Search results for: registered nurses
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1026

Search results for: registered nurses

486 Bitcoin, Blockchain and Smart Contract: Attacks and Mitigations

Authors: Mohamed Rasslan, Doaa Abdelrahman, Mahmoud M. Nasreldin, Ghada Farouk, Heba K. Aslan

Abstract:

Blockchain is a distributed database that endorses transparency while bitcoin is a decentralized cryptocurrency (electronic cash) that endorses anonymity and is powered by blockchain technology. Smart contracts are programs that are stored on a blockchain. Smart contracts are executed when predetermined conditions are fulfilled. Smart contracts automate the agreement execution in order to make sure that all participants immediate-synchronism of the outcome-certainty, without any intermediary's involvement or time loss. Currently, the Bitcoin market worth billions of dollars. Bitcoin could be transferred from one purchaser to another without the need for an intermediary bank. Network nodes through cryptography verify bitcoin transactions, which are registered in a public-book called “blockchain”. Bitcoin could be replaced by other coins, merchandise, and services. Rapid growing of the bitcoin market-value, encourages its counterparts to make use of its weaknesses and exploit vulnerabilities for profit. Moreover, it motivates scientists to define known vulnerabilities, offer countermeasures, and predict future threats. In his paper, we study blockchain technology and bitcoin from the attacker’s point of view. Furthermore, mitigations for the attacks are suggested, and contemporary security solutions are discussed. Finally, research methods that achieve strict security and privacy protocol are elaborated.

Keywords: Cryptocurrencies, Blockchain, Bitcoin, Smart Contracts, Peer-to-Peer Network, Security Issues, Privacy Techniques

Procedia PDF Downloads 58
485 Use of Cloud-Based Virtual Classroom in Connectivism Learning Process to Enhance Information Literacy and Self-Efficacy for Undergraduate Students

Authors: Kulachai Kultawanich, Prakob Koraneekij, Jaitip Na-Songkhla

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The way of learning has been changed into a new paradigm since the improvement of network and communication technology, so learners have to interact with massive amount of the information. Thus, information literacy has become a critical set of abilities required by every college and university in the world. Connectivism is considered to be an alternative way to design information literacy course in online learning environment, such as Virtual Classroom (VC). With the change of learning pedagogy, VC is employed to improve the social capability by integrating cloud-based technology. This paper aims to study the use of Cloud-based Virtual Classroom (CBVC) in Connectivism learning process to enhance information literacy and self-efficacy of twenty-one undergraduate students who registered in an e-publishing course at Chulalongkorn University. The data were gathered during 6 weeks of the study by using the following instruments: (1) Information literacy test (2) Information literacy rubrics (3) Information Literacy Self-Efficacy (ILSE) Scales and (4) Questionnaire. The result indicated that students have information literacy and self-efficacy posttest mean scores higher than pretest mean scores at .05 level of significant after using CBVC in Connectivism learning process. Additionally, the study identified that the Connectivism learning process proved useful for developing information rich environment and a sense of community, and the CBVC proved useful for developing social connection.

Keywords: cloud-based, virtual classroom, connectivism, information literacy

Procedia PDF Downloads 437
484 Descriptive Study of Adverse Drug Reactions in a Paediatric Hospital in Mongolia from 2015 to 2019

Authors: Khaliun Nyambayar, Nomindari Azzaya, Batkhuyag Purevjav

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Pharmacovigilance was officially introduced in Mongolia in 2003, in accordance with the Health Minister Order 183 for the registry of adverse drug reactions (ADR), approved in 2006 and was reviewed in 2010. This study was designed to evaluate the incidence and common types of adverse drug reactions among hospitalized children, the frequency of adverse drug reaction reported by health care providers, and the follow-up processes resulting from adverse drug reactions. A retrospective study of paediatric patients who experienced an adverse drug reaction from 2015 to 2019, extracted from the “yellow” card at the State Research Center for Maternal and Child Health, (city). A total of 417 adverse drug reactions were reported with an overall incidence was 80 (21.5%). Adverse reactions resulting from the use of antibiotics (particularly gentamycin, cephalosporins, and vancomycin) were usually mild. ADR’s were reported by physicians and nurses (93.8%), pharmacists (6.25%). Although documentation of physician notification occurred for 93% of adverse drug reactions, only 29% of cases were documented in the patient's medical chart, 13% included follow-up education for individuals involved, and 10% were updated in the allergy profile of the hospital computer system. Measures to improve the detection and reporting of adverse drug reactions by all health care professionals should be improved, to enhance our understanding of the nature and impact of these reactions in children.

Keywords: adverse drug reaction, pediatric, yellow card, Mongolia

Procedia PDF Downloads 93
483 Data Disorders in Healthcare Organizations: Symptoms, Diagnoses, and Treatments

Authors: Zakieh Piri, Shahla Damanabi, Peyman Rezaii Hachesoo

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Introduction: Healthcare organizations like other organizations suffer from a number of disorders such as Business Sponsor Disorder, Business Acceptance Disorder, Cultural/Political Disorder, Data Disorder, etc. As quality in healthcare care mostly depends on the quality of data, we aimed to identify data disorders and its symptoms in two teaching hospitals. Methods: Using a self-constructed questionnaire, we asked 20 questions in related to quality and usability of patient data stored in patient records. Research population consisted of 150 managers, physicians, nurses, medical record staff who were working at the time of study. We also asked their views about the symptoms and treatments for any data disorders they mentioned in the questionnaire. Using qualitative methods we analyzed the answers. Results: After classifying the answers, we found six main data disorders: incomplete data, missed data, late data, blurred data, manipulated data, illegible data. The majority of participants believed in their important roles in treatment of data disorders while others believed in health system problems. Discussion: As clinicians have important roles in producing of data, they can easily identify symptoms and disorders of patient data. Health information managers can also play important roles in early detection of data disorders by proactively monitoring and periodic check-ups of data.

Keywords: data disorders, quality, healthcare, treatment

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482 Healing in Lourdes: Qualitative Research with Pilgrims and Their Carers

Authors: Emmylou Rahtz, Sarah Goldingay, Sara Warber, Ann Arbor, Paul Dieppe

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Introduction: Lourdes is a Catholic, Marian healing venue in South West France. Many miraculous cures have been attributed to visits there. In addition, many visitors seem to experience improvements in health and wellbeing, in the absence of a cure of disease. We wanted to investigate that phenomenon. Methods: We spent 10 days in Lourdes in 2017, carrying out ethnographic research, talking to many visitors, and carrying out formal, recorded interviews with several pilgrims, doctors, nurses, helpers, and priests. Results: Profound experiences and improvements in health and wellbeing were commonly reported. A number of ‘noetic’ experiences were also described. The paper will illustrate these phenomena. In addition, many participants in the research talked about why being in Lourdes was so beneficial to them. The community spirit, ethos of prayer, flow, synchronicity, and ability to find new meaning for life’s ills were cited as likely reasons. Conclusions: We believe that the ‘real miracle’ of Lourdes is the fact that of the many hundreds of thousands of people who go there each year, many find great benefit in health and wellbeing. It is likely that this is due to the ethos of the place, the community spirit, non-judgmental approach and loving acceptance of all aspects of humanity. Acknowledgments: We thank the BIAL foundation for generous funding of this research, and Dr. Alessandro de Franciscis and his team for facilitating our work, as well as all those who participated.

Keywords: healing, miracles, noetic experiences, wellbeing

Procedia PDF Downloads 124
481 Tempo-Spatial Pattern of Progress and Disparity in Child Health in Uttar Pradesh, India

Authors: Gudakesh Yadav

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Uttar Pradesh is one of the poorest performing states of India in terms of child health. Using data from the three round of NFHS and two rounds of DLHS, this paper attempts to examine tempo-spatial change in child health and care practices in Uttar Pradesh and its regions. Rate-ratio, CI, multivariate, and decomposition analysis has been used for the study. Findings demonstrate that child health care practices have improved over the time in all regions of the state. However; western and southern region registered the lowest progress in child immunization. Nevertheless, there is no decline in prevalence of diarrhea and ARI over the period, and it remains critically high in the western and southern region. These regions also poorly performed in giving ORS, diarrhoea and ARI treatment. Public health services are least preferred for diarrhoea and ARI treatment. Results from decomposition analysis reveal that rural area, mother’s illiteracy and wealth contributed highest to the low utilization of the child health care practices consistently over the period of time. The study calls for targeted intervention for vulnerable children to accelerate child health care service utilization. Poor performing regions should be targeted and routinely monitored on poor child health indicators.

Keywords: Acute Respiratory Infection (ARI), decomposition, diarrhea, inequality, immunization

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480 Depressive Trends in Children and Adolescents Suffering from Beta-Thalassemia

Authors: Sanober Khanum, Barerah Siddiqui, Asim Qidwai

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Objective: To determine the risk factors and frequency of depressive trends in children and adolescents suffering from Beta-Thalassemia. Background: Thalassemia is a chronic disease affecting 10,000 people in 60 countries. Many studies show that prolonged medical conditions cause depression. Due to the invasive procedures and suffering, Beta-Thalassemia cause great psychological distress to both children and their caregivers. The study shows 14-24% prevalence of psychiatric problems in Thalassemic patients. Method: Sample consisted of 195 registered patients of A.M.T.F (Female=95 and Male=100). Based on age range the sample was divided into two groups, Group A = children (4-9 years) and Group B = adolescent (10-16 years). A detailed interview with a self-made screening measure was administered on parents to find out the level of depression in patients. Statistics: Chi-square and t-test was applied in order to analyze the data. Results show high prevalence of depression, depression n= 131(66.83%), no depression n=65(33.16%). Analyses reflect that age influences the level of depression Adolescent (71.05%) and Children (64.16%). The analysis also shows a difference in level of depression between both genders. (t=2.975, p < .05). Conclusion: There is a high possibility of developing depressive trend in children affected with Beta Thalassemia; especially females. Therefore, there is a dire need for psychological screening and appropriate treatment in order to improve physical; as well as mental health.

Keywords: childhood depression, chronic illness, psychopathology, Thalassemia

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479 Strategies for Patient Families Integration in Caregiving: A Consensus Opinion

Authors: Ibrahim A. Alkali

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There is no reservation on the outstanding contribution of patient families in restoration of hospitalised patients, hence their consideration as essential component of hospital ward regimen. The psychological and emotional support a patient requires has been found to be solely provided by the patient’s family. However, consideration of their presence as one of the major functional requirements of an inpatient setting design have always been a source of disquiet, especially in developing countries where policies, norms and protocols of healthcare administration have no consideration for the patients’ family. This have been a major challenge to the hospital ward facilities, a concern for the hospital administration and patient management. The study therefore is aimed at obtaining a consensus opinion on the best approach for family integration in the design of an inpatient setting.  A one day visioning charrette involving Architects, Nurses, Medical Doctors, Healthcare assistants and representatives from the Patient families was conducted with the aim of arriving at a consensus opinion on practical design approach for sustainable family integration. Patient’s family are found to be decisive character of hospital ward regimen that cannot be undermined. However, several challenges that impede family integration were identified and subsequently a recommendation for an ideal approach. This will serve as a guide to both architects and hospital management in implementing much desired Patient and Family Centred Care.

Keywords: patient's family, inpatient setting, care giving, integration

Procedia PDF Downloads 190
478 Study of the Quality of Surface Water in the Upper Cheliff Basin

Authors: Touhari Fadhila, Mehaiguene Madjid, Meddi Mohamed

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This work aims to assess the quality of water dams based on the monitoring of physical-chemical parameters by the National Agency of Water Resources (ANRH) for a period of 10 years (1999-2008). Quality sheets of surface water for the four dams in the region of upper Cheliff (Ghrib, Deurdeur, Harreza, and Ouled Mellouk) show a degradation of the quality (organic pollution expressed in COD and OM) over time. Indeed, the registered amount of COD often exceeds 50 mg/ l, and the OM exceeds 15 mg/l. This pollution is caused by discharges of wastewater and eutrophication. The waters of dams show a very high salinity (TDS = 2574 mg/l in 2008 for the waters of the dam Ghrib, standard = 1500 mg/l). The concentration of nitrogenous substances (NH4+, NO2-) in water is high in 2008 at Ouled Melloukdam. This pollution is caused by the oxidation of nitrogenous organic matter. On the other hand, we studied the relationship between the evolution of quality parameters and filling dams. We observed a decrease in the salinity and COD following an improvement of the filling state of dams, this resides in the dilution water through the contribution of rainwater. While increased levels of nitrates and phosphorus in the waters of four dams studied during the rainy season is compared to the dry period, this increase may be due to leaching from fertilizers used in agricultural soils situated in watersheds.

Keywords: surface water quality, pollution, physical-chemical parameters, upper Cheliff basin.

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477 ParkedGuard: An Efficient and Accurate Parked Domain Detection System Using Graphical Locality Analysis and Coarse-To-Fine Strategy

Authors: Chia-Min Lai, Wan-Ching Lin, Hahn-Ming Lee, Ching-Hao Mao

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As world wild internet has non-stop developments, making profit by lending registered domain names emerges as a new business in recent years. Unfortunately, the larger the market scale of domain lending service becomes, the riskier that there exist malicious behaviors or malwares hiding behind parked domains will be. Also, previous work for differentiating parked domain suffers two main defects: 1) too much data-collecting effort and CPU latency needed for features engineering and 2) ineffectiveness when detecting parked domains containing external links that are usually abused by hackers, e.g., drive-by download attack. Aiming for alleviating above defects without sacrificing practical usability, this paper proposes ParkedGuard as an efficient and accurate parked domain detector. Several scripting behavioral features were analyzed, while those with special statistical significance are adopted in ParkedGuard to make feature engineering much more cost-efficient. On the other hand, finding memberships between external links and parked domains was modeled as a graph mining problem, and a coarse-to-fine strategy was elaborately designed by leverage the graphical locality such that ParkedGuard outperforms the state-of-the-art in terms of both recall and precision rates.

Keywords: coarse-to-fine strategy, domain parking service, graphical locality analysis, parked domain

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476 Nursing Experience of Providing Nursing Care to a Lung Transplantation Patient by Applying the Self-Efficacy Theory

Authors: Hsin-Yi Huang

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This study mainly discussed the disease-induced and surgery-induced physical, psychological, and spiritual issues faced by a patient who suffered from emphysema and respiratory failure and had underwent a right-lung transplantation surgery. Nursing care was provided from May 21 to May 29. Based on the observations, interviews, physical examinations, and evaluations that were carried out using Roy’s adaptation model, the following nursing issues were identified: risk of infection, lack of knowledge, and anxiety. Active care was provided and a good nursing relationship with the patient and the patient’s family was established. The four strategies of Bandura’s self-efficacy theory (self-transcendence, vicarious experience, verbal persuasion, and biofeedback) were employed. Instructions for the appropriate rehabilitation exercises were given, immunosuppressant concentration was monitored, and special measures were taken to prevent infection. The patient was encouraged to express feelings and was provided with sufficient information to alleviate anxiety. With assistance from nursing personnel and the medical team, the patient was successfully discharged from the hospital and thereafter embarked on the path of postoperative recovery. The patient learned about the importance of home self-care and regular follow-up outpatient visits, and patient management was implemented for discharge preparation services. This nursing case study may serve as a reference to nurses managing similar cases in future.

Keywords: anxiety, lung transplantation, Roy's adaptation model, self-efficacy theory

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475 Empirical Evidence on the Need for Harmonization of Audit Criteria for Small Enterprises in India

Authors: Satinder Bhatia

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Limited Liability Partnerships (LLPs) was a concept introduced in India in 2009. Ever since then, there has been a fierce growth in the number of organizations registered as LLPs outpacing the number of registrations as private companies. Among other benefits extended to LLPs, the audit being mandated only for LLPs having a turnover of at least Rs 40 lakhs or capital contribution of Rs 25 lakhs, has been a major attraction. This has resulted in only about 10 per cent of LLPs coming under mandatory audit. Even for such companies, the accounting standards to be followed in the preparation of financial statements have not been specified. The Revised Indian Accounting Standards (Revised IndAS) which are aligned with IFRS to a great extent, may apply to LLPs only under limited conditions. Thus, the veracity of even the audited financial statements of LLPs can be questioned. If in future, these LLPs would like to list on a stock exchange to raise capital, there can be serious hurdles if investors do not find the financial statements to be reliable and consistent. LLPs are generally governed by country-specific rules in the area of accounts and audit. Thus, such rules vary across UK, EU and the USA. Some countries have adopted the IFRS for SMEs and since LLPs can be referred to as SMEs; they would come under the ambit of these IFRS provisions. Besides, as the scope of audit widens to cover qualitative information in addition to quantitative data, audit of LLPs has now acquired a new meaning and a new urgency as demands for at least limited purpose audits are arising from different stakeholders including lenders, suppliers, customers and joint venture partners.

Keywords: audit disclosures, audit quality, guidance for SMEs, non-audit services

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474 Learning the C-A-Bs: Resuscitation Training at Rwanda Military Hospital

Authors: Kathryn Norgang, Sarah Howrath, Auni Idi Muhire, Pacifique Umubyeyi

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Description : A group of nurses address the shortage of trained staff to respond to critical patients at Rwanda Military Hospital (RMH) by developing a training program and a resuscitation response team. Members of the group who received the training when it first launched are now trainer of trainers; all components of the training program are organized and delivered by RMH staff-the clinical mentor only provides adjunct support. This two day training is held quarterly at RMH; basic life support and exposure to interventions for advanced care are included in the test and skills sign off. Seventy staff members have received the training this year alone. An increased number of admission/transfer to ICU due to successful resuscitation attempts is noted. Lessons learned: -Number of staff trained 2012-2014 (to be verified). -Staff who train together practice with greater collaboration during actual resuscitation events. -Staff more likely to initiate BLS if peer support is present-more staff trained equals more support. -More access to Advanced Cardiac Life Support training is necessary now that the cadre of BLS trained staff is growing. Conclusions: Increased access to training, peer support, and collaborative practice are effective strategies to strengthening resuscitation capacity within a hospital.

Keywords: resuscitation, basic life support, capacity building, resuscitation response teams, nurse trainer of trainers

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473 Nursing and Allied Health Perception of Desirable Junior Doctor Attributes for Effective Collaboration and Teamwork

Authors: Maneka Marianne Britto, Hansraj Riteesh Bookun

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The ability of a junior doctor to deliver complex multi-disciplinary care to patients in a paradigm of respect and collaboration requires a multitude of interpersonal skills and competencies. A short survey was used to explore the perspective of allied health staff on the desirable attributes of a junior doctor which are conducive to good teamwork. 23 allied health professionals (14 nurses, 4 physiotherapists, 2 dietitians, 1 occupational therapist, 1 speech therapist and 1 audiologist) responded to this 17-item survey. There were 17 females. The mean age of the respondents was 34.9 ± 10.1 years. The salient findings of our survey are that 95% of our respondents rated friendliness and non-clinical small talk with average importance or greater. 45% of them viewed these 2 items as very important or absolutely essential. A single respondent viewed these 2 items with little importance. The other criteria which were rated with high levels of importance were the acknowledgment of allied health suggestions and good ward organizational skills. Training these collaborative skills is challenging, and an enhanced understanding of interprofessional perspectives will help a junior doctor to achieve better clinical outcomes. It is hoped that this paper will further stimulate discussion in this area and will encourage junior doctors to engage in non-clinical conversations with allied health staff in the spirit of promoting effective teamwork.

Keywords: allied health, collaboration, doctor, medicine, surgery

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472 Evaluation of the Patient Identification Process in Healthcare Facilities in a Brazilian City Area

Authors: Carmen Silvia Gabriel, Maria de Fátima Paiva Brito, Mariane de Paula Candido, Vanessa Barato Oliveira

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Patient identification is a necessary practice to ensure patient safety in any healthcare environment, including emergency care units, test laboratories, home care and clinics. The present study aimed to provide evidence that can effectively contribute to practices concerning patient identification. Its objective was to investigate patient identification in basic healthcare units through patient safety standards. To do so, a descriptive and non-experimental research outline study was carried out to inquire how patient identification takes place in a particular situation. All technical manager nurses from the chosen healthcare facilities were included in the sample for the study. Data was collected in September of 2014 after approval from the Committee of Ethics. All researched institutions fit the same profile: they’re public facilities for general care with observation beds. None of them has a wristband identification protocol or policy. Only one institution mentioned using some kind of visual identification; namely, body tags separated by colors according to the type of care, but it still does not apply the recommended tags by the Brazilian Ministry of Health. This study allowed the authors to acknowledge how important the commitment from the whole healthcare team in the patient identification process is and also acknowledge how necessary it is to implement institutional policies that may aid the healthcare units in this area to promote a quality and safe patient care.

Keywords: patient safety, identification, nursing, emergency care units

Procedia PDF Downloads 387
471 Sleep Quality and Burnout, Mental and Physical Health of Polish Healthcare Workers

Authors: Maciej Bialorudzki, Zbigniew Izdebski, Alicja Kozakiewicz, Joanna Mazur

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The quality of sleep is extremely important for physical and mental health, especially among professional groups exposed to the suffering of the people they serve. The aim of the study is to assess sleep quality and various aspects of physical and mental health. A nationwide cross-sectional survey conducted in the first quarter of 2022 included 2227 healthcare professionals from 114 Polish hospitals and specialized outpatient clinics. The following distribution for each professional group was obtained (22% doctors; 52.6% nurses; 7.3% paramedics; 10.1% other medical professionals; 7.9% other non-medical professionals). The mean age of the respondents was 46.24 (SD=11.53). The Jenkins Sleep Scale with four items (JSS-4) was used to assess sleep quality, yielding a mean value of 5.35 (SD=5.20) in the study group and 13.7% of subjects with poor sleep quality using the cutoff point of the mean JSS-4 sum score as >11. More often, women than men reported poorer sleep quality (14,8% vs. 9,1% p=0,002). Respondents with poor sleep quality were more likely to report occupational burnout as measured by the BAT-12 (43.1% vs. 12.9% p<0.001) and high levels of stress as measured by the PSS-4 (72.5% vs. 27.5% p<0.001). In addition, those who declare experiencing a traumatic event compared to those who have not experienced it has an almost two times higher risk of poorer sleep quality (OR:1.958; 95% CI:1.509-2.542; p<0.001). In contrast, those with occupational burnout had more than five times the risk of those without occupational burnout (OR:5.092; 95% CI: 3.763-6.889; p<0.001). Sleep quality remains an important predictor of stress levels, job burnout, and quality of life assessment.

Keywords: quality of sleep, medical staff, mental health, physical health, occupational burnout, stress

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470 Status and Rights of Rohingya Migrants in Bangladesh: A Critical Analysis

Authors: Md Nur Uddin

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The Rohingya people are one of the world's most oppressed and persecuted refugee populations, having been stateless for over six generations and still are. In recent years, more than half-million Rohingya Muslims have fled Myanmar (Burma) for neighboring nations. This article discusses the Status and Rights of Rohingya Migrants in Bangladesh, with a focus on the living conditions of this vulnerable population. A lot of information has been studied about Rohingya refugees states that violence in Rakhine state has sent an estimated 615,500 Rohingya across the border into Bangladesh's Cox's Bazar since August 25, 2017. In Cox's Bazar, a total of 33,131 Rohingya refugees are housed in two registered camps, with an additional 854,024 living in informal settlements nearby. The living conditions of Rohingya refugees in overcrowded camps remain dismal. Mental health is bad, cleanliness is poor, malnutrition is common, and physical and sexual abuse is endemic. A coordinated diplomatic effort involving Bangladesh and Myanmar, as well as international mediators such as the Organization of Islamic Countries and the United Nations, is essential to adequately resolve this complex matter. Bangladeshi officials must ensure the safety of the Rohingyas in the camps and use available humanitarian aid to give the refugees basic amenities such as food, shelter, sanitation, and medical treatment. UNHCR officials should keep an eye on the actual repatriation process to ensure that refugees who have expressed a desire to stay in Bangladesh are not deported against their choice.

Keywords: international refugee laws, united nations, Rohingya, stateless, humanitarian

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469 Impact of Emergency Medicine Department Crowding on Mortality

Authors: Morteza Gharibi, Abdolghader Pakniat, Somayeh Bahrampouri

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Introduction: Emergency department (E.R.) crowding is a serious widespread problem in hospitals that leads to irregularities, a slower rate of delivery of services to patients, and a long-term stay. In addition, the long-term stay in the E.D. reduces the possibility of providing services with appropriate quality to other patients who are undergoing medical emergencies, which leads to dissatisfaction among patients. This study aimed to determine the relationship between ED-crowding and the mortality rate of the patients referred to the E.D. In a retrospective cohort study, all patients who expired in first 24 hours of admission were enrolled in the study. Crowding index at the moment of admission was calculated using Edwin Score. The data including history and physical examination, time of arrival in the E.D., diagnosis (using ICD 10 code), time of death, cause of death, demographic information was recoded based on triage forms on admission and patients’ medical files. Data analysis was performed by using descriptive statistics and chi square test, ANOVA tests using SPSS ver. 19. The time of arrival in E.D. to death in crowded E.D. conditions, with an average of five hours and 25 minutes, was significantly higher than the average admission Time of arrival in E.D. to death in active and crowded E.D. conditions. More physicians and nurses can be employed during crowded times to reduce staff fatigue and improve their performance during these hours.

Keywords: mortality, emergency, department, crowding

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468 Cancer Patients' Quality of Life and Fatigue: A Correlational Study

Authors: Abdul-Monim Batiha

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Aim: The aim of this study were to correlate Jordanian cancer patients’ quality of life and fatigue with selected variables (age, sex, religion, marital status, level of education, type of cancer, number of people living in the same household, type of radiotherapy, dose of radiotherapy, and hemoglobin level). Background: Radiotherapy and chemotherapy remain devastating agents that altered patients’ normal lives. Methods: A correlational design was used in this study to 80 cancer patients and required radiotherapy treatment using a convenience sampling procedure. Results: No significant differences were found in the relationship between quality of life scores and selected variables. A significant negative relationship was found between quality of life scores and the side effects of radiotherapy treatment. Significant positive relationships were found between fatigue scores measured by Piper Fatigue Scale and cancer complications, and radiotherapy side effects. Conclusion: Cancer patients’ quality of life and fatigue are affected by radiotherapy’s side effects and cancer complications. Implications for Nursing: Nurses should try to prevent and manage the negative side effects of radiotherapy and complications of cancer. Such an initiative would serve to design specific nursing interventions that have the potential to help patients enjoy their lives and perform their activities.

Keywords: cancer patients, piper fatigue scale, fatigue, quality of life, radiotherapy

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467 Strategic Leadership and Sustainable Project Management in Enugu, Nigeria

Authors: Nnadi Ezekiel Ejiofor

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In Enugu, Nigeria, this study investigates the connection between strategic leadership and project management sustainability, with an emphasis on building projects in the State. The study set out to accomplish two specific goals: first, it sought to establish a link between creative project management and resource efficiency in construction projects in Enugu State, Nigeria; and second, it sought to establish a link between innovative thinking and waste minimization in those same projects. A structured questionnaire was used to collect primary data from 45 registered construction enterprises in the study area as part of the study's descriptive research approach. Due to the nonparametric nature of the data, Spearman Rank Order Correlation was used to evaluate the acquired data. The findings demonstrate that creative project management had a significant positive impact on resource efficiency in construction projects carried out by architecture firms in Enugu State, Nigeria (r =.849; p.001), and that innovative thinking had a significant impact on waste reduction in those same projects (r =.849; p.001). It was determined that strategic leadership had a significant impact on the sustainability of project management, and it was thus advised that project managers should foresee, prepare for, and effectively communicate present and future developments to project staff in order to ensure that the objective of sustainable initiatives, such as recycling and reuse, is implemented in construction projects.

Keywords: construction, project management, strategic leadership, sustainability, waste reduction

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466 Evaluating the Effect of Nursing Ethics Education on Nursing Students' Sensitivity and Moral Judgments

Authors: Hsiao Lu Lee

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This study was based Quasi-experimental design. The study explored the relationships of nursing ethics education, nursing students’ moral sensitivity and moral judgments in Taiwan. A total of 242 nursing students (NS) participated the study.The proposed teaching nursing ethics from 2 to 16 weeks. Three questionnaires were adopted in this study. First, Demographic of nursing students questionnaire; Second, the questionnaire is Taiwan’s Moral Sensitivity Questionnaire for Student Nurses (TMMSQ-SN); Third, Defining Issues Test (DIT). The pre-test data were collected during the first week, and the post-test data was collected during the 17ᵗʰ week of the semester. The purpose of the study is explored evaluating the effect of nursing ethics education on nursing students’ moral sensitivity and moral judgments. The results of the study showed that moral sensitivities and moral judgments have been significantly improved after 16 weeks (Pair-t=--11.10***; Pair-t=-7.393***). Moral sensitivities and moral judgments were significant in the pretest. There was a negative correlation, but there was no correlation between moral sensitivity and moral judgments in the post-test. There was a significant correlation between the moral judgments (DIT)and the hours of work and other ethical courses (r=.28**; r=.015*). Nursing ethics education is necessary for nursing students in Taiwan. The nursing ethics courses are necessary to improve nursing students’ moral sensitivity and moral judgment (DIT).

Keywords: defining issues test, moral judgments, moral sensitivity, nursing ethics education, nursing students

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465 Valuation of Green Commercial Office Building: A Preliminary Study of Malaysian Valuers' Insight

Authors: Tuti Haryati Jasimin, Hishamuddin Mohd Ali

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Malaysia’s green building development is gaining momentum and green buildings have become a key focus area especially within the commercial sector with the encouragement of government legislation and policy. Due to the emerging awareness among the market players’ views of the benefits associated with the ownership of green buildings in Malaysia, there is a need for valuers to incorporate consideration of sustainability into their assessments of property market value to ensure the green buildings continue to increase in the market. This paper analyses the valuers’ current perception on the valuation practices with regard to the green issues in Malaysia. The study was based on a survey of registered real estate valuers and the experts whose work related to valuation in the Klang Valley area to rate their view regarding the perception on valuation of green building. The findings present evidence that even though Malaysian valuers have limited knowledge of green buildings, they recognize the importance of incorporating the green features in the valuation process. The inclusion of incorporating the green features in valuations in practice was hindered by the inadequacy of sufficient transactional data in the market. Furthermore, valuers experienced difficulty in identifying what are the various input parameters of green building and how to adjust it in order to reflect the benefit of sustainability features correctly in the valuation process. This paper focuses on the present challenges confronted by Malaysian valuers with regards to incorporating the green features in their valuation.

Keywords: green commercial office building, Malaysia, valuers’ perception, valuation, commercial sector

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464 Rabies Surveillance Data Analysis in Addis Ababa, Ethiopia during 2012/13: Retrospective Cross Sectional Study

Authors: Fantu Lombamo Untiso, Sylvia Murphy, Emily Pieracci

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Background: Rabies is a highly fatal viral disease of all warm-blooded animals including human globally. However, effective rabies control program still remains to be a reality and needs to be strengthened. Objective: Reviewing of recorded data and analyzing it to generate information on the status of rabies in Addis Ababa in the year 2012/13. Methods: A retrospective data were used from the Ethiopian Public Health Institute rabies case record book registered in the year 2012/13. Results: Among 1357 suspected rabid animals clinically examined; only 8.84% were positive for rabies. Out of 216 animal brains investigated in the laboratory with Fluorescent Antibody Technique, 55.5% were confirmed rabies positive. Among the laboratory confirmed positive rabies cases, high percentage of the animals came from Yeka (20%) and lower number from Kirkos subcity (3.3%). Out of 1149 humans who came to the institute seeking anti-rabies post-exposure prophylaxis, 85.65% and 7.87% of them were exposed to suspected dogs and cats respectively. 3 human deaths due to rabies were reported in the year after exposure to dog bite of unknown vaccination status. Conclusion: The principal vector of rabies in Addis Ababa is dog. Effective rabies management and control based on confirmed cases and mass-immunization and control of stray dog populations is recommended.

Keywords: Addis Ababa, exposure, rabies, surveillance

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463 Electrophoretic Changes in Testis and Liver of Mice after Exposure to Diclofenac Sodium

Authors: Deepak Mohan, Sushma Sharma, Mohammad Asif

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Diclofenac sodium being one of the most common non-steroidal anti-inflammatory drugs is normally used as painkiller and to reduce inflammation. The drug is known to alter the enzymatic activities of acid and alkaline phosphatase, glutamate oxaloacetate transaminase and glutamate pyruvate transaminases. The drug also results in change in the concentration of proteins and lipids in the body. The present study is an attempt to study different biochemical changes electrophoretically due to administration of different doses of diclofenac (4mg/kg/body weight and 14mg/kg/body weight) on liver and testes of mice from 7-28 days of investigation. Homogenization of the tissue was done, supernatant separated was loaded in the gel and native polyacrylamide gel electrophoresis was conducted. Diclofenac administration resulted in alterations of all these biochemical parameters which were observed in native polyacrylamide gel electrophoretic studies. The severe degenerative changes as observed during later stages of the experiment showed correlation with increase or decrease in the activities of all the enzymes studied in the present investigation. Image analysis of gel in liver showed a decline of 7.4 and 5.3 % in low and high dose group after 7 days whereas a decline of 9.6 and 7.5% was registered after 28 days of investigation. Similar analysis for testis also showed an appreciable decline in the activity of alkaline phosphatase after 28 days. Gel analysis of serum was also performed to find a correlation in the enzymatic activities between the tissue and blood.

Keywords: diclofenac, inflammation, polyacrylamide, phosphatase

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462 Late Payment Issues Faced by Subcontractors in the Malaysian Construction Industry

Authors: Nur Emma Mustaffa, Hii Ping Ping

Abstract:

Late payment is a common issue in the construction industry and the subcontractors are not spared from it. This study has been carried out with the objectives to identify the implications of late payment issues toward the subcontractors and the strategies adopted by them to overcome the late payment issues. In terms of the strategies which can be adopted in overcoming the late payment, the subcontractors may suspend or slow down the construction process, making periodic follow up with the client, demand the rights to interest on late payment or the issuance of a promissory note by the client. The focus of the study is primarily on Grade 4 to Grade 7 contractors in Johor Bahru, Malaysia who carried out subcontracting works and registered under Construction Industry Development Board (CIDB). Employing survey as the main research method for data collection, the analysis would therefore mainly be adopting Likert Scale Analysis, Ranking Analysis and Frequency Distribution Analysis. This research showed the main implication of late payment issues towards subcontractors is created financial hardship to them. Besides, the most effective strategy adopted by the subcontractors to overcome the late payment issues is follow-up with client using formal procedure. From the findings, most of the subcontractors had low level of experiences and frequency in the adoption of Construction Industry Payment and Adjudication Act (CIPAA) 2012 to solve the payment disputes in the construction industry. In a nutshell, it is hoped that these findings will become guidance to the subcontractors to overcome the late payment issues in their future projects.

Keywords: subcontractors, implications, strategies, CIPAA 2012, payment

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461 An Evaluative Microbiological Risk Assessment of Drinking Water Supply in the Carpathian Region: Identification of Occurrent Hazardous Bacteria with Quantitative Microbial Risk Assessment Method

Authors: Anikó Kaluzsa

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The article's author aims to introduce and analyze those microbiological safety hazards which indicate the presence of secondary contamination in the water supply system. Since drinking water belongs to primary foods and is the basic condition of life, special attention should be paid on its quality. There are such indicators among the microbiological features can be found in water, which are clear evidence of the presence of water contamination, and based on this there is no need to perform other diagnostics, because they prove properly the contamination of the given water supply section. Laboratory analysis can help - both technologically and temporally – to identify contamination, but it does matter how long takes the removal and if the disinfection process takes place in time. The identification of the factors that often occur in the same places or the chance of their occurrence is greater than the average, facilitates our work. The pathogen microbiological risk assessment by the help of several features determines the most likely occurring microbiological features in the Carpathian basin. From among all the microbiological indicators, that are recommended targets for routine inspection by the World Health Organization, there is a paramount importance of the appearance of Escherichia coli in the water network, as its presence indicates the potential ubietiy of enteric pathogens or other contaminants in the water network. In addition, the author presents the steps of microbiological risk assessment analyzing those pathogenic micro-organisms registered to be the most critical.

Keywords: drinking water, E. coli, microbiological indicators, risk assessment, water safety plan

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460 Youth NEET in Albania: Current Situation and Outreach Mechanisms

Authors: Emiljan Karma

Abstract:

One of the major problems of the present is young people who are not concerned with employment, education, or training (NEETs). Unfortunately, this group of people in Albania is a considerable part of working-age people, and despite the measures taken, they remain a major problem. NEETs in Albania are very heterogeneous. This is since youth unemployment and inactivity rate are at a very high level (Albania has the highest NEET rate among EU candidates/potential candidates’ countries and EU countries); the high level of NEET rate in Albania means that government agencies responsible for labour market regulation and other social actors interested in the phenomenon (representatives of employees, representatives of employers, non-governmental organizations, etc.) did not effectively materialize the policies in the field of youth employment promotion. The National Agency for Employment and Skills (NAES) delivers measures specifically designed to target unemployed youth, being the key stakeholder in the implementation of employment policies and skills development in Albania. In the context of identifying and assisting NEETs, this role becomes even stronger. The experience of different EU countries (e.g., Youth Guarantee) indicates that there are different policy-making structures and various outreach mechanisms for constraining the youth NEET phenomenon. The purpose of this research is to highlight: (1) The identification of NEETs feature in Albania; (2) The identification of tailored and efficient outreach mechanisms to assist vulnerable NEETs; (3) The fundamental importance of stakeholders’ partnership at central and regional level.

Keywords: labor market, NEETs, non-registered NEETs, unemployment

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459 Impact of Traditional Male Circumcision Mishaps Towards Newly Initiated Men's Advancement in Education in South Africa

Authors: Thanduxolo Nomngcoyiya, Simon M. Kang’ethe

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The aim of this article is to explore whether a relationship exists between traditional male circumcision mishaps and level of education in the Eastern Cape, South Africa, exemplified by an empirical case study. The study used qualitative paradigm; was exploratory in nature and used case study design that was descriptive and exploratory; and entailed interviewing twenty-eight (28) research participants comprising of eleven (11) newly initiated men and their families on one-on-one in-depth interviews, twelve (12) traditional nurses and community members in focus group discussions; and five (5) society key informants on key informant method. An interview guide served as a data collection instrument for focus group discussions, key informant method and in-depth interviews with unstructured open-ended questions. Findings indicated an array of traditional male circumcision (TMC) gaps, some of which were indicative of a relationship between the mishaps and level of education: the phenomenon of schooling became secondary in newly initiated men’s lives; TMC mishaps became a drawback towards the newly initiated men’s education progression; the newly initiated men are sacrificed at the altar of culture, and TMC mishaps ushered in socioeconomic setback to the newly initiated men. The study suggested that: TMC be developmental; TMC as a cultural endeavor be educational and human rights friendly; and the need to identify and integrate all other players with diverse specialties.

Keywords: culture, education for all, EFA, millennium development goals, traditional male circumcision

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458 Critical Thinking and Creativity of Undergraduate Nursing Students: Descriptive and Disposition in Academic Levels

Authors: Kamolrat Turner, Chularat Howharn

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Critical thinking and creativity are desirable competency for contemporary nurses although there are growing concerns supporting a disturbing paucity in its achievement. Nursing colleges in Thailand have developed teaching strategies and curricula that nurture critical thinking and creativity dispositions according academic levels. Objectives: This descriptive study identified critical thinking and creativity dispositions of Thai nursing students according academic levels. Methods: A cross-sectional questionnaire survey was conducted among 515 nursing students for four academic levels. All are studying at Boromarajonani College of Nursing Chon Buri, Thailand. Descriptive and univariate general linear model analysis were applied. Results: The scores on critical thinking disposition gradually increased as academic level is rising from the junior year throughout the senior year, but its scores are neutral. Scores on creativity skill is neutral and constant thorough the four academic years. The fourth grade students had slightly higher scores on creativity when compared to others. A significant relationship between critical thinking and creativity was also found. Conclusions: The scores on critical thinking disposition gradually improved which greatly increased in the senior year. However, creativity has neutrally progressed. The findings suggest the importance of targeting the development of curriculum and teaching strategies for all grades of nursing students to increase their critical thinking and creativity skills.

Keywords: critical thinking, creativity, undergraduate nursing students, competency

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457 Using Multiple Strategies to Improve the Nursing Staff Edwards Lifesciences Hemodynamic Monitoring Correctness of Operation

Authors: Hsin-Yi Lo, Huang-Ju Jiun, Yu-Chiao Chu

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Hemodynamic monitoring is an important in the intensive care unit. Advances in medical technology in recent years, more diversification of intensive care equipment, there are many kinds of instruments available for monitoring of hemodynamics, Edwards Lifesciences Hemodynamic Monitoring (FloTrac) is one of them. The recent medical safety incidents in parameters were changed, nurses have not to notify doctor in time, therefore, it is hoped to analyze the current problems and find effective improvement strategies. In August 2021, the survey found that only 74.0% of FloTrac correctness of operation, reasons include lack of education, the operation manual is difficulty read, lack of audit mechanism, nurse doesn't know those numerical changes need to notify doctor, work busy omission, unfamiliar with operation and have many nursing records then omissions. Improvement methods include planning professional nurse education, formulate the secret arts of FloTrac, enacting an audit mechanism, establish FloTrac action learning, make「follow the sun」care map, hold simulated training and establish monitoring data automatically upload nursing records. After improvement, FloTrac correctness of operation increased to 98.8%. The results are good, implement to the ICU of the hospital.

Keywords: hemodynamic monitoring, edwards lifesciences hemodynamic monitoring, multiple strategies, intensive care

Procedia PDF Downloads 65