Search results for: European treatment and outcome study score
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 54615

Search results for: European treatment and outcome study score

54105 Comparative Study of Active Release Technique and Myofascial Release Technique in Patients with Upper Trapezius Spasm

Authors: Harihara Prakash Ramanathan, Daksha Mishra, Ankita Dhaduk

Abstract:

Relevance: This qualitative study will educate the clinician in putting into practice the advanced method of movement science in restoring the function. Purpose: The purpose of this study is to compare the effectiveness of Active Release Technique and myofascial release technique on range of motion, neck function and pain in patients with upper trapezius spasm. Methods/Analysis: The study was approved by the institutional Human Research and Ethics committee. This study included sixty patients of age group between 20 to 55 years with upper trapezius spasm. Patients were randomly divided into two groups receiving Active Release Technique (Group A) and Myofascial Release Technique (Group B). The patients were treated for 1 week and three outcome measures ROM, pain and functional level were measured using Goniometer, Visual analog scale(VAS), Neck disability Index Questionnaire(NDI) respectively. Paired Sample 't' test was used to compare the differences of pre and post intervention values of Cervical Range of motion, Neck disability Index, Visual analog scale of Group A and Group B. Independent't' test was used to compare the differences between two groups in terms of improvement in cervical range of motion, decrease in visual analogue scale(VAS), decrease in Neck disability index score. Results: Both the groups showed statistically significant improvements in cervical ROM, reduction in pain and in NDI scores. However, mean change in Cervical flexion, cervical extension, right side flexion, left side flexion, right side rotation, left side rotation, pain, neck disability level showed statistically significant improvement (P < 0. 05)) in the patients who received Active Release Technique as compared to Myofascial release technique. Discussion and conclusions: In present study, the average improvement immediately post intervention is significantly greater as compared to before treatment but there is even more improvement after seven sessions as compared to single session. Hence, this proves that several sessions of Manual techniques are necessary to produce clinically relevant results. Active release technique help to reduce the pain threshold by removing adhesion and promote normal tissue extensibility. The act of tensioning and compressing the affected tissue both with digital contact and through the active movement performed by the patient can be a plausible mechanism for tissue healing in this study. This study concluded that both Active Release Technique (ART) and Myofascial release technique (MFR) are equally effective in managing upper trapezius muscle spasm, but more improvement can be achieved by Active Release Technique (ART). Impact and Implications: Active Release Technique can be adopted as mainstay of treatment approach in treating trapezius spasm for faster relief and improving the functional status.

Keywords: trapezius spasm, myofascial release, active release technique, pain

Procedia PDF Downloads 273
54104 Role of Urban-Rural Partnership in the Generation of Socio-Economic Success in Polish Metropolitan Areas

Authors: Jerzy Bański

Abstract:

The purpose of the paper is to describe the role of urban-rural partnership in social and economic development. The concept of urban-rural collaboration is relatively new and assumes the need to link large metropolitan areas with surrounding rural areas in a number of ways. It is strongly related to the existing concept of polycentric spatial development. At the European Union level, the first document to address the need for urban-rural partnerships was the European Spatial Development Perspective from 1999. The paper focuses on factors that generate social and economic success on examples of several metropolitan territories in Poland (Warsaw, Poznan, Wroclaw, Krakow). A survey focused on rural communes made it possible to assess key success factors (location, social and economic, technological and organizational) that could be later used to determine the right course of action in the area of urban-rural cooperation, with the desired outcome being effective metropolitan area development. The main challenges to urban-rural partnership are issues associated with spatial planning, infrastructure and public services. These are areas of the greatest conflict of interest, too. Any analysis of urban-rural cooperation in metropolitan areas really needs to focus on the unique nature of this type of relationship. This includes issues such as commuting to work in the urban core and vice versa, complementarity of technical infrastructure, and joint strategic planning. Other forms of cooperation should focus on the tourist and recreational aspects of areas surrounding the urban core.

Keywords: partnership, rural areas, urbanization, metropolitan areas, Poland

Procedia PDF Downloads 367
54103 The Effects of European Union’s Bordering Process

Authors: Ebru Dalgakiran

Abstract:

Border and bordering studies have come to the forefront in recent years especially with parallel to increase in international migratory movements. Although conceptualizations of the border and bordering are quite contested within academia, the general point of view is that borders are politically and socially constructed. It means that borders have always their own ‘us vs. them’, and bordering process produce separate identities as well. In that case, Turkey and Greece are notable examples since these two nation-states constructed their borders upon each other’s for years although the Turkish-Greek border was drawn with the Lausanne Treaty of 1923. Nevertheless, on the other hand, The European Union (EU) has been externalized of border management policies to build a stronger area of freedom, security, and justice within the borders. Thus, Turkish-Greek border has become one of the significant external borders of the EU. In this context, this study aims to understand whether the EU’s bordering process through externalizing border management policies can affect Turkey’s and Greece’s bordering processes. By examining official documents of the EU and conducting in-depth interviews with local actors of the border management policies of the EU in Edirne, where is the border city of Turkey with Greece, this study’s main finding is that the EU’s bordering process to control migration at the external borders affects Turkey’s and Greece’s bordering processes. It seems that Turkey and Greece construct their borders upon a common Other, ‘irregular migrants’ now.

Keywords: border, bordering, the European Union, externalization

Procedia PDF Downloads 237
54102 The Implementation of the European Landscape Convention in Turkey: Opportunities and Constraints

Authors: Tutku Ak, Abdullah Kelkit, Cihad Öztürk

Abstract:

An increase has been witnessed with the number of multinational environmental agreements in the past decade, particularly in Europe. Success with implementation, however, shows variation. While many countries are willing to join these agreements, they do not always fully honor their obligations to put their commitments into practice. One reason for this is that countries have different legal and administrative systems. One example of an international multilateral environmental agreement is the European Landscape Convention (ELC). ELC expresses a concern to achieve sustainable development based on a balanced and harmonious relationship between social needs, economic activity, and the environment. Member states are required to implement the convention in accordance with their own administrative structure, respecting subsidiarity. In particular, the importance of cooperation in the protection, management, and planning of the resources is expressed through the convention. In this paper, it is intended to give a broad view of ELC’s implementation process in Turkey and what factors have influenced by the process. Under this context, the paper will focus on the objectives of the convention for addressing the issue of the loss of European landscapes, and the justification and tools used to accomplish these objectives. The degree to which these objectives have been implemented in Turkey and the opportunities and constraints that have been faced during this process have been discussed.

Keywords: European landscape convention, implementation, multinational environmental agreements, policy tools

Procedia PDF Downloads 298
54101 Mineral Deposits in Spatial Planning Systems – Review of European Practices

Authors: Alicja Kot-Niewiadomska

Abstract:

Securing sustainable access to raw materials is vital for the growth of the European economy and for the goals laid down in Strategy Europe 2020. One of the most important sources of mineral raw materials are primary deposits. The efficient management of them, including extraction, will ensure competitiveness of the European economy. A critical element of this approach is mineral deposits safeguarding and the most important tool - spatial planning. The safeguarding of deposits should be understood as safeguarding of land access, and safeguarding of area against development, which may (potential) prevent the use of the deposit and the necessary mining activities. Many European Union countries successfully integrated their mineral policy and spatial policy, which has ensured the proper place of mineral deposits in their spatial planning systems. These, in turn, are widely recognized as the most important mineral deposit safeguarding tool, the essence of which is to ensure long-term access to its resources. The examples of Austria, Portugal, Slovakia, Czech Republic, Sweden, and the United Kingdom, discussed in the paper, are often mentioned as examples of good practices in this area. Although none of these countries managed to avoid cases of social and environmental conflicts related to mining activities, the solutions they implement certainly deserve special attention. And for many countries, including Poland, they can be a potential source of solutions aimed at improving the protection of mineral deposits.

Keywords: mineral deposits, land use planning, mineral deposit safeguarding, European practices

Procedia PDF Downloads 171
54100 Graph Clustering Unveiled: ClusterSyn - A Machine Learning Framework for Predicting Anti-Cancer Drug Synergy Scores

Authors: Babak Bahri, Fatemeh Yassaee Meybodi, Changiz Eslahchi

Abstract:

In the pursuit of effective cancer therapies, the exploration of combinatorial drug regimens is crucial to leverage synergistic interactions between drugs, thereby improving treatment efficacy and overcoming drug resistance. However, identifying synergistic drug pairs poses challenges due to the vast combinatorial space and limitations of experimental approaches. This study introduces ClusterSyn, a machine learning (ML)-powered framework for classifying anti-cancer drug synergy scores. ClusterSyn employs a two-step approach involving drug clustering and synergy score prediction using a fully connected deep neural network. For each cell line in the training dataset, a drug graph is constructed, with nodes representing drugs and edge weights denoting synergy scores between drug pairs. Drugs are clustered using the Markov clustering (MCL) algorithm, and vectors representing the similarity of drug pairs to each cluster are input into the deep neural network for synergy score prediction (synergy or antagonism). Clustering results demonstrate effective grouping of drugs based on synergy scores, aligning similar synergy profiles. Subsequently, neural network predictions and synergy scores of the two drugs on others within their clusters are used to predict the synergy score of the considered drug pair. This approach facilitates comparative analysis with clustering and regression-based methods, revealing the superior performance of ClusterSyn over state-of-the-art methods like DeepSynergy and DeepDDS on diverse datasets such as Oniel and Almanac. The results highlight the remarkable potential of ClusterSyn as a versatile tool for predicting anti-cancer drug synergy scores.

Keywords: drug synergy, clustering, prediction, machine learning., deep learning

Procedia PDF Downloads 79
54099 Additional Usage of Remdesivir with the Standard of Care in Patients with Moderate And Severe COVID-19: A Tertiary Hospital’s Experience

Authors: Pugazhenthan Thangaraju

Abstract:

Background: Since the pandemic began, more than millions of people have become infected with COVID-19. Globally, researchers are working for safe and effective treatments for this disease. Remdesivir is a drug that has been approved for the treatment of COVID-19. Many aspects are still being considered that may influence the future use of remdesivir. Aim: To assess the safety and efficacy of Remdesivir in hospitalized adult patients diagnosed with moderate and severe COVID-19. Methods: It was a record-based retrospective cohort study conducted between April 1st, 2020 and June 30th, 2021 at the tertiary care teaching hospital All India Institutes of Medical Sciences (AIIMS), Raipur Results: There were a total of 10,559 medical records of COVID-19 patients of which 1034 records were included in this study. Overall, irrespective of the survival status, there was statistical significant difference observed between the WHO score at the time of admission and discharge. Clinical improvement among the survivors was found to be statistically significant. Conclusion: Remdesivir's potential efficacy against coronaviruses has so far been limited to in vitro studies and animal models. However, information about COVID-19 is rapidly expanding. Several clinical trials for the treatment of COVID-19 with remdesivir are now underway. However, the findings of this study support remdesivir as a promising agent in the fight against SARS-CoV-2.

Keywords: Remdesivir, COVID-19, SARS-CoV-2, antiviral, RNA-dependent RNA polymerase, viral pneumonia

Procedia PDF Downloads 65
54098 The Rise of Populist Right-Wing Parties in Western Europe: A Case Study of the Front National in France

Authors: Jessica Da Silva

Abstract:

This paper examines France as a microcosm of the rise of right-wing populism in the broader European context. The attack on the Charlie Hebdo newspaper is arguably, a reaction to the aggressive European secularism spreading throughout Europe that sees its true enemy in the growth of extremist and violent interpretations of Islam. With each terrorist attack, the popularity of anti-immigrant policies and ideologies increases. What ultimately drives movements like the French National Front are the concepts of monoculture and ethnic identity. This paper analyses the character of right-wing populist parties using the National Front as a case study. Such parties generate anxiety and resentment by fomenting an irrational fear of the ‘other’. In this way, populists promote their identity on the basis of xenophobia, Islamophobia, and practices of social exclusion against targeted out-groups. They position immigrants and foreigners as ‘others’, claiming they are a threat to native cultures and a source of social and economic strife. Ultimately, right-wing populism exerts a negative influence over the democratic framework in Europe and opposes the European Union’s integration project. Right-wing populism attacks this supranational model because of its alleged inefficiency and departure from what it considers to be 'authentic' European traditions and citizenship. In this context, understanding the rise of radical right-wing populist parties is extremely important for the future of Europe, democracy and multiculturalism.

Keywords: cultural identity, Europeanization, front national, immigration, integration, Islamophobia, multiculturalism, nationalism, right-wing populist parties, xenophobia

Procedia PDF Downloads 354
54097 Impact of Customer Experience Quality on Loyalty of Mobile and Fixed Broadband Services: Case Study of Telecom Egypt Group

Authors: Nawal Alawad, Passent Ibrahim Tantawi, Mohamed Abdel Salam Ragheb

Abstract:

Providing customers with quality experiences has been confirmed to be a sustainable, competitive advantage with a distinct financial impact for companies. The success of service providers now relies on their ability to provide customer-centric services. The importance of perceived service quality and customer experience is widely recognized. The focus of this research is in the area of mobile and fixed broadband services. This study is of dual importance both academically and practically. Academically, this research applies a new model investigating the impact of customer experience quality on loyalty based on modifying the multiple-item scale for measuring customers’ service experience in a new area and did not depend on the traditional models. The integrated scale embraces four dimensions: service experience, outcome focus, moments of truth and peace of mind. In addition, it gives a scientific explanation for this relationship so this research fill the gap in such relations in which no one correlate or give explanations for these relations before using such integrated model and this is the first time to apply such modified and integrated new model in telecom field. Practically, this research gives insights to marketers and practitioners to improve customer loyalty through evolving the experience quality of broadband customers which is interpreted to suggested outcomes: purchase, commitment, repeat purchase and word-of-mouth, this approach is one of the emerging topics in service marketing. Data were collected through 412 questionnaires and analyzed by using structural equation modeling.Findings revealed that both outcome focus and moments of truth have a significant impact on loyalty while both service experience and peace of mind have insignificant impact on loyalty.In addition, it was found that 72% of the variation occurring in loyalty is explained by the model. The researcher also measured the net prompters score and gave explanation for the results. Furthermore, assessed customer’s priorities of broadband services. The researcher recommends that the findings of this research will extend to be considered in the future plans of Telecom Egypt Group. In addition, to be applied in the same industry especially in the developing countries that have the same circumstances with similar service settings. This research is a positive contribution in service marketing, particularly in telecom industry for making marketing more reliable as managers can relate investments in service experience directly with the performance closest to income for instance, repurchasing behavior, positive word of mouth and, commitment. Finally, the researcher recommends that future studies should consider this model to explain significant marketing outcomes such as share of wallet and ultimately profitability.

Keywords: broadband services, customer experience quality, loyalty, net promoters score

Procedia PDF Downloads 266
54096 Stuttering Persistence in Children: Effectiveness of the Psicodizione Method in a Small Italian Cohort

Authors: Corinna Zeli, Silvia Calati, Marco Simeoni, Chiara Comastri

Abstract:

Developmental stuttering affects about 10% of preschool children; although the high percentage of natural recovery, a quarter of them will become an adult who stutters. An effective early intervention should help those children with high persistence risk for the future. The Psicodizione method for early stuttering is an Italian behavior indirect treatment for preschool children who stutter in which method parents act as good guides for communication, modeling their own fluency. In this study, we give a preliminary measure to evaluate the long-term effectiveness of Psicodizione method on stuttering preschool children with a high persistence risk. Among all Italian children treated with the Psicodizione method between 2018 and 2019, we selected 8 kids with at least 3 high risk persistence factors from the Illinois Prediction Criteria proposed by Yairi and Seery. The factors chosen for the selection were: one parent who stutters (1pt mother; 1.5pt father), male gender, ≥ 4 years old at onset; ≥ 12 months from onset of symptoms before treatment. For this study, the families were contacted after an average period of time of 14,7 months (range 3 - 26 months). Parental reports were gathered with a standard online questionnaire in order to obtain data reflecting fluency from a wide range of the children’s life situations. The minimum worthwhile outcome was set at "mild evidence" in a 5 point Likert scale (1 mild evidence- 5 high severity evidence). A second group of 6 children, among those treated with the Piscodizione method, was selected as high potential for spontaneous remission (low persistence risk). The children in this group had to fulfill all the following criteria: female gender, symptoms for less than 12 months (before treatment), age of onset <4 years old, none of the parents with persistent stuttering. At the time of this follow-up, the children were aged 6–9 years, with a mean of 15 months post-treatment. Among the children in the high persistence risk group, 2 (25%) hadn’t had stutter anymore, and 3 (37,5%) had mild stutter based on parental reports. In the low persistency risk group, the children were aged 4–6 years, with a mean of 14 months post-treatment, and 5 (84%) hadn’t had stutter anymore (for the past 16 months on average).62,5% of children at high risk of persistence after Psicodizione treatment showed mild evidence of stutter at most. 75% of parents confirmed a better fluency than before the treatment. The low persistence risk group seemed to be representative of spontaneous recovery. This study’s design could help to better evaluate the success of the proposed interventions for stuttering preschool children and provides a preliminary measure of the effectiveness of the Psicodizione method on high persistence risk children.

Keywords: early treatment, fluency, preschool children, stuttering

Procedia PDF Downloads 216
54095 Voltage Polarity in Electrospinning: Way to Control Surface Properties of Polymer Fibers

Authors: Urszula Stachewicz

Abstract:

Surface properties of materials are the key parameter in many applications, especially in the biomedical field, to control cell-material interactions. In our work, we want to achieve the controllability of surface properties of polymer fibers via a single-step electrospinning process by alternating voltage polarities. Voltage polarity defines the charge accumulated on the surface of the liquid jet and the surface of the fibers. Positive polarity attracts negatively charged groups to fibers’ surface, whereas negative polarity moves the negatively charged functional groups away from the surface. This way, we can control the surface chemistry, wettability, and additionally surface potential of electrospun fibers. Within our research, we characterized surface chemistry using X-ray photoelectron microscopy (XPS) and surface potential with Kelvin probe force microscopy (KPFM) on electrospun fibers of commonly used polymers such as PCL, PVDF, and PMMA, often used as biomaterials. We proved the significant effect of fibers' surface potential on cell integration with the scaffolds and further cells development for the regeneration processes based on the osteoblast and fibroblast culture studies. Acknowledgments: The study was conducted within ‘Nanofiber-based sponges for atopic skin treatment’ project, which is carried out within the First TEAM programme of the Foundation for Polish Science co-financed by the European Union under the European Regional Development Fund, project no POIR.04.04.00-00- 4571/18-00.

Keywords: cell attachment, fibers, fibroblasts, osteoblast, proliferation, surface potential

Procedia PDF Downloads 116
54094 Resilience in Patients with Chronic Kidney Disease in Hemodialysis

Authors: Gomes C. C. Izabel, Lanzotti B. Rafaela, Orlandi S. Fabiana

Abstract:

Chronic Kidney Disease is considered a serious public health problem. The exploitation of resilience has been guided by studies conducted in various contexts, especially in hemodialysis, since the impact of diagnosis and restrictions produced during the treatment process because, despite advances in treatment, remains the stigma of the disease and the feeling of pain, hopelessness, low self-esteem and disability. The objective was to evaluate the level of resilience of patients in chronic renal dialysis. This is a descriptive, correlational, cross and quantitative research. The sample consisted of 100 patients from a Renal Replacement Therapy Unit in the countryside of São Paulo. For data collection were used the characterization instrument of Participants and the Resilience Scale. There was a predominance of males (70.0%) were Caucasian (45.0%) and had completed elementary education (34.0%). The average score obtained through the Resilience Scale was 131.3 (± 20.06) points. The resiliency level submitted may be considered satisfactory. It is expected that this study will assist in the preparation of programs and actions in order to avoid possible situations of crises faced by chronic renal patients.

Keywords: hemodialysis units, renal dialysis, renal insufficiency chronic, resilience psychological

Procedia PDF Downloads 282
54093 Life Satisfaction of Non-Luxembourgish and Native Luxembourgish Postgraduate Students

Authors: Chrysoula Karathanasi, Senad Karavdic, Angela Odero, Michèle Baumann

Abstract:

It is not only the economic determinants that impact on life conditions, but maintaining a good level of life satisfaction (LS) may also be an important challenge currently. In Luxembourg, university students receive financial aid from the government. They are then registered at the Centre for Documentation and Information on Higher Education (CEDIES). Luxembourg is built on migration with almost half its population consisting of foreigners. It is upon this basis that our research aims to analyze the associations with mental health factors (health satisfaction, psychological quality of life, worry), perceived financial situation, career attitudes (adaptability, optimism, knowledge, planning) and LS, for non-Luxembourgish and native postgraduate students. Between 2012 and 2013, postgraduates registered at CEDIES were contacted by post and asked to participate in an online survey with either the option of English or French. The study population comprised of 644 respondents. Our statistical analysis excluded: those born abroad who had Luxembourgish citizenship, or those born in Luxembourg who did not have citizenship. Two groups were formed one consisting 147 non-Luxembourgish and the other 284 natives. A single item measured LS (1=not at all satisfied to 10=very satisfied). Bivariate tests, correlations and multiple linear regression models were used in which only significant relationships (p<0.05) were integrated. Among the two groups no differences were found between LS indicators (7.8/10 non-Luxembourgish; 8.0/10 natives) as both were higher than the European indicator of 7.2/10 (for 25-34 years). In the case of non-Luxembourgish students, they were older than natives (29.3 years vs. 26.3 years) perceived their financial situation as more difficult, and a higher percentage of their parents had an education level higher than a Bachelor's degree (father 59.2% vs 44.6% for natives; mother 51.4% vs 33.7% for natives). In addition, the father’s education was related to the LS of postgraduates and the higher was the score, the greater was the contribution to LS. Whereas for native students, when their scores of health satisfaction and career optimism were higher, their LS’ score was higher. For both groups their LS was linked to mental health-related factors, perception of their financial situation, career optimism, adaptability and planning. The higher the psychological quality of life score was, the greater the LS of postgraduates’ was. Good health and positive attitudes related to the job market enhanced their LS indicator.

Keywords: career attributes, father's education level, life satisfaction, mental health

Procedia PDF Downloads 371
54092 Threshold Competency of Students in Graduate School

Authors: Terada Pinyo

Abstract:

This study is the survey research, designed to find out the threshold competency of graduate students in terms of knowledge excellency and professional skills proficiency based on Thai Qualifications Framework for Higher Education (TQF). The sample group consisted of 240 students. The results were collected by stratified sampling, using study programs for each stage. The results were analysed and calculated by computer program. Statistics used during analysing were percentage, mean, and standard deviation. From the study, the threshold competency of graduate students were in very high score range in both overall and specific category. The top category which received the most score was interpersonal skills and responsibility, following by ethics and morality, knowledge and skills, and numerical communication and information technology.

Keywords: threshold competency, Thai qualifications framework for higher education, graduate school

Procedia PDF Downloads 402
54091 Preventive Behaviors of Exposure to ‎Secondhand Smoke among Women: A Study Based on the Health Belief Model

Authors: Arezoo Fallahi

Abstract:

Introduction: Exposure to second-hand smoke is an important global health problem and threatens the health of people, especially children and women. The aim of this study was to determine the effect of education based on the Health Belief Model on preventive behaviors of exposure to secondhand smoke in women. Materials and Methods: This experimental study was performed in 2023in Sanandaj, west of Iran. Seventy-four people were selected by simple random sampling and divided into an intervention group (37 people) and a control group (37 people). Data collection tools included demographic characteristics and a second-hand smoke exposure questionnaire based on the Health Beliefs Model. The training in the intervention group was conducted in three one-hour sessions in the comprehensive health service centers in the form of lectures, pamphlets, and group discussions. Data were analyzed using SPSS software version 21 and statistical tests such as correlation, paired t-test, and independent t-test. Results: The intervention and control groups were homogeneous before education. They were similar in terms of mean scores of the Health Belief Model. However, after an educational intervention, some of the scores increased, including the mean perceived sensitivity score (from 17.62±2.86 to 19.75±1.23), perceived severity score (28.40±4.45 to 31.64±2), perceived benefits score (27.27±4.89 to 31.94±2.17), practice score (32.64±4.68 to 36.91±2.32) perceived barriers from 26.62±5.16 to 31.29±3.34, guide for external action (from 17.70±3.99 to 22/89 ±1.67), guide for internal action from (16.59±2.95 to 1.03±18.75), and self-efficacy (from 19.83 ±3.99 to 23.37±1.43) (P <0.05). Conclusion: The educational intervention designed based on the Health Belief Model in women was effective in performing preventive behaviors against exposure to secondhand smoke.

Keywords: women, health behaviour, smoke, belive

Procedia PDF Downloads 54
54090 Assessing the Impact of the Rome II Regulation's General Rule on Cross-Border Road Traffic Accidents: A Critique of Recent Case Law

Authors: Emma Roberts

Abstract:

The Rome II Regulation has established a uniform regime of conflict of law rules across the European Union (except for Denmark) which determines the law applicable in non-contractual obligations disputes. It marks a significant development towards the Europeanization of private international law and aims to provide the most appropriate connecting factors to achieve both legal certainty and justice in individual cases. Many non-contractual obligations are recognised to present such distinct factors that, to achieve these aims, a special rule is provided for determining the applicable law in cases in respect of product liability and environmental torts, for example. Throughout the legislative process, the European Parliament sought to establish a separate rule for road traffic accidents, recognising that these cases too present such novel situations that a blanket application of a lex loci damni approach would not provide an appropriate answer. Such attempts were rejected and, as a result, cases arising out of road traffic accidents are subject to the Regulation’s general lex loci damni rule along with its escape clause and limited exception. This paper offers a critique of the Regulation’s response to cross-border road traffic accident cases. In England and Wales, there have been few cases that have applied the Regulation’s provisions to date, but significantly the majority of such cases are in respect of road traffic accidents. This paper examines the decisions in those cases and challenges the legislators’ decision not to provide a special rule for such incidences. Owing to the diversity in compensation systems globally, applying the Regulation’s general rule to cases of road traffic accidents – given the breadth of matters that are to be subject to the lex cause – cannot ensure an outcome that provides ‘justice in individual cases’ as is assured by the Regulation's recitals. Not only does this paper suggest that the absence of a special rule for road traffic accidents means that the Regulation fails to achieve one of its principal aims, but it further makes out a compelling case for the legislative body of the European Union to implement a corrective instrument.

Keywords: accidents abroad, applicable law, cross-border torts, non-contractual obligations, road traffic accidents

Procedia PDF Downloads 256
54089 Impact of Mammographic Screening on Ethnic Inequalities in Breast Cancer Stage at Diagnosis and Survival in New Zealand

Authors: Sanjeewa Seneviratne, Ian Campbell, Nina Scott, Ross Lawrenson

Abstract:

Introduction: Indigenous Māori women experience a 60% higher breast cancer mortality rate compared with European women in New Zealand. We explored the impact of difference in the rate of screen detected breast cancer between Māori and European women on more advanced disease at diagnosis and lower survival in Māori women. Methods: All primary in-situ and invasive breast cancers diagnosed in screening age women (as defined by the New Zealand National Breast Cancer Screening Programme) between 1999 and 2012 in the Waikato area were identified from the Waikato Breast Cancer Register and the national screening database. Association between screen versus non-screen detection and cancer stage at diagnosis and survival were compared by ethnicity and socioeconomic deprivation. Results: Māori women had 50% higher odds of being diagnosed with more advance staged cancer compared with NZ European women, a half of which was explained by the lower rate of screen detected cancer in Māori women. Significantly lower breast cancer survival rates were observed for Māori compared with NZ European and most deprived compared with most affluent socioeconomic groups for symptomatically detected breast cancer. No significant survival differences by ethnicity or socioeconomic deprivation were observed for screen detected breast cancer. Conclusions: Low rate of screen detected breast cancer appears to be a major contributor for more advanced stage disease at diagnosis and lower breast cancer survival in Māori compared with NZ European women. Increasing screening participation for Māori has the potential to substantially reduce breast cancer mortality inequity between Māori and NZ European women.

Keywords: breast cancer, screening, ethnicity, inequity

Procedia PDF Downloads 514
54088 The Effect of Modified Posterior Shoulder Stretching Exercises on Posterior Shoulder Tightness, Shoulder Pain, and Dysfunction in Patients with Subacromial Impingement

Authors: Ozge Tahran, Sevgi Sevi Yesilyaprak

Abstract:

Objective: The aim of the study was to investigate the effect of the Wilk’s modified two different stretching exercises on posterior shoulder tightness, pain, and dysfunction in patients with subacromial impingement syndrome (SIS). Method: This study was carried out on 67 patients who have more than 15° difference in shoulder internal rotation range of motion between two sides and had been diagnosed as SIS. Before treatment, all patients were randomly assigned into three groups. Standard physiotherapy programme was applied to the Group 3 (n=23), standard physiotherapy program with Wilk’s modified cross-body stretching exercises were applied to Group 1 (n=22), and standard physiotherapy program with Wilk’s modified sleeper stretching exercises were applied to Group 2 (n= 23). All the patients received 20 sessions of physiotherapy during 4 weeks, 5 days in a week by a physiotherapist. The patients continued their exercises at home at the weekends. Pain severity, shoulder rotation range of motion, posterior shoulder tightness, upper extremity functionality with Constant and Murley Score (CMS) and disability level with The Disabilities of the Arm, Shoulder and Hand Score (QuickDASH) were evaluated before and after physiotherapy programme. Results: Before treatment, demographic and anthropometric characteristics were similar in groups and there was no statistical difference (p > 0.05). It was determined that pain severity decreased, shoulder rotation range of motion, posterior shoulder tightness, upper extremity functionality, and disability were improved after physiotherapy in both groups (p < 0.05). Group 1 and 2 had better results in terms of reduction of pain severity during activity, increase in shoulder rotation range of motion, posterior shoulder mobility and upper extremity functionality and improvement in upper extremity disability, compared to Group 3 (p < 0.05). Conclusion: Modified posterior shoulder stretching exercises in addition to standard physiotherapy programme is more effective for reduction of pain during activity, to improve shoulder rotation range of motion, posterior shoulder mobility, and upper extremity functionality in patients with SIS compared to standard physiotherapy programme alone.

Keywords: modified posterior shoulder stretching exercises, posterior shoulder tightness, shoulder complex, subacromial impingement syndrome

Procedia PDF Downloads 178
54087 Systematic Review of the Efficacy of Traditional Chinese Medicine in Parkinson Disease

Authors: Catarina Ramos Pereira, Jorge Rodrigues, Natália Oliveira, Jorge Machado, Maria Begoña Criado, Jorge Machado, Henri J. Greten

Abstract:

Background: Parkinson's disease is a multi-system neurodegenerative disorder characterized by motor and non-motor symptoms. To slow disorder progression, different treatment options are now available, but in most cases, these therapeutic strategies also involve the presence of important side effects. This has led many patients to pursue complementary therapies, such as acupuncture, to alleviate PD symptoms. Therefore, an update on the efficacy of this treatment for patients of PD is of great value. This work presents a systematic review of the efficacy of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central), and Scielo databases were systematically searched from January 2011 through July 2021. Randomized controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles were conducted by two blinding authors through the Rayyan application. Results: 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Additional evidence should be supported by rigorous methodological strategies. Although firm conclusions cannot be drawn, acupuncture treatment, in the framework of an interdisciplinary care team, appears to have positive effects on PD symptoms.

Keywords: systematic review, Parkinson disease, acupuncture, traditional Chinese medicine

Procedia PDF Downloads 143
54086 New Vision of 'Social Europe': Renationalising the Integration Process in the Internal Market of the European Union

Authors: Robert Grzeszczak, Magdalena Gniadzik

Abstract:

The article deals with one of the most significant issues concerning the functioning of the internal market of the European Union – the free movement of workers and free movement of persons. The purpose is to identify the political and legal effects of the “renationalisation process” on the EU and its Member States. The concept of renationalisation is expressed through Member States’ aim to verify the relationship with the EU. The tendency is more visible in the public opinion of several MS’s of the ‘EU core’ and may be confirmed by the changes applied by the regulatory body. The thesis for the article is the return of renationalisation tendencies in the area of the Single Market, which is supported by, among others, an open criticism of the foundations of EU integration or considerations on withdrawal from the EU by some MS. This analysis will focus primarily on the effects that renationalisation may have on the free movement of persons. The free movement of persons is one of the key issues for the development of the European integration. It is still subject to theoretical reflections, new doubts and practical issues. The latest developments in politics, law and jurisprudence demonstrate the need to reflect on the attempts to redefine certain principles regarding migrant EU workers and their protection against nationality-based discrimination.

Keywords: European Union, Singel Market, free movement of persons, posting of workers

Procedia PDF Downloads 229
54085 Effect of Cryogenic Treatment on Various Mechanical and Metallurgical Properties of Different Material: A Review

Authors: Prashant Dhiman, Viranshu Kumar, Pradeep Joshi

Abstract:

Lot of research is going on to study the effect of cryogenic treatment on materials. Cryogenic treatment is a heat treatment process which is used widely to enhance the mechanical and metallurgical properties of various materials whether the material is ferrous or non ferrous. In almost all ferrous metals, it is found that retained austenite is converted into martensite. Generally deep cryogenic treatment is done using liquid nitrogen having temperature of -195 ℃. The austenite is unstable at this stage and converts into martensite. In non ferrous materials there presents a microcavity and under the action of stress it becomes crack. When this crack propagates, fracture takes place. As the metal contract under low temperature, by doing cryogenic treatment these microcavities will be filled hence increases the soundness of the material. Properties which are enhanced by cryogenic treatment of both ferrous and non ferrous materials are hardness, tensile strength, wear rate, electrical and thermal conductivity, and others. Also there is decrease in residual stress. A large number of manufacturing process (EDM, CNC etc.) are using cryogenic treatment on different tools or workpiece to reduce their wear. In this Review paper the use of cryogenic heat treatment in different manufacturing has been shown along with their advantages.

Keywords: cyrogenic treatment, EDM (Electrical Discharge Machining), CNC (Computer Numeric Control), Mechanical and Metallurgical Properties

Procedia PDF Downloads 436
54084 Application of an Educational Program for Al Jouf University Students regarding Scientific Writing and Presentation Skills

Authors: Fatma Abdel Moneim Al Tawil

Abstract:

This study was undertaken to evaluate an educational program regarding scientific writing and presentation skills among university students. This interventional study used a one-group, pretest/posttest design and was conducted in Al Jouf University among four colleges in Saudi Arabia. Baseline students’ assessment was conducted for developing educational program. Interventional, one group, pretest/posttest study was designed to evaluate the effectiveness of the educational program. Three parts evaluation sheet with total scores of 30 was used for 113 students for the development of the program and 52 students for test pretest phase. Wilcoxon signed ranks showed statistically significant improvement in the combined overall program skills score from a median of 56.7 pre to a median of 86.7 post, (z = 6.231, p < 0.001). When compared to preprogram intervention, post interventions 51.9 % of students achieve excellent performance. While pre intervention no students (0.0 %) achieve this score. Regarding to scientific writing skills, Wilcoxon signed ranks showed statistically significant improvement in the score from a median of 60 pre to a median of 90 post, (z = 6.122, p < 0.001). None of students had excellent performance changed to 73.1%. Regarding to oral presentation skills, Wilcoxon signed ranks showed statistically significant improvement in the score from a median of 50 pre to a median of 80 post, (z = 6.153, p < 0.001). None of students had excellent performance changed to 48.1%. Such educational program needs to be incorporated into classroom delivery of the students’ curriculum. Scientific writing skills book needed to be developed to be recommended as a basic educational strategy for all university faculties.

Keywords: scientific writing, presentation skills, university students, educational program

Procedia PDF Downloads 451
54083 Physicians’ Knowledge and Perception of Gene Profiling in Malaysia: A Pilot Study

Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

Abstract:

Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires was returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age range from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge. However, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non-significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: gene profiling, knowledge, Malaysia, physician

Procedia PDF Downloads 326
54082 Video Object Segmentation for Automatic Image Annotation of Ethernet Connectors with Environment Mapping and 3D Projection

Authors: Marrone Silverio Melo Dantas Pedro Henrique Dreyer, Gabriel Fonseca Reis de Souza, Daniel Bezerra, Ricardo Souza, Silvia Lins, Judith Kelner, Djamel Fawzi Hadj Sadok

Abstract:

The creation of a dataset is time-consuming and often discourages researchers from pursuing their goals. To overcome this problem, we present and discuss two solutions adopted for the automation of this process. Both optimize valuable user time and resources and support video object segmentation with object tracking and 3D projection. In our scenario, we acquire images from a moving robotic arm and, for each approach, generate distinct annotated datasets. We evaluated the precision of the annotations by comparing these with a manually annotated dataset, as well as the efficiency in the context of detection and classification problems. For detection support, we used YOLO and obtained for the projection dataset an F1-Score, accuracy, and mAP values of 0.846, 0.924, and 0.875, respectively. Concerning the tracking dataset, we achieved an F1-Score of 0.861, an accuracy of 0.932, whereas mAP reached 0.894. In order to evaluate the quality of the annotated images used for classification problems, we employed deep learning architectures. We adopted metrics accuracy and F1-Score, for VGG, DenseNet, MobileNet, Inception, and ResNet. The VGG architecture outperformed the others for both projection and tracking datasets. It reached an accuracy and F1-score of 0.997 and 0.993, respectively. Similarly, for the tracking dataset, it achieved an accuracy of 0.991 and an F1-Score of 0.981.

Keywords: RJ45, automatic annotation, object tracking, 3D projection

Procedia PDF Downloads 167
54081 A Clinical Study of Placenta Previa and Its Effect on Fetomaternal Outcome in Scarred and Unscarred Uterus at a Tertiary Care Hospital

Authors: Sharadha G., Suresh Kanakkanavar

Abstract:

Background: Placenta previa is a condition characterized by partial or complete implantation of the placenta in the lower uterine segment. It is one of the main causes of vaginal bleeding in the third trimester and a significant cause of maternal and perinatal morbidity and mortality. Materials and Methods: This is an observational study involving 130 patients diagnosed with placenta previa and satisfying inclusion criteria. The demographic data, clinical, surgical, and treatment, along with maternal and neonatal outcome parameters, were noted in proforma. Results: The incidence of placenta previa among scarred uterus was 1.32%, and in unscarred uterus was 0.67%. The mean age of the study population was 27.12±4.426years. High parity, high abortion rate, multigravida status, and less gestational age at delivery were commonly seen in scarred uterus compared to unscarred uterus. Complete placenta previa, anterior placental position, and adherent placenta were significantly associated with a scarred uterus compared to an unscarred uterus. The rate of caesarean hysterectomy was higher in the scarred uterus, along with statistical association to previous lower-segment caesarean sections. Intraoperative procedures like uterine artery ligation, bakri balloon insertion, and iliac artery ligation were higher in the scarred group. The maternal intensive care unit admission rate was higher in the scarred group and also showed its statistical association with previous lower segment caesarean section. Neonatal outcomes in terms of pre-term birth, still birth, neonatal intensive care unit admission, and neonatal death, though higher in the scarred group, did not differ statistically among the groups. Conclusion: Advancing maternal age, multiparity, prior uterine surgeries, and abortions are independent risk factors for placenta previa. Maternal morbidity is higher in the scarred uterus group compared to the unscarred group. Neonatal outcomes did not differ statistically among the groups. This knowledge would help the obstetricians to take measures to reduce the incidence of placenta previa and scarred uterus which would improve the fetomaternal outcome of placenta previa.

Keywords: placenta previa, scarred uterus, unscarred uterus, adherent placenta

Procedia PDF Downloads 59
54080 Comparative Evaluation of Pentazocine and Tramadol as Pre-Emptive Analgesics for Ovariohysterectomy in Female Dogs

Authors: Venkatgiri, Ranganath, L. Nagaraja, B. N. Sagar Pandav, S. M. Usturge, D. Dilipkumar, B. V. Shivprakash, B. Bhagwanthappa, D. Jahangir

Abstract:

A comparative evaluation of Tramadol and Pentazocine as a pre-emptive analgesic in clinical cases of female dogs undergoing ovariohysterectomy was undertaken during this study. During the study, the following parameters were assessed viz., Rectal temperature (ᵒF), Respiratory rate (breaths/min) and Heart rate (beats/min). Hematological and biochemical parameters viz., total erythrocyte count (TEC) (millions/cmm), hemoglobin (g %), otal leucocytes count (TLC) (thousands/cmm), differential leucocytes count (DLC) (%), serum creatinine (mg/dl), plasma protein (mg/dl), blood glucose (mg/dl) was estimated before the surgery and after administration of general anaesthesia and immediate postoperative periods of 0, 12 and 24 hr respectively. Mean Total Pain Score (MTPS) includes measurement of parameters like posture, vocalization, activity level, response to palpation and agitation at different intervals was calculated before surgery and after administration of general anesthesia and post-operative periods of 1, 2, 4, 6, 12hrs and 24 hrs respectively. Mean Total Pain Score (MTPS) was given for each parameter (Posture, Vocalization, Activity Level, Response to Palpation and Agitation) like 0,1,2,3. (maximum score will be given was 4.). Results were revealed in all three groups including control group. There were significant minor alterations in physiological, hematological and biochemical parameters. MTPS (mean total pain score) were revealed and found a significant alteration when compared with control group. In conclusion, Tramadol found to be a better analgesic and had up to 8hrs of analgesic effect and Pentazocine is superior in post-operative pain management when compared to Tramadol because this group of dogs experienced less surgical stress, consumed less anesthetic dose, they recovered early, and they had less MTPS score.

Keywords: dog, pentazocine, tramadol, ovariohysterectomy

Procedia PDF Downloads 167
54079 Driving Green Public Procurement – A Framework for a Supporting Structure for Public Authorities Based on Good Practices in Europe

Authors: Pia Moschall, Kathrin Sackmann

Abstract:

Considering a purchasing volume of around two trillion Euros per year, which equals about 14% of the European Union’s gross domestic product, European public authorities have significant market power. Making use of this market power by prioritizing the procurement of green products and services offers a great potential to contribute to the Green New Deal. The market demand that is created by Green Public Procurement (GPP) sets incentives for European producers to design and develop Green Products and Eco-Innovations. However, most procurement still does not consider environmental criteria. The goal of the work is to encourage the adaptation of GPP in the European Union. To this end, the drivers for the adaptation were investigated over different case studies. The paper analyzes good-practice cases from European authorities from 2010 to 2020 that were provided by the European Commission. This analysis was guided by Philipp Mayring’s method of qualitative content analysis, whereby the inductively formed categories led to the identification of nine major drivers. The most important ones are ‘use of official guidelines and standards, ‘political support and requirements as well as ‘market research and involvement.’ Further, the paper discusses mutual dependencies between several drivers and how to exploit them. A supporting infrastructure was identified as a crucial factor for the successful adaption of green public procurement. In the next step, the work aims to examine on which administrative level the single drivers can be implemented most effectively. Practical implications of this research are recommendations on how to create a supporting structure on a municipal, federal and national level, including training for the responsible staff, support tools, as well as guidelines and standards for involved stakeholders.

Keywords: content analysis, green public procurement, public authorities, sustainable procurement

Procedia PDF Downloads 146
54078 From Cultural Diversity to Cultural Diplomacy: The Practice of Normative Power Europe

Authors: Tzuli Lin

Abstract:

This paper aims to explore that the EU and Member State (UK) converges on cultural diplomacy to constitute an influential European external relations. It will address the development of EU cultural diplomacy and practice at Member state level. It also discusses the EU and Member States suffering in cultural resource overlapped. In contrast to the literature on the EU external relations, studies of the cultural dimension are rare. Thus, this paper will utilise the broad policy papers to explore how the cultural diversity among the Member States and the EU has a constructive progress at European level but not at Member State level. It can be argued that cultural component is the pivotal strategy for the stagnated EU external relations since the Euro crisis. The EU recognises that if it wants to promote the trade relations from the inside of Europe to outside, it requires the broad culture context among its traditional diplomacy, which brings the cultural component into a significant role. Even though in the area of Member State level, they share the fundamental value and idea, it does not elaborate Member States regarding the EU as a representative of European cultural diplomacy. In theory and practice, the discourse of Normative Power Europe (NPE) can be the analytic framework to construct the research of cultural diplomacy in Europe. NPE is an idea of the EU’s global role and spreading its norms to others. Moreover, Member States’ national interest has supreme priority rather than the EU. Therefore, this paper will utilise the UK as a case study to explore that cultural diplomacy shows fragmentation at European level. In the result, this paper will illustrate that the EU and the UK have mutual recognised each other as a partner not a leader.

Keywords: EU cultural diplomacy, cultural policy, cultural diversity, normative power

Procedia PDF Downloads 314
54077 Effects of Different Processing Methods of Typha Grass on Feed Intake Milk Yield/Composition and Blood Parameters of Diry Cows

Authors: Alhaji Musa Abdullahi, Usman Abdullahi, Adamu Lawan, Aminu Maidala

Abstract:

Abstract 16 healthy lactating cows will be randomly selected for the trial and will be randomly divided in to 4 groups with 4 cows in each. They will be kept under similar management condition (conventional management system). Animals of relatively same weight and age will be used. After 11days for adaptation, feed intake and performance of the experimental animals will be determine. Milk sample will be collected at each milking in the morning and afternoon to determine; Milk yield, Milk fat percentage, Solid not fat percentage, Total solid percentage of milk. Cows dung will be observe to determine; Score 1 very loose watery stool, Score 2 semi solid with undigested raw material, Score 3 semi solid with less undigested raw material, Score 4 solid with very less undigested raw material, Score 5 good dung no undigested raw material. At the end of the experiment, blood samples will be analyzed for full blood counts and differentials {White Blood Cells (WBC), Red Blood Cells (RBC), Hemoglobin (Hb), Packed Cell Volume (PCV), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin Concentration (MCHC), Platelets (PLT), Lymphocytes (LYM), Basophils, Eosinophils and Monocytes Proportion (MXD) and Neutrophils (NEUT)} using automated hematology analyzer. Serum samples will be analyzed for heat shock transcription factors, heat shock proteins and hormones (Serum glucocorticoid, prolactin and cortisol). Moreover, biochemical analysis will also be conducted to check for Total protein (TP), Albumen (ALB), Globulin (GBL), Total cholesterol (TCH), glucose (G), sodium (Na+), potassium (K+), chloride (Cl-) and pH. Keywords: Lactating cows, milk composition, dung score and blood parameters.

Keywords: Lactating cows , Milk yield , Dung score , Blood parameters

Procedia PDF Downloads 184
54076 The Effects of Evidence-Based Nursing Training and Consultation Program on Self-Efficacy and Outcome Expectancy of Evidence-Based Practice among Nurses

Authors: Yea-Pyng Lin

Abstract:

Evidence-based nursing (EBN) can improve quality of patient care and reduce medical expenses. Development of training and consultation program according to nurses’ needs and difficulties is essential to promote their competence and self-efficacy in EBN. However, limited research evaluated the effects of EBN program on EBN self-efficacy among nurses. This study aimed to evaluate the effects of an EBN consultation program on self-efficacy and outcome expectancy of evidence-based practice (EBP) among nurses. A two-group pretest-posttest quasi-experimental design was used. A purposive sample of full-time nurses was recruited from a hospital. Experimental group (n=28) received the EBN consultation program including 18-hour EBN training courses, hand-on practices and group discussion by faculty mentors. Control group (n=33) received regular in-service education with no EBN program. All participants received baseline and post-test assessment using Chinese version of Self-Efficacy in EBP scale (SE-EBP) and Outcome Expectancy for EBP scale (OE-EBP). After receiving EBN consultation program, experimental group’s posttest scores of SE-EBP (t=-4.98, p<0.001) and OE-SEP (t=-3.65, p=0.001) were significantly higher than those of the pretests. By controlling the age and years of nursing work experience, the experimental group‘s SE-EBP(F=10.47, p=0.002) and OE-SEP(F=9.53, p=0.003) scores were significantly improved compared to those of the control group. EBN program focus on hand-on practice and group discussion by faculty mentors in addition to EBN training courses can improve EBP self-efficacy and outcome expectancy among nurses. EBN program focus on English literature reading, database searching, and appraisal practice according to nurses’ needs and difficulties can promote implementation of EBN.

Keywords: evidence-based nursing, evidence-based practice, consultation program, self-efficacy, outcome expectancy

Procedia PDF Downloads 500