Search results for: medical students

Authors: Kwaku Damoah

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This paper presents a methodology and software application (App) designed to empower users in accessing, retrieving, and comparatively exploring data within the hierarchical network framework of the Government Finance Statistics (GFS) system. It explores the ease of navigating the GFS system and identifies the gaps filled by the new methodology and App. The GFS, embodies a complex Hierarchical Network Classification (HNC) structure, encapsulating institutional units, revenues, expenses, assets, liabilities, and economic activities. Navigating this structure demands specialized knowledge, experience, and skill, posing a significant challenge for effective analytics and fiscal policy decision-making. Many professionals encounter difficulties deciphering these classifications, hindering confident utilization of the system. This accessibility barrier obstructs a vast number of professionals, students, policymakers, and the public from leveraging the abundant data and information within the GFS. Leveraging R programming language, Data Science Analytics and Machine Learning, an efficient methodology enabling users to access, navigate, and conduct exploratory comparisons was developed. The machine learning Fiscal Analytics App (FLOWZZ) democratizes access to advanced analytics through its user-friendly interface, breaking down expertise barriers.

Keywords: data science, data wrangling, drilldown analytics, government finance statistics, hierarchical network classification, machine learning, web application.

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Authors: Chenyao Shen, Jie Shen

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The rating system provides an effective framework for assessing building environmental performance and integrating sustainable development into building and construction processes; as it can be used as a design tool by developing appropriate sustainable design strategies and determining performance measures to guide the sustainable design and decision-making processes. Healthcare buildings are resource (water, energy, etc.) intensive. To maintain high-cost operations and complex medical facilities, they require a great deal of hazardous and non-hazardous materials, stringent control of environmental parameters, and are responsible for producing polluting emission. Compared with other types of buildings, the impact of healthcare buildings on the full cycle of the environment is particularly large. With broad recognition among designers and operators that energy use can be reduced substantially, many countries have set up their own green rating systems for healthcare buildings. There are four main green healthcare building evaluation systems widely acknowledged in the world - Green Guide for Health Care (GGHC), which was jointly organized by the United States HCWH and CMPBS in 2003; BREEAM Healthcare, issued by the British Academy of Building Research (BRE) in 2008; the Green Star-Healthcare v1 tool, released by the Green Building Council of Australia (GBCA) in 2009; and LEED Healthcare 2009, released by the United States Green Building Council (USGBC) in 2011. In addition, the German Association of Sustainable Building (DGNB) has also been developing the German Sustainable Building Evaluation Criteria (DGNB HC). In China, more and more scholars and policy makers have recognized the importance of assessment of sustainable development, and have adapted some tools and frameworks. China’s first comprehensive assessment standard for green building (the GBTs) was issued in 2006 (lately updated in 2014), promoting sustainability in the built-environment and raise awareness of environmental issues among architects, engineers, contractors as well as the public. However, healthcare building was not involved in the evaluation system of GBTs because of its complex medical procedures, strict requirements of indoor/outdoor environment and energy consumption of various functional rooms. Learn from advanced experience of GGHC, BREEAM, and LEED HC above, China’s first assessment criteria for green hospital/healthcare buildings was finally released in December 2015. Combined with both quantitative and qualitative assessment criteria, the standard highlight the differences between healthcare and other public buildings in meeting the functional needs for medical facilities and special groups. This paper has focused on the assessment criteria framework for sustainable healthcare buildings, for which the comparison of different rating systems is rather essential. Descriptive analysis is conducted together with the cross-matrix analysis to reveal rich information on green assessment criteria in a coherent manner. The research intends to know whether the green elements for healthcare buildings in China are different from those conducted in other countries, and how to improve its assessment criteria framework.

Keywords: assessment criteria framework, green building design, healthcare building, building performance rating tool

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Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi

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Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.

Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery

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Authors: J. A. López, J. E. Olguín, C. W. Camargo, G. A. Quijano, R. Martínez

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This paper presents an anthropometric study conducted to 300 employees in a maquiladora industry that belongs to the cluster of medical products as part of a research project to pretend simulate workplace conditions under which operators conduct their activities. This project is relevant because traditionally performed a study to design ergonomic workspaces according to anthropometric profile of users, however, this paper demonstrates the importance of making decisions when the infrastructure cannot be adapted for economic whichever put emphasis on user activity.

Keywords: anthropometry, biomechanics, design, ergonomics, productivity

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Authors: Oluwole Victor Falobi, Lawrence Olusola Ige

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The cardinal drawing force of this study is to examine the influence of audio-visual resources in teaching business subjects in selected secondary schools in IfakoIjaiye Local Government Area of Lagos State, Nigeria. A descriptive survey research design was employed for the study. By using a quantitative research approach and a sample size of 120 students were randomly selected from four public schools. Three research questions with one hypothesis guided the study. Data collected were analysed using frequency, the mean and standard deviation for the research questions, and Pearson Product Moment Correlation PPMC were used to analysed the inferential statistic. Findings from the study revealed that the Influence of audio-visual resources in teaching business subjects in selected secondary schools in IfakoIjaiye Local Government Area of Lagos State is low. It further revealed data the knowledge of teachers on the use of audio-visual resources is high in Ifako Local Government Area. It was recommended that government should create a timely monitoring system in other to check secondary school laboratories and classrooms to replace outdated facilities and also purchase needed facilities for effective teaching and learning to take place.

Keywords: audio-visual resources, business subjects, school, teaching

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Authors: Tamara Roma, Emma Capulli

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Pregnancy and fertility, in other words, reproduction, has become, in the last half of the century, increasingly and globally controlled, medicalized, and regulated. The reflection proposed starts from the consequences of the inscription of reproduction into the neoliberal economic paradigm. The new biotechnologies developments have raised a new patriarchal justification for State’s control of uterus bodies and a new construction of knowledge about reproductive health. Moral discussion and juridification remove reproduction and non-reproduction from their personal and intimate context and frame them under words like “duties”, “rights”, “family planning”, “demography”, and “population policy”, reinvent them as “States business” and ultimately help to re/confirm a specific construct of fertility, motherhood, and family. Moreover, the interaction between the neoliberal economy and medical biotechnologies brought about a new formulation of the connection between feminine generative potential and value production. The widespread and contemporary debates on Medically Assisted Reproduction (MAR), surrogacy and abortion suggest the need for a “feminist/queer global bioethical discourse” capable of inserting itself into the official bioethical debate characterized by the traditional dichotomy of laic bioethics/Catholic bioethics. The contribution moves from a feminist bioethics perspective on reproductive technologies to introduce a feminist/queer global bioethics point of view on reproductive health. The comparison between reproduction and non-reproduction debates is useful to analyze and demonstrate how restrictive legislations, dichotomic bioethical discussion and medical control confirm and strengthens gender injustice in reproductive life. In fact, MAR, surrogacy, and abortion restrictions stem from a shared social and legal paradigm that depends on traditional gender roles revealing how the stratification of reproduction is based on multiple discrimination along the lines of gender, race, and class. In conclusion, the perspective of feminist/queer global bioethics tries to read the concept of universal reproductive justice, introducing an original point of view on reproductive health access.

Keywords: queer bioethics, reproductive health, reproductive justice, reproductive technologies

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Authors: Alessandra Marino

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This paper thoroughly investigates the design characteristics necessary for intergenerational living and evaluates their applicability within the Italian social panorama in order to identify a model that can serve as a reference for subsequent regulatory adjustments of a new building typology. The applied methodology involves the collaboration of people with various background and architects, all representing the three main ages of life - childhood or youth, adulthood, seniority - through questionnaires aimed at researching the peculiar characteristics that contemporary intergenerational housing should include; the questionnaires are then compared with each other in order to identify any recurring patterns by age group and/or influenced by the specialist knowledge on the subject of the architects compared to the rest of the user sample. The results indicate that among specialist users in the field of architecture, young students identify home automation as the key to the inclusion of the weakest groups within the building, adult architects believe that the identification of intergenerational/community services within the building is the cornerstone, and senior architects focus on widespread spatial accessibility. At the same time, the results among non-specialist users do not identify a significantly diversified model by age group but are generally in agreement in the importance of separation between private environments and collective spaces. The interpretation of the results obtained leads to a compositional study of a new building typology with the future objective of channeling the subsequent outcomes within the regulatory adjustments of the sector.

Keywords: intergenerational living, social sustainability, health, lifestyle, well-being

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Authors: Courtley Pharaoh, D. J. Visser

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University management is often caught between competing interests from stakeholders like students, trustees, donors, government and the community it serves. This study aimed to identify what management competencies are required by executive management members of universities of technology to effectively manage a university of technology in South Africa from the perspective of the executive management members. This exploratory study will make use of a qualitative methodology to establish what management competencies are deemed as important to manage a university of technology in South Africa from the executive management perspective. Due to the consequences of the COVID-19 Pandemic, the study made use of online face-to-face interviews to ascertain from executive management members of universities of technology what the required management competencies needed by executive management members of universities of technology to effectively manage a University of Technology in South Africa. Qualitative Content Analysis was used to analyse the data collected. The findings of the study identified a total of 26 management competencies which were categorised into three groupings or themes. This study identified a list of required management competencies needed by executive management members of universities of technology to effectively manage a university of technology in South Africa, as per the lived experience of executive management members. The researcher recommends further studies at traditional and comprehensive universities and compares the results of those future studies with the results of this study. A comprehensive list of management competencies could then be identified, which could assist with the compilation of job descriptions of executive management members of universities in South Africa.

Keywords: university of technology, management competencies, executive management, executive management members, important

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Authors: Abdul Rahim Razalli, Nordin Mamat, Lee Kean Low

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The objective of the study is to examine the acquisition of Bahasa Melayu hand coded and Malaysian Sign Language of hearing impaired children and the factors that influencing the acquisition of Malay language at early intervention. A qualitative research design was chosen to answer two research questions. Two sets of instruments have been used to obtain information of proficiency and factors that influence it. Five children with hearing problems, four teachers and three parents were selected as the respondents through purposive sampling technique. The findings show that pupils with hearing problems who mastered Bahasa Melayu hand coded have better acquisition of Bahasa Melayu as compared to those who acquired Malaysian Sign Language. The study also found that the parents, pupils, teachers and environmental factors have an impact on the acquisition of Bahasa Melayu hand coded. The implications of this study show that early intervention of Bahasa Melayu hand coded and the parents, pupils, teachers and environmental factors do help in the language proficiency of children with hearing problems. A more comprehensive study should be undertaken at a higher level to see the impact on an early intervention program for Malay language acquisition of hearing impaired children.

Keywords: Bahasa Melayu hand coded, Malaysian sign Language, hearing impaired children, early intervention

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Authors: Debangana Mukherjee

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This study delves into the pivotal role of parenting styles in shaping the development of aggression and empathy in children aged 10 to 12. Using a sample of 300 school students, we employed self-assessment questionnaires and scales to investigate correlations between parenting styles—authoritative, authoritarian, permissive, and neglectful—and behavioural traits, focusing on aggression and empathy as primary outcomes. The findings underscore the intricate relationships between parenting styles, aggressive behaviours, and empathetic tendencies. Notably, certain parenting approaches demonstrated strong correlations with specific behavioural outcomes. For instance, authoritarian parenting showed associations with increased aggression and reduced empathy, while authoritative parenting exhibited the opposite trend. These correlations emphasize the potential impact of parenting styles on children's behavioural development during this critical transitional phase. However, this study is limited by its correlational nature, which does not imply causation. The complexities of human behaviour, the limited scope of analysis, and the need for further research into causative relationships and cultural influences call for a nuanced understanding of these dynamics. Moving forward, longitudinal studies, causality investigations, consideration of cultural diversity, and exploration of additional variables could enrich our understanding of the interplay between parenting styles, empathy, and aggression. Validating these findings across diverse populations and refining interventions could pave the way for nurturing healthy behavioural development in children.

Keywords: aggression, correlational nature, empathy, longitudinal studies, parenting style

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Authors: Asif Khaliq, Sayeeda A. Sayed

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The drug information centers provide drug related information to the requesters that include physicians, pharmacist, nurses and other allied health care professionals. The International Pharmacist Federation (FIP) describes basic functions of a drug and poison information centers as drug evaluation, therapeutic counseling, pharmaceutical advice, research, pharmaco-vigilence and toxicology. Continuous advancement in the field of medicine has expanded the medical literature, which has increased demand of a drug and poison information center for the guidance, support and facilitation of physicians. The objective of the study is to determine the need of drug and poison information centers in public and private hospitals of Karachi, Pakistan. A cross sectional study was conducted during July 2013 to April 2014 using a self-administered, multi-itemed questionnaire. Non Probability Convenient sampling was used to select the study participants. A total of 307 physicians from public and private hospitals of Karachi participated in the study. The need for 24/7 Drug and poison information center was highlighted by 92 % of physicians and 67% physicians suggested opening a drug information center at the hospital. It was reported that 70% physicians take at least 15 minutes for searching the information about the drug while managing a case. Regarding the poisoning case management, 52% physicians complaint about the unavailability of medicines in hospitals; and mentioned the importance of medicines for safe and timely management of patients. Although 73% physicians attended continued medical education (CME) sessions, 92 % physicians insisted on the need of 24/7 Drug and poison information center. The scarcity of organized channel for obtaining the information about drug and poisons is one of the most crucial problems for healthcare workers in Pakistan. The drug and poison information center is an advisory body that assists health care professional and patients in provision of appropriate drug and hazardous substance information. Drug and poison information center is one of the integral needs for running an effective health care system. Provision of a 24 /7 drug information centers with specialized staff offer multiple benefits to the hospitals while reducing treatment delays, addressing awareness gaps of all stakeholders and ensuring provision of quality health care.

Keywords: drug and poison information centers, Pakistan, physicians, public and private hospitals

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Authors: Pooja Booluck

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This project seeks to translate a chapter in Le Silence des Chagos by Shenaz Patel a Mauritian author whose work has never been translated before. The chapter discusses the attempt of the protagonist to return to her home country Diego Garcia after her deportation. The English translation will offer an historical account to the target audience of the deportation of Chagossians to Mauritius during the 1970s. The target audience comprises of English-speaking translation scholars translation students and African literature scholars. In light of making the cultural elements of Mauritian culture accessible the translation will maintain the cultural items such as food and oral discourses in Creole so as to preserve the authenticity of the source culture. In order to better comprehend the cultural elements mentioned the target reader will be provided with detailed footnotes explaining the cultural and historical references. This translation will also address the importance of folkloric songs in Mauritius and its intergenerational function in Mauritian communities which will also remain in Creole. While such an approach will help to preserve the meaning of the source text the borrowing technique and the foreignizing method will be employed which will in turn help the reader in becoming more familiar with the Mauritian community. Translating a text from French to English while maintaining certain words or discourses in a minority language such as Creole bears certain challenges: How does the translator ensure the comprehensibility of the reader? Are there any translation losses? What are the choices of the translator?

Keywords: Chagos archipelagos in Exile, English translation, Le Silence des Chagos, Mauritian culture and history

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Authors: Ayesha Mushtaq

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Asthma is a pulmonary disease in which blockade of the airway takes place due to inflammation as a response to certain allergens. Breathing troubles, cough, and dyspnea are one of the few symptoms. Several studies have indicated a significant effect on asthma due to changes in dietary routines. Certain food items, such as oily foods and other materials, are known to cause an increase in the symptoms of asthma. Low dietary intake of fruits and vegetables may be important in relation to asthma prevalence. The objective of this study is to assess and compare the nutritional status of asthmatic and non-asthmatic patients. The significance of this study lies in the factor that it will help nutritionists to arrange a feasible dietary routine for asthmatic patients. This research was conducted at the Pulmonology Department of the Pakistan Institute of Medical Science Islamabad. About thirty hundred thirty-four million people are affected by asthma worldwide. Pakistan is on the verge of being an uplifted urban population and asthma cases are increasingly high these days. Several studies suggest an increase in the Asthmatic patient population due to improper diet. Other studies conducted at different institutions have conducted research on similar topics. These studies have suggested that there is a substantial alteration in the nutritional status of asthmatic and non-Asthmatic patients. This is a cross-sectional study aimed at assessing the nutritious standing of Asthmatic and non-asthmatic patients. This research took place at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. The research included asthmatic and non-asthmatic patients coming to the pulmonology department clinic at the Pakistan Institute of Medical Sciences (PIMS). These patients were aged between 20-60 years. A questionnaire was developed for these patients to estimate their dietary plans in these patients. The methodology included four sections. The first section was the Socio-Demographic profile, which included age, gender, monthly income and occupation. The next section was anthropometric measurements which included the weight, height and body mass index (BMI) of the individual. The next section, section three, was about the biochemical attributes, such as for biochemical profiling, pulmonary function testing (PFT) was performed. In the next section, Dietary habits, which were assessed by using a food frequency questionnaire (FFQ) through food habits and consumption pattern, was assessed. The next section life style data, in which the person's level of physical activity, sleep and smoking habits were assessed. The next section was statistical analysis. All the data obtained from the study were statistically analyzed and assessed. Most of the asthma Patients were females, with weight more than normal or even obese. Body Mass Index (BMI) was higher in asthma Patients than those in non-Asthmatic ones. When the nutritional Values were assessed, we came to know that these patients were low on certain nutrients and their diet included more junk and oily food than healthy vegetables and fruits. Beverages intake was also included in the same assessment. It is evident from this study that nutritional status has a contributory effect on asthma. So, patients on the verge of developing asthma or those who have developed asthma should focus on their diet, maintain good eating habits and take healthy diets, including fruits and vegetables rather than oily foods. Proper sleep may also contribute to the control of asthma.

Keywords: NUTRI, BMI, asthma, food

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Authors: Gina Aurora Necula

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From its transformation into a taboo and its hiding under the so-called “Moldovan language” or under the euphemistic expression “state language” to its regained status recognition as an official language, the Romanian language spoken in the Republic of Moldova has undergone impressive reforms in the last 60 years. Meant to erase the awareness of citizens’ ethnic identity and turn a majority language into a minority one, all the laws and regulations issued on the field succeeded into setting numerous barriers for speakers of Romanian. Either manifested as social constraints or materialized into assumed rejection of mother tongue usage, all these laws have demonstrated their usefulness and major impact on the Romanian-speaking population. This article is the result of our research carried out over 10 years with the support of students, and Moldovan citizens, from the master's degree program "Romanian language - identity and cultural awareness." We present here a retrospective insight of the reforms, laws, and regulations that contributed to the shifted status of the Romanian language from the official language, seen as the language of common use both in the public and private spheres, in the minority language that surrendered its privileged place to the Russian language, firstly in the public sphere, and then, slowly but surely, in the private sphere. Our main goal here is to identify and make speakers understand what the barriers to learning Romanian language are nowadays when the social pressure on using Russian no longer exists.

Keywords: linguistic barriers, lingua franca, private sphere, public sphere, reformation

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Authors: Yunus Emre Karakaya, Sebahattin Devecioglu, Bilal Coban

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Today, information technology’s presence is felt in every field of life. Fields of education and sports sciences have their own share too. Especially developments in informatics technologies changed the perspectives of these fields. The altered technological conditions made distance education argumentative in these fields. Due to advantages distance education provides to students, they can access the desired education without concerns about time and place. Education facilities are seen to head for distance education in this manner and expedite the process. Distance education applications, which was first started to be applied in the mid-1800s, have been implemented in Turkey since 1970s and still continues today. In this study, the historical development of distance education in the world and Turkey and the problems athletes face in education were discussed. Accordingly, suggestions were made evaluating the importance and requirements of distance education in sports education facilities at higher education level. Additionally, Questions of “Is distance education important in sports education in Turkey?”, “What are the problems of athletes in the education field in Turkey?” and similar questions were attempted to be answered. Finally, in Turkey, distance sports education applications in universities should be launched to ensure that athletes’ educations are not deficit and unfinished. Within this framework, legal regulations should be implemented by “Council of Higher Education” to develop the distance sports education in Turkey and utilize distance education efficiently in solving the sports education problems. By ensuring the advancement of athletes with this method, it is expected for athletes to contribute to sports in the country in both government and the private sector in the medium and long terms. Individuals who participated in the distance sports education will set an example in extending the country’s youth to national and international fields.

Keywords: athletes, distance education, higher education, sports education, Turkey

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Authors: Junior George Martin

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The purpose of this study was to explore college instructors’ integration of technology in their content area curriculum. The instructors indicated that they were in need of additional training to successfully integrate technology in their subject areas. The findings point to the implementation of a proposed the Technological, Pedagogical, and Content Knowledge (TPACK) model professional development workshop to satisfactorily address the weaknesses of the instructors in technology integration. The professional development workshop is proposed as a rational solution to adequately address the instructors’ inability to the successful integration of technology in their subject area in an effort to improve their pedagogy. The intense workshop would last for 5 days and will be designed to provide instructors with training in areas such as a use of technology applications and tools, and using modern methodologies to improve technology integration. Exposing the instructors to the specific areas identified will address the weaknesses they demonstrated during the study. Professional development is deemed the most appropriate intervention based on the opportunities it provides the instructors to access hands-on training to overcome their weaknesses. The purpose of the TPACK professional development workshop will be to improve the competence of the instructors so that they are adequately prepared to integrate technology successfully in their curricula. At the end of the period training, the instructors are expected to adopt strategies that will have a positive impact on the learning experiences of the students.

Keywords: higher education, modern technology tools, professional development, technology integration

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Authors: Nadine Sammy, Mark Wilson, Samuel Vine

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The Theory of Challenge and Threat States in Athletes (TCTSA) states that self-efficacy is an antecedent of challenge and threat. These states result from conscious and unconscious evaluations of situational demands and personal resources and are represented by both cognitive and physiological markers. Challenge is considered a more adaptive stress response as it is associated with a more efficient cardiovascular profile, as well as better performance and attention effects compared with threat. Self-efficacy is proposed to influence challenge/threat because an individual’s belief that they have the skills necessary to execute the courses of action required to succeed contributes to a perception that they can cope with the demands of the situation. This study experimentally examined the effects of self-efficacy on cardiovascular responses (challenge and threat), demand and resource evaluations, performance and attention under pressurised conditions. Forty-five university students were randomly assigned to either a control (n=15), low self-efficacy (n=15) or high self-efficacy (n=15) group and completed baseline and pressurised golf putting tasks. Self-efficacy was manipulated using false feedback adapted from previous studies. Measures of self-efficacy, cardiovascular reactivity, demand and resource evaluations, task performance and attention were recorded. The high self-efficacy group displayed more favourable cardiovascular reactivity, indicative of a challenge state, compared with the low self-efficacy group. The former group also reported high resource evaluations, but no task performance or attention effects were detected. These findings demonstrate that levels of self-efficacy influence cardiovascular reactivity and perceptions of resources under pressurised conditions.

Keywords: cardiovascular, challenge, performance, threat

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Authors: Yijun Shao, Yan Cheng, Rashmee U. Shah, Charlene R. Weir, Bruce E. Bray, Qing Zeng-Treitler

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Deep neural network (DNN) models are being explored in the clinical domain, following the recent success in other domains such as image recognition. For clinical adoption, outcome prediction models require explanation, but due to the multiple non-linear inner transformations, DNN models are viewed by many as a black box. In this study, we developed a deep neural network model for predicting 1-year mortality of patients who underwent major cardio vascular procedures (MCVPs), using temporal image representation of past medical history as input. The dataset was obtained from the electronic medical data warehouse administered by Veteran Affairs Information and Computing Infrastructure (VINCI). We identified 21,355 veterans who had their first MCVP in 2014. Features for prediction included demographics, diagnoses, procedures, medication orders, hospitalizations, and frailty measures extracted from clinical notes. Temporal variables were created based on the patient history data in the 2-year window prior to the index MCVP. A temporal image was created based on these variables for each individual patient. To generate the explanation for the DNN model, we defined a new concept called impact score, based on the presence/value of clinical conditions’ impact on the predicted outcome. Like (log) odds ratio reported by the logistic regression (LR) model, impact scores are continuous variables intended to shed light on the black box model. For comparison, a logistic regression model was fitted on the same dataset. In our cohort, about 6.8% of patients died within one year. The prediction of the DNN model achieved an area under the curve (AUC) of 78.5% while the LR model achieved an AUC of 74.6%. A strong but not perfect correlation was found between the aggregated impact scores and the log odds ratios (Spearman’s rho = 0.74), which helped validate our explanation.

Keywords: deep neural network, temporal data, prediction, frailty, logistic regression model

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Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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Authors: Jennifer K. Bowerman, Rhonda L. Reich

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The purpose of this paper is to explore the concepts ACDC (Amore, Consciousness, Discipline, and Commitment) which the authors first discovered as a philosophy and framework for recruitment and organizational development in a successful start-up tech company in Brazil. This paper represents an exploration of these concepts as a potential pedagogical foundation for undergraduate business education in the classroom. It explores whether their application has potential to build emotional and practical resilience in the face of constant organizational and societal change. Derived from Holonomy this paper explains the concepts and develops a narrative around how change influences the operation of organizations. Using examples from leading edge organizational theorists, it explains why a different educational approach grounded in ACDC concepts may not only have relevance for the working world, but also for undergraduates about to enter that world. The authors propose that in the global context of constant change, it makes sense to develop an approach to education, particularly business education, beyond cognitive knowledge, models and tools, in such a way that emotional and practical resilience and creative thinking may be developed. Using the classroom as an opportunity to explore these concepts, and aligning personal passion with the necessary discipline and commitment, may provide students with a greater sense of their own worth and potential as they venture into their ever-changing futures.

Keywords: ACDC, holonomic thinking, organizational learning, organizational change, business pedagogy

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Authors: Chhavi Rana, Sanjay K Jain

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All sides of every education debate agree that quality learning happens when knowledgeable, caring teachers use sound pedagogy. Many deliberations of pedagogy make the fault of considering it as principally being about teaching. There has been lot of research about how to build a positive climate for learning, improve student curiosity, and enhance classroom association. However, these things can only be facilitated when teachers are equipped with better teaching techniques that use sound and accurate pedagogy. Pedagogy is the science and art of education. Its aims range from the full development of the human being to skills acquisition. In India, a project named Mission 10 x has been started by an esteemed IT Corporation Wipro as a faculty development programme (FDP) that particularly focus on elements that facilitated teachers in developing curriculum and new pedagogies that can lead to improvement in student engagement. This paper presents a study of these FDPs and examines (1) the parameters that help teachers in building new pedagogies (2) the extent to which appropriate usage of pedagogy is improved after the conduct of Mission 10 x FDPs, and (3) whether institutions differ in terms of their ability to convert usage of improved pedagogy into academic performance via these FDPs. The sample consisted of 2,236 students at 6 four-year engineering colleges and universities that completed several FDPs during 2012-2014. Many measures of usage of better pedagogy were linked positively with such FDPs, although some of the relationships were weak in strength. The results suggest that the usage of pedagogy were more benefited after conducting these FDPs and application of novel approaches in conducting classes.

Keywords: student engagement, critical thinking; achievement, student learning, pedagogy

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Authors: M. Yaqoob, C. S. O’Neill, S. Faraj, C. L. O’Neill

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This paper presents the preliminary findings from a study exploring nurse’s contributions to end of life decisions and to the care of dying patients in ICU units in the Kingdom of Bahrain. The process of dying is complex as medical clinicians are frequently unable to say with certainty when death will occur. It is generally accepted that end of life care begins when it is possible to know that death is imminent. Nurses do not make medical treatment decisions when caring for a dying patient. There are, however, many other types of decisions made when a patient is approaching the end of life and nurses are either formally or informally part of these decision making processes. This study explored nurses care practices at the end of life, in two ICU units in large hospitals in the Kingdom of Bahrain. The research design was a grounded theory approach. Ten nurses participated, six of whom were Bahraini nationals and four were Indian. A core category death avoidance talk was supported by three major subcategories, degrees of involvement in decision making; signalling and creating an awareness of death; care shifting from dying patients to family. Despite nurses asserting that they carried out the orders of doctors and had no role in decision making processes at end of life this study showed that there were degrees of nurse involvement. Doctors frequently discussed the patient’s clinical condition with nurses and also sought information regarding the family. Information about the family was of particular relevance if the doctor was considering a DNR order, which the nurses equated with dying. Families were not always informed when a DNR decision was made. When families were not informed the nurses engaged in sophisticated rituals signalling and creating awareness to family members that the death of their loved one was near. This process also involved a subtle shifting of care from the dying patient to the family. This seminar paper will focus particularly on how nurses signal and create an awareness of death in an ICU setting. The findings suggest that despite the avoidance of death talk in the ICU nurses indirectly convey and create an awareness that death is near to family members.

Keywords: decision making, dying patients, end of life, intensive care unit

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Authors: Callie Mady

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This study investigated the Canadian French as an additional language teacher candidates’ confidence and language maintenance strategies by means of questionnaires and interviews pre- and post- a Francophone home-stay practicum experience. Teacher French language proficiency is one of the components of teacher knowledge that can influence students’ French as an additional language acquisition. Although advantageous, seeking opportunities to use French in a French milieu comes with challenges. Teachers, for example, have been found to be hesitant to speak French with native speakers for fear of judgment. Another identified challenge to spending time in a French milieu is finances; while teachers have recognized the value of such an experience, cost is prohibitive. In recognition of the potential barriers and the need to maintain/improve the French proficiency of 'French as an additional language' teachers, this study provided a two-week home stay in a Francophone environment for teacher candidates of French as an additional language with financial subsidies for their participation. Through the post-experience interviews, the French as an additional language teacher candidates revealed an improvement in French proficiency. Similarly, the teacher candidates cited an increase in confidence in the interviews and through the questionnaire. They linked this increase in proficiency and confidence to their experiences with their host families and other Francophone members of the community. This study highlights the provision of immersion experiences as means to support teachers’ language confidence and proficiency.

Keywords: French as an additional language education, teacher language confidence, teacher language maintenance, teacher language proficiency

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Authors: Laura M. Schwarz

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WebQuests are an internet-based interactive teaching/learning tool and utilize a scaffolded methodology. WebQuests employ critical thinking, afford inquiry-based constructivist learning, and readily employ Bloom’s Taxonomy. WebQuests have generally been used as instructional technology tools in primary and secondary education and have more recently grown in popularity in higher education. The study of the efficacy of WebQuests as an instructional approach to learning, however, has been limited, particularly in the nursing education arena. The purpose of this mixed-methods study was to determine nursing students’ perceptions of the effectiveness of the Nursing WebQuest as a teaching/learning strategy for holistic nursing-related content. Quantitative findings (N=42) suggested that learners were active participants, used reflection, thought of new ideas, used analysis skills, discovered something new, and assessed the worth of something while taking part in the WebQuests. Qualitative findings indicated that participants found WebQuest positives as easy to understand and navigate; clear and organized; interactive; good alternative learning format, and used a variety of quality resources. Participants saw drawbacks as requiring additional time and work; and occasional failed link or link causing them to lose their location in the WebQuest. Recommendations include using larger sample size and more diverse populations from various programs and universities. In conclusion, WebQuests were found to be an effective teaching/learning tool as positively assessed by study participants.

Keywords: holistic nursing, nursing education, teaching/learning strategy, WebQuests

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Authors: Amal A. Mashali, Omar Eltaweel, Elerian Ekladious

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Stature of an individual has an important role in identification, which is often required in medico-legal practice. The estimation of stature is an important step in the identification of dismembered remains or when only a part of a skeleton is only available as in major disasters or with mutilation. There is no published data on anthropological data among Jordanian population. The present study was designed in order to find out relationship of stature to some anthropometric measures among a sample of Jordanian population and to determine the most accurate and reliable one in predicting the stature of an individual. A cross sectional study was conducted on 336 adult healthy volunteers , free of bone diseases, nutritional diseases and abnormalities in the extremities after taking their consent. Students of Faculty of Medicine, Mutah University helped in collecting the data. The anthropometric measurements (anatomically defined) were stature, humerus length, hand length and breadth, foot length and breadth, foot index and knee height on both right and left sides of the body. The measurements were typical on both sides of the bodies of the studied samples. All the anthropologic data showed significant relation with age except the knee height. There was a significant difference between male and female measurements except for the foot index where F= 0.269. There was a significant positive correlation between the different measures and the stature of the individuals. Three equations were developed for estimation of stature. The most sensitive measure for prediction of a stature was found to be the humerus length.

Keywords: foot index, foot length, hand length, humerus length, stature

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Authors: Michael W. Markowitz, Jeffrey Gingerich

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The landscape of higher education in the United States has undergone significant changes in the last 25 years. What was once a domain of competition among prospective students for a limited number of college and university seats has become a marketplace in which institutions vie for the enrollment of educational consumers. A central figure in this paradigm shift has been the Chief Academic Officer (CAO), whose institutional role has also evolved beyond academics to include such disparate responsibilities as strategic planning, fiscal oversight, student recruitment, fundraising and personnel management. This paper explores the scope and impact of this transition by, first, explaining its context: the intersection of key social, economic and political factors in neo-conservative, late 20th Century America that redefined the value and accountability of institutions of higher learning. This context, in turn, is shown to have redefined the role and function of the CAO from a traditional academic leader to one centered on the successful application of corporate principles of organizational and fiscal management. Information gathered from a number of sitting Provosts, Vice-Presidents of Academic Affairs and Deans of Faculty is presented to illustrate the parameters of this change, as well as the extent to which today’s academic officers feel prepared and equipped to fulfill this broader institutional role. The paper concludes with a discussion of the impact of this transition on the American academy and whether it serves as a portend of change to come in higher education systems around the globe.

Keywords: academic administration, higher education, leadership, organizational management

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Authors: Husain Rajib, K. S. Kishor, D. G. Jewel

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Background: Uncorrected refractive error is a common cause of preventable visual impairment in pediatric age group which can be lead to blindness but early detection of visual impairment can reduce the problem that will have good effective in education and more involve in social activities. Glasses are the cheapest and commonest form of correction of refractive errors. To achieve this, patient must exhibit good compliance to spectacle wear. Patient’s attitude and perception of glasses and eye health could affect compliance. Material and method: A Prospective community based cross sectional study was designed in order to evaluate the knowledge, attitude and practices about refractive errors and eye health amongst the primary school going children. Result: Among 140 respondents, 72 were males and 68 were females. We found 50 children were myopic and out of them 26 were male and 24 were female, 27 children were hyperopic and out of them 14 were male and 13 were female. About 63 children were astigmatic and out of them 32 were male and 31 were female. The level of knowledge, attitude was satisfactory. The attitude of the students, teachers and parents was cooperative which helps to do cycloplegic refraction. Practice was not satisfactory due to social stigma and information gap. Conclusion: Knowledge of refractive error and acceptance of glasses for the correction of uncorrected refractive error. Public awareness program such as vision screening program, eye camp, and teachers training program are more beneficial for wearing and prescribing spectacle.

Keywords: refractive error, stigma, knowledge, attitude, practice

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Authors: Chrysanthi Nega, Fotini-Sonia Apergi

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Child sexual abuse (CSA) in Greece is a highly prevalent phenomenon and yet remains largely underreported. CSA can negatively impact cognitive, emotional and psychosocial development, as well as personality formation and capacity for initiation and maintenance of healthy interpersonal relationships. It is particularly important for school-based prevention programs to be implemented early in elementary school, as they are reportedly effective in lowering abuse incidences and providing knowledge for coping in threatening environments. The purpose of the current study was to test the effectiveness of a school-based CSA prevention program (Safe-Touches) on Greek elementary school students (grades 1-3, N=272) and explore the effect of age and time of testing (academic term). There was a significant effect of age in the knowledge of Inappropriate Touch, when comparing pre and post-intervention assessments, with third graders showing greatest gains in knowledge, followed by second and first graders. Time of testing during the academic year also had a significant effect, as first graders tested later in the school year, scored higher on knowledge of Inappropriate Touch. The findings of the current study provide insight into the optimal timing to implement CSA prevention programs. Exposure to such programs and incorporation in the school curricula could largely benefit children of the Greek community in terms of safety and awareness.

Keywords: child sexual abuse, Safe-Touches, school-based prevention, schooling

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Authors: Vichai Tienthavorn

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Background: Recently, the patients of non-communicable diseases (NCDs) are increasing in Thailand; especially hypertension and diabetes. Hypertension and Diabetes patients were found to be of 3.7 million in 2008. The varieties of human behaviors have been extensively changed in health. Hence, Thai Government has a policy to reduce NCDs. Generally, primary care plays an important role in treatment using medical process. However, NCDs patients have not been decreased. Objectives: This study not only reduce the patient and mortality rate but also increase the quality of life, could apply in different areas and propose to be the national policy, effectively for a long term operation. Methods: Here we report that primary health care (PHC), which is a primary process to screening, rapidly seek the person's risk. The screening tool of the study was Vichai's 7 color balls model, the medical education tool to transfer knowledge from student health team to community through health volunteers, creating community engagement in terms of social participation. It was found that people in community were realized in their health and they can evaluate the level of risk using this model. Results: Projects implementation (2015) in Nong Lom Health Center in Phayao (target group 15-65 years, 2529); screening hypertension coveraged 99.01%, risk group (light green) was decreased to normal group (white) from 1806 to 1893, significant severe patient (red) was decreased to moderate (orange) from 10 to 5. Health Program in behaving change with best practice of 3Es (Eating, Exercise, Emotion) and 3Rs (Reducing tobacco, alcohol, obesity) were applied in risk group; and encourage strictly medication, investigation in severe patient (red). Conclusion: This is the first demonstration of knowledge transfer to community engagement by student, which is the sustainable education in PHC.

Keywords: non-communicable disease, surveillance control and prevention systems, community engagement, primary health care

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Authors: Laura X. Martinez, Andrés F. Rodríguez, Ruth A. Catacoli

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One of the most important factors for air pollution is that the concentrations of PM₁₀ maintain a constant trend, with the exception of some places where that frequently surpasses the allowed ranges established by Colombian legislation. The community that surrounds the Universidad Libre Bogotá is inhabited by a considerable number of students and workers, all of whom are possibly being exposed to PM₁₀ for long periods of time while on campus. Thus, the chemical characterization of PM₁₀ found in the ambient air at the Universidad Libre Bogotá was identified as a problem. A Hi-Vol sampler and EPA Test Method 5 were used to determine if the quality of air is adequate for the human respiratory system. Additionally, quartz fiber filters were utilized during sampling. Samples were taken three days a week during a dry period throughout the months of November and December 2015. The gravimetric analysis method was used to determine PM₁₀ concentrations. The chemical characterization includes non-conventional carcinogenic pollutants. Atomic absorption spectrophotometry (AAS) was used for the determination of metals and VOCs were analyzed using the FTIR (Fourier transform infrared spectroscopy) method. In this way, concentrations of PM₁₀, ranging from values of 13 µg/m³ to 66 µg/m³, were obtained; these values were below standard conditions. This evidence concludes that the PM₁₀ concentrations during an exposure period of 24 hours are lower than the values established by Colombian law, Resolution 610 of 2010; however, when comparing these with the limits set by the World Health Organization (WHO), these concentrations could possibly exceed permissible levels.

Keywords: air quality, atomic absorption spectrophotometry, gas chromatography, particulate matter

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