achievement. Positive academic emotion had a correlation with academic achievement (β=.191). Positive emotion had 8.5% explanatory power for academic achievement. Especially, sense of accomplishment had a significant impact on learning performance (β=.265). On the other hand, negative emotion, major satisfaction, and learning flow did not affect academic performance. Also, there were differences in sense of great (F=5.446, p=.001) and interest (F=2.78, p=.043) among positive emotion, boredom (F=3.55, p=.016), anger (F=4.346, p=.006), and petulance (F=3.779, p=.012) among negative emotion by grade. This study suggested that medical students' positive emotion was an important contributor to their academic achievement. At the same time, it is important to consider that some negative emotions can act to increase one’s motivation. Of particular importance is the notion that instructors can and should create learning environment that foster positive emotion for students. In doing so, instructors improve their chances of positively impacting students’ achievement emotions, as well as their subsequent motivation, learning, and performance. This result had an implication for medical educators striving to understand the personal emotional factors that influence learning and performance in medical training.

Keywords: academic achievement, learning emotion, learning flow, major satisfaction

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3158 Development of Pediatric Medical Trauma Stress (PMTS) Among Children at Risk

Authors: Amichai Ben ari, Daniella Margalit

Abstract:

Medical procedures, such as surgery, may have traumatic significance for some children. This study examines the relationship between maltreatment in children and the development Pediatric Medical Traumatic Stress (PMTS). To this end, differences in the level of distress of children after surgery were examined between two groups: children who were maltreated ("children at risk") and children from the control group ("children who are not at risk"). The study involved 230 parents of children who came to the hospital to undergo surgery. Parents filled out demographic questionnaires to measure socioeconomic variables and psychological questionnaires to measure the distress of the child and parent before surgery. After 6 months from the time of surgery, the parents again filled in the questionnaire measuring the child's distress. The results of the study showed that the level of distress experienced by children at risk after surgery was significantly higher relative to children who are not at risk. It was also found that the level of distress experienced by parents of children at risk in relation to their child’s surgery is significantly higher compared to parents of children who are not at risk. Finally, it was found that the variables: (1) pre-morbid psychological functioning of the child. (2) Parental and family functioning in daily life. (3) Exposure of the child to traumatic events. (4) Support factors for the family. Are variables that predict the development of PMTS in children after surgery, but only for children at risk and not for children who are not at risk. The significance of the findings in relation to the need to identify at-risk populations in the hospitals and the policies derived from them were discussed, and several directions were raised for further research.

Keywords: children at risk, pediatric medical traumatic stress (PMTS), PTSD, medical procedures

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3157 HIS Integration Systems Using Modality Worklist and DICOM

Authors: Kulvinder Singh Mann

Abstract:

The usability and simulation of information systems, known as Hospital Information System (HIS), Radiology Information System (RIS), and Picture Archiving, Communication System, for electronic medical records has shown a good impact for actors in the hospital. The objective is to help and make their work easier; such as for a nurse or administration staff to record the medical records of the patient, and for a patient to check their bill transparently. However, several limitations still exists on such area regarding the type of data being stored in the system, ability for data transfer, storage and protocols to support communication between medical devices and digital images. This paper reports the simulation result of integrating several systems to cope with those limitations by using the Modality Worklist and DICOM standard. It succeeds in documenting the reason of that failure so future research will gain better understanding and be able to integrate those systems.

Keywords: HIS, RIS, PACS, modality worklist, DICOM, digital images

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3156 The Provision of a Safe Face-to-Face Teaching Program for Final Year Medical Students during the COVID-19 Pandemic

Authors: Rachel Byrne

Abstract:

Background: Due to patient and student safety concerns, combined with clinical teachers being redeployed to clinical practice, COVID-19 has resulted in a reduction in face-to-face teaching sessions for medical students. Traditionally such sessions are particularly important for final year medical students, especially in preparing for their final practical exams. A reduced student presence on the wards has also resulted in fewer opportunities for junior doctors to provide teaching sessions. This has implications for junior doctors achieving their own curriculum outcomes for teaching, as well as potentially hindering the development of a future interest in medical education. Aims: The aims of the study are 1) To create a safe face-to-face teaching environment during COVID-19 which focussed on exam preparation for final year medical students, 2) To provide a platform for doctors to gain teaching experience, 3 ) to enable doctors to gain feedback or assessments on their teaching, 4) To create beginners guide to designing a new teaching program for future junior doctors. Methods: We created a program of timed clinical stations consisting of four sessions every five weeks during the student’s medicine attachment. Each session could be attended by 6 students and consisted of 6 stations ran by junior doctors, with each station following social distancing and personal protective equipment requirements. Junior doctors were asked to design their own stations. The sessions ran out-of-hours on weekday evenings and were optional for the students. Results: 95/95 students and 20/40 doctors involved in the programme completed feedback. 100% (n=95) of students strongly agreed/agreed that sessions were aimed at an appropriate level and provided constructive feedback. 100% (n=95) of students stated they felt more confident in their abilities and would recommend the session to peers. 90% (n=18) of the teachers strongly agreed/agreed that they felt more confident in their teaching abilities and that the sessions had improved their own medical knowledge. 85% (n=17) of doctors had a teaching assessment completed, and 83% (n=16) said the program had made them consider a career in medical education. The difficulties of creating such a program were highlighted throughout, and a beginner’s guide was created with the hopes of helping future doctors who are interested in teaching address the common obstacles.

Keywords: COVID-19, education, safety, medical

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3155 Attitudes towards People with Disability and Career Interest in Disability Studies: A Study of Clinical Medical Students of a Tertiary Institution in Southeastern Nigeria

Authors: Ebele V. Okoli, Emmanuel Nwobi, Dozie Ezechukwu, Ijeoma Itanyi

Abstract:

One in seven people worldwide suffer from a disability. 80% of people with disabilities live in developing countries. Negative attitudes and misconceptions among health-care providers constitute barri¬ers to optimal health care for people with disabilities. This underscores the relevance of a study of the attitude of Nigerian medical students towards disability and their willingness to work in the disability sector. This was a descriptive cross-sectional study conducted among 254 penultimate and final year medical students of a university in southeastern Nigeria. The mean age of the students was 24.8 ± 3.12 years. Majority of the students were male (75.2%), single (96.9%), of the Igbo tribe (86.6%), Christian (97.6%) and grew up in urban areas (68.1%). Results indicated that the medical students had a predominantly positive attitude towards people with disability as 73.8% had a positive attitude and mean attitude score was 67.03 ± 0.14 (positive attitude = 61 – 120, negative attitude = 0 - 60). Chi-square analysis did not show any significant effect of demographic and social factors on the students’ attitude towards People with Disabilities. The students were mostly willing to work in areas that address the challenges of people with disability (70.4%) but a greater proportion had never heard about Disability Studies (67.5%). About a third of the students (33.2%) would like to travel abroad to practice in the disability sector. Conclusions: The students generally had a positive attitude towards people with disability and a greater percentage were willing to work in the disability sector in their future career. About two-thirds had however, never heard about disability studies. There was some potential for brain drain among the students as a third of the population intended to practice abroad on graduation.

Keywords: attitudes, career interest, disability, medical students

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3154 Peer Support Groups as a Tool to Increase Chances of Passing General Practice UK Qualification Exams

Authors: Thomas Abraham, Garcia de la Vega Felipe, Lubna Nishath, Nzekwe Nduka, Powell Anne-Marie

Abstract:

Introduction: The purpose of this paper is to discuss the effectiveness of a peer support network created to provide medical education, pastoral support, and reliable resources to registrars to help them pass the MRCGP exams. This paper will include a description of the network and its purpose, discuss how it has been used by trainees since its creation, and explain how this methodology can be applied to other areas of medical education and primary care. Background: The peer support network was created in February 2021, using Facebook, Telegram, and WhatsApp platforms to facilitate discussion of cases and answer queries about the exams, share resources, and offer peer support from qualified GPs and specialists. The network was created and is maintained by the authors of this paper and is open to anyone who is registered with the General Medical Council (GMC) and is studying for the MRCGP exams. Purpose: The purpose of the network is to provide medical education, pastoral support, and reliable resources to registrars to help them pass the exams. The network is free to use and is designed to take the onus away from a single medical educator and collate a vast amount of information from multiple medical educators/trainers; thereby creating a digital library of information for all trainees - exam related or otherwise. Methodology The network is managed by a team of moderators who respond to queries and facilitate discussion. Smaller study groups are created from the main group and provide a platform for trainees to work together, share resources, and provide peer support. The network has had thousands of trainees using it since February 2021, with positive feedback from all trainees. Results: The feedback from trainees has been overwhelmingly positive. Word of mouth has spread rapidly, growing the groups exponentially. Trainees add colleagues to the groups and often stay after they pass their exams to 'give back' to their fellow trainees. To date, thousands of trainees have passed the MRCGP exams using the resources and support provided by the network. Conclusion The success of this peer support network demonstrates the effectiveness of creating a network of thousands of doctors to provide medical education and support.

Keywords: peer support, medical education, pastoral support, MRCGP exams

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3153 The Role of Evaluation for Effective and Efficient Change in Higher Education Institutions

Authors: Pattaka Sa-Ngimnet

Abstract:

That the University as we have known it is no longer serving the needs of the vast majority of students and potential students has been a topic of much discussion. Institutions of higher education, in this age of global culture, are in a process of metamorphosis. Technology is being used to allow more students, older students, working students and disabled students, who cannot attend conventional classes, to have greater access to higher education through the internet. But change must come about only after much evaluation and experimentation or education will simply become a commodity as, in some cases, it already has. This paper will be concerned with the meaning and methods of change and evaluation as they are applied to institutions of higher education. Organization’s generally have different goals and different approaches in order to be successful. However, the means of reaching those goals requires rational and effective planning. Any plans for successful change in any institution must take into account both effectiveness and efficiency and the differences between them. “Effectiveness” refers to an adequate means of achieving an objective. “Efficiency” refers to the ability to achieve an objective without waste of time or resources (The Free Dictionary). So an effective means may not be efficient and an efficient means may not be effective. The goal is to reach a synthesis of effectiveness and efficiency that will maximize both to the extent each is limited by the other. This focus of this paper then is to determine how an educational institution can become either successful or oppressive depending on the kinds of planning, evaluating and changes that operate by and on the administration. If the plan is concerned only with efficiency, the institution can easily become oppressive and lose sight of its purpose of educating students. If it is overly concentrated on effectiveness, the students may receive a superior education in the short run but the institution will face operating difficulties. In becoming only goal oriented, institutions also face problems. Simply stated, if the institution reaches its goals, the stake holders may become satisfied and fail to change and keep up with the needs of the times. So goals should be seen only as benchmarks in a process of becoming even better in providing quality education. Constant and consistent evaluation is the key to making all these factors come together in a successful process of planning, testing and changing the plans as needed. The focus of the evaluation has to be considered. Evaluations must take into account progress and needs of students, methods and skills of instructors, resources available from the institution and the styles and objectives of administrators. Thus the role of evaluation is pivotal in providing for the maximum of both effective and efficient change in higher education institutions.

Keywords: change, effectiveness, efficiency, education

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