Search results for: patient safety culture

Authors: Liam Martin, Martha Watson

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Patients with learning disabilities (LD) are at increased risk of physical and mental illness due to health inequality. To address this, NICE recommends that people from the age of 14 with a learning disability should have an annual LD health check. This consultation should include a holistic review of the patient’s physical, mental and social health needs with a view of creating an action plan to support the patient’s care. The expected standard set by the Quality and Outcomes Framework (QOF) is that each general practice should review at least 75% of their LD patients annually. During COVID-19, there have been barriers to primary care, including health anxiety, the shift to online general practice and the increase in GP workloads. A surgery in North London wanted to assess whether they were falling short of the expected standard for LD patient annual reviews in order to optimize care post Covid-19. A baseline audit was completed to assess how many LD patients were receiving their annual reviews over the period of 29th September 2020 to 29th September 2021. This information was accessed using EMIS Web Health Care System (EMIS). Patients included were aged 14 and over as per QOF standards. Doctors were not notified of this audit taking place. Following the results of this audit, the creation of learning disability clinics was recommended. These clinics were recommended to be on the ground floor and should be a dedicated time for LD reviews. A re-audit was performed via the same process 6 months later in March 2022. At the time of the baseline audit, there were 71 patients aged 14 and over that were on the LD register. 54% of these LD patients were found to have documentation of an annual LD review within the last 12 months. None of the LD patients between the ages of 14-18 years old had received their annual review. The results were discussed with the practice, and dedicated clinics were set up to review their LD patients. A second pass of the audit was completed 6 months later. This showed an improvement, with 84% of the LD patients registered at the surgery now having a documented annual review within the last 12 months. 78% of the patients between the ages of 14-18 years old had now been reviewed. The baseline audit revealed that the practice was not meeting the expected standard for LD patient’s annual health checks as outlined by QOF, with the most neglected patients being between the ages of 14-18. Identification and awareness of this vulnerable cohort is important to ensure measures can be put into place to support their physical, mental and social wellbeing. Other practices could consider an audit of their annual LD health checks to make sure they are practicing within QOF standards, and if there is a shortfall, they could consider implementing similar actions as used here; dedicated clinics for LD patient reviews.

Keywords: COVID-19, learning disability, learning disability health review, quality and outcomes framework

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Authors: Anahita Suri

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Myriad cultures form the warp and weft of the fabric of this world. The last century saw mass migration of people across geographical boundaries, owing to industrialization and globalization. These people took with them their cultures, costumes, traditions, and folklore, which mingled with the local cultures to create something new and place it in a different context to make it contemporary. With the surge in population and growth of the fashion industry, there has been an increasing demand for innovative and individual fashion, from street markets to luxury brands. Exhausted by local influences, designers take inspiration from the so called ‘low’ culture and create artistic products, place it in a different context, and the end-product is categorized as ‘high’ culture. It is challenging as to why a design/culture is ‘high’ or ‘low’. Who decides which works, practices, activities, etc., are ‘high’ and which are ‘low’? The justification for this distinction is often found not in the design itself but the context attached to it. Also, the concept of high/ low is relative to time- what is ‘high’ today can be ‘low’ tomorrow and ‘high’ again the day after. This raises certain concerns. Firstly, it is sad that a culture which offers inspiration is looked down upon as ‘low’ culture. Secondly, it is ironic because the so designated ‘high’ culture is a manipulation of the truth from the authentic ‘low’ culture, which is capable of true expression. When you borrow from a different culture, you pretend to be authentic because you actually are not. Finally, it is important to be aware of crossing cultural boundaries and the context attached to a design/product so as to use it a responsible way that communicates the design without offending anyone. Is it ok for a person’s cultural identity to become another person’s fashion accessory? This essay explores the complex, multi-layered subject of fashion appropriation and aims to provoke debate over cultural ‘borrowing’ and create awareness that commodification of cultural symbols and iconography in fashion is inappropriate and offensive and not the same as ‘celebrating cultural differences’.

Keywords: context, culture, fashion appropriation, inoffensive, responsible

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Authors: Mohsen Shirani, Micaela Demichela

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Food supply chain is one of the most complex supply chain networks due to its perishable nature and customer oriented products, and food safety is the major concern for this industry. IT system could help to minimize the production and consumption of unsafe food by controlling and monitoring the entire system. However, there have been many issues in adoption of IT system in this industry specifically within SMEs sector. With this regard, this study presents a novel approach to use IT and tractability systems in the food supply chain, using application of RFID and central database.

Keywords: food supply chain, IT system, safety, SME

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Authors: Ali Baker, Russel Krawitz

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This paper describes a rare occurrence where a potentially fatal complication of COVID-19 infection (MIS-A) was misdiagnosed as an acute abdomen. As most patients with this syndrome present with fever and gastrointestinal symptoms, they may inadvertently fall under the care of the surgical unit. However, unusual imaging findings and a poor response to anti-microbial therapy should prompt clinicians to suspect a non-surgical etiology. More than half of MIS-A patients require ICU admission and vasopressor support. Prompt referral to a physician is key, as the cornerstone of treatment is IVIG and corticosteroid therapy. A 32 year old woman presented with right sided abdominal pain and fevers. She had also contracted COVID-19 two months earlier. Abdominal examination revealed generalised right sided tenderness. The patient had raised inflammatory markers, but other blood tests were unremarkable. CT scan revealed extensive lymphadenopathy along the ileocolic chain. The patient proved to be a diagnostic dilemma. She was reviewed by several surgical consultants and discussed with several inpatient teams. Although IV antibiotics were commenced, the right sided abdominal pain, and fevers persisted. Pan-culture returned negative. A mild cholestatic derangement developed. On day 5, the patient underwent preparation for colonoscopy to assess for a potential intraluminal etiology. The following day, the patient developed sinus tachycardia and hypotension that was refractory to fluid resuscitation. That patient was transferred to ICU and required vasopressor support. Repeat CT showed peri-portal edema and a thickened gallbladder wall. On re-examination, the patient was Murphy’s sign positive. Biliary ultrasound was equivocal for cholecystitis. The patient was planned for diagnostic laparoscopy. The following morning, a marked rise in cardiac troponin was discovered, and a follow-up echocardiogram revealed moderate to severe global systolic dysfunction. The impression was post-COVID MIS with myocardial involvement. IVIG and Methylprednisolone infusions were commenced. The patient had a great response. Vasopressor support was weaned, and the patient was discharged from ICU. The patient continued to improve clinically with oral prednisolone, and was discharged on day 17. Although MIS following COVID-19 infection is well-described syndrome in children, only recently has it come to light that it can occur in adults. The exact incidence is unknown, but it is thought to be rare. A recent systematic review found only 221 cases of MIS-A, which could be included for analysis. Symptoms vary, but the most frequent include fever, gastrointestinal, and mucocutaneous. Many patients progress to multi-organ failure and require vasopressor support. 7% succumb to the illness. The pathophysiology of MIS is only partly understood. It shares similarities with Kawasaki disease, macrophage activation syndrome, and cytokine release syndrome. Importantly, by definition, the patient must have an absence of severe respiratory symptoms. It is thought to be due to a dysregulated immune response to the virus. Potential mechanisms include reduced levels of neutralising antibodies and autoreactive antibodies that promote inflammation. Further research into MIS-A is needed. Although rare, this potentially fatal syndrome should be considered in the unwell surgical patient who has recently contracted COVID-19 and poses a diagnostic dilemma.

Keywords: acute-abdomen, MIS, COVID-19, ICU

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Authors: Jami Wang, Brian Kao, Davin Agustines

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COVID-19 highlighted the active discrimination against the Asian American population easily seen through media, social tension, and increased crimes against the specific population. It is well known that long-term racism can also have a large impact on both emotional and psychological well-being. However, the healthcare disparity during this time also revealed how the Asian American community lacked the research data, political support, and medical infrastructure for this particular population. During a time when Asian American fear for safety with decreasing mental health, telepsychiatry is particularly promising. COVID-19 demonstrated how well psychiatry could integrate with telemedicine, with psychiatry being the second most utilized telemedicine visits. However, the Asian American community did not utilize the telepsychiatry resources as much as other groups. Because of this, we wanted to understand why the patient population who was affected the most by COVID-19 mentally did not seek out care. To do this, we decided to study the top top telepsychiatry platforms. The current top telepsychiatry companies in the United States include Teladoc and BetterHelp. In the Teladoc mental health sector, they only had 4 available languages (English, Spanish, French, and Danis,) with none of them being an Asian language. In a similar manner, Teladoc’s top competitor in the telepsychiatry space, BetterHelp, only listed a total of 3 Asian languages, including Mandarin, Japanese, and Malaysian. However, this is still a short list considering they have over 20 languages available. The shortage of available physicians that speak multiple languages is concerning, as it could be difficult for the Asian American community to relate with. There are limited mental health resources that cater to their likely cultural needs, further exacerbating the structural racism and institutional barriers to appropriate care. It is important to note that these companies do provide interpreters to comply with the nondiscrimination and language assistance federal law. However, interactions with an interpreter are not only more time-consuming but also less personal than talking directly with a physician. Psychiatry is the field that emphasizes interpersonal relationships. The trust between a physician and the patient is critical in developing patient rapport to guide in better understanding the clinical picture and treating the patient appropriately. The language barrier creates an additional barrier between the physician and patient. Because Asian Americans are one of the largest growing patient population bases, these telehealth companies have much to gain by catering to the Asian American market. Without providing adequate access to bilingual and bicultural physicians, the current system will only further exacerbate the growing disparity. The healthcare community and telehealth companies need to recognize that the Asian American population is a severely underserved population in mental health and has much to gain from telepsychiatry. The lack of language is one of many reasons why there is a disparity for Asian Americans in the mental health space.

Keywords: telemedicine, psychiatry, Asian American, disparity

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Authors: M. Sadoughi, R. Ehsani

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The aim of the present study is examining the relationship between conceptual organizational culture and the level of tolerance in employees of Islamic Azad University of Shahre Ghods. This research is a correlational and analytic-descriptive one. The samples included 144 individuals. A 24-item standard questionnaire of organizational culture by Cameron and Queen was used in this study. This questionnaire has six criteria and each criterion includes four items that each item indicates one cultural dimension. Reliability coefficient of this questionnaire was normed using Cronbach's alpha of 0.91. Also, the 25-item questionnaire of tolerance by Conor and Davidson was used. This questionnaire is in a five-degree Likert scale form. It has seven criteria and is designed to measure the power of coping with pressure and threat. It has the needed content reliability and its reliability coefficient is normed using Cronbach's alpha of 0.87. Data were analyzed using Pearson correlation coefficient and multivariable regression. The results showed among various dimensions of organizational culture, there is a positive significant relationship between three dimensions (family, adhocracy, bureaucracy) and tolerance, there is a negative significant relationship between dimension of market and tolerance and components of organizational culture have the power of prediction and explaining the tolerance. In this explanation, the component of family is the most effective and the best predictor of tolerance.

Keywords: adhocracy, bureaucracy, organizational culture, tolerance

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Authors: Mookgo Solomon Kgatle

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Introductory Statement: The effect of corruption in South Africa has seriously constrained development of the national economy and has significantly inhibited good governance in the country. The significance of this paper is a demonstration that Corruption in a South African government is greatly influenced by the culture of greed by leaders in government. Many leaders in government are not satisfied with what they receive on monthly basis in the form of salaries and allowances. Thus, the quest to accumulate, as many material possessions by cabinet ministers and public servants is what is crippling the annual budget and disadvantaging the poor masses of our people including women, children and the elderly. Basic Methodology: In order to deal with this dilemma, this paper proposes ethical leadership as a theological and ethical alternative and antidote to the culture of greed in government. Research Findings: Ethical leadership is proposed because unlike the culture of greed, it is a leadership that is based on respect for ethical principles and standards and for the dignity and privileges of others. Ethical leadership is synonymous with principles like trust, morality, consideration, equality, and justice. Conclusion: The conclusion is that ethical leadership is one of the solutions that can assist the South African government to deal with the root causes of corruption, that is, the culture of greed.

Keywords: ethical leadership, theological ethics, culture of greed, corruption, governance

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Authors: Syed Qasim Gilani, Muhammad Umair, Muhammad Noman, Syed Bilawal Shah, Aqib Abbasi, Muhammad Waheed

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Cardiovascular Diseases(CVD's) are the major cause of death in the world. The main reason for these deaths is the unavailability of first aid for heart failure. In many cases, patients die before reaching the hospital. We in this paper are presenting innovative online health service for Cardiac Patients. The proposed online health system has two ends. Users through device developed by us can communicate with their doctor through a mobile application. This interface provides them with first aid.Also by using this service, they have an easy interface with their doctors for attaining medical advice. According to the proposed system, we developed a device called Cardiac Care. Cardiac Care is a portable device which a patient can use at their home for monitoring heart condition. When a patient checks his/her heart condition, Electrocardiogram (ECG), Blood Pressure(BP), Temperature are sent to the central database. The severity of patients condition is checked using Artificial Intelligence Algorithm at the database. If the patient is suffering from the minor problem, our algorithm will suggest a prescription for patients. But if patient's condition is severe, patients record is sent to doctor through the mobile Android application. Doctor after reviewing patients condition suggests next step. If a doctor identifies the patient condition as critical, then the message is sent to the central database for sending an ambulance for the patient. Ambulance starts moving towards patient for bringing him/her to hospital. We have implemented this model at prototype level. This model will be life-saving for millions of people around the globe. According to this proposed model patients will be in contact with their doctors all the time.

Keywords: cardiovascular disease, classification, electrocardiogram, blood pressure

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Authors: A. M. Bumbea, A. Musetescu, P. Ciurea, A. Bighea

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Objectives: The authors present a Parsonage Turner syndrome, a rare disease characterized by onset in apparently healthy person with shoulder and/or arm pain, sensory deficit, motor deficit. The causes are not established, could be determinate by vaccination, postoperative, immunologic disease, post traumatic etc. Methods: The authors present a woman case, 32 years old, (in 2006), no medical history, with arm pain and no other symptom. The onset was sudden with pain at very high level quantified as 10 to a 0 to 10 scale, with no response to classical analgesic and corticoids. The only drugs which can reduce the intensity of pain were oxycodone hydrochloride, 60 mg daily and pregabalinum150 mg daily. After two weeks the intensity of pain was reduced to 5. The patient started a rehabilitation program. After 6 weeks the patient associated sensory and motor deficit. We performed electromyography for upper limb that showed incomplete denervation with reduced neural transmission speed. The patient receives neurotrophic drugs and painkillers for a long period and physical and kinetic therapy. After 6 months the pain was reduced to level 2 and the patient maintained only 150 mg pregabalinum for another 6 months. Then, the evaluation showed no pain but general amiotrophy in upper limb. Results: At the evaluation in 2009, the patient developed a rheumatoid syndrome with tender and swelling joints, but no positive inflammation test, no antibodies or rheumatoid factor. After two years, in 2011 the patient develops an increase of antinuclear antibodies. This context certifies the diagnosis of lupus and the patient receives the specific therapy. Conclusions: This case is not a typical case of onset of lupus with PTS, but the onset of PTS could include the onset of an immune disease.

Keywords: lupus, arm pain, patient, swelling

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Authors: Sz. Klátyik, B. Darvas, M. Mörtl, M. Ottucsák, E. Takács, H. Bánáti, L. Simon, G. Gyurcsó, A. Székács

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Environmental and health safety of condiments used for spicing food products in food processing or by culinary means receive relatively low attention, even though possible contamination of spices may affect food quality and safety. Contamination surveys mostly focus on microbial contaminants or their secondary metabolites, mycotoxins. Chemical contaminants, particularly pesticide residues, however, are clearly substantial factors in the case of given condiments in the Capsicum family including spice paprika and chilli. To assess food safety and support the quality of the Hungaricum product spice paprika, the pesticide residue status of spice paprika and chilli is assessed on the basis of reported pesticide contamination cases and non-compliances in the Rapid Alert System for Food and Feed of the European Union since 1998.

Keywords: spice paprika, Capsicum, pesticide residues, RASFF

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Authors: Ramadhan Febriansyah, Sarah Novianti, Santi Agustini

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Indonesia is a big country with Moslem population. The government must fulfill all needs of the people. However, we do not have a good policy yet especially on healthy, safety and halal food. We try to offer a new solution to overcome this with ASUH (Aman, Sehat, Utuh, Halal) or in English is SHIH (Safe, Healthy, Intact, Halal) as alternative Indonesian policy on food security. This policy is Indonesian Government’s commitment to support Sustainability Development Goals program for the zero hunger (end hunger, to achieve food security and improved nutrition for Indonesian people, of course, to promote sustainable agriculture). Hopefully, it not only can increasing quality on food especially on livestock goods (meat, egg, milk) but also to guarantee the halal food. However, this policy can be an example to others country especially Moslem countries to support SDG’s programs. This research conducted means of the descriptive method; the authors find compare the secondary data obtained from journals, textbook and scientific articles in order to determine the factors that influence food safety and food security. Relevant data used and contain a description of SDG’s as well as about the system food safety and food security that SHIH (Safe, Healthy, Intact and Halal) so these ideas can be implemented.

Keywords: food safety, food security, food sovereignty, halal SDG's

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Authors: Peri Harish Kumar, Rafique Umer Harvitkar

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Background: The emergency department mandates maximum efficacy in the utilization of the available resources. Non-urgent patient visits pose a serious concern to the treatment, patient triage, and resources available. Aims and Objectives: We conducted a retrospective case-control study of the emergency department patient list from October 2019 to November 2022. A total of 839 patients formed part of the study. Somatic complaints, vital signs, diagnostic test results, admission to the hospital, etc., were some of the criteria used for the categorization of patients. Results: The proportion of non-urgent visits varied from 7.2% to 43%, with a median of 21%. Somatic complaints were the least associated with further hospital admissions (n=28%), while diagnostic test results were the most significant indicator of further hospital admissions (n=74%). Effective triage helped minimize emergency department admissions by 36%. Conclusion: Our study shows that effective triaging, patient counselling, and round-the-clock consumable monitoring helped in the effective management of patients admitted and also significantly helped provide treatment to the patients most in need.

Keywords: urgent visits, non-urgent visits, traiging, emergency department admissions

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Authors: Wilailak Siripornadulsil, Siriyanapat Tasaku, Jutamas Buahorm, Surasak Siripornadulsil

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The objectives of this study were to isolate LAB from various sources, dietary supplement, Thai traditional fermented food, and freshwater fish and to characterize their potential as probiotic cultures. Out of 1,558 isolates, 730 were identified as LAB based on isolation on MRS agar supplemented with a bromocresol purple indicator and CaCO3 and gram-positive, catalase and oxidase negative characteristics. Eight isolates showed the potential probiotic properties including tolerance to acid, bile salt and heat, proteolytic, amylolytic and lipolytic activities and oxalate-degrading capability. They all showed the antimicrobial activity against some Gram-negative and Gram-positive pathogenic bacteria. Based on 16S rDNA sequence analysis, they were identified as Enterococcus faecalis BT2 and MG30, Leconostoc mesenteroides SW64 and Pediococcus pentosaceous BD33, CF32, NP6, PS34 and SW5. The health beneficial effects and food safety will be further investigated and developed as a probiotic or protective culture used in Nile tilapia belly flap meat fermentation.

Keywords: probiotic, lactic acid bacteria, pathogen, protective culture

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Authors: Sonny Nyeko, Moses Niwe

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Purpose: This research paper examined the mediation effect of organization culture in the relationship between information technology (IT) competence and IT governance effectiveness in Ugandan public universities. The purpose of the research paper is to examine the role of organizational culture in the relationship between IT competence and IT governance effectiveness. Design/methodology/approach: The paper adopted the MedGraph program, Sobel tests and Kenny and Baron Approach for testing the mediation effects. Findings: It is impeccable that IT competence and organization culture are true drivers of IT governance effectiveness in Ugandan public universities. However, organizational culture reveals partial mediation in the IT competence and IT governance effectiveness relationship. Research limitations/implications: The empirical investigation in this research depends profoundly on public universities. Future research in Ugandan private universities could be undertaken to compare results. Practical implications: To effectively achieve IT governance effectiveness, it means senior management requires IT knowledge which is a vital ingredient of IT competence. Moreover, organizations today ought to adopt cultures that are intended to have them competitive in their businesses, with IT operations not in isolation. Originality/value: Spending thousands of dollars on IT resources in advanced institutes of learning necessitates IT control. Preliminary studies in Ugandan public universities have revealed the ineffective utilization of IT resources. Besides, IT governance issues with IT competence and organization culture remain outstanding. Thus, it’s a new study testing the mediating outcome of organization culture in the association between IT competence and IT governance effectiveness in the Ugandan universities.

Keywords: organization culture, IT competence, IT governance, effectiveness, mediating effect, universities, Uganda

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Authors: Devieta Romadhon Saendardy

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Introduction: The case of aneurysmal subarachnoid hemorrhage (SAH) associated with intraventricular hemorrhage (IVH) in many way. In general, the anterior communicating artery and posterior circulation aneurysms cause Intraventricular Hemorrhage. The development of intraventricular hemorrhage (IVH) in aneurysmal subarachnoid hemorrhage (aSAH) is linked with higher mortality and poor neurological recovery. Case: This case report presents a 51-year-old female patient who developed IVH following SAH. The patient's Glasgow Coma Scale score was 14, the patient has a severe headache, and there were right extremity hemipharese neurological deficits. A non-contrast head CT scan revealed a massive intraventricular haemorrhage. In an hour, the patient got her headache and pharese worse. Discussion: Intraventricular hemorrhage is a serious complication of subarachnoid hemorrhage, necessitating prompt recognition and management. This case highlights the importance of a time management, medical management and surgical intervention to optimize outcomes in patients with intraventricular hemorrhage caused by subarachnoid hemorrhage. Placement of a shunt system improves clinical outcome in intraventricular hemorrhage.

Keywords: Intraventricular hemorrhage, subarachnoid hemorrhage, shunt, time

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Authors: Ghulam Shabir, Masood Nadeem

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The research work has been done on the Portrayal of Foreign Culture including Film, Art, and Drama in Pakistani English newspapers (Dawn and The News). For this purpose the weekly newspapers of three months (January to March) of the years 1990, 1995, 2000, 2005, and 2010 were analyzed. Content Analysis was employed for data interpretation and to draw the inferences. It was explored that to what extent the Foreign Culture has been depicted in our print media in the form of Film, Art, and Drama in comparison to Pakistani cultural context. The qualitative analysis revealed that Pakistani English newspapers gave more coverage to Foreign Culture. Pakistani film, art, and drama related issues have been less portrayed in the form of stories, columns, pictures, and news about music, fashion, ceremonies, programs, and shows. However, most of the space has been occupied by Western and Indian pictures, and news about music, fashion, ceremonies, programs and shows on the Cultural Page of these English newspapers.

Keywords: newspapers, portrayal of foreign culture, qualitative analysis, Pakistani English newspapers

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Authors: Mohammad Raihan Mukhlis, M. Abdur Rahman Bhuiyan

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Bangladesh is a developing country in which a lot of multi-span simply/continuous supported flyovers are being constructed in its major cities. Being situated in a seismically active region, seismic safety evaluation of flyovers is essential for seismic risk reduction. Effects of site amplification on seismic safety evaluation of flyover piers are the main concern of this study. In this regard, failure mode, lateral strength and displacement ductility of piers of a typical multi-span simply supported flyover have been evaluated by Japan Road Association (JRA) recommended guidelines, with and without considering site amplification. Ultimate flexural strengths of piers have been computed using the pushover analysis results. Shear capacity of piers has been calculated using the guidelines of JRA. Lateral strengths have been determined depending on the failure modes of the piers. Displacement ductility of piers has been computed using yield and ultimate displacements of the piers obtained from the pushover analysis results. Selected earthquake time history is used in seismic safety evaluation of the flyover piers. Finally, the ductility design method is used to conduct the seismic safety evaluation of the piers with and without considering site amplification. From the numerical results, it has been revealed that the effects of site amplification on seismic safety evaluation of bridge structures should be carefully taken into account.

Keywords: displacement ductility, flyover pier, lateral strength, safety evaluation, site amplification

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Authors: Dhanpat Singh Dhania

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Kurma-avatara and the Kachchhapraj is the name of the same person. Tortoise is called Kurma in Kerma valley (Nubia) and also called Kachchhap in India. Wherever a culture migrates, its faiths and beliefs remain intact. The tortoise culture of Kurma valley migrated to Dholavira, and its cultural symbolism remained the same as Kurma, the tortoise. Culture is known by burial traditions, pottery formations, language use, faiths, and beliefs. Following the cultural identification methodology, the Kurma culture buried their dead in circular burials found during excavation at Toshka, Nubia, and built their houses the type of tortoise shell. The Nubian tortoise of a specific species had a triangular on the shell found to be extinct was the cultural symbolism of the culture found on the excavated pottery. Kurma cultural head known as the Seth was known as Kurma-avatara. The Seth of Egypt came to know when the combined efforts of the Seth and the Osiris defeated the Egyptian 1st dynastic rule in about 2775 BCE. Osiris became the king of the 2nd dynastic Egypt. It annoyed Seth. He killed the Osiris and went to Rann of Kachchh and declared him as the Chachchhapraj, the king of Kachchh (now Gujarat, India). The Kurma (Kachchhap) culture migration at Dholavira (Gujarat) attested by the Dholavira signboard found during excavation and deciphered as the ‘Chakradhar’, the eighth incarnation of Kurma-avatara.

Keywords: Kurma, Egyptian, Kachchhap, Dholavira, Harappan

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Authors: Sheridan Wigginton

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This research project investigates the representation of Dominicans and Dominican culture in nine widely-used Spanish textbooks in universities and colleges in the United States. The project uses the “culture” standard established by the American Council on the Teaching of Foreign Languages to examine the texts. The organization, commonly referred to by its acronym ACTFL, describes products as books, tools, foods, laws, music, and games; practices as patterns of social interactions; and perspectives as meanings, attitudes, values, and ideas. The content analysis of the texts will also specifically include visual analysis of the physical representation of the people depicted in Dominican-themed culture activities to more clearly integrate issues of color and national identity into the discussion.

Keywords: blackness, culture, Dominican republic, foreign language education, national identity, Spanish, textbooks

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Authors: Ayodele James Akinola

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This study examines how social and linguistic variables influenced communication between neurologists and patients in selected university teaching hospitals (UTHs) in southwestern Nigeria. Jacob Mey’s Pragmatic Acts, complemented by Emanuel and Emanuel’s model of doctor-patient relationship, served as the theoretical framework. Data comprising 22 audio-recorded neurologist-patient interactions were collected from two UTHs in the southwestern region of Nigeria. Data revealed that educational attainment of patients has insignificant influence on the interaction where the linguistic prowess of the patient has been impaired for consultative communication. However, the status influenced the degree of attention paid to patients by neurologists and determines the amount of time 'trying to help patients to communicate'. Patients with lower educational status and who could not communicate in English spent more time narrating their ailment to neurologists. Patients with higher educational status and could communicate in English saves consultation time as they express themselves briefly unlike those who were of little or no education in the clinics. Through this, diagnoses and therapeutic processes took eight to 12 minutes. 20 minutes was the longest duration recorded. Neurologist-patient interaction in the observed hospitals is shaped by neurologists’ experience, patients’ social variables and language.

Keywords: medical pragmatics, neurologist-patient interaction, nigeria, socio-linguistic influence

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Authors: Carlos V. Gonzalez

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Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.

Keywords: harm, patients, resilience, safety, mental illness, disability

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Authors: Nana Benma Osei

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Patient discharge can be a hectic process. Patients are sometimes sent to the wrong location or forgotten in lounges in the waiting room. This ends up compromising patient care because the delay in picking the patients can affect how they adhere to medication. Patients may fail to take their medication, and this will lead to negative outcomes. The situation highlights the demands of modern-day healthcare, and the use of technology can help in reducing such challenges and in enhancing the patient’s experience, leading to greater satisfaction with the care provided. The paper contains the proposed changes to a healthcare facility by introducing the clinical decision support system, which will be needed to improve coordination and communication during patient discharge. This will be done under Kurt Lewin’s Change Management Model, which recognizes the different phases in the change process. A pilot program is proposed initially before the program can be implemented in the entire organization. This allows for the identification of challenges and ways of managing them. The paper anticipates some of the possible challenges that may arise during implementation, and a multi-disciplinary approach is considered the most effective. Opposition to the change is likely to arise because staff members may lack information on how the changes will affect them and the skills they will need to learn to use the new system. Training will occur before the technology can be implemented. Every member will go for training, and adequate time is allocated for training purposes. A comparison of data will determine whether the project has succeeded.

Keywords: patient discharge, clinical decision support system, communication, collaboration

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Authors: Mohd Naqiuddin Bin Husri, Siti Rahmah Abd Rahman, Dalilah Abu Bakar, Dayang Izawati Abang Masli, Meilina Ong Abdullah

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A serious shortage of prime agricultural land coupled with environmental concerns inland expansion has daunted efforts to increase the national yield average. To address this issue, maximising yield per unit hectare through quality planting material is of great importance. Breeding for improved planting materials has been a continuous effort since the early days of this industry, it is time-consuming, and the likelihood of segregation within the progenies further impedes progress in this area. Incorporation of the cloning technology in oil palm breeding programmes is therefore advantageous to expedite the development of commercial elite and high-yielding planting materials. After more than 22 years of research and development through this project, reliable protocols for liquid/suspension culture systems coupled with various innovative technologies which are effective at promoting proliferation and growth of oil palm culture have been established. Subsequently, clonal palms derived from the suspension culture system were extensively studied in the field, and the results have been encouraging. Clones such as CPS1, CPS2 and a few others recorded superior performance in comparison with D x P standard crosses.

Keywords: tissue culture, suspension culture, oil palm, Elaeis guineensis

Procedia PDF Downloads 176

Authors: Mirjana Đ. Laban, Dragan N. Đurica, Nemanja M. Erceg

Abstract:

Volunteer fire departments (VFD) in Serbia were established as civic associations in XIX Century. The founders and members of the first VFDs were prominent members of local communities. Today, those are volunteer organizations for preventing and extinguishing fires and rescuing people and property in various accidents. The paper presents the results of research about the number and resources of active VFDs done in Autonomous Province of Vojvodina, Serbia and about activities they perform today. The survey was done based on data provided by all registered VFDs in Vojvodina. Firefighters Association of Vojvodina includes 35 municipal firefighting associations, 230 volunteer fire departments with 5,300 active members in qualified fire units and more than 15,000 supporting members. Volunteer involvement is primarily an expression of high moral values and as such it has to be respected and stimulated. Better position of the volunteers would have a major impact on the formation of safety culture concept and general public awareness of fire safety and risk reduction, and therefore the security of the society as a whole. Volunteer fire departments make a significant contribution to educate young people and prevent catastrophic consequences of fires and natural disasters.

Keywords: education, prevention, rescue, volunteer fire departments

Procedia PDF Downloads 189

Authors: Bei Shan Lin, Chun Mei Lu, Ya Ping Chen, Li Chen Lu

Abstract:

This study explores the ethical issues concerning the use of physical restraint in geriatric care. Physical restraint use in a medical care setting is seen as a controversial form of treatment that has occurred over decades. There is no doubt that people nowadays are living longer than previous generations. The ageing process is inevitable. Common disease such as impaired comprehension, memory loss, and trouble expressing one’s self contribute to the difficulty that these older patients have in adapting to medical institution. For these reasons, physical restraint is often used in reducing the risk of falling, managing wandering behaviour, preventing agitation, and promoting patient compliance in geriatric care. It can mean that physical restraints are considered as a common practice that is used in the care of older patients. It is most commonly used for three specific purposes, including procedural restraint, restraint to prevent falls, and behavioural restraints. Although there have been well documented instances of morbidity and mortality recognised as being potential risks associated with physical restraint use, it continues to be permitted and used in healthcare, often in the name of safety. However, there is insufficient evidence supporting the effectiveness of physical restraint use reducing injuries from falls and controlling challenging behaviour in geriatric care settings. There is barely any empirical evidence of either a scientific basis or clinical trials have evaluated the improvement in patient safety following physical restraint. In difficult clinical situations, guidelines and practical suggestions for Healthcare professionals to comply requirements can help those making appropriate decisions and to facilitate better judgement regarding physical restraint use. The following recommendations are given for physical restraint use in long-term care settings: an interdisciplinary team approach to assess, evaluate, and treat underlying diseases to determine if treatment can ease issues precipitating physical restraint use; a clearly stated purpose of treatment plan should be made after weighing up the risk of physical restraint use against the risk of without physical restraint use; a care plan for physical restraint has to include individualised treatment planning, informed consent, identification and remedial action to avoid negative consequences, regular assessment and modification, reduction and removal of risks; patients and their families must have the opportunity to consider and give voluntary informed consent prior to physical restraint utilisation; patients, family members, and Healthcare professionals should be educated on use and adverse consequences of physical restraints in order to make raise awareness of potential risks and to take appropriate steps to prevent unnecessary harm; after physical restraint removal, Healthcare professionals should discuss with patients and family members about their experience, feelings, and any anxieties regarding the treatment. Physical restraint should always be considered a last resort as deprive patient’s freedom, control, and individuality. Healthcare professionals should emphasise on providing individualized care, interdisciplinary decision-making process, and creative and collaborative alternatives to promote older patient’s rights, dignity and overall well-being as much as possible.

Keywords: ethics healthcare, geriatric care, healthcare, physical restraint

Procedia PDF Downloads 126

Authors: Shilpa Sondkar, Maithili Patil, Atharva Potnis

Abstract:

The current health care landscape desires efficiency and patient satisfaction for optimal performance. Medical appointment booking apps have increased the overall efficiency of clinics, hospitals, and e-health marketplaces while simplifying processes. These apps allow patients to connect with doctors online. Not only are mobile doctor appointment apps a reliable and efficient solution, but they are also the future of clinical progression and a distinct new stage in the patient-doctor relationship. Compared to the usual queuing method, the web-based appointment system could significantly increase patients' satisfaction with registration and reduce total waiting time effectively.

Keywords: appointment, patient, scheduling, design and development, Figma

Procedia PDF Downloads 74

Authors: Ahmad Badawi Saluy, Novawiguna Kemalasari

Abstract:

This study aims to examine and analyze the influence of organizational culture, organizational commitment, and transformational leadership style on employee performance. This study used descriptive survey method with quantitative approach, and questionnaires as a tool used for basic data collection. The sampling technique used is proportionate stratified random sampling technique; all respondents in this study were 70 respondents. The analytical method used in this research is multiple linear regressions. The result of determination coefficient of 52.3% indicates that organizational culture, organizational commitment, and transformational leadership style simultaneously have a significant influence on the performance of employees, while the remaining 47.7% is explained by other factors outside the research variables. Partially, organization culture has strong and positive influence on employee performance, organizational commitment has a moderate and positive effect on employee performance, while the transformational leadership style has a strong and positive influence on employee performance and this is also the variable that has the most impact on employee performance.

Keywords: organizational culture, organizational commitment, transformational leadership style, employee performance

Procedia PDF Downloads 209

Authors: K. Hinde, R. Bookun, P. Tran

Abstract:

Percutaneous CT guided biopsies provide a fast, minimally invasive, cost effective and safe method for obtaining tissue for histopathology and culture. Standards for diagnostic yield vary depending on whether the tissue is being obtained for histopathology or culture. We present a retrospective audit from Western Health in Melbourne Australia over a 12-month period which aimed to determine the diagnostic yield, technical success and complication rate for CT guided bone biopsies and identify factors affecting these results. The digital imaging storage program (Synapse Picture Archiving and Communication System – Fujifilm Australia) was analysed with key word searches from October 2015 to October 2016. Nineteen CT guided bone biopsies were performed during this time. The most common referring unit was oncology, work up imaging included CT, MRI, bone scan and PET scan. The complication rate was 0%, overall diagnostic yield was 74% with a technical success of 95%. When performing biopsies for histologic analysis diagnostic yield was 85% and when performing biopsies for bacterial culture diagnostic yield was 60%. There was no significant relationship identified between size of lesion, distance of lesion to skin, lesion appearance on CT, the number of samples taken or gauge of needle to diagnostic yield or technical success. CT guided bone biopsy at Western Health meets the standard reported at other major clinical centres for technical success and safety. It is a useful investigation in identification of primary malignancy in distal bone metastases.

Keywords: bone biopsy, computed tomography, core biopsy, histopathology

Procedia PDF Downloads 188

Authors: Royia Soliman, Salma ElAnsary, Akram Amin Abdellatif, Florian Holzapfel

Abstract:

Model-Based Safety Analysis (MBSA) is an approach in which the system and safety engineers share a common system model created using a model-based development process. The model can also be extended by the failure modes of the system components. There are two famous approaches for the addition of fault behaviors to system models. The first one is to enclose the failure into the system design directly. The second approach is to develop a fault model separately from the system model, thus combining both independent models for safety analysis. This paper introduces a hybrid approach of MBSA. The approach tries to use informal abstracted models to investigate failure behaviors. The approach will combine various concepts such as directed graph traversal, event lists and Constraint Satisfaction Problems (CSP). The approach is implemented using an Object Oriented programming language. The components are abstracted to its failure logic and relationships of connected components. The implemented approach is tested on various flight control systems, including electrical and multi-domain examples. The various tests are analyzed, and a comparison to different approaches is represented.

Keywords: flight control systems, model based safety analysis, safety assessment analysis, system modelling

Procedia PDF Downloads 150

Authors: Meiliana, Achmad Eko Prabowo, Muhammad Fathan Mubina

Abstract:

AFTA agreement in 2015 will bring a significant impact on Indonesian society. Indonesia’s people will face competition both in the economic, political, and cultural regionally among ten countries in ASEAN. Indonesia is a rich country in culture and has a large enough demographic bonus when compared to other ASEAN countries. Indonesia also has a lot of cultural enrichment in every its region. It’s mean, the role of society and culture of Indonesia's abundant if combined properly it will help Indonesia in the face of the ASEAN Economic Community (AEC) in 2015. This paper will discuss the role of one-stop culture workshop (OSCW) concept at Saung Angklung Udjo (SAU), a cultural tourist area of Angklung which is located in Bandung. OSCW is a concept that implemented a cultural tour in SAU that invites the visitor to engage in the cultural empowerment. In this research, we will answer how the concepts are applied by SAU can be an alternative to re-discover the potential of Indonesia in the face of the AEC 2015. Units of analysis that we used is among the programs, outcomes, and community empowerment. This study used a qualitative approach with in-depth interviews and observation. The finding of this study prove that OSCW concept is an opportunity for Indonesia to encourage a culture to go international. The concept of OSCW can really be used other communities to develop cultures of Indonesia so that later institutionalized culture that not only can be used as a tourist attraction but also as an educational laboratory for the community.

Keywords: OSCW concept, citizen empowerment, cultural tour, AEC 2015

Procedia PDF Downloads 456