Search results for: teaching hospital of Oran
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5223

Search results for: teaching hospital of Oran

753 Analysing Tertiary Lecturers’ Teaching Practices and Their English Major Students’ Learning Practices with Information and Communication Technology (ICT) Utilization in Promoting Higher-Order Thinking Skills (HOTs)

Authors: Malini Ganapathy, Sarjit Kaur

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Maximising learning with higher-order thinking skills with Information and Communications Technology (ICT) has been deep-rooted and emphasised in various developed countries such as the United Kingdom, the United States of America and Singapore. The transformation of the education curriculum in the Malaysia Education Development Plan (PPPM) 2013-2025 focuses on the concept of Higher Order Thinking (HOT) skills which aim to produce knowledgeable students who are critical and creative in their thinking and can compete at the international level. HOT skills encourage students to apply, analyse, evaluate and think creatively in and outside the classroom. In this regard, the National Education Blueprint (2013-2025) is grounded based on high-performing systems which promote a transformation of the Malaysian education system in line with the vision of Malaysia’s National Philosophy in achieving educational outcomes which are of world class status. This study was designed to investigate ESL students’ learning practices on the emphasis of promoting HOTs while using ICT in their curricula. Data were collected using a stratified random sampling where 100 participants were selected to take part in the study. These respondents were a group of undergraduate students who undertook ESL courses in a public university in Malaysia. A three-part questionnaire consisting of demographic information, students’ learning experience and ICT utilization practices was administered in the data collection process. Findings from this study provide several important insights on students’ learning experiences and ICT utilization in developing HOT skills.

Keywords: English as a second language students, critical and creative thinking, learning, information and communication technology and higher order thinking skills

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752 Rights, Differences and Inclusion: The Role of Transdisciplinary Approach in the Education for Diversity

Authors: Ana Campina, Maria Manuela Magalhaes, Eusebio André Machado, Cristina Costa-Lobo

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Inclusive school advocates respect for differences, for equal opportunities and for a quality education for all, including for students with special educational needs. In the pursuit of educational equity, guaranteeing equality in access and results, it becomes the responsibility of the school to recognize students' needs, adapting to the various styles and rhythms of learning, ensuring the adequacy of curricula, strategies and resources, materials and humans. This paper presents a set of theoretical reflections in the disciplinary interface between legal and education sciences, school administration and management, with the aim of understand the real inclusion characteristics in a balance with the inclusion policies and the need(s) of an education for Human Rights, especially for diversity. Considering the actual social complexity but the important education instruments and strategies, mostly patented in the policies, this paper aims expose the existing contexts opposed to the laws, policies and inclusion educational needs. More than a single study, this research aims to develop a map of the reality and the guidelines to implement the action. The results point to the usefulness and pertinence of a school in which educational managers, teachers, parents, and students, are involved in the creation, implementation and monitoring of flexible curricula and adapted to the educational needs of students, promoting a collaborative work among teachers. We are then faced with a scenario that points to the need to reflect on the legislation and curricular management of inclusive classes and to operationalize the processes of elaboration of curricular adaptations and differentiation in the classroom. The transdisciplinary is a pedagogic and social education perfect approach using the Human Rights binomio – teaching and learning – supported by the inclusion laws according to the realistic needs for an effective successful society construction.

Keywords: rights, transdisciplinary, inclusion policies, education for diversity

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751 Management Tools for Assessment of Adverse Reactions Caused by Contrast Media at the Hospital

Authors: Pranee Suecharoen, Ratchadaporn Soontornpas, Jaturat Kanpittaya

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Background: Contrast media has an important role for disease diagnosis through detection of pathologies. Contrast media can, however, cause adverse reactions after administration of its agents. Although non-ionic contrast media are commonly used, the incidence of adverse events is relatively low. The most common reactions found (10.5%) were mild and manageable and/or preventable. Pharmacists can play an important role in evaluating adverse reactions, including awareness of the specific preparation and the type of adverse reaction. As most common types of adverse reactions are idiosyncratic or pseudo-allergic reactions, common standards need to be established to prevent and control adverse reactions promptly and effectively. Objective: To measure the effect of using tools for symptom evaluation in order to reduce the severity, or prevent the occurrence, of adverse reactions from contrast media. Methods: Retrospective review descriptive research with data collected on adverse reactions assessment and Naranjo’s algorithm between June 2015 and May 2016. Results: 158 patients (10.53%) had adverse reactions. Of the 1,500 participants with an adverse event evaluation, 137 (9.13%) had a mild adverse reaction, including hives, nausea, vomiting, dizziness, and headache. These types of symptoms can be treated (i.e., with antihistamines, anti-emetics) and the patient recovers completely within one day. The group with moderate adverse reactions, numbering 18 cases (1.2%), had hypertension or hypotension, and shortness of breath. Severe adverse reactions numbered 3 cases (0.2%) and included swelling of the larynx, cardiac arrest, and loss of consciousness, requiring immediate treatment. No other complications under close medical supervision were recorded (i.e., corticosteroids use, epinephrine, dopamine, atropine, or life-saving devices). Using the guideline, therapies are divided into general and specific and are performed according to the severity, risk factors and ingestion of contrast media agents. Patients who have high-risk factors were screened and treated (i.e., prophylactic premedication) for prevention of severe adverse reactions, especially those with renal failure. Thus, awareness for the need for prescreening of different risk factors is necessary for early recognition and prompt treatment. Conclusion: Studying adverse reactions can be used to develop a model for reducing the level of severity and setting a guideline for a standardized, multidisciplinary approach to adverse reactions.

Keywords: role of pharmacist, management of adverse reactions, guideline for contrast media, non-ionic contrast media

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750 Measurement of Nasal Septal Cartilage in Adult Filipinos Using Computed Tomography

Authors: Miguel Limbert Ramos, Joseph Amado Galvez

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Background: The nasal septal cartilage is an autologous graft that is widely used in different otolaryngologic procedures of the different subspecialties, such as in septorhinoplasty and ear rehabilitation procedures. The cartilage can be easily accessed and harvested to be utilized for such procedures. However, the dimension of the nasal septal cartilage differs, corresponding to race, gender, and age. Measurements can be done via direct measurement of harvested septal cartilage in cadavers or utilizing radiographic imaging studies giving baseline measurement of the nasal septal cartilage distinct to every race. A preliminary baseline measurement of the dimensions of Filipino nasal septal cartilage was previously established by measuring harvested nasal septal cartilage in Filipino Malay cadavers. This study intends to reinforce this baseline measurement by utilizing computed tomography (CT) scans of adult Filipinos in a tertiary government hospital in the City of Manila, Philippines, which will cover a larger sampling population. Methods: The unit of observation and analysis will be the computed tomography (CT) scans of patients ≥ 18years old who underwent cranial, facial, orbital, paranasal sinus, and temporal bone studies for the year 2019. The measurements will be done in a generated best midsagittal image (155 subjects) which is a view through the midline of the cerebrum that is simultaneously viewed with its coronal and axial views for proper orientation. The view should reveal important structures that will be used to plot the anatomic boundaries, which will be measured by a DICOM image viewing software (RadiAnt). The measured area of nasal septal cartilage will be compared by gender and age. Results: The total area of the nasal septal cartilage is larger in males compared to females, with a mean value of 6.52 cm² and 5.71 cm², respectively. The harvestable nasal septal cartilage area is also larger in males with a mean value of 3.57 cm² compared to females with only a measured mean value of 3.13 cm². The total and harvestable area of the nasal septal cartilage is largest in the 18-30 year-old age group with a mean value of 6.47 cm² and 3.60 cm² respectively and tends to decrease with the advancement of age, which can be attributed to continuous ossification changes. Conclusion: The best time to perform septorhinoplasty and other otolaryngologic procedures which utilize the nasal septal cartilage as graft material is during post-pubertal age, hence surgeries should be avoided or delayed to allow growth and maturation of the cartilage. A computed tomography scan is a cost-effective and non-invasive tool that can provide information on septal cartilage areas prior to these procedures.

Keywords: autologous graft, computed tomography, nasal septal cartilage, septorhinoplasty

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749 Evaluating the Understanding of the University Students (Basic Sciences and Engineering) about the Numerical Representation of the Average Rate of Change

Authors: Saeid Haghjoo, Ebrahim Reyhani, Fahimeh Kolahdouz

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The present study aimed to evaluate the understanding of the students in Tehran universities (Iran) about the numerical representation of the average rate of change based on the Structure of Observed Learning Outcomes (SOLO). In the present descriptive-survey research, the statistical population included undergraduate students (basic sciences and engineering) in the universities of Tehran. The samples were 604 students selected by random multi-stage clustering. The measurement tool was a task whose face and content validity was confirmed by math and mathematics education professors. Using Cronbach's Alpha criterion, the reliability coefficient of the task was obtained 0.95, which verified its reliability. The collected data were analyzed by descriptive statistics and inferential statistics (chi-squared and independent t-tests) under SPSS-24 software. According to the SOLO model in the prestructural, unistructural, and multistructural levels, basic science students had a higher percentage of understanding than that of engineering students, although the outcome was inverse at the relational level. However, there was no significant difference in the average understanding of both groups. The results indicated that students failed to have a proper understanding of the numerical representation of the average rate of change, in addition to missconceptions when using physics formulas in solving the problem. In addition, multiple solutions were derived along with their dominant methods during the qualitative analysis. The current research proposed to focus on the context problems with approximate calculations and numerical representation, using software and connection common relations between math and physics in the teaching process of teachers and professors.

Keywords: average rate of change, context problems, derivative, numerical representation, SOLO taxonomy

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748 Eco-Literacy and Pedagogical Praxis in the Multidisciplinary University Greenhouse toward the Food Security Strengthening

Authors: Citlali Aguilera Lira, David Lynch Steinicke, Andrea León García

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One of the challenges that higher education faces is to find how to approach the sustainability in an inclusive way to the student within all the different academic areas, how to move the sustainable development from the abstract field to the operational field. This research comes from the ecoliteracy and the pedagogical praxis as tools for rebuilding the teaching processes inside of universities. The purpose is to determine and describe which are the factors involved in the process of learning particularly in the Greenhouse-School Siembra UV. In the Greenhouse-School Siembra UV, of the University of Veracruz, are cultivated vegetables, medicinal plants and small cornfields under the usage of eco-technologies such as hydroponics, Wickingbed and Hugelkultur, which main purpose is the saving of space, labor and natural resources, as well as function as agricultural production alternatives in the urban and periurban zones. The sample was formed with students from different academic areas and who are actively involved in the greenhouse, as well as institutes from the University of Veracruz and governmental and non-governmental departments. This project comes from a pedagogic praxis approach, from filling the needs that the different professional profiles of the university students have. All this with the purpose of generate a pragmatic dialogue with the sustainability. It also comes from the necessity to understand the factors that intervene in the students’ praxis. In this manner is how the students are the fundamental unit in the sphere of sustainability. As a result, it is observed that those University of Veracruz students who are involved in the Greenhouse-school, Siembra UV, have enriched in different levels the sense of urban and periurban agriculture because of the diverse academic approaches they have and the interaction between them. It is concluded that the eco-technologies act as fundamental tools for ecoliteracy in society, where it is strengthen the nutritional and food security from a sustainable development approach.

Keywords: farming eco-technologies, food security, multidisciplinary, pedagogical praxis

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747 Development of mHealth Information in Community Based on Geographical Information: A Case Study from Saraphi District, Chiang Mai, Thailand

Authors: Waraporn Boonchieng, Ekkarat Boonchieng, Wilawan Senaratana, Jaras Singkaew

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Geographical information system (GIS) is a designated system widely used for collecting and analyzing geographical data. Since the introduction of ultra-mobile, 'smart' devices, investigators, clinicians, and even the general public have had powerful new tools for collecting, uploading and accessing information in the field. Epidemiology paired with GIS will increase the efficacy of preventive health care services. The objective of this study is to apply GPS location services that are available on the common mobile device with district health systems, storing data on our private cloud system. The mobile application has been developed for use on iOS, Android, and web-based platforms. The system consists of two parts of district health information, including recorded resident data forms and individual health recorded data forms, which were developed and approved by opinion sharing and public hearing. The application's graphical user interface was developed using HTML5 and PHP with MySQL as a database management system (DBMS). The reporting module of the developed software displays data in a variety of views, from traditional tables to various types of high-resolution, layered graphics, incorporating map location information with street views from Google Maps. Multi-extension exporting is also supported, utilizing standard platforms such as PDF, PNG, JPG, and XLS. The data were collected in the database beginning in March 2013, by district health volunteers and district youth volunteers who had completed the application training program. District health information consisted of patients’ household coordinates, individual health data, social and economic information. This was combined with Google Street View data, collected in March 2014. Studied groups consisted of 16,085 (67.87%) and 47,811 (59.87%) of the total 23,701 households and 79,855 people were collected by the system respectively, in Saraphi district, Chiang Mai Province. The report generated from the system has had a major benefit directly to the Saraphi District Hospital. Healthcare providers are able to use the basic health data to provide a specific home health care service and also to create health promotion activities according to medical needs of the people in the community.

Keywords: health, public health, GIS, geographic information system

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746 The Use of Venous Glucose, Serum Lactate and Base Deficit as Biochemical Predictors of Mortality in Polytraumatized Patients: Acomparative with Trauma and Injury Severity Score and Acute Physiology and Chronic Health Evalution IV

Authors: Osama Moustafa Zayed

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Aim of the work: To evaluate the effectiveness of venous glucose, levels of serum lactate and base deficit in polytraumatized patients as simple parameters to predict the mortality in these patients. Compared to the predictive value of Trauma and injury severity (TRISS) and Acute Physiology And Chronic Health Evaluation IV (APACHE IV). Introduction: Trauma is a serious global health problem, accounting for approximately one in 10 deaths worldwide. Trauma accounts for 5 million deaths per year. Prediction of mortality in trauma patients is an important part of trauma care. Several trauma scores have been devised to predict injury severity and risk of mortality. The trauma and injury severity score (TRISS) was most common used. Regardless of the accuracy of trauma scores, is based on an anatomical description of every injury and cannot be assigned to the patients until a full diagnostic procedure has been performed. So we hypothesized that alterations in admission glucose, lactate levels and base deficit would be an early and easy rapid predictor of mortality. Patient and Method: a comparative cross-sectional study. 282 Polytraumatized patients attended to the Emergency Department(ED) of the Suez Canal university Hospital constituted. The period from 1/1/2012 to 1/4/2013 was included. Results: We found that the best cut off value of TRISS probability of survival score for prediction of mortality among poly-traumatized patients is = 90, with 77% sensitivity and 89% specificity using area under the ROC curve (0.89) at (95%CI). APACHE IV demonstrated 67% sensitivity and 95% specificity at 95% CI at cut off point 99. The best cutoff value of Random Blood Sugar (RBS) for prediction of mortality was>140 mg/dl, with 89%, sensitivity, 49% specificity. The best cut off value of base deficit for prediction of mortality was less than -5.6 with 64% sensitivity, 93% specificity. The best cutoff point of lactate for prediction of mortality was > 2.6 mmol/L with 92%, sensitivity, 42% specificity. Conclusion: According to our results from all evaluated predictors of mortality (laboratory and scores) and mortality based on the estimated cutoff values using ROC curves analysis, the highest risk of mortality was found using a cutoff value of 90 in TRISS score while with laboratory parameters the highest risk of mortality was with serum lactate > 2.6 . Although that all of the three parameter are accurate in predicting mortality in poly-traumatized patients and near with each other, as in serum lactate the area under the curve 0.82, in BD 0.79 and 0.77 in RBS.

Keywords: APACHE IV, emergency department, polytraumatized patients, serum lactate

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745 Estimate Robert Gordon University's Scope Three Emissions by Nearest Neighbor Analysis

Authors: Nayak Amar, Turner Naomi, Gobina Edward

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The Scottish Higher Education Institutes must report their scope 1 & 2 emissions, whereas reporting scope 3 is optional. Scope 3 is indirect emissions which embodies a significant component of total carbon footprint and therefore it is important to record, measure and report it accurately. Robert Gordon University (RGU) reported only business travel, grid transmission and distribution, water supply and transport, and recycling scope 3 emissions. This study estimates the RGUs total scope 3 emissions by comparing it with a similar HEI in scale. The scope 3 emission reporting of sixteen Scottish HEI was studied. Glasgow Caledonian University was identified as the nearest neighbour by comparing its students' full time equivalent, staff full time equivalent, research-teaching split, budget, and foundation year. Apart from the peer, data was also collected from the Higher Education Statistics Agency database. RGU reported emissions from business travel, grid transmission and distribution, water supply, and transport and recycling. This study estimated RGUs scope 3 emissions from procurement, student-staff commute, and international student trip. The result showed that RGU covered only 11% of the scope 3 emissions. The major contributor to scope 3 emissions were procurement (48%), student commute (21%), international student trip (16%), and staff commute (4%). The estimated scope 3 emission was more than 14 times the reported emissions. This study has shown the relative importance of each scope 3 emissions source, which gives a guideline for the HEIs, on where to focus their attention to capture maximum scope 3 emissions. Moreover, it has demonstrated that it is possible to estimate the scope 3 emissions with limited data.

Keywords: HEI, university, emission calculations, scope 3 emissions, emissions reporting

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744 Emotional Intelligence Training: Helping Non-Native Pre-Service EFL Teachers to Overcome Speaking Anxiety: The Case of Pre-Service Teachers of English, Algeria

Authors: Khiari Nor El Houda, Hiouani Amira Sarra

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Many EFL students with high capacities are hidden because they suffer from speaking anxiety (SA). Most of them find public speaking much demanding. They feel unable to communicate, they fear to make mistakes and they fear negative evaluation or being called on. With the growing number of the learners who suffer from foreign language speaking anxiety (FLSA), it is becoming increasingly difficult to ignore its harmful outcomes on their performance and success, especially during their first contact with the pupils, as they will be teaching in the near future. Different researchers suggested different ways to minimize the negative effects of FLSA. The present study sheds light on emotional intelligence skills training as an effective strategy not only to influence public speaking success but also to help pre-service EFL teachers lessen their speaking anxiety and eventually to prepare them for their professional career. A quasi-experiment was used in order to examine the research hypothesis. We worked with two groups of third-year EFL students at Oum El Bouaghi University. The Foreign Language Classroom Anxiety Scale (FLCAS) and the Emotional Quotient Inventory (EQ-i) were used to collect data about the participants’ FLSA and EI levels. The analysis of the data has yielded that the assumption that there is a negative correlation between EI and FLSA was statistically validated by the Pearson Correlation Test, concluding that, the more emotionally intelligent the individual is the less anxious s/he will be. In addition, the lack of amelioration in the results of the control group and the noteworthy improvement in the experimental group results led us to conclude that EI skills training was an effective strategy in minimizing the FLSA level and therefore, we confirmed our research hypothesis.

Keywords: emotional intelligence, emotional intelligence skills training, EQ-I, FLCAS, foreign language speaking anxiety, pre-service EFL teachers

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743 Evaluation of Microbial Accumulation of Household Wastewater Purified by Advanced Oxidation Process

Authors: Nazlı Çetindağ, Pelin Yılmaz Çetiner, Metin Mert İlgün, Emine Birci, Gizemnur Yıldız Uysal, Özcan Hatipoğlu, Ehsan Tuzcuoğlu, Gökhan Sır

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Water scarcity is an unavoidable issue impacting an increasing number of individuals daily, representing a global crisis stemming from swift population growth, urbanization, and excessive resource exploitation. Consequently, solutions that involve the reclamation of wastewater are considered essential. In this context, household wastewater, categorized as greywater, plays a significant role in freshwater used for residential purposes and is attributed to washing. This type of wastewater comprises diverse elements, including organic substances, soaps, detergents, solvents, biological components, and inorganic elements such as certain metal ions and particles. The physical characteristics of wastewater vary depending on its source, whether commercial, domestic, or from a hospital setting. Consequently, the treatment strategy for this wastewater type necessitates comprehensive investigation and appropriate handling. The advanced oxidation process (AOP) emerges as a promising technique associated with the generation of reactive hydroxyl radicals highly effective in oxidizing organic pollutants. This method takes precedence over others like coagulation, flocculation, sedimentation, and filtration due to its avoidance of undesirable by-products. In the current study, the focus was on exploring the feasibility of the AOP for treating actual household wastewater. To achieve this, a laboratory-scale device was designed to effectively target the formed radicals toward organic pollutants, resulting in lower organic compounds in wastewater. Then, the number of microorganisms present in treated wastewater, in addition to the chemical content of the water, was analyzed to determine whether the lab-scale device eliminates microbial accumulation with AOP. This was also an important parameter since microbes can indirectly affect human health and machine hygiene. To do this, water samples were taken from treated and untreated conditions and then inoculated on general purpose agar to track down the total plate count. Analysis showed that AOP might be an option to treat household wastewater and lower microorganism growth.

Keywords: usage of household water, advanced oxidation process, water reuse, modelling

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742 Chronic Hepatitis C Virus Screening: The Role, Strategies and Challenging of Primary Healthcare Faced to Augment and Identify Asymptomatic Infected Patients

Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

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Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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741 Bringing Feminist Critical Pedagogy to the ESP Higher Education Classes: Feasibility and Challenges

Authors: Samira Essabari

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What, unfortunately, governs the Moroccan educational philosophy and policy today is a concerning neoliberal discourse with its obsession with market logics and individualism. Critical education has been advocated to resist the neoliberal hegemony since it holds the promise to reclaim the social function of education. Significantly, the mounting forms of sexism and discrimination against women combined with hegemonic educational practices are jeopardizing the social function of teaching and learning, hence the relevance of feminist critical pedagogy. A substantial body of research worldwide has explored the ways in which feminist pedagogy can develop feminist consciousness and examine power relations in different educational contexts. In Morocco, however, the feasibility of feminist pedagogy has not been researched despite the overwhelming interest in gender issues in different educational settings. The research on critical pedagogies in Morocco remains very promising. Yet, most studies were conducted in contexts which are already engaged with issues of theory, discourse, and discourse analysis. The field of ESP ( English for Specific Purposes) is pragmatic by nature, and priority in research has been given to questions that adhere to the mainstream concerns of need analysis and study skills and ignore issues of power, gender power relations, and intersectional forms of oppression. To address these gaps in the existing literature, this participatory action research seeks to investigate the feasibility of Feminist pedagogy in ESP higher education and how it can foster feminist critical consciousness among ESP students without compromising their language learning needs. The findings of this research will contribute to research on critical applied linguistics and critical ESP more specifically and add to the practice of critical pedagogies in Moroccan higher education by providing in-depth insights into the enablers and barriers to the implementation of feminist critical pedagogy, which is still feeling its way into the educational scene in Morocco.

Keywords: feminist pedagogy, critical pedagogy, power relations, gender, ESP, intersectionality

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740 Regional Anesthesia in Carotid Surgery: A Single Center Experience

Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Riteesh Bookun

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Patients with carotid stenosis, which may be asymptomatic or symptomatic in the form of transient ischaemic attack (TIA), amaurosis fugax, or stroke, often require an endarterectomy to reduce stroke risk. Risks of this procedure include stroke, death, myocardial infarction, and cranial nerve damage. Carotid endarterectomy is most commonly performed under general anaesthetic, however, it can also be undertaken with a regional anaesthetic approach. Our tertiary centre generally performs carotid endarterectomy under regional anaesthetic. Our major tertiary hospital mostly utilises regional anaesthesia for carotid endarterectomy. We completed a cross-sectional analysis of all cases of carotid endarterectomy performed under regional anaesthesia across a 10-year period between January 2010 to March 2020 at our institution. 350 patients were included in this descriptive analysis, and demographic details for patients, indications for surgery, procedural details, length of surgery, and complications were collected. Data was cross tabulated and presented in frequency tables to describe these categorical variables. 263 of the 350 patients in the analysis were male, with a mean age of 71 ± 9. 172 patients had a history of ischaemic heart disease, 104 had diabetes mellitus, 318 had hypertension, and 17 patients had chronic kidney disease greater than Stage 3. 13.1% (46 patients) were current smokers, and the majority (63%) were ex-smokers. Most commonly, carotid endarterectomy was performed conventionally with patch arterioplasty 96% of the time (337 patients). The most common indication was TIA and stroke in 64% of patients, 18.9% were classified as asymptomatic, and 13.7% had amaurosis fugax. There were few general complications, with 9 wound complications/infections, 7 postoperative haematomas requiring return to theatre, 3 myocardial infarctions, 3 arrhythmias, 1 exacerbation of congestive heart failure, 1 chest infection, and 1 urinary tract infection. Specific complications to carotid endarterectomy included 3 strokes, 1 postoperative TIA, and 1 cerebral bleed. There were no deaths in our cohort. This analysis of a large cohort of patients from a major tertiary centre who underwent carotid endarterectomy under regional anaesthesia indicates the safety of such an approach for these patients. Regional anaesthesia holds the promise of less general respiratory and cardiac events compared to general anaesthesia, and in this vulnerable patient group, calls for comparative research between local and general anaesthesia in carotid surgery.

Keywords: anaesthesia, carotid endarterectomy, stroke, carotid stenosis

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739 Using Problem-Based Learning on Teaching Early Intervention for College Students

Authors: Chen-Ya Juan

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In recent years, the increasing number of children with special needs has brought a lot of attention by many scholars and experts in education, which enforced the preschool teachers face the harsh challenge in the classroom. To protect the right of equal education for all children, enhance the quality of children learning, and take care of the needs of children with special needs, the special education paraprofessional becomes one of the future employment trends for students of the department of the early childhood care and education. Problem-based learning is a problem-oriented instruction, which is different from traditional instruction. The instructor first designed an ambiguous problem direction, following the basic knowledge of early intervention, students had to find clues to solve the problem defined by themselves. In the class, the total instruction included 20 hours, two hours per week. The primary purpose of this paper is to investigate the relationship of student academic scores, self-awareness, learning motivation, learning attitudes, and early intervention knowledge. A total of 105 college students participated in this study and 97 questionnaires were effective. The effective response rate was 90%. The student participants included 95 females and two males. The average age of the participants was 19 years old. The questionnaires included 125 questions divided into four major dimensions: (1) Self-awareness, (2) learning motivation, (3) learning attitudes, and (4) early intervention knowledge. The results indicated (1) the scores of self-awareness were 58%; the scores of the learning motivations was 64.9%; the scores of the learning attitudes was 55.3%. (2) After the instruction, the early intervention knowledge has been increased to 64.2% from 38.4%. (3) Student’s academic performance has positive relationship with self-awareness (p < 0.05; R = 0.506), learning motivation (p < 0.05; R = 0.487), learning attitudes (p < 0.05; R = 0.527). The results implied that although students had gained early intervention knowledge by using PBL instruction, students had medium scores on self-awareness and learning attitudes, medium high in learning motivations.

Keywords: college students, children with special needs, problem-based learning, learning motivation

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738 Use of a Novel Intermittent Compression Shoe in Reducing Lower Limb Venous Stasis

Authors: Hansraj Riteesh Bookun, Cassandra Monique Hidajat

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This pilot study investigated the efficacy of a newly designed shoe which will act as an intermittent pneumatic compression device to augment venous flow in the lower limb. The aim was to assess the degree with which a wearable intermittent compression device can increase the venous flow in the popliteal vein. Background: Deep venous thrombosis and chronic venous insufficiency are relatively common problems with significant morbidity and mortality. While mechanical and chemical thromboprophylaxis measures are in place in hospital environments (in the form of TED stockings, intermittent pneumatic compression devices, analgesia, antiplatelet and anticoagulant agents), there are limited options in a community setting. Additionally, many individuals are poorly tolerant of graduated compression stockings due to the difficulty in putting them on, their constant tightness and increased associated discomfort in warm weather. These factors may hinder the management of their chronic venous insufficiency. Method: The device is lightweight, easy to wear and comfortable, with a self-contained power source. It features a Bluetooth transmitter and can be controlled with a smartphone. It is externally almost indistinguishable from a normal shoe. During activation, two bladders are inflated -one overlying the metatarsal heads and the second at the pedal arch. The resulting cyclical increase in pressure squeezes blood into the deep venous system. This will decrease periods of stasis and potentially reduce the risk of deep venous thrombosis. The shoe was fitted to 2 healthy participants and the peak systolic velocity of flow in the popliteal vein was measured during and prior to intermittent compression phases. Assessments of total flow volume were also performed. All haemodynamic assessments were performed with ultrasound by a licensed sonographer. Results: Mean peak systolic velocity of 3.5 cm/s with standard deviation of 1.3 cm/s were obtained. There was a three fold increase in mean peak systolic velocity and five fold increase in total flow volume. Conclusion: The device augments venous flow in the leg significantly. This may contribute to lowered thromboembolic risk during periods of prolonged travel or immobility. This device may also serve as an adjunct in the treatment of chronic venous insufficiency. The study will be replicated on a larger scale in a multi—centre trial.

Keywords: venous, intermittent compression, shoe, wearable device

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737 An AI-generated Semantic Communication Platform in HCI Course

Authors: Yi Yang, Jiasong Sun

Abstract:

Almost every aspect of our daily lives is now intertwined with some degree of human-computer interaction (HCI). HCI courses draw on knowledge from disciplines as diverse as computer science, psychology, design principles, anthropology, and more. Our HCI courses, named the Media and Cognition course, are constantly updated to reflect state-of-the-art technological advancements such as virtual reality, augmented reality, and artificial intelligence-based interactions. For more than a decade, our course has used an interest-based approach to teaching, in which students proactively propose some research-based questions and collaborate with teachers, using course knowledge to explore potential solutions. Semantic communication plays a key role in facilitating understanding and interaction between users and computer systems, ultimately enhancing system usability and user experience. The advancements in AI-generated technology, which have gained significant attention from both academia and industry in recent years, are exemplified by language models like GPT-3 that generate human-like dialogues from given prompts. Our latest version of the Human-Computer Interaction course practices a semantic communication platform based on AI-generated techniques. The purpose of this semantic communication is twofold: to extract and transmit task-specific information while ensuring efficient end-to-end communication with minimal latency. An AI-generated semantic communication platform evaluates the retention of signal sources and converts low-retain ability visual signals into textual prompts. These data are transmitted through AI-generated techniques and reconstructed at the receiving end; on the other hand, visual signals with a high retain ability rate are compressed and transmitted according to their respective regions. The platform and associated research are a testament to our students' growing ability to independently investigate state-of-the-art technologies.

Keywords: human-computer interaction, media and cognition course, semantic communication, retainability, prompts

Procedia PDF Downloads 87
736 Evaluation of Pragmatic Information in an English Textbook: Focus on Requests

Authors: Israa A. Qari

Abstract:

Learning to request in a foreign language is a key ability within pragmatics language teaching. This paper examines how requests are taught in English Unlimited Book 3 (Cambridge University Press), an EFL textbook series employed by King Abdulaziz University in Jeddah, Saudi Arabia to teach advanced foundation year students English. The focus of analysis is the evaluation of the request linguistic strategies present in the textbook, frequency of the use of these strategies, and the contextual information provided on the use of these linguistic forms. The researcher collected all the linguistic forms which consisted of the request speech act and divided them into levels employing the CCSARP request coding manual. Findings demonstrated that simple and commonly employed request strategies are introduced. Looking closely at the exercises throughout the chapters, it was noticeable that the book exclusively employed the most direct form of requesting (the imperative) when giving learners instructions: e.g. listen, write, ask, answer, read, look, complete, choose, talk, think, etc. The book also made use of some other request strategies such as ‘hedged performatives’ and ‘query preparatory’. However, it was also found that many strategies were not dealt with in the book, specifically strategies with combined functions (e.g. possibility, ability). On a sociopragmatic level, a strong focus was found to exist on standard situations in which relations between the requester and requestee are clear. In general, contextual information was communicated implicitly only. The textbook did not seem to differentiate between formal and informal request contexts (register) which might consequently impel students to overgeneralize. The paper closes with some recommendations for textbook and curriculum designers. Findings are also contrasted with previous results from similar body of research on EFL requests.

Keywords: EFL, requests, saudi, speech acts, textbook evaluation

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735 Behavioral and EEG Reactions in Children during Recognition of Emotionally Colored Sentences That Describe the Choice Situation

Authors: Tuiana A. Aiusheeva, Sergey S. Tamozhnikov, Alexander E. Saprygin, Arina A. Antonenko, Valentina V. Stepanova, Natalia N. Tolstykh, Alexander N. Savostyanov

Abstract:

Situation of choice is an important condition for the formation of essential character qualities of a child, such as being initiative, responsible, hard-working. We have studied the behavioral and EEG reactions in Russian schoolchildren during recognition of syntactic errors in emotionally colored sentences that describe the choice situation. Twenty healthy children (mean age 9,0±0,3 years, 12 boys, 8 girls) were examined. Forty sentences were selected for the experiment; the half of them contained a syntactic error. The experiment additionally had the hidden condition: 50% of the sentences described the children's own choice and were emotionally colored (positive or negative). The other 50% of the sentences described the forced-choice situation, also with positive or negative coloring. EEG were recorded during execution of error-recognition task. Reaction time and quality of syntactic error detection were chosen as behavioral measures. Event-related spectral perturbation (ERSP) was applied to characterize the oscillatory brain activity of children. There were two time-frequency intervals in EEG reactions: (1) 500-800 ms in the 3-7 Hz frequency range (theta synchronization) and (2) 500-1000 ms in the 8-12 Hz range (alpha desynchronization). We found out that behavioral and brain reactions in child brain during recognition of positive and negative sentences describing forced-choice situation did not have significant differences. Theta synchronization and alpha desynchronization were stronger during recognition of sentences with children's own choice, especially with negative coloring. Also, the quality and execution time of the task were higher for this types of sentences. The results of our study will be useful for improvement of teaching methods and diagnostics of children affective disorders.

Keywords: choice situation, electroencephalogram (EEG), emotionally colored sentences, schoolchildren

Procedia PDF Downloads 254
734 Perceptions and Experiences of Students and Their Instructors on Online versus Face-To-Face Classrooms

Authors: Rahime Filiz Kiremit

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This study involves investigating the comparisons of both online and face-to-face classes, along with providing their respective differences. The research project contains information pertaining to the two courses, provided with testimony from students and instructors alike. There were a total of 37 participants involved within the study from San Jacinto College; 35 students and the two instructors of their respective courses. The online instructor has a total of four years of teaching experience, while the face-to-face instructor has accrued 11 years of instructional education. The both instructors were interviewed and the samples were collected from three different classes - TECA 1311-702 (Educating Young Children 13 week distance learning), TECA 1311-705 (Educating Young Children 13 week distance learning) and TECA 1354 (Child Growth and Development). Among all three classes, 13 of the 29 students enrolled in either of the online courses considered participation within the survey, while 22 of the 28 students enrolled in the face-to-face course elected to do the same thing. With regards to the students’ prior class enrollment, 25 students had taken online classes previously, 9 students had taken early-childhood courses, 4 students had taken general classes, 11 students had taken both types of classes, 10 students had not yet taken online classes, and only 1 of them had taken a hybrid course. 10 of the participants professed that they like face-to-face classes, because they find that they can interact with their classmates and teachers. They find that online classes have more work to do, because they need to read the chapters and instructions on their own time. They said that during the face-to-face instruction, they could take notes and converse concerns with professors and fellow peers. They can have hands-on activities during face-to-face classes, and, as a result, improve their abilities to retain what they have learned within that particular time. Some of the students even mentioned that they are supposed to discipline themselves, because the online classes require more work. According to the remaining six students, online classes are easier than face-to-face classes. Most of them believe that the easiness of a course is dependent on the types of classes, the instructors, and the respective subjects of which they teach. With considerations of all 35 students, almost 63% of the students agreed that they interact more with their classmates in face-to-face classes.

Keywords: distance education, face-to-face education, online classroom, students' perceptions

Procedia PDF Downloads 266
733 Understanding the Interactive Nature in Auditory Recognition of Phonological/Grammatical/Semantic Errors at the Sentence Level: An Investigation Based upon Japanese EFL Learners’ Self-Evaluation and Actual Language Performance

Authors: Hirokatsu Kawashima

Abstract:

One important element of teaching/learning listening is intensive listening such as listening for precise sounds, words, grammatical, and semantic units. Several classroom-based investigations have been conducted to explore the usefulness of auditory recognition of phonological, grammatical and semantic errors in such a context. The current study reports the results of one such investigation, which targeted auditory recognition of phonological, grammatical, and semantic errors at the sentence level. 56 Japanese EFL learners participated in this investigation, in which their recognition performance of phonological, grammatical and semantic errors was measured on a 9-point scale by learners’ self-evaluation from the perspective of 1) two types of similar English sound (vowel and consonant minimal pair words), 2) two types of sentence word order (verb phrase-based and noun phrase-based word orders), and 3) two types of semantic consistency (verb-purpose and verb-place agreements), respectively, and their general listening proficiency was examined using standardized tests. A number of findings have been made about the interactive relationships between the three types of auditory error recognition and general listening proficiency. Analyses based on the OPLS (Orthogonal Projections to Latent Structure) regression model have disclosed, for example, that the three types of auditory error recognition are linked in a non-linear way: the highest explanatory power for general listening proficiency may be attained when quadratic interactions between auditory recognition of errors related to vowel minimal pair words and that of errors related to noun phrase-based word order are embraced (R2=.33, p=.01).

Keywords: auditory error recognition, intensive listening, interaction, investigation

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732 Intrathecal: Not Intravenous Administration of Evans Blue Reduces Pain Behavior in Neuropathic Rats

Authors: Kun Hua O., Dong Woon Kim, Won Hyung Lee

Abstract:

Introduction: Neuropathic pain induced by spinal or peripheral nerve injury is highly resistant to common painkillers, nerve blocks, and other pain management approaches. Recently, several new therapeutic drug candidates have been developed to control neuropathic pain. In this study, we used the spinal nerve L5 ligation (SNL) model to investigate the ability of intrathecal or intravenous Evans blue to decrease pain behavior and to study the relationship between Evans blue and the neural structure of pain transmission. Method: Neuropathic pain (allodynia) of the left hind paw was induced by unilateral SNL in Sprague-Dawley rats(n=10) in each group. Evans blue (5, 15, 50μg/10μl) or phosphate buffer saline(PBS,10μl) was injected intrathecally at 3days post-ligation or intravenously(1mg/200 μl) 3days and 5days post-ligation . Mechanical sensitivity was assessed using Von Frey filaments at 3 days post-ligation and at 2 hours, days 1, 2, 3, 5,7 after intrathecal Evans blue injection, and on days 2, 4, 7, and 11 at 14 days after intravenous injection. In the intrathecal group, microglia and glutaminergic neurons in the dorsal horn and VNUT(vesicular nucleotide transporter) in the dorsal root ganglia were tested to evaluate co-staining with Evans blue. The experimental procedures were performed in accordance with the animal care guideline of the Korean Academy of Medical Science(Animal ethic committee of Chungnam National University Hospital: CNUH-014-A0005-1). Results: Tight ligation of the L5 spinal nerve induced allodynia in the left hind paw 3 days post-ligation. Intrathecal Evans blue most significantly(P<0.001) alleviated allodynia at 2 days after intrathecal, but not an intravenous injection. Glutaminergic neurons in the dorsal horn and VNUT in the dorsal root ganglia were co-stained with Evans blue. On the other hand, microglia in the dorsal horn were partially co-stained with Evans blue. Conclusion: We confirmed that Evans blue might have an analgesic effect through the central nervous system, not another system in neuropathic pain of the SNL animal model. These results suggest Evans blue may be a potential new drug for the treatment of chronic pain. This research was supported by the National Research Foundation of Korea (NRF-2020R1A2C100757512), funded by the Ministry of Education.

Keywords: neuropathic pain, Evas blue, intrathecal, intravenous

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731 Mobile-Assisted Language Learning (MALL) Applications for Interactive and Engaging Classrooms: APPsolutely!

Authors: Ajda Osifo, Amanda Radwan

Abstract:

Mobile-assisted language learning (MALL) or m-learning which is defined as learning with mobile devices that can be utilized in any place that is equipped with unbroken transmission signals, has created new opportunities and challenges for educational use. It introduced a new learning model combining new types of mobile devices, wireless communication services and technologies with teaching and learning. Recent advancements in the mobile world such as the Apple IOS devices (IPhone, IPod Touch and IPad), Android devices and other smartphone devices and environments (such as Windows Phone 7 and Blackberry), allowed learning to be more flexible inside and outside the classroom, making the learning experience unique, adaptable and tailored to each user. Creativity, learner autonomy, collaboration and digital practices of language learners are encouraged as well as innovative pedagogical applications, like the flipped classroom, for such practices in classroom contexts are enhanced. These developments are gradually embedded in daily life and they also seem to be heralding the sustainable move to paperless classrooms. Since mobile technologies are increasingly viewed as a main platform for delivery, we as educators need to design our activities, materials and learning environments in such a way to ensure that learners are engaged and feel comfortable. For the purposes of our session, several core MALL applications that work on the Apple IPad/IPhone will be explored; the rationale and steps needed to successfully implement these applications will be discussed and student examples will be showcased. The focus of the session will be on the following points: 1-Our current pedagogical approach, 2-The rationale and several core MALL apps, 3-Possible Challenges for Teachers and Learners, 4-Future implications. This session is aimed at instructors who are interested in integrating MALL apps into their own classroom planning.

Keywords: MALL, educational technology, iPads, apps

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730 The Effect of Early Skin-To-Skin Contact with Fathers on Their Supporting Breastfeeding

Authors: Shu-Ling Wang

Abstract:

Background: Multiple studies showed early skin-to-skin contact (SSC) with mothers was beneficial to newborns such as breastfeeding and maternal childcare. In cases of newborns unable to have early SSC with mothers, fathers’ involvement could let early SSC continue without interruption. However, few studies had explored the effects of early SSC by fathers in comparison to early SSC with mothers. Paternal involvement of early SSC should be equally important in term of childcare and breastfeeding. The purpose of this study was to evaluate the efficacy of early SSC by fathers in particular in their support of breastfeeding. Methods: A quasi-experimental design was employed by the study. One hundred and forty-four father-infant pairs had participated the study, in which infants were assigned either to SSC with their fathers (n = 72) or to routine care (n = 72) as the control group. The study was conducted at a regional hospital in northern Taiwan. Participants included parents of both vaginal delivery (VD) and caesarean section birth (CS) infants. To be eligible for inclusion, infants must be over 37-week gestational ages. Data were collected twice: as pretest upon admission and as posttest with online questionnaire during first, second, and third postpartum months. The questionnaire included items for Breastfeeding Social Support, methods of feeding, and the mother-infant 24-hour rooming-in rate. The efficacy of early SSC with fathers was evaluated using the generalized estimating equation (GEE) modeling. Research Result: The primary finding was that SSC with fathers had positive impact on fathers’ support of breastfeeding. Analysis of the online questionnaire indicated that early SSC with fathers improved the support of breastfeeding than the control group (VD: t = -4.98, p < .001; CS: t = -2.37, p = .02). Analysis of mother-infant 24-hour rooming-in rate showed that SSC with fathers after CS had a positive impact on the rooming-in rate (χ² = 5.79, p = .02); however, with VD the difference between early SSC with fathers and the control group was insignificant (χ² = .23, p = .63). Analysis of the rate of exclusive breastfeeding indicated that early SSC with fathers had a higher rate than the control group during first three postpartum months for both delivery methods (VD: χ² = 12.51, p < .001 on 1st postpartum month, χ² = 8.13, p < .05 on 2nd postpartum month, χ² = 4.43, p < .05 on 3rd postpartum month; CS: χ² = 6.92, p < .05 on 1st postpartum month, χ² = 7.41, p < .05 on 2nd postpartum month, χ² = 6.24, p < .05 on 3rd postpartum month). No significant difference was found on the rate of exclusive breastfeeding with both methods of delivery between two groups during hospitalization. (VD: χ² =2 .00, p = .16; CS: χ² = .73, p = .39). Conclusion: Implementing early SSC with fathers has many benefits to both parents. The result of this study showed increasing fathers’ support of breastfeeding. This encourages our nursing personnel to focus the needs of father during breastfeeding, therefore further enhancing the quality of parental care, the rate and duration of breastfeeding.

Keywords: breastfeeding, skin-to-skin contact, support of breastfeeding, rooming-in

Procedia PDF Downloads 199
729 Utilization of Standard Paediatric Observation Chart to Evaluate Infants under Six Months Presenting with Non-Specific Complaints

Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes

Abstract:

Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.

Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart

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728 Haematological Correlates of Ischemic Stroke and Transient Ischemic Attack: Lessons Learned

Authors: Himali Gunasekara, Baddika Jayaratne

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Haematological abnormalities are known to cause Ischemic Stroke or Transient Ischemic Attack (TIA). The identification of haematological correlates plays an important role in a management and secondary prevention. The objective of this study was to describe haematological correlates of stroke and their association between stroke profile. The haematological correlates screened were Lupus Anticoagulant, Dysfibroginemia, Paroxysmal nocturnal haemoglobinurea (PNH), Sickle cell disease, Systemic Lupus Erythematosis (SLE) and Myeloploriferative Neoplasms (MPN). A cross sectional descriptive study was conducted in a sample of 152 stroke patients referred to haematology department of National Hospital of Sri Lanka for thrombophilia screening. Different tests were performed to assess each hematological correlate. Diluted Russels Viper Venom Test and Kaolin clotting time were done to assess Lupus anticoagulant. Full blood count (FBC), blood picture, Sickling test and High Performance Liquid Chromatography were the tests used for detection of Sickle cell disease. Paroxysmal nocturnal haemoglobinurea was assessed by FBC, blood picture, Ham test and Flowcytometry. FBC, blood picture, Janus Kinase 2 (V617F) mutation analysis, erythropoietin level and bone marrow examination were done to look for the Myeloproliferative neoplasms. Dysfibrinogenaemia was assessed by TT, fibrinogen antigen test, clot observation and clauss test. Anti nuclear antibody test was done to look for systemic lupus erythematosis. Among study sample, 134 patients had strokes and only 18 had TIA. The recurrence of stroke/TIA was observed in 13.2% of patients. The majority of patients (94.7%) have had radiological evidence of thrombotic event. One fourth of patients had past thrombotic events while 12.5% had family history of thrombosis. Out of haematological correlates screened, Lupus anticoagulant was the commonest haematological correlate (n=16 ) and dysfibrigonaemia(n=11 ) had the next high prevalence. One patient was diagnosed with Essential thrombocythaemia and one with SLE. None of the patients were positive for screening tests done for sickle cell disease and PNH. The Haematological correlates were identified in 19% of our study sample. Among stroke profile only presence of past thrombotic history was statistically significantly associated with haematological disorders (P= 0.04). Therefore, hematological disorders appear to be an important factor in etiological work-up of stroke patients particularly in patients with past thrombotic events.

Keywords: stroke, transient ischemic attack, hematological correlates, hematological disorders

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727 Coping Strategies Used by Persons with Spinal Cord Injury: A Rehabilitation Hospital Based Qualitative Study

Authors: P. W. G. D. P. Samarasekara, S. M. K. S. Seneviratne, D. Munidasa, S. S. Williams

Abstract:

Sustaining a spinal cord injury (SCI) causes severe disruption of all aspects of a person’s life, resulting in the difficult process of coping with the distressing effects of paralysis affecting their ability to lead a meaningful life. These persons are hospitalized in the acute stage of injury and subsequently for rehabilitation and the treatment of complications. The purpose of this study was to explore coping strategies used by persons with SCI during their rehabilitation period. A qualitative study was conducted among persons with SCI, undergoing rehabilitation at the Rheumatology and Rehabilitation Hospitals, Ragama and Digana Sri Lanka. Twelve participants were selected purposively to represent both males and females, with cervical, thoracic or lumbar levels of injuries due to traumatic and non-traumatic causes as well as from different socioeconomic backgrounds. Informed consent was taken from the participants. In-depth interviews were conducted using an interview guide to collect data. Probes were used to get more information and to encourage participants. Interviews were audio taped and transcribed verbatim. Qualitative content analysis was conducted. Ethical approval for this study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya. Five themes were identified in the content analysis: social support, religious beliefs, determination, acceptance and making comparisons. Participants indicated that the support from their family members had been an essential factor in coping, after sustaining an SCI and they expressed the importance of emotional support from family members during their rehabilitation. Many participants had a strong belief towards the God, who had a personal interest in their lives, played an important role in their ability to cope with the injury. They believed that what happens to them in this life results from their actions in previous lives. They expressed that determination was essential as a factor that helps them cope with their injury. They indicated their focus on the positive aspects of the life and accepted the disability. They made comparisons to other persons who were worse off than them to help lift them out of unpleasant experience. Even some of the most severely injured and disabled participants presented evidence of using this coping strategy. Identification of coping strategies used by persons with SCI will help nurses and other health-care professionals in reinforcing the most effective coping strategies among persons with SCI. The findings recommend that engagement coping positively influences psychosocial adaptation.

Keywords: content analysis, coping strategies, rehabilitation, spinal cord injury

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726 Self-Inflicted Major Trauma: Inpatient Mental Health Management and Patient Outcomes

Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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725 Outcomes of Teacher’s Pedagogical Approach on Mainstreaming of Adolescents with Exceed Weight into Physical Education in United Arab Emirates: Ajman’s Case Study

Authors: Insaf Sayar, Moôtez Marzougui, Abderraouf Ben Abderrahman

Abstract:

Background: Physical Education and Sports (PES) plays an important role in the overall education of the student. It has physical, affective, psychological, and social repercussions. In fact, overweight children are sometimes underestimated by their lower physical performance and suffer from discriminatory attitudes by their peers and their physical education (PE) teachers. Objectives: The aim of this study was to investigate the impacts of both teacher’s pedagogy and overweight or obesity on the inclusion of obese students in physical education classes in the school setting in the Emirate of Ajman (United Arab Emirates) and to understand how physical education and sports (PES) teachers adapt their pedagogical interventions towards this category. Methods: A sample of 48 overweight or obese students and 20 teachers were approached from different schools in Ajman Emirate. Two standardized questionnaires for obese students and PSE teachers were used. Overweight and obesity were defined using age and sex-specific Body Mass Index (BMI). Results: Our results showed that the average BMI of the surveyed students is 28.58 ± 3.14 kg/m². According to the collected data, 85.42% of obese students report that they do not practice physical activity or rarely practice outside of school, and 73.42% go to school by bus or car. In addition, 66.7% of the surveyed students said that being overweight is a barrier to PES practice, and 100% of obese or overweight students do not prefer some physical activities such as running and jumping. Similarly, 75% of the surveyed teachers said that obese students are not integrated into the PES course, but only 55% of teachers reported that the obese student became an obstacle in PES sessions, while 80% of teachers reported that obese or overweight students were marginalized by their colleagues. In the same way, most of them (75%) said that obese students are exempted from PES courses. Conclusion: Overweight/obesity is prevalent among school children in the Emirate of Ajman, with a high correlation with sedentary behavior. The study confirmed an urgent need and effective teaching strategies/ pedagogies for including overweight or obese students in physical education engagement and learning.

Keywords: adolescent, mainstreaming, obesity, PES education, UAE

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724 Experimental Study on the Effectiveness of Extracurricular Football Training for Improving Primary Students Physical Fitness

Authors: Yizhi Zhang, Xiaozan Wang, Mingming Guo, Pengpeng Li

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Introduction: The purpose of this study is to examine the effectiveness of after-school football training in improving the physical fitness of primary school students, so as to provide corresponding suggestions for carrying out after-school football training in primary schools. Methods: A total of 72 students from the experimental primary school of Mouping district, Yantai city, Shandong province, participated in this experiment. The experiment was conducted for two semesters. During the experiment period, the experimental group conducted one-hour football training after school from Monday to Thursday afternoon every week, and two hours of football training on Saturday morning every week. The control group conducted sports teaching and extracurricular activities as usual without other intervention. Before and after the experiment, both the experimental group and the control group underwent physical fitness tests according to the physical fitness test standards of Chinese students, including lung capacity, 50-meter run, one-minute skipping rope, sitting forward flexor, and one-minute sit-ups. The test results were all converted to the 100-point system according to the scoring standards. Results: (1) Before the experiment, there was no significant difference between the experimental group and the control group in various physical fitness indicators (p > 0.05). (2) After the experiment, the lung capacity score (T = 3.108, p < 0.05), the 50-meter run score (T = 6.593, p < 0.05), the skipping score (T = 9.227, p < 0.05), the sitting forward flexor score (T = 3.742, p < 0.05), and the sit-up score (T = 5.210, p < 0.05) of the experimental group were significantly higher than that of the control group. Conclusion: This study shows that the physical fitness of primary school students can be improved by football training in their spare time. It is suggested to carry out after-school football training activities in primary schools so as to effectively improve the physical fitness of pupils.

Keywords: after-school football training, physical fitness, primary school students, school sports

Procedia PDF Downloads 123