Search results for: problem-oriented medical record

Authors: Deepak Chaudhary

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This paper attempts to analyze the leadership phenomena, its challenges, and prospects in Nepal. Literature is reviewed rigorously to explain the theoretical and empirical aspects of leadership. Besides, In-depth interviews with three national leaders were interviewed to know the challenges regarding polity and leadership. Similarly, a survey among 434 households in Katahari rural municipality and Godavari municipality was carried out to assess people’s perceptions of leaders. Leadership is normally pronounced in the wake of the success of the country’s development or crisis management. Real leaders are those who can avert any crisis successfully and proceed with the country in a progressive and normal way. Leadership’s working style can create a favorable institutional environment in the public institution that can lead development programs successfully. However, the literature suggests that Nepal is still struggling towards modernization in comparison to some East-Asian countries whose socio-economic situation was more similar in the 1950s. Similarly, Nepal has been facing several social movements after the 1990s, which resulted in a new political system, though the performance of the public institution has been a question and it goes to the leadership’s role. The poor tackling of natural disasters like earthquakes flooding, and pandemics raises the questions of the leadership’s role to some extent. The government of Nepal's record of developmental expenditures is dismal. However, leadership has been the central part of people, community, and country, and hence, the study of leadership phenomena in relation to a country’s well-being is intrinsic.

Keywords: challenges, leadership, institutionalization, effectiveness

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Authors: D. L. David, J. A. Wahedi, Q. T. Zaku

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A study was conducted at River Mayo Ranewo and River Lau, Taraba State Nigeria. The two rivers empty into the Upper Benue Basin. A visual encounter survey was conducted within the two wetlands from June to August, 2014. The fish record was based entirely on landings of fishermen, number of canoes that land fish was counted, types of nets and baits used on each sampling day. Fish were sorted into taxonomic groups, identified to family/species level, counted and weighed in groups. The relative species abundance was determined by dividing the number of species from a site by the total number of species from all tributaries/sites. Fish was preserved in 2% formaldehyde solution and taken to the laboratory, where they were identified. Shannon-Weiner index of species diversity indicated that the diversity was highest at River Mayo Ranewo than River Lau. In the result showed at River Mayo Ranewo, the family Mochokidae recorded the highest (23.15%), followed by Mormyridae (2.64%) and the least was the family Lepidosirenidae (0.04%). While at River Lau the family Mochokidae recorded the highest occurrence of (24.1%), followed by Bagridae (20.20%), and then Mormyridae, which also was the second highest in River Lau, with 18.46% occurrence. There was no occurrence of Malapteruridae and Osteoglossidae (0%) in River Lau, but the least occurrence was the family Gymnarchidae (0.04%). These results indicated that the fish composition were not significantly (p ≤ 0.05) different based on t-test.

Keywords: conservation, diversity index, Lau, Mayo Ranewo, wetlands

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Authors: Retno Supriyanti, Best Leader Nababan, Yogi Ramadhani, Wahyu Siswandari

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Blood cell morphology is an important parameter in a hematology test. Currently, in developing countries, a lot of hematology is done manually, either by physicians or laboratory staff. According to the limitation of the human eye, examination based on manual method will result in a lower precision and accuracy. In addition, the hematology test by manual will further complicate the diagnosis in some areas that do not have competent medical personnel. This research aims to develop a simple tool in the detection of blood cell morphology-based computer. In this paper, we focus on the detection of the outer contour of leukocytes. The results show that the system that we developed is promising for detecting blood cell morphology automatically. It is expected, by implementing this method, the problem of accuracy, precision and limitations of the medical staff can be solved.

Keywords: morphology operation, developing countries, hematology test, limitation of medical personnel

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Authors: Haitao Yang, Zhenjiang Ruan, Fei Xu, Lanting Xia

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Industry data centers often need to sync data changes reliably and instantly from a large-scale of heterogeneous autonomous relational databases accessed via the not-so-reliable Internet, for which a practical universal sync middle of low maintenance and operation costs is most wanted, but developing such a product and adapting it for various scenarios are a very sophisticated and continuous practice. The authors have been devising, applying, and optimizing a generic sync middleware system, named GSMS since 2006, holding the principles or advantages that the middleware must be SyncML-compliant and transparent to data application layer logic, need not refer to implementation details of databases synced, does not rely on host computer operating systems deployed, and its construction is light weighted and hence, of low cost. A series of ultimate experiments with GSMS sync performance were conducted for a persuasive example of a source relational database that underwent a broad range of write loads, say, from one thousand to one million intensive writes within a few minutes. The tests proved that GSMS has achieved an instant sync level of well below a fraction of millisecond per record sync, and GSMS’ smooth performances under ultimate write loads also showed it is feasible and competent.

Keywords: heterogeneous massive data, instantly sync intensive writes, Internet generic middleware design, optimization

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Authors: Dawei Li, Cheng Liu, Yiteng Liu

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This paper introduces an embedded digital image system for Chinese space environment vertical exploration sounding rocket. In order to record the flight status of the sounding rocket as well as the payloads, an onboard embedded image processing system based on ADV212, a JPEG2000 compression chip, is designed in this paper. Since the sounding rocket is not designed to be recovered, all image data should be transmitted to the ground station before the re-entry while the downlink band used for the image transmission is only about 600 kbps. Under the same condition of compression ratio compared with other algorithm, JPEG2000 standard algorithm can achieve better image quality. So JPEG2000 image compression is applied under this condition with a limited downlink data band. This embedded image system supports lossless to 200:1 real time compression, with two cameras to monitor nose ejection and motor separation, and two cameras to monitor boom deployment. The encoder, ADV7182, receives PAL signal from the camera, then output the ITU-R BT.656 signal to ADV212. ADV7182 switches between four input video channels as the program sequence. Two SRAMs are used for Ping-pong operation and one 512 Mb SDRAM for buffering high frame-rate images. The whole image system has the characteristics of low power dissipation, low cost, small size and high reliability, which is rather suitable for this sounding rocket application.

Keywords: ADV212, image system, JPEG2000, sounding rocket

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Authors: Gheimati Salar

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The objective of conducting this research was to study the influence of plyometric exercises on the biomechanical selected factor of elite teen swimmers and compare the influence of plyometric exercises on the speed of front crawl and back crawl in empirical and control groups of teens. In order to conduct these study 30 swimmers with minimum of 3 years' experience who were 11 or 12 were randomly chosen and divided into 2 groups of 15. The first group was empirical and the second was control group. The speed of the swimmer was analyzed after 25 meters of swimming and their speed were recorded in the last. The researcher was standing stable at the beginning and then started the chronometer and stopped it at the end of the swimming. He repeated the record taking two times and then the average was taken. Before conducting plyometric exercises, a speed test was taken from both groups in both types of swimming. The duration of plyometric exercises was 8 weeks, every week 3 sessions and 24 sessions in total. The exercises in this study were focused on 3 parts of the body. Upper limb part, the lower part of the body and trunk area. Upper limb exercises consisted of four parts. The lower limb exercises consisted of 5 parts, and the trunk exercises consisted of four sections. A Medicine ball, cone and different weights were used in these exercises.

Keywords: plyometric, exercises, front crawl and back crawl, speed

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Authors: Einat Peles, Anat Sason, Ariel Claman, Gabriel Barkay, Miriam Adelson

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Individuals with opioid addiction are characterized as suffering from stress responses disturbance, including the hypothalamic-pituitary-adrenal (HPA) axis, and autonomic nervous system function. HPA axis is known to be stabilized during methadone maintenance treatment (MMT). Mindfulness (present-oriented, nonjudgmental awareness of cognitions, emotions, perceptions, and habitual behavioral reactions in daily life) counteracts stress. To our knowledge, the relation between perceived stress and mindfulness trait among MMT patients has never been studied. To measure indices of mindfulness and their relation to perceived stress among MMT patients, a cross-sectional random sample of current MMT patients was performed using questionnaires for perceived stress (PSS) and mindfulness trait (FFMQ- yields a total score and individual scores for five internally consistent mindfulness factors: Observing, Describing, Acting with awareness and consciousness, Non-judging the inner experience, Non-reactivity to the inner experience). Two additional groups were studied to serve as reference groups; Medical students that are known to suffer from stress, and Axis II psychiatric diagnosis patients that are known to characterized with poor mindfulness trait. Results: Groups included 41 MMT patients, 27 Axis II patients and 36 medical students. High perceived stressed (PSS≥18) defined among 61% of the MMT patients and 50% of the medical students. Highest mindfulness score observed among non-stressed MMT patients (153.5±17.2) followed by the groups of stressed MMT and non-stressed student (128.9±17.0 and 130.5±13.3 respectively), with the lowest score among stressed students (116.3±17.9) (multivariate analyses, corrected model p (F=14.3) < 0.0005, p (group) < 0.0005, p (stress) < 0.0005, p (interaction) =0.2). Linear inverse correlations were found between perceived stress score and mindfulness score among MMT patients (R=-0.65, p < 0.0005) and students (R=-0.51, p=0.002). Axis II patients had the lowest mindfulness score (103.4±25.3). Conclusion: High prevalence of high perceived stressed which characterized with poor mindfulness trait observed in both MMT patients and medical students, two different population groups. The effectiveness of mindfulness treatment in reducing stress and improve mindfulness trait should be evaluated to improve rehabilitation of MMT patients, and students success.

Keywords: mindfulness, stress, methadone maintenance treatment, medical students

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Authors: Asm Habibullah Choudhury

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Background: This study is an investigation into medical care, ethics, and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in the context of Bangladesh. The low prevalence of HIV and high prevalence of STDs in Bangladesh, in common with the global experience of HIV epidemics, has been characterized by tremendous stigmatization of those affected. Stigmatization has resulted in an extraordinary degree of unjust discrimination and in numerous human rights violations of PLWHA. Methodology: This will be a cross-sectional descriptive study and will be conducted at different points of Bangladesh. Result: PLWHA will be identified as many as possible and will be interviewed. Medical care providers will be interviewed to assess their attitude and will be observed for stigma while providing medical services. Some of the religious leaders, local influential people will be interviewed to assess their attitude towards PLWHA. Conclusion: If effective responses to HIV/AIDS-related stigma and discrimination are to be promoted in the region, work has to occur simultaneously on several fronts: Legal challenge, where necessary, to bring to account governments, employers, institutions and individuals. To create enabling environment in which PLWHA and their families, women, boys, and girls are able to access prevention and care services. Access to quality and comprehensive care. The fundamental objective, however, is to strive for action based on this understanding—action that will promote egalitarian and gender-progressive role models, and that will help guide the manner in which we interact with one another.

Keywords: HIV, AIDS, Bangladesh, human rights

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Authors: A. F. Jaber, E. Dean, M. Liu, J. He, D. Sabata, J. Radel

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Background: Stroke is a serious health care concern and a major cause of disability in the United States. This condition impacts the individual’s functional ability to perform daily activities. Predicting functional performance of people with stroke assists health care professionals in optimizing the delivery of health services to the affected individuals. The purpose of this study was to identify significant predictors of Motor FIM and of Cognitive FIM subscores among individuals with stroke after discharge from inpatient rehabilitation (typically 4-6 weeks after stroke onset). A second purpose is to explore the relation among personal characteristics, health status, and functional performance of daily activities within 2 weeks of stroke onset. Methods: This study used a retrospective chart review to conduct a secondary analysis of data obtained from the Healthcare Enterprise Repository for Ontological Narration (HERON) database. The HERON database integrates de-identified clinical data from seven different regional sources including hospital electronic medical record systems of the University of Kansas Health System. The initial HERON data extract encompassed 1192 records and the final sample consisted of 207 participants who were mostly white (74%) males (55%) with a diagnosis of ischemic stroke (77%). The outcome measures collected from HERON included performance scores on the National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Functional Independence Measure (FIM). The data analysis plan included descriptive statistics, Pearson correlation analysis, and Stepwise regression analysis. Results: significant predictors of discharge Motor FIM subscores included age, baseline Motor FIM subscores, discharge NIHSS scores, and comorbid electrolyte disorder (R2 = 0.57, p <0.026). Significant predictors of discharge Cognitive FIM subscores were age, baseline cognitive FIM subscores, client cooperative behavior, comorbid obesity, and the total number of comorbidities (R2 = 0.67, p <0.020). Functional performance on admission was significantly associated with age (p < 0.01), stroke severity (p < 0.01), and length of hospital stay (p < 0.05). Conclusions: our findings show that younger age, good motor and cognitive abilities on admission, mild stroke severity, fewer comorbidities, and positive client attitude all predict favorable functional outcomes after inpatient stroke rehabilitation. This study provides health care professionals with evidence to evaluate predictors of favorable functional outcomes early at stroke rehabilitation, to tailor individualized interventions based on their client’s anticipated prognosis, and to educate clients about the benefits of making lifestyle changes to improve their anticipated rate of functional recovery.

Keywords: functional performance, predictors, stroke, recovery

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Authors: Glenda Marie D. Balitaan

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The branch of business management that deals with inventory planning and control is known as inventory management. It comprises keeping track of supply levels and forecasting demand, as well as scheduling when and how to plan. Keeping excess inventory results in a loss of money, takes up physical space, and raises the risk of damage, spoilage, and loss. On the other hand, too little inventory frequently causes operations to be disrupted and raises the possibility of low customer satisfaction, both of which can be detrimental to a company's reputation. The United Victorious Feed mill Corporation's present inventory management practices were assessed in terms of inventory level, warehouse allocation, ordering frequency, shelf life, and production requirement. To help the company achieve their optimal level of inventory, a mathematical model was created using Integer Linear Programming. Due to the season, the goal function was to reduce the cost of purchasing US Soya and Yellow Corn. Warehouse space, annual production requirements, and shelf life were all considered. To ensure that the user only uses one application to record all relevant information, like production output and delivery, the researcher built a Visual Basic system. Additionally, the technology allows management to change the model's parameters.

Keywords: inventory management, integer linear programming, inventory management system, feed mill

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Authors: Nagri Sateesh, Kundavarapu Vengalrao, Kopparthi Phaneendra Kumar

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Vacuum assisted resin transfer molding (VARTM) is one of the manufacturing technique that is viable for production of fiber reinforced polymer composite components suitable for aerospace, marine and commercial applications. However, the repeatable quality of the product can be achieved by critically fixing the process parameters such as Vacuum Pressure (VP) and permeability of the preform. The present investigation is aimed at studying the effect of permeability for production of Glass Fiber Reinforced Plastic (GFRP) components with consistent quality. The VARTM mould is made with an acrylic transparent top cover to observe and record the resin flow pattern. Six layers of randomly placed glass fiber under five different vacuum pressures VP1 = 0.013, VP2 = 0.026, VP3 = 0.039, VP4 = 0.053 and VP5 = 0.066 MPa were studied. The laminates produced by this process under the above mentioned conditions were characterized with ASTM D procedures so as to study the effect of these process parameters on the quality of the laminate. Moreover, as mentioned there is a considerable effect of permeability on the impact strength and the void content in the laminates under different vacuum pressures. SEM analysis of the impact tested fractured GFRP composites showed the bonding of fiber and matrix.

Keywords: permeability, vacuum assisted resin transfer molding (VARTM), ASTM D standards, SEM

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Authors: Seyed Mehdi Hashemi, Gholamreza Raisali, Mehran Taheri

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One of the important problems of using high energy linacs at IMRT is the production of photoneutrons. Besides the clinically useful photon beams, high-energy photon beams from medical linacs produce secondary neutrons. These photoneutrons increase the patient dose and may cause secondary malignancies. The effect of the shield on the reduction of photoneutron dose equivalent produced by a high energy medical linac at the patient plane is investigated in this study. To determine the photoneutron dose equivalent received to the patient a Varian linac working at 18 MV photon mode investigated. Photoneutron dose equivalent measured with Polycarbonate films of 0.25 mm thick. PC films placed at distances of 0, 10, 20, and 50 cm from the center of X-ray field on the patient couch. The results show that by increasing the distance from the center of the X-ray beam towards the periphery, the photoneutron dose equivalent decreases rapidly for both open and shielded fields and that by inserting the shield in the path of the X-ray beam, the photoneutron dose equivalent was decreased obviously compared to open field. Results show the shield, significantly reduces photoneutron dose equivalent to the patient. Results can be readily generalized to other models of medical linacs. It may be concluded that using this kind of shield can help more safe, inexpensive and efficient employment of high energy linacs in radiotherapy and IMRT.

Keywords: photoneutron, Linac, PMMA shield, equivalent dose

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Authors: Israr Ahmad, Sehrish Sabir

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Present study deals with the taxonomic and ethno medicinal uses of some Pteridophytes species present in District Bagh AJK, Pakistan. The people of District Bagh extensively use Pteridophytes for different purposes. Ethno botanical evidence and Ornamental Potential of the taxa of wild pteridophytes was documented through field trips during 2017-2018, and data was collected through a structured questionnaire, and in-depth interviews were conducted from the natives in the hilly regions. Total of 22 Pteridophytes belonging to 13 genera 9 families were collected. Out of 22 species, one species (Cystoathyriumchinense ) newly record from Pakistan. The most leading family is Pteridaceae, having 9species, followed by Dryopteridaceae, having 4species, and Aspleniaceae having 3species. The remaining families are represented by single species of each. Inhabitants of mountainous and rural zones regularly used these taxa for different remedy, which are not discussed in the previous available literature. The novel remedies reported in this research areCystoathyriumchinense decoction used for irregular menstruation, Cyclosorusopulentus crushed leaves and stem are used for the treatment of stomach disorder.Onychiumlucidumused to treatJaundice, injury, pain dysentery, common cold, and arresting bleeding. Based on these findings, it is further recommended that phytochemical studies should be conducted to explore active chemical constituents for the cure of various diseases. Conservation efforts must be done to conserve many threatened species of the research area.

Keywords: adiantum, cancer, pakistan, pteridophytes

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Authors: S. M. Kulkarni, D. S. Bormane, S. L. Nalbalwar

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The rapid development in the technology have dramatic impact on the medical health care field. Medical data base obtained with latest machines like CT Machine, MRI scanner requires large amount of memory storage and also it requires large bandwidth for transmission of data in telemedicine applications. Thus, there is need for video compression. As the database of medical images contain number of frames (slices), hence while coding of these images there is need of motion estimation. Motion estimation finds out movement of objects in an image sequence and gets motion vectors which represents estimated motion of object in the frame. In order to reduce temporal redundancy between successive frames of video sequence, motion compensation is preformed. In this paper three step search (TSS) block matching algorithm is implemented on different types of video sequences. It is shown that three step search algorithm produces better quality performance and less computational time compared with exhaustive full search algorithm.

Keywords: block matching, exhaustive search motion estimation, three step search, video compression

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Authors: M. Brik, S. Harmand, I. Zaaroura

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This report, an experimental investigation, concerns the sessile daughter drop remaining during the coalescence of water drops in a liquid-liquid (LL) system. The two drops are initially vertically aligned where the sessile drop is deposited on a chemically treated super-hydrophobic surface of a cube fill of silicone oil. In order to analyze the coalescence dynamics, a series of experiments have been performed using a generation droplets system (KRUSS) that measures contact angles as well coupled with a high-speed camera (Keyence VW-9000E) to record the process at a frame rate of 15000s-1. It’s depicted that in such configuration, the head drop volume has a primordial impact on the dynamics of the coalescence process, especially at the last stage. It’s found that for a sessile drop deposited on a super-hydrophobic surface, where the contact angle is about θ ≈ 145°, the coalescence process is remarked to be complete without any recoiling of the coalesced drop or a generation of a sessile daughter drop at the super-hydrophobic surface when the head drop volume is small enough (Vₐᵦ< Vₛ up to Vₐᵦ = 3Vₛ). On the other side, the coalescence process starts to be followed by jumping off the resulted drop as well as a remaining of a small sessile daughter drop on the bottom surface of the cube from a head drop volume Vₐᵦ of about 4 times than that of the sessile drop Vₛ.

Keywords: drops coalescence, dispersed multiphase flow, drops dynamics, liquid-liquid system

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Authors: Cherish Romina Prajitno, Sunisa Thaichinda

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One indicator of facial aging is wrinkles. Not only that, but wrinkles are a key indicator in our world of facial aesthetics. Wrinkles occur where fault lines develop in aging skin. Nowadays, people are more motivated to keep up their appealing and young appearance. Many individuals are seeking a fast recovery time for their aesthetic procedures and are interested in non-invasive techniques that have a proven track record for successful outcomes. The purpose of this study is to see the efficacy of 100% (pure) grapeseed oil for reducing periorbital wrinkles. This study used the split-face, double-blind method, and this treatment was administered for three months at random to fifteen patients, with the grapeseed oil at one side of the face and the other side with the placebo. The main outcome measure was determined by conducting a comparative analysis of the participants' wrinkle results during each visit using the VIsioscan® VC98. Additionally, we evaluated the skin's elasticity and barrier function using the Cutometer® MP 530 and Tewameter® TM300. Furthermore, we administered a satisfaction score questionnaire to the patients in the 12th week. The findings of the study indicate that grapeseed oil exhibited a noteworthy effect in diminishing the appearance of wrinkles in the periorbital region, enhancing the viscoelastic properties of the periorbital skin, and improving the functionality of the skin barrier in the periorbital area.

Keywords: periorbital wrinkles, pure grapeseed oil, split-face method

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Authors: Islam Abou El-Magd, Elham Ali, Ali Amasha

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Earthquakes strike without warning and cause widespread damage to social and economic infrastructures and creating life losses. These can neither be predicted nor prevented in terms of their magnitude, place, and time of occurrence. It is a global phenomenon that creates nearly 18% of life losses and nearly 35% of economic damage. The coastal zone of Egypt is considered low to medium risk, however, there is a record of high magnitude earthquakes that created Tsunami in the past. The northern coastal zone of Egypt is under the force of tension shear zones of African and European plates that have considerable earthquakes with variable degrees. This research studied the earthquakes in the last 65 years in the Mediterranean Basin in relation to the geotectonic shear zones. 85% of these earthquakes are in the marine that might create Tsunami. Aegean and Anatolia shear zones are the highest contributors of the earthquakes with nearly 37% and 36% respectively. However the least one is the Arabia zone with 1%, and Africa is about 26%. The research proposed three scenarios for the socioeconomic hazards, earthquakes with Tsunami that will destroy one fifth of the economic infrastructures with unpredictable life losses. The estimated cost of recovery of such losses is nearly 400B USD. The second scenario is earthquake without Tsunami that will impact the major urban and infrastructures. The last scenario is tidal gauges events that threaten the low-lying areas particularly the eastern side which has major land subsidence.

Keywords: natural hazards, earthquakes, tusnami, Nile delta, Egypt

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Authors: Manoj Deepak, N. Mathivanan, K. Venkatachalam

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Nerve root stenosis is one of the main cause for back pain. There are many methods both conservative and surgical to treat this disease. It is pertinent to decompress the spine to a proper extent so as to avoid the recurrence of symptoms. But too much of an aggressive approach also has its disadvantages. We present one of the methods to effectively decompress the nerve with better results. Our study was carried out in 52 patients with foramina stenosis between 2008 to 2011.We carried out the surgical procedure of shaving off the medial part of the facet joint so as to decompress the root. We selected those patients who had symptoms of claudication for more than 2 years. They had no signs of instability and they underwent conservative treatment for a period of 2 months before the procedure. Oswersty scoring was used to record the functional level of the patient before and after the procedure. All patients were followed up for a period of minimum 2.5 years. After evaluation for a minimum of 2.5 years, 34 patients had no evidence of recurrence of symptoms with improvement in the functional level.7 patients complained of minimal pain but their functional quality had improved postop. Six patients had symptoms of lumbar canal disease which reduced with conservative treatment. 5 patients required spinal fusion surgeries in the later period. Conclusion: Thus, we can effectively conclude that our procedure is safe and effective in reducing the symptoms in those patients with neurogenic claudication.

Keywords: facetectoemy, stenosis, decompression, Lumbar Foraminal Stenosis, hemi-facetectomy

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Authors: Jung Yoon Kim

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Introduction: Wounds inevitably cause patients to experience discomfort, distress, and consequentially reduced quality of life due to entailed pain, maceration, and foul odor. The dressing has been a universal wound care method in which wounds are covered and protected, and an optimum environment for healing is provided. This study aimed to investigate Korean nurses’ level of awareness of pain and skin tearing in wound beds and/or peri-wound skin at dressing change. Methods: A descriptive study was performed. Convenience sampling was employed, and registered nurses were recruited from attendees of continuing education program. A total of 399 participants (RN) completed the questionnaire. Data were collected from September to November 2022. Results: Many of them perceived skin tearing and wound-related pain associated with dressing changes, but most of them did not assess and record pain and skin tearing at dressing change. More than half of the respondents reported that they did not provide nursing intervention to prevent pain and skin tearing. Many of them reported that a systematic educational program for preventing pain and skin tearing at dressing changes was needed. Discussion: Many of the respondents were aware of pain and skin tearing at dressing change but did not take any further necessary measures, including nursing intervention, for the most appropriate, systematic pain and skin tearing management. Therefore, this study suggested that a systematic and comprehensive educational program for Korean healthcare professionals needs to be developed and implemented in Korea’s hospital settings.

Keywords: skin tearing, pain, dressing change, nurses

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Authors: Xiao Zhou, Kazuhiro Imai, Xiaoxuan Liu

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Badminton is one type of racket sports that requires repetitive overhead motion, with the shoulder in abduction/external rotation and requires players to perform jumps, lunges, and quick directional changes. These characteristics could be stressful for body regions that may cause badminton injuries. Regarding racket players including badminton players, there have not been any studies that have utilized medical check-up to evaluate epidemiology and mechanism of injuries. In addition, epidemiology of badminton injury in school age badminton players is unknown. The first purpose of this study was to investigate the badminton injuries, physical fitness parameters, and intensity of shoulder pain using medical check-up so that the mechanisms of shoulder injuries might be revealed. The second purpose of this study was to survey the distribution of badminton injuries in elementary school age players so that injury prevention can be implemented as early as possible. The results of this study revealed that shoulder pain occurred in all players, and present shoulder pain players had smaller weight, greater shoulder external rotation (ER) gain, significantly thinner circumference of upper limbs and greater trunk extension. Identifying players with specific of these factors may enhance the prevention of badminton injury. This study also shows that there are high incidences of knee, ankle, plantar, and shoulder injury or pain in elementary school age badminton players. Injury prevention program might be implemented for elementary school age players.

Keywords: badminton injury, epidemiology, medical check-up, school age players

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Authors: H. Chabalala, A. Grootboom, M. Tang

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The innovative development, production, and clinical utilisation of African natural medicines requires frameworks from systematisation, innovation, registration. Afrika faces challenges when it comes to these sectors. The opposite is the case as is is evident in ancient Asian (Traditional Chinese Medicine and Indian Ayurveda and Siddha) medical systems, which are interfaced into their respective national health and educational systems. Afrikan Natural Medicines (ANMs) are yet to develop systematisation frameworks, i.e. disease characterisation and medicines classification. This paper explores classical medical systems drawn from Afrikan and Chinese experts in natural medicines. An Afrikological research methodology was used to conduct in-depth interviews with 20 key respondents selected through purposeful sampling technique. Data was summarised into systematisation frameworks for classical disease theories, patient categorisation, medicine classification, aetiology and pathogenesis of disease, diagnosis and prognosis techniques and treatment methods. It was discovered that ancient Afrika had systematic medical cosmologies, remnants of which are evident in most Afrikan cultural health practices. Parallels could be drawn from classical medical concepts of antiquity, like Chinese Taoist and Indian tantric health systems. Data revealed that both the ancient and contemporary ANM systems were based on living medical cosmologies. The study showed that African Natural Healing Systems have etiological systems, general pathogenesis knowledge, differential diagnostic techniques, comprehensive prognosis and holistic treatment regimes. Systematisation models were developed out of these frameworks, and this could be used for evaluation of clinical research, medical application including development of curriculum for high-education. It was envisaged that frameworks will pave way towards the development, production and commercialisation of ANMs. This was piloted in inclusive innovation, technology transfer and commercialisation of South African natural medicines, cosmeceuticals, nutraceuticals and health infusions. The central model presented here in will assist in curriculum development and establishment of Afrikan Medicines Hospitals and Pharmaceutical Industries.

Keywords: African Natural Medicines, Indigenous Knowledge Systems, Medical Cosmology, Clinical Application

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Authors: Neeti Rustagi, Naveen Dutt, Arvind Sinha, Mahaveer S. Rhodha, Pankaja R. Raghav

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Background: Pre-hospital trauma care services are in developing stage in fast-urbanizing cities of India including Jodhpur. Training of health professionals in providing necessary pre-hospital trauma care is an essential step in decreasing accident related morbidity and mortality. The current study explores the response of a medical graduate toward helping an accident victim in a pre-hospital setting before patient can be transferred to definitive trauma facility. Methodology: This study examines the perceived competence in predicting response to an accident victim by medical graduates in Jodhpur, Rajasthan. Participants completed measures of attitude, normative influence and perceived behavior control toward providing pre-hospital care to an accident victim. Likert scale was used to measure the participant responses. Preliminary and descriptive analysis were used using SPSS 21.0. Internal consistency of the responses received was measured using Cronbach’s alpha. Results: Almost all medical graduates agreed that road accidents are common in their area (male: 92%; female: 78%). More male medical graduates (28%) reported helping an accident victim as compared to female physicians (9%) in the previous three months. Majority of study participants (96%) reported that providing immediate care to an accident victim is essential to save the life of an individual. Experience of helping an accident victim was considered unpleasant by the majority of female participants (70%) as compared to male participants (36%). A large number of participants believed that their friends (80%) and colleagues (96%) would appreciate them helping an accident victim in a pre-hospital setting. A large number of participants also believed that they possess the necessary skills and competencies (80%) towards helping a roadside accident victim in the pre-hospital care environment. Perceived competence of helping a roadside accident victim until they are transferred to a health facility was reported by less than half of the participants (male: 56%; female: 43%). Conclusion: Medical graduates have necessary attitude, competencies, and intention of helping a roadside accident victim. The societal response towards helping a road side accident victim is also supportive. In spite of positive determinants, a large proportion of medical graduates have perceived lack of competence in helping a roadside accident victim. This is essential to explore further as providing pre-hospital care to a roadside accident victim is an essential step in establishing the continuum of care to an accident victim especially in countries where pre-hospital services are in developing phase.

Keywords: prehospital care, perceived behavior, perceived competence, medical graduates

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Authors: Prateek Rastogi

Abstract:

Medical teaching in present era concentrates not only on teaching but on effective teaching. For effective teaching a combination of effective carefully designed curriculum, an educated educator, competent learner and fool proof evaluation system is required. Keeping these parameters in mind and study was undertaken at Kasturba Medical College, Mangalore among medical students. In this study, evaluation of Forensic Medicine syllabus along with its teaching and evaluation methodology was done using 20 different parameters. This questionnaire based study was done over a period of two years i.e. 2013 and 2014. Batch of students who just passed the forensic medicine subject was included for study. Carefully designed questionnaire contained questions related to course content, teaching methodology and evaluation system along with provisions to mention merits and demerits of subject. The feedbacks in first round were analyzed and suggestions were implemented before conducting the second round of study. Overall evaluation of course was done as well as it was compared with other subjects of second MBBS. It was noted that Scores improved in 2nd survey thus stressing the importance of course evaluation and student feedback in teaching improvement.

Keywords: teaching methodology, system of evaluation, course content, bioinformatics, biomedicine

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Authors: R. Stoyanova, R. Dimova, M. Tarnovska, T. Boeva, R. Dimov, I. Doykov

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Patient safety culture (PSC) is an essential component of quality of healthcare. Improving PSC is considered a priority in many developed countries. Specialized software platform for registration and evaluation of hospital patient safety culture has been developed with the support of the Medical University Plovdiv Project №11/2017. The aim of the study is to assess the status of PSC in Bulgarian hospitals and to compare it to that in USA and Croatian hospitals. Methods: The study was conducted from June 01 to July 31, 2018 using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). Two hundred and forty-eight medical professionals from different hospitals in Bulgaria participated in the study. To quantify the differences of positive scores distributions for each of the 42 HSOPSC items between Bulgarian, Croatian and USA samples, the x²-test was applied. The research hypothesis assumed that there are no significant differences between the Bulgarian, Croatian and US PSCs. Results: The results revealed 14 significant differences in the positive scores between the Bulgarian and Croatian PSCs and 15 between the Bulgarian and the USA PSC, respectively. Bulgarian medical professionals provided less positive responses to 12 items compared with Croatian and USA respondents. The Bulgarian respondents were more positive compared to Croatians on the feedback and communication of medical errors (Items - C1, C4, C5) as well as on the employment of locum staff (A7) and the frequency of reported mistakes (D1). Bulgarian medical professionals were more positive compared with their USA colleagues on the communication of information at shift handover and across hospital units (F5, F7). The distribution of positive scores on items: ‘Staff worries that their mistakes are kept in their personnel file’ (RA16), ‘Things ‘fall between the cracks’ when transferring patients from one unit to another’ (RF3) and ‘Shift handovers are problematic for patients in this hospital’ (RF11) were significantly higher among Bulgarian respondents compared with Croatian and US respondents. Conclusions: Significant differences of positive scores distribution were found between Bulgarian and USA PSC on one hand and between Bulgarian and Croatian on the other. The study reveals that distribution of positive responses could be explained by the cultural, organizational and healthcare system differences.

Keywords: patient safety culture, healthcare, HSOPSC, medical error

Procedia PDF Downloads 121

Authors: Rasha Shoumar

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Background: Since the onset of the Syria crisis in 2011, Jordan has hosted many Syrian refugees, many of which are residing in urban and rural areas. Vulnerability of refugees has increased due to the COVID-19 pandemic, adding to their already existing challenge in access to medical services, rendering them vulnerable to the complications of untreated medical conditions and amplifying their risk for severe COVID-19 disease. To improve health outcomes and access to health care services in a COVID-19 context, IOM (The International Organization for Migration) provided health services including awareness raising, direct primary health care through mobile teams and referrals to secondary services were extended to the vulnerable populations of refugees. Method: 6 community health volunteers were trained and deployed to different governorates to provide COVID-19 and non-communicable disease awareness and collect data rated to non-communicable disease and access to medical health services. Primary health care services were extended to 7 governorates through a mobile medical team, providing medical management. The collected Data was reviewed and analyzed. Results: 2150 refugees in rural areas were reached out by community health volunteers, out of which 78 received their medications through the Ministry of Health, 121 received their medications through different non-governmental organizations, 665 patients couldn’t afford buying any medications, 1286 patients were occasionally buying their medications when they were able to afford it. 853 patients received medications and follow up through IOM mobile clinics, the most common conditions were hypertension, diabetes, hyperlipidemia, anemia, heart disease, thyroid disease, asthma, seizures, and psychiatric conditions. 709 of these patients had more than 3 of the comorbidities. Multiple cases were referred for secondary and tertiary lifesaving interventions. Conclusion: Non communicable diseases are highly prevalent among refugee population in Jordan, access to medical services have proven to be a challenge in rural areas especially during the COVID-19 era, many of the patients have multiple uncontrolled medical conditions placing them at risk for complications and risk for severe COVID-19 disease. Deployment of mobile clinics to rural areas plays an essential role in managing such medical conditions, thus improving the continuum of health care approach, physical and mental wellbeing of refugees and reducing the risk for severe COVID-19 disease among this group, taking us one step forward toward universal health access.

Keywords: COVID-19, refugees, mobile clinics, primary health care

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Authors: Bhavani Veasuvalingam

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Case-based learning (CBL) is a popular instructional method aimed to bridge theory to clinical practice. This study aims to explore CBL mixed modality curriculum in influencing students’ learning styles and strategies that support learning. An explanatory sequential mixed method study was employed with initial phase, 44-itemed Felderman’s Index of Learning Style (ILS) questionnaire employed across year one medical students (n=142) using convenience sampling to describe the preferred learning styles. The qualitative phase utilised three focus group discussions (FGD) to explore in depth on the multimodal learning style exhibited by the students. Most students preferred combination of learning stylesthat is reflective, sensing, visual and sequential i.e.: RSVISeq style (24.64%) from the ILS analysis. The frequency of learning preference from processing to understanding were well balanced, with sequential-global domain (66.2%); sensing-intuitive (59.86%), active- reflective (57%), and visual-verbal (51.41%). The qualitative data reported three major themes, namely Theme 1: CBL mixed modalities navigates learners’ learning style; Theme 2: Multimodal learners active learning strategies supports learning. Theme 3: CBL modalities facilitating theory into clinical knowledge. Both quantitative and qualitative study strongly reports the multimodal learning style of the year one medical students. Medical students utilise multimodal learning styles to attain the clinical knowledge when learning with CBL mixed modalities. Educators’ awareness of the multimodal learning style is crucial in delivering the CBL mixed modalities effectively, considering strategic pedagogical support students to engage and learn CBL in bridging the theoretical knowledge into clinical practice.

Keywords: case-based learning, learnign style, medical students, learning

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Authors: Emhimed Saffor

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In this paper, the problem of edge detection in digital images is considered. Three methods of edge detection based on mathematical morphology algorithm were applied on two sets (Brain and Chest) CT images. 3x3 filter for first method, 5x5 filter for second method and 7x7 filter for third method under MATLAB programming environment. The results of the above-mentioned methods are subjectively evaluated. The results show these methods are more efficient and satiable for medical images, and they can be used for different other applications.

Keywords: CT images, Matlab, medical images, edge detection

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Authors: Mehravar Javid, Laura Reid Harris, Zahra Khodadadi, Rachel Walton

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The study aimed to explore commitment precedence through self-expansion among students at the Medical Science University of Shiraz, Iran. Method: The statistical population was comprised of students at Shiraz University of Medical Science during the academic years 2013 to 2014. Using random sampling, 133 married students (50 males and 83 females) were selected. The commitment condition of this studied group was assessed using Adam and Jones' (1999) Marital Commitment Dimensions Scale (DCI), and self-expansion was measured using Aron and Lewandowski's (2002) Self-Expansion Questionnaire. Simple regression analyses investigated commitment precedence via self-expansion. Results: The data revealed a positive correlation between total commitment (r=0.35, p < 0.01), the subscales of commitment to the spouse (r=0.43, p < 0.01), and commitment to marriage (r=0.31, p < 0.01). Regression analyses indicated that perceived self-expansion positively correlated with commitment to marital relationships in married students. The findings suggest that an increased possibility of self-expansion in a marital relationship corresponds with heightened commitment.

Keywords: commitment to marital relationship, married students, relationship dynamics, self-expansion

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Authors: Busari Moshood Olanyi

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Good governance remains the expectation of every political party in power, especially in this democratic dispensation of the Nigerian Nation. The need to ensure that the citizenry enjoys the dividends of democracy as often promised during various electioneering campaigns is envisioned to be the motif for different agendas and political slogans by different administrations. Unfortunately, different political agendas towards the security of lives and properties, halting the pillage of the economy by corrupt public officials and creation of employment opportunities for the youths, have a record of setback in the history of political leadership and governance in Nigeria. Therefore, the paper examined the principles of Islamic theocracy in its advocacy for a paradigm shift in the Nigerian political system, with a view to engendering good governance. Islamic political terms such as Shūrā (mutual consultation), ‘Adālah (equality and justice), Khilāfah (succession and stewardship) Majlis ash-Shūrā (consultative forum) and Muḥāsabah (accountability) were espoused as sacrosanct to implementing Islamic theocracy as an alternative system of government in Nigeria. The paper concluded by being flexible on the nomenclature of the suggested political system, considering the multi-religious nature of the country as a political entity. Among other recommendations, infusion of politics into our moral/religious system and not the other way round was considered a good step in the direction of a political paradigm shift for ensuring good governance and guaranteeing its sustainability in Nigeria.

Keywords: Nigerian nation, democracy, good governance, Islamic theocracy, paradigm shift

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Authors: Monika Michałowska, Anna Alichniewicz

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Detrimental outcomes of advanced maternal age on the chances of fertilization, pregnancy as well as mother and fetus health have been recognized for several decades. It seemed interesting to investigate whether there is a comparable awareness of the detrimental influence on the reproductive outcomes of late fatherhood, given that it has been already ten years since an intense and growing interest concerning later-age fatherhood commenced in medical research. To address that issue a two-step research was done. First, we performed a review of the subject literature to answer the following questions: 1) What age is defined as advanced?; 2) Is the same age defined as advanced in both genders?; 3) What terminology concerning age issues is used?; 4) Is the same age terminology used regarding both genders? The second part of our studies was devoted to the views of medical students. This part of our research comprised both quantitative and qualitative studies. Opinions of medical students in one of the Polish medical universities on several issues connected with assisted reproduction technology (ART) were gathered: 1) students’ attitude to in vitro fertilization (IVF) for women over 40 and for postmenopausal women; 2) students’ attitude to late fatherhood; 3) students’ reasoning given against acceptability of IVF procedure for all of these group of patients involved in an IVF procedure. Our analyses revealed that: First, there is no universal definition of the term ‘advanced age’; secondly, there is a general tendency to adopt different age limits depending on whether they refer to maternal or paternal age, but no justification is provided by the researchers explaining why they set different age limits for women and men; thirdly, the image of postponed fatherhood stands in stark contrast to postponed motherhood - while postponed fatherhood is frequently portrayed as a reasonable and conscious decision enabling a stable family environment for a child, the reasonableness of postponed motherhood is often questioned; finally, the bias regarding maternal versus paternal age is deeply embedded in medical students’ attitude to IVF for women over 40 and for postmenopausal women.

Keywords: gender stereotypes, reproductive medicine, maternal age, paternal age

Procedia PDF Downloads 250