Search results for: COBIT 2019
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1086

Search results for: COBIT 2019

576 Seroprevalence of Bovine Brucellosis and its Public Health Significance in Selected Sites of Central High Land of Ethiopia

Authors: Temesgen Kassa Getahun, Gezahegn Mamo, Beksisa Urge

Abstract:

A cross-sectional study was conducted from December 2019 to May 2020 with the aim of determining the seroprevalence of brucellosis in dairy cows and their owners in the central highland of Oromia, Ethiopia. A total of 352 blood samples from dairy cattle, 149 from animal owners, and 17 from farm workers were collected and initially screened using the Rose Bengal Plate test and confirmed by the Complement Fixation test. Overall seroprevalence was 0.6% (95% CI: 0.0016–0.0209) in bovines and 1.2% (95% CI: 0.0032–0.0427) in humans. Market-based stock replacement (OR=16.55, p=0.002), breeding by artificial insemination (OR=7.58, p=0.05), and parturition pen (OR = 11.511, p=0.027) were found to be significantly associated with the seropositivity for Brucella infection in dairy cattle. Human housing (OR=1.8, p=0.002), contact with an aborted fetus (OR=21.19, p=0.017), drinking raw milk from non-aborted (OR=24.99, p=0.012), aborted (OR=5.72, p=0.019) and retained fetal membrane (OR=4.22, p=0.029) cows had a significant influence on human brucellosis. A structured interview question was administered to 284 respondents. Accordingly, most respondents had no knowledge of brucellosis (93.3%), and in contrast, 90% of them consumed raw milk. In conclusion, the present seroprevalence study revealed that brucellosis was low among dairy cattle and exposed individuals in the study areas. However, since there were no control strategies implemented in the study areas, there is a potential risk of transmission of brucellosis in dairy cattle and the exposed human population in the study areas. Implementation of a test and slaughter strategy with compensation to farmers is recommended, while in the case of human brucellosis, continuous social training and implementing one health approach framework must be applied.

Keywords: abortion, bovine brucellosis, human brucellosis, risk factors, seroprevalence

Procedia PDF Downloads 103
575 Awareness on Department of Education’s Disaster Risk Reduction Management Program at Oriental Mindoro National High School: Basis for Support School DRRM Program

Authors: Nimrod Bantigue

Abstract:

The Department of Education is continuously providing safe teaching-learning facilities and hazard-free environments to the learners. To achieve this goal, teachers’ awareness of DepEd’s DRRM programs and activities is extremely important; thus, this descriptive correlational quantitative study was conceptualized. This research answered four questions on the profile and level of awareness of the 153 teacher respondents of Oriental Mindoro National High School for the academic year 2018-2019. Stratified proportional sampling was employed, and both descriptive and inferential statistics were utilized to treat data. The findings revealed that the majority of the teachers at OMNHS are female and are in the age bracket of 20-40. Most are married and pursue graduate studies. They have moderate awareness of the Department of Education’s DRRM programs and activities in terms of assessment of risks activities, planning activities, implementation activities during disaster and evaluation and monitoring activities with 3.32, 3.12, 3.40 and 3.31 as computed means, respectively. Further, the result showed a significant relationship between the profile of the respondents such as age, civil status and educational attainment and the level of awareness. On the contrary, sex does not have a significant relationship with the level of awareness. The Support School DRRM program with Utilization Guide on School DRRM Manual was proposed to increase, improve and strengthen the weakest areas of awareness rated in each DRRM activity, such as assessment of risks, planning, and implementation during disasters and monitoring and evaluation.

Keywords: awareness, management, monitoring, risk reduction

Procedia PDF Downloads 212
574 Healthcare Workers’ Knowledge and Attitude Toward Telemedicine During the COVID-19 Pandemic: A Global Survey

Authors: Saman Naqvi

Abstract:

Introduction: Telemedicine is the practise of providing remote healthcare to patients via the utilisation of communication technologies. Its application has become increasingly important since the Coronavirus Disease 2019 (COVID-19) pandemic. It is essential to determine the knowledge and attitudes of healthcare professionals concerning its use in order to maximise its application. Purpose: We aim to examine and evaluate the current understanding and perceptions of medical staff toward the use of telemedicine. Methods: In this cross-sectional study, we surveyed 1091 healthcare professionals worldwide. Following an extensive review of the literature, data were gathered using a questionnaire. To depict the participant profile, frequency, percentages, and cumulative percentages were determined. Results: The majority of respondents had either heard of (90.9%), seen (65.3%), or were familiar with (74.6%) how telemedicine is implemented in practice. 72.2% of people were familiar with the tools that could be applied to this technology. Those with a medical degree and experience of under five years were found to be more familiar with telemedicine. Additionally, opinions on providing healthcare remotely were largely favorable, with 80% of respondents stating that it reduced staff burden and 80.6% thinking that it eliminated unnecessary transportation costs. Furthermore, 83% expressed that it saves clinicians' time. However, 20% of participants believed telemedicine adds to staff workload and 40% of healthcare professionals felt it compromises patient privacy and information confidentiality. Conclusion: Despite being a new and developing practice in many countries, telemedicine appears to have a bright future. This is crucial during a pandemic as it provides effective healthcare while maintaining social isolation measures. Moreover, the majority of the participants in this study demonstrated a good understanding and a favorable attitude toward telemedicine.

Keywords: healthcare system, global survey, knowledge, attitude, covid 19, telemedicine

Procedia PDF Downloads 87
573 Canine Neonatal Mortality at the São Paulo State University Veterinary Hospital, Botucatu, São Paulo, Brazil – Preliminary Data

Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

The neonatal mortality rates in dogs are considered high, varying between 5.7 and 21.2% around the world, and the causes of the deaths are often unknown. Data regarding canine neonatal mortality are scarce in Brazil. This study aims at describing the neonatal mortality rates in dogs, as well as the main causes of death. The study included 152 litters and 669 neonates admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil between January 2018 and September 2019. The overall mortality rate was 16.7% (112/669), with 40% (61/152) of the litters presenting at least one case of stillbirth or neonatal mortality. The rate of stillbirths was 7.7% (51/669), while the neonatal mortality rate was 9% (61/669). The early mortality rate (0 to 2 days) was 13.7% (92/669), accounting for 82.1% (92/112) of all deaths. The late mortality rate (3 to 30 days) was 2.7% (18/669), accounting for 16% (18/112) of all deaths. Infection was the causa mortis in 51.8% (58/112) of the newborns, of which 30.3% (34/112) were caused by bacterial sepsis, and 21.4% (24/112) were caused by other bacterial, viral or parasite infections. Other causes of death included congenital malformations (15.2%, 17/112), of which 5.3% (6/112) happened through euthanasia due to malformations incompatible with life; asphyxia/hypoxia by dystocia (9.8%, 11/112); wasting syndrome in debilitated newborns (6.2%, 7/112); aspiration pneumonia (3.6%, 4/112); agalactia (2.7%, 3/112); trauma (1.8%, 2/112); administration of contraceptives to the mother (1.8%, 2/112) and unknown causes (7.1%, 8/112). The neonatal mortality rate was considered high, but they may be even higher in locations without adequate care for the mothers and neonates. Therefore, prenatal examinations and early neonatal care are of utmost importance for the survival of these patients.

Keywords: neonate dogs, puppies, mortality rate, neonatal death

Procedia PDF Downloads 201
572 Histopathological Spectrum of Skin Lesions in the Elderly: Experience from a Tertiary Hospital in Southeast Nigeria

Authors: Ndukwe, Chinedu O.

Abstract:

Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in the geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Material and methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1 and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1±9.5 years. In the female patients, it was 70.1±7.5 years. The commonest disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. Commonest was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms and papulosquamous disorders are the three commonest histologically diagnosed skin lesions in our geriatric population. The commonest skin malignancies in this group of patients are squamous cell carcinoma and malignant melanoma.

Keywords: geriatric, skin, Nigeria, histopathology

Procedia PDF Downloads 167
571 Suicide Prevention among Young People: Findings from the Evaluation of Youth Aware of Mental Health in Australian Secondary Schools

Authors: Lauren McGillivray, Michelle Torok, Alison Calear

Abstract:

Suicide is the leading cause of death for Australians aged 15-24 years, with rates increasing over the past decade. As young people can be particularly vulnerable to mental health problems and suicidal behavior, they are an essential and obvious target for suicide prevention efforts. This study investigates the effectiveness of the universal mental health promotion and suicide prevention program, Youth Aware of Mental Health (YAM), to reduce suicidal ideation and attempts and increase help-seeking in young people. This trial took place in Australian schools across four regions in New South Wales that form part of LifeSpan, a larger multilevel suicide prevention research trial. The YAM program was delivered to Year 9 students in up to 78 schools over two years (from January 2017 to December 2019). All schools were invited to participate in YAM's evaluation, which included completing a student questionnaire at three time-points: baseline, 3-month post-intervention, and 6-month follow-up. The primary outcome is suicidal ideation severity. Secondary outcomes are new reports of suicide attempts, stigma towards suicide, knowledge about suicide, help-seeking intentions and behaviors, and depressive symptoms. Results from pre-post and follow-up data will be presented. These research findings are promising and will contribute to the evidence-based for YAM and suicide prevention programs in Australian schools. These findings are also expected to promote YAM's value and sustainability to be more widely delivered in Australian secondary schools.

Keywords: adolescent mental health, suicidal ideation, suicide prevention, universal program

Procedia PDF Downloads 130
570 More Precise: Patient-Reported Outcomes after Stroke

Authors: Amber Elyse Corrigan, Alexander Smith, Anna Pennington, Ben Carter, Jonathan Hewitt

Abstract:

Background and Purpose: Morbidity secondary to stroke is highly heterogeneous, but it is important to both patients and clinicians in post-stroke management and adjustment to life after stroke. The consideration of post-stroke morbidity clinically and from the patient perspective has been poorly measured. The patient-reported outcome measures (PROs) in morbidity assessment help improve this knowledge gap. The primary aim of this study was to consider the association between PRO outcomes and stroke predictors. Methods: A multicenter prospective cohort study assessed 549 stroke patients at 19 hospital sites across England and Wales during 2019. Following a stroke event, demographic, clinical, and PRO measures were collected. Prevalence of morbidity within PRO measures was calculated with associated 95% confidence intervals. Predictors of domain outcome were calculated using a multilevel generalized linear model. Associated P -values and 95% confidence intervals are reported. Results: Data were collected from 549 participants, 317 men (57.7%) and 232 women (42.3%) with ages ranging from 25 to 97 (mean 72.7). PRO morbidity was high post-stroke; 93.2% of the cohort report post-stroke PRO morbidity. Previous stroke, diabetes, and gender are associated with worse patient-reported outcomes across both the physical and cognitive domains. Conclusions: This large-scale multicenter cohort study illustrates the high proportion of morbidity in PRO measures. Further, we demonstrate key predictors of adverse outcomes (Diabetes, previous stroke, and gender) congruence with clinical predictors. The PRO has been demonstrated to be an informative and useful stroke when considering patient-reported outcomes and has wider implications for considerations of PROs in clinical management. Future longitudinal follow-up with PROs is needed to consider association of long-term morbidity.

Keywords: morbidity, patient-reported outcome, PRO, stroke

Procedia PDF Downloads 127
569 Treatment of NMSC with Traditional Medicine Method

Authors: Aferdita Stroka Koka, Laver Stroka, Juna Musa, Samanda Celaj

Abstract:

Non-melanoma skin cancers (NMSCs) are the most common human malignancies. About 5.4 million basal and squamous cell skin cancers are diagnosed each year in the US and new cases continue to grow. About eight out of ten of these are basal cell cancers. Squamous cell cancers occur less often. NMSC usually are treatable, but treatment is expensive and can leave scars. In 2019, 167 patients of both sexes suffering from NMSC were treated by traditional medicine. Patients who have been diagnosed with Basal Cell Carcinoma were 122 cases, Squamous Cell Carcinoma 32 cases and both of them 13 cases. Of these,122 cases were ulcerated lesions and 45 unulcerated lesions. All patients were treated with the herbal solution called NILS, which contains extracts of some Albanian plants such as Allium sativum, Jugulans regia and Laurus nobilis. The treatment is done locally, on the surface of the tumor, applying the solution until the tumor mass is destroyed and, after that, giving the necessary time to the wound to make the regeneration that coincides with the complete healing of the wound. We have prepared a collection of photos for each case. Since the first sessions, a shrinkage and reduction of the tumor mass were evident, up to the total disappearance of the lesion at the end of treatment. The normal period of treatment lasted 1 to 2 weeks, depending on the size of the tumor, then take care of it until the closure of the wound, taking the whole process from 1 to 3 months. In 7 patients, the lesion failed to be dominated by treatment and they underwent standard treatment with radiotherapy or surgery, while in 10 patients, the lesion recurred and was treated again. The aim of this survey was to put in evidence the good results obtained by treatment of NMSC with Albanian traditional medicine methods.

Keywords: local treatment, nils, NMSC, traditional medicine

Procedia PDF Downloads 207
568 Photomicrograph-Based Neuropathology Consultation in Tanzania; The Utility of Static-Image Neurotelepathology in Low- And Middle-Income Countries

Authors: Francis Zerd, Brian E. Moore, Atuganile E. Malango, Patrick W. Hosokawa, Kevin O. Lillehei, Laurence Lemery Mchome, D. Ryan Ormond

Abstract:

Introduction: Since neuropathologic diagnosis in the developing world is hampered by limitations in technical infrastructure, trained laboratory personnel, and subspecialty-trained pathologists, the use of telepathology for diagnostic support, second-opinion consultations, and ongoing training holds promise as a means of addressing these challenges. This research aims to assess the utility of static teleneuropathology in improving neuropathologic diagnoses in low- and middle-income countries. Methods: Consecutive neurosurgical biopsy and resection specimens obtained at Muhimbili National Hospital in Tanzania between July 1, 2018, and June 30, 2019, were selected for retrospective, blinded static-image neuropathologic review followed by on-site review by an expert neuropathologist. Results: A total of 75 neuropathologic cases were reviewed. The agreement of static images and on-site glass diagnosis was 71% with strict criteria and 88% with less stringent criteria. This represents an overall improvement in diagnostic accuracy from 36% by general pathologists to 71% by a neuropathologist using static telepathology (or 76% to 88% with less stringent criteria). Conclusions: Telepathology offers a suitable means of providing diagnostic support, second-opinion consultations, and ongoing training to pathologists practicing in resource-limited countries. Moreover, static digital teleneuropathology is an uncomplicated, cost-effective, and reliable way to achieve these goals.

Keywords: neuropathology, resource-limited settings, static image, Tanzania, teleneuropathology

Procedia PDF Downloads 101
567 Endoscopic Treatment of Esophageal Injuries Using Vacuum Therapy

Authors: Murad Gasanov, Shagen Danielyan, Ali Gasanov, Yuri Teterin, Peter Yartsev

Abstract:

Background: Despite the advances made in modern surgery, the treatment of patients with esophageal injuries remains one of the most topical and complex issues. In recent years, high-technology minimally invasive methods, such as endoscopic vacuum therapy (EVT) in the treatment of esophageal injuries. The effectiveness of EVT has been sufficiently studied in case of failure of esophageal anastomoses, however the application of this method in case of mechanical esophageal injuries is limited by a small series of observations, indicating the necessity of additional study. Aim: The aim was to аnalyzed of own experience in the use of endoscopic vacuum therapy (EVT) in a comprehensive examination of patients with esophageal injuries. Methods: We analyzed the results of treatment of 24 patients with mechanical injuries of the esophagus for the period 2019-2021. Complex treatment of patients included the use of minimally invasive technologies, including percutaneous endoscopic gastrostomy (PEG), EVT and video-assisted thoracoscopic debridement. Evaluation of the effectiveness of treatment was carried out using multislice computed tomography (MSCT), endoscopy and laboratory tests. The duration of inpatient treatment and the duration of EVT, the number of system replacements, complications and mortality were taken into account. Result: EVT in patients with mechanical injuries of the esophagus allowed to achieve epithelialization of the esophageal defect in 21 patients (87.5%) in the form of linear scar on the site of perforation or pseudodiverticulum. Complications were noted in 4 patients (16.6%), including bleeding (2) and and esophageal stenosis in the perforation area (2). Lethal outcome was in one observation (4.2%). Conclusion. EVT may be the method of choice in complex treatment in patients with esophageal lesions.

Keywords: esophagus injuries, damage to the esophagus, perforation of the esophagus, spontaneous perforation of the esophagus, mediastinitis, endoscopic vacuum therapy

Procedia PDF Downloads 104
566 Zarit Burden Interview among Informal Caregiver of Person with Dementia: A Systematic Review and Meta-Analysis

Authors: Nuraisyah H. Zulkifley, Suriani Ismail, Rosliza Abdul Manaf, Poh Y. Lim

Abstract:

Taking care of a person with dementia (PWD) is one of the most problematic and challenging caregiving situations. Without proper support, caregiver would need to deal with the impact of caregiving that would lead to caregiver burden. One of the most common tools used to measure caregiver burden among caregivers of PWD is Zarit Burden Interview (ZBI). A systematic review has been conducted through searching Medline, Science Direct, Cochrane Library, Embase, PsycINFO, ProQuest, and Scopus databases to identify relevant articles that elaborate on intervention and outcomes on ZBI among informal caregiver of PWD. The articles were searched in October 2019 with no restriction on language or publication status. Inclusion criteria are randomized control trial (RCT) studies, participants were informal caregivers of PWD, ZBI measured as outcomes, and intervention group was compared with no intervention control or usual care control. Two authors reviewed and extracted the data from the full-text articles. From a total of 344 records, nine studies were selected and included in this narrative review, and eight studies were included in the meta-analysis. The types of interventions that were implemented to ease caregiver burden are psychoeducation, physical activity, psychosocial, and computer-based intervention. The meta-analysis showed that there is a significant difference in the mean score of ZBI (p = 0.006) in the intervention group compared to the control group after implementation of intervention. In conclusion, interventions such as psychoeducation, psychosocial, and physical activity can help to reduce the burden experiencing by the caregivers of PWD.

Keywords: dementia, informal caregiver, randomized control trial, Zarit burden interview

Procedia PDF Downloads 177
565 Selectivity Mechanism of Cobalt Precipitation by an Imidazole Linker From an Old Battery Solution

Authors: Anna-Caroline Lavergne-Bril, Jean-François Colin, David Peralta, Pascale Maldivi

Abstract:

Cobalt is a critical material, widely used in Li-ion batteries. Due to the planned electrification of European vehicles, cobalt needs are expending – and resources are limited. To meet the needs in cobalt to come, it is necessary to develop new efficient ways to recycle cobalt. One of the biggest sources comes from old electrical vehicles batteries (batteries sold in 2019: 500 000 tons of waste to be). A closed loop process of cobalt recycling has been developed and this presentation aims to present the selectivity mechanism of cobalt over manganese and nickel in solution. Cobalt precipitation as a ZIF material (Zeolitic Imidazolate framework) from a starting solution composed of equimolar nickel, manganese and cobalt is studied. A 2-MeIm (2-methylimidazole) linker is introduced in a multimetallic Ni, Mn, Co solution and the resulting ZIF-67 is 100% pure Co among its metallic centers. Selectivity of Co over Ni is experimentally studied and DFT modelisation calculation are conducted to understand the geometry of ligand-metal-solvent complexes in solution. Selectivity of Co over Mn is experimentally studied, and DFT modelisation calcucation are conducted to understand the link between pKa of the ligand and precipitration of Mn impurities within the final material. Those calculation open the way to other ligand being used in the same process, with more efficiency. Experimental material are synthetized from bimetallic (Ni²⁺/Co²⁺, Mn²⁺/Co²⁺, Mn²⁺/Ni²⁺) solutions. Their crystallographic structure is analysed by XRD diffraction (Brüker AXS D8 diffractometer, Cu anticathode). Morphology is studied by scanning electron microscopy, using a LEO 1530 FE-SEM microscope. The chemical analysis is performed by using ICP-OES (Agilent Technologies 700 series ICP-OES). Modelisation calculation are DFT calculation (density functional theory), using B3LYP, conducted with Orca 4.2.

Keywords: MOFs, ZIFs, recycling, closed-loop, cobalt, li-ion batteries

Procedia PDF Downloads 134
564 Assessing Perinatal Mental Illness during the COVID-19 Pandemic: A Review of Measurement Tools

Authors: Mya Achike

Abstract:

Background and Significance: Perinatal mental illness covers a wide range of conditions and has a huge influence on maternal-child health. Issues and challenges with perinatal mental health have been associated with poor pregnancy, birth, and postpartum outcomes. It is estimated that one out of five new and expectant mothers experience some degree of perinatal mental illness, which makes this a hugely significant health outcome. Certain factors increase the maternal risk for mental illness. Challenges related to poverty, migration, extreme stress, exposure to violence, emergency and conflict situations, natural disasters, and pandemics can exacerbate mental health disorders. It is widely expected that perinatal mental health is being negatively affected during the present COVID-19 pandemic. Methods: A review of studies that reported a measurement tool to assess perinatal mental health outcomes during the COVID-19 pandemic was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, CINAHL, and Google Scholar were used to search for peer-reviewed studies published after late 2019, in accordance with the emergence of the virus. The search resulted in the inclusion of ten studies. Approach to measure health outcome: The main approach to measure perinatal mental illness is the use of self-administered, validated questionnaires, usually in the clinical setting. Summary: Widespread use of these tools has afforded the clinical and research communities the ability to identify and support women who may be suffering from mental illness disorders during a pandemic. More research is needed to validate tools in other vulnerable, perinatal populations.

Keywords: mental health during covid, perinatal mental health, perinatal mental health measurement tools, perinatal mental health tools

Procedia PDF Downloads 131
563 Developments in corporate governance and economic growth in Sub Saharan Africa

Authors: Martha Matashu

Abstract:

This study examined corporate governance and economic growth trends in Sub Saharan African (SSA) countries. The need for corporate governance arise from the fact that the day to day running of the business is done by management who in accordance with the neoclassical theory and agency theory have inborn tendencies to use the resources of the company to their advantage. This prevails against a background where the endogenous economic growth theory hold the assumption that economic growth is an outcome of the overall performance of all companies within an economy. This suggest that corporate governance at firm level determine economic growth through its impact on the overall performance. Nevertheless, insight into literature suggest that efforts to promote corporate governance in countries across SSA since the 1980s to date have not yet yielded desired outcomes. The board responsibilities, shareholder rights, disclosure and transparency, protection of minority shareholder, and liability of directors were thus used as proxies of corporate governance because these are believed to be mechanisms that are believed to enhance company performance their effect on enhancing accountability and transparency. Using panel data techniques, corporate governance and economic growth data for 29 SSA countries from the period of 2008 to 2019 was analysed. The findings revealed declining economic growth trend despite an increase in corporate governance aspects such as director liability, shareholders’ rights, and protection of minority shareholder in SSA countries. These findings are in contradiction to the popularly held theoretical principles of economic growth and corporate governance. The study reached the conclusion thata nonlinearrelationship exists between corporate governance and economic growth within the selectedSSA countries during the period under investigation. This study thus recommends that measures should be taken to create conditions for corporate governance that would bolster significant positive contributions to economic growth in the region.

Keywords: corporate governance, economic growth, sub saharan Africa, agency theory, endogenous theory

Procedia PDF Downloads 141
562 The Effects of L-Arginine Supplementation on Clinical Symptoms, Quality of Life, and Anal Internal Sphincter Pressure in Patients with Chronic Anal Fissure

Authors: Masoumeh Khailghi Sikaroudi, Mohsen Masoodi, Fazad Shidfar, Meghdad Sedaghat

Abstract:

Background: The hypertonicity of internal anal sphincter resting pressure is one of the main reasons for chronic anal fissures. The aim of this study is to assess the effect of oral administration of L-arginine on anal fissure symptom improvement by relaxation of the internal anal sphincter. Method: Seventy-six chronic anal fissure patients (age: 18-65 years) took part in this randomized, double-blind, placebo-controlled trial study from February 2019 to October 2020 at Rasoul-e-Akram Hospital, Tehran, Iran. Participants were allocated into treatment (L-arginine) or placebo groups. They took a 1000 mg capsule three times a day for one month and were followed up at the end of the first and third months after receiving the intervention. Clinical symptoms, anal sphincter resting pressure, and quality of life (QoL) were completed at baseline and the end of the study. Result: The analysis of data was shown significant improvement in bleeding, fissure size, and pain within each group; however, this effect was more seen in the arginine group compared to the control group at the end of the study (P-values<0.001). Following that, a significant increase in QoL was seen just in patients who were treated with arginine (P-value=0.006). Also, the comparison of anal pressures to baseline and between groups at the end of the study showed a significant reduction in sphincter pressure in treated patients (P-value<0.001, =0.049; respectively). Conclusion: Oral administration of 3000 mg L-arginine can heal chronic anal fissures by reducing anal internal sphincter pressure with fewer side effects. However, a long-term study with more follow-up is recommended.

Keywords: L-arginine, anal fissure, sphincter pressure, clinical symptoms, quality of life

Procedia PDF Downloads 68
561 Economics Analysis of Chinese Social Media Platform Sina Weibo and E-Commerce Platform Taobao

Authors: Xingyue Yang

Abstract:

This study focused on Chinese social media stars and the relationship between their level of fame on the social media platform Sina Weibo and their sales revenue on the E-commerce platform Taobao/Tmall.com. This was viewed from the perspective of Adler’s superstardom theory and Rosen and MacDonald’s theories examining the economics of celebrities who build their audience using digital, rather than traditional platforms. Theory and empirical research support the assertion that stars of traditional media achieve popular success due to a combination of talent and market concentration, as well as a range of other factors. These factors are also generally considered relevant to the popularisation of social media stars. However, success across digital media platforms also involves other variables - for example, upload strategies, cross-platform promotions, which often have no direct corollary in traditional media. These factors were the focus of our study, which investigated the relationship between popularity, promotional strategy and sales revenue for 15 social media stars who specialised in culinary topics on the Chinese social media platform Sina Weibo. In 2019, these food bloggers made a total of 2076 Sina Weibo posts, and these were compiled alongside calculations made to determine each food blogger’s sales revenue on the eCommerce platforms Taobao/Tmall. Quantitative analysis was then performed on this data, which determined that certain upload strategies on Weibo - such as upload time, posting format and length of video - have an important impact on the success of sales revenue on Taobao/Tmall.com.

Keywords: attention economics, digital media, network effect, social media stars

Procedia PDF Downloads 226
560 School Partners in Initial Teacher Education: An Including or Excluding Approach When Engaging Schools

Authors: Laila Niklasson

Abstract:

The aim of the study is to critically discuss how partner schools are engaged during Initial teacher education, ITE. The background is an experiment in Sweden where the practicum organization is reorganized due to a need to enhance quality during practicum. It is a national initiative from the government, supported by the National Agency of Education and lasts 2014-2019. The main features are concentration of students to school with a certain amount of mentors, mentors who have a mentor education and teachers with relevant subject areas and where there could be a mentor team with a leader at the school. An expected outcome is for example that the student teachers should be engaged in peer-learning. The schools should be supported by extra lectures from university teachers during practicum and also extra research projects where the schools should be engaged. A case study of one university based ITE was carried out to explore the consequences for the schools not selected. The result showed that from engaging x schools in a region, x was engaged. The schools are both in urban and rural areas, mainly in the latter. There is also a tendency that private schools are not engaged. On a unit level recruitment is perceived as harder for schools not engaged. In addition they cannot market themselves as ´selected school´ which can affect parent´s selection of school for their children. Also, on unit level, but with consequences for professional development, they are not selected for research project and thereby are not fully supported during school development. The conclusion is that from an earlier inclusive approach concerning professions where all teachers were perceived as possible mentors, there is a change to an exclusive approach where selected schools and selected teachers should be engaged. The change could be perceived as a change in governance mentality, but also in how professions are perceived, and development work is pursued.

Keywords: initial teacher education, practicum schools, profession, quality development

Procedia PDF Downloads 140
559 Green Public Procurement in Open Access and Traditional Journals: A Comparative Bibliometric Analysis

Authors: Alonso-Cañadas J., Galán-Valdivieso F., Saraite-Sariene L., García-Tabuyo M., Alonso-Morales N.

Abstract:

Green Public Procurement (GPP) has recently gained attention in the academic and policy arenas since climate change has shown the need to be addressed by both private companies and public entities. Such growing interest motivates this article, aiming to explore the most influential journals, publishers, categories, and topics, as well as the recent trends and future research lines in GPP. Based on the Web of Science database, 578 articles from 2004 to February 2022 devoted to GPP are analyzed using Bibliometrix, an R-tool to perform bibliometric analysis, and Google’s Big Query and Data Studio. This article introduces a variety of findings. First, the most influential journals by far are “Journal of Cleaner Production” and “Sustainability,” differing in that the latter is open access while the former publishes via traditional subscription. This result also occurs regarding the main publishers (Elsevier and MDPI). These features lead us to split the sample into open-access journals and traditional journals to deepen into the similarities and differences between them, confirming that traditional journals exhibit a higher degree of influence in the literature than their open-access counterparts in terms of the number of documents, number of citations and impact (according to the H index). Second, this research also highlights the recent emergence of green-related terms (sustainable, environment) and, parallelly, the increase in categorizing GPP papers in “green” WoS categories, particularly since 2019. Finally, a number of related topics are emerging and will lead the research, such as food security, infrastructures, and implementation barriers of GPP.

Keywords: bibliometric analysis, green public procurement, open access, traditional journals

Procedia PDF Downloads 101
558 COVID_ICU_BERT: A Fine-Tuned Language Model for COVID-19 Intensive Care Unit Clinical Notes

Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

Abstract:

Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as vital physiological signs, images, and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision-making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful in influencing the judgement of clinical sentiment in ICU clinical notes. This paper introduces two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of clinical transformer models that can reliably predict clinical sentiment for notes of COVID patients in the ICU. We train the model on clinical notes for COVID-19 patients, a type of notes that were not previously seen by clinicalBERT, and Bio_Discharge_Summary_BERT. The model, which was based on clinicalBERT achieves higher predictive accuracy (Acc 93.33%, AUC 0.98, and precision 0.96 ). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and precision 0.92 ).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation

Procedia PDF Downloads 202
557 Polarization of Lithuanian Society on Issues Related to Language Politics

Authors: Eglė Žurauskaitė, Eglė Gudavičienė

Abstract:

The goal of this paper is to reveal how polarization is constructed through the use of impoliteness strategies. In general, media helps to spread various ideas very fast, and it means that processes of polarization are best revealed in computer-mediated communication (CMC) contexts. For this reason, data for the research was collected from online texts about a current, very diverse topic in Lithuania - Lithuanian language policy and regulations, because this topic is causing a lot of tension in Lithuanian society. Computer-mediated communication allows users to edit their message before they send it. It means that addressees carefully select verbal expressions to convey their message. In other words, each impoliteness strategy and its verbal expression were created intentionally. Impoliteness strategies in this research are understood as various ways to reach a communicative goal: belittle the other. To reach the goal, the public opinions of various Lithuanian public figures (e. g., cultural people, politicians, officials) were collected from new portals in 2019–2023 and analyzed using both quantitative and qualitative approaches. First, problematic aspects of the language policy, for which public figures complain, were identified. Then instances when public figures take a defensive position were analyzed: how they express this position and what it reveals about Lithuanian culture. Findings of this research demonstrate how concepts of impoliteness theory can be applied in analyzing the process of polarization in Lithuanian society on issues related to the State language policy. Also, to reveal how polarization is constructed, these tasks were set: a) determine which impoliteness strategies are used throughout the process of creating polarization, b) analyze how they were expressed verbally (e. g., as an advice, offer, etc.).

Keywords: impoliteness, Lithuanian language policy, polarization, impoliteness strategies

Procedia PDF Downloads 54
556 The Optimization of TICSI in the Convergence Mechanism of Urban Water Management

Authors: M. Macchiaroli, L. Dolores, V. Pellecchia

Abstract:

With the recent Resolution n. 580/2019/R/idr, the Italian Regulatory Authority for Energy, Networks, and Environment (ARERA) for the Urban Water Management has introduced, for water managements characterized by persistent critical issues regarding the planning and organization of the service and the implementation of the necessary interventions for the improvement of infrastructures and management quality, a new mechanism for determining tariffs: the regulatory scheme of Convergence. The aim of this regulatory scheme is the overcoming of the Water Service Divided in order to improve the stability of the local institutional structures, technical quality, contractual quality, as well as in order to guarantee transparency elements for Users of the Service. Convergence scheme presupposes the identification of the cost items to be considered in the tariff in parametric terms, distinguishing three possible cases according to the type of historical data available to the Manager. The study, in particular, focuses on operations that have neither data on tariff revenues nor data on operating costs. In this case, the Manager's Constraint on Revenues (VRG) is estimated on the basis of a reference benchmark and becomes the starting point for defining the structure of the tariff classes, in compliance with the TICSI provisions (Integrated Text for tariff classes, ARERA's Resolution n. 665/2017/R/idr). The proposed model implements the recent studies on optimization models for the definition of tariff classes in compliance with the constraints dictated by TICSI in the application of the Convergence mechanism, proposing itself as a support tool for the Managers and the local water regulatory Authority in the decision-making process.

Keywords: decision-making process, economic evaluation of projects, optimizing tools, urban water management, water tariff

Procedia PDF Downloads 114
555 A Cost-Benefit Analysis of Routinely Performed Transthoracic Echocardiography in the Setting of Acute Ischemic Stroke

Authors: John Rothrock

Abstract:

Background: The role of transthoracic echocardiography (TTE) in the diagnosis and management of patients with acute ischemic stroke remains controversial. While many stroke subspecialist reserve TTE for selected patients, others consider the procedure obligatory for most or all acute stroke patients. This study was undertaken to assess the cost vs. benefit of 'routine' TTE. Methods: We examined a consecutive series of patients who were admitted to a single institution in 2019 for acute ischemic stroke and underwent TTE. We sought to determine the frequency with which the results of TTE led to a new diagnosis of cardioembolism, redirected therapeutic cerebrovascular management, and at least potentially influenced the short or long-term clinical outcome. We recorded the direct cost associated with TTE. Results: There were 1076 patients in the study group, all of whom underwent TTE. TTE identified an unsuspected source of possible/probable cardioembolism in 62 patients (6%), confirmed an initially suspected source (primarily endocarditis) in an additional 13 (1%) and produced findings that stimulated subsequent testing diagnostic of possible/probable cardioembolism in 7 patients ( < 1%). TTE results potentially influenced the clinical outcome in a total of 48 patients (4%). With a total direct cost of $1.51 million, the mean cost per case wherein TTE results potentially influenced the clinical outcome in a positive manner was $31,375. Diagnostically and therapeutically, TTE was most beneficial in 67 patients under the age of 55 who presented with 'cryptogenic' stroke, identifying patent foramen ovale in 21 (31%); closure was performed in 19. Conclusions: The utility of TTE in the setting of acute ischemic stroke is modest, with its yield greatest in younger patients with cryptogenic stroke. Given the greater sensitivity of transesophageal echocardiography in detecting PFO and evaluating the aortic arch, TTE’s role in stroke diagnosis would appear to be limited.

Keywords: cardioembolic, cost-benefit, stroke, TTE

Procedia PDF Downloads 120
554 Political Agency of Women Voters in India: Dependent or Independent Voters

Authors: Priyanka Sharma

Abstract:

The women voter turnout in India is increasing. The rising female voter turnout is explained in part by men intimidating women in the household to vote. Women are more likely than men to be guided before voting. What is perhaps more significant is that the gender gap has shrunk significantly over the years. However, there are layers and categories of women voters in India. Some women are much more likely than the average woman to follow advice. Against this backdrop, this paper investigates the variation among women voters during the national elections of 2019 in India. The central question of this research paper is whether or not the development of greater political opinion among women would offset guided voting and allow them to emerge as more independent voters. So the independent variable of the study is Indian women’s opinion on politics, and the dependent variable is their voting behavior. The methodology used in this paper is both quantitative and qualitative. This study investigated and examined Lokniti’s election survey data. The sample size used in this survey is 11568. The analysis of this study has revealed that there is a considerable impact of women having a political opinion on their voting behavior. The Bivariate analysis of the variables states that 83% of Indian women who have opinions on political issues do not seek advice while going to vote. This proves the hypothesis of this paper that women with an opinion on politics are more likely to be independent voters. To check the statistical significance of the finding, a chi-square test was done and the p-value found is 0.009737, which shows it is statistically significant. Furthermore, a regression test has been done by controlling certain variables like age, educational qualification, caste, and financial position of the women to probe the influence on the dependent variable. The findings provide worthwhile insights into the relationship between these control variables and the women voting behavior in India.

Keywords: dependent voter, independent voter, political opinion, voting behavior, women voter

Procedia PDF Downloads 75
553 The Impact of COVID-19 on Reconstructive Breast Surgery and Future Prospective

Authors: Amenah Galo, Mohammed Farid, Kareem Alsharkawy, Robert Warner, Karthikeyan Srinivasan, Haitham Khalil, Ruth Waters

Abstract:

Introduction: The cessation of elective surgery, particularly breast reconstruction, continue to be affected by the COVID-19 pandemic. The restructuring of medical services and staff redeployment severely affected the ability to return to normality for surgical specialties. The aim of this study is to determine the decline in breast reconstruction affected by the COVID-19 pandemic in a tertiary center. Methods: A retrospective review of breast reconstruction cases (autologous, non-autologous) or mastectomies Pre- COVID (March 2019-March 2020) and during COVID (March 2020- March 2021) at Queen Elizabeth Hospital, Birmingham, were collated. Data included patient demographics, BMI, previous and recent reconstruction, length of hospital stay, and mastectomies, including risk-reducing. Results: The number of patients who had breast reconstruction was significantly lower during COVID (n=62) compared to pre-COVID (n=199). The mean age (pre-COVID 51, COVID 59 years), BMI (Pre-COVID and COVID = 27), previous reconstruction (pre-COVID n=101, 51%, COVID n=33, 53%) and length hospital stay was less during COVID (3 days) compared to Pre-COVID (4 days). The proportion of risk-reducing mastectomies and reconstruction during COVID (32%, n=20) were higher than pre-COVID (21%, n=41). A higher proportion rate of autologous reconstruction (DIEP 56, TRAM 17) Pre-COVID compared to COVID (DIEP 22, TRAM 7). Implant reconstructions were higher during COVID (n=19, 31%) than pre-COVID (n=31, 16%). Conclusion: The lack of regular provision for breast reconstruction continues to decline during the pandemic. This will have a tremendous impact on waiting lists without a timeline for reconstruction to offer patients. An international survey highlights the disparities in offering breast reconstruction and strategies to rectify this issue.

Keywords: breast reconstruction, COVID-19 pandemic, mastectomy, autologous, implant

Procedia PDF Downloads 216
552 A Case Study of Business Analytic Use in European Football: Analysis and Implications

Authors: M. C. Schloesser

Abstract:

The purpose of this paper is to explore the use and impact of business analytics in European football. Despite good evidence from other major sports leagues, research on this topic in Europe is currently very scarce. This research relies on expert interviews on the use and objective of business analytics. Along with revenue data over 16 seasons spanning from 2004/05 to 2019/20 from Manchester City FC, we conducted a time series analysis to detect a structural breakpoint on the different revenue streams, i.e., sponsorship and ticketing, after analytical tools have been implemented. We not only find that business analytics have indeed been applied at Manchester City FC and revenue increase is the main objective of their utilization but also that business analytics is indeed a good means to increase revenues if applied sufficiently. We can thereby support findings from other sports leagues. Consequently, professional sports organizations are advised to apply business analytics if they aim to increase revenues. This research has shown that analytical practices do, in fact, support revenue growth and help to work more efficiently. As the knowledge of analytical practices is very confidential and not publicly available, we had to select one club as a case study which can be considered a research limitation. Other practitioners should explore other clubs or leagues. Further, there are other factors that can lead to increased revenues that need to be considered. Additionally, sports organizations need resources to be able to apply and utilize business analytics. Consequently, findings might only apply to the top teams of the European football leagues. Nonetheless, this paper combines insights and results on usage, objectives, and impact of business analytics in European professional football and thereby fills a current research gap.

Keywords: business analytics, expert interviews, revenue management, time series analysis

Procedia PDF Downloads 73
551 Factors Affecting the Caregiving Experience of Children with Parental Mental Illnesses: A Systematic Review

Authors: N. Anjana

Abstract:

Worldwide, the prevalence of mental illnesses is increasing. The issues of persons with mental illness and their caregivers have been well documented in the literature. However, data regarding the factors affecting the caregiving experience of children with parental mental illnesses is sparse. This systematic review aimed to examine the existing literature of the factors affecting the caregiving experience of children of parents with mental illnesses. A comprehensive search of databases such as PubMed, EBSCO, JSTOR, ProQuest Central, Taylor and Francis Online, and Google Scholar were performed to identify peer-reviewed papers examining the factors associated with caregiving experiences of children with parental mental illnesses such as schizophrenia and major depression, for the 10-year period ending November 2019. Two researchers screened studies for eligibility. One researcher extracted data from eligible studies while a second performed verification of results for accuracy and completeness. Quality appraisal was conducted by both reviewers. Data describing major factors associated with caregiving experiences of children with parental mental illnesses were synthesized and reported in narrative form. Five studies were considered eligible and included in this review. Findings are organized under major themes such as the impact of parental mental illness on children’s daily life, how children provide care to their mentally ill parents as primary carers, social and relationship factors associated with their caregiving, positive and negative experiences in caregiving and how children cope with their experiences with parental mental illnesses. Literature relating to the caregiving experiences of children with parental mental illnesses is sparse. More research is required to better understand the children’s caregiving experiences related to parental mental illnesses so as to better inform management for enhancing their mental health, wellbeing, and caregiving practice.

Keywords: caregiving experience, children, parental mental illnesses, wellbeing

Procedia PDF Downloads 140
550 Entrepreneurship Training of Young People as a Pillar to Generate Income and Create Jobs: Progress Report of the Moroccan National Human Development Initiative in the Region of Meknes

Authors: Bennani Zoubir Nada, El Hiri Abderrazak, El Hajri Aimad

Abstract:

In context of economic and health crisis, sustainable entrepreneurship has become one of the best solutions to economic recovery. This study is about the third program of the Moroccan national human development initiative in her third phase which began in 2019 and continuous until 2023, and which deals with income improvement and social inclusion of young people, under the high patronage of his majesty the king of Morocco. What is the approach of this program and how entrepreneurship training of young people can be a pillar to generate income and create jobs? Starting on the effectuation theory, we adopted an exploratory qualitative approach through semi-structured interviews with national human development initiative stakeholders in the area of Meknes-Morocco, which allowed us the state of progress of this program. We carried out a survey based on a grid of questions to collect information that we processed using NVIVO software. The most relevant results are that people eligible are jobless young people, who are between 18 and 35 years old, who reside in Meknes and surroundings and who have a project idea. They are trained by experts in entrepreneurship and management through targeted and diversified courses. To ensure the sustainability of projects, the project organisers have provided measures to ensure the sustainability of the companies through continuous monitoring and evaluation as well as support during all phases from the project idea to the realisation and progress.

Keywords: sustainable entrepreneurship, training, social inclusion, national human development initiative in Morocco (INDH), youth entrepreneurship, the effectuation theory

Procedia PDF Downloads 108
549 Exploring Selected Nigerian Fictional Work and Films as Sources of Peace Building and Conflict Resolution in the Natural Resource Extraction Regions of Nigeria: A Social Conflict Theoretical Perspective and Analysis

Authors: Joyce Onoromhenre Agofure

Abstract:

Research has shown how fictional work and films reflect the destruction of the environment due to the exploitation of oil, gas, gold, and forest products by multinational companies for profits but overlook discussions on conflict resolution and peacebuilding. However, this paper examines the manner art forms project peace and conflict resolution, thereby contributing to mediation and stability geared towards changing appalling situations in the resource extraction regions of Nigeria. This paper draws from selected Nigerian films- Blood and Oil (2019), directed by Curtis Graham, Black November (2012), directed by Jeta Amata, and a novel- Death of Eternity (2007), by Adamu Kyuka Usman. The study seeks to show that the disruptions caused in the natural resource regions of Nigeria have not only left adverse effects on the social well-being of the people but require resolutions through means of peacebuilding. By adopting the theoretical insights of Social Conflict, this paper focuses on artistic processes that enhance peacebuilding and conflict resolution in non-violent ways by using scenes, visual effects, themes, and images that can educate by shaping opinions, influencing attitudes, and changing ideas and behavioral patterns of individuals and communities. Put together; the research will open up critical perceptions brought about by the artists of study to shed light on the dire need to sustain peace and actively participate in conflict resolution in natural resource extraction spaces.

Keywords: natural resource, extraction, conflict resolution, peace building

Procedia PDF Downloads 76
548 Study of Heat Transfer through the Ground and its Accumulation Properties to Increase the Energy Efficiency of Underground Buildings

Authors: Sandeep Bandarwadkar, Tadas Zdankus

Abstract:

To maintain a comfortable indoor temperature for its residents in the colder season, heating a building is necessary. Due to the expansion in the construction sectors, the consumption of heating energy is increasing. According to Eurostat data, in the European Union, the share of energy consumption of heating energy for space and cooling in residential buildings was around 63% in 2019. These figures indicate that heating energy still accounts for a significant portion of total energy consumption in Europe. Innovation is crucial to reduce energy consumption in buildings and achieve greater energy efficiency and sustainability. It can bring about new solutions that are smarter and more natural energy generation to reduce greenhouse gas emissions. The ground can serve as an effective and sustainable heat accumulator for heating and cooling. The temperature of the ground is higher than that of the ambient air in the colder period and lower in the warmer period. The building deep in the soil could use less thermal energy compared to the above-ground buildings that provide the same amount of thermal comfort. The temperature difference between the soil and the air inside the building decreases as the temperature of the soil increases. In progress, this process generates the condition that acts against heat loss. However, heat dissipates further to the consecutive layers and reaches thermal equilibrium. The charging of the ground by heat and its dissipation through the adjacent soil layers was investigated experimentally. The results of this research showed that 9% of the energy savings in partially underground buildings and 44.4% in completely underground buildings were derived from heating the space. Heat loss to the ground is treated as a charge of the soil by thermal energy. The dependence of the intensity of the charge on time was analysed and presented.

Keywords: heat transfer, accumulation of heat, underground building, soil charge

Procedia PDF Downloads 67
547 The Value of Routine Terminal Ileal Biopsies for the Investigation of Diarrhea

Authors: Swati Bhasin, Ali Ahmed, Valence Xavier, Ben Liu

Abstract:

Aims: Diarrhea is a problem that is a frequent clinic referral to the gastroenterology and surgical team from the General practitioner. To establish a diagnosis, these patients undergo colonoscopy. The current practice at our district general hospital is to perform random left and right colonic biopsies. National guidelines issued by the British Society of Gastroenterology advise all patients presenting with chronic diarrhea should have an Ileoscopy as an indicator for colonoscopy completion. Our primary aim was to check if Terminal ileum (TI) biopsy is required to establish a diagnosis of inflammatory bowel disease (IBD). Methods: Data was collected retrospectively from November 2018 to November 2019. The target population were patients who underwent colonoscopies for diarrhea. Demographic data, endoscopic and histology findings of TI were assessed and analyzed. Results: 140 patients with a mean age of 57 years (19-84) underwent a colonoscopy (M: F; 1:2.3). 92 patients had random colonic biopsies taken and based on the histological results of these, 15 patients (16%) were diagnosed with IBD. The TI was successfully intubated in 40 patients, of which 32 patients had colonic biopsies taken as well. 8 patients did not have a colonic biopsy taken. Macroscopic abnormality in the TI was detected in 5 patients, all of whom were biopsied. Based on histological results of the biopsy, 3 patients (12%) were diagnosed with IBD. These 3 patients (100%) also had colonic biopsies taken simultaneously and showed inflammation. None of the patients had a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were not done). None of the patients has a diagnosis of IBD confirmed on TI intubation alone (where colonic biopsies were negative). Conclusion: TI intubation is a highly-skilled, time-consuming procedure with a higher risk of perforation, which as per our study, has little additional diagnostic value in finding IBD for symptoms of diarrhea if colonic biopsies are taken. We propose that diarrhea is a colonic symptom; therefore, colonic biopsies are positive for inflammation if the diarrhea is secondary to IBD. We conclude that all of the IBDs can be diagnosed simply with colonic biopsies.

Keywords: biopsy, colon, IBD, terminal ileum

Procedia PDF Downloads 119