Search results for: university hospital

Authors: Gizem Akcan, Erdinc Ozturk

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The purpose of the study was to determine some psychosocial variables that predict dissociation in university students. These psychosocial variables were perceived childhood trauma, alexithymia, and gender. 150 (75 males, 75 females) university students (bachelor, master and postgraduate) were enrolled in this study. They were chosen from universities in Istanbul at the education year of 2016-2017. Dissociative Experiences Scale (DES), Childhood Trauma Questionnaire (CTQ) and Toronto Alexithymia Scale were used to assess related variables. Demographic Information Form was given to students in order to have their demographic information. Frequency Distribution, Linear Regression Analysis, and t-test analysis were used for statistical analysis. Childhood trauma and alexithymia were found to have predictive value on dissociation among university students. However, physical abuse, physical neglect and emotional neglect sub dimensions of childhood trauma and externally-oriented thinking sub dimension of alexithymia did not have predictive value on dissociation. Moreover, there was no significant difference between males and females in terms of dissociation scores of participants.

Keywords: childhood trauma, dissociation, alexithymia, gender

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Authors: Le-Quyen Nguyen, Hoang Van Bui, Ngoc Thi Tran, Binh Thanh Le, Linus Olson, Thanh Quang Le

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Objective: We compared of outcomes between infected and non-infected COVID-19 pregnant at the largest obstetrics and gynecology hospital in southern Vietnam. Materials and Methods: A retrospective study was conducted at gestational age (GA) 28-42 weeks, who terminated pregnancy and had a real-time PCR test for SARS-CoV-2 at Tu Du Hospital. Demographic, clinical, laboratory, and epidemiological data were collected from hospital electronic-medical-records. Diagnosis and screening of SARS-CoV-2 used Real-time-PCR. Results: From July to October 2021, 9,246 pregnant with GA of 28-42 weeks were delivered, including 664 infected with COVID-19 and 8,582 non-infected. The cesarean section (CS) rates of pregnant with and without COVID-19 were 47.3% and 46.0%. At GA 32-34 weeks, the rate of CS with COVID-19 was 5.07 times higher than without. The rate of postpartum hemorrhage (PPH) and the Apgar score between these two groups were similar. The mortality rate of infected pregnants was 2.26%. Conclusions: COVID-19 infection increased the CS rate in the group of preterm pregnancies from 32 to less than 34 weeks. COVID-19 did not increase the risk of complications related to adverse pregnancy outcomes such as PPH, Apgar scores, the ratio of stillbirths, deaths due to malformation, and fetal deaths in labor.

Keywords: COVID-19, SARS-CoV-2, pregnancy, outcome, vietnam

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Authors: Ibrahim Alhumaidan

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As King Saud University believes in the critical role played by technology and its effectiveness in achieving quality, speed of achievement, facilitating follow-up and enhancing responsibility undertaking; the university is keen on activating its e-services for the purpose of attaining the primary requirements of achievement and perfection. The web portal of the student's academic system comes as one of the most important practices in technological and e-transaction aspects. It enables students to carry out their processes–registration, addition, evaluation, viewing their results, and scholastic accomplishments, etc.– through the relevant web portal. The aim of this study is to recognize Education College students' attitude -as one of King's University Colleges- regarding the usage of the academic system web portal, its effectiveness in saving time and effort, and, efficiency in enhancing student's planning skills. The study society is all students of college of education in King Saud University and the sample has been chosen randomly from them. The study tool is a questionnaire designed to learn about students' views about using the web portal; as the researcher used the surveying methodology to achieve the aim of the study.

Keywords: web portal, academic system, education faculty, students, planning skills

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Authors: Mubita Namuyamba

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Despite an increase in the number of cancer programs and partnerships in cancer care provision, the burden of cancer in Zambia is increasingly having a significant impact on morbidity and mortality rates. The increase in cancer morbidity and mortality rates has given rise to psychological and psycho social implications (PPsI) in cancer care. Cancer patients, care givers and health care providers are faced with a multitude of PPsIs in cancer care that mainly impact negatively on the management of cancer patients. The study adopted a case study design and was purposively conducted at the Cancer Diseases Hospital in Lusaka (Zambia) after obtaining ethical clearance from the Ethics committee. The sample for this study included 70 cancer patients, 20 care givers and 5 hospital staff (4 nurses and 1 doctor). Data was collected using interviews guides, focus group discussion guides and questionnaires respectively. The qualitative data was analysed thematically. The various psychological and psychosocial challenges that conspire to deter the provision of effective cancer care nursing and improved methods of minimizing the psychological and psychosocial implications in cancer care are the products of this study.

Keywords: case study, enquiry, psychological and psycho social aspects, Zambia

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Authors: Fred Alinda, Marjorie Negesa, Gerald Karyeija

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Like elsewhere in the world, youth unemployment remains a big problem more so to the most educated youth and female. In Rwanda, unemployment is estimated at 13.2% among youth graduates compared to 10.9% and 2.6 among secondary and primary graduates respectively. Though empirical evidence elsewhere associate youth unemployment with education level, relevance of skills and access to business support opportunities, mixed evidence still exist on the significance of these factors to youth employment. As youth employment strategies in countries like Rwanda continue to recognize the potential role university education can play to enhance employment, there is a need to understand the catalysts or barriers. This paper, therefore, draws empirical evidence from a survey on the influence of education qualification, skills relevance and access to business support opportunities on employment of the youth university graduates in Masaka sector, Rwanda. The analysis tested four hypotheses; access to university education significantly affects youth employment, Relevance of university education significantly contributes to youth employment; access to business support opportunities significantly contributes to youth employment, and significant gender differences exist in the employment of youth university graduates. A cross-section survey was used in lieu of the need to explore the prevailing status of youth employment and contributing factors across the sector. A questionnaire was used to collect data on a large sample of 269 youth to allow statistical analysis. This was beefed up with qualitative views of leaders and technical officials in the sector. The youth University graduates were selected using simple random sampling while the leaders and technical officials were selected purposively. Percentages were used to describe respondents in line with the variables under while a regression model for youth employment was fitted to determine the significant factors. The model results indicated a significant influence (p<0.05) of gender, education level and access to business support opportunities on employment of youth university graduates. This finding was also affirmed by the qualitative views of key informants. Qualitative views pointed to the fact that university education generally equipped the youth with skills that enabled their transition into employment mainly for a salary or wage. The skills were, however, deficient in technical and practical aspects. In addition, the youth generally lacked limited access to business support opportunities particularly guarantees for loans, business advisory, and grants for business as well as training in business skills that would help them gain salaried employment or transit into self-employment. The study findings bear an implication on the strategy for catalyzing youth employment through university education. The findings imply that university education should be embraced but with greater emphasis on or supplementation with specialized training in practical and technical skills as well as extending business support opportunities to the youth. This will accelerate the contribution of university education to youth employment.

Keywords: education, employment, self-employment, youth

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Authors: Nicole Virgili, Romolo Remetti

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The aim of this work is to characterize, from radiation protection point of view, the emission into the environment of air contaminated by argon-41. In this research work, 41Ar is produced by a TR19PET cyclotron, operated at 19 MeV, installed at 'A. Gemelli' University Hospital, Rome, Italy, for fluorine-18 production. The production rate of 41Ar has been calculated on the basis of the scheduled operation cycles of the cyclotron and by utilising proper production algorithms. Then extensive Monte Carlo calculations, carried out by MCNP code, have allowed to determine the absolute detection efficiency to 41Ar gamma rays of a Geiger Muller detector placed in the terminal part of the chimney. Results showed unsatisfactory detection efficiency values and the need for integrating the detection system with more efficient detectors.

Keywords: Cyclotron, Geiger Muller detector, MCNPX, argon-41, emission of radioactive gas, detection efficiency determination

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Authors: Dasha Karzunina, Laura Bridgestock

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Our oral presentation will be based on our qualitative and quantitative findings into motivations and challenges faced by international and UK students when choosing a university abroad. The insight was gathered through a series of over 60 focus groups held with prospective university students all over the world, including masters and PhD applicants. We spoke to students face-to-face in Latin America, North American, India, China, South East Asia and the major European cities. A survey was carried out alongside, to gather additional insight on their priorities and attitudes to universities’ reputation, collecting over 1,800 responses. The session’s aims are to break down some of the myths about the perspectives of international students and inform university leaders interested in recruiting more highly talented students from abroad and those currently working with international students. As a provider of one of the most demanded resources in higher education, QS World University Rankings, we specialize in understanding universities’ performance, their institutional brand and the impact of rankings on student recruitment. We therefore feel we are well placed to carry out and present this research. We hope for our findings to act as a bridge between bright students and their future universities abroad. We intend for our session to be interactive and so are happy to go into more depth on any of the destinations we visited, depending on what the audience is most interested in and which questions we receive.

Keywords: international student recruitment, market research, rankings, study abroad

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Authors: Sabreen Al Shamli, Abdul Rahman Al azure

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Microscopic examination by histopathology is the gold standard for diagnosing many oral and maxillofacial pathologies. Current clinical guidelines and medicolegal regulations recommend the utilization of histopathology services for confirming pathologies being treated. The goal of this study was to determine the prevalence and distribution of oral and maxillofacial biopsies that had been histopathologically diagnosed at Anahdha Hospital (ANH). A total of 512 biopsies randomly selected from a ground total of 3310 biopsies, which were submitted for oral and maxillofacial histopathological specimens, were analyzed at Nahdha Hospital in Oman between January 2010 and December 2022. Data collected retrospectively selected from all case notes of patients who had oral histopathology examinations performed as part of their treatment. Data collected from the Shifa system was transferred to Microsoft Excel and analyzed using SPSS. Research ethics approval was obtained from the research committee of the hospital. This study provides background information on oral histopathology prevalence that could be helpful in future research in Oman. The findings of the present study are in agreement with the reported data from other investigations, even when it is taken into account how difficult it is to compare prevalence rates from different studies.

Keywords: oral biopsy, maxillofacial histopathology, oral disease, maxillofacial specimens

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Authors: Muhammad Ashraf

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It is experimentally conceded reality that education not just promotes social and intellectual abilities yet, in addition, the incomes of people. The present study is directed to investigate the connection between education level and student income. Data of different education levels is acquired from 300 students through field review from four public sector Universities; two from upper Punjab (University of Gujarat and Government college university-Lahore) and two from lower Punjab (Islamia University-Bahawalpur and The University of Sahiwal). Two-phase estimation is based on the Mincerian human capital model. The first stage presents statistical/descriptive investigation, which shows positive linkage among higher education and income of the students. Econometric estimation is estimated in the second stage by applying Ordinary least Square Method (OLS). Econometric examination reaffirms the importance of higher education as the impact of higher education on students’ incomes accelerates as we move from lower-level education to higher-level education. Educational levels, experience, and working hours are sure and noteworthy with student’s income. Econometric estimation additionally investigated that M. Phil and Ph.D. students have a higher income than bachelor students. Concerning the students, the income profile study commended that the Government ought to give part-time jobs or internships to students as indicated to labor market demand.

Keywords: education, student’s income, experience, universities

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Authors: Valerie Isaak

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Background: This study explores the effectiveness of refresher training sessions of an intervention program at reducing the employees’ risk of injury due to patient violence in a forensic psychiatric hospital. Methods: The original safety intervention program that consisted of a 3 days’ workshop was conducted in the maximum-security ward of a psychiatric hospital in Israel. Ever since the original intervention, annual refreshers were conducted, highlighting one of the safety elements covered in the original intervention. The study examines the effect of the intervention program along with the refreshers over a period of 10 years in four wards. Results: Analysis of the data demonstrates that beyond the initial reduction following the original intervention, refreshers seem to have an additional positive long-term effect, reducing both the number of violent incidents and the number of actual employee injuries in a forensic psychiatric hospital. Conclusions: We conclude that such an intervention program followed by refresher training would promote employees’ wellbeing. A healthy work environment is part of management’s commitment to improving employee wellbeing at the workplace.

Keywords: wellbeing, violence at work, intervention program refreshers, public sector mental healthcare

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Authors: S. K. Ashiquer Rahman

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The paper concentrates on the importance of Sustainable Campus Strategies, emphasizing the significance of mobilizing Innovative technological tools for constructing effectiveness of higher education strategy and institutional cooperation for sustainable campus at the university level and preparing the university’s authority to face the upcoming higher education strategy and institutional cooperation difficulties to the Sustainable Campus Plan. Within a framework of Sustainable Campus Strategies and institutional cooperation, the paper discusses the significance of a set of reference points that will lead to operational activities for multi-stakeholder multi-criteria evaluation of Higher Education and Research Institutions relative to the Sustainable Campus criteria and potential action plan for the University’s Strategy and Institutional Cooperation. It makes mention of the emergence of the effectiveness of Higher Education Strategy and Institutional Cooperation as well as the necessity of mobilizing innovative technological methods and tools for constructing the effectiveness of this Process. The paper outlines the conceptual framing of a Sustainable Campus Strategy, Institutional Cooperation and Action Plan for a sustainable campus. Optimistically, these will be a milestone in higher education, a pathway to meet the imminent Sustainable Campus Strategy and Institutional Cooperation of the completive world, and be able to manage the required criteria for a Sustainable University.

Keywords: higher education strategy, institutional cooperation, sustainable campus, multi-criteria evaluation, innovative method and tools

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Authors: Sogol Zarafshan

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The present study aimed to identify important factors affecting the effectiveness of quality control circles in a hospital, as well as rank them using a combination of fuzzy VIKOR and Grey Relational Analysis (GRA). The study population consisted of five academic members and five experts in the field of nursing working in a hospital, who were selected using a purposive sampling method. Also, a sample of 107 nurses was selected through a simple random sampling method using their employee codes and the random-number table. The required data were collected using a researcher-made questionnaire which consisted of 12 factors. The validity of this questionnaire was confirmed through giving the opinions of experts and academic members who participated in the present study, as well as performing confirmatory factor analysis. Its reliability also was verified (α=0.796). The collected data were analyzed using SPSS 22.0 and LISREL 8.8, as well as VIKOR–GRA and IPA methods. The results of ranking the factors affecting the effectiveness of quality control circles showed that the highest and lowest ranks were related to ‘Managers’ and supervisors’ support’ and ‘Group leadership’. Also, the highest hospital performance was for factors such as ‘Clear goals and objectives’ and ‘Group cohesiveness and homogeneity’, and the lowest for ‘Reward system’ and ‘Feedback system’, respectively. The results showed that although ‘Training the members’, ‘Using the right tools’ and ‘Reward system’ were factors that were of great importance, the organization’s performance for these factors was poor. Therefore, these factors should be paid more attention by the studied hospital managers and should be improved as soon as possible.

Keywords: Quality control circles, Fuzzy VIKOR, Grey Relational Analysis, Importance–Performance Analysis

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Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

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Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: anxiety, depression, sickle cell disease, socio-demographic quality of life, characteristics, Ghana

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Authors: Okafor Joan, Nwodo Uchechukwu

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Klebsiella pneumoniae (K. pneumoniae) is a significant pathogen responsible for opportunistic and nosocomial infection. One of the most significant antibiotic resistance mechanisms in K. pneumoniae isolates is efflux pumps. Our current study identified efflux genes (AcrAB, OqxAB, MacAB, and TolC) and regulatory genes (RamR and RarA) in multidrug-resistant (MDR) K. pneumoniae isolated from hospital effluents and investigated their relationship with antibiotic resistance. The sum of 145 K. pneumoniae isolates was established by PCR and screened for antibiotic susceptibility. PCR detected efflux pump genes, and their link with antibiotic resistance was statistically examined. However, 120 (83%) of the confirmed isolated were multidrug-resistant, with the largest percentage of resistance to ampicillin (88.3%) and the weakest rate of resistance to imipenem (5.5%). Resistance to the other antibiotics ranged from 11% to 76.6%. Molecular distribution tests show that AcrA, AcrB, MacA, oqxB oqxA, TolC, MacB were detected in 96.7%, 85%, 76.7%, 70.8%, 55.8%, 39.1%, and 29.1% respectively. However, 14.3% of the isolates harboured all seven genes screened. Efflux pump system AcrAB (83.2%) was the most commonly detected in K. pneumonia isolated across all the antibiotics class-tested. In addition, the frequencies of RamR and RarA were 46.2% and 31.4%, respectively. AcrAB and OqxAB efflux pump genes were significantly associated with fluoroquinolone, beta-lactam, carbapenem, and tetracycline resistance (p<0.05). The high rate of efflux genes in this study demonstrated that this resistance mechanism is the dominant way in K. pneumoniae isolates. Appropriate treatment must be used to reduce and tackle the burden of resistant Klebsiella pneumonia in hospital wastewater effluents.

Keywords: Klebsiella pneumonia, efflux pumps, regulatory genes, multidrug-resistant, hospital, PCR

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Authors: Antonio Lopez-Villegas, Daniel Catalan-Matamoros, Remedios Lopez-Liria

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Objectives: The purpose of this study was to analyze clinical data, health-related quality of life (HRQoL) and functional capacity of patients using a telemonitoring follow-up system (TM) compared to patients followed-up through standard outpatient visits (HM) 5 years after the implantation of a pacemaker. Methods: This is a controlled, non-randomised, nonblinded clinical trial, with data collection carried out at 5 years after the pacemakers implant. The study was developed at Hospital de Poniente (Almeria, Spain), between October 2012 and November 2013. The same clinical outcomes were analyzed in both follow-up groups. Health-Related Quality of Life and Functional Capacity was assessed through EuroQol-5D (EQ-5D) questionnaire and Duke Activity Status Index (DASI) respectively. Sociodemographic characteristics and clinical data were also analyzed. Results: 5 years after pacemaker implant, 55 of 82 initial patients finished the study. Users with pacemakers were assigned to either a conventional follow-up group at hospital (HM=34, 50 initials) or a telemonitoring system group (TM=21, 32 initials). No significant differences were found between both groups according to sociodemographic characteristics, clinical data, Health-Related Quality of Life and Functional Capacity according to medical record and EQ5D and DASI questionnaires. In addition, conventional follow-up visits to hospital were reduced in 44,84% (p < 0,001) in the telemonitoring group in relation to hospital monitoring group. Conclusion: Results obtained in this study suggest that the telemonitoring of users with pacemakers is an equivalent option to conventional follow-up at hospital, in terms of Health-Related Quality of Life and Functional Capacity. Furthermore, it allows for the early detection of cardiovascular and pacemakers-related problem events and significantly reduces the number of in-hospital visits. Trial registration: ClinicalTrials.gov NCT02234245. The PONIENTE study has been funded by the General Secretariat for Research, Development and Innovation, Regional Government of Andalusia (Spain), project reference number PI/0256/2017, under the research call 'Development and Innovation Projects in the Field of Biomedicine and Health Sciences', 2017.

Keywords: cardiovascular diseases, health-related quality of life, pacemakers follow-up, remote monitoring, telemedicine

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Authors: Malgorzata Bartoszewicz, Grzegorz Krzysko

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Chemistry students plan a career path based on their interests, predispositions, and preferences. This study aims to determine what percentage of all chemistry students selected teaching as a career. There is a lack of science teachers (especially physics and chemistry) in Poland, and there is limited research on students' choices and professional preferences. At the Faculty of Chemistry of the Adam Mickiewicz University in the academic year 2019/2020, changes were introduced to the study program resulting from legal regulations and as part of the funds raised from the project "Teacher - competent practitioner, supervisor, expert", No. POWR.03.01.00-00-KN40/18. The aim of the study was to determine how many first-cycle and second-cycle studies students declare the teaching profession as a career. In the case of first-cycle studies students, 9.5% of respondents choose the teaching profession and 9.2% of second-cycle studies students. It was found that the number of students who chose the teacher preparation programme at Faculty of Chemistry of the Adam Mickiewicz University has decreased since 5 years.

Keywords: faculty of chemistry, Adam Mickiewicz University, professional ambitions, students, teacher

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Authors: P. Daniels, T. Adonis, P. September-Brown, R. Comalie

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The community engagement unit at the University of the Western Cape was tasked with establishing a community engagement database. The database would store information of all community engagement projects related to the university. The wealth of knowledge obtained from the various disciplines would be used to facilitate interdisciplinary collaboration within the university, as well as facilitating community university partnership opportunities. The purpose of this qualitative study was to explore electronic data collection through the development of a database. Two types of electronic data collection platforms were used, namely online questionnaire and email. The semi structured questionnaire was used to collect data related to community engagement projects from different faculties and departments at the university. There are many benefits for using an electronic data collection platform, such as reduction of costs and time, ease in reaching large numbers of potential respondents, and the possibility of providing anonymity to participants. Despite all the advantages of using the electronic platform, there were as many challenges, as depicted in our findings. The findings suggest that certain barriers existed by using an electronic platform for data collection, even though it was in an academic environment, where knowledge and resources were in abundance. One of the challenges experienced in this process was the lack of dissemination of information via email to staff within faculties. The actual online software used for the questionnaire had its own limitations, such as only being able to access the questionnaire from the same electronic device. In a few cases, academics only completed the questionnaire after a telephonic prompt or face to face meeting about "Is higher education in South Africa ready to embrace electronic platform in data collection?"

Keywords: community engagement, database, data collection, electronic platform, electronic tools, knowledge sharing, university

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Authors: Olufemi Sunday Onabajo

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Radio according to communication scholars is a veritable instrument of mass education. However, its full potentials in boosting higher education have not been realized because of the commercial nature of radio stations in Nigeria. The licensing of campus radio for disseminating information on university curricular is aimed at reinforcing information shared during face to face teaching. This study anchored on Agenda Setting and Technology determinism theories seeks to find out the extent to which university students in Lead City University and University of Ibadan, Nigeria have keyed-in to the philosophy of their campus radio – Lead City FM and Diamond FM in making information dissemination in their domiciled universities less cumbersome. The study employs both qualitative and quantitative methods though the use of depth interview for ten (10) academic staff and five (5) radio personnel of both radio stations; and a questionnaire addressed to 200 students of both institutions using the systematic random sampling technique. The data collected was analyzed using simple percentage and chi-square one tail test, and it was discovered that students of both universities and their radio personnel are yet to realize the potentials of campus radio as a resource alternative to effective learning, and recommends the coming together of all stakeholders to articulate the way forward.

Keywords: disseminating information, effective learning, resource alternative, utilizing radio

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Authors: Perttu Heino

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Universities of applied sciences (UASs) were introduced as part of the Finnish higher education system in the early 1990’s. Research, development and innovation (RDI) were mentioned in the legislation on UASs from the very beginning, but very little attention was paid to it in the early years of UASs due to reasons that are easy to understand. Required changes in the organization of the UAS and its educational offering were a big challenge, and it took several years to get things in order. There were RDI projects already then, but their number was low and there was no systematical coordination or management of those activities. In this paper, the institutional transformation of UASs is discussed based on how Tampere University of Applied Sciences has transformed during the years from a traditional tertiary level school to a modern higher education institution with a strong RDI activity, characterized by lively university-industry interaction and tight integration to education.

Keywords: research, development, management, practices

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Authors: Puntarikorn Rungrattanakasin

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Objectives: To develop the trigger tool to warn about the risk of bleeding as an adverse event from warfarin drug usage during admission in Medical Wards of Chumphae Hospital. Methods: A retrospective study was performed by reviewing the medical records for the patients admitted between June 1st,2020- May 31st, 2021. ADEs were evaluated by Naranjo’s algorithm. The international normalized ratio (INR) and events of bleeding during admissions were collected. Statistical analyses, including Chi-square test and Reciever Operating Characteristic (ROC) curve for optimal INR threshold, were used for the study. Results: Among the 139 admissions, the INR range was found to vary between 0.86-14.91, there was a total of 15 bleeding events, out of which 9 were mild, and 6 were severe. The occurrence of bleeding started whenever the INR was greater than 2.5 and reached the statistical significance (p <0.05), which was in concordance with the ROC curve and yielded 100 % sensitivity and 60% specificity in the detection of a bleeding event. In this regard, the INR greater than 2.5 was considered to be an optimal threshold to alert promptly for bleeding tendency. Conclusions: The INR value of greater than 2.5 (>2.5) would be an appropriate trigger tool to warn of the risk of bleeding for patients taking warfarin in Chumphae Hospital.

Keywords: trigger tool, warfarin, risk of bleeding, medical wards

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Authors: Jihene Jlassi, Ahmed Frikha, Wazna Kortli

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The objectives of Nurse-Patient Assignment are the minimization of the overall hospital cost and the maximization of nurses ‘preferences. This paper aims to assess nurses' satisfaction related to the implementation of patient acuity tool-based assignments. So, we used an integer linear program that assigns patients to nurses while balancing nurse workloads. Then, the proposed model is applied to the Paediatrics Department at Kasserine Hospital Tunisia. Where patients need special acuities and high-level nursing skills and care. Hence, numerical results suggested that proposed nurse-patient assignment models can achieve a balanced assignment

Keywords: nurse-patient assignment, mathematical model, logistics, pediatrics department, balanced assignment

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Authors: E. Steen, B. Dewulf, N. Müller, C. Vandycke, Y. Vandekerckhove

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Introduction: The care for a ST-elevation myocardial infarction (STEMI) patient is time-critical. Reperfusion therapy within 90 minutes of initial medical contact is mandatory in the improvement of the outcome. Primary percutaneous coronary intervention (PCI) without previous fibrinolytic treatment, is the preferred reperfusion strategy in patients with STEMI, provided it can be performed within guideline-mandated times. Aim of the study: During a one year period (January 2013 to December 2013) the files of all consecutive STEMI patients with urgent referral from non-PCI facilities for primary PCI were reviewed. Special attention was given to a subgroup of patients with prior out-of-hospital medical contact generated by the 112-system. In an effort to reduce out-of-hospital system delay to definitive care a change in pre-hospital 112 dispatch strategies is proposed for these time-critical patients. Actual time recordings were compared with travel time simulations for two suggested scenarios. A first scenario (SC1) involves the decision by the on scene ground EMS (GEMS) team to transport the out-of-hospital diagnosed STEMI patient straight forward to a PCI centre bypassing the nearest non-PCI hospital. Another strategy (SC2) explored the potential role of helicopter EMS (HEMS) where the on scene GEMS team requests a PCI-centre based HEMS team for immediate medical transfer to the PCI centre. Methods and Results: 49 (29,1% of all) STEMI patients were referred to our hospital for emergency PCI by a non-PCI facility. 1 file was excluded because of insufficient data collection. Within this analysed group of 48 secondary referrals 21 patients had an out-of-hospital medical contact generated by the 112-system. The other 27 patients presented at the referring emergency department without prior contact with the 112-system. The table below shows the actual time data from first medical contact to definitive care as well as the simulated possible gain of time for both suggested strategies. The PCI-team was always alarmed upon departure from the referring centre excluding further in-hospital delay. Time simulation tools were similar to those used by the 112-dispatch centre. Conclusion: Our data analysis confirms prolonged reperfusion times in case of secondary emergency referrals for STEMI patients even with the use of HEMS. In our setting there was no statistical difference in gain of time between the two suggested strategies, both reducing the secondary referral generated delay with about one hour and by this offering all patients PCI within the guidelines mandated time. However, immediate HEMS activation by the on scene ground EMS team for transport purposes is preferred. This ensures a faster availability of the local GEMS-team for its community. In case these options are not available and the guideline-mandated times for primary PCI are expected to be exceeded, primary fibrinolysis should be considered in a non-PCI centre.

Keywords: STEMI, system delay, HEMS, emergency medicine

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Authors: Azidah Abu Ziden, Adu Ifedayo Emmanuel

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This study investigated the optical board as an artificial technology for peer teaching in a Nigerian university. A design and development research (DDR) design was adopted, which entailed the planning and testing of instructional design models adopted to produce the optical board. This research population involved twenty-five (25) peer-teaching students at a Nigerian university consisting of theatre arts, religion, and language education-related disciplines. Also, using a random sampling technique, this study selected eight (8) students to work on the optical board. Besides, this study introduced a research instrument titled lecturer assessment rubric containing 30-mark metrics for evaluating students’ teaching with the optical board. In this study, it was discovered that the optical board affords students acquisition of self-employment skills through their exposure to the peer teaching course, which is a teacher training module in Nigerian universities. It is evident in this study that students were able to coordinate their design and effectively develop the optical board without lecturer’s interference. This kind of achievement in this research shows that the Nigerian university curriculum had been designed with contents meant to spur students to create jobs after graduation, and effective implementation of the readily available curriculum contents is enough to imbue students with the needed entrepreneurial skills. It was recommended that the Federal Government of Nigeria (FGN) must discourage the poor implementation of Nigerian university curriculum and invest more in the betterment of the readily available curriculum instead of considering a synonymously acclaimed new curriculum for regurgitated teaching and learning process.

Keywords: optical board, artificial technology, peer teaching, educational technology, Nigeria, Malaysia, university, glass, wood, electrical, improvisation

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Authors: Dimitrios Vlachopoulos, George Tsokkas

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Although it is not intended to identify distance education students as a homogeneous group, recent research has demonstrated that there are some demographic and personality common traits among most of them that provide the basis for the description of a typical distance learning student. The purpose of this paper is to describe these common traits and to facilitate their learning journey within a distance education program. The described research is an initiative of the Distance Education Unit at the European University Cyprus (Laureate International Universities) in the context of its action for the improvement of the students’ performance.

Keywords: distance education students, successful student performance, European University Cyprus, common traits

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Authors: Duchduen Bhanthumnavin

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One of the most important characteristics to increase competitive ability in undergraduate students after post COVID-19 era is goal setting and self-control. This correlational study aimes at investigating the influence of psycho-social antecedents on goal setting and self-control in 550 Thai university students. Results from multiple regression analysis revealed that the important predictors of this characteristic were reasoning ability, psychological immunity, attitudes toward competition, core self-evaluation, and family nurture, which yielded 54.28 predictive percentage in the total sample. Moreover, the analysis identified three at-risk groups, namely, male students, low GPA students, and students with siblings. Discussion and implications in general and for specific purposes for the at-risk groups were offered.

Keywords: antecedents, plan and self-control, predictors, university students

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Authors: Jose Ruiz, Jose Velasquez, Holger Lovon

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Peruvian university buildings are critical structures for which very little research about its seismic vulnerability is available. This paper develops a probabilistic methodology that predicts seismic loss for university buildings with simulated fragility functions. Two university buildings located in the city of Cusco were analyzed. Fragility functions were developed considering seismic and structural parameters uncertainty. The fragility functions were generated with the Latin Hypercube technique, an improved Montecarlo-based method, which optimizes the sampling of structural parameters and provides at least 100 reliable samples for every level of seismic demand. Concrete compressive strength, maximum concrete strain and yield stress of the reinforcing steel were considered as the key structural parameters. The seismic demand is defined by synthetic records which are compatible with the elastic Peruvian design spectrum. Acceleration records are scaled based on the peak ground acceleration on rigid soil (PGA) which goes from 0.05g to 1.00g. A total of 2000 structural models were considered to account for both structural and seismic variability. These functions represent the overall building behavior because they give rational information regarding damage ratios for defined levels of seismic demand. The university buildings show an expected Mean Damage Factor of 8.80% and 19.05%, respectively, for the 0.22g-PGA scenario, which was amplified by the soil type coefficient and resulted in 0.26g-PGA. These ratios were computed considering a seismic demand related to 10% of probability of exceedance in 50 years which is a requirement in the Peruvian seismic code. These results show an acceptable seismic performance for both buildings.

Keywords: fragility functions, university buildings, loss assessment, Montecarlo simulation, latin hypercube

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Authors: Subramanyam Devarakonda Hanumantharao, Udayendu Prakash Sharma, Mahesh Garg

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Introduction: Gomabai Netralaya a reputed eye hospital is located in Neemuch a small city of Madhya Pradesh, India. The hospital is established in 1992 by Late. G.D Agrawal a renowned educationist, freedom fighter and philanthropist. The eye hospital was established to serve all sections of the society in affordable manner. To provide comprehensive eye care services to the rural poor the hospital started organizing outreach camps since 1994. Purpose: To study the cost effectiveness of outreach eye camps for addressing the sustainability issues of the outreach program. Methods: One year statistics of outreach eye camps were collected from Hospital Management Information System software to analyze the productivity of camps. Income and expenses report was collected from outreach department records to analyze per camp expenses and per patient expenses against the income generated. All current year records were analyzed to have accuracy of information and results. Information was collected in two ways: 1)Actual camp performance records and expenses from book of accounts. 2)Cross verification was done through one to one discussion with outreach staff. Results: Total 17534 outpatients were examined through 52 outreach eye camps. Total 6042 (34% of total outpatients) patients were advised with cataracts and 4651 (77% of advice) operations were performed. The average OPD per camp was 337 and per camp 116 patients was advised for cataract surgery and 89 surgeries were performed per camp. Total 18200 US$ incurred on organizing 52 outreach camps in the radius of 100 k.ms. Considering the total outpatients screened through camps the screening cost per patient was 1.00 US$ and considering the surgical output the per surgery expenses was 4.00 US$. The cost recovery of the total expenses was through Government grant of US$ 16.00 per surgery (that includes surgical grant). All logistics cost of camps and patients transportation cost was taken care by local donors. Conclusion: The present study demonstrates that with people’s participation, successful high volume outreach eye camps can be organized. The cost effectiveness of the outreach camps is totally depended on volume of outpatient’s turn-up at camp site and per camp surgical output. The only solution to sustainability of outreach eye camps is sharing of cost with local donors and increasing productivity.

Keywords: camps, outreach, productivity, sustainable

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Authors: Tadesse Melaku Abegaz

Abstract:

Background: there was paucity of data on the self-reported adverse drug reactions (ADRs), level of adherence and clinical outcomes with antidepressants among major depressive disorder (MDD) patients in Ethiopia. Hence, the present study sought to determine the level of adherence for and clinical outcome with antidepressants and the magnitude of ADRs. Methods: A prospective cross-sectional study was employed on MDD patients from September 2016 to January 2017 at Gondar university hospital psychiatry clinic. All patients who were available during the study period were included under the study population. The Naranjo adverse drug reaction probability scale was employed to assess the adverse drug reaction. The rate of medication adherence was determined using morisky medication adherence measurement scale eight. Clinical Outcome of patients was measured by using patient health questionnaire. Multivariable logistic carried out to determine factors for adherence and patient outcome. Results: two hundred seventy patients were participated in the study. More than half of the respondents were males 122(56.2%). The mean age of the participants was 30.94 ± 8.853. More than one-half of the subjects had low adherence to their medications 124(57.1%). About 186(85.7%) of patients encountered ADR. The most common ADR was weight gain 29(13.2). Around 198(92.2%) ADRs were probable and 19(8.8%) were possible. Patients with long standing MDD had high risk of non-adherence COR: 2.458[4.413-4.227], AOR: 2.424[1.185-4.961]. More than one-half 125(57.6) of respondents showed improved outcome. Optimal level of medication adherence was found to be associated with reduced risk of progression of the diseases COR: 0.37[0.110-5.379] and AOR: 0.432[0.201-0.909]. Conclusion: Patient reported adverse drug reactions were more prevalent in major depressive disorder patients. Adherence to medications was very poor in the setup. However, the clinical outcome was relatively higher. Long standing depression was associated with non-adherence. In addition, clinical outcome of patients were affected by non-adherence. Therefore, adherence enhancing interventions should be provided to improve medication adherence and patient outcome.

Keywords: adverse drug reactions, clinical outcomes, Ethiopia, prospective study, medication adherence

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Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk

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Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.

Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life

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Authors: Mohammed Seid, Aklilu Azazh, Fikre Enquselassie, Engida Yisma

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Background: Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death for young people. More than a million people die each year on the world’s roads, and the risk of dying as a result of a road traffic injury is highest in the Africa. Methods: A prospective hospital-based study was undertaken to assess injury characteristics and outcome of road traffic accident among victims at Adult Emergency Department of Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia. A structured pre-tested questionnaire was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Results: A total of 230 road traffic accident victims were studied. The majority of the study subjects were men 165 (71.7%) and the male/female ratio was 2.6:1. The victims’ ages ranged from 14 to 80 years with the mean and standard deviations of 32.15 and ± 14.38 years respectively. Daily laborers (95 (41.3%)) and students (28 (12.2%)) were the majority of road traffic accident victims. Long-distance travelling Minibus (16.5%) was responsible for the majority of road traffic crash followed by followed by Taxi (14.8%) and pedestrians (62.6%) accounted for the majority of road traffic accident. Head (50.4%) and musculoskeletal (extremities) (47.0%) were the most common body region injured. Fractures (78.0%) and open wounds (56.5%) were the most common type of injuries sustained. Treatment of fracture was the most common procedure performed in 57.7 % of the victims. The overall length of hospital stay (LOS) ranged from 1 day to 61 days with mean (± standard deviation) of 7.12 ± 10.5 days and the mortality rate was 7.4 %. A significant higher proportion of victims aged 14-55 years were had less likelihood of death compared to those victims aged more than 55 years of age [Adjusted OR = 0.1 (95% CI: 0.01, 0.82)]. Conclusions: This study showed diverse injury characteristics and high morbidity and mortality among the victims attending Adult Emergency Department of Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia. The findings reflect that road traffic accident is a major public health problem. Urgent road traffic accident preventive measures and prompt treatment of the victims are warranted in order to reduce morbidity and mortality among the victims.

Keywords: road traffic accident, injury characteristics, outcome, Tikur Anbesa specialized hospital, Addis Ababa, Ethiopia

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