Search results for: clinical and patient outcomes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8192

Search results for: clinical and patient outcomes

3242 The Relation between the Organizational Trust Level and Organizational Justice Perceptions of Staff in Konya Municipality: A Theoretical and Empirical Study

Authors: Handan Ertaş

Abstract:

The aim of the study is to determine the relationship between organizational trust level and organizational justice of Municipality officials. Correlational method has been used via descriptive survey model and Organizational Justice Perception Scale, Organizational Trust Inventory and Interpersonal Trust Scale have been applied to 353 participants who work in Konya Metropolitan Municipality and central district municipalities in the study. Frequency as statistical method, Independent Samples t test for binary groups, One Way-ANOVA analyses for multi-groups and Pearson Correlation analysis have been used to determine the relation in the data analysis process. It has been determined in the outcomes of the study that participants have high level of organizational trust, “Interpersonal Trust” is in the first place and there is a significant difference in the favor of male officials in terms of Trust on the Organization Itself and Interpersonal Trust. It has also been understood that officials in district municipalities have higher perception level in all dimensions, there is a significant difference in Trust on the Organization sub-dimension and work status is an important factor on organizational trust perception. Moreover, the study has shown that organizational justice implementations are important in raising trust of official on the organization, administrator and colleagues, and there is a parallel relation between Organizational Trust components and Organizational Trust dimensions.

Keywords: organizational trust level, organizational justice perceptions, staff, Konya

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3241 A New Correlation Between SPT-N and SSPT-N values for Various Soil Types in Peninsular Malaysia

Authors: Abdull Halim

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The Standard Penetration Test (SPT-N) is the most common in situ test for soil investigations. The Shearing Seismic Standard Penetration Test (SSPT-N), on the other hand, is a new method using shearing wave with propagation exponent equation between the shearing wave, Vs., and hardness, N values without any need for borehole data. Due to the fast and accurate results that can be obtained, the SSPT has found many applications such as in the field rectification buried pipe line, the acid tank settlement and foundation design analyses, and the quality control assessment. Many geotechnical regimes and properties have attempted to correlate both the SSPT and the SPT-N values. Various foundation design methods have been developed based on the outcomes of these tests. Hence, it is pertinent to correlate these tests so that either one of the test can be used in the absence of the other, especially for preliminary evaluation and design purposes. The primary purpose of this study was to investigate the relationship between the SSPT-N and SPT-N values for different types of cohesive soil in Peninsular Malaysia. Data were collected from four different sites, and the correlations were established between the hardness N values, principal stress-strain Mohr circle curve, cohesion, friction angle and vertical effective stress. A positive exponent relationship was found between the shearing wave, sVs., and the hardness N values of the soil. In general, the SSPT-N value was slightly lower than the SPT-N value due to the upper limit boundary of the soil layer.

Keywords: InsituSoil determination; shearing wave; hardness; correlation, SSPT-N, SPT-N

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3240 Investigating the Post-Liver Transplant Complications and Their Management in Children Referred to the Children’s Medical Center

Authors: Hosein Alimadadi, Fatemeh Farahmand, Ali Jafarian, Nasir Fakhar, Mohammad Hassan Sohouli, Neda Raeesi

Abstract:

Backgroundsː Regarding the important role of liver transplantation as the only treatment in many cases of end-stage liver disease in children, the aim of this study is to investigate the complications of liver transplantation and their management in children referred to the Children's Medical Center. Methods: This study is a cross-sectional study on pediatric patients who have undergone liver transplants in the years 2016 to 2021. The indication for liver transplantation in this population was confirmed by a pediatric gastroenterologist, and a liver transplant was performed by a transplant surgeon. Finally, information about the patient before and after the transplantation was collected and recorded. Results: A total of 53 patients participated in this study, including 25 (47.2%) boys and 28 (52.8%) girls. The most common causes of liver transplantation were cholestatic and metabolic diseases. The most common early complication of liver transplantation in children was acute cellular rejection (ACR) and anastomotic biliary stricture. The most common late complication in these patients was an infection which was observed in 56.6% of patients. Among the drug side effects, neurotoxicity (convulsions) was seen more in patients, and 15.1% of the transplanted patients died. Conclusion: In this study, the most common early complication of liver transplantation in children was ACR and biliary stricture, and the most common late complication was infection. Neurotoxicity (convulsions) was the most common side effect of drugs.

Keywords: liver transplantation, complication, infection, survival rate

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3239 The Impact of Corporate Social Responsibility and Knowledge Management Factors on Students’ Job Performance: A Case Study of Silpakorn University’s Internship Program

Authors: Naritphol Boonjyakiat

Abstract:

This research attempts to investigate the effects of corporate social responsibility and knowledge management factors on students’ job performance of the Silpakorn University’s internship program within various organizations. The goal of this study is to fill the literature gap by gaining an understanding of corporate social responsibility and the knowledge management factors that fundamentally relate to students’ job performance within the organizations. Thus, this study will focus on the outcomes that were derived from a set of secondary data that were obtained using a Silpakorn university’s data base of 200 students and selected employer assessment and evaluation forms from the companies. The results represent the perceptions of students towards the corporate social responsibility aspects and knowledge management factors within the university and their job performance evaluation from the employers in various organizations. The findings indicate that corporate social responsibility and knowledge management have significant effects on students’ job performance. This study may assist us in gaining a better understanding of the integrated aspects of university and workplace environments to discover how to optimally allocate university’s resources and management approaches to gain benefits from corporate social responsibility and knowledge management practices toward students’ job performance within an organizational experience settings. Therefore, there is a sufficient reason to believe that the findings can contribute to research in the area of CSR, KM, and job performance as essential aspect of involved stakeholder.

Keywords: corporate social responsibility, knowledge management, job performance, internship program

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3238 Crossbite Unilateral Correction Using Transpalatal Arch with Extension Arm Modification

Authors: Hanifa Maryani Ahmad, Muslim Yusuf

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Background: Unilateral crossbite can be defined as an abnormal transverse relationship between the upper and lower teeth where the mandibular buccal cusp occluding to the maxillary buccal cusp and which involves only one side of the arch. This report describes the treatment of an adolescent female with Class III malocclussion unilateral crossbite resulting from a mildly constricted maxillary arch. The patient had a Class III skeletal relationship, Class III molar relationships, unilateral crossbite on the left side, and deviated midlines. Objectives: The treatment objectives were to correct the abnormal transverse relationship, achieve proper dental inclination, and correct the unilateral crossbites to improve the facial profile. Case management: The treatment protocol was using transpalatal arch with extension arm modification to expand the maxillary arch. Following the levelling and aligning stage of treatment, using a vertical loop while mandibular arch was expanded after getting an end to end relationship on the anterior side. Results: Corrections of the unilateral crossbite were achieved in 4 months. The treatment is still on process because the canines relationship were not corrected. Conclusions: This report highlights a treatment using transpalatal arch with extension arm modification that can be used to expand the transverse width of an arch to correct the discrepancy. Even though the treatment processes were still ongoing, the correction of the unilateral crossbite have been achieved in 4 months by only using the transpalatal arch.

Keywords: crossbite unilateral, late growing, non-extraction, transpalatal arch

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3237 Future Applications of 4D Printing in Dentistry

Authors: Hosamuddin Hamza

Abstract:

The major concept of 4D printing is self-folding under thermal and humidity changes. This concept relies on understanding how the microstructures of 3D-printed models can undergo spontaneous shape transformation under thermal and moisture changes. The transformation mechanism could be achieved by mixing, in a controllable pattern, a number of materials within the printed model, each with known strain/shrinkage properties. 4D printing has a strong potential to be applied in dentistry as the technology could produce dynamic and adaptable materials to be used as functional objects in the oral environment under the continuously changing thermal and humidity conditions. The motion criteria could override the undesired dimensional changes, thermal instability, polymerization shrinkage and microleakage. 4D printing could produce restorative materials being self-adjusted spontaneously without further intervention from the dentist or patient; that is, the materials could be capable of fixing its failed portions, compensating for some lost tooth structure, while avoiding microleakage or overhangs at the margins. In prosthetic dentistry, 4D printing could provide an option to manage the influence of bone and soft tissue imbalance during mastication (and at rest) with high predictability of the type/direction of forces. It can also produce materials with better fitting and retention characteristics than conventional or 3D-printed materials. Nevertheless, it is important to highlight that 4D-printed objects, having dynamic properties, could provide some cushion as they undergo self-folding compensating for any thermal changes or mechanical forces such as traumatic forces.

Keywords: functional material, self-folding material, 3D printing, 4D printing

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3236 The Correlation between Education, Food Intake, Exercise, and Medication Obedience with the Average of Blood Sugar in Indonesia

Authors: Aisyah Rahmatul Laily

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Indonesia Ministry of Health is increasing their awareness on non communicable diseases. From the top ten causes of death, two of them are non communicable diseases. Diabetes Mellitus is one of the two non communicable diseases above that have the increasing number of patient from year to year. From that problem, this research is made to determine the correlation between education, food intake, exercise, and the medication obedience with the average of blood sugar. In this research, the researchers used observational and cross-sectional studies. The sample that used in this research were 50 patients in Puskesmas Gamping I Yogyakarta who have suffered from Diabetes Mellitus in long period. The researcher doing anamnesis by using questionnaire to collect the data, then analyzed it with Chi Square to determine the correlation between each variable. The dependent variable in this research is the average of blood sugar, whereas the independent variables are education, food intake, do exercise, and the obedience of medication. The result shows a relation between education and average blood sugar level (p=0.029), a relation between food intake and average blood sugar level (p=0.009), and a relation between exercise and average blood sugar level (p=0.023). There is also a relation between the medication obedience with the average of blood sugar (p=0,002). The conclusion is that the positive correlations exist between education and average blood sugar level, between food intake and average blood sugar level, and between medication obedience and average blood sugar level.

Keywords: average of blood sugar, education, exercise, food intake, medication obedience

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3235 Thick Data Analytics for Learning Cataract Severity: A Triplet Loss Siamese Neural Network Model

Authors: Jinan Fiaidhi, Sabah Mohammed

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Diagnosing cataract severity is an important factor in deciding to undertake surgery. It is usually conducted by an ophthalmologist or through taking a variety of fundus photography that needs to be examined by the ophthalmologist. This paper carries out an investigation using a Siamese neural net that can be trained with small anchor samples to score cataract severity. The model used in this paper is based on a triplet loss function that takes the ophthalmologist best experience in rating positive and negative anchors to a specific cataract scaling system. This approach that takes the heuristics of the ophthalmologist is generally called the thick data approach, which is a kind of machine learning approach that learn from a few shots. Clinical Relevance: The lens of the eye is mostly made up of water and proteins. A cataract occurs when these proteins at the eye lens start to clump together and block lights causing impair vision. This research aims at employing thick data machine learning techniques to rate the severity of the cataract using Siamese neural network.

Keywords: thick data analytics, siamese neural network, triplet-loss model, few shot learning

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3234 Case of A Huge Retroperitoneal Abscess Spanning from the Diaphragm to the Pelvic Brim

Authors: Christopher Leung, Tony Kim, Rebecca Lendzion, Scott Mackenzie

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Retroperitoneal abscesses are a rare but serious condition with often delayed diagnosis, non-specific symptoms, multiple causes and high morbidity/mortality. With the advent of more readily available cross-sectional imaging, retroperitoneal abscesses are treated earlier and better outcomes are achieved. Occasionally, a retroperitoneal abscess is present as a huge retroperitoneal abscess, as evident in this 53-year-old male. With a background of chronic renal disease and left partial nephrectomy, this gentleman presented with a one-month history of left flank pain without any other symptoms, including fevers or abdominal pain. CT abdomen and pelvis demonstrated a huge retroperitoneal abscess spanning from the diaphragm, abutting the spleen, down to the iliopsoas muscle and abutting the iliac vessels at the pelvic brim. This large retroperitoneal abscess required open drainage as well as drainage by interventional radiology. A long course of intravenous antibiotics and multiple drainages was required to drain the abscess. His blood culture and fluid culture grew Proteus species suggesting a urinary source, likely from his non-functioning kidney, which had a partial nephrectomy. Such a huge retroperitoneal abscess has rarely been described in the literature. The learning point here is that the basic principle of source control and antibiotics is paramount in treating retroperitoneal abscesses regardless of the size of the abscess.

Keywords: retroperitoneal abscess, retroperitoneal mass, sepsis, genitourinary infection

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3233 Understanding Innovation by Analyzing the Pillars of the Global Competitiveness Index

Authors: Ujjwala Bhand, Mridula Goel

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Global Competitiveness Index (GCI) prepared by World Economic Forum has become a benchmark in studying the competitiveness of countries and for understanding the factors that enable competitiveness. Innovation is a key pillar in competitiveness and has the unique property of enabling exponential economic growth. This paper attempts to analyze how the pillars comprising the Global Competitiveness Index affect innovation and whether GDP growth can directly affect innovation outcomes for a country. The key objective of the study is to identify areas on which governments of developing countries can focus policies and programs to improve their country’s innovativeness. We have compiled a panel data set for top innovating countries and large emerging economies called BRICS from 2007-08 to 2014-15 in order to find the significant factors that affect innovation. The results of the regression analysis suggest that government should make policies to improve labor market efficiency, establish sophisticated business networks, provide basic health and primary education to its people and strengthen the quality of higher education and training services in the economy. The achievements of smaller economies on innovation suggest that concerted efforts by governments can counter any size related disadvantage, and in fact can provide greater flexibility and speed in encouraging innovation.

Keywords: innovation, global competitiveness index, BRICS, economic growth

Procedia PDF Downloads 252
3232 Segmentation of Liver Using Random Forest Classifier

Authors: Gajendra Kumar Mourya, Dinesh Bhatia, Akash Handique, Sunita Warjri, Syed Achaab Amir

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Nowadays, Medical imaging has become an integral part of modern healthcare. Abdominal CT images are an invaluable mean for abdominal organ investigation and have been widely studied in the recent years. Diagnosis of liver pathologies is one of the major areas of current interests in the field of medical image processing and is still an open problem. To deeply study and diagnose the liver, segmentation of liver is done to identify which part of the liver is mostly affected. Manual segmentation of the liver in CT images is time-consuming and suffers from inter- and intra-observer differences. However, automatic or semi-automatic computer aided segmentation of the Liver is a challenging task due to inter-patient Liver shape and size variability. In this paper, we present a technique for automatic segmenting the liver from CT images using Random Forest Classifier. Random forests or random decision forests are an ensemble learning method for classification that operate by constructing a multitude of decision trees at training time and outputting the class that is the mode of the classes of the individual trees. After comparing with various other techniques, it was found that Random Forest Classifier provide a better segmentation results with respect to accuracy and speed. We have done the validation of our results using various techniques and it shows above 89% accuracy in all the cases.

Keywords: CT images, image validation, random forest, segmentation

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3231 Trafficking, Forced Prostitution, and Minors in the Sex Trade in Post-Legalisation New Zealand

Authors: Natalie Thorburn

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New Zealand legalised and regulated prostitution 13 years ago with the hope of eradicating unsafe or exploitative practices in the sex trade, but the extent to which this has been successful has been hotly contested, with the New Zealand Government denying any existence of sex trafficking and evidence generally indicating the success of the 2004 reform. The aim of the research was therefore to establish the circumstances in which sex trafficking may be occurring without using any previously instrumental gatekeepers of the New Zealand sex industry. 14 survivors of gang, family, or intimate partner trafficking (all of whom had first been trafficked prior to the age of 16) were interviewed, as well as several key informants. It was found that there was a perceived lack of commitment by Police to investigate instances of trafficking, and this was considered to be linked to the legal status of prostitution. The lack of recognition at both community and political levels of the existence and prevalence of trafficking also meant that medical and social service practitioners were unaware trafficking was occurring, and would not know who to refer to if it was disclosed. Participants commonly normalised coercion into sex, seeing this as a continuation of prior sexually abusive experiences that were prevalent in their childhood and early adolescent environments. Their experiences with the helping services were typically either negative or non-existent, and they expressed frustration regarding the absence of justice, the lack of awareness, and health and outcomes they suffered in relation to their experiences of having been trafficked. Barriers to engagement and strategies to facilitate meaningful and sustainable engagement with this population group are therefore presented.

Keywords: legalisation, regulation, service access, socio-political context

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3230 Computational Agent-Based Approach for Addressing the Consequences of Releasing Gene Drive Mosquito to Control Malaria

Authors: Imran Hashmi, Sipkaduwa Arachchige Sashika Sureni Wickramasooriya

Abstract:

Gene-drive technology has emerged as a promising tool for disease control by influencing the population dynamics of disease-carrying organisms. Various gene drive mechanisms, derived from global laboratory experiments, aim to strategically manage and prevent the spread of targeted diseases. One prominent strategy involves population replacement, wherein genetically modified mosquitoes are introduced to replace the existing local wild population. To enhance our understanding and aid in the design of effective release strategies, we employ a comprehensive mathematical model. The utilized approach employs agent-based modeling, enabling the consideration of individual mosquito attributes and flexibility in parameter manipulation. Through the integration of an agent-based model and a meta-population spatial approach, the dynamics of gene drive mosquito spreading in a released site are simulated. The model's outcomes offer valuable insights into future population dynamics, providing guidance for the development of informed release strategies. This research significantly contributes to the ongoing discourse on the responsible and effective implementation of gene drive technology for disease vector control.

Keywords: gene drive, agent-based modeling, disease-carrying organisms, malaria

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3229 MSIpred: A Python 2 Package for the Classification of Tumor Microsatellite Instability from Tumor Mutation Annotation Data Using a Support Vector Machine

Authors: Chen Wang, Chun Liang

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Microsatellite instability (MSI) is characterized by high degree of polymorphism in microsatellite (MS) length due to a deficiency in mismatch repair (MMR) system. MSI is associated with several tumor types and its status can be considered as an important indicator for tumor prognostic. Conventional clinical diagnosis of MSI examines PCR products of a panel of MS markers using electrophoresis (MSI-PCR) which is laborious, time consuming, and less reliable. MSIpred, a python 2 package for automatic classification of MSI was released by this study. It computes important somatic mutation features from files in mutation annotation format (MAF) generated from paired tumor-normal exome sequencing data, subsequently using these to predict tumor MSI status with a support vector machine (SVM) classifier trained by MAF files of 1074 tumors belonging to four types. Evaluation of MSIpred on an independent 358-tumor test set achieved overall accuracy of over 98% and area under receiver operating characteristic (ROC) curve of 0.967. These results indicated that MSIpred is a robust pan-cancer MSI classification tool and can serve as a complementary diagnostic to MSI-PCR in MSI diagnosis.

Keywords: microsatellite instability, pan-cancer classification, somatic mutation, support vector machine

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3228 Impact of Protean Career Attitude on Career Success with the Mediating Effect of Career Insight

Authors: Prabhashini Wijewantha

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This study looks at the impact of protean career attitude of employees on their career success and next it looks at the mediation effect of career insights on the above relationship. Career success is defined as the accomplishment of desirable work related outcomes at any point in person’s work experiences over time and it comprises of two sub variables, namely, career satisfaction and perceived employability. Protean career attitude was measured using the eight items from the Self Directedness subscale of the Protean Career Attitude scale developed by Briscoe and Hall, where as career satisfaction was measured by the three item scale developed by Martine, Eddleston, and Veiga. Perceived employability was also evaluated using three items and career insight was measured using fourteen items that were adapted and used by De Vos and Soens. Data were collected from a sample of 300 mid career executives in Sri Lanka deploying the survey strategy and data were analyzed using the SPSS and AMOS software version 20.0. A preliminary analysis of data was initially performed where data were screened and reliability and validity were ensured. Next a simple regression analysis was performed to test the direct impact of protean career attitude on career success and the hypothesis was supported. The Baron and Kenney’s four steps, three regressions approach for mediator testing was used to calculate the mediation effect of career insight on the above relationship and a partial mediation was supported by the data. Finally theoretical and practical implications are discussed.

Keywords: career success, career insight, mid career MBAs, protean career attitude

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3227 Using Athletics to Mitigate the Negative Relational Outcomes Bullying Has On Youth with Disabilities

Authors: Kaycee Bills

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Studies have demonstrated that middle and high school students with disabilities are more likely to experience bullying than other student groups. The high rates of bullying victimization observed among youth with disabilities can result in severe socio-emotional consequences. These socio-emotional consequences often manifest in detrimental impacts on the students’ personal relationships. Past studies have indicated that participating in extracurricular athletic activities can have several socio-emotional benefits for students with disabilities. Given the findings of past studies demonstrating the positive relationship between mental health and participation in sports among students with disabilities, it is possible that participating in athletics could have a moderating relationship on the severity of the impact that bullying has on a student’s relationships with family and friends. Using the National Crime Victimization Survey/School Crime Supplement (NCVS/SCS), this study employs an ordinal logistic regression to determine if participation in extracurricular athletic activities mitigates the damaging impact bullying has on the personal relationships with friends and family among students who have disabilities. This study identified statistically significant results suggesting that students with disabilities who participate in athletics reported reduced levels of negative personal relationships resulting from bullying compared to their peers who did not participate in athletics.

Keywords: disability, inclusion, bullying, relationships

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3226 Prevalence, Awareness, and Risk Factors of Diabetes in Ahvaz: South West of Iran

Authors: Leila Yazdanpanah, Hajieh Shahbazian, Seyed Mahmoud Latifi, Armaghan Moravej Aleali, Saeed Ghanbari

Abstract:

Introduction: This study was designed to determine the prevalence of diabetes in people aged over 20 years in Ahvaz, Iran. Material and Methods: The study population selected by cluster sampling. Fasting blood sugar (FBS) assessed after minimum 8 hours night fasting. A questionnaire included: age, sex, weight, height, blood pressure, waist circumference and previous history of diabetes were completed for each patient. FBS≥126mg/dl and/or oral hypoglycemic treatment and/or insulin was defined as diabetes, FBS=100-125 mg/dl as impaired fasting glucose (IFG) and FBS<100mg/dl as normal. Results: Study population was 936 persons (47.2 % male and 52.8% female). The mean age of a population was 42.2±14 years. Diabetes was detected in 15.1 % of population. Only 57cases(6.1%) were aware of their disease and 9% had unknown diabetes. Diabetes was detected in 14.5% of male (11.3% unknown and 3.2 % known diabetes) and in 11.7% of female (7% unknown and 4.7% known diabetes). Prevalence of diabetes had no significant difference (P=0.21) in male and female but unknown diabetes was significantly higher in male (P=0.025). Prevalence of diabetes was increased with rising of age between 20-60 years old but decreasing after 60 years old. Diabetes was related to age, waist circumference and systolic and diastolic blood pressure, TG level and BMI in both sex (P=0.0001). Conclusion: More than half of female and three-fourth of male diabetic patients are unaware of their disease in South of Iran. Diabetes screening should be intensified in this population.

Keywords: diabetes, prevalence, risk factor, awareness

Procedia PDF Downloads 455
3225 Stereotypical Motor Movement Recognition Using Microsoft Kinect with Artificial Neural Network

Authors: M. Jazouli, S. Elhoufi, A. Majda, A. Zarghili, R. Aalouane

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Autism spectrum disorder is a complex developmental disability. It is defined by a certain set of behaviors. Persons with Autism Spectrum Disorders (ASD) frequently engage in stereotyped and repetitive motor movements. The objective of this article is to propose a method to automatically detect this unusual behavior. Our study provides a clinical tool which facilitates for doctors the diagnosis of ASD. We focus on automatic identification of five repetitive gestures among autistic children in real time: body rocking, hand flapping, fingers flapping, hand on the face and hands behind back. In this paper, we present a gesture recognition system for children with autism, which consists of three modules: model-based movement tracking, feature extraction, and gesture recognition using artificial neural network (ANN). The first one uses the Microsoft Kinect sensor, the second one chooses points of interest from the 3D skeleton to characterize the gestures, and the last one proposes a neural connectionist model to perform the supervised classification of data. The experimental results show that our system can achieve above 93.3% recognition rate.

Keywords: ASD, artificial neural network, kinect, stereotypical motor movements

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3224 Total Parenteral Nutrition Wastage: A Retrospective Cohort Study in a Small District General Hospital

Authors: Muhammad Faizan Butt, Maria Ambreen Tahir, Joshua James Pilkington, A. A. Warsi

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Background: Total parenteral nutrition (TPN) use within the NHS is crucial in the prevention of malnourishment. TPN prescriptions are tailored to an individual patient’s needs. TPN bags come in fixed sizes, and minimizing wastage has financial and sustainability implications for the health service. The aim of the study is to assess current prescribing practices, look at the volume of TPN wastage and identify reasons for it. Methodology: A retrospective cohort study on TPN prescriptions over a period of 1 year (Jan-Dec 2022) was performed. All patients prescribed TPN that had been admitted under a general surgery consultant in a small district hospital were included. Data were extracted from hospital electronic records and dietician charts. Data were described, and reasons for TPN wastage were explored. Results: 49 patients were identified. The average length of TPN prescription was 8 days (median). This totaled 608 prescriptions. Of the bags prescribed, 258, 169, and 181 were 10g (2500ml), 14g (2000ml), and 18g (2000ml), respectively. The mean volume wasted from each type of bag was 634ml, 634ml, and 648ml, respectively. Reasons for TPN wastage identified were: no loss (25%), smaller bags not available (53.6%), step-down regime (8.1%), and other (12.2%). Conclusion: This study has identified that the current stocking and prescribing of TPN within a district general hospital leads to a significant wastage of 638.2ml (average). The commonest reason for wastage is the non-availability of a more appropriate sized bag.

Keywords: general surgery, TPN, sustainability, wastage

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3223 The Effect of Merger Transference on the Maintenance of a Narcissistic Patient with a History of Treatment Interruption with Previous Therapists

Authors: Mehravar Javid

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This case study delves into the psychological complexities of a 33-year-old woman, the second of three children, whose upbringing under a critical mother and a high-expectation father has significantly shaped her psychological landscape. Exhibiting a blend of worthlessness and a grandiose self, her life is a constant struggle between idealizing her father and devaluing her mother and sisters, coupled with a fear of intimacy and a desire for merger. This internal conflict manifests in symptoms of depression, anxiety, and a pattern of forming and quitting multiple relationships, all driven by a deep-seated need for validation and approval. The therapeutic journey reveals her resistance to treatment, particularly when her defense mechanisms are challenged, reflecting a complex transference dynamic where she yearns for merger yet fears it. The treatment focuses on empathetically addressing her idealization and mirroring needs, allowing for autonomy while repairing communication gaps. This approach not only confronts her emotional deficits rooted in her family dynamics but also aids in her quest for self-identity, navigating through her feelings of emptiness, inferiority, and powerlessness. The study highlights the nuanced interplay of family influence on the development and maintenance of narcissistic traits, offering insights into the therapeutic strategies that can facilitate growth and self-awareness in similar cases.

Keywords: narcissistic personality disorder, merger transference, treatment interruption, case study, family dynamics

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3222 Impact of Hepatitis C Virus Chronic Infection on Quality of Life in Egypt

Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Walaa A. Fouad, Thanaa M. Rabah, Amira Mohsen, Fatma A. Shaaban, Iman I. Salama

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The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL) , its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know that any patient will need to take the time to know that his new physical limitations do not limit him as a person, as soul, no matter what other people are thinking as a positive hopeful attitude is essential for combating HCV.

Keywords: hepatitis C virus chronic infection - physical health component and mental health component of QoL– total quality of life

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3221 Investigation of Suspected Viral Hepatitis Outbreaks in North India

Authors: Mini P. Singh, Manasi Majumdar, Kapil Goyal, Pvm Lakshmi, Deepak Bhatia, Radha Kanta Ratho

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India is endemic for Hepatitis E virus and frequent water borne outbreaks are reported. The conventional diagnosis rests on the detection of serum anti-HEV IgM antibodies which may take 7-10 days to develop. Early diagnosis in such a situation is desirable for the initiation of prompt control measures. The present study compared three diagnostic methods in 60 samples collected during two suspected HEV outbreaks in the vicinity of Chandigarh, India. The anti-HEV IgM, HEV antigen and HEV-RNA could be detected in serum samples of 52 (86.66%), 16 (26.66%) and 18 (30%) patients respectively. The suitability of saliva samples for antibody detection was also evaluated in 21 paired serum- saliva samples. A total of 15 serum samples showed the presence of anti HEV IgM antibodies, out of which 10 (10/15; 66.6%) were also positive for these antibodies in saliva samples (χ2 = 7.636, p < 0.0057), thus showing a concordance of 76.91%. The positivity of reverse transcriptase PCR and HEV antigen detection was 100% within one week of illness which declined to 5-10% thereafter. The outbreak was attributed to HEV Genotype 1, Subtype 1a and the clinical and environmental strains clustered together. HEV antigen and RNA were found to be an early diagnostic marker with 96.66% concordance. The results indicate that the saliva samples can be used as an alternative to serum samples in an outbreak situation.

Keywords: HEV-antigen, outbreak, phylogenetic analysis, saliva

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3220 Supporting the ESL Student in a Tertiary Setting: Carrot and Stick

Authors: Ralph Barnes

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The internationalization and globalization of education are now a huge, multi-million dollar industry. The movement of international students across the globe has provided a rich vein of revenue for universities and institutions of higher learning to exploit and harvest. A concerted effort has been made by universities worldwide to court students from overseas, with some countries relying up to one-third of student fees, coming from international students. Australian universities and English Language Centres are coming under increased government scrutiny in respect to such areas as the academic progression of international students, management and understanding of student visa requirements and the design of higher education courses and effective assessment regimes. As such, universities and other higher education institutions are restructuring themselves more as service providers rather than as strictly education providers. In this paper, the high-touch, tailored academic model currently followed by some Australian educational institutions to support international students, is examined and challenged. Academic support services offered to international students need to be coordinated, sustained and reviewed regularly, in order to assess their effectiveness. Maintaining the delivery of high-quality educational programs and learning outcomes for this high income-generating student cohort is vital, in order to continue the successful academic and social engagement by international students across the Australian university and higher education landscape.

Keywords: ESL, engagement, tertiary, learning

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3219 The Innovative Leadership in Air Forces

Authors: Ahmet Emre Yonder

Abstract:

The concept of present time is inevitably and rapidly changing. That provokes unbalanced, uncertain and elusive platform in the world order. Keeping up with this fluctuation requires a willingness to step beyond the comfort zones and to take a step through unknown. That is the perspectives of organizations in which the shareholders persistently create and then they share their creation. Moreover they are adapted to the unpredictable shifts and they establish vision. These are the meaning of innovation which is a process that converts new ideas to invaluable outcomes and that process can be ensured via innovative leaders. Leaders’ creativity is needed when challenging against countless complicated and unsteady situations in the battlefield. However, little attention has been paid to the importance of being innovative leader apart from innovating new technologies so far. Additionally, in most situation militarist organizations are hesitant to welcome different attitudes and that may discourage new ideas. Furthermore military leaders may complain about the lack of sources in today's world where the sources are very rare. In that point military leaders should change the strategies they apply from conventional views to the innovation of different point of views. But the constant occupation in Air Forces can be counted as a huge obstacle for innovative thinking. An organizational structure is needed to be developed for solutions of the problems which the creative leaders will encounter.This article focuses on how to raise innovative military leaders with innovative thinking skills and the need for a change from conventional to the innovative leadership in Air Forces. It also gives important suggestions to encourage raising innovative military leaders.

Keywords: air force, creativity, leadership, military, innovation

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3218 Optimization of Two Quality Characteristics in Injection Molding Processes via Taguchi Methodology

Authors: Joseph C. Chen, Venkata Karthik Jakka

Abstract:

The main objective of this research is to optimize tensile strength and dimensional accuracy in injection molding processes using Taguchi Parameter Design. An L16 orthogonal array (OA) is used in Taguchi experimental design with five control factors at four levels each and with non-controllable factor vibration. A total of 32 experiments were designed to obtain the optimal parameter setting for the process. The optimal parameters identified for the shrinkage are shot volume, 1.7 cubic inch (A4); mold term temperature, 130 ºF (B1); hold pressure, 3200 Psi (C4); injection speed, 0.61 inch3/sec (D2); and hold time of 14 seconds (E2). The optimal parameters identified for the tensile strength are shot volume, 1.7 cubic inch (A4); mold temperature, 160 ºF (B4); hold pressure, 3100 Psi (C3); injection speed, 0.69 inch3/sec (D4); and hold time of 14 seconds (E2). The Taguchi-based optimization framework was systematically and successfully implemented to obtain an adjusted optimal setting in this research. The mean shrinkage of the confirmation runs is 0.0031%, and the tensile strength value was found to be 3148.1 psi. Both outcomes are far better results from the baseline, and defects have been further reduced in injection molding processes.

Keywords: injection molding processes, taguchi parameter design, tensile strength, high-density polyethylene(HDPE)

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3217 Prescribing Pattern of Drugs in Patients with ARDS: An Observational Study

Authors: Rahul Magazine, Shobitha Rao

Abstract:

The aim of this study was to study the prescribing pattern of drugs in patients with ARDS (Acute Respiratory Distress Syndrome) managed at a tertiary care hospital. This observational study was conducted at Kasturba Hospital, Karnataka, India. Data of patients admitted from January 2010 to December 2012 was collected. A total of 150 patients of ARDS were included. Data included patients’ age, gender, clinical disorders precipitating ARDS, and prescribing pattern of drugs. The mean age of the study population was 42.92±13.91 years. 48% of patients were less than 40 years of age. Infection was the cause of ARDS in 81.3% of subjects. Antibiotics were prescribed in all the subjects and beta-lactams were prescribed in 97.3%. 41.3% were prescribed corticosteroids, 39.3% diuretics and 89.3% intravenous fluids. Infection was the commonest etiology for ARDS, and beta-lactams were the commonest antibiotics prescribed. Corticosteroids and diuretics were prescribed in a significant number of patients. Most of the patients received intravenous fluids.

Keywords: acute respiratory syndrome, beta lactams, corticosteroids, Acute Respiratory Distress Syndrome (ARDS)

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3216 Efficacy of Educational Program on the Performance of Internship Nursing Students Regarding Electronic Fetal Monitoring

Authors: Aida Abd El-Razek, Alyaa Salman Madian, Gamila Gaber Ayoub

Abstract:

Background: Electronic fetal monitoring is an obstetric technology that helps to record any changes in fetal heart rate and uterine activity. The aim of this study was to determine the efficacy of educational programs on the performance of internship nursing students regarding electronic fetal monitoring in obstetrics and gynecology departments. Design: A quasi-experimental research design (pre- and post-test) was used. Sample: A convenient sample of all internship nursing students (180 internship nursing students) from the Faculty of Nursing at Menoufia University during the academic year 2022-2023). The instruments of this study were a structured, self-administered interview questionnaire consisting of two parts: the socio-demographic characteristics of the study participants and an assessment of internship nursing students’ knowledge regarding electronic fetal monitoring (pre- and post-test). Observational checklist to assess internship nursing students’ performance regarding EFM. Results: There were highly statistically significant differences between the internship nurses' students’ knowledge and performance on the pretest and posttest. Conclusion: An educational program on electronic fetal monitoring carries a vital value for enhancing internship nursing students’ knowledge and performance, which ultimately leads to improved maternal and fetal outcomes. Recommendation: Regular educational programs and workshops about electronic fetal monitoring should be encouraged for all maternity nurses and internship nursing students.

Keywords: educational program, internship nursing students, performance, efficacy

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3215 Nutritional Management of Polycystic Ovary Syndrome Using a Mediterranean Diet

Authors: Mohamed Radwan

Abstract:

Introduction: Polycystic ovary syndrome is becoming very common among girls from ages 14 to 21 years old, alongside women in their childbearing period. A combination of menstrual irregularities, overweight or obesity, insulin resistance (type 2 diabetes), and symptoms of virilization are characteristics of these cases. Background: A multidisciplinary team should be involved in managing these cases and may consist of A gynecologist, endocrinologist, nutritionist, and psychologist. The role of nutritionists is crucial in these cases in weight reduction and nutritional management. It is mandatory to present some questions that may help in expanding further our understanding of the nutritional management of this syndrome, such as it is not an easy process to reduce the weight of PCO patients (2) we need to know what suitable nutritional plans for these cases are. Methodology: It is not successful to use one diet plan for all patients or a specific plan, but we need to give tailored plans for each patient. We will summarize the medical, nutritional therapy and weight management in polycystic ovary patients and highlight the best eating plan and dietary composition in the treatment of these women. We will also discuss the role of dieticians in treating polycystic ovary cases and overcoming the challenges these women face. Conclusion: All diet plans would decrease the weight of Polycystic ovary cases as low calory diet, low glycemic index diet, high protein diet, as well as Dash diet, but the most suitable diet plan to improve hormones and lead to spontaneous pregnancy is the Mediterranean diet.

Keywords: obesity, PCO mediteranian diet, dash diet, high protein diet

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3214 Youth and International Environmental Voluntary Initiatives: A Case Study of IGreen Project by AIESEC in Bandung

Authors: Yoel Agustheo Rinding

Abstract:

Globalization has made physical borders between countries become more obscure. Due to the free flow of information between countries, issue for instance, environment has become global concern. The concern has grown as the result of endless campaign made by most of the non-governmental organizations (NGOs). By means of this situation, international voluntary initiatives on environmental issues have appeared to be popular among world’s society today especially for youth. AIESEC as international non-governmental organization (INGO) through IGreen Project has initiated environmental international voluntary initiatives concerning in environmental awareness of Bandung’s citizen. Bandung itself is still struggling on solving flood as one of its major problems regardless the fact that Bandung is one of the most developed cities in Indonesia. This paper would like to discuss on how globalization affects AIESEC as an INGO in order to spread its influence and also on how it could build international voluntary initiatives networks. Afterwards, author would like to elaborate how both AIESEC and youth perceive the importance of international voluntary initiatives by using cosmopolitanism approach. In order to get a deep understanding of how this activity works, this paper also would like to explain regarding the management, expected outcomes, and the real impacts of IGreen project towards Bandung. In the end of this paper, author would like to propose solutions on how to utilize international voluntary initiatives as a solution for environmental issues nowadays.

Keywords: AIESEC, cosmopolitanism, environmental issues, globalization, IGreen project, international environmental voluntary initiatives, INGO, youth

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3213 Drowning: An Emergency Department Guideline

Authors: Thomas P. Jones

Abstract:

Overview: Drowning is an important cause of accidental death, particularly in children and young people. Although many survive drowning incidents, it is a relatively rare presenting complaint in Emergency Departments. When cases do present, they can be complex and unpredictable. For patients to receive the best care, it is important that their management is standardized and evidence based, however this can be difficult in a topic area with limited studies and inconsistencies in case reporting. Objectives: To review recent cases to assess the performance of Manchester Royal Infirmary Emergency Department in the management of near drowning. To produce evidence based guideline on the management of drowning victims in the ED. Methods: Emergency department records were searched for patients with the diagnosis of ‘fatal drowning’ or ‘nearly drowning’ and two relevant case notes reviewed. To produce the guideline a literature review was conducted and a series of structured short cut systematic reviews known as Best BETs carried out. This information was used to produce a clear treatment pathway. Results: The case studies emphasized the variety in presentation of drowning victims whilst highlighting inconsistencies in management and documentation. An evidence-based guideline is presented as a flowchart, which illustrates the relevant investigations and treatment that victims of a drowning incident should receive, based on the best available evidence. Conclusion: It is hoped that when put into practice, the guideline will improve and standardize patient care in cases of near drowning. An audit is recommended to assess its effectiveness.

Keywords: drowning, near drowning, non fatal drowning, fatal drowning

Procedia PDF Downloads 192