Search results for: pain assessment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6712

Search results for: pain assessment

6292 Pre-Operative Psychological Factors Significantly Add to the Predictability of Chronic Narcotic Use: A Two Year Prospective Study

Authors: Dana El-Mughayyar, Neil Manson, Erin Bigney, Eden Richardson, Dean Tripp, Edward Abraham

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Use of narcotics to treat pain has increased over the past two decades and is a contributing factor to the current public health crisis. Understanding the pre-operative risks of chronic narcotic use may be aided through investigation of psychological measures. The objective of the reported study is to determine predictors of narcotic use two years post-surgery in a thoracolumbar spine surgery population, including an array of psychological factors. A prospective observational study of 191 consecutively enrolled adult patients having undergone thoracolumbar spine surgery is presented. Baseline measures of interest included the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia, Multidimensional Scale for Perceived Social Support (MSPSS), Chronic Pain Acceptance Questionnaire (CPAQ-8), Oswestry Disability Index (ODI), Numeric Rating Scales for back and leg pain (NRS-B/L), SF-12’s Mental Component Summary (MCS), narcotic use and demographic variables. The post-operative measure of interest is narcotic use at 2-year follow-up. Narcotic use is collapsed into binary categories of use and no use. Descriptive statistics are run. Chi Square analysis is used for categorical variables and an ANOVA for continuous variables. Significant variables are built into a hierarchical logistic regression to determine predictors of post-operative narcotic use. Significance is set at α < 0.05. Results: A total of 27.23% of the sample were using narcotics two years after surgery. The regression model included ODI, NRS-Leg, time with condition, chief complaint, pre-operative drug use, gender, MCS, PCS subscale helplessness, and CPAQ subscale pain willingness and was significant χ² (13, N=191)= 54.99; p = .000. The model accounted for 39.6% of the variance in narcotic use and correctly predicted in 79.7% of cases. Psychological variables accounted for 9.6% of the variance over and above the other predictors. Conclusions: Managing chronic narcotic usage is central to the patient’s overall health and quality of life. Psychological factors in the preoperative period are significant predictors of narcotic use 2 years post-operatively. The psychological variables are malleable, potentially allowing surgeons to direct their patients to preventative resources prior to surgery.

Keywords: narcotics, psychological factors, quality of life, spine surgery

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6291 An Engineered Epidemic: Big Pharma's Role in the Opioid Crisis

Authors: Donna L. Roberts

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2019 marked 23 years since Purdue Pharma launched its flagship drug, OxyContin, that unleashed an unprecedented epidemic touching both celebrities and common citizens, metropolitan, suburbia and rural areas and all levels of socioeconomic status. From rural Appalachia to East LA individuals, families and communities have been devastated by a trajectory of addiction that often began with the legitimate prescription of a pain killer for anything from a tooth extraction to a sports injury to recovery from surgery or chronic arthritis. Far from being a serendipitous progression of events, the proliferation of this new breed of 'miracle drug' was instead a carefully crafted marketing program aimed at both the medical community and common citizens. This research represents and in-depth investigation of the evolution of the marketing, distribution and promotion of prescription opioids by pharmaceutical companies and its relationship to the propagation of the opioid crisis. Specifically, key components of Purdue Pharma’s aggressive marketing campaign, including its bonus system and sales incentives, were analyzed in the context of the sociopolitical environment that essential created the proverbial 'perfect storm' for the changing manner in which pain is treated in the U.S. The analyses of these series of events clearly indicate their role in first, the increase in prescription of opioids for non-terminal pain relief and subsequently, the incidence of related addiction, overdose, and death. Through this examination of the conditions that facilitated and maintained this drug crisis, perhaps we can begin to chart a course toward its resolution.

Keywords: addiction, opioid, opioid crisis, Purdue Pharma

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6290 Online Formative Assessment Challenges Experienced by Grade 10 Physical Sciences Teachers during Remote Teaching and Learning

Authors: Celeste Labuschagne, Sam Ramaila, Thasmai Dhurumraj

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Although formative assessment is acknowledged as crucial for teachers to gauge students’ understanding of subject content, applying formative assessment in an online context is more challenging than in a traditional Physical Sciences classroom. This study examines challenges experienced by Grade 10 Physical Sciences teachers when enacting online formative assessment. The empirical investigation adopted a generic qualitative design and involved three purposively selected Grade 10 Physical Sciences teachers from three different schools and quintiles within the Tshwane North District in South Africa. Data were collected through individual and focus group interviews. Technological, pedagogical, and content knowledge (TPACK) was utilised as a theoretical framework underpinning the study. The study identified a myriad of challenges experienced by Grade 10 Physical Sciences teachers when enacting online formative assessment. These challenges include the utilisation of Annual Teaching Plans, lack of technological knowledge, and internet connectivity. The Department of Basic Education faces the key imperative to provide continuous teacher professional development and concomitant online learning materials that can facilitate meaningful enactment of online formative assessment in various educational settings.

Keywords: COVID-19, challenges, online formative assessment, physical sciences, TPACK

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6289 Early Childhood Education: Teachers Ability to Assess

Authors: Ade Dwi Utami

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Pedagogic competence is the basic competence of teachers to perform their tasks as educators. The ability to assess has become one of the demands in teachers pedagogic competence. Teachers ability to assess is related to curriculum instructions and applications. This research is aimed at obtaining data concerning teachers ability to assess that comprises of understanding assessment, determining assessment type, tools and procedure, conducting assessment process, and using assessment result information. It uses mixed method of explanatory technique in which qualitative data is used to verify the quantitative data obtained through a survey. The technique of quantitative data collection is by test whereas the qualitative data collection is by observation, interview and documentation. Then, the analyzed data is processed through a proportion study technique to be categorized into high, medium and low. The result of the research shows that teachers ability to assess can be grouped into 3 namely, 2% of high, 4% of medium and 94% of low. The data shows that teachers ability to assess is still relatively low. Teachers are lack of knowledge and comprehension in assessment application. The statement is verified by the qualitative data showing that teachers did not state which aspect was assessed in learning, record children’s behavior, and use the data result as a consideration to design a program. Teachers have assessment documents yet they only serve as means of completing teachers administration for the certification program. Thus, assessment documents were not used with the basis of acquired knowledge. The condition should become a consideration of the education institution of educators and the government to improve teachers pedagogic competence, including the ability to assess.

Keywords: assessment, early childhood education, pedagogic competence, teachers

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6288 Referrals to Occupational Therapy Driving Assessors: A Qualitative Study of General Practitioners

Authors: Mary Butler

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Background: Screening programmes for older drivers in Europe (though not the UK), and in many states in the US and in Australia are based on medical assessment of fitness to drive. These programmes require physicians (including general practitioners) to carry out an assessment of fitness to drive in their offices. In 2006, New Zealand changed from doing on-road driving tests with all older drivers from the age of 80, to a screening programme that uses medical assessment of fitness to drive only. Aim: This study set out to understand the experience of New Zealand GPs as they manage the process of medical assessment of fitness to drive assessments for older people. In particular, it aimed to establish how GPs understand the role of specialist driving assessment and rehabilitation carried out by occupational therapists. Design and setting: The study used an interpretive descriptive approach to analyze data from ten interviews with GPs in New Zealand. Results: The results indicated that GPs lack understanding about how occupational therapists can assist their patients, and tend to refer only when there is a disagreement with the patient. Conclusion: There are problems with the medical assessment of fitness to drive carried out by GPs, and there is a need for a more comprehensive community approach to driving cessation. Patients, families and the multidisciplinary team all have a role in deciding when driving cessation should occur. Occupational therapists have a particular responsibility for strategic leadership in this area of practice.

Keywords: assessment, driving, older people, occupational therapy

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6287 Development of Active Learning Calculus Course for Biomedical Program

Authors: Mikhail Bouniaev

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The paper reviews design and implementation of a Calculus Course required for the Biomedical Competency Based Program developed as a joint project between The University of Texas Rio Grande Valley, and the University of Texas’ Institute for Transformational Learning, from the theoretical perspective as presented in scholarly work on active learning, formative assessment, and on-line teaching. Following a four stage curriculum development process (objective, content, delivery, and assessment), and theoretical recommendations that guarantee effectiveness and efficiency of assessment in active learning, we discuss the practical recommendations on how to incorporate a strong formative assessment component to address disciplines’ needs, and students’ major needs. In design and implementation of this project, we used Constructivism and Stage-by-Stage Development of Mental Actions Theory recommendations.

Keywords: active learning, assessment, calculus, cognitive demand, mathematics, stage-by-stage development of mental action theory

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6286 The Analysis of Questionnaires about the Health Condition of Students Involved in the Korean Medicine Doctors` Visiting School Program-Cohort Study: Middle and High School Participator of Seong-Nam-

Authors: Narae Yang, Hyun Kyung Sung, Seon Mi Shin, Hee Jung, Yong Ji Kim, Tae-Yong Park, Ho Yeon Go

Abstract:

The aim of this study was to build base-line data for the Korean Medicine Doctors` Visiting School Program (KMDVSP) by analyzing a student health survey filled out by the students. Korean medicine doctors assigned to 20 middle and high schools in Seong-nam visited these schools eight times in five months. During each visit, the assigned doctors performed health consultations and Korean medicine treatment, and taught health education classes. 12115 students answered self-reported questionnaires about their own physical condition at the beginning of the program. In a question about pain, 7080(58%) reported having a headache, while 4048(33%) said they had a backache, nuchal pain/shoulder pain was reported by 5993(49%), dyspepsia was present in 2736(23%), rhinitis/sinusitis was reported by 4176(34%), coughing/dyspnea by 7102(59%), itching/skin rash by 2840(23%), and constipation was reported by 1091(9%), while 2264(18%) said they had diarrhea. Increased urinary frequency/feeling of residual urine was reported by 569 students (5%), and 3324(27%) said they had insomnia/fitful sleep/morning fatigue. When asked about menstruation, 4450(83%) of the female students reported irregular menstruation or said they experienced menstrual pain. Understanding the health condition of adolescent students is the starting point to determining national health policy to prevent various diseases in the future. We have developed the pilot project of KMDVSP and collected research about students’ health. Based on this data, further studies should be performed in order to develop a cooperative program between schools and the Korean medical center.

Keywords: korean medicine doctors` visiting school program(kmdvsp), student`s health condition, questionnaires, cohort study

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6285 Antioxidant Potential of Pomegranate Rind Extract Attenuates Pain, Inflammation and Bone Damage in Experimental Rats

Authors: Ritu Karwasra, Surender Singh

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Inflammation is an important physiological response of the body’s self-defense system that helps in eliminating and protecting organism from harmful stimuli and in tissue repair. It is a highly regulated protective response which helps in eliminating the initial cause of cell injury, and initiates the process of repair. The present study was designed to evaluate the ameliorative effect of pomegranate rind extract on pain and inflammation. Hydroalcoholic standardized rind extract of pomegranate at doses 50, 100 and 200 mg/kg and indomethacin (3 mg/kg) was tested against eddy’s hot plate induced thermal algesia, carrageenan (acute inflammation) and Complete Freund’s Adjuvant (chronic inflammation) induced models in Wistar rats. Parameters analyzed were inhibition of paw edema, measurement of joint diameter, levels of GSH, TBARS, SOD, TNF-α, radiographic imaging, tissue histology and synovial expression of pro-inflammatory cytokine receptor (TNF-R1). Radiological and light microscopical analysis were carried out to find out the bone damage in CFA-induced chronic inflammatory model. Findings of the present study revealed that pomegranate rind extract at a dose of 200 mg/kg caused a significant (p<0.05) reduction in paw swelling in both the inflammatory models. Nociceptive threshold was also significantly (p<0.05) improved. Immunohistochemical analysis of TNF-R1 in CFA-induced group showed elevated level, whereas reduction in level of TNF-R1 was observed in pomegranate (200 mg/kg). Henceforth, we might say that pomegranate produced a dose-dependent reduction in inflammation and pain along with the reduction in levels of oxidative stress markers and tissue histology, and the effect was found to be comparable to that of indomethacin. Thus, it can be concluded that pomegranate is a potential therapeutic target in the pathogenesis of inflammation and pain, and punicalagin is the major constituents found in rind extract might be responsible for the activity.

Keywords: carrageenan, inflammation, nociceptive-threshold, pomegranate, histopathology

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6284 Kazakh Language Assessment in a New Multilingual Kazakhstan

Authors: Karlygash Adamova

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This article is focused on the KazTest as one of the most important high-stakes tests and the key tool in Kazakh language assessment. The research will also include the brief introduction to the language policy in Kazakhstan. Particularly, it is going to be changed significantly and turn from bilingualism (Kazakh, Russian) to multilingual policy (three languages - Kazakh, Russian, English). Therefore, the current status of the abovementioned languages will be described. Due to the various educational reforms in the country, the language evaluation system should also be improved and moderated. The research will present the most significant test of Kazakhstan – the KazTest, which is aimed to evaluate the Kazakh language proficiency. Assessment is an ongoing process that encompasses a wide area of knowledge upon the productive performance of the learners. Test is widely defined as a standardized or standard method of research, testing, diagnostics, verification, etc. The two most important characteristics of any test, as the main element of the assessment - validity and reliability - will also be described in this paper. Therefore, the preparation and design of the test, which is assumed to be an indicator of knowledge, and it is highly important to take into account all these properties.

Keywords: multilingualism, language assessment, testing, language policy

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6283 Intellectual Property Risk Assessment in Planning Market Entry to China

Authors: Qing Cao

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Generally speaking, China has a relatively high level of intellectual property (IP) infringement. Risk assessment is indispensable in the strategic planning process. To complement the current literature in international business, the paper sheds the light on how to assess IP risk for foreign companies in planning market entry to China. Evaluating internal and external IP environment, proposed in the paper, consists of external analysis, internal analysis and further internal analysis. Through position the company’s IP environment, the risk assessment approach enables the foreign companies to either build the corresponding IP strategies or abort the entry plan beforehand to minimize the IP risks.

Keywords: intellectual property, IP environment, risk assessment

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6282 Unified Assessment of Power System Reserve-based Reliability Levels

Authors: B. M. Alshammari, M. A. El-Kady

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This paper presents a unified framework for assessment of reserve-based reliability levels in electric power systems. The unified approach is based on reserve-based analysis and assessment of the relationship between available generation capacities and required demand levels. The developed approach takes into account the load variations as well as contingencies which occur randomly causing some generation and/or transmission capacities to be lost (become unavailable). The calculated reserve based indices, which are important to assess the reserve capabilities of the power system for various operating scenarios are therefore probabilistic in nature. They reflect the fact that neither the load levels nor the generation or transmission capacities are known with absolute certainty. They are rather subjects to random variations and consequently. The calculated reserve-based reliability indices are all subjects to random variations where only expected values of these indices can be evaluated. This paper presents a unified approach to reserve-based reliability assessment of power systems using various reserve assessment criteria. Practical applications are also presented for demonstration purposes to the Saudi electricity power grid.

Keywords: assessment, power system, reserve, reliability

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6281 Navigating the Assessment Landscape in English Language Teaching: Strategies, Challengies and Best Practices

Authors: Saman Khairani

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Assessment is a pivotal component of the teaching and learning process, serving as a critical tool for evaluating student progress, diagnosing learning needs, and informing instructional decisions. In the context of English Language Teaching (ELT), effective assessment practices are essential to promote meaningful learning experiences and foster continuous improvement in language proficiency. This paper delves into various assessment strategies, explores associated challenges, and highlights best practices for assessing student learning in ELT. The paper begins by examining the diverse forms of assessment, including formative assessments that provide timely feedback during the learning process and summative assessments that evaluate overall achievement. Additionally, alternative methods such as portfolios, self-assessment, and peer assessment play a significant role in capturing various aspects of language learning. Aligning assessments with learning objectives is crucial. Educators must ensure that assessment tasks reflect the desired language skills, communicative competence, and cultural awareness. Validity, reliability, and fairness are essential considerations in assessment design. Challenges in assessing language skills—such as speaking, listening, reading, and writing—are discussed, along with practical solutions. Constructive feedback, tailored to individual learners, guides their language development. In conclusion, this paper synthesizes research findings and practical insights, equipping ELT practitioners with the knowledge and tools necessary to design, implement, and evaluate effective assessment practices. By fostering meaningful learning experiences, educators contribute significantly to learners’ language proficiency and overall success.

Keywords: ELT, formative, summative, fairness, validity, reliability

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6280 Uncommon Causes of Acute Abdominal Pain: A Pictorial Essay

Authors: Mahesh Hariharan, Rajan Balasubramaniam, Sharath Kumar Shetty, Shanthala Yadavalli, Mohammed Ahetasham, Sravya Devarapalli

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Acute abdomen is one of the most common clinical conditions requiring a radiological investigation. Ultrasound is the primary modality of choice which can diagnose some of the common causes of acute abdomen. However, sometimes the underlying cause for the pain is far more complicated than expected to mandate a high degree of suspicion to suggest further investigation with contrast-enhanced computed tomography or magnetic resonance imaging. Here, we have compiled a comprehensive series of selected cases to highlight the conditions which can be easily overlooked unless carefully sought for. This also emphasizes the importance of multimodality approach to arrive at the final diagnosis with an increased overall diagnostic accuracy which in turn improves patient management and prognosis.

Keywords: acute abdomen, contrast-enhanced computed tomography scan, magnetic resonance imaging, plain radiographs, ultrasound

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6279 Juvenile Justice in Maryland: The Evidence Based Approach to Youth with History of Victimization and Trauma

Authors: Gabriela Wasileski, Debra L. Stanley

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Maryland efforts to decrease the juvenile criminality and recidivism shifts towards evidence based sentencing. While in theory the evidence based sentencing has an impact on the reduction of juvenile delinquency and drug abuse; the assessment of juveniles’ risk and needs usually lacks crucial information about juvenile’s prior victimization. The Maryland Comprehensive Assessment and Service Planning (MCASP) Initiative is the primary tool for developing and delivering a treatment service plan for juveniles at risk. Even though it consists of evidence-based screening and assessment instruments very little is currently known regarding the effectiveness and the impact of the assessment in general. In keeping with Maryland’s priority to develop successful evidence-based recidivism reduction programs, this study examined results of assessments based on MCASP using a representative sample of the juveniles at risk and their assessment results. Specifically, it examined: (1) the results of the assessments in an electronic database (2) areas of need that are more frequent among delinquent youth in a system/agency, (3) the overall progress of youth in an agency’s care (4) the impact of child victimization and trauma experiences reported in the assessment. The project will identify challenges regarding the use of MCASP in Maryland, and will provide a knowledge base to support future research and practices.

Keywords: Juvenile Justice, assessment of risk and need, victimization and crime, recidivism

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6278 Comparison of Trunk and Hip Muscle Activities and Anterior Pelvic Tilt Angle during Three Different Bridging Exercises in Subjects with Chronic Low Back Pain

Authors: Da-Eun Kim, Heon-Seock Cynn, Sil-Ah Choi, A-Reum Shin

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Bridging exercise in supine position with the hips and knees flexed have been commonly performed as one of the therapeutic exercises and is a comfortable and pain-free position to most individuals with chronic low back pain (CLBP). Many previous studies have investigated the beneficial way of performing bridging exercises to improve activation of abdominal and gluteal muscle and reduce muscle activity of hamstrings (HAM) and erector spinae (ES) and compensatory lumbopelvic motion. The purpose of this study was to compare the effects of three different bridging exercises on the HAM, ES, gluteus maximus (Gmax), gluteus medius (Gmed), and transverse abdominis/internal abdominis oblique (TrA/IO) activities and anterior pelvic tilt angle in subjects with CLBP. Seventeen subjects with CLBP participated in this study. They performed bridging under three different conditions (with 30° hip abduction, isometric hip abduction, and isometric hip adduction). Surface electromyography was used to measure muscle activity, and the ImageJ software was used to calculate anterior pelvic tilt angle. One-way repeated-measures analysis of variance was used to assess the statistical significance of the measured variables. HAM activity was significantly lower in bridging with 30° hip abduction and isometric hip abduction than in bridging with isometric hip adduction. Gmax and Gmed activities were significantly greater in bridging with isometric hip abduction than in bridging with 30° hip abduction and isometric hip adduction. TrA/IO muscle activity was significantly greater and anterior pelvic tilt angle was significantly lower in bridging with isometric hip adduction than in bridging with 30° hip abduction and isometric hip abduction. Bridging with isometric hip abduction using Thera-Band can effectively reduce HAM activity, and increase Gmax and Gmed activities in subjects with CLBP. Bridging with isometric hip adduction using a pressure biofeedback unit can be a beneficial exercise to improve TrA/IO activity and minimize anterior pelvic tilt in subjects with CLBP.

Keywords: bridging exercise, electromyography, low back pain, lower limb exercise

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6277 Validation of a Placebo Method with Potential for Blinding in Ultrasound-Guided Dry Needling

Authors: Johnson C. Y. Pang, Bo Pengb, Kara K. L. Reevesc, Allan C. L. Fud

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Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding are potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26±5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms and quality of life (QOL), were analyzed by repeated-measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: reliability, jumping, 3D motion analysis, anterior crucial ligament reconstruction

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6276 Integration of FMEA and Human Factor in the Food Chain Risk Assessment

Authors: Mohsen Shirani, Micaela Demichela

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During the last decades, a number of food crises such as Bovine Spongiform Encephalopathy (BSE), Mad-Cow disease, Dioxin in chicken food, Food-and-Mouth Disease (FMD), have certainly inflicted the reliability of the food industry. Consequently, the trend in applying different scientific methods of risk assessment in food safety has obtained more attentions in the academic and practice. However, lack of practical approach considering entire food supply chain is tangible in the academic literature. In this regard, this paper aims to apply risk assessment tool (FMEA) with integration of Human Factor along the entire supply chain of food production and test the method in a case study of Diary production, and analyze its results.

Keywords: FMEA, food supply chain, risk assessment, human factor

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6275 Assessing the Competence of Oral Surgery Trainees: A Systematic Review

Authors: Chana Pavneet

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Background: In more recent years in dentistry, a greater emphasis has been placed on competency-based education (CBE) programmes. Undergraduate and postgraduate curriculums have been reformed to reflect these changes, and adopting a CBE approach has shown to be beneficial to trainees and places an emphasis on continuous lifelong learning. The literature is vast; however, very little work has been done specifically to the assessment of competence in dentistry and even less so in oral surgery. The majority of the literature tends to opinion pieces. Some small-scale studies have been undertaken in this area researching assessment tools which can be used to assess competence in oral surgery. However, there is a lack of general consensus on the preferable assessment methods. The aim of this review is to identify the assessment methods available and their usefulness. Methods: Electronic databases (Medline, Embase, and the Cochrane Database of systematic reviews) were searched. PRISMA guidelines were followed to identify relevant papers. Abstracts of studies were reviewed, and if they met the inclusion criteria, they were included in the review. Papers were reviewed against the critical appraisal skills programme (CASP) checklist and medical education research quality instrument (MERQSI) to assess their quality and identify any bias in a systematic manner. The validity and reliability of each assessment method or tool were assessed. Results: A number of assessment methods were identified, including self-assessment, peer assessment, and direct observation of skills by someone senior. Senior assessment tended to be the preferred method, followed by self-assessment and, finally, peer assessment. The level of training was shown to affect the preferred assessment method, with one study finding peer assessment more useful in postgraduate trainees as opposed to undergraduate trainees. Numerous tools for assessment were identified, including a checklist scale and a global rating scale. Both had their strengths and weaknesses, but the evidence was more favourable for global rating scales in terms of reliability, applicability to more clinical situations, and easier to use for examiners. Studies also looked into trainees’ opinions on assessment tools. Logbooks were not found to be significant in measuring the competence of trainees. Conclusion: There is limited literature exploring the methods and tools which assess the competence of oral surgery trainees. Current evidence shows that the most favourable assessment method and tool may differ depending on the stage of training. More research is required in this area to streamline assessment methods and tools.

Keywords: competence, oral surgery, assessment, trainees, education

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6274 Difficulties in Providing Palliative Care in Rural India, West Bengal: Experience of an NGO

Authors: Aditya Manna

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Introduction: As in any developing countries state of West Bengal in India has a huge burden of cancer patients in advanced stage coming from rural area where awareness regarding the usefulness of palliative care in rather poor. Objective: Our goal is to give a pain free good quality of life in these advanced stage cancer patients. Objective of this study is to identify the main difficulties in achieving the above goal in a rural village setting in India. Method: Advanced cancer patients in need of palliative care in various villages in of rural India were selected for this study. Their symptoms and managements in that rural surroundings were evaluated by an NGO (under the guidance of a senior palliative care specialist) working in that area. An attempt was made to identify the main obstacles in getting proper palliative care in a rural setting. Results: Pain, fatigue are the main symptoms effecting these patients. In most patients pain and other symptoms control were grossly inadequate due to lack of properly trained manpower in the rural India. However regular homecare visits by a group of social workers were of immense help in the last few months of life. NGO team was well guided by a palliative care specialist. Conclusion: There is a wide gap of trained manpower in this filled in rural areas of India. Dedicated groups from rural area itself need encouragement and proper training, so that difficult symptoms can be managed locally along with necessary social and psychological support to these patients.

Keywords: palliative care, NGO, rural India, home care

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6273 Developing a Complete Profile: Vocational Assessment, Rehabilitation, and Management for Adults with Intellectual Disability in India

Authors: Virakti Dhaval Shah

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Advances in technology and the changes in lifestyle and work expectations amid the COVID-19 pandemic are requiring changes to vocational assessment, provision of vocational training, and identification of job matches for individuals with intellectual disability. Vocational assessment involves the assessment of interests, skills, abilities, and strengths/weaknesses, as well as a detailed understanding of healthcare, familial, social, community, workplace-related and policy-level protective and risk factors impacting the individual. In India, vocational assessment procedures such as interviews play a major role in vocational placement today. Unfortunately, many of the most widely used vocational assessment instruments in India were developed in the 1970s to 2000s and have not been revised since. Hence, there is a dire need to update existing tools and prepare a structured approach for vocational service providers to meet the unique employment needs of individuals with intellectual disabilities. To address this need, this project designed a multi-domain assessment toolkit for a structured approach to vocational assessment, training, and job placement for individuals with intellectual disabilities in India. Methods included conducting an empirical review of the available tools currently in use in India for the vocational assessment of persons with intellectual disabilities. Domains addressed in the instrument review were organized into a structured system, and additional items related to contemporary technology, pandemic-related experiences of persons with disabilities, and changes in lifestyle and work expectations due to the pandemic were added. Items assessing behaviors, provision of vocational training, and identification of job matches for individuals with intellectual disabilities were developed. The proposed tool has the potential to benefit organizations working with and preparing individuals with intellectual disabilities to find successful employment by undertaking a structured approach to vocational assessment, rehabilitation, training, and placement. It can be particularly useful for guiding new professionals doing vocational rehabilitation in India.

Keywords: intellectual disability, rehabilitation, vocational assessment, vocational rehabilitation

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6272 Randomized Controlled Trial of Ultrasound Guided Bilateral Intermediate Cervical Plexus Block in Thyroid Surgery

Authors: Neerja Bharti, Drishya P.

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Introduction: Thyroidectomies are extensive surgeries involving a significant degree of tissue handling and dissection and are associated with considerable postoperative pain. Regional anaesthesia techniques have immerged as possible inexpensive and safe alternatives to opioids in the management of pain after thyroidectomy. The front of the neck is innervated by branches from the cervical plexus, and hence, several approaches for superficial and deep cervical plexus block (CPB) have been described to provide postoperative analgesia after neck surgery. However, very few studies have explored the analgesic efficacy of intermediate CPB for thyroid surgery. In this study, we have evaluated the effects of ultrasound-guided bilateral intermediate CPB on perioperative opioid consumption in patients undergoing thyroidectomy under general anesthesia. Methods: In this prospective randomized controlled study, fifty ASA grade I-II adult patients undergoing thyroidectomy were randomly divided into two groups: the study group received ultrasound-guided bilateral intermediate CPB with 10 ml 0.5% ropivacaine on each side, while the control group received the same block with 10 ml normal saline on each side just after induction of anesthesia. Anesthesia was induced with propofol, fentanyl, and vecuronium and maintained with propofol infusion titrated to maintain the BIS between 40 and 60. During the postoperative period, rescue analgesia was provided with PCA fentanyl, and the pain scores, total fentanyl consumption, and incidence of nausea and vomiting during 24 hours were recorded, and overall patient satisfaction was assessed. Results: The groups were well-matched with respect to age, gender, BMI, and duration of surgery. The difference in intraoperative propofol and fentanyl consumption was not statistically significant between groups. However, the intraoperative haemodynamic parameters were better maintained in the study group than in the control group. The postoperative pain scores, as measured by VAS at rest and during movement, were lower, and the total fentanyl consumption during 24 hours was significantly less in the study group as compared to the control group. Patients in the study group reported better satisfaction scores than those in the control group. No adverse effects of ultrasound-guided intermediate CPB block were reported. Conclusion: We concluded that ultrasound-guided intermediate cervical plexus block is a safe and effective method for providing perioperative analgesia during thyroid surgery.

Keywords: thyroidectomy, cervical plexus block, pain relief, opioid consumption

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6271 Risk Assessment Results in Biogas Production from Agriculture Biomass

Authors: Sandija Zeverte-Rivza, Irina Pilvere, Baiba Rivza

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The use of renewable energy sources incl. biogas has become topical in accordance with the increasing demand for energy, decrease of fossil energy resources and the efforts to reduce greenhouse gas emissions as well as to increase energy independence from the territories where fossil energy resources are available. As the technologies of biogas production from agricultural biomass develop, risk assessment and risk management become necessary for farms producing such a renewable energy. The need for risk assessments has become particularly topical when discussions on changing the biogas policy in the EU take place, which may influence the development of the sector in the future, as well as the operation of existing biogas facilities and their income level. The current article describes results of the risk assessment for farms producing biomass from agriculture biomass in Latvia, the risk assessment system included 24 risks, that affect the whole biogas production process and the obtained results showed the high significance of political and production risks.

Keywords: biogas production, risks, risk assessment, biosystems engineering

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6270 Exploring Teachers’ Beliefs about Diagnostic Language Assessment Practices in a Large-Scale Assessment Program

Authors: Oluwaseun Ijiwade, Chris Davison, Kelvin Gregory

Abstract:

In Australia, like other parts of the world, the debate on how to enhance teachers using assessment data to inform teaching and learning of English as an Additional Language (EAL, Australia) or English as a Foreign Language (EFL, United States) have occupied the centre of academic scholarship. Traditionally, this approach was conceptualised as ‘Formative Assessment’ and, in recent times, ‘Assessment for Learning (AfL)’. The central problem is that teacher-made tests are limited in providing data that can inform teaching and learning due to variability of classroom assessments, which are hindered by teachers’ characteristics and assessment literacy. To address this concern, scholars in language education and testing have proposed a uniformed large-scale computer-based assessment program to meet the needs of teachers and promote AfL in language education. In Australia, for instance, the Victoria state government commissioned a large-scale project called 'Tools to Enhance Assessment Literacy (TEAL) for Teachers of English as an additional language'. As part of the TEAL project, a tool called ‘Reading and Vocabulary assessment for English as an Additional Language (RVEAL)’, as a diagnostic language assessment (DLA), was developed by language experts at the University of New South Wales for teachers in Victorian schools to guide EAL pedagogy in the classroom. Therefore, this study aims to provide qualitative evidence for understanding beliefs about the diagnostic language assessment (DLA) among EAL teachers in primary and secondary schools in Victoria, Australia. To realize this goal, this study raises the following questions: (a) How do teachers use large-scale assessment data for diagnostic purposes? (b) What skills do language teachers think are necessary for using assessment data for instruction in the classroom? and (c) What factors, if any, contribute to teachers’ beliefs about diagnostic assessment in a large-scale assessment? Semi-structured interview method was used to collect data from at least 15 professional teachers who were selected through a purposeful sampling. The findings from the resulting data analysis (thematic analysis) provide an understanding of teachers’ beliefs about DLA in a classroom context and identify how these beliefs are crystallised in language teachers. The discussion shows how the findings can be used to inform professional development processes for language teachers as well as informing important factor of teacher cognition in the pedagogic processes of language assessment. This, hopefully, will help test developers and testing organisations to align the outcome of this study with their test development processes to design assessment that can enhance AfL in language education.

Keywords: beliefs, diagnostic language assessment, English as an additional language, teacher cognition

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6269 Mismatch of Heavy Equipment Repairer Student’s Skills and Employer’s Needs

Authors: Bolormaa Dalanbayar, Batsaikhan Ulaankhuu, Bayarmaa Tsogtbaatar

Abstract:

In this study, we surveyed employers and students to identify compliance between employers' needs and student self-assessment of skills. Employers' survey consisted of fifteen questions to determine employers' assessment of the knowledge and skills of graduates in heavy equipment repairer's programs from four TVET schools. We also compared a survey questionnaire with Liebherr brands' job duty requirements, which determines the training needs and qualification level of their new workers. The study shows more than 76% of employers assessed professional knowledge as sufficient, more than 47% of employers assessed vocational skills as sufficient and more than 43% of employers rated attitudes as sufficient. Therefore, we can state there is a skill mismatch between the employer's assessment and students' self-assessment.

Keywords: skill mismatch, employers needs, competence-based curriculum

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6268 Teachers’ Reactions, Learning, Organizational Support, and Use of Lesson Study for Transformative Assessment

Authors: Melaku Takele Abate, Abbi Lemma Wodajo, Adula Bekele Hunde

Abstract:

This study aimed at exploring mathematics teachers' reactions, learning, school leaders’ support, and use of the Lesson Study for Transformative Assessment (LSforTA) program ideas in practice. The LSforTA program was new, and therefore, a local and grounded approach was needed to examine teachers’ knowledge and skills acquired using LSforTA. So, a design-based research approach was selected to evaluate and refine the LSforTA approach. The results showed that LSforTA increased teachers' knowledge and use of different levels of mathematics assessment tasks. The program positively affected teachers' practices of transformative assessment and enhanced their knowledge and skills in assessing students in a transformative way. The paper concludes how the LSforTA procedures were adapted in response to this evaluation and provides suggestions for future development and research.

Keywords: classroom assessment, feedback practices, lesson study, mathematics, design-based research

Procedia PDF Downloads 52
6267 Downtime Modelling for the Post-Earthquake Building Assessment Phase

Authors: S. Khakurel, R. P. Dhakal, T. Z. Yeow

Abstract:

Downtime is one of the major sources (alongside damage and injury/death) of financial loss incurred by a structure in an earthquake. The length of downtime associated with a building after an earthquake varies depending on the time taken for the reaction (to the earthquake), decision (on the future course of action) and execution (of the decided course of action) phases. Post-earthquake assessment of buildings is a key step in the decision making process to decide the appropriate safety placarding as well as to decide whether a damaged building is to be repaired or demolished. The aim of the present study is to develop a model to quantify downtime associated with the post-earthquake building-assessment phase in terms of two parameters; i) duration of the different assessment phase; and ii) probability of different colour tagging. Post-earthquake assessment of buildings includes three stages; Level 1 Rapid Assessment including a fast external inspection shortly after the earthquake, Level 2 Rapid Assessment including a visit inside the building and Detailed Engineering Evaluation (if needed). In this study, the durations of all three assessment phases are first estimated from the total number of damaged buildings, total number of available engineers and the average time needed for assessing each building. Then, probability of different tag colours is computed from the 2010-11 Canterbury earthquake Sequence database. Finally, a downtime model for the post-earthquake building inspection phase is proposed based on the estimated phase length and probability of tag colours. This model is expected to be used for rapid estimation of seismic downtime within the Loss Optimisation Seismic Design (LOSD) framework.

Keywords: assessment, downtime, LOSD, Loss Optimisation Seismic Design, phase length, tag color

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6266 Comprehensive Feature Extraction for Optimized Condition Assessment of Fuel Pumps

Authors: Ugochukwu Ejike Akpudo, Jank-Wook Hur

Abstract:

The increasing demand for improved productivity, maintainability, and reliability has prompted rapidly increasing research studies on the emerging condition-based maintenance concept- Prognostics and health management (PHM). Varieties of fuel pumps serve critical functions in several hydraulic systems; hence, their failure can have daunting effects on productivity, safety, etc. The need for condition monitoring and assessment of these pumps cannot be overemphasized, and this has led to the uproar in research studies on standard feature extraction techniques for optimized condition assessment of fuel pumps. By extracting time-based, frequency-based and the more robust time-frequency based features from these vibrational signals, a more comprehensive feature assessment (and selection) can be achieved for a more accurate and reliable condition assessment of these pumps. With the aid of emerging deep classification and regression algorithms like the locally linear embedding (LLE), we propose a method for comprehensive condition assessment of electromagnetic fuel pumps (EMFPs). Results show that the LLE as a comprehensive feature extraction technique yields better feature fusion/dimensionality reduction results for condition assessment of EMFPs against the use of single features. Also, unlike other feature fusion techniques, its capabilities as a fault classification technique were explored, and the results show an acceptable accuracy level using standard performance metrics for evaluation.

Keywords: electromagnetic fuel pumps, comprehensive feature extraction, condition assessment, locally linear embedding, feature fusion

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6265 Identification of a Lead Compound for Selective Inhibition of Nav1.7 to Treat Chronic Pain

Authors: Sharat Chandra, Zilong Wang, Ru-Rong Ji, Andrey Bortsov

Abstract:

Chronic pain (CP) therapeutic approaches have limited efficacy. As a result, doctors are prescribing opioids for chronic pain, leading to opioid overuse, abuse, and addiction epidemic. Therefore, the development of effective and safe CP drugs remains an unmet medical need. Voltage-gated sodium (Nav) channels act as cardiovascular and neurological disorder’s molecular targets. Nav channels selective inhibitors are hard to design because there are nine closely-related isoforms (Nav1.1-1.9) that share the protein sequence segments. We are targeting the Nav1.7 found in the peripheral nervous system and engaged in the perception of pain. The objective of this project was to screen a 1.5 million compound library for identification of inhibitors for Nav1.7 with analgesic effect. In this study, we designed a protocol for identification of isoform-selective inhibitors of Nav1.7, by utilizing the prior information on isoform-selective antagonists. First, a similarity search was performed; then the identified hits were docked into a binding site on the fourth voltage-sensor domain (VSD4) of Nav1.7. We used the FTrees tool for similarity searching and library generation; the generated library was docked in the VSD4 domain binding site using FlexX and compounds were shortlisted using a FlexX score and SeeSAR hyde scoring. Finally, the top 25 compounds were tested with molecular dynamics simulation (MDS). We reduced our list to 9 compounds based on the MDS root mean square deviation plot and obtained them from a vendor for in vitro and in vivo validation. Whole-cell patch-clamp recordings in HEK-293 cells and dorsal root ganglion neurons were conducted. We used patch pipettes to record transient Na⁺ currents. One of the compounds reduced the peak sodium currents in Nav1.7-HEK-293 stable cell line in a dose-dependent manner, with IC50 values at 0.74 µM. In summary, our computer-aided analgesic discovery approach allowed us to develop pre-clinical analgesic candidate with significant reduction of time and cost.

Keywords: chronic pain, voltage-gated sodium channel, isoform-selective antagonist, similarity search, virtual screening, analgesics development

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6264 Pellegrini-Stieda Syndrome: A Physical Medicine and Rehabilitation Approach

Authors: Pedro Ferraz-Gameiro

Abstract:

Introduction: The Pellegrini-Stieda lesion is the result of post-traumatic calcification and/or ossification on the medial collateral ligament (MCL) of the knee. When this calcification is accompanied by gonalgia and limitation of knee flexion, it is called Pellegrini-Stieda syndrome. The pathogenesis is probably the calcification of a post-traumatic hematoma at least three weeks after the initial trauma or secondary to repetitive microtrauma. On anteroposterior radiographs, a Pellegrini-Stieda lesion is a linear vertical ossification or calcification of the proximal portion of the MCL and usually near the medial femoral condyle. Patients with Pellegrini-Stieda syndrome present knee pain associated with loss of range of motion. The treatment is usually conservative with analgesic and anti-inflammatory drugs, either systemic or intra-articular. Physical medicine and rehabilitation techniques associated with shock wave therapy can be a way of reduction of pain/inflammation. Patients who maintain instability with significant limitation of knee mobility may require surgical excision. Methods: Research was done using PubMed central using the terms Pellegrini-Stieda syndrome. Discussion/conclusion: Medical treatment is the rule, with initial rest, anti-inflammatory, and physiotherapy. If left untreated, this ossification can potentially form a significant bone mass, which can compromise the range of motion of the knee. Physical medicine and rehabilitation techniques associated with shock wave therapy are a way of reduction of pain/inflammation.

Keywords: knee, Pellegrini-Stieda syndrome, rehabilitation, shock waves therapy

Procedia PDF Downloads 136
6263 Discussion as a Means to Improve Peer Assessment Accuracy

Authors: Jung Ae Park, Jooyong Park

Abstract:

Writing is an important learning activity that cultivates higher level thinking. Effective and immediate feedback is necessary to help improve students' writing skills. Peer assessment can be an effective method in writing tasks because it makes it possible for students not only to receive quick feedback on their writing but also to get a chance to examine different perspectives on the same topic. Peer assessment can be practiced frequently and has the advantage of immediate feedback. However, there is controversy about the accuracy of peer assessment. In this study, we tried to demonstrate experimentally how the accuracy of peer assessment could be improved. Participants (n=76) were randomly assigned to groups of 4 members. All the participant graded two sets of 4 essays on the same topic. They graded the first set twice, and the second set or the posttest once. After the first grading of the first set, each group in the experimental condition 1 (discussion group), were asked to discuss the results of the peer assessment and then to grade the essays again. Each group in the experimental condition 2 (reading group), were asked to read the assessment on each essay by an expert and then to grade the essays again. In the control group, the participants were asked to grade the 4 essays twice in different orders. Afterwards, all the participants graded the second set of 4 essays. The mean score from 4 participants was calculated for each essay. The accuracy of the peer assessment was measured by Pearson correlation with the scores of the expert. The results were analyzed by two-way repeated measure ANOVA. The main effect of grading was observed: Grading accuracy got better as the number of grading experience increased. Analysis of posttest accuracy revealed that the score variations within a group of 4 participants decreased in both discussion and reading conditions but not in the control condition. These results suggest that having students discuss their grading together can be an efficient means to improve peer assessment accuracy. By discussing, students can learn from others about what to consider in grading and whether their grading is too strict or lenient. Further research is needed to examine the exact cause of the grading accuracy.

Keywords: peer assessment, evaluation accuracy, discussion, score variations

Procedia PDF Downloads 266