Search results for: patients’ related risks in the current home hemodialysis practices

Authors: Phan Minh Trang, Joacim Rocklöv, Kim Bao Giang, Gunnar Kullgren, Maria Nilsson

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There are recent studies from high income countries reporting an association between heat waves and hospital admissions for mental health disorders. It is not previously studied if such relations exist in sub-tropical and tropical low- and middle-income countries. In this study from Vietnam, the assumption was that hospital admissions for mental disorders may be triggered, or exacerbated, by heat exposure and heat waves. A database from Hanoi Mental Hospital with mental disorders diagnosed by the International Classification of Diseases 10, spanning over five years, was used to estimate the heatwave-related impacts on admissions for mental disorders. The relationship was analysed by a Negative Binomial regression model accounting for year, month, and days of week. The focus of the study was heat-wave events with periods of three or seven consecutive days above the threshold of 35oC daily maximum temperature. The preliminary study results indicated that heat-waves increased the risks for hospital admission for mental disorders (F00-79) from heat-waves of three and seven days with relative risks (RRs) of 1.16 (1.01–1.33) and 1.42 (1.02–1.99) respectively, when compared with non-heat-wave periods. Heatwave-related admissions for mental disorders increased statistically significantly among men, among residents in rural communities and in elderly. Moreover, cases for organic mental disorders including symptomatic illnesses (F0-9) and mental retardation (F70-79) raised in high risks during heat waves. The findings are novel studying a sub-tropical middle-income city, facing rapid urbanisation and epidemiological and demographic transitions.

Keywords: mental disorders, admissions for F0-9 or F70-79, maximum temperature, heat waves

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Authors: Ku Aina Afiqah Ku Adzman, Manmeet Mahinderjit Singh, Zarul Fitri Zaaba

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NFC operates on low-range 13.56 MHz frequency within a distance from 4cm to 10cm, and the applications can be categorized as touch and go, touch and confirm, touch and connect, and touch and explore. NFC applications are vulnerable to various security and privacy attacks such due to its physical nature; unprotected data stored in NFC tag and insecure communication between its applications. This paper aims to determine the likelihood of security risks happening in an NFC technology and application. We present an NFC technology taxonomy covering NFC standards, types of application and various security and privacy attack. Based on observations and the survey presented to evaluate the risk assessment within the touch and go application demonstrates two security attacks that are high risks namely data corruption and DOS attacks. After the risks are determined, risk countermeasures by using AHP is adopted. The guideline and solutions to these two high risks, attacks are later applied to a secure NFC-enabled Smartphone Attendance System.

Keywords: Near Field Communication (NFC), risk assessment, multi-criteria decision making, Analytical Hierarchy Process (AHP)

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Authors: Shedy Maharani Nariswari, Prima Agustia Nova, I. Made Kariasa

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Background. Heart Failure (HF) is a chronic and progressive condition associated with significant morbidity, mortality, health care expenditures, and a high readmission rate over the years. Self‐care is essential to manage chronic heart failure in the long term, and it is related to better outcomes and can enhance the quality of life. Objective. The aims of this study were to describe the relationship between self-care behavior and quality of life among heart failure patients in East Jakarta, Indonesia. Methods. This study used a correlational-descriptive design with a cross-sectional study, the sampling method used purposive sampling method. Self-care was measured using Self-care Heart Failure Index version 6.2, and quality of life was measured using The Minnesota Living with Heart Failure. Pearson correlation and Spearman-rho correlations are used to analyze the data. Results. We recruited 103 patients with HF in both outpatient and inpatient ward: mean age 59.26 ± 11.643 years, 63.1% male. Patients with higher levels of education were associated with higher self-care maintenance (p= 0.007). The patient's average quality of life is quite high, with a score of 72,07 ± 16,89. There were a significant relationship among self-care maintenance (r=0,305, p=0,001), self-care management (r=0,330, p=0,001), and self-care confidence (r=0,335, p=0,001) towards the quality of life. Most participants have inadequate self-care maintenance, self-care management, and self-care confidence (score < 70), while the score of quality of life is categorized as poor. Conclusion. The self-care behaviors were limited among patients living with HF in Indonesia yet was associated with better quality of life. It is necessary to promote health related to knowledge and adherence to self-care behavior so that it can improve the quality of life of heart failure patients. This study can be used as a reference to promote self-care among patients with heart failure, it can help to enhance their quality of life.

Keywords: heart failure, self-care maintenance, self-care management, self-care confidence, quality of life

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Authors: Aisha Maroof

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Introduction: Coronavirus Disease 2019 (COVID-19) is spreading rapidly around the world with devastating consequences on patients, health care workers and health systems. Severe 2019 novel coronavirus infectious disease (COVID-19) with pneumonia is associated with high rates of admission to the intensive care unit (ICU) and they are at high risk to obtain the hospital acquire bloodstream infection (HAIs) such as central line associated bloodstream infection (CLABSI), catheter associated urinary tract infections (CAUTI) and laboratory confirm bloodstream infection (LCBSI). The chances of infection transmission increase when healthcare worker’s (HCWs) practice is inappropriate. Risk related to hand hygiene (HH) and personal protective equipment (PPE) as regards multidrug-resistant organism transmission: use of multiple gloving instead of HH and incorrect use of PPE can lead to a significant increase of device-related infections. As it reaches low- and middle-income countries, its effects could be even more, because it will be difficult for them to react aggressively to the pandemic. HAIs are one of the biggest medical concerns, resulting in increased mortality rates. Objective: To assess the effect of intervention on compliance of hand hygiene and PPE among HCWs reduce the rate of HAI in COVID-19 patients. Method: An interventional study was done between July to December, 2020. CLABSI, CAUTI and LCBSI data were collected from the medical record and direct observation. There were total of 50 Nurses, 18 doctors and all patients with laboratory-confirmed severe COVID-19 admitted to the hospital were included in this research study. Respiratory tract specimens were obtained after the first 48 h of ICU admission. Practices were observed after and before intervention. Education was provided based on WHO guidelines. Results: During the six months of study July to December, the rate of CLABSI, CAUTI and LCBSI pre and post intervention was reported. CLABSI rate decreasedd from 22.7 to 0, CAUTI rate was decreased from 1.6 to 0, LCBSI declined from 3.3 to 0 after implementation of intervention. Conclusion: HAIs are an important cause of morbidity and mortality. Most of the device related infections occurs due to lack of correct use of PPE and hand hygiene compliance. Hand hygiene and PPE is the most important measure to protect patients, through education it can be improved the correct use of PPE and hand hygiene compliance and can reduce the bacterial infection in COVID-19 patients.

Keywords: hospital acquire infection, healthcare workers, hand hygiene, personal protective equipment

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Authors: Elizabeth Behrens, Anne Timmermann, Alexander Yerkan, Joshua Thomas, Deborah Katz, Agne Paner, Melissa Larson, Shivi Jain, Seo-Hyun Kim, Celalettin Ustun, Ankur Varma, Parameswaran Venugopal, Jamile Shammo

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Coronavirus Disease-2019 (COVID-19) causes persistent concern for poor outcomes in vulnerable populations. Patients with hematologic malignancies (HM) have been found to have higher COVID-19 case fatality rates compared to those without malignancy. While cytopenias are common in patients with HM, especially in those undergoing chemotherapy treatment, hemoglobin (Hgb) and platelet count have not yet been studied, to our best knowledge, as potential prognostic indicators for patients with HM and COVID-19. The goal of this study is to identify factors that may increase the risk of mortality in patients with HM and COVID-19. In this single-center, retrospective, observational study, 65 patients with HM and laboratory confirmed COVID-19 were identified between March 2020 and January 2021. Information on demographics, laboratory data the day of COVID-19 diagnosis, and prognosis was extracted from the electronic medical record (EMR), chart reviewed, and analyzed using the statistical software SAS version 9.4. Chi-square testing was used for categorical variable analyses. Risk factors associated with mortality were established by logistic regression models. Non-Hodgkin lymphoma (37%), chronic lymphocytic leukemia (20%), and plasma cell dyscrasia (15%) were the most common HM. Higher Hgb level upon COVID-19 diagnosis was related to decreased mortality, odd ratio=0.704 (95% confidence interval [CI]: 0.511-0.969; P = .0263). Platelet count the day of COVID-19 diagnosis was lower in patients who ultimately died (mean 127 ± 72K/uL, n=10) compared to patients who survived (mean 197 ±92K/uL, n=55) (P=.0258). Female sex was related to decreased mortality, odd ratio=0.143 (95% confidence interval [CI]: 0.026-0.785; P = .0353). There was no mortality difference between the patients who were on treatment for HM the day of COVID-19 diagnosis compared to those who were not (P=1.000). Lower Hgb and male sex are independent risk factors associated with increased mortality of HM patients with COVID-19. Clinicians should be especially attentive to patients with HM and COVID-19 who present with cytopenias. Larger multi-center studies are urgently needed to further investigate the impact of anemia, thrombocytopenia, and demographics on outcomes of patients with hematologic malignancies diagnosed with COVID-19.

Keywords: anemia, COVID-19, hematologic malignancy, prognosis

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Authors: Duhania O. Mahara, Santi W. Purnami, Aulia N. Fitria, Merissa N. Z. Wirontono, Revina Musfiroh, Shofi Andari, Sagiran Sagiran, Estiana Khoirunnisa, Wahyudi Widada

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For assessing interventions in numerous disease areas, the use of multiple time-to-event outcomes is common. An individual might experience two different events called bivariate time-to-event data, the events may be correlated because it come from the same subject and also influenced by individual characteristics. The bivariate time-to-event case can be applied by copula-based bivariate Cox survival model, using the Clayton and Frank copulas to analyze the dependence structure of each event and also the covariates effect. By applying this method to modeling the recurrent event infection of hemodialysis insertion on chronic kidney disease (CKD) patients, from the AIC and BIC values we find that the Clayton copula model was the best model with Kendall’s Tau is (τ=0,02).

Keywords: bivariate cox, bivariate event, copula function, survival copula

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Authors: Monika Szpringer, Mariola Wojciechowska, Robert Dutkiewicz, Grażyna Nowak-Starz, Marzena Olędzka

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The main aim of this article is to determine the phenomenon of stress among academic teachers as well as to identify the extent to which the teachers experience work-related psychological risks. It is also important to support academic teachers trade unions in scope of stress-oriented activities, including psychological dangers in the assessment of risk in the workplace (college). The authors used a method of a diagnostic survey with a polling as a technique and authors’ questionnaire as a tool. The survey was conducted between September and December of 2013 and it comprised 1890 academic teachers from five voivodeships. The study reveals that 84.0% of the respondents found the work of an academic teacher to be borne with a considerable stress. The percentage values of the most frequent causes of stress are as follows: frequent changes of both organisational and didactic matters as well as overwhelming bureaucracy (77.8 %), time pressure regarding professional development and related risk of losing job (68.2 %), difficult working conditions (45.4%), conflicts and rivalry between teachers (44.1%), excessive amount of duties as well as increasing requirements and demanding attitude of students (33.7%). Work-related stress affects or significantly affects the private life of 69 % and 66.4 % of the respondents respectively. The majority of the people surveyed deals with stress by undertaking various activities, with 40% pointing at using various substances, mostly cigarettes and alcohol (p > 0,05) Physical ailments were experienced by 81% of the respondents, in 9% they were rare and 8 % of the respondents had never experienced such disorders. The entire group of the surveyed people (100 %) claimed that they have no possibility of contacting a psychologist at their workplace (p > 0.05), and they stated that the need of contacting specialists does exist.

Keywords: stress, academic teachers, psychological risks, work-related

Procedia PDF Downloads 397

Authors: Kulsum Maula, Md Kamrul Alam, Md Ibrahim Khalil, Md Nazmul Hasan, Mohammad Omar Faruq

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Background: Percutaneous Tube Thoracostomy (PTT) is an invasive procedure that can save a life now and then in different traumatic and non-traumatic conditions. But still, it is an enigma; how our trainee surgeons are at home in this procedure. Objectives: To evaluate the outcome of the percutaneous tube thoracostomy performed by trainees in both trauma and non-trauma patients. Study design: Prospective, Observational Study. The duration of the study was September 2018 to February 2019. Methods: All patients who need PTT in traumatic and non-traumatic conditions were selected by purposive sampling. Thereafter, they were scrutinized according to eligibility criteria and 96 patients were finalized. A pre-tested, observation-based, peer-reviewed data collection sheet was prepared before the study. Data regarding clinical and surgical outcome profiles were recorded. Data were compiled, edited, and analyzed. Results: Among 96 patients, the highest 32.29% belonged to age group 31-40 years and the lowest 9.37% belonged to the age group ≤20. The mean age of the respondents was 29.19±9.81. We found out of 96 patients, 70(72.91%) were indicated PTT for traumatic conditions and the rest 26(27.08%) were indicated PTT for non-traumatic chest conditions, where 36(37.5%) had simple penumothorax, 21(21.87%) haemothorax, 14(14.58%) massive pleural effusion, 13(13.54%) tension pneumothorax, 10(10.41%) haemopneumothorax, and 2(2.08%) had pyothorax respectively. In 53.12% of patients had right-sided intercostal chest tube (ICT) insertion, whereas 46.87% had left-sided ICT insertion. In our study, 89.55 % of the tube was placed at the normal anatomical position. Besides, 10.41% of tube thoracostomy were performed deviated from anatomical site. Among 96 patients 62.5% patients had length of incision 2-3cm, 35.41% had >3cm and 2.08% had <2cm respectively. Out of 96 patients, 75(78.13%) showed uneventful outcomes, whereas 21(21.87%) had complications, including 11.15%(11) each had wound infection, 4.46%(4) subcutaneous emphysema, 4.28%(3) drain auto expulsion, 2.85%(2) hemorrhage, 1.45%(1) had a non-functioning drain and empyema with ascending infection respectively (p=<0.05). Conclusion: PTT is a life-saving procedure that is most frequently implemented in chest trauma patients in our country. In the majority of cases, the outcome of PTT was uneventful (78.13). Besides this, more than one-third of patients had a length of incision more than 3 cm that needed extra stitches and 10.41% of cases of PTT were placed other than the normal anatomical site. Trainees of Dhaka Medical College Hospitals are doing well in their performance of PTT insertion, but still, some anatomical orientations are necessary to avoid operative and post-operative complications.

Keywords: PTT, trainee, trauma, non-chest trauma patients

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Authors: Eu Tteum Ha, Seyoung Kim, Jeongmin Kim, Kwang Ryel Ryu

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The smart home environment backed up by IoT (internet of things) technologies enables intelligent services based on the awareness of the situation a user is currently in. One of the convenient sensors for recognizing the situations within a home is the smart meter that can monitor the status of each electrical appliance in real time. This paper aims at learning a Bayesian network that models the causal relationship between the user situations and the status of the electrical appliances. Using such a network, we can infer the current situation based on the observed status of the appliances. However, learning the conditional probability tables (CPTs) of the network requires many training examples that cannot be obtained unless the user situations are closely monitored by any means. This paper proposes a method for learning the CPT entries of the network relying only on the user feedbacks generated occasionally. In our case study with a robot vacuum cleaner, the feedback comes in whenever the user gives an order to the robot adversely from its preprogrammed setting. Given a network with randomly initialized CPT entries, our proposed method uses this feedback information to adjust relevant CPT entries in the direction of increasing the probability of recognizing the desired situations. Simulation experiments show that our method can rapidly improve the recognition performance of the Bayesian network using a relatively small number of feedbacks.

Keywords: Bayesian network, IoT, learning, situation -awareness, smart home

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

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

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

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Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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Authors: Katerine Moraes dos Satons, Gisele Massante Peixoto Tracera, Regina Célia Gollner Zeitoune

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To analyze the psychosocial risks related to the organization of nursing work in outpatient clinics of university hospitals. Cross-sectional epidemiological study developed in 11 outpatient units linked to the three public universities of the city of Rio de Janeiro, Brazil. Participants were 388 nursing professionals who worked in patient care at the time of the research. Data were collected from July to December 2018, using a self-applicable instrument. A questionnaire was used for sociodemographic, occupational and health characterization, and the Work Organization Scale. The bivariate analyses were performed using the odds ratio (OR), with a confidence interval of 95%, significance level of 5%. The organization of nursing work received an assessment of medium psychosocial risk by the professionals participating in the research, demanding interventions in the short and medium term. There was no association between sociodemographic, occupational and health characteristics and the organization of outpatient work. Interventional measures should be performed in the psychosocial risk factors presented in this research, with a view to improving the work environment, so that the importance of maintaining satisfactory material conditions is considered, as well as the adequate quantity of human resources. In addition, it aims to expand the spaces of nursing participation in decision- making, strengthening its autonomy as a profession.

Keywords: occupational risks, nursing, nursing team, worker’s health, psychosocial risks

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Authors: Y. I. Tretyakova, S. G. Shulkina, T. Y. Kravtsova, A. A. Antipova, N. Y. Kolomeets

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The research aimed to assess the functional significance of tumor necrosis factor-alpha (TNF-α) gene polymorphism at the -308G/A (rs1800629) region and vascular endothelial growth factor A (VEGFA) gene polymorphism at the -634G/C (rs 2010963) region in the development of ulcerative colitis (UC), focusing on patients from the Perm region, Russia. We examined 70 UC patients and 50 healthy donors during the active phase of the disease. Our focus was on TNF-α and VEGF concentration in the blood serum, as well as TNF-α and VEGFA gene polymorphisms at the -308G/А and -634G/C regions, respectively. We found that TNF-α and VEGF levels were significantly higher in patients with severe UC and high endoscopic activity compared to those with milder forms of the disease and low endoscopic activity. These tests could serve as additional non-invasive markers for assessing mucosal damage in the large intestine of UC patients. The frequency of allele variations in the TNF-α gene -308G/A (rs1800629) revealed a significantly higher occurrence of the unfavorable homozygote AA in UC patients compared to donors. Additionally, the major allele G and the allele pair GG were more frequent in patients with mild to moderate disease and 1-2 degree of endoscopic activity than in those with severe UC and 3-4 degree of endoscopic activity (χ2=14.19; p=0.000). We also observed a mutant allele A and the unfavorable homozygote AA associated with severe progressive UC. The occurrence of the mutant allele increased the risk of severe UC by 5 times (OR 5.03; CI 12.07-12.21). We did not find any significant differences in the frequency of the CC homozygote (χ2=1.02; p=0.6; OR=1.32) and the mutant allele C of the VEGFA gene -634G/C (rs 2010963) (χ2=0.01; p=0.913; OR=0.97) between groups of UC patients and healthy individuals. However, we detected that the mutant allele C and the unfavorable homozygote CC of the VEGFA gene were associated with more severe endoscopic changes in the colonic mucosa of UC patients (χ2=25,76; р=0,000; OR=0,15). The presence of the mutant allele increased the risk of severe UC by 6 times (OR 6,78; CI 3,13–14,7). We found a direct correlation between TNF-α and VEGFA gene polymorphisms, increased production of the same factors, disease severity, and endoscopic activity (р=0.000). Therefore, the presence of the mutant allele A and homozygote AA of the TNF-α gene at the -308G/A region and the mutant allele C and homozygote CC of the VEGFA gene at the -634G/C region are associated with risks related to an unfavorable clinical course of UC, frequent recurrences, and rapid progression. These findings should be considered when making prognoses regarding the clinical course of the disease and selecting treatment strategies. The presence of the homozygote AA in the TNF-α gene (rs1800629) is considered a sign of genetic predisposition to UC.

Keywords: gene polymorphism, TNF-α, ulcerative colitis, VEGF

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Authors: Isabel Cristina Ortiz Trujillo, Lina Maria Martinez Sanchez, Felipe Hernández Restrepo, Daniel Gallego Gonzalez, Natalia Vargas Grisales, Camilo Andrés Agudelo Vélez

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Chorioamnionitis, is a pregnancy infection, causes different fetal and maternal symptoms. Streptococcus agalactiae present in the normal vaginal microflora of some women, favouring its abnormal multiplication during pregnancy, causing perinatal morbidity and mortality. Objective. Describe the clinical and epidemiological profile of the patients with diagnosis of clinical chorioanmionitis. Methodology. Descriptive, cross-sectional study. The population was patients with diagnosis of clinical chorioanmionitis. The information was taken from the medical records. The research was approved by the Ethics Committee. We used the program SPSS ® version 17.0 (SPSS Inc; Chicago, Illinois, USA) for the information analysis, descriptive statistics were used. Results. 78 patients in total with clinical chorioamnionitis, with a mean age of 26.3 ±5, 8 years old, the 69.2% primigravid women. 2.6% of women had positive culture for Streptococcus agalactiae in urine sample during current pregnancy and 30.7% had received some kind of antibiotics during current pregnancy. The 57.7% had 37 to 40 weeks of gestation in the current pregnancy it was calculated more frequently by ultrasound (66.7% in first quarter, 11.5% in the second and 1.9% in the third). In a 60.3% way of termination of pregnancy was vaginal and a 35.9 percent were caesarean section. Among the women in the study, a 30.8% had premature rupture of membranes. Conclusion. The chorioamnionitis continues to be an important cause of antibiotic use during pregnancy or labour and the decision to do a caesarean, with highest percentage in pregnancies-preterm and preterm premature rupture of membranes.

Keywords: chorioamnionitis, Streptococcus agalactiae, pregnancy complications, infectious

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Authors: Mashael AlSalem

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While research into language assessment has expanded in recent years, few if any studies to date have targeted the nature of thought processes used by teachers when constructing classroom-based assessment. This study reports on teachers’ conceptions of English grammar assessment and their classroom assessment practices in their Saudi higher educational facilities. A mixed-method approach using both qualitative and quantitative research instruments was employed to elicit teachers’ perceptions of English grammar assessment and their relationship to their current practices. Participants of the study included EFL teachers from 4 different educational facilities: King Saudi University, Princess Noura University, Imam Mouhamed Islamic University, and Institute of Public Administration. Data collection involved questionnaire (N=100), semi-structured interviews (N=30), retrospective thinking (N=20), and document analysis (N=20). Activity theory is used as an interpretive framework to explore and investigate the entire system of constructing classroom-based assessment. Preliminary findings reveal several similarities and differences between the participants’ stated beliefs and their current practices of assessing English grammar. Findings also showed that teacher participant’s beliefs about how English grammar should be assessed are influenced mostly by prior learning experience as well as their teaching instruction practices. Their practices, on the other hand, was more guided by educational policies and lack of teacher training in the field of assessment, among other factors. This research makes a significant contribution to knowledge in three different areas: it enriches the literature on language teacher cognition; it builds on the body of research on language classroom assessment, and it expands on the possibilities to use AC to investigate the relationship between teachers’ beliefs and practices.

Keywords: activity theory, classroom-based assessment, language teacher cognition, mixed method approach

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Authors: Joanna Konstantinou

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Due to the pandemic, we have recently witnessed an explosion of HR Tech offering a variety of solutions for digital transformation, as well as a large number of HR practices implemented by professionals both in data science and occupational psychology. The aim of this study is to explore the impact of these practices and their effectiveness and to develop an understanding of digital leadership. The study will be based on semi-structured interviews using qualitative research methods and tools.

Keywords: HR practices, digital trasformation, pandemic, digital leadership

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Authors: Hariz Halilovich

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Based on conventional and digital ethnography, this paper discusses the ways Bosnian refugees utilise digital technologies and new media to recreate, synchronise and sustain their identities and memories in the aftermath of ‘ethnic cleansing’ and genocide and in the contexts of their new emplacements and home-making practices in diaspora. In addition to discussing representations of displacement and emplacement in the ‘digital age’, the paper also aims to make a contribution to the understanding and application of digital ethnography as an emerging method of inquiry in anthropology and related social science disciplines. While some researchers see digital ethnography as an exclusively online–based research, the author of this paper argues that it is critical to understand the online world in the context of the real world—made of real people, places, and social relations.

Keywords: Bosnia, cyber villages, digital diaspora, refugees

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Authors: K. C. Wong, K. L. Siu, S. N. Ng, K. N. Yip, Y. Y. Yuen, K. W. Lee, K. W. Wong, C. C. Li, H. P. Lam

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Background: Occupational injuries among nursing profession were found related to repeated bedside nursing care, such as transfer, lifting and manual handling patients from previous studies. Likewise, undergraduate nursing students are also exposed to potential safety hazard due to their similar work nature of registered nurses. Especially, those students who worked as Temporary undergraduate nursing students (TUNS) which is a part-time clinical job in hospitals in Hong Kong who mainly assisted in providing bedside cares appeared to at high risk of work-related injuries. Several studies suggested the level of compliance with safe work behaviors was highly associated with work-related injuries. Yet, it had been limitedly studied among nursing students. This study was conducted to assess and compare the compliance with safe work behaviors and the levels of awareness of different workplace safety issues between undergraduate nursing students with or without TUNS experiences. Methods: This is a quantitative descriptive study using convenience sampling. 362 undergraduate nursing students in Hong Kong were recruited. The Safe Work Behavior relating to Patient Handling (SWB-PH) was used to assess their compliance of safe-work behaviors and the level of awareness of different workplace safety issues. Results: The results showed that most of the participants (n=250, 69.1%) who were working as TUNS. However, students who worked as TUNS had significantly lower safe-work behaviors compliance (mean SWB-PH score = 3.64±0.54) than those did not worked as TUNS (SWB-PH score=4.21±0.54) (p<0.001). Particularly, these students had higher awareness to seek help and use assistive devices but lower awareness of workplace safety issues and awareness of proper work posture than students without TUNS experiences. The students with TUNS experiences had higher engagement in help-seeking behaviors might be possibly explained by their richer clinical experiences which served as a facilitator to seek help from clinical staff whenever necessary. Besides, these experienced students were more likely to bear risks for occupational injuries and worked alone when no available aid which might be related to the busy working environment, heightened work pressures and high expectations of TUNS. Eventually, students who worked as TUNS might target on completing the assigned tasks and gradually neglecting the occupational safety. Conclusion: The findings contributed to an understanding of the level of compliance with safe work behaviors among nursing students with different clinical experiences. The results might guide the modification of current safety protocols and the introduction of multiple clinical training courses to improve nursing student’s engagement in safe work behaviors.

Keywords: Occupational safety, Safety compliance, Safe-work behavior, Nursing students

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Authors: Amani K. Abu-Shaheen, Abdullah Nofal, Humariya Heena

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Introduction: Parental perceptions and practices are important for improving the asthma outcomes in children; indeed, evidence shows that parents of asthmatic children harbor considerable misperceptions of the disease. Objective: To identify the prevalence of asthma and to investigate the perceptions and practices of parents toward asthma and its management in Saudi children. Methods: A two-stage cross-sectional survey of 2000 parents of children aged 3–15 years from schools located in all five districts of Riyadh province located in central Saudi Arabia, was conducted. Data collection was accomplished using a self-administered questionnaire based on information obtained from the literature. Results: Of 1450 children whose parents participated in the study, 600 had asthma, dyspnea, or chest allergy. The overall number of children with parental reports of ever having been diagnosed with asthma was 478 (32.9%). The majority of parents (321, 53.5%) believed that asthma was a hereditary disease. Of these parents, 361 (60.3%) were concerned about side effects of inhaled steroids, and 192 (32%) about development of dependency on asthma medications. Three hundred sixty seven (61.2%) parents reported that they could treat the asthma attack at home and almost 76% of parents went to pediatric emergency department during asthma attack. Conclusions: In this study, the overall prevalence of children whose parents reported that they were diagnosed with asthma was high (32.9%). Furthermore, parents of children with asthma had misperceptions regarding asthma and exhibited ineffective practices in its management. To improve asthma care and compliance, adequate education should be provided to parents.

Keywords: asthma, management, parents, quality of life

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Authors: Majid Shahbazi

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Subclavian artery stenosis (SAS) is a common vascular disease that can cause a range of symptoms, from arm fatigue and weakness to ischemic stroke. Revascularization procedures, such as percutaneous transluminal angioplasty and stenting, are widely used to treat SAS and improve blood flow to the affected arm. However, the optimal management of patients with SAS is still unclear, and further research is needed to evaluate the safety and efficacy of different treatment options. This study aims to investigate the characteristics of patients with SAS who underwent revascularization procedures in Latvia (Specifically RAKUS). The research part of this paper aims to describe and analyze the demographics, comorbidities, diagnostic methods, types of revascularization procedures, and antiaggregant therapy used. The goal of this study is to provide insights into the current clinical practice in Latvia and help future treatment decision-makers. To achieve this aim, a retrospective study of 76 patients with SAS who underwent revascularization procedures was performed. After statistical analysis of the data, the study provided insights into the characteristics and management of patients with SAS in Latvia, highlighting the most observed comorbidities in these patients, the preferred diagnostic methods, and the most performed procedures. These findings can inform clinical decision-making and may have implications for the management of patients with subclavian artery stenosis in Latvia.

Keywords: subclavian artery stenosis, revascularization, characteristics of patients, comorbidities, retrospective analysis

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Authors: Manuela Nayantara Jeyaraj

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Green IT is a term that refers to the collective strategic and tactical practices that unswervingly condense the carbon footprint to a diminished proportion in an establishment’s computing procedures. This concept has been tightly knit with IT related organizations; hence it has been precluded to be applied within non-IT organizations in Sri Lanka. With the turn of the century, computing technologies have taken over commonplace activities in every nook and corner in Sri Lanka, which is still on the verge of moving forth in its march towards being a developed country. Hence, it needs to be recursively proven that non-IT industries are well-bound to adhere to ‘Green IT’ practices as well, in order to reduce their carbon footprint and move towards considering the practicality of implementing Green-IT practices within their work-arounds. There are several spheres that need to be taken into account in creating awareness of ‘Green IT’, such as the economic breach, technologies available, legislative bounds, community mind-set and many more. This paper tends to reconnoiter causes that currently restrain non-IT organizations from considering Green IT concepts. By doing so, it is expected to prove the beneficial providence gained by implementing this concept within the organization. The ultimate goal is to propose feasible ‘Green IT’ practices that could be implemented within the context of Sri Lankan non-IT sectors in order to ensure that organization’s sustainable growth towards a long term existence.

Keywords: computing practices, Green IT, non-IT industries, Sri Lanka, sustainability

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Authors: Ramona Moldovan, Doina Cosman, Sebastian Moldovan, Radu Popp, Victor Pop

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MENTALICA is a project aimed at developing and evaluating a platform that can assist individuals diagnosed with severe mental disorders and their families in managing the consequences associated with severe mental disorders, recurrence risks, prevention strategies and treatment options. MENTALICA is a platform based on guidance issued by some of the most prominent scientific organizations in the world. In order to personalize the information provided, the program explores details about the personal and family history of mental disorders. MENTALICA summarizes the answers and gives respondents a personal assessment. This includes personalized information and support about schizophrenia, bipolar disorder and schizoaffective disorder. MENTALICA includes several modules: Family history tools, Risk assessment tools and Risk factor sheets, Practical guides for patients, Practical guides for families, Guidelines for clinicians. Currently, there are no available guidelines for genetic counselling for mental disorders. Respondents can print out their reports and discuss them with family members or their doctors. We will briefly present the current status of MENTALICA and its implications for patients, professionals and the community.

Keywords: genetic counseling, mental disorders, platform

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Authors: Kemal Izci

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Assessment forms an important part of instruction. Assessment that aims to support learning is known as formative assessment and it contributes student’s learning gain and motivation. However, teachers rarely use assessment formatively to aid their students’ learning. Thus, reviewing the factors that limit or support teachers’ practices of formative assessment will be crucial for guiding educators to support prospective teachers in using formative assessment and also eliminate limiting factors to let practicing teachers to engage in formative assessment practices during their instruction. The study, by using teacher’s change environment framework, reviews literature on formative assessment and presents a tentative model that illustrates the factors impacting teachers’ adoption of formative assessment in their teaching. The results showed that there are four main factors consisting personal, contextual, resource-related and external factors that influence teachers’ practices of formative assessment.

Keywords: assessment practices, formative assessment, teacher education, factors for use of formative assessment

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Authors: Derwin K. C. Chan, Alfred S. Y. Lee

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The integrated model of self-determination theory and the theory of planned behaviour has been successfully applied to explain individuals’ adherence to health behaviours, including behavioural adherence toward rehabilitation. This study was a randomised controlled trial that examined the effectiveness of an mHealth intervention (i.e., mobile application) developed based on this integrated model in promoting treatment adherence of patients of anterior cruciate ligament rupture during their post-surgery home-based rehabilitation period. Subjects were 67 outpatients (aged between 18 and 60) who undertook anterior cruciate ligament (ACL) reconstruction surgery for less than 2 months for this study. Participants were randomly assigned either into the treatment group (who received the smartphone application; N = 32) and control group (who receive standard treatment only; N = 35), and completed psychological measures relating to the theories (e.g., motivations, social cognitive factors, and behavioural adherence) and clinical outcome measures (e.g., subjective knee function (IKDC), laxity (KT-1000), muscle strength (Biodex)) relating to ACL recovery at baseline, 2-month, and 4-month. Generalise estimating equation showed the interaction between group and time was significant on intention was only significant for intention (Wald x² = 5.23, p = .02), that of perceived behavioural control (Wald x² = 3.19, p = .07), behavioural adherence (Wald x² = 3.08, p = .08, and subjective knee evaluation (Wald x² = 2.97, p = .09) were marginally significant. Post-hoc between-subject analysis showed that control group had significant drop of perceived behavioural control (p < .01), subjective norm (p < .01) and intention (p < .01), behavioural adherence (p < .01) from baseline to 4-month, but such pattern was not observed in the treatment group. The treatment group had a significant decrease of behavioural adherence (p < .05) in the 2-month, but such a decrease was not observed in 4-month (p > .05). Although the subjective knee evaluation in both group significantly improved at 2-month and 4-month from the baseline (p < .05), and the improvements in the control group (mean improvement at 4-month = 40.18) were slightly stronger than the treatment group (mean improvement at 4-month = 34.52). In conclusion, the findings showed that the theory driven mobile application ameliorated the decline of treatment intention of home-based rehabilitation. Patients in the treatment group also reported better muscle strength than control group at 4-month follow-up. Overall, the mobile application has shown promises on tackling the problem of orthopaedics outpatients’ non-adherence to medical treatment.

Keywords: self-determination theory, theory of planned behaviour, mobile health, orthopaedic patients

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Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani

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Background: The TP53 mutation is frequently detected in acute myeloid leukemia (AML) patients with complex karyotype (CK), but the stability of this mutation during the clinical course remains unclear. Material and Methods: In this study, TP53 mutations were identified in 7% of 500 patients with de novo AML and 58.8% of patients with CK in Tabriz, Iran. TP53 mutations were closely associated with older age, lower white blood cell (WBC) and platelet counts, FAB M6 subtype, unfavorable-risk cytogenetics, and CK, but negatively associated with NPM1 mutation, FLT3/ITD and DNMT3A mutation. Result: Multivariate analysis demonstrated that TP53 mutation was an independent poor prognostic factor for overall survival and disease-free survival among the total cohort and the subgroup of patients with CK. A scoring system incorporating TP53 mutation and nine other prognostic factors, including age, WBC counts, cytogenetics, and gene mutations, into survival analysis proved to be very useful to stratify AML patients. Sequential study of 420 samples showed that TP53 mutations were stable during AML evolution, whereas the mutation was acquired only in 1 of the 126 TP53 wild-type patients when therapy-related AML originated from different clone emerged. Conclusion: In conclusion, TP53 mutations are associated with distinct clinic-biological features and poor prognosis in de novo AML patients and are rather stable during disease progression.

Keywords: acute myloblastic leukemia, TP53, FLT3/ITD, Iran

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Authors: Markus Feufel, Friederike Kendel, Caren Hilger, Selamawit Woldai

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Since the corona pandemic, the use of video consultation has increased remarkably. For vulnerable groups such as oncological patients, the advantages seem obvious. But how does video consultation potentially change the doctor-patient relationship compared to face-to-face consultation? Which barriers may hinder the effective use of this consultation format in practice? We are presenting first results from a mixed-methods field study, funded by Federal Ministry of Health, which will provide the basis for a hands-on guide for both physicians and patients on how to improve the quality of video consultations. We use a quasi-experimental design to analyze qualitative and quantitative differences between face-to-face and video consultations based on video recordings of N = 64 actual counseling sessions (n = 32 for each consultation format). Data will be recorded from n = 32 gynecological and n = 32 urological cancer patients at two clinics. After the consultation, all patients will be asked to fill out a questionnaire about their consultation experience. For quantitative analyses, the counseling sessions will be systematically compared in terms of verbal and nonverbal communication patterns. Relative frequencies of eye contact and the information exchanged will be compared using 𝝌2 -tests. The validated questionnaire MAPPIN'Obsdyad will be used to assess the expression of shared decision-making parameters. In addition, semi-structured interviews will be conducted with n = 10 physicians and n = 10 patients experienced with video consultation, for which a qualitative content analysis will be conducted. We will elaborate the comprehensive methodological approach we used to compare video vs. face-to-face consultations and present first evidence on how video consultations change the doctor-patient interaction. We will also outline possible barriers of video consultations and best practices on how they may be overcome. Based on the results, we will present and discuss recommendations outlining best practices for how to prepare and conduct high-quality video consultations from the perspective of both physicians and patients.

Keywords: video consultation, patient-doctor-relationship, digital applications, technical barriers

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Authors: Jeffrey Ho, Scott Joing, Paul Nystrom, William Heegaard, Danielle Hart, David Plummer, James Miner

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Body-Worn Cameras (BWCs) are used in public safety to record encounters. They are shown to enhance the accuracy of documentation in virtually every situation. They are not widely used in medical encounters in part because of concern for patient acceptance. The goal of this pilot study was to determine if BWC use is acceptable to the patient. This was a prospective, observational study of the AXON Flex BWC (TASER International, Scottsdale, AZ) conducted at an urban, Level 1 Trauma Center Emergency Department (ED). The BWC was worn by Emergency Physicians (EPs) on their shifts during a 30-day period. The BWC was worn at eye-level mounted on a pair of clear safety glasses. Patients seen by the EP were enrolled in the study by a trained research associate. Patients who were <18 years old, who were with other people in the exam room, did not speak English, were critically ill, had chief complaints involving genitalia or sexual assault, were considered to be vulnerable adults, or with an altered mental status were excluded. Consented patients were given a survey after the encounter to determine their perception of the BWC. The questions asked involved the patients’ perceptions of a BWC being present during their interaction with their EP. Data were analyzed with descriptive statistics. There were 417 patients enrolled in the study. 3/417 (0.7%) patients were intimidated by the BWC, 1/417 (0.2%) was nervous because of the BWC, 0/417 (0%) were inhibited from telling the EP certain things because of the BWC, 57/417 (13.7%) patients did not notice the device, and 305/417 (73.1%) patients were had a favorable perception about the BWC being used during their encounter. The use of BWCs appears feasible in the ED, with largely favorable perceptions and acceptance of the device by the patients. Further study is needed to determine the best use and practices of BWCs during ED patient encounters.

Keywords: body-worn camera, documentation, patient satisfaction, video

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Authors: Bharti Chogtu Magazine, Dhanya Soodana Mohan, Shruti Nair, Tanwi Trushna

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The study was undertaken to analyse the cardiovascular drugs being prescribed in patients with concomitant reactive airway disease and hypertension or ischemic heart diseases (IHD). Also, the effect of beta-blockers on respiratory symptoms in these patients was recorded. Data was collected from medical records of patients with reactive airway disease and concomitant hypertension and IHD. It included demographic details of the patients, diagnosis, drugs prescribed and the patient outcome regarding the exacerbation of asthma symptoms with intake of beta blockers. Medical records of 250 patients were analysed.13% of patients were prescribed beta-blockers. 12% of hypertensive patients, 16.6% of IHD patients and 20% of patients with concomitant hypertension and IHD were prescribed beta blockers. Of the 33 (13%) patients who were on beta-blockers, only 3 patients had an exacerbation of bronchial asthma symptoms. Cardioselective beta-blockers under supervision appear to be safe in patients with reactive airway disease and concomitant hypertension and IHD.

Keywords: beta blockers, hypertension, ischemic heart disease, asthma

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Authors: Ayala Kobo-Greenhut, Amos Notea, Izhar Ben-Shlomo

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In R&D projects, there is no doubt about the need to change a current concept to an alternative one over time (i.e., concept leaping). Concept leaping is required since with most R&D projects uncertainty is present as they take place in dynamic environments. Despite the importance of concept leaping when needed, R&D teams may fail to do so (i.e., frozen concept). This research suggests a possible reason why frozen concept happens in the framework of quality engineering and control engineering. We suggest that frozen concept occurs since concept determines the derived plan and its implementation may be considered as equivalent to a closed-loop process, and is subject to the problem of not recognizing gaps as failures. We suggest that although implementing quality practices into an R&D project’s routine has many advantages, it intensifies the frozen concept problem since working according to quality practices relates to exploitation of learning behavior, while leaping to a new concept relates to exploring learning behavior.

Keywords: closed loop, control engineering, design, leaping, frozen concept, quality engineering, quality practices

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Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

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Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

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