Search results for: clinical communication
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7415

Search results for: clinical communication

1625 Bionaut™: A Minimally Invasive Microsurgical Platform to Treat Non-Communicating Hydrocephalus in Dandy-Walker Malformation

Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher

Abstract:

The Dandy-Walker malformation (DWM) represents a clinical syndrome manifesting as a combination of posterior fossa cyst, hypoplasia of the cerebellar vermis, and obstructive hydrocephalus. Anatomic hallmarks include hypoplasia of the cerebellar vermis, enlargement of the posterior fossa, and cystic dilatation of the fourth ventricle. Current treatments of DWM, including shunting of the cerebral spinal fluid ventricular system and endoscopic third ventriculostomy (ETV), are frequently clinically insufficient, require additional surgical interventions, and carry risks of infections and neurological deficits. Bionaut Labs develops an alternative way to treat Dandy-Walker Malformation (DWM) associated with non-communicating hydrocephalus. We utilize our discreet microsurgical Bionaut™ particles that are controlled externally and remotely to perform safe, accurate, effective fenestration of the Dandy-Walker cyst, specifically in the posterior fossa of the brain, to directly normalize intracranial pressure. Bionaut™ allows for complex non-linear trajectories not feasible by any conventional surgical techniques. The microsurgical particle safely reaches targets in the lower occipital section of the brain. Bionaut™ offers a minimally invasive surgical alternative to highly involved posterior craniotomy or shunts via direct fenestration of the fourth ventricular cyst at the locus defined by the individual anatomy. Our approach offers significant advantages over the current standards of care in patients exhibiting anatomical challenge(s) as a manifestation of DWM, and therefore, is intended to replace conventional therapeutic strategies. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.

Keywords: Bionaut™, cerebral spinal fluid, CSF, cyst, Dandy-Walker, fenestration, hydrocephalus, micro-robot

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1624 New Advanced Medical Software Technology Challenges and Evolution of the Regulatory Framework in Expert Software, Artificial Intelligence, and Machine Learning

Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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1623 Women, Quality of Life, and Infertility: The Mediating Role of Social Support and Hope

Authors: Saeideh Lotfi Nikoo, Azadeh Ghaheri, Reza Omani Samani

Abstract:

Context: In most cultures around the globe, infertility is recognized as a crisis and exposed infertile couples are under psychosocial pressure. Indeed, the quality of life (QoL) for infertile women is lower in comparison with fertile control. Objective, The purpose of this study, was to investigate the impact of social support and hope on QoL in women undergoing infertility treatment. Methods: A cross-sectional study. Patient(s): In this cross-sectional study, 350 infertile women were recruited who were referred to an infertility clinic for the first time and had no history of Assisted Reproductive Techniques (ART) failure. Intervention(s): Questionnaires on the Fertility Quality of Life (FertiQoL), Multi-dimensional Scale of Perceived Social Support (family and friends), and Snyder Hope Scale (pathway and agency) were used to collect data. Data analysis was done by univariate and multivariate analysis. P value <0.05 was considered statistically significant. Result(s): Multivariate analysis indicated that infertile women with a higher score of social support (by family & friends) (b= 0.59 (CI 95%: 0.03, 1.15) (P = 0.040), b= 0.61 (CI 95%: 0.17, 1.04) (P = 0.006)) and hope (pathway & agency) (b= 0.94 (CI 95%: 0.29, 1.59) (P = 0.005), b= 1.13 (CI 95%: 0.45, 1.82) (P = 0.001) respectively) have significantly better Core FertiQoL. The result revealed that social support and hope are significantly and positively associated with other subscales of FertiQoL as well. Conclusions: According to the results, lifestyle interventions such as receiving social support, building a sound family with effective communication, and providing appropriate health education are of crucial importance to address psychological distress and improve the fertility QoL of women experiencing fertility problems.

Keywords: inertility, social support, infertile women, hope

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1622 A Paradigm Model of Educational Policy Review Strategies to Develop Professional Schools

Authors: Farhad Shafiepour Motlagh, Narges Salehi

Abstract:

Purpose: The aim of the present study was a paradigm model of educational policy review strategies for the development of Professional schools in Iran. Research Methodology: The research method was based on Grounded theory. The statistical population included all articles of the ten years 2022-2010 and the method of sampling in a purposeful manner to the extent of theoretical saturation to 31 articles. For data analysis, open coding, axial coding and selective coding were used. Results: The results showed that causal conditions include social requirements (social expectations, educational justice, social justice); technology requirements (use of information and communication technology, use of new learning methods), educational requirements (development of educational territory, Development of educational tools and development of learning methods), contextual conditions including dual dimensions (motivational-psychological context, context of participation and cooperation), strategic conditions including (decentralization, delegation, organizational restructuring), intervention conditions (poor knowledge) Human resources, centralized system governance) and outcomes (school productivity, school professionalism, graduate entry into the labor market) were obtained. Conclusion: A review of educational policy is necessary to develop Iran's Professional schools, and this depends on decentralization, delegation, and, of course, empowerment of school principals.

Keywords: school productivity, professional schools, educational policy, paradigm

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1621 Quorum-Sensing Driven Inhibitors for Mitigating Microbial Influenced Corrosion

Authors: Asma Lamin, Anna H. Kaksonen, Ivan Cole, Paul White, Xiao-Bo Chen

Abstract:

Microbiologically influenced corrosion (MIC) is a process in which microorganisms initiate, facilitate, or accelerate the electrochemical corrosion reactions of metallic components. Several reports documented that MIC accounts for about 20 to 40 % of the total cost of corrosion. Biofilm formation due to the presence of microorganisms on the surface of metal components is known to play a vital role in MIC, which can lead to severe consequences in various environmental and industrial settings. Quorum sensing (QS) system plays a major role in regulating biofilm formation and control the expression of some microbial enzymes. QS is a communication mechanism between microorganisms that involves the regulation of gene expression as a response to the microbial cell density within an environment. This process is employed by both Gram-positive and Gram-negative bacteria to regulate different physiological functions. QS involves production, detection, and responses to signalling chemicals, known as auto-inducers. QS controls specific processes important for the microbial community, such as biofilm formation, virulence factor expression, production of secondary metabolites and stress adaptation mechanisms. The use of QS inhibitors (QSIs) has been proposed as a possible solution to biofilm related challenges in many different applications. Although QSIs have demonstrated some strength in tackling biofouling, QSI-based strategies to control microbially influenced corrosion have not been thoroughly investigated. As such, our research aims to target the QS mechanisms as a strategy for mitigating MIC on metal surfaces in engineered systems.

Keywords: quorum sensing, quorum quenching, biofilm, biocorrosion

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1620 Creatine Associated with Resistance Training Increases Muscle Mass in the Elderly

Authors: Camila Lemos Pinto, Juliana Alves Carneiro, Patrícia Borges Botelho, João Felipe Mota

Abstract:

Sarcopenia, a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, currently affects over 50 million people and increases the risk of adverse outcomes such as physical disability, poor quality of life and death. The aim of this study was to examine the efficacy of creatine supplementation associated with resistance training on muscle mass in the elderly. A 12-week, double blind, randomized, parallel group, placebo controlled trial was conducted. Participants were randomly allocated into one of the following groups: placebo with resistance training (PL+RT, n=14) and creatine supplementation with resistance training (CR + RT, n=13). The subjects from CR+RT group received 5 g/day of creatine monohydrate and the subjects from the PL+RT group were given the same dose of maltodextrin. Participants were instructed to ingest the supplement on non-training days immediately after lunch and on training days immediately after resistance training sessions dissolved in a beverage comprising 100 g of maltodextrin lemon flavored. Participants of both groups undertook a supervised exercise training program for 12 weeks (3 times per week). The subjects were assessed at baseline and after 12 weeks. The primary outcome was muscle mass, assessed by dual energy X-ray absorptiometry (DXA). The secondary outcome included diagnose participants with one of the three stages of sarcopenia (presarcopenia, sarcopenia and severe sarcopenia) by skeletal muscle mass index (SMI), handgrip strength and gait speed. CR+RT group had a significant increase in SMI and muscle (p<0.0001), a significant decrease in android and gynoid fat (p = 0.028 and p=0.035, respectively) and a tendency of decreasing in body fat (p=0.053) after the intervention. PL+RT only had a significant increase in SMI (p=0.007). The main finding of this clinical trial indicated that creatine supplementation combined with resistance training was capable of increasing muscle mass in our elderly cohort (p=0.02). In addition, the number of subjects diagnosed with one of the three stages of sarcopenia at baseline decreased in the creatine supplemented group in comparison with the placebo group (CR+RT, n=-3; PL+RT, n=0). In summary, 12 weeks of creatine supplementation associated with resistance training resulted in increases in muscle mass. This is the first research with elderly of both sexes that show the same increase in muscle mass with a minor quantity of creatine supplementation in a short period. Future long-term research should investigate the effects of these interventions in sarcopenic elderly.

Keywords: creatine, dietetic supplement, elderly, resistance training

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1619 Comparing Hotels' Official Websites with Their Pages on Booking Sites: An Exploratory Study

Authors: Iman Shawky

Abstract:

Hotel websites frequently aim at encouraging visitors to become potential guests by completing their booking procedures, and accordingly, they have been proved to be attractive and appealing. That might be due to the consideration of them as one of the direct efficacious tools to promote and sell hotels' facilities, besides building strong communication with guests to create unforgettable brand images. This study tried to find out a step for five-star and four-star hotels to develop their websites to meet their visitors' or guests' requirements for an effective site. In addition, it aimed at exploring to what extent hotels' official websites compared with their pages on hotel booking sites still influence visitors' or guests' desires to book. Besides, it also aimed at investigating to what extent visitors or guests widely trust and use those sites to accomplish their booking. Furthermore, it tried to explore to what extent visitors' or guests' preferences of those sites can influence on hotels' financial performance. To achieve these objectives, the researcher conducted an exploratory study by surfing both hotels' official websites and their pages on booking sites of such hotels in Alexandria city in Egypt to make a comparison between them. Moreover, another separate comparison was made on Arab and foreign guests' views conducted by using a questionnaire during the past seven months to investigate the effectiveness of hotels' official websites against their pages on booking sites to trust and motive them to book. The results indicated that hotels' pages on booking sites represented widely trusted and used sites compared with their official websites for achieving visitors' or guests' booking process, while a few other visitors or guests still trusted official hotel websites for completing their booking.

Keywords: five-star and four-star hotels, hotel booking sites, hotels' financial performance, hotels' official websites

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1618 Developing Optical Sensors with Application of Cancer Detection by Elastic Light Scattering Spectroscopy

Authors: May Fadheel Estephan, Richard Perks

Abstract:

Context: Cancer is a serious health concern that affects millions of people worldwide. Early detection and treatment are essential for improving patient outcomes. However, current methods for cancer detection have limitations, such as low sensitivity and specificity. Research Aim: The aim of this study was to develop an optical sensor for cancer detection using elastic light scattering spectroscopy (ELSS). ELSS is a noninvasive optical technique that can be used to characterize the size and concentration of particles in a solution. Methodology: An optical probe was fabricated with a 100-μm-diameter core and a 132-μm centre-to-centre separation. The probe was used to measure the ELSS spectra of polystyrene spheres with diameters of 2, 0.8, and 0.413 μm. The spectra were then analysed to determine the size and concentration of the spheres. Findings: The results showed that the optical probe was able to differentiate between the three different sizes of polystyrene spheres. The probe was also able to detect the presence of polystyrene spheres in suspension concentrations as low as 0.01%. Theoretical Importance: The results of this study demonstrate the potential of ELSS for cancer detection. ELSS is a noninvasive technique that can be used to characterize the size and concentration of cells in a tissue sample. This information can be used to identify cancer cells and assess the stage of the disease. Data Collection: The data for this study were collected by measuring the ELSS spectra of polystyrene spheres with different diameters. The spectra were collected using a spectrometer and a computer. Analysis Procedures: The ELSS spectra were analysed using a software program to determine the size and concentration of the spheres. The software program used a mathematical algorithm to fit the spectra to a theoretical model. Question Addressed: The question addressed by this study was whether ELSS could be used to detect cancer cells. The results of the study showed that ELSS could be used to differentiate between different sizes of cells, suggesting that it could be used to detect cancer cells. Conclusion: The findings of this research show the utility of ELSS in the early identification of cancer. ELSS is a noninvasive method for characterizing the number and size of cells in a tissue sample. To determine cancer cells and determine the disease's stage, this information can be employed. Further research is needed to evaluate the clinical performance of ELSS for cancer detection.

Keywords: elastic light scattering spectroscopy, polystyrene spheres in suspension, optical probe, fibre optics

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1617 Building Collapse: Factors and Resisting Mechanisms: A Review of Case Studies

Authors: Genevieve D. Fernandes, Nisha P. Naik

Abstract:

All through the ages in all human civilizations, men have been engaged in construction activity, not only to build their dwellings and house their activities, but also roads, bridges to facilitate means of transport, and communication etc. The main concern in this activity was to ensure safety and reduce the collapse of the buildings and other structures. But even after taking all precautions, it is impossible to guarantee safety and collapse because of several unforeseen reasons like faulty constructions, design errors, overloading, soil liquefaction, gas explosion, material degradation, terrorist attacks and economic factors also contributing to the collapse. It is also uneconomical to design the structure for unforeseen events unless they have a reasonable chance of occurrence. In order to ensure safety and prevent collapse, many guidelines have been framed by local bodies and government authorities in many countries like the United States Department of Defence (DOD), United States General Service Administration (GSA) and Euro-Codes in European Nations. Some other practices are followed to incorporate redundancies in the structure like detailing, ductile designs, tying of elements at particular locations, and provision of hinges and interconnections. It is also to be admitted that a full-proof safe design structure for accidental events cannot be prepared and implemented as it is uneconomical and the chances of such occurrences are less. This paper reviews past case studies of the collapse of structures with the aim of developing an understanding of the collapse mechanism. This study will definitely help to bring about a detailed improvement in the design to maximise the quality of the construction at a minimal cost.

Keywords: unforeseen factors, progressive collapse, collapse resisting mechanisms, column removal scenario

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1616 FSO Performance under High Solar Irradiation: Case Study Qatar

Authors: Syed Jawad Hussain, Abir Touati, Farid Touati

Abstract:

Free-Space Optics (FSO) is a wireless technology that enables the optical transmission of data though the air. FSO is emerging as a promising alternative or complementary technology to fiber optic and wireless radio-frequency (RF) links due to its high-bandwidth, robustness to EMI, and operation in unregulated spectrum. These systems are envisioned to be an essential part of future generation heterogeneous communication networks. Despite the vibrant advantages of FSO technology and the variety of its applications, its widespread adoption has been hampered by rather disappointing link reliability for long-range links due to atmospheric turbulence-induced fading and sensitivity to detrimental climate conditions. Qatar, with modest cloud coverage, high concentrations of airborne dust and high relative humidity particularly lies in virtually rainless sunny belt with a typical daily average solar radiation exceeding 6 kWh/m2 and 80-90% clear skies throughout the year. The specific objective of this work is to study for the first time in Qatar the effect of solar irradiation on the deliverability of the FSO Link. In order to analyze the transport media, we have ported Embedded Linux kernel on Field Programmable Gate Array (FPGA) and designed a network sniffer application that can run into FPGA. We installed new FSO terminals and configure and align them successively. In the reporting period, we carry out measurement and relate them to weather conditions.

Keywords: free space optics, solar irradiation, field programmable gate array, FSO outage

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1615 Efficacy of Technology for Successful Learning Experience; Technology Supported Model for Distance Learning: Case Study of Botho University, Botswana

Authors: Ivy Rose Mathew

Abstract:

The purpose of this study is to outline the efficacy of technology and the opportunities it can bring to implement a successful delivery model in Distance Learning. Distance Learning has proliferated over the past few years across the world. Some of the current challenges faced by current students of distance education include lack of motivation, a sense of isolation and a need for greater and improved communication. Hence the author proposes a creative technology supported model for distance learning exactly mirrored on the traditional face to face learning that can be adopted by distance learning providers. This model suggests the usage of a range of technologies and social networking facilities, with the aim of creating a more engaging and sustaining learning environment to help overcome the isolation often noted by distance learners. While discussing the possibilities, the author also highlights the complexity and practical challenges of implementing such a model. Design/methodology/approach: Theoretical issues from previous research related to successful models for distance learning providers will be considered. And also the analysis of a case study from one of the largest private tertiary institution in Botswana, Botho University will be included. This case study illustrates important aspects of the distance learning delivery model and provides insights on how curriculum development is planned, quality assurance is done, and learner support is assured for successful distance learning experience. Research limitations/implications: While some of the aspects of this study may not be applicable to other contexts, a number of new providers of distance learning can adapt the key principles of this delivery model.

Keywords: distance learning, efficacy, learning experience, technology supported model

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1614 Contemporary Art of Healing: New Generation of Shamanism Ritual

Authors: Yeaeun Jang

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Shamanism, in general, has been steadily reinterpreted as research and art from cult, superstition, mysticism, and historical perspectives. Shamanism has existed throughout the five-thousand-year-old history of Korea, and it still actively is ongoing. It is interesting to observe how this tradition has had a profound impact on its current high-technology society. Many still ask Shamans for pieces of advice rituals for their problems to be solved. Historically, Korean shamanism has a strong connection and many similarities with Mongolian and Eastern Siberian Shamanism. 'God' is 'Nature'. 'Shaman' is a 'Mediator of communication chosen by God' and is a divine being who has entered the mysterious realm by challenging human limitations through harsh training. A shaman in ancient society used to be a leader of a group and entertainer who played various roles; king, counsellor, doctor, singer, dancer, painter, and performer. This artistic research focuses on the Shaman role as an artist with multiple mediums and reconstructing their ancient ritual into multimedia performing art that attempts to deal with traumatic memories in one’s life. This fusion style of contemporary ritual is mainly inspired by ‘Gut(굿)’, Korean Shamanism ritual. This comprehensive art needs several important elements; a shaman, a client, musicians, helpers, and the audience. It is a feast to gather people in a big circle. Nowadays, art has been divided into separate fields and developed, but before, there existed art of Synesthesia, whose boundaries were unclear that were not determined through which medium to express that abstract ideas. Multiple disciplines coexist and harmonise with each other. Studying shamanism ritual as an ancient form of performing art can create a warm, spiritual feast for everyone and remind us about ‘togetherness’.

Keywords: healing, multimedia art, performance art, shamanism, spirituality

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1613 A Design of Elliptic Curve Cryptography Processor based on SM2 over GF(p)

Authors: Shiji Hu, Lei Li, Wanting Zhou, DaoHong Yang

Abstract:

The data encryption, is the foundation of today’s communication. On this basis, how to improve the speed of data encryption and decryption is always a problem that scholars work for. In this paper, we proposed an elliptic curve crypto processor architecture based on SM2 prime field. In terms of hardware implementation, we optimized the algorithms in different stages of the structure. In finite field modulo operation, we proposed an optimized improvement of Karatsuba-Ofman multiplication algorithm, and shorten the critical path through pipeline structure in the algorithm implementation. Based on SM2 recommended prime field, a fast modular reduction algorithm is used to reduce 512-bit wide data obtained from the multiplication unit. The radix-4 extended Euclidean algorithm was used to realize the conversion between affine coordinate system and Jacobi projective coordinate system. In the parallel scheduling of point operations on elliptic curves, we proposed a three-level parallel structure of point addition and point double based on the Jacobian projective coordinate system. Combined with the scalar multiplication algorithm, we added mutual pre-operation to the point addition and double point operation to improve the efficiency of the scalar point multiplication. The proposed ECC hardware architecture was verified and implemented on Xilinx Virtex-7 and ZYNQ-7 platforms, and each 256-bit scalar multiplication operation took 0.275ms. The performance for handling scalar multiplication is 32 times that of CPU(dual-core ARM Cortex-A9).

Keywords: Elliptic curve cryptosystems, SM2, modular multiplication, point multiplication.

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1612 The Integration of ICT in EFL Classroom and Its Impact on Teacher Development

Authors: Tayaa Karima, Bouaziz Amina

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Today's world is knowledge-based; everything we do is somehow connected with technology which it has a remarkable influence on socio-cultural and economic developments, including educational settings. This type of technology is supported in many teaching/learning setting where the medium of instruction is through computer technology, and particularly involving digital technologies. There has been much debate over the use of computers and the internet in foreign language teaching for more than two decades. Various studies highlights that the integration of Information Communications Technology (ICT) in foreign language teaching will have positive effects on both the teachers and students to help them be aware of the modernized world and meet the current demands of the globalised world. Information and communication technology has been gradually integrated in foreign learning environment as a platform for providing learners with learning opportunities. Thus, the impact of ICT on language teaching and learning has been acknowledged globally, this is because of the fundamental role that it plays in the enhancement of teaching and learning quality, modify the pedagogical practice, and motivate learners. Due to ICT related developments, many Maghreb countries regard ICT as a tool for changes and innovations in education. Therefore, the ministry of education attempted to set up computer laboratories and provide internet connection in the schools. Investment in ICT for educational innovations and improvement purposes has been continuing the need of teacher who will employ it in the classroom as vital role of the curriculum. ICT does not have an educational value in itself, but it becomes precious when teachers use it in learning and teaching process. This paper examines the impacts of ICT on teacher development rather than on teaching quality and highlights some challenges facing using ICT in the language learning/teaching.

Keywords: information communications technology (ICT), integration, foreign language teaching, teacher development, learning opportunity

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1611 Self Help Groups among the Ao Nagas : A Case Study of Alongkima of Nagaland, NorthEast India

Authors: Imkongtenla Pongen

Abstract:

Self Help Groups (SGHs) are socio-commercial instruments in addressing urban poverty and strengthening livelihoods. Being a member of Self Help Group helped in mutual exchanges of ideas, develop risk taking behaviour, learns flexibility in planning of a programme, and interpersonal communication within the group. In the present study, an attempt has been made to examine the functions, characteristics and practices of Self Help Groups and its impact on sustainable development among the Ao Nagas of Alongkima, Nagaland, NorthEast India. They are a tribal group and racially belong to the Mongoloid stock and linguistically to the Tibeto-Burman group. They follow endogamous, patriarchal, and patrilineal system. Major characteristics of Self Help groups in this study are found to be team spirit and group cohesiveness. Such groups are found to be geared towards a number of self-sufficiency based business ventures. The problems faced in normal functioning of the groups are unpunctuality and the inability to attend a meeting by all the members .Participation in such groups has increased women’s influence over the economic resources and decision making in the household, improved self-confidence and living standard, capacity building, self- dependent and self-reliant with no educational and entrepreneurial background, generate savings and hone their skills as motivators and leaders. All these has enhanced her status in every sphere of life in par with the opposite gender. In a nutshell, we can say that what she cannot achieve as an individual, she can achieve as a member of a Self Help Group. Hence, we should try to develop mechanisms to guarantee the sustainability of Self Help Groups which depends on the way they can deal with both internal and external conflicts like globalization and competition from new markets.

Keywords: Ao nagas, microfinance, self help group, women empowerment

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1610 The Effectiveness of Blended Learning in Pre-Registration Nurse Education: A Mixed Methods Systematic Review and Met Analysis

Authors: Albert Amagyei, Julia Carroll, Amanda R. Amorim Adegboye, Laura Strumidlo, Rosie Kneafsey

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Introduction: Classroom-based learning has persisted as the mainstream model of pre-registration nurse education. This model is often rigid, teacher-centered, and unable to support active learning and the practical learning needs of nursing students. Health Education England (HEE), a public body of the Department of Health and Social Care, hypothesises that blended learning (BL) programmes may address health system and nursing profession challenges, such as nursing shortages and lack of digital expertise, by exploring opportunities for providing predominantly online, remote-access study which may increase nursing student recruitment, offering alternate pathways to nursing other than the traditional classroom route. This study will provide evidence for blended learning strategies adopted in nursing education as well as examine nursing student learning experiences concerning the challenges and opportunities related to using blended learning within nursing education. Objective: This review will explore the challenges and opportunities of BL within pre-registration nurse education from the student's perspective. Methods: The search was completed within five databases. Eligible studies were appraised independently by four reviewers. The JBI-convergent segregated approach for mixed methods review was used to assess and synthesize the data. The study’s protocol has been registered with the International Register of Systematic Reviews with registration number// PROSPERO (CRD42023423532). Results: Twenty-seven (27) studies (21 quantitative and 6 qualitative) were included in the review. The study confirmed that BL positively impacts nursing students' learning outcomes, as demonstrated by the findings of the meta-analysis and meta-synthesis. Conclusion: The review compared BL to traditional learning, simulation, laboratory, and online learning on nursing students’ learning and programme outcomes as well as learning behaviour and experience. The results show that BL could effectively improve nursing students’ knowledge, academic achievement, critical skills, and clinical performance as well as enhance learner satisfaction and programme retention. The review findings outline that students’ background characteristics, BL design, and format significantly impact the success of the BL nursing programme.

Keywords: nursing student, blended learning, pre-registration nurse education, online learning

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1609 Population Pharmacokinetics of Levofloxacin and Moxifloxacin, and the Probability of Target Attainment in Ethiopian Patients with Multi-Drug Resistant Tuberculosis

Authors: Temesgen Sidamo, Prakruti S. Rao, Eleni Akllilu, Workineh Shibeshi, Yumi Park, Yong-Soon Cho, Jae-Gook Shin, Scott K. Heysell, Stellah G. Mpagama, Ephrem Engidawork

Abstract:

The fluoroquinolones (FQs) are used off-label for the treatment of multidrug-resistant tuberculosis (MDR-TB), and for evaluation in shortening the duration of drug-susceptible TB in recently prioritized regimens. Within the class, levofloxacin (LFX) and moxifloxacin (MXF) play a substantial role in ensuring success in treatment outcomes. However, sub-therapeutic plasma concentrations of either LFX or MXF may drive unfavorable treatment outcomes. To the best of our knowledge, the pharmacokinetics of LFX and MXF in Ethiopian patients with MDR-TB have not yet been investigated. Therefore, the aim of this study was to develop a population pharmacokinetic (PopPK) model of levofloxacin (LFX) and moxifloxacin (MXF) and assess the percent probability of target attainment (PTA) as defined by the ratio of the area under the plasma concentration-time curve over 24-h (AUC0-24) and the in vitro minimum inhibitory concentration (MIC) (AUC0-24/MIC) in Ethiopian MDR-TB patients. Steady-state plasma was collected from 39 MDR-TB patients enrolled in the programmatic treatment course and the drug concentrations were determined using optimized liquid chromatography-tandem mass spectrometry. In addition, the in vitro MIC of the patients' pretreatment clinical isolates was determined. PopPK and simulations were run at various doses, and PK parameters were estimated. The effect of covariates on the PK parameters and the PTA for maximum mycobacterial kill and resistance prevention was also investigated. LFX and MXF both fit in a one-compartment model with adjustments. The apparent volume of distribution (V) and clearance (CL) of LFX were influenced by serum creatinine (Scr), whereas the absorption constant (Ka) and V of MXF were influenced by Scr and BMI, respectively. The PTA for LFX maximal mycobacterial kill at the critical MIC of 0.5 mg/L was 29%, 62%, and 95% with the simulated 750 mg, 1000 mg, and 1500 mg doses, respectively, whereas the PTA for resistance prevention at 1500 mg was only 4.8%, with none of the lower doses achieving this target. At the critical MIC of 0.25 mg/L, there was no difference in the PTA (94.4%) for maximum bacterial kill among the simulated doses of MXF (600 mg, 800 mg, and 1000 mg), but the PTA for resistance prevention improved proportionately with dose. Standard LFX and MXF doses may not provide adequate drug exposure. LFX PopPK is more predictable for maximum mycobacterial kill, whereas MXF's resistance prevention target increases with dose. Scr and BMI are likely to be important covariates in dose optimization or therapeutic drug monitoring (TDM) studies in Ethiopian patients.

Keywords: population PK, PTA, moxifloxacin, levofloxacin, MDR-TB patients, ethiopia

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1608 Transforming Healthcare with Immersive Visualization: An Analysis of Virtual and Holographic Health Information Platforms

Authors: Hossein Miri, Zhou YongQi, Chan Bormei-Suy

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The development of advanced technologies and innovative solutions has opened up exciting new possibilities for revolutionizing healthcare systems. One such emerging concept is the use of virtual and holographic health information platforms that aim to provide interactive and personalized medical information to users. This paper provides a review of notable virtual and holographic health information platforms. It begins by highlighting the need for information visualization and 3D representation in healthcare. It then proceeds to provide background knowledge on information visualization and historical developments in 3D visualization technology. Additional domain knowledge concerning holography, holographic computing, and mixed reality is then introduced, followed by highlighting some of their common applications and use cases. After setting the scene and defining the context, the need and importance of virtual and holographic visualization in medicine are discussed. Subsequently, some of the current research areas and applications of digital holography and holographic technology are explored, alongside the importance and role of virtual and holographic visualization in genetics and genomics. An analysis of the key principles and concepts underlying virtual and holographic health information systems is presented, as well as their potential implications for healthcare are pointed out. The paper concludes by examining the most notable existing mixed-reality applications and systems that help doctors visualize diagnostic and genetic data and assist in patient education and communication. This paper is intended to be a valuable resource for researchers, developers, and healthcare professionals who are interested in the use of virtual and holographic technologies to improve healthcare.

Keywords: virtual, holographic, health information platform, personalized interactive medical information

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1607 In vitro and in vivo Infectivity of Coxiella burnetii Strains from French Livestock

Authors: Joulié Aurélien, Jourdain Elsa, Bailly Xavier, Gasqui Patrick, Yang Elise, Leblond Agnès, Rousset Elodie, Sidi-Boumedine Karim

Abstract:

Q fever is a worldwide zoonosis caused by the gram-negative obligate intracellular bacterium Coxiella burnetii. Following the recent outbreaks in the Netherlands, a hyper virulent clone was found to be the cause of severe human cases of Q fever. In livestock, Q fever clinical manifestations are mainly abortions. Although the abortion rates differ between ruminant species, C. burnetii’s virulence remains understudied, especially in enzootic areas. In this study, the infectious potential of three C. burnetii isolates collected from French farms of small ruminants were compared to the reference strain Nine Mile (in phase II and in an intermediate phase) using an in vivo (CD1 mice) model. Mice were challenged with 105 live bacteria discriminated by propidium monoazide-qPCR targeting the icd-gene. After footpad inoculation, spleen and popliteal lymph node were harvested at 10 days post-inoculation (p.i). The strain invasiveness in spleen and popliteal nodes was assessed by qPCR assays targeting the icd-gene. Preliminary results showed that the avirulent strains (in phase 2) failed to pass the popliteal barrier and then to colonize the spleen. This model allowed a significant differentiation between strain’s invasiveness on biological host and therefore identifying distinct virulence profiles. In view of these results, we plan to go further by testing fifteen additional C. burnetii isolates from French farms of sheep, goat and cattle by using the above-mentioned in vivo model. All 15 strains display distant MLVA (multiple-locus variable-number of tandem repeat analysis) genotypic profiles. Five of the fifteen isolates will bee also tested in vitro on ovine and bovine macrophage cells. Cells and supernatants will be harvested at day1, day2, day3 and day6 p.i to assess in vitro multiplication kinetics of strains. In conclusion, our findings might help the implementation of surveillance of virulent strains and ultimately allow adapting prophylaxis measures in livestock farms.

Keywords: Q fever, invasiveness, ruminant, virulence

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1606 Effects of Social Stories toward Social Interaction of Students with Autism Spectrum Disorder

Authors: Sawitree Wongkittirungrueang

Abstract:

The objectives of this research were: 1) to study the effect of social stories on social interaction of students with autism. The sample was Pratomsuksa level 5 student with autism, Khon Kaen University Demonstration School, who was diagnosed by the Physician as High Functioning Autism since he was able to read, write, calculate and was studying in inclusive classroom. However, he still had disability in social interaction to participate in social activity group and communication. He could not learn how to develop friendship or create relationship. He had inappropriate behavior in social context. He did not understand complex social situations. In addition, he did seemed not know time and place. He was not able to understand feeling of oneself as well as the others. Consequently, he could not express his emotion appropriately. He did not understand or express his non-verbal language for communicating with friends. He lacked of common interest or emotion with nearby persons. He greeted inappropriately or was not interested in greeting. In addition, he did not have eye contact. He used inadequate language etc. He was elected by Purposive Sampling. His parents were willing to allow them to participate in this study. The research instruments were the lesson plan of social stories, and the picture book of social stories. The instruments used for data collection, were the social interaction evaluation of autistic students. This research was Quasi Experimental Research as One Group Pre-test, Post-test Design. For the Pre-test, the experiment was conducted by social stories. Then, the Post-test was implemented. The statistic used for data analysis, included the Mean, and Standard Deviation. The research findings were shown by Graph. The findings revealed hat the autistic students taught by social stories indicated better social interaction after being taught by social stories.

Keywords: social story, autism spectrum disorder (ASD), autism, social interaction

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1605 Scentscape of the Soul as a Direct Channel of Communication with the Psyche and Physical Body

Authors: Elena Roadhouse

Abstract:

“When it take the kitchen middens from the latest canning session out to the compost before going to bed, the orchestra is in full chorus. Night vapors and scents from the earth mingle with the fragrance of honeysuckle nearby and basil grown in the compost. They merge into the rhythmic pulse of night”. William Longgood Carl Jung did not specifically recognize scent and olfactory function as a window into the psyche. He did recognize instinct and the natural history of mankind as key to understanding and reconnecting with the Psyche. The progressive path of modern humans has brought incredible scientific and industrial advancements that have changed the human relationship with Mother Earth, the primal wisdom of mankind, and led to the loss of instinct. The olfactory bulbs are an integral part of our ancient brain and has evolved in a way that is proportional to the human separation with the instinctual self. If olfaction is a gateway to our instinct, then it is also a portal to the soul. Natural aromatics are significant and powerful instruments for supporting the mind, our emotional selves, and our bodies. This paper aims to shed light on the important role of scent in the understanding of the existence of the psyche, generational trauma, and archetypal fragrance. Personalized Natural Perfume combined with mindfulness practices can be used as an effective behavioral conditioning tool to promote the healing of transgenerational and individual trauma, the fragmented self, and the physical body.

Keywords: scentscape of the soul, psyche, individuation, epigenetics, depth psychology, carl Jung, instinct, trauma, archetypal scent, personal myth, holistic wellness, natural perfumery

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1604 Developing an Instrument to Measure Teachers’ Self-Efficacy of Teaching Innovation Skills

Authors: Huda S. Al-Azmi

Abstract:

There is a growing consensus that adoption of teachers’ self-efficacy measurement tools help to assess teachers’ abilities in specific areas in order to improve their skills. As a result, different instruments to assess teachers’ ability were developed by academics and practitioners. However, many of these instruments focused either on general teaching skills, or on the other hand, were very specific to one subject. As such, these instruments do not offer a tool to measure the ability of teachers in teaching 21st century skills such as innovation skills. Teaching innovation skills helps to prepare students for lives and careers in the 21st century. The purpose of this study is to develop an instrument measuring teachers’ self-efficacy of teaching innovation skills related to the classroom context and evaluating the teachers’ beliefs regarding their ability in teaching innovation skills. To reach this goal, the 16-item instrument measures four dimensions of innovation skills: creativity, critical thinking, communication, and collaboration. 211 secondary-school teachers filled out the survey to quantitatively analyze the quality of the instrument. The instrument’s reliability and item analysis were measured by using jMetrik. The results concluded that the mean of self-efficacy ranged from 3 to 3.6 without extreme high or low self-efficacy scores. The discrimination analysis revealed that one item recorded a negative correlation with the total, and three items recorded low correlation with the total. The reliabilities of items ranged from 0.64 to 0.69 and the instrument needed a couple of revisions before practical use. The study concluded the need to discard one item and revise five items to increase the quality of the instrument for future work.

Keywords: critical thinking, collaboration, innovation skills, self-efficacy

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1603 Effects of Group Cognitive Restructuring and Rational Emotive Behavioral Therapy on Psychological Distress of Awaiting-Trial Inmates in Correctional Centers in North- West, Nigeria

Authors: Muhammad Shafi'u Adamu

Abstract:

This study examined the effects of two Group Cognitive Behavioural Therapies (Cognitive Restructuring and Rational Emotive Behavioural Therapy) on Psychological Distress of awaiting-trial Inmates in Correctional Centres in North-West, Nigeria. The study had four specific objectives, four research questions, and four null hypotheses. The study used a quasi-experimental design that involved pre-test and post-test. The population comprised of all 7,962 awaiting-trial inmates in correctional centres in North-west, Nigeria. 131 awaiting trial inmates from three intact Correctional Centres were randomly selected using the census technique. The respondents were sampled and randomly put into 3 groups (CR, REBT and Control). Kessler Psychological Distress Scale (K10) was adapted for data collection in the study. The instrument was validated by experts and subjected to pilot study using Cronbach's Alpha with reliability co-efficient of 0.772. Each group received treatment for 8 consecutive weeks (60 minutes/week). Data collected from the field were subjected to descriptive statistics of mean, standard deviation and mean difference to answer the research questions. Inferential statistics of ANOVA and independent sample t-test were used to test the null hypotheses at P≤ 0.05 level of significance. Results in the study revealed that there was no significant difference among the pre-treatment mean scores of experimental and control groups. Statistical evidence also showed a significant difference among the mean sores of the three groups, and thus, results of the Post Hoc multiple-comparison test indicating the posttreatment reduction of psychological distress on the awaiting-trial inmates. Documented output also showed a significant difference between the post-treatment psychologically distressed mean scores of male and female awaiting-trial inmates, but there was no difference on those exposed to REBT. The research recommends that a standardized structured CBT counselling technique treatment should be designed for correctional centres across Nigeria, and CBT counselling techniques could be used in the treatment of PD in both correctional and clinical settings.

Keywords: awaiting-trial inmates, cognitive restructuring, correctional centres, group cognitive behavioural therapies, rational emotive behavioural therapy

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1602 Understanding of Malaysian Community Disaster Resilience: Australian Scorecard Adaptation

Authors: Salizar Mohamed Ludin, Mohd Khairul Hasyimi Firdaus, Paul Arbon

Abstract:

Purpose: This paper aims to develop Malaysian Government and community-level critical thinking, planning and action for improving community disaster resilience by reporting Phase 1, Part 1 of a larger community disaster resilience measurement study about adapting the Torrens Resilience Institute Australian Community Disaster Resilience Scorecard to the Malaysian context. Methodology: Pparticipatory action research encouraged key people involved in managing the six most affected areas in the 2014 flooding of Kelantan in Malaysia’s north-east to participate in discussions about adapting and self-testing the Australian Community Disaster Resilience Scorecard to measure and improve their communities’ disaster resilience. Findings: Communities need to strengthen their disaster resilience through better communication, cross-community cooperation, maximizing opportunities to compare their plans, actions and reactions with those reported in research publications, and aligning their community disaster management with reported best practice internationally while acknowledging the need to adapt such practice to local contexts. Research implications: There is a need for a Malaysia-wide, simple-to-use, standardized disaster resilience scorecard to improve the quality, quantity and capability of healthcare and emergency services’ preparedness, and to facilitate urgent reallocation of aid. Value: This study is the first of its kind in Malaysia. The resulting community disaster resilience guideline based on participants’ feedback about the Kelantan floods and scorecard self-testing has the potential for further adaptation to suit contexts across Malaysia, as well as demonstrating how the scorecard can be adapted for international use.

Keywords: community disaster resilience, CDR Scorecard, participatory action research, flooding, Malaysia

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1601 Nursing System Development in Patients Undergoing Operation in 3C Ward

Authors: Darawan Augsornwan, Artitaya Sabangbal, Maneewan Srijan, Kanokarn Kongpitee, Lalida Petphai, Palakorn Surakunprapha

Abstract:

Background: Srinagarind Hospital, Ward 3C, has patients with head and neck cancer, congenital urology anomalies such as hypospadis, cleft lip and cleft palate and congenital megacolon who need surgery. Undergoing surgery is a difficult time for patients/ family; they feel fear and anxiety. Nurses work closely with patients and family for 24 hours in the process of patients care, so should have the good nursing ability, innovation and an efficient nursing care system to promote patients self-care ability reducing suffering and preventing complications. From previous nursing outcomes we found patients did not receive appropriate information, could not take care of their wound, not early ambulation after the operation and lost follow-up. Objective: to develop the nursing system for patients who were undergoing an operation. Method: this is a participation action research. The sample population was 11 nurses and 60 patients. This study was divided into 3 phase: Phase 1. Situation review In this phase we review the clinical outcomes, the process of care from documents such as nurses note and interview nurses, patients and family about the process of care by nurses. Phase 2: focus group with 11 nurses, searching guideline for specific care, nursing care system then establish the protocol. This phase we have the protocol for giving information, teaching protocol and teaching record, leaflet for all of top five diseases, make video media to convey information, ambulation package and protocol for patients with head and neck cancer, patients zoning, primary nurse, improved job description for each staff level. Program to record number of patients, kind of medical procedures for showing nurses activity each day. Phase 3 implementation and evaluation. Result: patients/family receive appropriate information about deep breathing exercise, cough, early ambulation after the operation, information during the stay in the hospital. Patients family satisfaction is 95.04 percent, appropriate job description for a practical nurse, nurse aid, and worker. Nurses satisfaction is 95 percent. The complications can be prevented. Conclusion: the nursing system is the dynamic process using evidence to develop nursing care. The appropriate system depends on context and needs to keep an eye on every event.

Keywords: development, nursing system, patients undergoing operation, 3C Ward

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1600 The International Field Placement: Experience in Vietnam Social Work International Placement Programme

Authors: Ngo Thi Thanh Mai, Nguyen Thu Ha, Frances Crawford

Abstract:

The demand for developing international social work field education is on the rise. Global foreign universities have considered international collaboration and cross-cultural perspective as an essential part of their social work training curriculum. International placement program at Faculty of Social Work (FSW), Hanoi National University of Education (HNUE) has met the need of international social work students, as well as the institutions involved in achieving social work professional social work knowledge in the Vietnamese context. This program has also lead to a long-term collaboration between HNUE and several global institutions in developing social work education, research and practice skill. This paper focuses on the benefits and challenges of students who involved in the global placement programme at Faculty of Social Work (FSW), Hanoi National University of Education (HNUE) and content of international field education provided to the international students based on the experience of the authors. Study results indicated that the participants have opportunity them to explore a new culture and social work system abroad especially in the Vietnamese context. However, there are still difficulties that international students have to face during different phases of the exchange process such as language and communication barriers, cultural value differences, insufficient support and supervision during placement. Basing on these results, the authors intend to propose some recommendations to enhance the programme activities such as pre-departure orientation, support and supervision during placement, cultural exchange and follow-up activities.

Keywords: social work education, social work, international placement, field placement, Vietnam

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1599 A Survey of WhatsApp as a Tool for Instructor-Learner Dialogue, Learner-Content Dialogue, and Learner-Learner Dialogue

Authors: Ebrahim Panah, Muhammad Yasir Babar

Abstract:

Thanks to the development of online technology and social networks, people are able to communicate as well as learn. WhatsApp is a popular social network which is growingly gaining popularity. This app can be used for communication as well as education. It can be used for instructor-learner, learner-learner, and learner-content interactions; however, very little knowledge is available on these potentials of WhatsApp. The current study was undertaken to investigate university students’ perceptions of WhatsApp used as a tool for instructor-learner dialogue, learner-content dialogue, and learner-learner dialogue. The study adopted a survey approach and distributed the questionnaire developed by Google Forms to 54 (11 males and 43 females) university students. The obtained data were analyzed using SPSS version 20. The result of data analysis indicates that students have positive attitudes towards WhatsApp as a tool for Instructor-Learner Dialogue: it easy to reach the lecturer (4.07), the instructor gives me valuable feedback on my assignment (4.02), the instructor is supportive during course discussion and offers continuous support with the class (4.00). Learner-Content Dialogue: WhatsApp allows me to academically engage with lecturers anytime, anywhere (4.00), it helps to send graphics such as pictures or charts directly to the students (3.98), it also provides out of class, extra learning materials and homework (3.96), and Learner-Learner Dialogue: WhatsApp is a good tool for sharing knowledge with others (4.09), WhatsApp allows me to academically engage with peers anytime, anywhere (4.07), and we can interact with others through the use of group discussion (4.02). It was also found that there are significant positive correlations between students’ perceptions of Instructor-Learner Dialogue (ILD), Learner-Content Dialogue (LCD), Learner-Learner Dialogue (LLD) and WhatsApp Application in classroom. The findings of the study have implications for lectures, policy makers and curriculum developers.

Keywords: instructor-learner dialogue, learners-contents dialogue, learner-learner dialogue, whatsapp application

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1598 Assessment of the Implementation of Recommended Teaching and Evaluation Methods of NCE Arabic Language Curriculum in Colleges of Education in North Western Nigeria

Authors: Hamzat Shittu Atunnise

Abstract:

This study on Assessment of the Implementation of Recommended Teaching and Evaluation Methods of the Nigeria Certificate in Education (NCE) Arabic Language Curriculum in Colleges of Education in North Western Nigeria was conducted with four objectives, four research questions and four null hypotheses. Descriptive survey design was used and the multistage sampling procedure adopted. Frequency count and percentage were used to answer research questions and chi-square was used to test all the null hypotheses at an Alpha 0.05 level of significance. Two hundred and ninety one subjects were drawn as sample. Questionnaires were used for data collection. The Context, Input, Process and Product (CIPP) model of evaluation was employed. The study findings indicated that: there were no significant difference in the perceptions of lecturers and students from Federal and State Colleges of Education on the following: extent of which lecturers employ appropriate methods in teaching the language and extent of which recommended evaluation methods are utilized for the implementation of Arabic Curriculum. Based on these findings, it was recommended among other things that: lecturers should adopt teaching methodologies that promote interactive learning; Governments should ensure that information and communication technology facilities are made available and usable in all Colleges of Education; Lecturers should vary their evaluation methods because other methods of evaluation can meet and surpass the level of learning and understanding which essay type questions are believed to create and that language labs should be used in teaching Arabic in Colleges of Education because comprehensive language learning is possible through both classroom and language lab teaching.

Keywords: assessment, arabic language, curriculum, methods of teaching, evaluation methods, NCE

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1597 BLS-2/BSL-3 Laboratory for Diagnosis of Pathogens on the Colombia-Ecuador Border Region: A Post-COVID Commitment to Public Health

Authors: Anderson Rocha-Buelvas, Jaqueline Mena Huertas, Edith Burbano Rosero, Arsenio Hidalgo Troya, Mauricio Casas Cruz

Abstract:

COVID-19 is a disruptive pandemic for the public health and economic system of whole countries, including Colombia. Nariño Department is the southwest of the country and draws attention to being on the border with Ecuador, constantly facing demographic transition affecting infections between countries. In Nariño, the early routine diagnosis of SARS-CoV-2, which can be handled at BSL-2, has affected the transmission dynamics of COVID-19. However, new emerging and re-emerging viruses with biological flexibility classified as a Risk Group 3 agent can take advantage of epidemiological opportunities, generating the need to increase clinical diagnosis, mainly in border regions between countries. The overall objective of this project was to assure the quality of the analytical process in the diagnosis of high biological risk pathogens in Nariño by building a laboratory that includes biosafety level (BSL)-2 and (BSL)-3 containment zones. The delimitation of zones was carried out according to the Verification Tool of the National Health Institute of Colombia and following the standard requirements for the competence of testing and calibration laboratories of the International Organization for Standardization. This is achieved by harmonization of methods and equipment for effective and durable diagnostics of the large-scale spread of highly pathogenic microorganisms, employing negative-pressure containment systems and UV Systems in accordance with a finely controlled electrical system and PCR systems as new diagnostic tools. That increases laboratory capacity. Protection in BSL-3 zones will separate the handling of potentially infectious aerosols within the laboratory from the community and the environment. It will also allow the handling and inactivation of samples with suspected pathogens and the extraction of molecular material from them, allowing research with pathogens with high risks, such as SARS-CoV-2, Influenza, and syncytial virus, and malaria, among others. The diagnosis of these pathogens will be articulated across the spectrum of basic, applied, and translational research that could receive about 60 daily samples. It is expected that this project will be articulated with the health policies of neighboring countries to increase research capacity.

Keywords: medical laboratory science, SARS-CoV-2, public health surveillance, Colombia

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1596 Using a Phenomenological Approach to Explore the Experiences of Nursing Students in Coping with Their Emotional Responses in Caring for End-Of-Life Patients

Authors: Yun Chan Lee

Abstract:

Background: End-of-life care is a large area of all nursing practice and student nurses are likely to meet dying patients in many placement areas. It is therefore important to understand the emotional responses and coping strategies of student nurses in order for nursing education systems to have some appreciation of how nursing students might be supported in the future. Methodology: This research used a qualitative phenomenological approach. Six student nurses understanding a degree-level adult nursing course were interviewed. Their responses to questions were analyzed using interpretative phenomenological analysis. Finding: The findings identified 3 main themes. First, the common experience of ‘unpreparedness’. A very small number of participants felt that this was unavoidable and that ‘no preparation is possible’, the majority felt that they were unprepared because of ‘insufficient input’ from the university and as a result of wider ‘social taboos’ around death and dying. The second theme showed that emotions were affected by ‘the personal connection to the patient’ and the important sub-themes of ‘the evoking of memories’, ‘involvement in care’ and ‘sense of responsibility’. The third theme, the coping strategies used by students, seemed to fall into two broad areas those ‘internal’ with the student and those ‘external’. In terms of the internal coping strategies, ‘detachment’, ‘faith’, ‘rationalization’ and ‘reflective skills’ are the important components of this part. Regarding the external coping strategies, ‘clinical staff’ and ‘the importance of family and friends’ are the importance of accessing external forms of support. Implication: It is clear that student nurses are affected emotionally by caring for dying patients and many of them have apprehension even before they begin on their placements but very often this is unspoken. Those anxieties before the placement become more pronounced during and continue after the placements. This has implications for when support is offered and possibly its duration. Another significant point of the study is that participants often highlighted their wish to speak to qualified nurses after their experiences of being involved in end-of-life care and especially when they had been present at the time of death. Many of the students spoke that qualified nurses were not available to them. This seemed to be due to a number of reasons. Because the qualified nurses were not available, students had to make use of family members and friends to talk to. Consequently, the implication of this study is not only to educate student nurses but also to educate the qualified mentors on the importance of providing emotional support to students.

Keywords: nursing students, coping strategies, end-of-life care, emotional responses

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