Search results for: medical predictors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3853

Search results for: medical predictors

3223 Self-Determination Needs, Coping Strategies and Quality of Life Among Chronic Non-Specific Lower Back Pain Patients

Authors: Zubana Afzal, Afsheen Massod

Abstract:

This quantitative study was carried out in order to explore the role of coping strategies as an explanatory mechanism in the relationship between self-determination needs and quality of life. A cross-sectional survey research design was conducted using scales such as the Basic Psychological Needs Scale (Deci&Ryan, 2000) to measure self-determination-based needs, Pain Coping Strategies Questionnaire (Harland &Georgieff, 2003), and Quality of Life Brief (The WHOQOL Group, 1998), in translated form in addition to a demographic information sheet. The sample comprised 120 (Women=63, Men=57), taken from different hospitals in Lahore, Multan, and Gojra. Descriptive and Inferential analyses were executed through SPSS version 23.00. All self-determination needs were found in result to be significantly and positively correlated with diversion and cognitive pain coping strategies, physical, psychological, social, and environmental quality of life, and significantly negatively correlated with catastrophizing and reinterpreting pain coping strategies. Cognitive and diversion pain coping strategies were found to be significantly and positively associated with all physical, psychological, social, and environmental quality of life. The regression analyses revealed that the strongest predictors were autonomy, cognitive and diversion pain coping strategies in predicting quality of life. All coping strategies except reinterpreting played a mediating role between self-determination needs and quality of life. The findings can lead to a better understanding of the role of self-determination needs and pain coping strategies in determining the quality of life among chronic non-specific lower back pain patients.

Keywords: quality of life, chronic lower back pain, coping strategies, self determination needs

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3222 Degradation of Heating, Ventilation, and Air Conditioning Components across Locations

Authors: Timothy E. Frank, Josh R. Aldred, Sophie B. Boulware, Michelle K. Cabonce, Justin H. White

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Materials degrade at different rates in different environments depending on factors such as temperature, aridity, salinity, and solar radiation. Therefore, predicting asset longevity depends, in part, on the environmental conditions to which the asset is exposed. Heating, ventilation, and air conditioning (HVAC) systems are critical to building operations yet are responsible for a significant proportion of their energy consumption. HVAC energy use increases substantially with slight operational inefficiencies. Understanding the environmental influences on HVAC degradation in detail will inform maintenance schedules and capital investment, reduce energy use, and increase lifecycle management efficiency. HVAC inspection records spanning 14 years from 21 locations across the United States were compiled and associated with the climate conditions to which they were exposed. Three environmental features were explored in this study: average high temperature, average low temperature, and annual precipitation, as well as four non-environmental features. Initial insights showed no correlations between individual features and the rate of HVAC component degradation. Using neighborhood component analysis, however, the most critical features related to degradation were identified. Two models were considered, and results varied between them. However, longitude and latitude emerged as potentially the best predictors of average HVAC component degradation. Further research is needed to evaluate additional environmental features, increase the resolution of the environmental data, and develop more robust models to achieve more conclusive results.

Keywords: climate, degradation, HVAC, neighborhood component analysis

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3221 A Model for Academic Coaching for Success and Inclusive Excellence in Science, Technology, Engineering, and Mathematics Education

Authors: Sylvanus N. Wosu

Abstract:

Research shows that factors, such as low motivation, preparation, resources, emotional and social integration, and fears of risk-taking, are the most common barriers to access, matriculation, and retention into science, technology, engineering, and mathematics (STEM) disciplines for underrepresented (URM) students. These factors have been shown to impact students’ attraction and success in STEM fields. Standardized tests such as the SAT and ACT often used as predictor of success, are not always true predictors of success for African and Hispanic American students. Without an adequate academic support environment, even a high SAT score does not guarantee academic success in science and engineering. This paper proposes a model for Academic Coaching for building success and inclusive excellence in STEM education. Academic coaching is framed as a process of motivating students to be independent learners through relational mentorship, facilitating learning supports inside and outside of the classroom or school environment, and developing problem-solving skills and success attitudes that lead to higher performance in the specific subjects. The model is formulated based on best strategies and practices for enriching Academic Performance Impact skills and motivating students’ interests in STEM. A scaled model for measuring the Academic Performance Impact (API) index and STEM is discussed. The study correlates API with state standardized test and shows that the average impact of those skills can be predicted by the Academic Performance Impact (API) index or Academic Preparedness Index.

Keywords: diversity, equity, graduate education, inclusion, inclusive excellence, model

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3220 Creation of a Care Robot Impact Assessment

Authors: Eduard Fosch-Villaronga

Abstract:

This paper pioneers Care Robot Impact Assessment (CRIA), a methodology used to identify, analyze, mitigate and eliminate the risks posed by the insertion of non-medical personal care robots (PCR) in medical care facilities. Its precedent instruments (Privacy and Surveillance Impact Assessment (PIA and SIA)) fall behind in coping with robots. Indeed, personal care robots change dramatically how care is delivered. The paper presents a specific risk-sector methodology, identifies which robots are under its scope and presents some of the challenges introduced by these robots.

Keywords: ethics, impact assessment, law, personal care robots

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3219 Laboratory Findings as Predictors of St2 and NT-Probnp Elevations in Heart Failure Clinic, National Cardiovascular Centre Harapan Kita, Indonesia

Authors: B. B. Siswanto, A. Halimi, K. M. H. J. Tandayu, C. Abdillah, F. Nanda , E. Chandra

Abstract:

Nowadays, modern cardiac biomarkers, such as ST2 and NT-proBNP, have important roles in predicting morbidity and mortality in heart failure patients. Abnormalities of serum electrolytes, sepsis or infection, and deteriorating renal function will worsen the conditions of patients with heart failure. It is intriguing to know whether cardiac biomarkers elevations are affected by laboratory findings in heart failure patients. We recruited 65 patients from the heart failure clinic in NCVC Harapan Kita in 2014-2015. All of them have consented for laboratory examination, including cardiac biomarkers. The findings were recorded in our Research and Development Centre and analyzed using linear regression to find whether there is a relationship between laboratory findings (sodium, potassium, creatinine, and leukocytes) and ST2 or NT-proBNP. From 65 patients, 26.9% of them are female, and 73.1% are male, 69.4% patients classified as NYHA I-II and 31.6% as NYHA III-IV. The mean age is 55.7+11.4 years old; mean sodium level is 136.1+6.5 mmol/l; mean potassium level is 4.7+1.9 mmol/l; mean leukocyte count is 9184.7+3622.4 /ul; mean creatinine level is 1.2+0.5 mg/dl. From linear regression logistics, the relationship between NT-proBNP and sodium level (p<0.001), as well as leukocyte count (p=0.002) are significant, while NT-proBNP and potassium level (p=0.05), as well as creatinine level (p=0.534) are not significant. The relationship between ST2 and sodium level (p=0.501), potassium level (p=0.76), leukocyte level (p=0.897), and creatinine level (p=0.817) are not significant. To conclude, laboratory findings are more sensitive in predicting NT-proBNP elevation than ST2 elevation. Larger studies are needed to prove that NT-proBNP correlation with laboratory findings is more superior than ST2.

Keywords: heart failure, laboratory, NT-proBNP, ST2

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3218 Evaluation of Clinical Decision Support System in Electronic Medical Record System: A Case of Malawi National Art Electronic Medical Record System

Authors: Pachawo Bisani, Goodall Nyirenda

Abstract:

The Malawi National Antiretroviral Therapy (NART) Electronic Medical Record (EMR) system was designed and developed with guidance from the Ministry of Health through the Department of HIV and AIDS (DHA) with the aim of supporting the management of HIV patient data and reporting in high prevalence ART clinics. As of 2021, the system has been scaled up to over 206 facilities across the country. The system is integrated with the clinical decision support system (CDSS) to assist healthcare providers in making a decision about an individual patient at a particular point in time. Despite NART EMR undergoing several evaluations and assessments, little has been done to evaluate the clinical decision support system in the NART EMR system. Hence, the study aimed to evaluate the use of CDSS in the NART EMR system in Malawi. The study adopted a mixed-method approach, and data was collected through interviews, observations, and questionnaires. The study has revealed that the CDSS tools were integrated into the ART clinic workflow, making it easy for the user to use it. The study has also revealed challenges in system reliability and information accuracy. Despite the challenges, the study further revealed that the system is effective and efficient, and overall, users are satisfied with the system. The study recommends that the implementers focus more on the logic behind the clinical decision-support intervention in order to address some of the concerns and enhance the accuracy of the information supplied. The study further suggests consulting the system's actual users throughout implementation.

Keywords: clinical decision support system, electronic medical record system, usability, antiretroviral therapy

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3217 Hybrid Knowledge Approach for Determining Health Care Provider Specialty from Patient Diagnoses

Authors: Erin Lynne Plettenberg, Jeremy Vickery

Abstract:

In an access-control situation, the role of a user determines whether a data request is appropriate. This paper combines vetted web mining and logic modeling to build a lightweight system for determining the role of a health care provider based only on their prior authorized requests. The model identifies provider roles with 100% recall from very little data. This shows the value of vetted web mining in AI systems, and suggests the impact of the ICD classification on medical practice.

Keywords: electronic medical records, information extraction, logic modeling, ontology, vetted web mining

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3216 A Multi-Output Network with U-Net Enhanced Class Activation Map and Robust Classification Performance for Medical Imaging Analysis

Authors: Jaiden Xuan Schraut, Leon Liu, Yiqiao Yin

Abstract:

Computer vision in medical diagnosis has achieved a high level of success in diagnosing diseases with high accuracy. However, conventional classifiers that produce an image to-label result provides insufficient information for medical professionals to judge and raise concerns over the trust and reliability of a model with results that cannot be explained. In order to gain local insight into cancerous regions, separate tasks such as imaging segmentation need to be implemented to aid the doctors in treating patients, which doubles the training time and costs which renders the diagnosis system inefficient and difficult to be accepted by the public. To tackle this issue and drive AI-first medical solutions further, this paper proposes a multi-output network that follows a U-Net architecture for image segmentation output and features an additional convolutional neural networks (CNN) module for auxiliary classification output. Class activation maps are a method of providing insight into a convolutional neural network’s feature maps that leads to its classification but in the case of lung diseases, the region of interest is enhanced by U-net-assisted Class Activation Map (CAM) visualization. Therefore, our proposed model combines image segmentation models and classifiers to crop out only the lung region of a chest X-ray’s class activation map to provide a visualization that improves the explainability and is able to generate classification results simultaneously which builds trust for AI-led diagnosis systems. The proposed U-Net model achieves 97.61% accuracy and a dice coefficient of 0.97 on testing data from the COVID-QU-Ex Dataset which includes both diseased and healthy lungs.

Keywords: multi-output network model, U-net, class activation map, image classification, medical imaging analysis

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3215 Exploring the Biocompatibility and Performance of Metals and Ceramics as Biomaterials, A Comprehensive Study for Advanced Medical Applications

Authors: Ala Abobakr Abdulhafidh Al-Dubai

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Biomaterials, specifically metals and ceramics, are indispensable components in the realm of medical science, shaping the landscape of implantology and prosthetics. This study delves into the intricate interplay between these materials and biological systems, aiming to scrutinize their suitability, performance, and biocompatibility. Employing a multi-faceted approach, a range of methodologies were meticulously employed to comprehensively characterize these biomaterials. Advanced material characterization techniques were paramount in this research, with scanning electron microscopy providing intricate insights into surface morphology, and X-ray diffraction unraveling the crystalline structures. These analyses were complemented by in vitro assessments, which gauged the biological response of cells to metals and ceramics, shedding light on their potential applications within the human body. A key facet of our investigation involved a comparative study, evaluating the corrosion resistance and osseointegration potential of both metals and ceramics. Through a series of experiments, we sought to understand how these biomaterials interacted with physiological environments, paving the way for informed decisions in medical applications

Keywords: metals, ceramics, biomaterials, biocompatibility, osseointegration

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3214 Service Quality, Skier Satisfaction, and Behavioral Intentions in Leisure Skiing: The Case of Beijing

Authors: Shunhong Qi, Hui Tian

Abstract:

Triggered off by the forthcoming 2022 Winter Olympics, ski centers are blossoming in China, the number being 742 in 2018. Although the number of skier visits of ski resorts soared to 19.7 million in 2018, one-time skiers account for a considerable portion therein. In light of the extremely low return rates and skiing penetration level (0.5%) of leisure skiing in China, this study proposes and tests a leisure ski service performance framework which assesses the ski resorts’ service quality, skier satisfaction, as well as their impact on skiers’ behavioral intentions, with an aim to assess the success of ski resorts and provide suggestions for improvement. Three self-administered surveys and 16 interviews were conducted upon a convenience sample of leisure skiers in two major ski destinations within two hours’ drive from Beijing – Nanshan and Jundushan ski resorts. Of the 680 questionnaires distributed, 416 usable copies were returned, the response rate being 61.2%. The questionnaire used for the study was developed based on the existing literature of 'push' factors of skiers (intrinsic desire) and 'pull' factors (attractiveness of a destination), as well as leisure sport satisfaction. The scale comprises four parts: skiers’ demographic profiles, their perceived service quality (including ski resorts’ infrastructure, expense, safety and comfort, convenience, daily needs support, skill development support, and accessibility), their overall levels of satisfaction (satisfaction with the service and the experience), and their behavioral intentions (including loyalty, future visitation and greater tolerance of price increases). Skiers’ demographic profiles show that among the 220 males and 196 females in the survey, a vast majority of the skiers are age 17-39 (87.2%). 64.7% are not married, and nearly half (48.3%) of the skiers have a monthly family income exceeding 10,000 yuan (USD 1,424), and 80% are beginners or intermediate skiers. The regression examining the influence of service quality on skier satisfaction reveals that service quality accounts for 44.4% of the variance in skier satisfaction, the variables of safety and comfort, expense, skill development support, and accessibility contributing significantly in descending order. Another regression analyzing the influence of service quality as well as skier satisfaction on their behavioral intentions shows that service quality and skier satisfaction account for 39.1% of the variance in skiers’ behavioral intentions, and the significant predictors are skier satisfaction, safety and comfort, expense, and accessibility, in descending order, though a comparison between groups also indicates that for expert skiers, the significant variables are skier satisfaction, skill development support, safety, and comfort. Suggestions are thus made for ski resorts and other stakeholders to improve skier satisfaction and increase visitation: developing diversified ski courses to meet the demands of skiers of different skiing skills and to reduce crowding, adopting enough chairlifts and magic carpets, reinforcing safety measures and medical force; further exploring their various resources and lower the skiing expense on ski pass, equipment renting, accommodation and dining; adding more bus lines and/or develop platforms for skiers’ car-pooling, and offering diversified skiing activities with local flavors for better entertainment.

Keywords: behavioral intentions, leisure skiing, service quality, skier satisfaction

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3213 Development of a Practical Screening Measure for the Prediction of Low Birth Weight and Neonatal Mortality in Upper Egypt

Authors: Prof. Ammal Mokhtar Metwally, Samia M. Sami, Nihad A. Ibrahim, Fatma A. Shaaban, Iman I. Salama

Abstract:

Objectives: Reducing neonatal mortality by 2030 is still a challenging goal in developing countries. low birth weight (LBW) is a significant contributor to this, especially where weighing newborns is not possible routinely. The present study aimed to determine a simple, easy, reliable anthropometric measure(s) that can predict LBW) and neonatal mortality. Methods: A prospective cohort study of 570 babies born in districts of El Menia governorate, Egypt (where most deliveries occurred at home) was examined at birth. Newborn weight, length, head, chest, mid-arm, and thigh circumferences were measured. Follow up of the examined neonates took place during their first four weeks of life to report any mortalities. The most predictable anthropometric measures were determined using the statistical package of SPSS, and multiple Logistic regression analysis was performed.: Results: Head and chest circumferences with cut-off points < 33 cm and ≤ 31.5 cm, respectively, were the significant predictors for LBW. They carried the best combination of having the highest sensitivity (89.8 % & 86.4 %) and least false negative predictive value (1.4 % & 1.7 %). Chest circumference with a cut-off point ≤ 31.5 cm was the significant predictor for neonatal mortality with 83.3 % sensitivity and 0.43 % false negative predictive value. Conclusion: Using chest circumference with a cut-off point ≤ 31.5 cm is recommended as a single simple anthropometric measurement for the prediction of both LBW and neonatal mortality. The predicted measure could act as a substitute for weighting newborns in communities where scales to weigh them are not routinely available.

Keywords: low birth weight, neonatal mortality, anthropometric measures, practical screening

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3212 Ideation, Plans, and Attempts for Suicide among Adolescents with Disability

Authors: Nyla Anjum, Humaira Bano

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Disability, regardless of its type and nature limits one or two significant life activities. These limitations constitute risk factors for suicide. Rate and intensity of problem upsurges in critical age of adolescence. Researches in the field of mental health over look problem of suicide among persons with disability. Aim of the study was to investigate prevalence and risk factors for suicide among adolescents with disability. The study constitutes purposive sample of 106 elements of both gender with four major categories of disability: hearing impairment, physical impairment, visual impairment and intellectual disabilities. Face to face interview technique was opted for data collection. Other variable are: socio-economic status, social and family support, provision of services for persons with disability, education and employment opportunities. For data analysis independent sample t-test was applied to find out significant differences in gender and One Way Analysis of variance was run to find out differences among four types of disability. Major predictors of suicide were identified with multiple regression analysis. It is concluded that ideation, plans and attempts of suicide among adolescents with disability is a multifaceted and imperative concern in the area of mental health. Urgent research recommendations contains valid measurement of suicide rate and identification of more risk factors for suicide among persons with disability. Study will also guide towards prevention of this pressing problem and will bring message of happy and healthy life not only for persons with disability but also for their families. It will also help to reduce suicide rate in society.

Keywords: suicide, risk factors, adolescent, disability, mental health

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3211 Levels and Determinants of Experiencing Violence during Pregnancy among Adolescent Women - The Case of Southern Africa

Authors: Sibusiso Mkwananzi

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The health of mother and child remain at risk among pregnant adolescents. Nevertheless, these are placed in even greater jeopardy when an expectant adolescent experiences violence. This paper sought to explore the levels and determinants of expecting adolescents in five Southern African countries. The study used the most recent (2010/2015) nationally representative demographic health survey (DHS) data from Malawi, Mozambique, Namibia, Zambia, and Zimbabwe. The highest levels of violence during pregnancy occurred amongst adolescent females living in Zimbabwe at 11.4%, followed by Zambia (8.3%) and Namibia (7.7%). Lowest levels were seen in Mozambique at 3.6%. Additionally, the determinants of experiencing violence during pregnancy included educational attainment, marital status, wealth and place of residence. Expectant adolescents that had a higher likelihood of experiencing violence were married and lived predominantly in rural settings. Higher risk was also associated with lower acquisition of education and poverty. These results show a very similar pattern to the risk factors associated with early pregnancy in the region. The predictors point to issues of possible lowered empowerment amongst younger women in their relationships and the structural challenges faced by this fledgling group. Nevertheless, addressing these dynamics could go a long way in not only decreasing the likelihood of unwanted motherhood at this early stage of the life course, but indeed even ensuring the prevention of violence during wanted early pregnancy. This would lead to improved levels of maternal and child health despite younger maternal age and aid in achieving a number of sustainable development goals.

Keywords: adolescents, determinants, Southern Africa, violence during pregnancy

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3210 The Development Status of Terahertz Wave and Its Prospect in Wireless Communication

Authors: Yiquan Liao, Quanhong Jiang

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Since terahertz was observed by German scientists, we have obtained terahertz through different generation technologies of broadband and narrowband. Then, with the development of semiconductor and other technologies, the imaging technology of terahertz has become increasingly perfect. From the earliest application of nondestructive testing in aviation to the present application of information transmission and human safety detection, the role of terahertz will shine in various fields. The weapons produced by terahertz were epoch-making, which is a crushing deterrent against technologically backward countries. At the same time, terahertz technology in the fields of imaging, medical and livelihood, communication and communication are for the well-being of the country and the people.

Keywords: terahertz, imaging, communication, medical treatment

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3209 Federated Learning in Healthcare

Authors: Ananya Gangavarapu

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Convolutional Neural Networks (CNN) based models are providing diagnostic capabilities on par with the medical specialists in many specialty areas. However, collecting the medical data for training purposes is very challenging because of the increased regulations around data collections and privacy concerns around personal health data. The gathering of the data becomes even more difficult if the capture devices are edge-based mobile devices (like smartphones) with feeble wireless connectivity in rural/remote areas. In this paper, I would like to highlight Federated Learning approach to mitigate data privacy and security issues.

Keywords: deep learning in healthcare, data privacy, federated learning, training in distributed environment

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3208 Evidence Based Medicine: Going beyond Improving Physicians Viewpoints, Usage and Challenges Upcoming

Authors: Peyman Rezaei Hachesu, Vahideh Zareh Gavgani, Zahra Salahzadeh

Abstract:

To survey the attitudes, awareness, and practice of Evidence Based Medicine (EBM), and to determine the barriers that influence apply’ EBM in therapeutic process among clinical residents in Iran.We conducted a cross sectional survey during September to December 2012 at the teaching hospitals of Tehran University of Medical Sciences among 79 clinical residents from different medical specialties. A valid and reliable questionnaire consisted of five sections and 27 statements were used in this research. We applied Spearman and Mann Whitney test for correlation between variables. Findings showed that the knowledge of residents about EBM is low. Their attitude towards EBM was positive but their knowledge and skills in regard with the evidence based medical information resources were mostly limited to PubMed and Google scholar. The main barrier was the lack of enough time to practicing EBM. There was no significant correlation between residency grade and familiarity and use of electronic EBM resources (Spearman, P = 0.138). Integration of training approaches like journal clubs or workshops with clinical practice is suggested.

Keywords: evidence-based medicine, clinical residents, decision-making, attitude, questionnaire

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3207 Quality Assessment of the Given First Aid on the Spot Events in the Opinion of Members of the Teams of the Medical Rescue in Warsaw in Poland

Authors: Aneta Binkowska, Artur Kamecki

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The ability to provide first aid should be one of the basic skills of each of us. First aid by the Law on National Medical Emergency dated 8 September 2006 as amended, is a set of actions undertaken to save a person at the scene of an accident. In Poland, on the basis of Article 162 of the Criminal Code, we are obliged to provide first aid to the victim. In addition, according to a large part of society, unselfishness towards others in need of help is our moral obligation. The aim of the study was to learn the opinion of the members of Medical Rescue Teams (MRT) of the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service (PA and STS ‘Meditrans’) in Warsaw on how people react in real situations threatening life or health of the injured person. The study was conducted in the third quarter of 2015 on 335 members of medical rescue teams, including 77 W and 258 M, who provided medical services in the ‘Meditrans’ Provincial Ambulance and Sanitary Transport Service MRT in Warsaw. The research tool was an anonymous questionnaire survey of own design, which consisted of 12 questions: closed, half open and one open question. Respondents were divided into 3 age groups and by individual medical professions (doctor, paramedic, nurse). The straight majority of respondents encountered granting the first aid the event on the spot. However, the frequency of appearing in such proceedings isn’t too high. The first aid has most often been given in the street and in houses. The final audited fairly important element is the reason not to provide first aid by bystanders in the opinion of members of the medical teams. Respondents to this question, which was an open question were asked to name the reason for not taking any action while waiting for an ambulance. Over 50% of respondents could not answer. The most common answers were: fear, lack of knowledge and skills, reluctance, indifference, lack of training, lack of experience and fear that harm. Conclusion: The majority of respondents have encountered instances of first aid provision, but respondents assessed the frequency of such situations as low. Placing the victim in the recovery position is the simplest and most common form of first aid. Therefore, training should be introduced not only on CPR but also in the scope of helping persons in sudden health emergency, who do not have a sudden cardiac arrest. A statement can be formulated, as a main conclusion of the analysis, that only continuous education and in particular practical training will help people to overcome the barrier of their limitations in order to help others. Among the largest group of witnesses providing first aid are the elderly and youth, who are subjected to various forms of education related to first aid provision.

Keywords: BLS, first aid, medical rescue, resuscitation

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3206 Membrane-Localized Mutations as Predictors of Checkpoint Blockade Efficacy in Cancer

Authors: Zoe Goldberger, Priscilla S. Briquez, Jeffrey A. Hubbell

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Tumor cells have mutations resulting from genetic instability that the immune system can actively recognize. Immune checkpoint immunotherapy (ICI) is commonly used in the clinic to re-activate immune reactions against mutated proteins, called neoantigens, resulting in tumor remission in cancer patients. However, only around 20% of patients show durable response to ICI. While tumor mutational burden (TMB) has been approved by the Food and Drug Administration (FDA) as a criterion for ICI therapy, the relevance of the subcellular localizations of the mutated proteins within the tumor cell has not been investigated. Here, we hypothesized that localization of mutations impacts the effect of immune responsiveness to ICI. We analyzed publicly available tumor mutation sequencing data of ICI treated patients from 3 independent datasets. We extracted the subcellular localization from the UniProtKB/Swiss-Prot database and quantified the proportion of membrane, cytoplasmic, nuclear, or secreted mutations per patient. We analyzed this information in relation to response to ICI treatment and overall survival of patients showing with 1722 ICI-treated patients that high mutational burden localized at the membrane (mTMB), correlate with ICI responsiveness, and improved overall survival in multiple cancer types. We anticipate that our results will ameliorate predictability of cancer patient response to ICI with potential implications in clinical guidelines to tailor ICI treatment. This would not only increase patient survival for those receiving ICI, but also patients’ quality of life by reducing the number of patients enduring non-effective ICI treatments.

Keywords: cancer, immunotherapy, membrane neoantigens, efficacy prediction, biomarkers

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3205 Cultural Self-Efficacy of Child Protection Social Workers in Norway: Barriers and Opportunities in Working with Migrant Families

Authors: Justyna Mroczkowska

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Social worker's ability to provide culturally sensitive assistance in child protection is taken for granted; given limited training opportunities and lack of clear guidance, practitioners report working with migrant families more demanding in comparison to working with native families. In this study, the author developed and factor analyzed the Norwegian Cultural Self-Efficacy Scale to describe the level of cultural capability among Norwegian child protection professionals. The study aimed to determine the main influencing factors to cultural efficacy and examine the relationship between self-efficacy and perceived difficulty in working with migrant families. The scale was administered to child protection workers in Norway (N=251), and the reliability of the scale measured by Cronbach's alpha coefficient was .904. The confirmatory factor analysis of social work cultural self-efficacy found support for four separate but correlated subscales: Assessment, Communication, Support Request, and Teamwork. Regression analyses found the experience in working with migrant families, training and support from external agencies, and colleague support to be significant predictors of cultural self-efficacy. Self-efficacy in assessment skills and self-efficacy in communication skills were moderately related to the perceived difficulty to work with migrant families. The findings conclude with previous research and highlight the need for both professional development programs and institutional resources to be provided to support the practitioner's preparation for multicultural practice in child protection.

Keywords: child protection, cultural self-efficacy, cultural competency, migration, resources

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3204 Changing the Biopower Hierarchy between Women’s Bodily Knowledge and the Medical Knowledge about the Body: The Case of Female Ejaculation and #Notpee

Authors: Lior B. Navon

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The objective of this study is to investigate how technology, such as social media, can influence the biopower hierarchy between the medical knowledge about the body and women’s bodily knowledge through the case study of the hashtag 'notpee'. In January 2015, the hashtag #notpee, relating to a feminine physiological phenomenon called female ejaculation (FE) or squirting (SQ) started circulating on twitter. This hashtag, born as a reaction to a medical study claiming that SQ is essentially involuntary emission of urine during sexual activity, sparked an unusual public discourse about FE, a phenomenon that is usually not discussed or referred to in socio-legitimate public spheres. This unusual backlash got the attention of women’s magazines and blogs, as well as more mainstream large and respected outlets such as The Guardian and CNN. Both the tweets on twitter, as well as the media coverage of them, were mainly aimed at rejecting the research’s findings. While not offering an alternative and choosing to define the phenomenon by negation, women argued that the fluid extracted was not pee based on their personal experiences. Based on a critical discourse analysis of 742 tweets with the hashtag 'notpee' between January 2015 and January 2016, and of 15 articles covering the backlash, this study suggests that the #notpee backlash challenged the power balance between the medical knowledge about the feminine body and the feminine bodily knowledge through two different, yet related, forms of resistance to biopower. The first resistance is to the authority over knowledge production — who has the power to produce 'true' statements when it comes to the body? Is it the women who experience the phenomenon, or is it the medical institution? The second resistance to biopower has to do with what we regard as facts or veracity. A critical discourse analysis reveals that while both the scientific field, as well as the women arguing against its findings, use empirical information, they, nevertheless, rely on two dichotomic databases- while the scientific research relies on samples from the 'dead like body', these woman are relying on their lived subjective senses as a source for fact making. Nevertheless, while #notpee is asking to change the power relations between the feminine subjective bodily knowledge and the seemingly objective masculine medical knowledge about the body, it by no means dismisses it. These women are essentially asking the medical institution to take into consideration the subjective body as well as the objective one while acknowledging and accepting the power of the latter over knowledge production.

Keywords: biopower, female ejaculation, new media, bodily knowledge

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3203 Executive Function Assessment with Aboriginal Australians

Authors: T. Keiller, E. Hindman, P. Hassmen, K. Radford, L. Lavrencic

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Background: Psychosocial disadvantage is associated with impaired cognitive abilities, with executive functioning (EF) abilities particularly vulnerable. EF abilities strongly predict general daily functioning, educational and career prospects, and health choices. A reliable and valid assessment of EF is important to support appropriate care and intervention strategies. However, evidence-based EF assessment tools for use with Aboriginal Australians are limited. Aim and Method: This research aims to develop and validate a culturally appropriate EF tool for use with indigenous Australians. To this end, Study One aims to review current literature examining the benefits and disadvantages of current EF assessment tools for use with Indigenous Australians. Study Two aims to collate expert opinion on the strengths and weaknesses of various current EF assessment tools for use with Indigenous Australians using Delphi methodology with experienced psychologists (n = 10). The initial two studies will inform the development of a culturally appropriate assessment tool. Study Three aims to evaluate the psychometric properties of the tool with an Indigenous sample living in the New South Wales Mid-North Coast. The study aims to quantify the predictive validity of this tool via comparison to functionality predictors and neuropsychological assessment scores. Study Four aims to collect qualitative data surrounding the feasibility and acceptability of the tool among indigenous Australians and health professionals. Expected Results: Findings from this research are likely to inform cognitive assessment practices and tool selection for health professionals conducting cognitive assessments with Indigenous Australians. Improved assessment of EF will inform appropriate care and intervention strategies for individuals with EF deficits.

Keywords: aboriginal Australians, assessment tool, cognition, executive functioning

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3202 Healthcare Workers' Attitudes Towards People Living With Hiv And Drug Users

Authors: Delband Yekta Moazami

Abstract:

Background: For proper care and treatment of HIV patients and drug users, the medical staff and physicians must have a correct and positive attitude and knowledge towards such patients. We aimed to assess the attitudes in a sample of health care workers (HCW) working in different hospitals and clinics and medical students in Georgia towards HIV infected people and drug users in Tbilisi. Method: We conducted a cross-sectional study to assess attitudes of health care workers towards people living with HIV and drug users in hospitals and clinics in Tbilisi. The study was carried out from 1st of May 2020 till 30th of September 2020. Data were collected using a self-administered structured online questionnaire. With this tool we evaluated four facets of attitudes: Discrimination, Acceptance of HIV/AIDS patients, Acceptance of drug users and Fear. All data were imported and analyzed with the software SPSS 22 for windows. Results: In total data was collected from168 respondents, that among them 107 (65%) were women and majority of the participants were medical doctors. Women had more acceptance attitudes rather than men towards drug abusers. We found significant differences regarding expressing negative attitudes among HCW who were more than 50 years old comparing with other age groups in all four aspects. Medical doctors expressed more acceptances towards people with HIV and drug users comparing two other groups. Also our study revealed that the group with working experience 21 years and more, showed more discriminatory attitudes comparing other groups. Conclusion: Based on our study findings, there are significant differences regarding respondent’s attitudes based on gender, medical specialty and working experience in health care system. People struggling with HIV and drug use need nonjudgmental and positive behaviors from health care workers and physicians in order to help them for harm reduction and receiving appropriate treatment.

Keywords: hiv, addiction, attitudes, healthcare workers

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3201 Multimedia Technologies Utilisation as Predictors of Lecturers’ Teaching Effectiveness in Colleges of Education in South-West, Nigeria

Authors: Abel Olusegun Egunjobi, Olusegun Oyeleye Adesanya

Abstract:

Teaching effectiveness of lecturers in a tertiary institution in Nigeria is one of the determinants of the lecturer’s productivity. In this study, therefore, lecturers’ teaching effectiveness was examined vis-à-vis their multimedia technologies utilisation in Colleges of Education (CoE) in South-West, Nigeria. This is for the purpose of ascertaining the relationship and contribution of multimedia technologies utilisation to lecturers’ teaching effectiveness in Nigerian colleges of education. The descriptive survey research design was adopted in the study, while a multi-stage sampling procedure was used in the study. A stratified sampling technique was used to select colleges of education, and a simple random sampling method was employed to select lecturers from the selected colleges of education. A total of 862 lecturers (627 males and 235 females) were selected from the colleges of education used for the study. The instrument used was lecturers’ questionnaire on multimedia technologies utilisation and teaching effectiveness with a reliability coefficient of 0.85 at 0.05 level of significance. The data collected were analysed using descriptive statistics, multiple regression, and t-test. The findings showed that the level of multimedia technologies utilisation in colleges of education was low, whereas lecturers’ teaching effectiveness was high. Findings also revealed that the lecturers used multimedia technologies purposely for personal and professional developments, so also for up to date news on economic and political matters. Also, findings indicated that laptop, Ipad, CD-ROMs, and computer instructional software were the multimedia technologies frequently utilised by the lecturers. There was also a significant difference in the teaching effectiveness between lecturers in the Federal and State COE. The government should, therefore, make adequate provision for multimedia technologies in the COE in Nigeria for lecturers’ utilisation in their instructions so as to boost their students’ learning outcomes.

Keywords: colleges of education, lecturers’ teaching effectiveness, multimedia technologies utilisation, Southwest Nigeria

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3200 Influence of Social Media on Perceived Learning Outcome of Agricultural Students in Tertiary Institutions in Oyo State, Nigeria

Authors: Adedoyin Opeyemi Osokoya

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The study assesses the influence of social media on perceived learning outcome of agricultural science students in tertiary institutions in Oyo state, Nigeria. The four-stage sampling procedure was used to select participants. All students in the seven tertiary institutions that offer agriculture science as a course of study in Oyo State was the population. A university, a college of agriculture and a college of education were sampled, and a department from each was randomly selected. Twenty percent of the students’ population in the respective selected department gave a sample size of 165. Questionnaire was used to collect information on respondents’ personal characteristics and information related to access to social media. Data were analysed using descriptive statistics, chi-square, correlation, and multiple regression at the 0.05 confidence level. Age and household size were 21.13 ± 2.64 years and 6 ± 2.1 persons respectively. All respondents had access to social media, majority (86.1%) owned Android phone, 57.6% and 52.7% use social media for course work and entertainment respectively, while the commonly visited sites were WhatsApp, Facebook, Google, Opera mini. Over half (53.9%) had an unfavourable attitude towards the use of social media for learning; benefits of the use of social media for learning was high (56.4%). Removal of information barrier created by distance (x̄=1.58) was the most derived benefit, while inadequate power supply (x̄=2.36), was the most severe constraints. Age (β=0.23), sex (β=0.37), ownership of Android phone (β=-1.29), attitude (β=0.37), constraints (β =-0.26) and use of social media (β=0.23) were significant predictors of influence on perceived learning outcomes.

Keywords: use of social media, agricultural science students, undergraduates of tertiary institutions, Oyo State of Nigeria

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3199 Effects of an Educational Program on Nurses Knowledge and Practice Related to Hepatitis-B: Pre-Experimental Design

Authors: R. S. Mehta, G. N. Mandal

Abstract:

Hepatitis-B is the major infectious disease of mankind. In Nepal it is reported that more than 4.3% of Nepalese population at any time in their life has been infected with Hepatitis-B virus (HBV). The objective of this study was to evaluate the effectiveness of planned educational programme regarding knowledge and practice of hepatitis-B among the nurses working at medical units of BPKIHS. Pre-experimental research design was used to conduct the study among the nurses working in medical units of BPKIHS. Total 40 nurses were included in the pre-test and 34 in the post-test. The education intervention was arranged on 24th May 2012 from 2:15 pm to 4:45 pm i.e. two and half hours. After two weeks of education intervention post-test was conducted. Most of the participants (60%) were of the age group of 18-22 years, Hindu (82.5%), and unmarried (65%). After education intervention there is significant differences in knowledge on the components of Hepatitis-B at 0.05 level of significance. There is no difference in the attitude components after post-test except the component patient contaminated with Hepatitis-B must be called as the last patient (p=0.035). It can conclude that hepatitis-B educational program improved knowledge and practice among the nurses.

Keywords: educational program, Hepatitis-B, pre-experimental design, medical units

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3198 Developing an Accurate AI Algorithm for Histopathologic Cancer Detection

Authors: Leah Ning

Abstract:

This paper discusses the development of a machine learning algorithm that accurately detects metastatic breast cancer (cancer has spread elsewhere from its origin part) in selected images that come from pathology scans of lymph node sections. Being able to develop an accurate artificial intelligence (AI) algorithm would help significantly in breast cancer diagnosis since manual examination of lymph node scans is both tedious and oftentimes highly subjective. The usage of AI in the diagnosis process provides a much more straightforward, reliable, and efficient method for medical professionals and would enable faster diagnosis and, therefore, more immediate treatment. The overall approach used was to train a convolution neural network (CNN) based on a set of pathology scan data and use the trained model to binarily classify if a new scan were benign or malignant, outputting a 0 or a 1, respectively. The final model’s prediction accuracy is very high, with 100% for the train set and over 70% for the test set. Being able to have such high accuracy using an AI model is monumental in regard to medical pathology and cancer detection. Having AI as a new tool capable of quick detection will significantly help medical professionals and patients suffering from cancer.

Keywords: breast cancer detection, AI, machine learning, algorithm

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3197 Utilizing Street Medicine to Reduce Communicable Disease Prevalence in a Cost-Effective Way

Authors: Bailey Hall, Athena Hoppe, Tevyn Kagele, Anna Nichols, Breeanna Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to people experiencing homelessness in Spokane, Washington. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to a largely underserved population. In this analysis, the SSM Program’s medical charts from street and shelter encounters in early 2021 were reviewed in order to identify illness and diseases in people experiencing homelessness in Spokane. More than half of the prescriptions written during these encounters were for either an antibacterial, an antibiotic, or an antifungal. Estimates of the cost to the local healthcare system are included. Initiating treatment for communicable diseases in people experiencing homelessness via street medicine efforts greatly reduces economic costs while improving health outcomes.

Keywords: ethical issues in public health, equity issues in public health, health economics, health disparities, healthcare costs, medical public health, public health ethics, street medicine

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3196 The Effect of Socio-Affective Variables in the Relationship between Organizational Trust and Employee Turnover Intention

Authors: Paula A. Cruise, Carvell McLeary

Abstract:

Employee turnover leads to lowered productivity, decreased morale and work quality, and psychological effects associated with employee separation and replacement. Yet, it remains unknown why talented employees willingly withdraw from organizations. This uncertainty is worsened as studies; a) priorities organizational over individual predictors resulting in restriction in range in turnover measurement; b) focus on actual rather than intended turnover thereby limiting conceptual understanding of the turnover construct and its relationship with other variables and; c) produce inconsistent findings across cultures, contexts and industries despite a clear need for a unified perspective. The current study addressed these gaps by adopting the theory of planned behavior (TPB) framework to examine socio-cognitive factors in organizational trust and individual turnover intentions among bankers and energy employees in Jamaica. In a comparative study of n=369 [nbank= 264; male=57 (22.73%); nenergy =105; male =45 (42.86)], it was hypothesized that organizational trust was a predictor of employee turnover intention, and the effect of individual, group, cognitive and socio-affective variables varied across industry. Findings from structural equation modelling confirmed the hypothesis, with a model of both cognitive and socio-affective variables being a better fit [CMIN (χ2) = 800.067, df = 364, p ≤ .000; CFI = 0.950; RMSEA = 0.057 with 90% C.I. (0.052 - 0.062); PCLOSE = 0.016; PNFI = 0.818 in predicting turnover intention. The findings are discussed in relation to socio-cognitive components of trust models and predicting negative employee behaviors across cultures and industries.

Keywords: context-specific organizational trust, cross-cultural psychology, theory of planned behavior, employee turnover intention

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3195 Bio-Psycho-Social Consequences and Effects in Fall-Efficacy Scale in Seniors Using Exercise Intervention of Motor Learning According to Yoga Techniques

Authors: Milada Krejci, Martin Hill, Vaclav Hosek, Dobroslava Jandova, Jiri Kajzar, Pavel Blaha

Abstract:

The paper declares effects of exercise intervention of the research project “Basic research of balance changes in seniors”, granted by the Czech Science Foundation. The objective of the presented study is to define predictors, which influence bio-psycho-social consequences and effects of balance ability in senior 65 years old and above. We focused on the Fall-Efficacy Scale changes evaluation in seniors. Comprehensive hypothesis of the project declares, that motion uncertainty (dyskinesia) can negatively affect the well-being of a senior in bio-psycho-social context. In total, random selection and testing of 100 seniors (30 males, 70 females) from Prague and Central Bohemian region was provided. The sample was divided by stratified random selection into experimental and control groups, who underwent input and output testing. For diagnostics the methods of Medical Anamnesis, Functional anthropological examinations, Tinetti Balance Assessment Tool, SF-36 Health Survey, Anamnestic comparative self-assessment scale were used. Intervention method called "Life in Balance" based on yoga techniques was applied in four-week cycle. Results of multivariate regression were verified by repeated measures ANOVA: subject factor, phase of intervention (between-subject factor), body fluid (within-subject factor) and phase of intervention × body fluid interaction). ANOVA was performed with a repetition involving the factors of subjects, experimental/control group, phase of intervention (independent variable), and x phase interaction followed by Bonferroni multiple comparison assays with a test strength of at least 0.8 on the probability level p < 0.05. In the paper results of the first-year investigation of the three years running project are analysed. Results of balance tests confirmed no significant difference between females and males in pre-test. Significant improvements in balance and walking ability were observed in experimental group in females comparing to males (F = 128.4, p < 0.001). In the females control group, there was no significant change in post- test, while in the female experimental group positive changes in posture and spine flexibility in post-tests were found. It seems that females even in senior age react better to incentives of intervention in balance and spine flexibility. On the base of results analyses, we can declare the significant improvement in social balance markers after intervention in the experimental group (F = 10.5, p < 0.001). In average, seniors are used to take four drugs daily. Number of drugs can contribute to allergy symptoms and balance problems. It can be concluded that static balance and walking ability of seniors according Tinetti Balance scale correlate significantly with psychic and social monitored markers.

Keywords: exercises, balance, seniors 65+, health, mental and social balance

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3194 Negative Perceptions of Ageing Predicts Greater Dysfunctional Sleep Related Cognition Among Adults Aged 60+

Authors: Serena Salvi

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Ageistic stereotypes and practices have become a normal and therefore pervasive phenomenon in various aspects of everyday life. Over the past years, renewed awareness towards self-directed age stereotyping in older adults has given rise to a line of research focused on the potential role of attitudes towards ageing on seniors’ health and functioning. This set of studies has showed how a negative internalisation of ageistic stereotypes would discourage older adults in seeking medical advice, in addition to be associated to negative subjective health evaluation. An important dimension of mental health that is often affected in older adults is represented by sleep quality. Self-reported sleep quality among older adults has shown to be often unreliable when compared to their objective sleep measures. Investigations focused on self-reported sleep quality among older adults have suggested how this portion of the population would tend to accept disrupted sleep if believed to be up to standard for their age. On the other hand, unrealistic expectations, and dysfunctional beliefs towards sleep in ageing, might prompt older adults to report sleep disruption even in the absence of objective disrupted sleep. Objective of this study is to examine an association between personal attitudes towards ageing in adults aged 60+ and dysfunctional sleep related cognition. More in detail, this study aims to investigate a potential association between personal attitudes towards ageing, sleep locus of control and dysfunctional beliefs towards sleep among this portion of the population. Data in this study were statistically analysed in SPSS software. Participants were recruited through the online participants recruitment system Prolific. Inclusion of attention check questions throughout the questionnaire and consistency of responses were looked at. Prior to the commencement of this study, Ethical Approval was granted (ref. 39396). Descriptive statistics were used to determine the frequency, mean, and SDs of the variables. Pearson coefficient was used for interval variables, independent T-test for comparing means between two independent groups, analysis of variance (ANOVA) test for comparing the means in several independent groups, and hierarchical linear regression models for predicting criterion variables based on predictor variables. In this study self-perceptions of ageing were assessed using APQ-B’s subscales, while dysfunctional sleep related cognition was operationalised using the SLOC and the DBAS16 scales. Of the final subscales taken in consideration in the brief version of the APQ questionnaire, Emotional Representations (ER), Control Positive (PC) and Control and Consequences Negative (NC) have shown to be of particularly relevance for the remits of this study. Regression analysis show how an increase in the APQ-B subscale Emotional Representations (ER) predicts an increase in dysfunctional beliefs and attitudes towards sleep in this sample, after controlling for subjective sleep quality, level of depression and chronological age. A second regression analysis showed that APQ-B subscales Control Positive (PC) and Control and Consequences Negative (NC) were significant predictors in the change of variance of SLOC, after controlling for subjective sleep quality, level of depression and dysfunctional beliefs about sleep.

Keywords: sleep-related cognition, perceptions of aging, older adults, sleep quality

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