Search results for: difficulty in hospital acceptance
Commenced in January 2007
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Edition: International
Paper Count: 3701

Search results for: difficulty in hospital acceptance

3191 Merits and Demerits of Participation of Fellow Examinee as Subjects in Observed Structured Practical Examination in Physiology

Authors: Mohammad U. A. Khan, Md. D. Hossain

Abstract:

Background: Department of Physiology finds difficulty in managing ‘subjects’ in practical procedure. To avoid this difficulty fellow examinees of other group may be used as subjects. Objective: To find out the merits and demerits of using fellow examinees as subjects in the practical procedure. Method: This cross-sectional descriptive study was conducted in the Department of Physiology, Noakhali Medical College, Bangladesh during May-June’14. Forty-two 1st year undergraduate medical students from a selected public medical college of Bangladesh were enrolled for the study purposively. Consent of students and authority was taken. Eighteen of them were selected as subjects and designated as subject-examinees. Other fellow examinees (non-subject) examined their blood pressure and pulse as part of ‘observed structured practical examination’ (OSPE). The opinion of all examinees regarding the merits and demerits of using fellow examinee as subjects in the practical procedure was recorded. Result: Examinees stated that they could perform their practical procedure without nervousness (24/42, 57.14%), accurately and comfortably (14/42, 33.33%) and subjects were made available without wasting time (2/42, 4.76%). Nineteen students (45.24%) found no disadvantage and 2 (4.76%) felt embracing when the subject was of opposite sex. The subject-examinees narrated that they could learn from the errors done by their fellow examinee (11/18, 61.1%). 75% non-subject examinees expressed their willingness to be subject so that they can learn from their fellows’ error. Conclusion: Using fellow examinees as subjects is beneficial for both the non-subject and subject examinees. Funding sources: Navana, Beximco, Unihealth, Square & Acme Pharma, Bangladesh Ltd.

Keywords: physiology, teaching, practical, OSPE

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3190 Simulation-based Decision Making on Intra-hospital Patient Referral in a Collaborative Medical Alliance

Authors: Yuguang Gao, Mingtao Deng

Abstract:

The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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3189 Healthcare Associated Infections in an Intensive Care Unit in Tunisia: Incidence and Risk Factors

Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

Abstract:

Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

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3188 Post-Traumatic Stress Disorder: Management at the Montfort Hospital

Authors: Kay-Anne Haykal, Issack Biyong

Abstract:

The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: post-traumatic stress disorder, co-morbidities, diagnosis, mental health disorders

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3187 A Learning Effects Research Applied a Mobile Guide System with Augmented Reality for Education Center

Authors: Y. L. Chang, Y. H. Huang

Abstract:

This study designed a mobile guide system that integrates the design principles of guidance and interpretation with augmented reality (AR) as an auxiliary tool for National Taiwan Science Education Center guidance and explored the learning performance of participants who were divided into two visiting groups: AR-guided mode and non-guided mode (without carrying any auxiliary devices). The study included 96 college students as participants and employed a quasi-experimental research design. This study evaluated the learning performance of education center students aided with different guided modes, including their flow experience, activity involvement, learning effects, as well as their attitude and acceptance of using the guide systems. The results showed that (a) the AR guide promoted visitors’ flow experience; (b) the AR-guidance activity involvement and flow experience having a significant positive effect; (c) most of the visitors of mobile guide system with AR elicited a positive response and acceptance attitude. These results confirm the necessity of human–computer–context interaction. Future research can continue exploring the advantages of enhanced learning effectiveness, activity involvement, and flow experience through application of the results of this study.

Keywords: augmented reality, mobile guide system, informal learning, flow experience, activity involvement

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3186 Risk Factors for Significant Obstetric Anal Sphincter Injury in a District General Hospital

Authors: A. Wahid Uddin

Abstract:

Obstetric anal sphincter injury carries significant morbidity for a woman and affects the quality of life to the extent of permanent damage to anal sphincter musculature. The study was undertaken in a district general hospital by retrospectively reviewing random 63 case notes of patients diagnosed with a significant third or fourth-degree perineal tear admitted between the year of 2015 to 2018. The observations were collected by a pre-designed questionnaire. All variables were expressed as percentages. The major risk factors noted were nulliparity (37%), instrumental delivery (25%), and birth weight of more than 4 kg (14%). Forceps delivery with or without episiotomy was the major contributing factor (75%). In the majority of the cases (71%), no record of any perineal protection measures undertaken. The study concluded that recommended perineal protection measures should be adopted as a routine practise.

Keywords: forceps, obstetrics, perineal, sphincter

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3185 Design of a Professional Development Framework in Teaching and Learning for Engineering Educators

Authors: Orla McConnell, Cormac MacMahon, Jen Harvey

Abstract:

Ireland’s national professional development framework for those who teach in higher education, aims to provide guidance and leadership in the planning, developing and engaging in professional development practices. A series of pilot projects have been initiated to help explore the framework’s likely utility and acceptance by educators and their institutions. These projects require engagement with staff in the interpretation and adaption of the framework within their working contexts. The purpose of this paper is to outline the development of one such project with engineering educators at three Institutes of Technology seeking designation as a technological university. The initiative aims to gain traction in the acceptance of the framework with the engineering education community by linking core and discipline-specific teaching and learning competencies with professional development activities most valued by engineering educators. Informed by three strands of literature: professional development in higher education; engineering education; and teaching and learning training provisions, the project begins with a survey of all those involved in teaching and learning in engineering across the three institutes. Based on engagement with key stakeholders, subsequent qualitative research informs the contextualization of the national framework for discipline-specific and institutional piloting. The paper concludes by exploring engineering educator perceptions of the national framework’s utility based on their engagement with the pilot process. Feedback from the pilot indicates that there is a significant gap between the professional development needs of engineering educators and the current professional development provision in teaching and learning.

Keywords: engineering education, pilot, professional development, teaching and learning

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3184 Out of the Closet: Transgressive Representations of Queer Intimacy in Filipino Mainstream Media

Authors: Darel Magramo

Abstract:

This study argues that media representations of queer intimacies can be transgressive. Representations of queerness in local and international media can be a reflection of the culture where the media product belongs to and these representations can be peculiar and intolerable to different communities. Since these representations of queerness in any media product are rare and unacceptable it can be seen as transgressive in a way that it goes beyond the norms of a particular community and violates the common perceptions about gender and sexuality. Examining media representations of the queer community in a predominantly Catholic country means breaking the religious belief, principles, and stereotypes about homosexuality and same-sex relationship. Using a mainstream media and gender theory this study examined whether and how one particular Filipino mainstream media representation of queer intimacies can enact such transgression. Over the past years Original Pinoy Music (Original Filipino Music) or OPM has produced chart-topping and controversial hit songs which includes: This guy is in love with you pare (pare refers to a guy or men) released in 2002: Nagmahal ako ng bakla (I fell in love with a gay) released in 2009: and lastly Pare mahal mo raw ako (Man, you love me?) released in 2014. By examining these songs, this study outlines tropes on how OPM songs present transgression in queer intimacy including the image of love for money only to gaiety and satisfaction which presents how an openly gay man makes a cisgender man falls in love for him by satisfying him through his humorous antics, this is one way of showing transgression in queer relationship in Philippine context by going beyond the common stereotype of a cisgender man falling in love to a gay man for his wealth to falling in love genuinely because of gaiety and satisfaction in the relationship. This study also identifies how media created a new way of presenting gay and homosexual relationship - from the stereotypes of gays having illnesses and mental health problems, mainstream media continues to present that queer relationship is not all about love and sexual desire but also it promotes acceptance and love towards people in the community. A queer relationship does not only revolve in the idea of having a same-sex relationship but the idea that queer relationship is also between friends and other people of the community by manifesting acceptance and love. Amidst the conservative culture of the Philippines, mainstream media continues to progress and develop ways on how to present gender and sexuality in different media products. These representations create a transgressive way of showing acceptance and understanding towards identities particularly homosexuality and queer relationships.

Keywords: gender studies, homosexuality, media representations, queer intimacy

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3183 The Influence of Human Factors Education on the Irish Registered Pre-Hospital Practitioner within the National Ambulance Service

Authors: Desmond Wade, Alfredo Ormazabal

Abstract:

Background: Ever since it commenced its registration process of pre-hospital practitioners in the year 2000 through the Irish Government Statute Instrument (SI 109 of 2000) process, the approach to education of its professionals has changed drastically. The progression from the traditional behaviouristic to the current constructivist approach has been based on experiences from other sectors and industries, nationally and internationally. Today, the delivery of a safe and efficient ambulance service heavily depends on its practitioners’ range of technical skills, academic knowledge, and overall competences. As these increase, so does the level of complexity of paramedics’ everyday practice. This has made it inevitable to consider the 'Human Factor' as a source of potential risk and made formative institutions like the National Ambulance Service College to include it in their curriculum. Methods: This paper used a mixed-method approach, where both, an online questionnaire and a set of semi-structured interviews were the source of primary data. An analysis of this data was carried out using qualitative and quantitative data analysis. Conclusions: The evidence presented leads to the conclusion that in the National Ambulance Service there is a considerable lack of education of Human Factors and the levels in understanding of how to manage Human Factors in practice vary across its spectrum. Paramedic Practitioners in Ireland seem to understand that the responsibility of patient care lies on the team, rather than on the most hierarchically senior practitioner present in the scene.

Keywords: human factors, ergonomics, stress, decision making, pre-hospital care, paramedic, education

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3182 Day-Case Ketamine Infusions in Patients with Chronic Pancreatitis

Authors: S. M. C. Kelly, M. Goulden

Abstract:

Introduction: Chronic Pancreatitis is an increasing problem worldwide. Pain is the main symptom and the main reason for hospital readmission following diagnosis, despite the use of strong analgesics including opioids. Ketamine infusions reduce pain in complex regional pain syndrome and other neuropathic pain conditions. Our centre has trialed the use of ketamine infusions in patients with chronic pancreatitis. We have evaluated this service to assess whether ketamine reduces emergency department admissions and analgesia requirements. Methods: This study collected retrospective data from 2010 in all patients who received a ketamine infusion for chronic pain secondary to a diagnosis of chronic pancreatitis. The day-case ketamine infusions were initiated in theatre by an anaesthetist, with standard monitoring and the assistance of an anaesthetic practitioner. A bolus dose of 0.5milligrams/kilogram was given in theatre. The infusion of 0.5 milligrams/kilogram per hour was then administered over a 6 hour period in the theatre recovery area. A study proforma detailed the medical history, analgesic use and admissions to hospital. Patients received a telephone follow up consultation. Results: Over the last eight years, a total of 30 patients have received intravenous ketamine infusions, with a total of 92 ketamine infusions being administered. 53% of the patients were male with the average age of 47. A total of 27 patients participated with the telephone consultation. A third of patients reported a reduction in hospital admissions with pain following the ketamine infusion. Analgesia requirements were reduced by an average of 48.3% (range 0-100%) for an average duration of 69.6 days (range 0-180 days.) Discussion: This service evaluation illustrates that ketamine infusions can reduce analgesic requirements and the number of hospital admissions in patients with chronic pancreatitis. In the light of increasing pressures on Emergency departments and the increasing evidence of the dangers of long-term opioid use, this is clearly a useful finding. We are now performing a prospective study to assess the long-term effectiveness of ketamine infusions in reducing analgesia requirements and improving patient’s quality of life.

Keywords: acute-on-chronic pain, intravenous analgesia infusion, ketamine, pancreatitis

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3181 The Taste of Macau: An Exploratory Study of Destination Food Image

Authors: Jianlun Zhang, Christine Lim

Abstract:

Local food is one of the most attractive elements to tourists. The role of local cuisine in destination branding is very important because it is the distinctive identity that helps tourists remember the destination. The objectives of this study are: (1) Test the direct relation between the cognitive image of destination food and tourists’ intention to eat local food. (2) Examine the mediating effect of tourists’ desire to try destination food on the relationship between the cognitive image of local food and tourists’ intention to eat destination food. (3) Study the moderating effect of tourists’ perceived difficulties in finding local food on the relationship between tourists’ desire to try destination food and tourists’ intention to eat local food. To achieve the goals of this study, Macanese cuisine is selected as the destination food. Macau is located in Southeastern China and is a former colonial city of Portugal. The taste and texture of Macanese cuisine are unique because it is a fusion of cuisine from many countries and regions of mainland China. As people travel to seek authentically exotic experience, it is important to investigate if the food image of Macau leaves a good impression on tourists and motivate them to try local cuisine. A total of 449 Chinese tourists were involved in this study. To analyze the data collected, partial least square-structural equation modelling (PLS-SEM) technique is employed. Results suggest that the cognitive image of Macanese cuisine has a direct effect on tourists’ intention to eat Macanese cuisine. Tourists’ desire to try Macanese cuisine mediates the cognitive image-intention relationship. Tourists’ perceived difficulty of finding Macanese cuisine moderates the desire-intention relationship. The lower tourists’ perceived difficulty in finding Macanese cuisine is, the stronger the desire-intention relationship it will be. There are several practical implications of this study. First, the government tourism website can develop an authentic storyline about the evolvement of local cuisine, which provides an opportunity for tourists to taste the history of the destination and create a novel experience for them. Second, the government should consider the development of food events, restaurants, and hawker businesses. Third, to lower tourists’ perceived difficulty in finding local cuisine, there should be locations of restaurants and hawker stalls with clear instructions for finding them on the websites of the government tourism office, popular tourism sites, and public transportation stations in the destination. Fourth, in the post-COVID-19 era, travel risk will be a major concern for tourists. Therefore, when promoting local food, the government tourism website should post images that show food safety and hygiene.

Keywords: cognitive image of destination food, desire to try destination food, intention to eat food in the destination, perceived difficulties of finding local cuisine, PLS-SEM

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3180 Computational Fluid Dynamics Simulation of Reservoir for Dwell Time Prediction

Authors: Nitin Dewangan, Nitin Kattula, Megha Anawat

Abstract:

Hydraulic reservoir is the key component in the mobile construction vehicles; most of the off-road earth moving construction machinery requires bigger side hydraulic reservoirs. Their reservoir construction is very much non-uniform and designers used such design to utilize the space available under the vehicle. There is no way to find out the space utilization of the reservoir by oil and validity of design except virtual simulation. Computational fluid dynamics (CFD) helps to predict the reservoir space utilization by vortex mapping, path line plots and dwell time prediction to make sure the design is valid and efficient for the vehicle. The dwell time acceptance criteria for effective reservoir design is 15 seconds. The paper will describe the hydraulic reservoir simulation which is carried out using CFD tool acuSolve using automated mesh strategy. The free surface flow and moving reference mesh is used to define the oil flow level inside the reservoir. The first baseline design is not able to meet the acceptance criteria, i.e., dwell time below 15 seconds because the oil entry and exit ports were very close. CFD is used to redefine the port locations for the reservoir so that oil dwell time increases in the reservoir. CFD also proposed baffle design the effective space utilization. The final design proposed through CFD analysis is used for physical validation on the machine.

Keywords: reservoir, turbulence model, transient model, level set, free-surface flow, moving frame of reference

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3179 A Descriptive Study to Assess the Knowledge Regarding Prevention and Management of Methicillin-Resistant Staphylococcus Aureus (MRSA) Infections Among Nursing Officers in a Selected Hospital, Bengaluru

Authors: Maneesha Pahlani, Najmin Sultana

Abstract:

A hospital is one of the most suitable places for acquiring an infection because it harbors a high population of virulent strains of microorganisms that may be resistant to antibiotics, especially the prevalence of Methicillin-Resistant Staphylococcus Aureus (MRSA) infections. The hospital-acquired infection has become a global challenge. In developed countries, healthcare-associated infections occur in 5-15% of hospitalized clients, affecting 9-37% of those admitted to intensive care units (ICU). A non-experimental descriptive study was conducted among 50 nursing officers working in a selected hospital in Bangalore to assess the nursing officers’ level of knowledge regarding the prevention and management of MRSA infections and to associate the pre-test knowledge mean scores of nursing officers with selected socio-demographic variables. Data was collected using a structured questionnaire consisting of socio-demographic data and a structured questionnaire on knowledge regarding the prevention and management of MRSA infections. The data was analyzed in terms of frequencies and percentages for the analysis of demographic variables and computing chi-square to determine the association between knowledge means scores and selected demographic variables. The study findings revealed that the nursing officer had an overall good level of knowledge (63.05%) regarding the prevention and management of MRSA infections, and there is no significant association found between the level of knowledge mean scores for prevention and management of MRSA infection with the selected socio-demographic variables. However, the categorization of knowledge items showed that the nursing officer must thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance for effective nursing care to patients with MRSA infections. The conclusions drawn from the study findings showed that it is necessary that the nursing officer thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance to provide effective nursing care to patients with MRSA infection as they constantly care for the patient who can be at risk for multi-drug resistance organisms to reduce the risk of MRSA infection in hospital care settings as well community settings.

Keywords: MRSA, nursing officers, knowledge, preventive and management

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3178 A Descriptive Study to Assess the Knowledge Regarding Prevention and Management of Methicillin-Resistant Staphylococcus Aureus Infections Among Nursing Officers in a Selected Hospital, Bengaluru.

Authors: Najmin Sultana, Maneesha Pahlani

Abstract:

A hospital is one of the most suitable places for acquiring an infection because it harbors a high population of virulent strains of microorganisms that may be resistant to antibiotics, especially the prevalence of Methicillin-Resistant Staphylococcus Aureus (MRSA) infections. The hospital-acquired infection has become a global challenge. In developed countries, healthcare-associated infections occur in 5-15% of hospitalized clients, affecting 9-37% of those admitted to intensive care units (ICU). A non-experimental descriptive study was conducted among 50 nursing officers working in a selected hospital in bengaluru to assess the nursing officers’ level of knowledge regarding the prevention and management of MRSA infections and to associate the pre-test knowledge mean scores of nursing officers with selected socio-demographic variables. Data was collected using a structured questionnaire consisting of socio-demographic data and a structured questionnaire on knowledge regarding the prevention and management of MRSA infections. The data was analyzed in terms of frequencies and percentages for the analysis of demographic variables and computing chi-square to determine the association between knowledge means scores and selected demographic variables. The study findings revealed that the nursing officer had an overall good level of knowledge (63.05%) regarding the prevention and management of MRSA infections, and there is no significant association found between the level of knowledge mean scores for prevention and management of MRSA infection with the selected socio-demographic variables. However, the categorization of knowledge items showed that the nursing officer must thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance for effective nursing care to patients with MRSA infections. The conclusions drawn from the study findings showed that it is necessary that the nursing officer thoroughly receive education on correct guidance and information regarding MRSA infection control policy, including measures and practices on hygiene precautions and information regarding antibiotic resistance to provide effective nursing care to patients with MRSA infection as they constantly care for the patient who can be at risk for multi-drug resistance organisms to reduce the risk of MRSA infection in hospital care settings as well community settings.

Keywords: MRSA, knowledge, nursing officers', prevention and management

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3177 Low Influenza Vaccine Coverage Rates among Polish Nurses

Authors: Aneta Nitsch-Osuch, Katarzyna Zycinska, Ewa Gyrczuk, Agnieszka Topczewska-Cabanek, Kazimierz Wardyn

Abstract:

Introduction: Influenza is an important clinical and epidemiological problem and should be considered as a possible nosocomial infection. The aim of the study was to determine the influenza vaccine coverage rates among Polish nurses and to find out drivers and barriers for influenza vaccination among this group of health care workers (HCWs). Material and methods: The self- fulfilled survey with 26 questions about the knowledge, perception, and influenza coverage rates was distributed among 461 nurses. Results: Only 15% of nurses were vaccinated against influenza in the consecutive seasons. The majority (75%) of the regularly vaccinated nurses were ambulatory careworkers. The difference between the number of vaccinated hospitals and ambulatory care nurses was statistically significant (p < 0.05). The main motivating factors for an influenza vaccination were: a fear of the illness and its complications (97%) and a free of charge vaccine available at the workplace (87%). Ambulatory care nurses more often declared that they were vaccinated mainly to protect themselves while hospital care nurses more often declared the will to protect their patients, these differences in the perception and attitudes to an influenza vaccination among hospital and ambulatory care nurses were statistically significant (p < 0.05). The main barriers for an influenza vaccination among the nursing staff were: a lack of reimbursement of the vaccine (95%), a lack of insufficient knowledge about the effectiveness, and safety of the influenza vaccine (54%). The ambulatory care nurses more often found influenza vaccination as the ethical duty compared to hospital care nurses (p < 0.05). Conclusions: The influenza vaccine coverage rates among the Polish nurses are low and must be improved in the future. More educational activities dedicated to HCWs may result in the increased awareness of influenza vaccination benefits for both medical professionals and patients.

Keywords: influenza, vaccination, nurses, ambulatory careworkers

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3176 Antibiotic Prescribing Pattern and Associated Risk Factors Promoting Antibiotic Resistance, a Cross Sectional Study in a Regional Hospital in Ghana

Authors: Nicholas Agyepong, Paul Gyan

Abstract:

Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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3175 Antibiotic Prescribing Pattern and Associated Risk Factors Promoting Antibiotic Resistance: A Cross-Sectional Study in a Regional Hospital in Ghana

Authors: Nicholas Agyepong, Paul Gyan

Abstract:

Inappropriate prescribing of antibiotic is a common healthcare concern globally resulted in an increased risk of adverse reactions and the emergence of antimicrobial resistance. The wrong antibiotic prescribing habits may lead to ineffective and unsafe treatment, worsening of disease condition, and thus increase in health care costs. The study was to examine the antibiotic prescribing pattern and associated risk factors at Regional Hospital in the Bono region of Ghana. A retrospective cross-sectional study was conducted to describe the current prescribing practices at the Hospital from January 2014 to December, 2021. A systematic random sampling method was used to select the participants for the study. STATA version 16 software was used for data management and analysis. Descriptive statistics and logistic regression analysis were used to analyze the data. Statistical significance set at p<0.05. Antibiotic consumption was equivalent to 11 per 1000 inhabitants consuming 1 DDD per day. Most common prescribed antibiotic was amoxicillin/clavulanic acid (14.39%) followed by erythromycin (11.44%), and ciprofloxacin (11.36%). Antibiotics prescription have been steadily increased over the past eight years (2014: n=59,280 to 2021: n=190,320). Prescribers above the age of 35 were more likely to prescribe antibiotics than those between the ages of 20 and 25 (COR=21.00; 95% CI: 1.78 – 48.10; p=0.016). Prescribers with at least 6 years of experience were also significantly more likely to prescribe antibiotics than those with at most 5 years of experience (COR=14.17; 95% CI: 2.39 – 84.07; p=0.004). Thus, the establishment of an antibiotic stewardship program in the hospitals is imperative, and further studies need to be conducted in other facilities to establish the national antibiotic prescription guideline.

Keywords: antibiotic, antimicrobial resistance, prescription, prescribers

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3174 Radiology Information System’s Mechanisms: HL7-MHS & HL7/DICOM Translation

Authors: Kulwinder Singh Mann

Abstract:

The innovative features of information system, known as Radiology Information System (RIS), for electronic medical records has shown a good impact in the hospital. The objective is to help and make their work easier; such as for a physician to access the patient’s data and for a patient to check their bill transparently. The interoperability of RIS with the other intra-hospital information systems it interacts with, dealing with the compatibility and open architecture issues, are accomplished by two novel mechanisms. The first one is the particular message handling system that is applied for the exchange of information, according to the Health Level Seven (HL7) protocol’s specifications and serves the transfer of medical and administrative data among the RIS applications and data store unit. The second one implements the translation of information between the formats that HL7 and Digital Imaging and Communication in Medicine (DICOM) protocols specify, providing the communication between RIS and Picture and Archive Communication System (PACS) which is used for the increasing incorporation of modern medical imaging equipment.

Keywords: RIS, PACS, HIS, HL7, DICOM, messaging service, interoperability, digital images

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3173 Time to CT in Major Trauma in Coffs Harbour Health Campus - The Australian Rural Centre Experience

Authors: Thampi Rawther, Jack Cecire, Andrew Sutherland

Abstract:

Introduction: CT facilitates the diagnosis of potentially life-threatening injuries and facilitates early management. There is evidence that reduced CT acquisition time reduces mortality and length of hospital stay. Currently, there are variable recommendations for ideal timing. Indeed, the NHS standard contract for a major trauma service and STAG both recommend immediate access to CT within a maximum time of 60min and appropriate reporting within 60min of the scan. At Coffs Harbour Health Campus (CHHC), a CT radiographer is on site between 8am-11pm. Aim: To investigate the average time to CT at CHHC and assess for any significant relationship between time to CT and injury severity score (ISS) or time of triage. Method: All major trauma calls between Jan 2021-Oct 2021 were audited (N=87). Patients were excluded if they went from ED to the theatre. Time to CT is defined as the time between triage to the timestamp on the first CT image. Median and interquartile range was used as a measure of central tendency as the data was not normally distributed, and Chi-square test was used to determine association. Results: The median time to CT is 51.5min (IQR 40-74). We found no relationship between time to CT and ISS (P=0.18) and time of triage to time to CT (P=0.35). We compared this to other centres such as John Hunter Hospital and Gold Coast Hospital. We found that the median CT acquisition times were 76min (IQR 52-115) and 43min, respectively. Conclusion: This shows an avenue for improvement given 35% of CT’s were >30min. Furthermore, being proactive and aware of time to CT as an important factor to trauma management can be another avenue for improvement. Based on this, we will re-audit in 12-24months to assess if any improvement has been made.

Keywords: imaging, rural surgery, trauma surgery, improvement

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3172 Direct and Indirect Effects of Childhood Traumas, Emotion Regulation Difficulties and Age on Tendency to Violence

Authors: Selin Kara-Bahçekapılı, Bengisu Nehir Aydın

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Objective: In this study, it is aimed to examine the relationship between childhood traumas (overprotection-control, emotional/physical/sexual abuse, emotional/physical neglect), age, emotional regulation difficulties, and the tendency of violence in adults. In the study, the direct and indirect effects of 6 sub-factors of childhood traumas, emotion regulation difficulties, and age on tendency to violence are evaluated on a model that theoretically reveals. Method: The population of this cross-sectional study consists of individuals between the ages of 18-65 living in Turkey. The data from 527 participants were obtained by online surveys and convenience sampling method within the scope of the study. As a result of exclusion criteria and then outlier data analysis, the data of 443 participants were included in the analysis. Data were collected by demographic information form, childhood trauma scale, emotion regulation difficulty scale, and violence tendency scale. Research data were analyzed by SPSS and AMOS using correlation, path analysis, direct and indirect effects. Results: According to the research findings, the variables in the model explained 28.2% of the variance of the mean scores of the individuals' tendency to violence. Emotion regulation difficulties have the most direct effect on the tendency to violence (d=.387; p<.01). The effects of excessive protection and control, emotional neglect, and physical neglect variables on the tendency to violence are not significant. When the significant and indirect effects of the variables on tendency to violence over emotion regulation difficulties are examined, age has a negative effect, emotional neglect has a positive effect, emotional abuse has a positive effect, and overprotection-control has a positive effect. The indirect effects of sexual abuse, physical neglect, and physical abuse on tendency to violence are not significant. Childhood traumas and age variables in the model explained 24.1% of the variance of the mean scores of the individuals’ emotion regulation difficulties. The variable that most affects emotion regulation difficulties is age (d=-.268; p<.001). The direct effects of sexual abuse, physical neglect, and physical abuse on emotion regulation difficulties are not significant. Conclusion: The results of the research emphasize the critical role of difficulty in emotion regulation on the tendency to violence. Difficulty in emotion regulation affects the tendency to violence both directly and by mediating different variables. In addition, it is seen that some sub-factors of childhood traumas have direct and/or indirect effects on the tendency to violence. Emotional abuse and age have both direct and indirect effects on the tendency to violence over emotion regulation difficulties.

Keywords: childhood trauma, emotion regulation difficulties, tendency to violence, path analysis

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3171 Paternity Index Analysis on Disputed Paternity Cases at Sardjito Hospital Yogyakarta, Indonesia

Authors: Taufik Hidayat, Yudha Nurhantari, Bambang U. D. Rianto

Abstract:

Introduction: The examination of the Short Tandem Repeats (STR) locus on nuclear DNA is very useful in solving the paternity cases. The purpose of this study is to know the description of paternity cases and paternity index/probability of paternity analysis based on Indonesian allele frequency at Sardjito Hospital Yogyakarta. Method: This was an observational study with cross-sectional analytic method. Population and sample were all cases of disputed paternity from January 2011 to June 2015 that fulfill the inclusion and exclusion criteria and were examined at Forensic Medicine Unit of Sardjito Hospital, Medical Faculty of Gadjah Mada University. The paternity index was calculated with EasyDNA Program by Fung (2013). Analysis of the study was conducted by comparing the results through unpaired categorical test using Kolmogorov-Smirnov test. This study was designed with 95% confidence interval (CI) with α = 5% and significance level is p < 0,05. Results: From 42 disputed paternity cases we obtained trio paternity cases were 32 cases (76.2%) and duo without a mother was 10 cases (23.8%). The majority of the fathers' estimated ages were 21-30 years (33.3%) and the mother's age was 31-40 years (38.1%). The majority of the ages of children examined for paternity were under 12 months (47.6%). The majority of ethnic clients are Javanese. Conclusion of inclusion was 57.1%, and exclusion was 42.9%. The Kolmogorov-Smirnov test obtained p-value = 0.673. Conclusion: There is no significant difference between paternity index/probability of paternity based on Indonesian allele frequency between trio and duo of paternity.

Keywords: disputed paternity, paternity index, probability of paternity, short tandem

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3170 Individual Differences in Affective Neuroscience Personality Traits Predict Several Dimensions of Psychological Wellbeing. A Cross-Sectional Study in Healthy Subjects

Authors: Valentina Colonnello, Paolo Maria Russo

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Decades of cross-species affective neuroscience research by Panksepp and others have identified basic evolutionarily preserved subcortical emotional systems that humans share with mammals and many vertebrates. These primary emotional systems encode unconditional affective responses and contribute to the development of personality traits throughout ontogenesis and interactions with the environment. The Affective Neuroscience Personality Scale (ANPS) measures individual differences in affective personality traits associated with the basic emotional systems of CARE, PLAY, SEEKING, SADNESS, FEAR, and ANGER, along with Spirituality, which is a more cognitively and socially refined expression of affectivity. Though the ANPS’s power to predict human psychological distress has been documented, to the best of our knowledge, its predictive power for psychological wellbeing has not been explored. This study therefore investigates the relationship between affective neuroscience traits and psychological wellbeing facets. Because the emotional systems are thought to influence cognitively-mediated mental processes about the self and the world, understanding the relationship between affective traits and psychological wellbeing is particularly relevant to understanding the affective dimensions of health. In a cross-sectional study, healthy participants (n = 402) completed the ANPS and the Psychological Wellbeing scale. Multiple regressions revealed that each facet of wellbeing was explained by two to four affective traits, and each trait was significantly related to at least one aspect of wellbeing. Specifically, SEEKING predicted all the wellbeing facets, except for positive relations; CARE predicted personal growth, positive relations, purpose in life, and self-acceptance; PLAY and, inversely, ANGER predicted positive relations; SADNESS inversely predicted autonomy, while FEAR inversely predicted purpose in life. SADNESS and FEAR inversely predicted environmental mastery and self-acceptance. Finally, Spirituality predicted personal growth, positive relations, and self-acceptance. These findings are the first to show the relationship between affective neuroscience personality traits and psychological wellbeing. They also call attention to the distinctive role of FEAR and PANIC traits in psychological wellbeing facets, thereby complementing or even overcoming the traditional personality approach to neuroticism as a global trait.

Keywords: affective neuroscience, individual differences, personality, wellbeing

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3169 Parenting a Child with Mental Health Problems: The Role of Self-compassion

Authors: Vered Shenaar-Golan, Nava Wald, Uri Yatzkar

Abstract:

Background: Parenting children with mental health problems poses multiple challenges, including coping with difficult behavior and negative child emotions. The impact on parents includes financial strain, negative social stigma, and negative feelings of guilt or blame, resulting in significant stress and lower levels of well-being. Given findings that self-compassion plays a significant role in reducing stress and improving well-being, the current study examined the role of self-compassion in the experience of parents raising a child with mental health problems. The study tested (1) whether child behavioral/emotional problem severity is associated with higher parental stress and lower parental well-being; (2) whether self-compassion is associated with lower parental stress and higher parental well-being; and (3) whether self-compassion is a stronger predictor of parental stress and well-being than child behavioral/emotional problem severity. Methods: Three hundred and six mothers and two hundred and fifty-six fathers of children attending a hospital child and adolescent psychiatric center were assessed at admission. Consenting parents completed four questionnaires: Child Strength and Difficulty – parent version, Self-compassion, Parent Feeling Inventory, and Well-Being. Results: Child behavioral/emotional problem severity was associated with higher parental stress and lower parental well-being, and self-compassion was a stronger predictor of parental stress and well-being levels than child behavioral/emotional problem severity. For children with internalizing but not externalizing behavioral/emotional problems, parental self-compassion was the only predictor of parental well-being beyond the severity of child behavioral/emotional problems. Conclusions: Cultivating self-compassion is important in reducing parental stress and increasing parental well-being, particularly with internalizing presentations, and should be considered when designing therapeutic interventions for parents.

Keywords: parenting children with mental health problems, self-compassion, parental stress, feelings, well-being

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3168 Determining the Efficacy of Phenol, Sodium Hypochlorite and Ethanol for Inactivation of Carbapenem-Resistant Strain of Acinetobacter baumannii

Authors: Deepika Biswas

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Acinetobacter baumannii, a hospital-acquired pathogen, causes nosocomial infections including pneumonia, urinary tract infection, and secondary meningitis. Carbapenem is most effective antibiotics against it. Its increased resistance to carbapenems has been a rising global concern. Antibiotics such as carbapenem are unable to use on hospital setups to eradicate A. baumannii, hence different concentrations of disinfectants including phenol; sodium hypochlorite and ethanol are increasingly being used. The objective of the present study is to find an effective concentration of above disinfectants against carbapenem-resistant strain RS307 of A. baumannii. Growth kinetics of RS307 has been determined using UV-Vis spectrophotometer in the presence and absence of disinfectants in triplicate and its standard deviation has also been calculated which make the results more reliable. Differential growth curves were plotted, which showed the effective concentration among all the concentrations of phenol, sodium hypochlorite and ethanol. On disc diffusion assay, antimicrobial effect was observed by comparing all the concentrations of disinfectants to check its synergy with imipenem, most effective carbapenem. All the results collectively revealed that 0.5% phenol, 0.5% sodium hypochlorite, and 70% ethanol could preferably be used as disinfectant for hospital setup against the carbapenem-resistant strain of A. baumannii. SDS PAGE analysis showed differential expression in the protein profile of A. baumannii after treatment. The present study highlighted that few disinfectants even in low concentration had shown better antimicrobial activity hence may be recommended for regular use in the hospitals, which will be cost effective and less harmful.

Keywords: Acenatobacter bomunii, phenol, sodium hypoclirite, ethanol, carbapenem resistance, disinfectant

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3167 Screening of Strategic Management Criterions in Hospitals Using Delphi-Fuzzy Method

Authors: Helia Moayedi, Mahdi Moaidi

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Nowadays, the managing and planning of hospitals is facing many problems. Failure to recognize the main criteria for strategic management to ensure long-term hospital performance can lead to many health problems. To achieve this goal, a qualitative-quantitate method titled Delphi-Fuzzy has been applied. This strategy makes it possible for experts to screen among the most important criteria in strategic management. To conduct this operation, a statistical society consisting of 20 experts in Ahwaz hospitals has been questioned. The final model confirms the key criterions after three stages of Delphi. This model provides the possibility to focus on the basic criteria and can determine the organization’s main orientation.

Keywords: Delphi-fuzzy method, hospital management, long-term planning, qualitative-quantitate method, screening of strategic criteria, strategic planning

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3166 Neurological Complications Related to Anesthesia in Pediatric Patients Receiving Radiation Therapy under Anesthesia

Authors: Behzad Sinaei, Shahryar Sane, Behzad Kazemi Haki

Abstract:

Children with different malignancies usually experience potential neurologic complications when treated with radiation therapy, especially if under frequent anesthesia. The aim of this study was to evaluate the neurologic problems associated with anesthesia in pediatrics treated with radiotherapy under anesthesia. The study was a cross-sectional experiment that consisted of 133 pediatric patients with different malignancies who needed anesthesia for performing radiotherapy and were referred to Omid Charity Hospital and Imam Khomeini University Hospital from 2014 to 2020 by the census. P-values less than 0.05 were considered statistically significant (P-value < 0.05). Anesthesia complications in this study were slight and insignificant. Some were due to the effects of the tumor on other important organs or either previous radiation therapy or chemotherapy. For safe anesthesia, considering the effects of tumors on body organs and the neurological complications they cause can greatly help reduce anesthesia complications in pediatrics under radiation therapy.

Keywords: anesthesia, neurologic complications, pediatrics, radiotherapy

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3165 Health Care Providers' Perceptions on mHealth Workplace Nutrition Wellness Program: A Thematic Analysis

Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

Abstract:

Background: Health care providers have been identified as an at-risk group for obesity. Mobile health technology can be used to motivate lifestyle behavioral changes. The aim of this study was to investigate hospital-based health care providers’ perceptions of mHealth Workplace Nutrition Wellness Program. Methods: This qualitative study was conducted at a regional hospital in Hong Kong. Ten health care providers were purposively selected for the study. Qualitative data was collected by individual face-to-face semi-structured interviews which were audio-taped, transcribed verbatim and analyzed by thematic analysis. Results: Four themes were identified: (1) mobile health technology motivates lifestyle changes, (2) self-perceived body weight initiates health behavioral changes, (3) organizational support promotes healthy behavior, (4) lack of self-confidence hinders lifestyle modification. The health care providers’ perceptions of mobile health technology, barriers, and facilitators to participation in the mHealth Workplace Nutrition Wellness Program were discussed in the study. Conclusions: Barriers, facilitators, self-perceived body weight and experiences of mobile health technology were associated with intention of participation in mHealth Workplace Nutrition Wellness Program. The knowledge generated from the study could be used to guide the design and implementation of effective interventions, strategies and policies of workplace wellness programs to promote participation for hospital’s employees.

Keywords: workplace wellness program, mobile health, barriers, facilitators, qualitative

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3164 Preventing Discharge to No Fixed Address-Youth (NFA-Y)

Authors: Cheryl Forchuk, Sandra Fisman, Steve Cordes, Dan Catunto, Katherine Krakowski, Melissa Jeffrey, John D’Oria

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The discharge of youth aged 16-25 from hospital into homelessness is a prevalent issue despite research indicating social, safety, health and economic detriments on both the individual and community. Lack of stable housing for youth discharged into homelessness results in long-term consequences, including exacerbation of health problems and costly health care service use and hospital readmission. People experiencing homelessness are four times more likely to be readmitted within one month of discharge and hospitals must spend $2,559 more per client. Finding safe housing for these individuals is imperative to their recovery and transition back to the community. People discharged from hospital to homelessness experience challenges, including poor health outcomes and increased hospital readmissions. Youth are the fastest-growing subgroup of people experiencing homelessness in Canada. The needs of youth are unique and include supports related to education, employment opportunities, and age-related service barriers. This study aims to identify the needs of youth at risk of homelessness by evaluating the efficacy of the “Preventing Discharge to No Fixed Address – Youth” (NFA-Y) program, which aims to prevent youth from being discharged from hospital into homelessness. The program connects youth aged 16-25 who are inpatients at London Health Sciences Centre and St. Joseph’s Health Care London to housing and financial support. Supports are offered through collaboration with community partners: Youth Opportunities Unlimited, Canadian Mental Health Association Elgin Middlesex, City of London Coordinated Access, Ontario Works, and Salvation Army’s Housing Stability Bank. This study was reviewed and approved by Western University’s Research Ethics Board. A series of interviews are being conducted with approximately ninety-three youth participants at three time points: baseline (pre-discharge), six, and twelve months post-discharge. Focus groups with participants, health care providers, and community partners are being conducted at three-time points. In addition, administrative data from service providers will be collected and analyzed. Since homelessness has a detrimental effect on recovery, client and community safety, and healthcare expenditure, locating safe housing for psychiatric patients has had a positive impact on treatment, rehabilitation, and the system as a whole. If successful, the findings of this project will offer safe policy alternatives for the prevention of homelessness for at-risk youth, help set them up for success in their future years, and mitigate the rise of the homeless youth population in Canada.

Keywords: youth homelessness, no-fixed address, mental health, homelessness prevention, hospital discharge

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3163 How Whatsappization of the Chatbot Affects User Satisfaction, Trust, and Acceptance in a Drive-Sharing Task

Authors: Nirit Gavish, Rotem Halutz, Liad Neta

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Nowadays, chatbots are gaining more and more attention due to the advent of large language models. One of the important considerations in chatbot design is how to create an interface to achieve high user satisfaction, trust, and acceptance. Since WhatsApp conversations sometimes substitute for face-to-face communication, we studied whether WhatsAppization of the chatbot -making the conversation resemble a WhatsApp conversation more- will improve user satisfaction, trust, and acceptance, or whether the opposite will occur due to the Uncanny Valley (UV) effect. The task was a drive-sharing task, in which participants communicated with a textual chatbot via WhatsApp and could decide whether to participate in a ride to college with a driver suggested by the chatbot. WhatsAppization of the chatbot was done in two ways: By a dialog-style conversation (Dialog versus No Dialog), and by adding WhatsApp indicators – “Last Seen”, “Connected”, “Read Receipts”, and “Typing…” (Indicators versus No Indicators). Our 120 participants were randomly assigned to one of the four 2 by 2 design groups, with 30 participants in each. They interacted with the WhatsApp chatbot and then filled out a questionnaire. The results demonstrated that, as expected from the manipulation, the interaction with the chatbot was longer for the dialog condition compared to the no dialog. This extra interaction, however, did not lead to higher acceptance -quite the opposite, since participants in the dialog condition were less willing to implement the decision made at the end of the conversation with the chatbot and continue the interaction with the driver they chose. The results are even more striking when considering the Indicators condition. Both for the satisfaction measures and the trust measures, participants’ ratings were lower in the Indicators condition compared to the No Indicators. Participants in the Indicators condition felt that the ride search process was harder to operate, and slower (even though the actual interaction time was similar). They were less convinced that the chatbot suggested real trips and they trusted the person offering the ride and referred to them by the chatbot less. These effects were more evident for participants who preferred to share their rides using WhatsApp compared to participants who preferred chatbots for that purpose. Considering our findings, we can say that the WhatsAppization of the chatbot was detrimental. This is true for the both chatbot WhatsAppization methods – by making the conversation more a dialog and adding WhatsApp indicators. For the chosen drive-sharing task, the results were, in addition to lower satisfaction, less trust in the chatbot’s suggestion and even in the driver suggested by the chatbot, and lower willingness to actually undertake the suggested ride. In addition, it seems that the most problematic WhatsAppization method was using WhatsApp’s indicators during the interaction with the chatbot. The current study suggests that a conversation with an artificial agent should also not imitate a WhatsApp conversation very closely. With the proliferation of WhatsApp use, the emotional and social aspect of face-to face commination are moving to WhatsApp communication. Based on the current study’s findings, it is possible that the UV effect also occurs in WhatsAppization, and not only in humanization, of the chatbot, with a similar feeling of eeriness, and is more pronounced for people who prefer to use WhatsApp over chatbots. The current research can serve as a starting point to study the very interesting and important topic of chatbots WhatsAppization. More methods of WhatsAppization and other tasks could be the focus of further studies.

Keywords: chatbot, WhatsApp, humanization, Uncanny Valley, drive sharing

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3162 The Experience of Head Nurse: Phenomenological Research of Implementing Islamic Leadership Style in Syarif Hidayatullah Hospital

Authors: Jamaludin Tarkim, Yoga Teguh Guntara, Maftuhah

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Islamic leadership style is model of leadership style applied by the Prophet Muhammad SAW. Islamic leadership style is applied, namely Syura (deliberation), ‘Adl bil qisth (justice, with equality), and Hurriyyah al-kalam (freedom of expression) and along with the values of Islam in the Islamic leadership style. This research aims to gain an overview of the experience of Head Nurse in the implementation of Islamic leadership style. This research is a qualitative one with descriptive phenomenology design through in-depth interviews. Participants were occupied as Head Nurse at the Hospital room Syarif Hidayatullah, set directly (purposive) with the principle of suitability (appropriateness) and sufficiency (adequacy). Retrieval of data and research conducted during the month of June 2014. Data collected in the form of recording in-depth interviews and analysis with Collazi method. This research identified four themes Syura (deliberation);‘Adl bil qisth (justice, with equality); Hurriyyah al-kalam (freedom of expression) and along with the values of Islam in the Islamic leadership style. The results of this research can provide a review of the Head Room experience in the application of Islamic leadership style at Syarif Hidayatullah Hospital already skilled leadership during the process, but the application is still not maximized. Required further research on in-depth exploration of how to get more comprehensive results from room Head Nurse experience in the application of Islamic leadership style, as well as subsequent researchers can choose a wider scope and complex so get more complete data.

Keywords: experience, Islamic leadership style, head nurse, nursing management

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