Search results for: post grouting
3778 A Case Study on Post-Occupancy Evaluation of User Satisfaction in Higher Educational Buildings
Authors: Yuanhong Zhao, Qingping Yang, Andrew Fox, Tao Zhang
Abstract:
Post-occupancy evaluation (POE) is a systematic approach to assess the actual building performance after the building has been occupied for some time. In this paper, a structured POE assessment was conducted using the building use survey (BUS) methodology in two higher educational buildings in the United Kingdom. This study aims to help close the building performance gap, provide optimized building operation suggestions, and to improve occupants’ satisfaction level. In this research, the questionnaire survey investigated the influences of environmental factors on user satisfaction from the main aspects of building overall design, thermal comfort, perceived control, indoor environment quality for noise, lighting, ventilation, and other non-environmental factors, such as the background information about age, sex, time in buildings, workgroup size, and so on. The results indicate that the occupant satisfaction level with the main aspects of building overall design, indoor environment quality, and thermal comfort in summer and winter on both two buildings, which is lower than the benchmark data. The feedback of this POE assessment has been reported to the building management team to allow managers to develop high-performance building operation plans. Finally, this research provided improvement suggestions to the building operation system to narrow down the performance gap and improve the user work experience satisfaction and productivity level.Keywords: building performance assessment systems, higher educational buildings, post-occupancy evaluation, user satisfaction
Procedia PDF Downloads 1473777 The Study of the Perspectives on Economic Development in Bilateral Investment Treaties
Authors: Anuj Kumar Vaksha
Abstract:
In the post cold war era the foreign direct investments have come to be considered as one of the most critical factors for economic development of a country particularly for the capital scarce countries like the developing and the under developed countries. The rush for foreign direct investments have led to intense competition between the countries treaties to attract foreign investments by entering into alluring Bilateral Investment Treaties (BITs). The Bilateral Investment Treaties are the intergovernmental legal framework for the promotion of private investments from one country to other. With more than 3000 BITs, the web of such BITs are the most dominant development of International Law in the post cold war era. The essence of all these BITs are bilateral cooperation for economic development and thus it is actually the theme of economic development around which the International Law had developed most dominantly in the post cold war era. Within the framework of two generally accepted premises that foreign direct investments are critical for economic development and the bilateral investment treaties are critical for promotion of foreign direct investments, the research paper seeks to explore the perspectives and paradigms on economic development as embodied in various Bilateral Investment Treaties. It seeks to address how and in what manners the perspectives on economic development as embodied in bilateral investment varies between the developed, developing and underdeveloped countries. It goes without saying that economic development is a very broad, complex and operationally intricate concept. In the paradigm of International Law it becomes much more complex and intricate. Understanding the concept of economic development from the perspectives of Bilateral Investment Treaties is a novel idea with far reaching significance. Such a perspective on economic development would help in enriching the contemporary International Law perspectives and paradigms on economic development.Keywords: bilateral investment treaties, economic development, international Law, perspectives
Procedia PDF Downloads 3203776 Thulium Laser Vaporisation and Enucleation of Prostate in Patients on Anticoagulants and Antiplatelet Agents
Authors: Abdul Fatah, Naveenchandra Acharya, Vamshi Krishna, T. Shivaprasad, Ramesh Ramayya
Abstract:
Background: Significant number of patients with bladder outlet obstruction due to BPH are on anti-platelets and anticoagulants. Prostate surgery in this group of patients either in the form of TURP or Open prostatectomy is associated with increased risk of bleeding complications requiring transfusions, packing of the prostatic fossa or ligation or embolization of internal iliac arteries. Withholding of antiplatelets and anticoagulants may be associated with cardiac and other complications. Efficacy of Thulium Laser in the above group of patients was evaluated in terms of peri-operative, postoperative and delayed bleeding complications as well as cardiac events in peri-operative and immediate postoperative period. Methods: 217 patients with a mean age of 68.8 years were enrolled between March 2009 and March 2013 (36 months), and treated for BPH with ThuLEP. Every patient was evaluated at base line according to: Digital Rectal Examination (DRE), prostate volume, Post-Voided volume (PVR), International Prostate Symptoms Score (I-PSS), PSA values, urine analysis and urine culture, uroflowmetry. The post operative complications in the form of drop in hemoglobin level, transfusion rates, post –operative cardiac events within a period of 30 days, delayed hematuria and events like deep vein thrombosis and pulmonary embolism were noted. Results: Our data showed a better post-operative outcome in terms of, postoperative bleeding requiring intervention 7 (3.2%), transfusion rate 4 (1.8%) and cardiac events within a period of 30 days 4(1.8%), delayed hematuria within 6 months 2(0.9 %) compared other series of prostatectomies. Conclusion: The thulium LASER prostatectomy is a safe and effective option for patients with cardiac comorbidties and those patients who are on antiplatelet agents and anticoagulants. The complication rate is less as compared to larger series reported with open and transurethral prostatectomies.Keywords: thulium laser, prostatectomy, antiplatelet agents, bleeding
Procedia PDF Downloads 3893775 The Relationship Between Exposure to Traumatic Events in the Delivery Room, Post-Traumatic Stress Symptoms, Personal Resilience, Organizational Commitment, and Professional Quality of Life Among Midwives
Authors: Kinneret Segal
Abstract:
Background: The work of a midwife is emotionally challenging, both positively and negatively. Midwives share moments of joy when a baby is welcomed into the world and also attend difficult events of loss and trauma. The relationship that develops with the maternity is the essence of the midwife's care, and it is a fundamental source of motivation and professional satisfaction. This close relationship with the maternity may be used as a double-edged sword in cases of exposure to traumatic events at birth. Birth problems, exposure to emergencies and traumatic events, and loss can affect the professional quality of life and the Compassion satisfaction of the midwife. It seems that the issue of traumatic experiences in the work of midwives has not been sufficiently explored. Aim: The present study examined the associations between exposure to traumatic events, personal resilience and post-traumatic symptoms, professional quality of life, and organizational commitment among midwifery nurses in Israeli hospitals. Methods: 131 midwives from three hospitals in the country's center in Israel participated in this study. The data were collected during 2021 using a self-report questionnaire that examined sociodemographic characteristics, the degree of exposure to traumatic events in the delivery room, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. Results: The three most difficult traumatic events for the midwives were death or fear of death of a newborn, death or fear of the death of a mother, and a quiet birth. The higher the frequency of exposure to traumatic events, the more numerous and intense the onset of post-trauma symptoms. The more numerous and powerful the post-trauma symptoms, the higher the level of professional burnout and/or compassion fatigue, and the lower the level of compassion satisfaction. High levels of compassion satisfaction and/or low professional burnout were expressed in a heightened sense of organizational commitment. Personal resilience, country of birth, traumatic symptoms, and organizational commitment predicted satisfaction from compassion. Conclusions: Midwives are exposed to traumatic events associated with dissatisfaction and impairment of the professional quality of life that accompanies burnout and compassion fatigue. Exposure to traumatic events leads to the appearance of traumatic symptoms, a decrease in organizational commitment, and psychological and mental well-being. The issue needs to be addressed by implementing training programs, organizational support, and policies to improving well-being and quality of care among midwives.Keywords: organizational commitment, traumatic experiences, personal resilience, quality of life
Procedia PDF Downloads 1083774 Effect of Resistance Training on Muscle Strength, IGF₁, and Physical Performance of Volleyball Players
Authors: Menan M. Elsayed, Hussein A. Heshmat
Abstract:
The aim of the study is to assess the effect of resistance training on muscle strength and physical performance of volleyball players of Physical Education College, Helwan University. The researcher used the experimental method of pre-post measurements of one group of 10 volleyball players. The execution of the program was through the period of 12/8/2018 to 12/10/2018; included 24 training units, 3 training units weekly for 8 weeks. The training program revealed an improvement in post measurement of muscle strength, IGF₁ (insulin-like growth factor 1), and physical performance of players. It may be concluded that the resistance training may include changes in hormones and muscle fibers leading to hypertrophy of the muscle and physical performance. It is recommended to use the results of the study in rationing the loads and training programs.Keywords: IGF₁, muscle strength, physical performance, resistance training, volleyball players
Procedia PDF Downloads 1873773 Migration and Identity Erosion: An Exploratory Study of First Generation Nigerian-Americans
Authors: Lolade Siyonbola
Abstract:
Nigerians are often celebrated as being the most educated cultural group in America. The cultural values and history that have led to this reality are particular to a generation that came of age post colonialism. Many of these cultural values have been passed down from post-colonial parent to millennial child, but most have not. This study, based on interviews and surveys of Nigerian millennials and their parents in the United States, explores the degree to which identity has been eroded in the millennial generation due to a lack of imparted cultural values and knowledge from the previous generation. Most of the subjects do not speak their native language or identify with their cultural heritage sufficiently to build ties with their native land. Most are experiencing some degree of identity crisis, and therefore limited self-actualization, with little to no support; as there are few successful tools available to this population. If governmental programs to reverse these trends are not implemented within this generation, the implications to the individual, family and home nation (Nigeria), will be felt for generations to come.Keywords: identity, culture, self-actualization, social identity theory, migration, transnationalism, value systems
Procedia PDF Downloads 3653772 Immature Platelet Fraction and Immature Reticulocyte Fraction as Early Predictors of Hematopoietic Recovery Post Stem Cell Transplantation
Authors: Aditi Mittal, Nishit Gupta, Tina Dadu, Anil Handoo
Abstract:
Introduction: Hematopoietic stem cell transplantation (HSCT) is a curative treatment done for hematologic malignancies and other clinical conditions. Its main objective is to reconstitute the hematopoietic system of the recipient by administering an infusion of donor hematopoietic stem cells. Transplant engraftment is the first sign of bone marrow recovery. The main objective of this study is to assess immature platelet fraction (IPF) and immature reticulocyte fraction (IRF) as early indicators of post-hematopoietic stem cell transplant engraftment. Methods: Patients of all age groups and both genders undergoing both autologous and allogeneic transplants were included in the study. All the CBC samples were run on Mindray CAL-8000 (BC-6800 plus; Shenzhen, China) analyser and assessed for IPF and IRF. Neutrophil engraftment was defined as the first of three consecutive days with an ANC >0.5 x 109/L and platelet engraftment with a count >20 x 109/L. The cut-off values for IRF were calculated as 13.5% with a CV of 5% and for IPF was 19% with a CV of 12%. Results: The study sample comprised 200 patients, of whom 116 had undergone autologous HSCT, and 84 had undergone allogeneic HSCT. We observed that IRF anticipated the neutrophil recovery by an average of 5 days prior to IPF. Though there was no significant variation in IPF and IRF for the prediction of platelet recovery, IRF was preceded by 1 or 2 days to IPF in 25% of cases. Conclusions: Both IPF and IRF can be used as reliable parameters as predictors for post-transplant engraftment; however, IRF seems to be more reliable than IPF as a simple, inexpensive, and widely available tool for predicting marrow recovery several days before engraftment.Keywords: transplantation, stem cells, reticulocyte, engraftment
Procedia PDF Downloads 823771 Numerical and Experimental Analysis of Stiffened Aluminum Panels under Compression
Authors: Ismail Cengiz, Faruk Elaldi
Abstract:
Within the scope of the study presented in this paper, load carrying capacity and buckling behavior of a stiffened aluminum panel designed by adopting current ‘buckle-resistant’ design application and ‘Post –Buckling’ design approach were investigated experimentally and numerically. The test specimen that is stabilized by Z-type stiffeners and manufactured from aluminum 2024 T3 Clad material was test under compression load. Buckling behavior was observed by means of 3 – dimensional digital image correlation (DIC) and strain gauge pairs. The experimental study was followed by developing an efficient and reliable finite element model whose ability to predict behavior of the stiffened panel used for compression test is verified by compering experimental and numerical results in terms of load – shortening curve, strain-load curves and buckling mode shapes. While finite element model was being constructed, non-linear behaviors associated with material and geometry was considered. Finally, applicability of aluminum stiffened panel in airframe design against to composite structures was evaluated thorough the concept of ‘Structural Efficiency’. This study reveals that considerable amount of weight saving could be gained if the concept of ‘post-buckling design’ is preferred to the already conventionally used ‘buckle resistant design’ concept in aircraft industry without scarifying any of structural integrity under load spectrum.Keywords: post-buckling, stiffened panel, non-linear finite element method, aluminum, structural efficiency
Procedia PDF Downloads 1373770 Self‑reported Auditory Problems Are Associated with Adverse Mental Health Outcomes and Alcohol Misuse in the UK Armed Forces
Authors: Fred N. H. Parker, Nicola T. Fear, S. A. M. Stevelink, L. Rafferty
Abstract:
Purpose Auditory problems, such as hearing loss and tinnitus, have been associated with mental health problems and alcohol misuse in the UK general population and in the US Armed Forces; however, few studies have examined these associations within the UK Armed Forces. The present study examined the association between auditory problems and probable common mental disorders, post-traumatic stress disorder and alcohol misuse. Methods 5474 serving and ex-service personnel from the UK Armed Forces were examined, selected from those who responded to phase two (data collection 2007–09) and phase three (2014–16) of a military cohort study. Multivariable logistic regression was used to examine the association between auditory problems at phase two and mental health problems at phase three. Results 9.7% of participants reported ever experiencing hearing problems alone, 7.9% reported tinnitus within the last month alone, and 7.8% reported hearing problems with tinnitus. After adjustment, hearing problems with tinnitus at phase two was associated with increased odds of probable common mental disorders (AOR = 1.50, 95% CI 1.09–2.08), post-traumatic stress disorder (AOR = 2.30, 95% CI 1.41–3.76), and alcohol misuse (AOR = 1.94, 95% CI 1.28–2.96) at phase three. Tinnitus alone was associated with probable post-traumatic stress disorder (AOR = 1.80, 95% CI 1.03–3.15); however, hearing problems alone were not associated with any outcomes of interest. Conclusions The association between auditory problems and mental health problems emphasizes the importance of the prevention of auditory problems in the Armed Forces: through enhanced audiometric screening, improved hearing protection equipment, and greater levels of utilization of such equipment.Keywords: armed forces, hearing problems, tinnitus, mental health, alcohol misuse
Procedia PDF Downloads 1593769 Post-Traumatic Stress Disorder: Management at the Montfort Hospital
Authors: Kay-Anne Haykal, Issack Biyong
Abstract:
The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.Keywords: post-traumatic stress disorder, co-morbidities, diagnosis, mental health disorders
Procedia PDF Downloads 3763768 Best Practice for Post-Operative Surgical Site Infection Prevention
Authors: Scott Cavinder
Abstract:
Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery
Procedia PDF Downloads 763767 Effects of EMS on Foot Drop Associated with Grade III Wound: A Case Report
Authors: Mirza Obaid Baig, MaimoonaYaqub
Abstract:
A 51 year old lady; known case of diabetes mellitus, post wound debridement i.e. 4 open wounds of grade III presented to us with foot drop, with prominent sensory deficit over right lower leg/foot i.e. 0 on Nottingham scale for impaired sensation, marked pedal edema and 5/10 – 6/10 pain on VAS during day and night respectively, Wounds were poorly granulated and foul smelling. Physiotherapy sessions were planned including twice a day electrical muscle stimulation sessions, strategies to decrease edema and improve muscle action which resulted in noticeable improvement in motor and sensory ability, pain levels, edema and psychological status of patient. Thus, this study gives evidence of the effect of Electrical muscle stimulation in grade III open wounds associated with motor/sensory weakness post-surgery.Keywords: EMS, foot drop, grade III wound, diabetes mellitus
Procedia PDF Downloads 4133766 Augmentation of Conventional Medicine for Post-concussion Syndrome with Cognitive Behavioral Therapy Accelerates Symptomatic Relief in Affected Individuals
Authors: Waqas Mehdi, Muhammad Umar Hassan, Khadeeja Mustafa
Abstract:
Objective: Post-concussion syndrome (PCS) is a medical term used to point out the complicated combination of physical, emotional, cognitive and behavioral signs and symptoms associated with Mild Traumatic Brain Injury(mTBI). This study was conducted to assess the improvement or debilitating effect of behavioral therapy in addition to the conventional treatment and to document these results for increasing the efficiency of treatment provided to such cases. Method: This was primarily an interventional prospective cohort study which was conducted in the Department of Neurosurgery, Mayo Hospital Lahore. The sample size was 200 patients who were randomly distributed into two groups. The interventional group with Cognitive behavioral therapy was added in addition to the conventional treatment regimen and the Control group receiving only conventional treatment. Results were noted initially as well as after two weeks of the follow-up period. Data were subsequently analyzed by Statistical Package for Social Sciences (SPSS) software and associations worked out. Result and conclusion: Among the patients that were given therapy sessions along with conventional medicine, there was a significant improvement in the symptoms and their overall quality of life. It is also important to notice that the time period taken for these effects to wane is cut down by psychiatric solutions too. So we can conclude that CBT sessions not only speed up recovery in patients with post-concussion syndrome they also aid in the efficiency improvement in functional capability and quality of life.Keywords: neurosurgery, CBT, PCS, mTBI
Procedia PDF Downloads 1613765 A Control Model for the Dismantling of Industrial Plants
Authors: Florian Mach, Eric Hund, Malte Stonis
Abstract:
The dismantling of disused industrial facilities such as nuclear power plants or refineries is an enormous challenge for the planning and control of the logistic processes. Existing control models do not meet the requirements for a proper dismantling of industrial plants. Therefore, the paper presents an approach for the control of dismantling and post-processing processes (e.g. decontamination) in plant decommissioning. In contrast to existing approaches, the dismantling sequence and depth are selected depending on the capacity utilization of required post-processing processes by also considering individual characteristics of respective dismantling tasks (e.g. decontamination success rate, uncertainties regarding the process times). The results can be used in the dismantling of industrial plants (e.g. nuclear power plants) to reduce dismantling time and costs by avoiding bottlenecks such as capacity constraints.Keywords: dismantling management, logistics planning and control models, nuclear power plant dismantling, reverse logistics
Procedia PDF Downloads 2983764 The Effects of a Nursing Dignity Care Program on Patients’ Dignity in Care
Authors: Yea-Pyng Lin
Abstract:
Dignity is a core element of nursing care. Maintaining the dignity of patients is an important issue because the health and recovery of patients can be adversely affected by a lack of dignity in their care. The aim of this study was to explore the effects of a nursing dignity care program upon patients’ dignity in care. A quasi-experimental research design was implemented. Nurses were recruited by purposive sampling, and their patients were recruited by simple random sampling. Nurses in the experimental group received the nursing educational program on dignity care, while nurses in the control group received in-service education as usual. Data were collected via two instruments: the dignity in care scale for nurses and the dignity in care scale to patients, both of which were developed by the researcher. Both questionnaires consisted of three domains: agreement, importance, and frequencies of providing dignity care. A total of 178 nurses in the experimental group and 193 nurses in the control group completed the pretest and the follow-up evaluations at the first month, the third month, and the sixth month. The number of patients who were cared for by the nurses in the experimental group was 94 in the pretest. The number of patients in the post-test at the first, third, and sixth months were 91, 85, and 77, respectively. In the control group, 88 patients completed the II pretest, and 80 filled out the post-test at the first month, 77 at the third, and 74 at the sixth month. The major findings revealed the scores of agreement domain among nurses in the experimental group were found significantly different from those who in the control group at each point of time. The scores of importance domain between these two groups also displayed significant differences at pretest and the first month of post-test. Moreover, the frequencies of proving dignity care to patients were significant at pretest, the third month and sixth month of post-test. However, the experimental group had only significantly different from those who in the control group on the frequencies of receiving dignity care especially in the items of ‘privacy care,’ ‘communication care,’ and ‘emotional care’ for the patients. The results show that the nursing program on dignity care could increase nurses’ dignity care for patients in three domains of agreement, importance, and frequencies of providing dignity care. For patients, only the frequencies of receiving dignity care were significantly increased. Therefore, the nursing program on dignity care could be applicable for nurses’ in-service education and practice to enhance the ability of nurses to care for patient’s dignity.Keywords: nurses, patients, dignity care, quasi-experimental, nursing education
Procedia PDF Downloads 4613763 The Influence of COVID-19 Pandemic: Global Policies Towards Chinese International Students
Authors: Xuefan Li, Donghua Li, Juanjuan Li
Abstract:
This study explores the changes in policies toward Chinese students studying abroad in different countries during the pre-pandemic, pandemic, and post-pandemic periods. Interviews and questionnaire surveys were conducted with participating institutions at the China International Education Exhibition. The results indicate that institutions were impacted by the pandemic differently, with a gradual recovery in the two years following the initial outbreak. Institutions encourage and support Chinese students to resume offline studies during the post-pandemic period. The impact of the pandemic on the recruitment of Chinese students by international institutions varied, with different measures being adopted by different institutions. Compared with universities, colleges were more affected in terms of student employment rates. Some institutions were able to respond quickly and effectively to the pandemic due to their online teaching platforms. Overall, this study is expected to provide insights into the changes in policies toward Chinese students studying abroad during the pandemic and highlights the diverse responses of international institutions.Keywords: international education, Chinese international education, COVID-19 pandemic, international institutions
Procedia PDF Downloads 813762 The Post-Confucian Korea: Destroying Hierarchies in Kim Yong Ha's "Oppa Came Back"
Authors: Steven D. Capener
Abstract:
The 1997 Asian financial crisis was a watershed event in Korea as it necessitated changes that begin an unravelling of many of the norms and traditions that had served to underpin society. Divorce skyrocketed; the era of lifetime employment was over; women came out the home to become, in many cases, the main breadwinners; competitive forces were exacerbated; and traditional sources of authority began to crumble. All of these changes weekend the power to structure human relations of the Confucian Three Bonds and Five Relationships (삼강오륜). Since then, this “de-confucianization” has only become more pronounced with women increasingly refusing to marry, partly in protest to what they perceive as entrenched gender inequality, married couples eschewing childbirth resulting in the lowest birthrate in the world, and diminishing inheritances eroding the traditionally strong sense of filial piety (효) of children toward parents. The result of all this can be seen in the continued weakening or outright crumbling of the hierarchies codified in the Three Bonds and Five Relationship, which have served as a social template in Korea for centuries. In his 2004 work “Oppa Came Back,” writer Kim Yong Ha depicts what he apparently sees as the “post-Confucian” family in a wickedly funny portrayal of what Korean society could look like if traditional bulwarks of prescriptive values suddenly collapse and are not replaced with tenable alternatives. In the short story, Kim subverts all the traditional hierarchies while leaving the desire to dominate these hierarchies intact. This produces the picture of a Korean family governed by the new values of money and physical power. After lying out what can be identified as major cultural changes in what could be called “traditional” society,” the article uses a close reading of Kim’s story for its implications regarding a possible new, dysfunctional version of Korean society. It seems apparent that Kim’s story is a cautionary tale of the pitfalls that lie athwart the late-modern Korean landscape. These changes have important implications in the areas of education and socio-political philosophy. The conclusion focuses on possible alternatives to this post-Confucian conundrum.Keywords: post-confucian, three bonds and five relationships, traditional society, hierarchies
Procedia PDF Downloads 613761 Screen Casting Instead of Illegible Scribbles: Making a Mini Movie for Feedback on Students’ Scholarly Papers
Authors: Kerri Alderson
Abstract:
There is pervasive awareness by post secondary faculty that written feedback on course assignments is inconsistently reviewed by students. In order to support student success and growth, a novel method of providing feedback was sought, and screen casting - short, narrated “movies” of audio visual instructor feedback on students’ scholarly papers - was provided as an alternative to traditional means. An overview of the teaching and learning experience as well as the user-friendly software utilized will be presented. This study covers an overview of this more direct, student-centered medium for providing feedback using technology familiar to post secondary students. Reminiscent of direct personal contact, the personalized video feedback is positively evaluated by students as a formative medium for student growth in scholarly writing.Keywords: education, pedagogy, screen casting, student feedback, teaching and learning
Procedia PDF Downloads 1133760 Effectiveness of Buteyko Method in Asthma Control and Quality of Life of School-Age Children
Authors: Romella C. Lina, Matthew Daniel V. Leysa, Zarah D. F. Libozada, Maria Francesca I. Lirio, Angelo A. Liwag, Gabriel D. Ramos, Margaret M. Natividad
Abstract:
This study aimed to determine the effectiveness of Buteyko Method in asthma control and quality of life of school-age children wherein a pretest-posttest design was utilized to measure the changes after the administration of Buteyko Method. Fourteen (14) subjects with bronchial asthma, aged 7-11 participated in the study. They were equally divided into two groups: the control group received no intervention while the experimental group was asked to attend sessions of Buteyko Method lecture and demonstration. The experimental group was visited for three (3) consecutive weeks to monitor their progress and compliance. Both groups were asked to answer ACQ pre- and post-intervention and PAQLQ before the start of the intervention phase and every week during the follow-up visits. In comparing the asthma control pre-test and post-test mean scores of the control group, no significant difference was noted (p=0.177) while the experimental group showed a significant difference after the administration of Buteyko Method (p=0.002). Moreover, the quality of life pre-test and post-test mean scores of the control group showed no significant difference in any week within one month of follow-up (p=0.736, 0.604, 0.689) while the experimental group showed a significant difference on the third week (p = 0.035) and fourth week (p=0.002) but no significant difference on the second week (p=0.111). Therefore, the use of Buteyko Method within 3-4 weeks as an adjunct to conventional management of asthma helps in improving asthma control and quality of life of school-age children.Keywords: Buteyko Method, asthma, school-age children, asthma control, quality of life
Procedia PDF Downloads 4113759 A Randomized Active Controlled Clinical Trial to Assess Clinical Efficacy and Safety of Tapentadol Nasal Spray in Moderate to Severe Post-Surgical Pain
Authors: Kamal Tolani, Sandeep Kumar, Rohit Luthra, Ankit Dadhania, Krishnaprasad K., Ram Gupta, Deepa Joshi
Abstract:
Background: Post-operative analgesia remains a clinical challenge, with central and peripheral sensitization playing a pivotal role in treatment-related complications and impaired quality of life. Centrally acting opioids offer poor risk benefit profile with increased intensity of gastrointestinal or central side effects and slow onset of clinical analgesia. The objective of this study was to assess the clinical feasibility of induction and maintenance therapy with Tapentadol Nasal Spray (NS) in moderate to severe acute post-operative pain. Methods: Phase III, randomized, active-controlled, non-inferiority clinical trial involving 294 cases who had undergone surgical procedures under general anesthesia or regional anesthesia. Post-surgery patients were randomized to receive either Tapentadol NS 45 mg or Tramadol 100mg IV as a bolus and subsequent 50 mg or 100 mg dose over 2-3 minutes. The frequency of administration of NS was at every 4-6 hours. At the end of 24 hrs, patients in the tramadol group who had a pain intensity score of ≥4 were switched to oral tramadol immediate release 100mg capsule until the pain intensity score reduced to <4. All patients who had achieved pain intensity ≤ 4 were shifted to a lower dose of either Tapentadol NS 22.5 mg or oral Tramadol immediate release 50mg capsule. The statistical analysis plan was envisaged as a non-inferiority trial involving comparison with Tramadol for Pain intensity difference at 60 minutes (PID60min), Sum of Pain intensity difference at 60 minutes (SPID60min), and Physician Global Assessment at 24 hrs (PGA24 hrs). Results: The per-protocol analyses involved 255 hospitalized cases undergoing surgical procedures. The median age of patients was 38.0 years. For the primary efficacy variables, Tapentadol NS was non-inferior to Inj/Oral Tramadol in relief of moderate to severe post-operative pain. On the basis of SPID60min, no clinically significant difference was observed between Tapentadol NS and Tramadol IV (1.73±2.24 vs. 1.64± 1.92, -0.09 [95% CI, -0.43, 0.60]). In the co-primary endpoint PGA24hrs, Tapentadol NS was non–inferior to Tramadol IV (2.12 ± 0.707 vs. 2.02 ±0.704, - 0.11[95% CI, -0.07, 0.28). However, on further assessment at 48hr, 72 hrs, and 120hrs, clinically superior pain relief was observed with the Tapentadol NS formulation that was statistically significant (p <0.05) at each of the time intervals. Secondary efficacy measures, including the onset of clinical analgesia and TOTPAR, showed non-inferiority to Tramadol. The safety profile and need for rescue medication were also similar in both the groups during the treatment period. The most common concomitant medications were anti-bacterial (98.3%). Conclusion: Tapentadol NS is a clinically feasible option for improved compliance as induction and maintenance therapy while offering a sustained and persistent patient response that is clinically meaningful in post-surgical settings.Keywords: tapentadol nasal spray, acute pain, tramadol, post-operative pain
Procedia PDF Downloads 2383758 Understanding Indigenous Perspectives and Critical Knowledge in International Law
Authors: Radhika Jagtap
Abstract:
Contemporary scholarship in international legal theory is investigating new avenues of providing alternatives to dominant concepts. Indigenous peoples’ philosophies and perspectives developed through them provide a fertile ground to explore similar alternative ideas. This review paper evaluates the theorized accounts of indigenous scholarships which have contributed towards a rich body of knowledge generating alternative visions on dominant notions of ‘post coloniality’, ‘resistance’ and ‘globalization’. Further, it shall assess the relevance of such a project in shaping contemporary international legal thought. Traditional or classical international law has been opined to be highly influenced by the colonial and imperialist history which also left a mark on the way dominant discourses of resistance and globalization are read in mainstream international law. The paper shall first define what do we mean by indigenous philosophy and what kind of indigeneity is that inclusive of. Second, the paper defines the dominant discourse and then counters the same with the alternative indigenous perspective in the case of each concept that is in question. Finally, the paper shall conclude with certain theoretical findings – that the post coloniality, from indigenous perspective, lead to the further marginalization of indigeneity, especially in the third world; that human rights as the sole means of representing resistance in international law ends up making it a very state-centric discipline and last, that globalization from an indigenous, marginalised perspective is not as celebrated as it is in mainstream international law. Major scholarly works that shall be central to the discussion are those of Linda Tuiwahi Smith, Ella Shohat and David Harvey. The nature of the research shall be inductive and involve mostly theoretical review of scholarly works.Keywords: indigenous, post colonial, globalization, perspectives
Procedia PDF Downloads 3273757 Cryopreservation of Ring-Necked Pheasant (Phasianus colchicus) Semen for Establishing Cryobank
Authors: Rida Pervaiz, Bushra Allah Rakha, Muhammad Sajjad Ansari, Shamim Akhter, Kainat Waseem, Sumiyyah Zuha, Tooba Javed
Abstract:
Ring-necked pheasant (Phasianus colchicus) belongs to order Galliformes and family Phasianidae. It has been recognized as the most hunted bird due to its attractive colorful appearance and meat. Loss of habitat and hunting pressure has caused population fluctuations in the native range. Under these circumstances, this species can be conserved by employing ex-situ in vitro conservation techniques. Captive breeding, in combination with semen cryobanking is the most appropriate option to conserve/propagate this species without deteriorating the genetic diversity. Cryopreservation protocols of adequate efficiency are necessary to establish semen cryobanking for a species. Therefore, present study was designed to devise an efficient extender for cryopreservation of ring-necked pheasant semen. For this purpose, a range of extenders (Beltsville Poultry, red fowl, Lake, EK, Tselutin Poultry and Chicken semen extenders) were evaluated for cryopreservation of ring-necked pheasant semen. Semen collected from 10 cocks, diluted in the Beltsville Poultry (BPSE), Red Fowl (RFE), Lake (LE), EK (EKE), Tselutin Poultry (TPE) and Chicken Semen (CSE) extenders and cryopreserved. Glycerol (10%) was added to semen at 4°C, equilibrated for 10 min, filled in 0.5 mL French straws, kept over liquid nitrogen vapors for 10 min, cryopreserved in LN2 and stored. Sperm motility (%), viability (%), live/dead ratio (%), plasma membrane (%) and DNA Integrity (%) were evaluated at post-dilution, post-cooling, post-equilibration and post-thawing stage of cryopreservation. Sperm motility (83.8 ± 3.1; 81.3 ± 3.8; 73.8 ± 2.4; 62.5 ± 1.4), viability (79.0 ± 1.7; 75.5 ± 1.6; 69.5 ± 2.3; 65.5 ± 2.4), live/dead ratio (80.5 ± 5.7; 77.3 ± 4.9; 76.0 ± 2.7; 68.3 ± 2.3), plasma membrane (74.5 ± 2.9; 73.8 ± 3.4; 71.3 ± 2.3; 75.0 ± 3.4) and DNA integrity (78.3 ± 1.7; 73.0 ± 1.2; 68.0 ± 2.0; 63.0 ± 2.5) at all four stages of cryopreservation were recorded higher (P < 0.05) in red fowl extender compared to all experimental extenders. It is concluded that red fowl extender is the best extender for cryopreservation of ring-necked pheasant semen and can be used in establishing cryobank for ex situ conservation.Keywords: ring-necked pheasant; extenders; cryopreservation; semen quality; DNA integrity
Procedia PDF Downloads 1363756 Fiberoptic Intubation Skills Training Improves Emergency Medicine Resident Comfort Using Modality
Authors: Nicholus M. Warstadt, Andres D. Mallipudi, Oluwadamilola Idowu, Joshua Rodriguez, Madison M. Hunt, Soma Pathak, Laura P. Weber
Abstract:
Endotracheal intubation is a core procedure performed by emergency physicians. This procedure is a high risk, and failure results in substantial morbidity and mortality. Fiberoptic intubation (FOI) is the standard of care in difficult airway protocols, yet no widespread practice exists for training emergency medicine (EM) residents in the technical acquisition of FOI skills. Simulation on mannequins is commonly utilized to teach advanced airway techniques. As part of a program to introduce FOI into our ED, residents received hands-on training in FOI as part of our weekly resident education conference. We hypothesized that prior to the hands-on training, residents had little experience with FOI and were uncomfortable with using fiberoptic as a modality. We further hypothesized that resident comfort with FOI would increase following the training. The education intervention consisted of two hours of focused airway teaching and skills acquisition for PGY 1-4 residents. One hour was dedicated to four case-based learning stations focusing on standard, pediatric, facial trauma, and burn airways. Direct, video, and fiberoptic airway equipment were available to use at the residents’ discretion to intubate mannequins at each station. The second hour involved direct instructor supervision and immediate feedback during deliberate practice for FOI of a mannequin. Prior to the hands-on training, a pre-survey was sent via email to all EM residents at NYU Grossman School of Medicine. The pre-survey asked how many FOI residents have performed in the ED, OR, and on a mannequin. The pre-survey and a post-survey asked residents to rate their comfort with FOI on a 5-point Likert scale ("extremely uncomfortable", "somewhat uncomfortable", "neither comfortable nor uncomfortable", "somewhat comfortable", and "extremely comfortable"). The post-survey was administered on site immediately following the training. A two-sample chi-square test of independence was calculated comparing self-reported resident comfort on the pre- and post-survey (α ≤ 0.05). Thirty-six of a total of 70 residents (51.4%) completed the pre-survey. Of pre-survey respondents, 34 residents (94.4%) had performed 0, 1 resident (2.8%) had performed 1, and 1 resident (2.8%) had performed 2 FOI in the ED. Twenty-five residents (69.4%) had performed 0, 6 residents (16.7%) had performed 1, 2 residents (5.6%) had performed 2, 1 resident (2.8%) had performed 3, and 2 residents (5.6%) had performed 4 FOI in the OR. Seven residents (19.4%) had performed 0, and 16 residents (44.4%) had performed 5 or greater FOI on a mannequin. 29 residents (41.4%) attended the hands-on training, and 27 out of 29 residents (93.1%) completed the post-survey. Self-reported resident comfort with FOI significantly increased in post-survey compared to pre-survey questionnaire responses (p = 0.00034). Twenty-one of 27 residents (77.8%) report being “somewhat comfortable” or “extremely comfortable” with FOI on the post-survey, compared to 9 of 35 residents (25.8%) on the pre-survey. We show that dedicated FOI training is associated with increased learner comfort with such techniques. Further direction includes studying technical competency, skill retention, translation to direct patient care, and optimal frequency and methodology of future FOI education.Keywords: airway, emergency medicine, fiberoptic intubation, medical simulation, skill acquisition
Procedia PDF Downloads 1763755 Perinatal and Postnatal Counseling as Determinants of Early Newborn Sepsis in Rural Bangladesh
Authors: Sajia Islam, T. Tahsina, S. Raihana, M. M. Rahman, Q. S. Rahman, T. M. Huda, S. E. Arifeen, M. J. Dibley
Abstract:
Early neonatal sepsis accounts for more than two-thirds of all deaths in the first year of life. This study assessed the counseling during antenatal, perinatal, post natal periods and its association with possible sepsis in rural Bangladesh. Method: Data were collected from a large community-based trial in Bangladesh where pregnant women were enrolled from 2013-2015 covering 29,497 newborns. Sepsis was defined using neonatal danger signs reported by 'The Young-Infants Clinical Science Study Group. 'Result: Signs of sepsis was found among 15% of the neonates. Neonatal sepsis was higher among those who did not receive advice on TT vaccinations (15.4% vs. 11%, p < 0.05) and danger signs (14.8% vs. 12.8%, p < 0.05) during pregnancy. Advice on delivering in well-lit place was significantly associated with lower incidence of sepsis (12.7% vs. 14.8% p < 0.05). Sepsis was lower among neonates whose mothers were counseled on immediate newborn care for bathing after 3 days of delivery (13.4% vs. 15.2% p=0), breastfeeding within 1hr of birth (13.82 % vs. 15.28% p=0), apply nothing on the cord (11.54 vs. 15.06 p=0), immediate drying of child (12.62% vs. 14.89%, p=0). Neonatal sepsis was lower among children whose mothers received 2-4 advice [OR=0.91(95% CI: 0.85-0.97)] compared to neonates whose mothers received only 1 or none. Overall, children to mothers who received ≥ 5 advice had lowest incidence of sepsis [OR=0.83 (95% CI: 0.71-0.97)] Conclusion: Advice on antenatal, prenatal and post natal is significantly reduced with early newborn sepsis. Further research is required to identify specific type of counseling messages that translate into practices and reduce pathways towards early-newborn morbidities.Keywords: ante natal care, counseling, neonatal sepsis, post natal care
Procedia PDF Downloads 2693754 Post Liberal Perspective on Minorities Visibility in Contemporary Visual Culture: The Case of Mizrahi Jews
Authors: Merav Alush Levron, Sivan Rajuan Shtang
Abstract:
From as early as their emergence in Europe and the US, postmodern and post-colonial paradigm have formed the backbone of the visual culture field of study. The self-representation project of political minorities is studied, described and explained within the premises and perspectives drawn from these paradigms, addressing the key issues they had raised: modernism’s crisis of representation. The struggle for self-representation, agency and multicultural visibility sought to challenge the liberal pretense of universality and equality, hitting at its different blind spots, on issues such as class, gender, race, sex, and nationality. This struggle yielded subversive identity and hybrid performances, including reclaiming, mimicry and masquerading. These performances sought to defy the uniform, universal self, which forms the basis for the liberal, rational, enlightened subject. The argument of this research runs that this politics of representation itself is confined within liberal thought. Alongside post-colonialism and multiculturalism’s contribution in undermining oppressive structures of power, generating diversity in cultural visibility, and exposing the failure of liberal colorblindness, this subversion is constituted in the visual field by way of confrontation, flying in the face of the universal law and relying on its ongoing comparison and attribution to this law. Relying on Deleuze and Guattari, this research set out to draw theoretic and empiric attention to an alternative, post-liberal occurrence which has been taking place in the visual field in parallel to the contra-hegemonic phase and as a product of political reality in the aftermath of the crisis of representation. It is no longer a counter-representation; rather, it is a motion of organic minor desire, progressing in the form of flows and generating what Deleuze and Guattari termed deterritorialization of social structures. This discussion shall have its focus on current post-liberal performances of ‘Mizrahim’ (Jewish Israelis of Arab and Muslim extraction) in the visual field in Israel. In television, video art and photography, these performances challenge the issue of representation and generate concrete peripheral Mizrahiness, realized in the visual organization of the photographic frame. Mizrahiness then transforms from ‘confrontational’ representation into a 'presence', flooding the visual sphere in our plain sight, in a process of 'becoming'. The Mizrahi desire is exerted on the plains of sound, spoken language, the body and the space where they appear. It removes from these plains the coding and stratification engendered by European dominance and rational, liberal enlightenment. This stratification, adhering to the hegemonic surface, is flooded not by way of resisting false consciousness or employing hybridity, but by way of the Mizrahi identity’s own productive, material immanent yearning. The Mizrahi desire reverberates with Mizrahi peripheral 'worlds of meaning', where post-colonial interpretation almost invariably identifies a product of internalized oppression, and a recurrence thereof, rather than a source in itself - an ‘offshoot, never a wellspring’, as Nissim Mizrachi clarifies in his recent pioneering work. The peripheral Mizrahi performance ‘unhook itself’, in Deleuze and Guattari words, from the point of subjectification and interpretation and does not correspond with the partialness, absence, and split that mark post-colonial identities.Keywords: desire, minority, Mizrahi Jews, post-colonialism, post-liberalism, visibility, Deleuze and Guattari
Procedia PDF Downloads 3223753 The Effect of Fetal Movement Counting on Maternal Antenatal Attachment
Authors: Esra Güney, Tuba Uçar
Abstract:
Aim: This study has been conducted for the purpose of determining the effects of fetal movement counting on antenatal maternal attachment. Material and Method: This research was conducted on the basis of the real test model with the pre-test /post-test control groups. The study population consists of pregnant women registered in the six different Family Health Centers located in the central Malatya districts of Yeşilyurt and Battalgazi. When power analysis is done, the sample size was calculated for each group of at least 55 pregnant women (55 tests, 55 controls). The data were collected by using Personal Information Form and MAAS (Maternal Antenatal Attachment Scale) between July 2015-June 2016. Fetal movement counting training was given to pregnant women by researchers in the experimental group after the pre-test data collection. No intervention was applied to the control group. Post-test data for both groups were collected after four weeks. Data were evaluated with percentage, chi-square arithmetic average, chi-square test and as for the dependent and independent group’s t test. Result: In the MAAS, the pre-test average of total scores in the experimental group is 70.78±6.78, control group is also 71.58±7.54 and so there was no significant difference in mean scores between the two groups (p>0.05). MAAS post-test average of total scores in the experimental group is 78.41±6.65, control group is also is 72.25±7.16 and so the mean scores between groups were found to have statistically significant difference (p<0.05). Conclusion: It was determined that fetal movement counting increases the maternal antenatal attachments.Keywords: antenatal maternal attachment, fetal movement counting, pregnancy, midwifery
Procedia PDF Downloads 2603752 Aerobic Exercise Increases Circulating Hematopoietic Stem Cells and Endothelial Progenitor Cells
Authors: Khaled A. shady, Fagr B. Bazeed, Nashwa K. Abousamra, Ihab H. Elberawe, Ashraf E. shaalan, Mohamed A. Sobh
Abstract:
Physical activity activates a variety of adult stem cells which might be released into the circulation or might be activated in their organ-resident state. A variety of stimuli such as metabolic, mechanical, and hormonal stimuli might by responsible for the mobilization. This study was done to know the changes in hematopoietic stem cells and endothelial progenitor in athletes in the 24 hours following 30 min of aerobic exercise. Methods: Ten healthy male's athlete's (age 20.7± 0.61 y) performed moderate running with 30 min at 80% of velocity of The IAT. Blood samples taken pre-, and immediately, 30 min, 2h, 6h and 24h post-exercise were analyzed for hematopoietic stem cells (HSCs ), endothelial progenitor cells (EPCs(, vascular endothelial growth factor (VEGF), nitric oxide (NO), lactic acid (LA), and white blood cells . HSCs and EPCs were quantified by flow cytometry. Results: After 30min of aerobic exercise significant increases in HSCs, EPC, VEGF, NO, LA and WBCs (p ˂ 0.05). This increase will be at different rates according to the timing of taking blood sample and was in the maximum rate of increase after 30 min of aerobic exercise. HSCs, EPC, NO and WBCs were in the maximum rate of increase 2h post exercise. In addition, VEGF was in the maximum rate of increase immediately post exercise and LA concentration not affected after exercise. Conclusion: These data suggest that HSCs and EPCs increased after aerobic exercise due to increase of VEGF which play an important role in mobilization of stem cells and promotes NO increase which contributes to increase EPCs.Keywords: physical activity, hematopoietic stem cells, mobilization, athletes
Procedia PDF Downloads 943751 Analytical Investigation of Replaceable Links with Reduced Web Section for Link-to-Column Connections in Eccentrically Braced Frames
Authors: Daniel Y. Abebe, Sijeong Jeong, Jaehyouk Choi
Abstract:
The use of eccentrically braced frame (EBF) is increasing day by day as EBF possesses high elastic stiffness, stable inelastic response under cyclic lateral loading, and excellent ductility and energy dissipation capacity. The ductility and energy dissipation capacity of EBF depends on the active link beams. Recently, there are two types EBFs; these are conventional EBFs and EBFs with replaceable links. The conventional EBF has a disadvantage during maintenance in post-earthquake. The concept of removable active link beam in EBF is developed to overcome the limitation of the conventional EBF in post-earthquake. In this study, a replaceable link with reduced web section is introduced and design equations are suggested. In addition, nonlinear finite element analysis was conducted in order to evaluate the proposed links.Keywords: EBFs, replaceable link, earthquake disaster, reduced section
Procedia PDF Downloads 3243750 Making the Right Call for Falls: Evaluating the Efficacy of a Multi-Faceted Trust Wide Approach to Improving Patient Safety Post Falls
Authors: Jawaad Saleem, Hannah Wright, Peter Sommerville, Adrian Hopper
Abstract:
Introduction: Inpatient falls are the most commonly reported patient safety incidents, and carry a significant burden on resources, morbidity, and mortality. Ensuring adequate post falls management of patients by staff is therefore paramount to maintaining patient safety especially in out of hours and resource stretched settings. Aims: This quality improvement project aims to improve the current practice of falls management at Guys St Thomas Hospital, London as compared to our 2016 Quality Improvement Project findings. Furthermore, it looks to increase current junior doctors confidence in managing falls and their use of new guidance protocols. Methods: Multifaceted Interventions implemented included: the development of new trust wide guidelines detailing management pathways for patients post falls, available for intranet access. Furthermore, the production of 2000 lanyard cards distributed amongst junior doctors and staff which summarised these guidelines. Additionally, a ‘safety signal’ email was sent from the Trust chief medical officer to all staff raising awareness of falls and the guidelines. Formal falls teaching was also implemented for new doctors at induction. Using an established incident database, 189 consecutive falls in 2017were retrospectively analysed electronically to assess and compared to the variables measured in 2016 post interventions. A separate serious incident database was used to analyse 50 falls from May 2015 to March 2018 to ascertain the statistical significance of the impact of our interventions on serious incidents. A similar questionnaire for the 2017 cohort of foundation year one (FY1) doctors was performed and compared to 2016 results. Results: Questionnaire data demonstrated improved awareness and utility of guidelines and increased confidence as well as an increase in training. 97% of FY1 trainees felt that the interventions had increased their awareness of the impact of falls on patients in the trust. Data from the incident database demonstrated the time to review patients post fall had decreased from an average of 130 to 86 minutes. Improvement was also demonstrated in the reduced time to order and schedule X-ray and CT imaging, 3 and 5 hours respectively. Data from the serious incident database show that ‘the time from fall until harm was detected’ was statistically significantly lower (P = 0.044) post intervention. We also showed the incidence of significant delays in detecting harm ( > 10 hours) reduced post intervention. Conclusions: Our interventions have helped to significantly reduce the average time to assess, order and schedule appropriate imaging post falls. Delays of over ten hours to detect serious injuries after falls were commonplace; since the intervention, their frequency has markedly reduced. We suggest this will lead to identifying patient harm sooner, reduced clinical incidents relating to falls and thus improve overall patient safety. Our interventions have also helped increase clinical staff confidence, management, and awareness of falls in the trust. Next steps include expanding teaching sessions, improving multidisciplinary team involvement to aid this improvement.Keywords: patient safety, quality improvement, serious incidents, falls, clinical care
Procedia PDF Downloads 1213749 Determining the Effectiveness of Dialectical Behavior Therapy in Reducing the Psychopathic Deviance of Criminals
Authors: Setareh Gerayeli
Abstract:
The present study tries to determine the effectiveness of dialectical behavior therapy in reducing the psychopathic deviance of employed criminals released from prison. The experimental method was used in this study, and the statistical population included employed criminals released from prison in Mashhad. Thirty offenders were selected randomly as the samples of the study. The MMPI-2 was used to collect data in the pre-test and post-test stages. The behavioral therapy was conducted on the experimental group during fourteen two and a half hour sessions, while the control group did not receive any intervention. Data analysis was conducted by using covariance. The results showed there is a significant difference between the post-test mean scores of the two groups. The findings suggest that dialectical behavior therapy is effective in reducing psychopathic deviance.Keywords: criminals, dialectical behavior therapy, psychopathic deviance, prison
Procedia PDF Downloads 228