Search results for: employee job-related outcomes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3859

Search results for: employee job-related outcomes

3439 Organizational Innovativeness: Motivation in Employee’s Innovative Work Behaviors

Authors: P. T. Ngan

Abstract:

Purpose: The study aims to answer the question what are motivational conditions that have great influences on employees’ innovative work behaviors by investigating the case of SATAMANKULMA/ Anya Productions Ky in Kuopio, Finland. Design/methodology: The main methodology utilized was the qualitative single case study research, analysis was conducted with an adapted thematic content analysis procedure, created from empirical material that was collected through interviews, observation and document review. Findings: The paper highlights the significance of combining relevant synergistic extrinsic and intrinsic motivations into the organizational motivation system. The findings show that intrinsic drives are essential for the initiation phases while extrinsic drives are more important for the implementation phases of innovative work behaviors. The study also offers the IDEA motivation model-interpersonal relationships & networks, development opportunities, economic constituent and application supports as an ideal tool to optimize business performance. Practical limitations/ implications: The research was only conducted from the perspective of SATAMANKULMA/Anya Productions Ky, with five interviews, a few observations and with several reviewed documents. However, further research is required to include other stakeholders, such as the customers, partner companies etc. Also the study does not offer statistical validity of the findings; an extensive case study or a qualitative multiple case study is suggested to compare the findings and provide information as to whether IDEA model relevant in other types of firms. Originality/value: Neither the innovation nor the human resource management field provides a detailed overview of specific motivational conditions might use to stimulate innovative work behaviors of individual employees. This paper fills that void.

Keywords: employee innovative work behaviors, extrinsic motivation, intrinsic motivation, organizational innovativeness

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3438 EPD as Technical Competencies Acceleration Program in Developing New Talent at HR Directorate, Pertamina Ltd.

Authors: A. A. A. Indira Pratyaksa, Achmad Zaki

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In every organization, there would be a demographic of young employees. They see themselves are the future leaders of the company. A special program needs to be prepared for them as a form of retention programs. Early Professional Program (EPD) must address challenges in the future. Aspects of the development of competence of young employees also become one of the answers in accelerating existing business processes. The role of the supervisor is the key success of EPD. Pertamina, thus, is better prepared to realize the vision and mission.

Keywords: young employee, competencies, development, leader, coaching

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3437 The Use of Robots for Children and Young People on the Autism Spectrum: A Systematic Review

Authors: Athanasia Kouroupa

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Existing research highlights the effect of employing robots in sessions with children and young people on the autism spectrum to develop and practice skills important to independent and functional living. The systematic review aimed to explore the way robots has been used with children and young people on the autism spectrum and the effect of using robots as a therapeutic interface. An electronic bibliographic database search using a combination of expressions was conducted. Data were extracted in relation to robot types, session characteristics, and outcomes and analysed using narrative synthesis. Forty studies were selected in the review. Humanoid robots were predominantly used to practice a range of social and communication skills. On average, children and young people on the autism spectrum had five sessions, twice a week, for approximately half an hour. Having sessions with a robot was commonly equal to or more effective than 'traditional' interventions delivered by a human therapist or having no therapy. The review reported encouraging outcomes to practice and develop a range of skills with children and young people on the autism spectrum. These findings suggest that some form of intervention is favourable over no intervention. However, there is little evidence for the relative effectiveness of the robot-based intervention as an innovative alternative option. Many of the studies had methodological weaknesses that make them vulnerable to bias. There is a need for further research that adheres to strict scientific methods making direct comparisons between different treatment options.

Keywords: autism, children, robots, outcomes

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3436 Workplace Development Programmes for Small and Medium-Sized Enterprises in Europe and Singapore: A Conceptual Study

Authors: Zhan Jie How

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With the heightened awareness of workplace learning and its impact on improving organizational performance and developing employee competence, governments and corporations around the world are forced to intensify their cooperation to establish national workplace development programmes to guide these corporations in fostering engaging and collaborative workplace learning cultures. This conceptual paper aims to conduct a comparative study of existing workplace development programmes for small and medium-sized enterprises (SMEs) in Europe and Singapore, focusing primarily on the Swedish Production Leap, Finnish TEKES Liideri Programme, and Singapore SkillsFuture SME Mentors Programme. The study carries out a systematic review of the three workplace development programmes to examine the roles of external mentors or coaches in influencing the design and implementation of workplace learning strategies and practices in SMEs. Organizational, personal and external factors that promote or inhibit effective workplace mentorship are also scrutinized, culminating in a critical comparison and evaluation of the strengths and weaknesses of the aforementioned programmes. Based on the findings from the review and analyses, a heuristic conceptual framework is developed to illustrate the complex interrelationships among external workplace development programmes, internal learning and development initiatives instituted by the organization’s higher management, and employees' continuous learning activities at the workplace. The framework also includes a set of guiding principles that can be used as the basis for internal mediation between the competing perspectives of mentors and mentees (employers and employees of the organization) regarding workplace learning conditions, practices and their intended impact on the organization. The conceptual study provides a theoretical blueprint for future empirical research on organizational workplace learning and the impact of government-initiated workplace development programmes.

Keywords: employee competence, mentorship, organizational performance, workplace development programme, workplace learning culture

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3435 Efficacy and Safety of Uventa Metallic Stent for Malignant and Benign Ureteral Obstruction

Authors: Deok Hyun Han

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Objective: To explore outcomes of UventaTM metallic ureteral stent between malignant and benign ureteral obstruction. Methods: We reviewed the medical records of 90 consecutive patients who underwent Uventa stent placement for benign or malignant ureteral obstruction from December 2009 to June 2013. We evaluated the clinical outcomes, complications, and reasons and results for unexpected stent removals. Results: The median follow-up was 10.7 (0.9 – 41) months. From a total of 125 ureter units, there were 24 units with benign obstructions and 101 units with malignant obstructions. Initial technical successes were achieved in all patients. The overall success rate was 70.8% with benign obstructions and 84.2% with malignant obstructions. The major reasons for treatment failure were stent migration (12.5%) in benign and tumor progression (11.9%) in malignant obstructions. The overall complication rate was similar between benign and malignant obstructions (58.3% and 42.6%), but severe complications, which are Clavien grade 3 or more, occurred in 41.7% of benign and 6.9% of malignant obstructions. The most common complications were stent migration (25.0%) in benign obstructions and persistent pain (14.9%) in malignant obstructions. The stent removal was done in 16 units; nine units that were removed by endoscopy and seven units were by open surgery. Conclusions: In malignant ureteral obstructions, the Uventa stent showed favorable outcomes with high success rate and acceptable complication rate. However, in benign ureteral obstructions, overall success rate and complication rate were less favorable. Malignant ureteral obstruction seems to be appropriate indication of Uventa stent placement. However, in chronic diffuse benign ureteral obstructions the decision of placement of Uventa stent has to be careful.

Keywords: cause, complication, ureteral obstruction, metal stent

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3434 Health Literacy Levels of South African Primary Health Care Patients

Authors: Boitumelo Ditshwane, Zelda Janse van Rensburg, Wanda Jacobs,

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Health literacy is defined as competencies and skills that individuals need to find, comprehend, evaluate, and use to make knowledgeable choices to improve their health and well-being. Low health literacy has been found to affect people’s ability to take care of their own health. Incomprehension of health education and health care instructions due to low health literacy is often due to information given at a level that is above the patient’s level of understanding. The study aimed to test the health literacy levels of South African PHC patients using a previously developed health literacy assessment tool. Determining health literacy levels may assist PHC nurses in providing health education and health care instructions to the patient on the patient’s level of understanding and, therefore, ensuring positive health outcomes for the patient. A health literacy assessment tool, translated into ten official South African languages, was used to quantitatively determine the health literacy levels of 400 PHC patients in five clinics in Gauteng, South Africa. Patients’ health literacy levels were tested in English, and nine other official languages spoken in South Africa and were compared. The results revealed that patients understand information better when given in their preferred language. Giving health education in a language and level that is better understood by the patient may lead to better health outcomes and prevent adverse health. Patients may better understand instructions provided, be more likely to follow the correct route of medication, honor appointments, comply with medication, and thus have better treatment outcomes.

Keywords: health literacy, primary health care, South Africa, patients

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3433 Prenatal Exposure to Organophosphate Pesticide and Fetal Growth

Authors: Yi-Shuan ShaoShao, Yen-An Tsai, Chia-Huang Chang, Kai-Wei Liao, Ming-Song Tsai, Mei-Lien Chen

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Organophosphate pesticides (OPs) is an environmental hormone with proven endocrine-disrupting effects that may affect the growth and development in human. A large amount of organophosphate pesticides (OPs) is used throughout Taiwan, and human may be exposed through dietary intake or residential use. During pregnancy, OPs can be transferred to the blood stream reaching the fetus through the placenta. The aim of this study was to explore the association between maternal OPs exposure levels and fetal developments and birth outcomes. A birth cohort was follow-up. Maternal urine sample were collected at the first, second, and third gestational trimester. Fetal growth characteristics were measured by ultrasonic scan and birth outcomes were assessed by pediatrician. Urinary metabolite of organophosphate pesticides were assessed using gas chromatography-mass spectrometry. The analytes included dimethylphosphate (DMP), dimethylthiophosphate (DMTP), dimethyldithiophosphates (DMDTP), diethylphosphate (DEP), diethylthiophosphate (DETP), and diethyldithiophosphate (DEDTP). We found that all of urine samples in each trimester were detected at least one metabolite for dialkyl phosphate (DAP). The detection rate range of OP urinary metabolites were from the lowest 22% DEDTP to the highest 100% DMP and DMTP. And to compared geometric means (GM) of urinary metabolites with three trimesters, that third trimester had the highest concentration for DMPs, DEPs, and DAPs in pregnant women were 368.01, 169.85 and 543.75 nmol/g creatinine, respectively. We observed that DAPs concentration in first and second trimester were significantly negative association with head circumference. DMPs in first trimester was significantly negative association with thoracic circumference (p=0.05) by spearman correlation. Our results support associations with prenatal OPs exposure with fetal head circumference and thoracic circumference. It provided that maternal OPs exposure might affect birth outcomes. Thus, prenatal exposure to OPs and health risk worthy of attention and concern.

Keywords: DAPs, birth outcomes, organophosphate pesticides, prenatal

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3432 High Input Driven Factors in Idea Campaigns in Large Organizations: A Case Depicting Best Practices

Authors: Babar Rasheed, Saad Ghafoor

Abstract:

Introduction: Idea campaigns are commonly held across organizations for generating employee engagement. The contribution is specifically designed to identify and solve prevalent issues. It is argued that numerous organizations fail to achieve their desired goals despite arranging for such campaigns and investing heavily in them. There are however practices that organizations use to achieve higher degree of effectiveness, and these practices may be up for exploration by research to make them usable for the other organizations. Purpose: The aim of this research is to surface the idea management practices of a leading electric company with global operations. The study involves a large sized, multi site organization that is attributed to have added challenges in terms of managing ideas from employees, in comparison to smaller organizations. The study aims to highlight the factors that are looked at as the idea management team strategies for the campaign, sets terms and rewards for it, makes follow up with the employees and lastly, evaluate and award ideas. Methodology: The study is conducted in a leading electric appliance corporation that has a large number of employees and is based in numerous regions of the world. A total of 7 interviews are carried out involving the chief innovation officer, innovation manager and members of idea management and evaluation teams. The interviews are carried out either on Skype or in-person based on the availability of the interviewee. Findings: While this being a working paper and while the study is under way, it is anticipated that valuable information is being achieved about specific details on how idea management systems are governed and how idea campaigns are carried out. The findings may be particularly useful for innovation consultants as resources they can use to promote idea campaigning. The usefulness of the best practices highlighted as a result is, in any case, the most valuable output of this study.

Keywords: employee engagement, motivation, idea campaigns, large organizations, best practices, employees input, organizational output

Procedia PDF Downloads 156
3431 A Systematic Review on Factors/Predictors and Outcomes of Parental Distress in Childhood Acute Lymphoblastic Leukemia

Authors: Ana Ferraz, Martim Santos, M. Graça Pereira

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Distress among parents of children with acute lymphoblastic leukemia (ALL) is common during treatment and can persist several years post-diagnosis, impacting the adjustment of children and parents themselves. Current evidence is needed to examine the scope and nature of parental distress in childhood ALL. This review focused on associated variables, predictors, and outcomes of parental distress following their ALL diagnosis of their child. PubMed, Web of Science, and PsycINFO databases were searched for English and Spanish papers published from 1983 to 2021. PRISMA statement was followed, and papers were evaluated through a standardized methodological quality assessment tool (NHLBI). Of the 28 papers included, 16 were evaluated as fair, eight as good, and four as poor. Regarding results, 11 papers reported subgroup differences, and 15 found potential predictors of parental distress, including sociodemographic, psychosocial, psychological, family, health, and ALL-specific variables. Significant correlations were found between parental distress, social support, illness cognitions, and resilience, as well as contradictory results regarding the impact of sociodemographic variables on parental distress. Family cohesion and caregiver burden were associated with distress, and the use of healthy coping strategies was associated with less anxiety. Caregiver strain contributed to distress, and the overall impact of illness positively predicted anxiety in mothers and somatization in fathers. Differences in parental distress were found regarding group risk, time since diagnosis, and treatment phases. Thirteen papers explored the outcomes of parental distress on psychological, family, health, and social/education outcomes. Parental distress was the most important predictor of family strain. Significant correlations were found between parental distress at diagnosis and further psychological adjustment of parents themselves and their children. Most papers reported correlations between parental distress on children’s adjustment and quality of life, although few studies reported no association. Correlations between maternal depression and child participation in education and social life were also found. Longitudinal studies are needed to better understand parental distress and its consequences on health outcomes, in particular. Future interventions should focus mainly on parents on distress reduction and psychological adjustment, both in parents and children over time.

Keywords: childhood acute lymphoblastic leukemia, family, parental distress, psychological adjustment, quality of life

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3430 Engaging Girls in 'Learn Science by Doing' as Strategy for Enhanced Learning Outcome at the Junior High School Level in Nigeria

Authors: Stella Y. Erinosho

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In an attempt to impact on girls’ interest in science, an instructional package on ‘Learn Science by Doing (LSD)’ was developed to support science teachers in teaching integrated science at the junior secondary level in Nigeria. LSD provides an instructional framework aimed at actively engaging girls in beginners’ science through activities that are discovery-oriented and allow for experiential learning. The goal of this study was to show the impact of application of LSD on girls’ performance and interest in science. The major hypothesis that was tested in the study was that students would exhibit higher learning outcomes (achievement and attitude) in science as effect of exposure to LSD instructional package. A quasi-experimental design was adopted, incorporating four all-girls schools. Three of the schools (comprising six classes) were randomly designated as experimental and one as the control. The sample comprised 357 girls (275 experimental and 82 control) and nine science teachers drawn from the experimental schools. The questionnaire was designed to gather data on students’ background characteristics and their attitude toward science while the cognitive outcomes were measured using tests, both within a group and between groups, the girls who had exposure to LSD exhibited improved cognitive outcomes and more positive attitude towards science compared with those who had conventional teaching. The data are consistent with previous studies indicating that interactive learning activities increase student performance and interest.

Keywords: active learning, school science, teaching and learning, Nigeria

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3429 Nutrition and Physical Activity Intervention on Health Screening Outcomes for Singaporean Employees: A Worksite Based Randomised Controlled Trial

Authors: Elaine Wong

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This research protocol aims to explore and justify the need for nutrition and physical activity intervention to improve health outcomes among SME (Small Medium Enterprise) employees. It was found that the worksite is an ideal and convenient setting for employees to take charge of their health thru active participation in health programmes since they spent a great deal of time at their workplace. This study will examine the impact of both general or/and targeted health interventions in both SME and non-SME companies utilizing the Workplace Health Promotion (WHP) grant over a 12 months period and assessed the improvement in chronic health disease outcomes in Singapore. Random sampling of both non-SME and SME companies will be conducted to undergo health intervention and statistical packages such as Statistical Package for Social Science (SPSS) 25 will be used to examine the impact of both general and targeted interventions on employees who participate and those who do not participate in the intervention and their effects on blood glucose (BG), blood lipid, blood pressure (BP), body mass index (BMI), and body fat percentage. Using focus groups and interviews, the data results will be transcribed to investigate enablers and barriers to workplace health intervention revealed by employees and WHP coordinators that could explain the variation in the health screening results across the organisations. Dietary habits and physical activity levels of the employees participating and not participating in the intervention will be collected before and after intervention to assess any changes in their lifestyle practices. It makes economic sense to study the impact of these interventions on health screening outcomes across various organizations that are existing grant recipients to justify the sustainability of these programmes by the local government. Healthcare policy makers and employers can then tailor appropriate and relevant programmes to manage these escalating chronic health disease conditions which is integral to the competitiveness and productivity of the nation’s workforce.

Keywords: chronic diseases, health screening, nutrition and fitness intervention , workplace health

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3428 Post Injury Experiences of New Immigrant Workers

Authors: Janki Shankar, Shu Ping Chen

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Background: New immigrants are one of most vulnerable sections of the Canadian society. Unable to gain entry into Canada’s strictly regulated professions and trades, several skilled and qualified new immigrants take up precarious jobs without adequate occupational health and safety training, thereby increasing their risk of sustaining occupational injury and illness compared to Canadian born workers. Access to timely and appropriate support is critical for injured new immigrant workers who face additional challenges compared to Canadian born workers in accessing information and support post-injury. The purpose of our study was to explore the post-injury experiences and support needs of new immigrant workers who have sustained work-related injuries. Methods: Using an interpretive research approach and semi structured face to face qualitative interviews, 27 new immigrant workers from a range of industries operating in two cities in a province in Canada were interviewed. All had sustained work-related injuries and reported these to their work supervisors. A constant comparative approach was used to identify key themes across the worker experiences. Results: Findings reveal several factors that can shape the experiences of new immigrant workers and influence their return-to-work outcomes. Conclusion: Based on the insights of study participants, policies, practices, and potential interventions informed by their needs and preferences are proposed that can improve return to work outcomes for these workers.

Keywords: new immigrant workers, post-injury experiences, return to work outcomes, qualified

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3427 Integration of Educational Data Mining Models to a Web-Based Support System for Predicting High School Student Performance

Authors: Sokkhey Phauk, Takeo Okazaki

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The challenging task in educational institutions is to maximize the high performance of students and minimize the failure rate of poor-performing students. An effective method to leverage this task is to know student learning patterns with highly influencing factors and get an early prediction of student learning outcomes at the timely stage for setting up policies for improvement. Educational data mining (EDM) is an emerging disciplinary field of data mining, statistics, and machine learning concerned with extracting useful knowledge and information for the sake of improvement and development in the education environment. The study is of this work is to propose techniques in EDM and integrate it into a web-based system for predicting poor-performing students. A comparative study of prediction models is conducted. Subsequently, high performing models are developed to get higher performance. The hybrid random forest (Hybrid RF) produces the most successful classification. For the context of intervention and improving the learning outcomes, a feature selection method MICHI, which is the combination of mutual information (MI) and chi-square (CHI) algorithms based on the ranked feature scores, is introduced to select a dominant feature set that improves the performance of prediction and uses the obtained dominant set as information for intervention. By using the proposed techniques of EDM, an academic performance prediction system (APPS) is subsequently developed for educational stockholders to get an early prediction of student learning outcomes for timely intervention. Experimental outcomes and evaluation surveys report the effectiveness and usefulness of the developed system. The system is used to help educational stakeholders and related individuals for intervening and improving student performance.

Keywords: academic performance prediction system, educational data mining, dominant factors, feature selection method, prediction model, student performance

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3426 Bullying Rates Among Students with Special Needs in the United States

Authors: Kaycee Bills

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Past studies have indicated students who have disabilities are at a higher risk of experiencing bullying victimization in comparison to other student groups. Extracurricular activity participation has been shown to establish better social outcomes for students. These positive social outcomes indirectly decrease the number of times a student is bullied. The following study uses the National Crime Victimization Survey – School Crime Supplement (NCVS/SCS) to analyze the bullying concurrences experienced among students, with disabilities being a focal variable. To explore the relationship between extracurricular involvement and bullying occurrence rates, this study employs a binary logistic regression to determine if athletic and non-athletic extracurricular activities have an impact on the number of times a student with disabilities experiences bullying. Implications for future social welfare practice and research are discussed.

Keywords: disability, bullying, extracurricular activities, athletics

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3425 Bacterial Causes of Cerebral Abscess and Impact on Long Term Patient Outcomes

Authors: Umar Rehman, Holly Roy, K. T. Tsang, D. S. Jeyaretna, W Singleton, B. Fisher, P. A. Glew, J. Greig, Peter C. Whitfield

Abstract:

Introduction: A brain abscess is a life-threatening condition, carrying significant mortality. It requires rapid identification and treatment. Management involves a combination of antibiotics and surgery. The aim of the current study was to identify common bacteria responsible for cerebral abscesses as well as the long term functional and neurological outcomes of patients following treatment in a retrospective series at a single UK neurosurgical centre. Methodology: We analysed patients that had received a diagnosis of 'cerebral abscess' or 'subdural empyema' between June 2002 and June 2018. This was done in the form of a retrospective review. The search resulted in a total of 180 patients; with 37 patients being excluded (spinal abscess, below 18 or non-abscess related admissions). Data were collected from medical case notes including information about demographics, comorbidities, immunosuppression, presentation, size/location of lesions, pathogens, treatment, and outcomes. Results: In total, we analysed 143 patients between the ages of 18-90. Focal neurological deficit and headaches were seen in 84% and 68% of patients respectively. 108 positive brain cultures were seen; with the largest proportion, 59.2% being gram-positive cocci, with strep intermedius being the most common pathogen identified in 13.9% of patients. Of the patients with positive blood cultures (n=11), 72.7% showed the same organism both in the blood and on the brain cultures. Long term outcomes (n=72) revealed that 48% of patients seizure-free without requiring anti-epileptics, 51.3% of patients had full recovery of their neurological symptoms. There was a mortality rate of 13.9% in the series. Conclusion: In conclusion, the largest bacterial cause of abscess within our population was due to gram-positive cocci. The majority of the patient demonstrated full neurological recovery with close to half of patients not requiring anti-epileptics following discharge.

Keywords: bacteria, cerebral abscess, long term outcome, neurological deficit

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3424 Midterm Clinical and Functional Outcomes After Treatment with Ponseti Method for Idiopathic Clubfeet: A Prospective Cohort Study

Authors: Neeraj Vij, Amber Brennan, Jenni Winters, Hadi Salehi, Hamy Temkit, Emily Andrisevic, Mohan V. Belthur

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Idiopathic clubfoot is a common lower extremity deformity with an incidence of 1:500. The Ponseti Method is well known as the gold standard of treatment. However, there is limited functional data demonstrating correction of the clubfoot after treatment with the Ponseti method. The purpose of this study was to study the clinical and functional outcomes after the Ponseti method with the Clubfoot Disease-Specific Instrument (CDS) and pedobarography. This IRB-approved prospective study included patients aged 3-18 who were treated for idiopathic clubfoot with the Ponseti method between January 2008 and December 2018. Age-matched controls were identified through siblings of clubfoot patients and other community members. Treatment details were collected through a chart review of the included patients. Laboratory assessment included a physical exam, gait analysis, and pedobarography. The Pediatric Outcomes Data Collection Instrument and the Clubfoot Disease-Specific Instrument were also obtained on clubfoot patients (CF). The Wilcoxson rank-sum test was used to study differences between the CF patients and the typically developing (TD) patients. Statistical significance was set at p < 0.05. There were a total of 37 enrolled patients in our study. 21 were priorly treated for CF and 16 were TD. 94% of the CF patients had bilateral involvement. The age at the start of treatment was 29 days, the average total number of casts was seven to eight, and the average total number of casts after Achilles tenotomy was one. The reoccurrence rate was 25%, tenotomy was required in 94% of patients, and ≥1 tenotomy was required in 25% of patients. There were no significant differences between step length, step width, stride length, force-time integral, maximum peak pressure, foot progression angles, stance phase time, single-limb support time, double limb support time, and gait cycle time between children treated with the Ponseti method and typically developing children. The average post-treatment Pirani and Dimeglio scores were 5.50±0.58 and 15.29±1.58, respectively. The average post-treatment PODCI subscores were: Upper Extremity: 90.28, Transfers: 94.6, Sports: 86.81, Pain: 86.20, Happiness: 89.52, Global: 88.6. The average post-treatment Clubfoot Disease-Specific Instrument scores subscores were: Satisfaction: 73.93, Function: 80.32, Overall: 78.41. The Ponseti Method has a very high success rate and remains to be the gold standard in the treatment of idiopathic clubfoot. Timely management leads to good outcomes and a low need for repeated Achilles tenotomy. Children treated with the Ponseti method demonstrate good functional outcomes as measured through pedobarography. Pedobarography may have clinical utility in studying congenital foot deformities. Objective measures for hours of brace wear could represent an improvement in clubfoot care.

Keywords: functional outcomes, pediatric deformity, patient-reported outcomes, talipes equinovarus

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3423 GBKMeans: A Genetic Based K-Means Applied to the Capacitated Planning of Reading Units

Authors: Anderson S. Fonseca, Italo F. S. Da Silva, Robert D. A. Santos, Mayara G. Da Silva, Pedro H. C. Vieira, Antonio M. S. Sobrinho, Victor H. B. Lemos, Petterson S. Diniz, Anselmo C. Paiva, Eliana M. G. Monteiro

Abstract:

In Brazil, the National Electric Energy Agency (ANEEL) establishes that electrical energy companies are responsible for measuring and billing their customers. Among these regulations, it’s defined that a company must bill your customers within 27-33 days. If a relocation or a change of period is required, the consumer must be notified in writing, in advance of a billing period. To make it easier to organize a workday’s measurements, these companies create a reading plan. These plans consist of grouping customers into reading groups, which are visited by an employee responsible for measuring consumption and billing. The creation process of a plan efficiently and optimally is a capacitated clustering problem with constraints related to homogeneity and compactness, that is, the employee’s working load and the geographical position of the consuming unit. This process is a work done manually by several experts who have experience in the geographic formation of the region, which takes a large number of days to complete the final planning, and because it’s human activity, there is no guarantee of finding the best optimization for planning. In this paper, the GBKMeans method presents a technique based on K-Means and genetic algorithms for creating a capacitated cluster that respects the constraints established in an efficient and balanced manner, that minimizes the cost of relocating consumer units and the time required for final planning creation. The results obtained by the presented method are compared with the current planning of a real city, showing an improvement of 54.71% in the standard deviation of working load and 11.97% in the compactness of the groups.

Keywords: capacitated clustering, k-means, genetic algorithm, districting problems

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3422 Long-Term Outcomes of Dysphagia in Children with Severe Cerebral Palsy Using Videofluoroscopic Evaluation

Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

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Oropharyngeal dysphagia is prevalent in children with cerebral palsy (CP). There are many studies concerning this problem, however, studies examining long term outcomes of dysphagia using videofluoroscopic study (VFSS) are very rare. The Aim of this study is to investigate long-term outcomes of dysphagia in children with severe CP using initial VFSS. It was a retrospective study and chart review was done from January 2000 to December 2013. Thirty one patients under 18 years who have been diagnosed as CP in outpatient clinic of Rehabilitation Medicine, and who did VFSS were included. Long-term outcomes such as feeding method, height percentile, weight percentile, and body mass index (BMI) were tracked up for at least 3 years by medical records. Significant differences between initial and follow-up datas were investigated. The patients consisted of 18 males and 13 females, and the mean age was 31.0±18.0 months old. 64.5% of patients were doing oral diet, and 25.8% of patients were doing non-oral diet. When comparing VFSS findings among oral feeding patients, oral and non-oral feeding patients, and non-oral feeding patients at initial period, dysphagia severity, supraglottic penetration, and subglottic aspiration showed significant differences. Most of the patients who could feed orally at initial period were found to have the same feeding method at follow-up. But among eight patients who required non-oral feeding initially, three patients became possible to feed orally, and one patient was doing oral and non-oral feeding method together at follow-up. Follow up feeding method showed correlation with dysphagia severity by initial VFSS. Weight percentile was decreased in patients with GMFCS level V at follow up, which may represent poor nutritional status due to severe dysphagia compared to other patients. Initial VFSS severity would play a significant role in making an assumption about future diet in children with severe CP. Patients with GMFCS level V seem to have serious dysphagia at follow up and have nutritional deficiency over time, therefore, more careful nutritional support is needed in children with severe CP are suggested.

Keywords: cerebral palsy, child, dysphagia, videofluoroscopic study

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3421 Surgical Hip Dislocation of Femoroacetabular Impingement: Survivorship and Functional Outcomes at 10 Years

Authors: L. Hoade, O. O. Onafowokan, K. Anderson, G. E. Bartlett, E. D. Fern, M. R. Norton, R. G. Middleton

Abstract:

Aims: Femoroacetabular impingement (FAI) was first recognised as a potential driver for hip pain at the turn of the last millennium. While there is an increasing trend towards surgical management of FAI by arthroscopic means, open surgical hip dislocation and debridement (SHD) remains the Gold Standard of care in terms of reported outcome measures. (1) Long-term functional and survivorship outcomes of SHD as a treatment for FAI are yet to be sufficiently reported in the literature. This study sets out to help address this imbalance. Methods: We undertook a retrospective review of our institutional database for all patients who underwent SHD for FAI between January 2003 and December 2008. A total of 223 patients (241 hips) were identified and underwent a ten year review with a standardised radiograph and patient-reported outcome measures questionnaire. The primary outcome measure of interest was survivorship, defined as progression to total hip arthroplasty (THA). Negative predictive factors were analysed. Secondary outcome measures of interest were survivorship to further (non-arthroplasty) surgery, functional outcomes as reflected by patient reported outcome measure scores (PROMS) scores, and whether a learning curve could be identified. Results: The final cohort consisted of 131 females and 110 males, with a mean age of 34 years. There was an overall native hip joint survival rate of 85.4% at ten years. Those who underwent a THA were significantly older at initial surgery, had radiographic evidence of preoperative osteoarthritis and pre- and post-operative acetabular undercoverage. In those whom had not progressed to THA, the average Non-arthritic Hip Score and Oxford Hip Score at ten year follow-up were 72.3% and 36/48, respectively, and 84% still deemed their surgery worthwhile. A learning curve was found to exist that was predicated on case selection rather than surgical technique. Conclusion: This is only the second study to evaluate the long-term outcomes (beyond ten years) of SHD for FAI and the first outside the originating centre. Our results suggest that, with correct patient selection, this remains an operation with worthwhile outcomes at ten years. How the results of open surgery compared to those of arthroscopy remains to be answered. While these results precede the advent of collison software modelling tools, this data helps set a benchmark for future comparison of other techniques effectiveness at the ten year mark.

Keywords: femoroacetabular impingement, hip pain, surgical hip dislocation, hip debridement

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3420 Shared Decision Making in Oropharyngeal Cancer: The Development of a Decision Aid for Resectable Oropharyngeal Carcinoma, a Mixed Methods Study

Authors: Anne N. Heirman, Lisette van der Molen, Richard Dirven, Gyorgi B. Halmos, Michiel W.M. van den Brekel

Abstract:

Background: Due to the rising incidence of oropharyngeal squamous cell cancer (OPSCC), many patients are challenged with choosing between transoral(robotic) surgery and radiotherapy, with equal survival and oncological outcomes. Also, functional outcomes are of little difference over the years. With this study, the wants and needs of patients and caregivers are identified to develop a comprehensible patient decision aid (PDA). Methods: The development of this PDA is based on the International Patient Decision Aid Standards criteria. In phase 1, relevant literature was reviewed and compared to current counseling papers. We interviewed ten post-treatment patients and ten doctors from four head and neck centers in the Netherlands, which were transcribed verbatim and analyzed. With these results, the first draft of the PDA was developed. Phase 2 beholds testing the first draft for comprehensibility and usability. Phase 3 beholds testing for feasibility. After this phase, the final version of the PDA was developed. Results: All doctors and patients agreed a PDA was needed. Phase 1 showed that 50% of patients felt well-informed after standard care and 35% missed information about treatment possibilities. Side effects and functional outcomes were rated as the most important for decision-making. With this information, the first version was developed. Doctors and patients stated (phase 2) that they were satisfied with the comprehensibility and usability, but there was too much text. The PDA underwent text reduction revisions and got more graphics. After revisions, all doctors found the PDA feasible and would contribute to regular counseling. Patients were satisfied with the results and wished they would have seen it before their treatment. Conclusion: Decision-making for OPSCC should focus on differences in side-effects and functional outcomes. Patients and doctors found the PDA to be of great value. Future research will explore the benefits of the PDA in clinical practice.

Keywords: head-and-neck oncology, oropharyngeal cancer, patient decision aid, development, shared decision making

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3419 A Quasi-Systematic Review on Effectiveness of Social and Cultural Sustainability Practices in Built Environment

Authors: Asif Ali, Daud Salim Faruquie

Abstract:

With the advancement of knowledge about the utility and impact of sustainability, its feasibility has been explored into different walks of life. Scientists, however; have established their knowledge in four areas viz environmental, economic, social and cultural, popularly termed as four pillars of sustainability. Aspects of environmental and economic sustainability have been rigorously researched and practiced and huge volume of strong evidence of effectiveness has been founded for these two sub-areas. For the social and cultural aspects of sustainability, dependable evidence of effectiveness is still to be instituted as the researchers and practitioners are developing and experimenting methods across the globe. Therefore, the present research aimed to identify globally used practices of social and cultural sustainability and through evidence synthesis assess their outcomes to determine the effectiveness of those practices. A PICO format steered the methodology which included all populations, popular sustainability practices including walkability/cycle tracks, social/recreational spaces, privacy, health & human services and barrier free built environment, comparators included ‘Before’ and ‘After’, ‘With’ and ‘Without’, ‘More’ and ‘Less’ and outcomes included Social well-being, cultural co-existence, quality of life, ethics and morality, social capital, sense of place, education, health, recreation and leisure, and holistic development. Search of literature included major electronic databases, search websites, organizational resources, directory of open access journals and subscribed journals. Grey literature, however, was not included. Inclusion criteria filtered studies on the basis of research designs such as total randomization, quasi-randomization, cluster randomization, observational or single studies and certain types of analysis. Studies with combined outcomes were considered but studies focusing only on environmental and/or economic outcomes were rejected. Data extraction, critical appraisal and evidence synthesis was carried out using customized tabulation, reference manager and CASP tool. Partial meta-analysis was carried out and calculation of pooled effects and forest plotting were done. As many as 13 studies finally included for final synthesis explained the impact of targeted practices on health, behavioural and social dimensions. Objectivity in the measurement of health outcomes facilitated quantitative synthesis of studies which highlighted the impact of sustainability methods on physical activity, Body Mass Index, perinatal outcomes and child health. Studies synthesized qualitatively (and also quantitatively) showed outcomes such as routines, family relations, citizenship, trust in relationships, social inclusion, neighbourhood social capital, wellbeing, habitability and family’s social processes. The synthesized evidence indicates slight effectiveness and efficacy of social and cultural sustainability on the targeted outcomes. Further synthesis revealed that such results of this study are due weak research designs and disintegrated implementations. If architects and other practitioners deliver their interventions in collaboration with research bodies and policy makers, a stronger evidence-base in this area could be generated.

Keywords: built environment, cultural sustainability, social sustainability, sustainable architecture

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3418 Learning Outcomes Alignment across Engineering Core Courses

Authors: A. Bouabid, B. Bielenberg, S. Ainane, N. Pasha

Abstract:

In this paper, a team of faculty members of the Petroleum Institute in Abu Dhabi, UAE representing six different courses across General Engineering (ENGR), Communication (COMM), and Design (STPS) worked together to establish a clear developmental progression of learning outcomes and performance indicators for targeted knowledge, areas of competency, and skills for the first three semesters of the Bachelor of Sciences in Engineering curriculum. The sequences of courses studied in this project were ENGR/COMM, COMM/STPS, and ENGR/STPS. For each course’s nine areas of knowledge, competency, and skills, the research team reviewed the existing learning outcomes and related performance indicators with a focus on identifying linkages across disciplines as well as within the courses of a discipline. The team reviewed existing performance indicators for developmental progression from semester to semester for same discipline related courses (vertical alignment) and for different discipline courses within the same semester (horizontal alignment). The results of this work have led to recommendations for modifications of the initial indicators when incoherence was identified, and/or for new indicators based on best practices (identified through literature searches) when gaps were identified. It also led to recommendations for modifications of the level of emphasis within each course to ensure developmental progression. The exercise has led to a revised Sequence Performance Indicator Mapping for the knowledge, skills, and competencies across the six core courses.

Keywords: curriculum alignment, horizontal and vertical progression, performance indicators, skill level

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3417 A Short Survey of Integrating Urban Agriculture and Environmental Planning

Authors: Rayeheh Khatami, Toktam Hanaei, Mohammad Reza Mansouri Daneshvar

Abstract:

The growth of the agricultural sector is known as an essential way to achieve development goals in developing countries. Urban agriculture is a way to reduce the vulnerability of urban populations of the world toward global environmental change. It is a sustainable and efficient system to respond to the environmental, social and economic needs of the city, which leads to urban sustainability. Today, many local and national governments are developing urban agriculture as an effective tool in responding to challenges such as poverty, food security, and environmental problems. In this study, we follow a perspective based on urban agriculture literature in order to indicate the urban agriculture’s benefits in environmental planning strategies in non-western countries like Iran. The methodological approach adopted is based on qualitative approach and documentary studies. A total of 35 articles (mixed quantitative and qualitative methods studies) were studied in final analysis, which are published in relevant journals that focus on this subject. Studies show the wide range of positive benefits of urban agriculture on food security, nutrition outcomes, health outcomes, environmental outcomes, and social capital. However, there was no definitive conclusion about the negative effects of urban agriculture. This paper provides a conceptual and theoretical basis to know about urban agriculture and its roles in environmental planning, and also conclude the benefits of urban agriculture for researchers, practitioners, and policymakers who seek to create spaces in cities for implementation urban agriculture in future.

Keywords: urban agriculture, environmental planning, urban planning, literature

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3416 Frequency of Tube Feeding in Aboriginal and Non-aboriginal Head and Neck Cancer Patients and the Impact on Relapse and Survival Outcomes

Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

Abstract:

Introduction: Head and neck cancer and treatments are known for their profound effect on nutrition and tube feeding is a common requirement to maintain nutrition. Aim: We aimed to evaluate the frequency of tube feeding in Aboriginal and non-Aboriginal patients, and to examine the relapse and survival outcomes in patients who require enteral tube feeding. Methods: We performed a retrospective cohort analysis of 320 head and neck cancer patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. Data collected included patient demographics, tumour features, treatment details, and cancer and survival outcomes. Results: Aboriginal and non-Aboriginal patients required feeding tubes at similar rates (42.5% vs 46.2% respectively), however Aboriginal patients were far more likely to fail to return to oral nutrition, with 26.3% requiring long-term tube feeding versus only 15% of non-Aboriginal patients. In the overall study population, 27.5% required short-term tube feeding, 17.8% required long-term enteral tube nutrition, and 45.3% of patients did not have a feeding tube at any point. Relapse was more common in patients who required tube feeding, with relapses in 42.1% of the patients requiring long-term tube feeding, 31.8% in those requiring a short-term tube, versus 18.9% in the ‘no tube’ group. Survival outcomes for patients who required a long-term tube were also significantly poorer when compared to patients who only required a short-term tube, or not at all. Long-term tube-requiring patients were half as likely to survive (29.8%) compared to patients requiring a short-term tube (62.5%) or no tube at all (63.5%). Patients requiring a long-term tube were twice as likely to die with active disease (59.6%) as patients with no tube (28%), or a short term tube (33%). This may suggest an increased relapse risk in patients who require long-term feeding, due to consequences of malnutrition on cancer and treatment outcomes, although may simply reflect that patients with recurrent disease were more likely to have longer-term swallowing dysfunction due to recurrent disease and salvage treatments. Interestingly long-term tube patients were also more likely to die with no active disease (10.5%) (compared with short-term tube requiring patients (4.6%), or patients with no tube (8%)), which is likely reflective of the increased mortality associated with long-term aspiration and malnutrition issues. Conclusions: Requirement for tube feeding was associated with a higher rate of cancer relapse, and in particular, long-term tube feeding was associated with a higher likelihood of dying from head and neck cancer, but also a higher risk of dying from other causes without cancer relapse. This data reflects the complex effect of head and neck cancer and its treatments on swallowing and nutrition, and ultimately, the effects of malnutrition, swallowing dysfunction, and aspiration on overall cancer and survival outcomes. Tube feeding was seen at similar rates in Aboriginal and non-Aboriginal patient, however failure to return to oral intake with a requirement for a long-term feeding tube was seen far more commonly in the Aboriginal population.

Keywords: head and neck cancer, enteral tube feeding, malnutrition, survival, relapse, aboriginal patients

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3415 Exploring the Spatial Characteristics of Mortality Map: A Statistical Area Perspective

Authors: Jung-Hong Hong, Jing-Cen Yang, Cai-Yu Ou

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The analysis of geographic inequality heavily relies on the use of location-enabled statistical data and quantitative measures to present the spatial patterns of the selected phenomena and analyze their differences. To protect the privacy of individual instance and link to administrative units, point-based datasets are spatially aggregated to area-based statistical datasets, where only the overall status for the selected levels of spatial units is used for decision making. The partition of the spatial units thus has dominant influence on the outcomes of the analyzed results, well known as the Modifiable Areal Unit Problem (MAUP). A new spatial reference framework, the Taiwan Geographical Statistical Classification (TGSC), was recently introduced in Taiwan based on the spatial partition principles of homogeneous consideration of the number of population and households. Comparing to the outcomes of the traditional township units, TGSC provides additional levels of spatial units with finer granularity for presenting spatial phenomena and enables domain experts to select appropriate dissemination level for publishing statistical data. This paper compares the results of respectively using TGSC and township unit on the mortality data and examines the spatial characteristics of their outcomes. For the mortality data between the period of January 1st, 2008 and December 31st, 2010 of the Taitung County, the all-cause age-standardized death rate (ASDR) ranges from 571 to 1757 per 100,000 persons, whereas the 2nd dissemination area (TGSC) shows greater variation, ranged from 0 to 2222 per 100,000. The finer granularity of spatial units of TGSC clearly provides better outcomes for identifying and evaluating the geographic inequality and can be further analyzed with the statistical measures from other perspectives (e.g., population, area, environment.). The management and analysis of the statistical data referring to the TGSC in this research is strongly supported by the use of Geographic Information System (GIS) technology. An integrated workflow that consists of the tasks of the processing of death certificates, the geocoding of street address, the quality assurance of geocoded results, the automatic calculation of statistic measures, the standardized encoding of measures and the geo-visualization of statistical outcomes is developed. This paper also introduces a set of auxiliary measures from a geographic distribution perspective to further examine the hidden spatial characteristics of mortality data and justify the analyzed results. With the common statistical area framework like TGSC, the preliminary results demonstrate promising potential for developing a web-based statistical service that can effectively access domain statistical data and present the analyzed outcomes in meaningful ways to avoid wrong decision making.

Keywords: mortality map, spatial patterns, statistical area, variation

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3414 The State of Oral Health after COVID-19 Lockdown: A Systematic Review

Authors: Faeze omid, Morteza Banakar

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Background: The COVID-19 pandemic has had a significant impact on global health and healthcare systems, including oral health. The lockdown measures implemented in many countries have led to changes in oral health behaviors, access to dental care, and the delivery of dental services. However, the extent of these changes and their effects on oral health outcomes remains unclear. This systematic review aims to synthesize the available evidence on the state of oral health after the COVID-19 lockdown. Methods: We conducted a systematic search of electronic databases (PubMed, Embase, Scopus, and Web of Science) and grey literature sources for studies reporting on oral health outcomes after the COVID-19 lockdown. We included studies published in English between January 2020 and March 2023. Two reviewers independently screened the titles, abstracts, and full texts of potentially relevant articles and extracted data from included studies. We used a narrative synthesis approach to summarize the findings. Results: Our search identified 23 studies from 12 countries, including cross-sectional surveys, cohort studies, and case reports. The studies reported on changes in oral health behaviors, access to dental care, and the prevalence and severity of dental conditions after the COVID-19 lockdown. Overall, the evidence suggests that the lockdown measures had a negative impact on oral health outcomes, particularly among vulnerable populations. There were decreases in dental attendance, increases in dental anxiety and fear, and changes in oral hygiene practices. Furthermore, there were increases in the incidence and severity of dental conditions, such as dental caries and periodontal disease, and delays in the diagnosis and treatment of oral cancers. Conclusion: The COVID-19 pandemic and associated lockdown measures have had significant effects on oral health outcomes, with negative impacts on oral health behaviors, access to care, and the prevalence and severity of dental conditions. These findings highlight the need for continued monitoring and interventions to address the long-term effects of the pandemic on oral health.

Keywords: COVID-19, oral health, systematic review, dental public health

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3413 Clinical Outcomes of Critically Ill Patients with Sepsis Receiving Extended and Standard Meropenem Infusion in Malaysian Hospitals

Authors: Fahmi Hassan, Noorizan Abdul Aziz, Yahaya Hassan, Hazlinda Abu Hassan

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Sepsis incidence in critical care settings is a major problem in health care. Extended antibiotic infusion is thought to be superior to traditional dosing especially when treating critically ill patients with sepsis. We compared clinical outcomes of critically ill patients with sepsis receiving 30-minute meropenem infusion and three-hour meropenem infusion. A retrospective case-control study was conducted among septic patients treated with meropenem infusion in ICUs of three hospitals. Patients included in the study received either extended or standard meropenem infusion as per the practice of individual settings. Outcomes and clinical data were retrospectively collected from the electronic databases and patients’ files. A total of 108 patients received extended meropenem infusion while another 117 patients received standard meropenem infusion. Patients receiving the extended meropenem infusion were found to have a significantly lower shorter length of hospital and ICU stay. It was also found that among those receiving extended meropenem infusion, 54.7% (64/117) had a reduction of SAPS II score, while only 44% (48/108) of patients receiving standard meropenem infusion had reduced scores. This study will strengthen the evidence in using extended meropenem infusion as a standard practice in critical care settings. As this is the first study of its kind done in Malaysia, it proves that prolonged meropenem infusion may be beneficial to critically ill patients with sepsis. However, randomized clinical trials with large sample size should be carried out in local settings in order to minimize other confounders that may influence with the result of the study.

Keywords: antibiotics, beta lactams, critical care, extended infusion, meropenem

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3412 The Difference of Learning Outcomes in Reading Comprehension between Text and Film as The Media in Indonesian Language for Foreign Speaker in Intermediate Level

Authors: Siti Ayu Ningsih

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This study aims to find the differences outcomes in learning reading comprehension with text and film as media on Indonesian Language for foreign speaker (BIPA) learning at intermediate level. By using quantitative and qualitative research methods, the respondent of this study is a single respondent from D'Royal Morocco Integrative Islamic School in grade nine from secondary level. Quantitative method used to calculate the learning outcomes that have been given the appropriate action cycle, whereas qualitative method used to translate the findings derived from quantitative methods to be described. The technique used in this study is the observation techniques and testing work. Based on the research, it is known that the use of the text media is more effective than the film for intermediate level of Indonesian Language for foreign speaker learner. This is because, when using film the learner does not have enough time to take note the difficult vocabulary and don't have enough time to look for the meaning of the vocabulary from the dictionary. While the use of media texts shows the better effectiveness because it does not require additional time to take note the difficult words. For the words that are difficult or strange, the learner can immediately find its meaning from the dictionary. The presence of the text is also very helpful for Indonesian Language for foreign speaker learner to find the answers according to the questions more easily. By matching the vocabulary of the question into the text references.

Keywords: Indonesian language for foreign speaker, learning outcome, media, reading comprehension

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3411 Clinical Outcomes and Surgical Complications in Patients with Cervical Disk Degeneration

Authors: Mirzashahi Babak, Mansouri Pejman, Najafi Arvin, Farzan Mahmoud

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Introduction: There are several surgical treatment choices for cervical spondylotic myelopathy (CSM). The aim of this study is to evaluate clinical outcomes and surgical complications in patients with cervical disk degeneration (CDD) undergoing either anterior cervical discectomy with or without fusion or cervical laminectomy and fusion. Methods: This prospective case series study included 45 consecutive patients with cervical spondylotic myelopathy between January 2010 and November 2014. There were 28 males and 17 females, with a mean age of 47 (range 37-68) years. The mean clinical follow-up was 14 months (range 3-24 months). The Neck Disability Index (NDI), visual analog scale (VAS) neck and arm pain, Short Form-36 (SF-36) were used as the functional outcome measurements. All of the complications in our patients were recorded. Results: In our study group, 26 patients underwent only one or two level anterior cervical discectomy. Ten patients underwent anterior cervical discectomy and fusion (ACDF) and nine cases underwent posterior laminectomy and fusion. We have found a statistically significant improvement between mean preoperative (29, range 19-43) and postoperative (7, range 0-12) NDI scores following surgery (P < 0.05). Also, there was a statistically significant difference between pre and post-operative VAS and SF-36 score (p < 0.05). There was a 7% overall complication rate (n = 3). The only complication in our patients was surgical site cellulitis which has been managed with oral antibiotic therapy. Conclusion: Both anterior cervical discectomy with or without fusion or posterior laminectomy and fusion are safe and efficacious treatment options for the management of CSM. The clinical outcomes seem to be fairly reproducible.

Keywords: cervical, myelopathy, discectomy, fusion, laminectomy

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3410 Traumatic Brain Injury in Cameroon: A Prospective Observational Study in a Level 1 Trauma Centre

Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

Abstract:

Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

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