Search results for: pediatric department
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1976

Search results for: pediatric department

1316 The First Fungal Identification from Mini-BAL of Critical COVID-19 Patients

Authors: Fatemeh Fallah, Ensieh Lotfali, Leila Azimi, Hannan Khodaei, Maryam Rajabnejad, Nafiseh Abdollahi, Hossein Tayebi, Saham Ansari, Saeedeh Yaghoubi, Abdollah Karimi

Abstract:

Background: Coronavirus disease 2019 (COVID-19) has become a worldwide issue due to its high prevalence and rapid transmission. Fungal infections have been detected in COVID-19 patients, leading to increased morbidity and mortality. Objectives: This study aimed to isolate Aspergillus fumigatus and Mucor spp. on mini-bronchoalveolar lavage samples obtained from children with COVID-19 hospitalized in an Iranian children’s hospital. Methods: A cross-sectional descriptive study was performed on mini-bronchoalveolar lavage samples from children confirmed positive for COVID-19 admitted to ICU with a ventilator from April 2021 to February 2022. Demographic characteristics were recorded, and fungal DNA was extracted from mini-BAL samples taken from children. Nested PCR was made with two primers for Aspergillus fumigatus and Mucor spp. Results: Out of 100 children with COVID-19, all samples were negative for Aspergillus fumigatus; however, 12 cases were positive for BAL PCR for Mucor spp. Among the 12 patients, fever, shortness of breath, cough, and decreased level of consciousness were reported in 8.3% (n: 1), 16.6% (n: 2), 25% (n: 3), and 25% (n: 3), respectively. Most cases (41.7%; n: 5) suffered from heart disease, followed by underlying malignancy (33.4%; n: 4). All positive BAL PCR for Mucor spp. cases had significantly higher chest CT scan scores and spent more time under a ventilator. Conclusions: The identification of COVID-19 with Mucor spp. was observed among 12% (n: 12) of children hospitalized in a COVID-19 ICU. When dealing with pediatric COVID-19 patients, clinicians should consider the differential diagnosis of fungal co-infections and have a low threshold to begin treatment. Moreover, it is highly advisable to take prophylactic measures, such as properly using corticosteroids and shortening the intubation time.

Keywords: aspergillosis, COVID-19 identification, mucormycosis, paediatrics

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1315 Complications of Contact Lens-Associated Keratitis: A Refresher for Emergency Departments

Authors: S. Selman, T. Gout

Abstract:

Microbial keratitis is a serious complication of contact lens wear that can be vision and eye-threatening. Diverse presentations relating to contact lens wear include dry corneal surface, corneal infiltrate, ulceration, scarring, and complete corneal melt leading to perforation. Contact lens wear is a major risk factor and, as such, is an important consideration in any patient presenting with a red eye in the primary care setting. This paper aims to provide an overview of the risk factors, common organisms, and spectrum of contact lens-associated keratitis (CLAK) complications. It will highlight some of the salient points relevant to the assessment and workup of patients suspected of CLAK in the emergency department based on the recent literature and therapeutic guidelines. An overview of the management principles will also be provided.

Keywords: microbial keratitis, corneal pathology, contact lens-associated complications, painful vision loss

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1314 Monitoring and Evaluation of the Water Quality of Taal Lake, Talisay, Batangas, Philippines

Authors: Felipe B. Martinez, Imelda C. Galera

Abstract:

This paper presents an update on the physico-chemical properties of the Taal Lake for local government officials and representatives of non-government organizations by monitoring and evaluating a total of nine (9) water quality parameters. The study further shows that the Taal Lakes surface temperature, pH, total dissolved solids, total suspended solids, color, and dissolved oxygen content conform to the standards set by the Department of Environment and Natural resources (DENR); while phosphate, chlorine, and 5-Day 20°C BOD are below the standard. Likewise, the T-test result shows no significant difference in the overall average of the two sites at the Taal Lake (P > 0.05). Based on the data, the Lake is safe for primary contact recreation such as bathing, swimming and skin diving, and can be used for aqua culture purposes.

Keywords: cool dry season, hot dry season, rainy season, Taal Lake, water quality

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1313 Educational Institutional Approach for Livelihood Improvement and Sustainable Development

Authors: William Kerua

Abstract:

The PNG University of Technology (Unitech) has mandatory access to teaching, research and extension education. Given such function, the Agriculture Department has established the ‘South Pacific Institute of Sustainable Agriculture and Rural Development (SPISARD)’ in 2004. SPISARD is established as a vehicle to improve farming systems practiced in selected villages by undertaking pluralistic extension method through ‘Educational Institutional Approach’. Unlike other models, SPISARD’s educational institutional approach stresses on improving the whole farming systems practiced in a holistic manner and has a two-fold focus. The first is to understand the farming communities and improve the productivity of the farming systems in a sustainable way to increase income, improve nutrition and food security as well as livelihood enhancement trainings. The second is to enrich the Department’s curriculum through teaching, research, extension and getting inputs from farming community. SPISARD has established number of model villages in various provinces in Papua New Guinea (PNG) and with many positive outcome and success stories. Adaption of ‘educational institutional approach’ thus binds research, extension and training into one package with the use of students and academic staff through model village establishment in delivering development and extension to communities. This centre (SPISARD) coordinates the activities of the model village programs and linkages. The key to the development of the farming systems is establishing and coordinating linkages, collaboration, and developing partnerships both within and external institutions, organizations and agencies. SPISARD has a six-point step strategy for the development of sustainable agriculture and rural development. These steps are (i) establish contact and identify model villages, (ii) development of model village resource centres for research and trainings, (iii) conduct baseline surveys to identify problems/needs of model villages, (iv) development of solution strategies, (v) implementation and (vi) evaluation of impact of solution programs. SPISARD envisages that the farming systems practiced being improved if the villages can be made the centre of SPISARD activities. Therefore, SPISARD has developed a model village approach to channel rural development. The model village when established become the conduit points where teaching, training, research, and technology transfer takes place. This approach is again different and unique to the existing ones, in that, the development process take place in the farmers’ environment with immediate ‘real time’ feedback mechanisms based on the farmers’ perspective and satisfaction. So far, we have developed 14 model villages and have conducted 75 trainings in 21 different areas/topics in 8 provinces to a total of 2,832 participants of both sex. The aim of these trainings is to directly participate with farmers in the pursuit to improving their farming systems to increase productivity, income and to secure food security and nutrition, thus to improve their livelihood.

Keywords: development, educational institutional approach, livelihood improvement, sustainable agriculture

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1312 Build Information Systems Environment Clean Through the Sms Gateway

Authors: Lutpi Ginanjar

Abstract:

Environmental hygiene is indispensable for people to live healthy, safe and peaceful. In a small environment, the cleanliness of the environment is very easy to overcome, but on the larger environment requires a more complicated management and considerable investments. In general environmental hygiene are managed by the Department of Hygiene and Landscaper. Found a good management, but much less good management. The difficulties that are often encountered on waste management also caused public awareness itself. In addition, communities have difficulty in making a report about the rubbish because not dibangunnyasistem good information. Essai aims to build information systems environment clean especially the handling of waste in the city of Bandung, West Java province. The system was built with PHP software. Expected results obtained after the construction of the information system of environmental hygiene can be demonstrated to the community will be the health of the environment.

Keywords: information systems, SMS gateway, management, software, PHP

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1311 Healthcare Associated Infections in an Intensive Care Unit in Tunisia: Incidence and Risk Factors

Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

Abstract:

Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

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1310 A New Genus Longicheles (Acari: Mesostigmata: Macrochelidae) for Pakistan Fauna from Punjab, Pakistan

Authors: Muhammad Asif Qayyoum, Bilal Saeed Khan

Abstract:

Macrochelid mites are poorly studied from the planes of Punjab, Pakistan. The study was conducted as a part of PhD thesis research partially funded by the Royal Society of Entomology, UK. The genus Longicheles was first time reported from the Pakistan. Samples were collected on the monthly basis from different districts of Punjab province, Pakistan. The genus Longicheles was frequently found from five districts (Faisalabad, Dera Ghazi Khan, Jhung, Layyah, and Rajanpur) of Punjab province. Taxonomic studies were performed in Acarology Lab., Department of Entomology, University of Agriculture, Faisalabad with slide deposition. Taxonomic work was performed by using Phase contrast microscope and adobe illustrator (drawings) for finishing of picture. The detail descriptions of two (Longicheles mandibularis and Longicheles hortorum) females are given along with diagrams and key.

Keywords: macrochelidae, longicheles, new records, Punjab

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1309 Investigation of Various Variabilities of Attitudes toward Teaching as a Profession Levels of Physical Education and Sports School Students

Authors: Turan Cetinkaya, Abdurrahman Kırtepe

Abstract:

The aim of this study is to determine the relation of the level attitudes toward teaching as a profession to various variables of the students in physical education and sports departments. 277 students who are studying at the departments of physical education and sports teaching, sports management and coaching in Ahi Evran University, College of Physical Education and Sports participated to the research. Personal information tool and teaching profession scale consisting 34 items were used as data collection tool in the research. Distribution, frequency, t test and anova test were used in comparison of the related data. As a result of statistical analysis, attitudes toward teaching as a profession levels do not differ according to gender, but significant differences were detected in the exercise regularly and department.

Keywords: teaching profession, attitude, physical education and sports students, university students

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1308 Social Work Students’ Reflection of Their Field Internship: A Study of Dhofar Region in Oman

Authors: Reem Abuiyada

Abstract:

This paper is an attempt to review the pursuance of social-work field practice run by the department of social work, Dhofar University, situated in Dhofar region, Sultanate of Oman. It assesses the students’ engagement in social work in local community training that equips them to practice their allocated tasks and management skills that in turn made them more educated in fieldwork concepts, and especially in helping to overcome the challenges experienced by the Omani community to bring them positive changes. Besides, this paper evaluates the efficacy of fieldwork practice from the students' standpoints in higher education. And, it assumes the fact that this practice helped the students in giving equal significance to academic instruction, preparing for them to face the futuristic professions in an effective way.

Keywords: social work field training, students, Dhofar University, Oman, education

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1307 Estimation of Level of Pesticide in Recurrent Pregnancy Loss and Its Correlation with Paraoxanase1 Gene in North Indian Population

Authors: Apurva Singh, S. P. Jaiswar, Apala Priyadarshini, Akancha Pandey

Abstract:

Objective: The aim of this study is to find the association of PON1 gene polymorphism with pesticides In RPL subjects. Background: Recurrent pregnancy loss (RPL) is defined as three or more sequential abortions before the 20th week of gestation. Pesticides and its derivatives (organochlorine and organophosphate) are proposed to accommodate a ruler chemical for RPL in the sub-humid region of India. The paraoxonase-1 enzyme (PON1) plays an important role in the toxicity of some organophosphate pesticides, with low PON1 activity being associated with higher pesticide sensitivity Methodology: This is a case-control study done in Department of Obstetrics & Gynaecology & Department of Biochemistry, K.G.M.U, Lucknow, India. The subjects were enrolled after fulfilling the inclusion & exclusion criteria. Inclusion criteria: Cases- Subject having two or more spontaneous abortions & Control- Healthy female having one or more alive child was selected. Exclusion criteria: Cases & Control- Subject having the following disease will be excluded from the study Diabetes mellitus, Hypertension, Tuberculosis, Immunocompromised patients, any endocrine disorder and genital, colon or breast cancer any other malignancies. Blood samples were collected in EDTA tubes from cases & healthy control women & genomic DNA was extracted by phenol-chloroform method. The estimation of pesticides residue from blood was done by HPLC. Biochemical estimation was also performed. Genotyping of PON1 gene polymorphism was performed by RFLP. Statistical analysis of the data was performed using the SPSS16.3 software. Results: A sum of total 14 pesticides (12 organochlorine and 2 organophosphate) selected on the basis of their persistent nature and consumption rate. The significant level of pesticide (ppb) estimated by the Mann whiney test and it was found to be significant at higher level of β-HCH (p:0.04), γ-HCH (p:0.001), δ-HCH (p: 0.002), chloropyrifos (p:0.001), pp-DDD (p:0.001) and fenvalrate (p: 0.001) in case group compare to its control. The level of antioxidant enzymes were found to be significantly decreased among the cases. Wild homozygous TT was more frequent and prevalent among control groups. However, heterozygous group (Tt) was more in cases than control groups (CI-0.3-1.3) (p=0.06). Conclusion: Higher levels of pesticides with endocrine disrupting potential in cases indicate the possible role of these compounds as one of the causes of recurrent pregnancy loss. Possibly, increased pesticide level appears to indicate increased levels of oxidative damage that has been associated with the possible cause of Recurrent Miscarriage, it may reflect indirect evidence of toxicity rather than the direct cause. Since both factors are reported to increase risk, individuals with higher levels of these 'Toxic compounds' especially in 'high-risk genotypes' might be more susceptible to recurrent pregnancy loss.

Keywords: paraoxonase, pesticides, PON1, RPL

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1306 The Executive Functioning Profile of Children and Adolescents with a Diagnosis of OCD: A Systematic Review and Meta-Analysis

Authors: Parker Townes, Aisouda Savadlou, Shoshana Weiss, Marina Jarenova, Suzzane Ferris, Dan Devoe, Russel Schachar, Scott Patten, Tomas Lange, Marlena Colasanto, Holly McGinn, Paul Arnold

Abstract:

Some research suggests obsessive-compulsive disorder (OCD) is associated with impaired executive functioning: higher-level mental processes involved in carrying out tasks and solving problems. Relevant literature was identified systematically through online databases. Meta-analyses were conducted for task performance metrics reported by at least two articles. Results were synthesized by the executive functioning domain measured through each performance metric. Heterogeneous literature was identified, typically involving few studies using consistent measures. From 29 included studies, analyses were conducted on 33 performance metrics from 12 tasks. Results suggest moderate associations of working memory (two out of five tasks presented significant findings), planning (one out of two tasks presented significant findings), and visuospatial abilities (one out of two tasks presented significant findings) with OCD in youth. There was inadequate literature or contradictory findings for other executive functioning domains. These findings suggest working memory, planning, and visuospatial abilities are impaired in pediatric OCD, with mixed results. More work is needed to identify the effect of age and sex on these results. Acknowledgment: This work was supported by the Alberta Innovates Translational Health Chair in Child and Youth Mental Health. The funders had no role in the design, conducting, writing, or decision to submit this article for publication.

Keywords: obsessive-compulsive disorder, neurocognition, executive functioning, adolescents, children

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1305 Analysis on the Converged Method of Korean Scientific and Mathematical Fields and Liberal Arts Programme: Focusing on the Intervention Patterns in Liberal Arts

Authors: Jinhui Bak, Bumjin Kim

Abstract:

The purpose of this study is to analyze how the scientific and mathematical fields (STEM) and liberal arts (A) work together in the STEAM program. In the future STEAM programs that have been designed and developed, the humanities will act not just as a 'tool' for science technology and mathematics, but as a 'core' content to have an equivalent status. STEAM was first introduced to the Republic of Korea in 2011 when the Ministry of Education emphasized fostering creative convergence talent. Many programs have since been developed under the name STEAM, but with the majority of programs focusing on technology education, arts and humanities are considered secondary. As a result, arts is most likely to be accepted as an option that can be excluded from the teachers who run the STEAM program. If what we ultimately pursue through STEAM education is in fostering STEAM literacy, we should no longer turn arts into a tooling area for STEM. Based on this consciousness, this study analyzed over 160 STEAM programs in middle and high schools, which were produced and distributed by the Ministry of Education and the Korea Science and Technology Foundation from 2012 to 2017. The framework of analyses referenced two criteria presented in the related prior studies: normative convergence and technological convergence. In addition, we divide Arts into fine arts and liberal arts and focused on Korean Language Course which is in liberal arts and analyzed what kind of curriculum standards were selected, and what kind of process the Korean language department participated in teaching and learning. In this study, to ensure the reliability of the analysis results, we have chosen to cross-check the individual analysis results of the two researchers and only if they are consistent. We also conducted a reliability check on the analysis results of three middle and high school teachers involved in the STEAM education program. Analyzing 10 programs selected randomly from the analyzed programs, Cronbach's α .853 showed a reliable level. The results of this study are summarized as follows. First, the convergence ratio of the liberal arts was lowest in the department of moral at 14.58%. Second, the normative convergence is 28.19%, which is lower than that of the technological convergence. Third, the language and achievement criteria selected for the program were limited to functional areas such as listening, talking, reading and writing. This means that the convergence of Korean language departments is made only by the necessary tools to communicate opinions or promote scientific products. In this study, we intend to compare these results with the STEAM programs in the United States and abroad to explore what elements or key concepts are required for the achievement criteria for Korean language and curriculum. This is meaningful in that the humanities field (A), including Korean, provides basic data that can be fused into 'equivalent qualifications' with science (S), technical engineering (TE) and mathematics (M).

Keywords: Korean STEAM Programme, liberal arts, STEAM curriculum, STEAM Literacy, STEM

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1304 Developing EFL Research Skills of Pre-Master Students through a Suggested Quest Based Learning Strategy

Authors: Heba Mustafa Abdullah

Abstract:

The research aimed at examining the effect of a using a quest based learning strategy on developing EFL Pre-Master Students. The study adopted the quasi-experimental design. The sample of the research consists of a group of 30 students enrolled in Pre-Master program, Curriculum and EFL Instruction Department, Faculty of Graduate Studies in Education Tools of the study included a EFL research skills checklist and EFL research skills test. Results revealed that there were statistically significant differences at 0.01 levels with regard to some research skills. Results were discussed in relation to several factors that affected the language learning process. Finally, the research provided beneficial contributions in relation to manipulating e-learning technologies in general and Quest based learning strategy in particular with respect to EFL research skills.

Keywords: English as foreign language, e-Learning, research skills, quest based learning

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1303 Possibility of Making Ceramic Models from Condemned Plaster of Paris (Pop) Moulds for Ceramics Production in Edo State Nigeria

Authors: Osariyekemwen, Daniel Nosakhare

Abstract:

Some ceramic wastes, such as discarded (condemn) Plaster of Paris (POP) in Auchi Polytechnic, Edo State, constitute environmental hazards. This study, therefore, bridges the forgoing gaps by undertaking the use of these discarded (POP) moulds to produced ceramic models for making casting moulds for mass production. This is in line with the possibility of using this medium to properly manage the discarded (condemn) Plaster of Paris (POP) that littered our immediate environment. Presently these are major wastes disposal in the department. Hence, the study has been made to fabricate sanitary miniature models and contract fuse models, respectively. Findings arising from this study show that discarded (condemn) Plaster of Paris (POP) can be carved when to set it neither shrink nor expand; hence warping is quite unusual. Above all, it also gives good finishing with little deterioration with time when compared to clay models.

Keywords: plaster of Paris, condemn, moulds, models, production

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1302 Suggested Role for Neutrophil Extracellular Traps Formation in Ewing Sarcoma Immune Microenvironment

Authors: Rachel Shukrun, Szilvia Baron, Victoria Fidel, Anna Shusterman, Osnat Sher, Netanya Kollender, Dror Levin, Yair Peled, Yair Gortzak, Yoav Ben-Shahar, Revital Caspi, Sagi Gordon, Michal Manisterski, Ronit Elhasid

Abstract:

Ewing sarcoma (EWS) is a highly aggressive cancer with a survival rate of 70–80% for patients with localized disease and under 30% for those with metastatic disease. Tumor-infiltrating neutrophils (TIN) can generate extracellular net-like DNA structures known as neutrophil extracellular traps (NETs). However, little is known about the presence and prognostic significance of tumor-infiltrating NETs in EWS. Herein, we investigated 46 patients diagnosed with EWS and treated in the Tel Aviv Medical Center between 2010 and 2021. TINs and NETs were identified in diagnostic biopsies of EWS by immunofluorescent. In addition, NETs were investigated in neutrophils isolated from peripheral blood samples of EWS patients at diagnosis and following neoadjuvant chemotherapy. The relationships between the presence of TINs and NETs, pathological and clinical features, and outcomes were analyzed. Our results demonstrate that TIN and NETs at diagnosis were higher in EWS patients with metastatic disease compared to those with local disease. High NETs formation at diagnosis predicted poor response to neo-adjuvant chemotherapy, relapse, and death from disease (P < .05). NETs formation in peripheral blood samples at diagnosis was significantly elevated among patients with EWS compared to pediatric controls and decreased significantly following neoadjuvant chemotherapy. In conclusion, NETs formation seems to have a role in the EWS immune microenvironment. Their presence can refine risk stratification, predict chemotherapy resistance and survival, and serve as a therapeutic target in patients with EWS.

Keywords: Ewing sarcoma, tumor microenvironment, neutrophil, neutrophil extracellular traps (NETs), prognosis

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1301 Students’ Awareness of the Use of Poster, Power Point and Animated Video Presentations: A Case Study of Third Year Students of the Department of English of Batna University

Authors: Bahloul Amel

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The present study debates students’ perceptions of the use of technology in learning English as a Foreign Language. Its aim is to explore and understand students’ preparation and presentation of Posters, PowerPoint and Animated Videos by drawing attention to visual and oral elements. The data is collected through observations and semi-structured interviews and analyzed through phenomenological data analysis steps. The themes emerged from the data, visual learning satisfaction in using information and communication technology, providing structure to oral presentation, learning from peers’ presentations, draw attention to using Posters, PowerPoint and Animated Videos as each supports visual learning and organization of thoughts in oral presentations.

Keywords: EFL, posters, PowerPoint presentations, Animated Videos, visual learning

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1300 Improving Patient Journey in the Obstetrics and Gynecology Emergency Department: A Comprehensive Analysis of Patient Experience

Authors: Lolwa Alansari, Abdelhamid Azhaghdani, Sufia Athar, Hanen Mrabet, Annaliza Cruz, Tamara Alshadafat, Almunzer Zakaria

Abstract:

Introduction: Improving the patient experience is a fundamental pillar of healthcare's quadruple aims. Recognizing the importance of patient experiences and perceptions in healthcare interactions is pivotal for driving quality improvement. This abstract centers around the Patient Experience Program, an endeavor crafted with the purpose of comprehending and elevating the experiences of patients in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). Methodology: This comprehensive endeavor unfolded through a structured sequence of phases following Plan-Do-Study-Act (PDSA) model, spanning over 12 months, focused on enhancing patient experiences in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). The study meticulously examined the journeys of patients with acute obstetrics and gynecological conditions, collecting data from over 100 participants monthly. The inclusive approach covered patients of different priority levels (1-5) admitted for acute conditions, with no exclusions. Historical data from March and April 2022 serves as a benchmark for comparison, strengthening causality claims by providing a baseline understanding of OB/GYN ED performance before interventions. Additionally, the methodology includes the incorporation of staff engagement surveys to comprehensively understand the experiences of healthcare professionals with the implemented improvements. Data extraction involved administering open-ended questions and comment sections to gather rich qualitative insights. The survey covered various aspects of the patient journey, including communication, emotional support, timely access to care, care coordination, and patient-centered decision-making. The project's data analysis utilized a mixed-methods approach, combining qualitative techniques to identify recurring themes and extract actionable insights and quantitative methods to assess patient satisfaction scores and relevant metrics over time, facilitating the measurement of intervention impact and longitudinal tracking of changes. From the themes we discovered in both the online and in-person patient experience surveys, several key findings emerged that guided us in initiating improvements, including effective communication and information sharing, providing emotional support and empathy, ensuring timely access to care, fostering care coordination and continuity, and promoting patient-centered decision-making. Results: The project yielded substantial positive outcomes, significantly improving patient experiences in the OB/GYN ED. Patient satisfaction levels rose from 62% to a consistent 98%, with notable improvements in satisfaction with care plan information and physician care. Waiting time satisfaction increased from 68% to a steady 97%. The project positively impacted nurses' and midwives' job satisfaction, increasing from 64% to an impressive 94%. Operational metrics displayed positive trends, including a decrease in the "left without being seen" rate from 3% to 1%, the discharge against medical advice rate dropping from 8% to 1%, and the absconded rate reducing from 3% to 0%. These outcomes underscore the project's effectiveness in enhancing both patient and staff experiences in the healthcare setting. Conclusion: The use of a patient experience questionnaire has been substantiated by evidence-based research as an effective tool for improving the patient experience, guiding interventions, and enhancing overall healthcare quality in the OB/GYN ED. The project's interventions have resulted in a more efficient allocation of resources, reduced hospital stays, and minimized unnecessary resource utilization. This, in turn, contributes to cost savings for the healthcare facility.

Keywords: patient experience, patient survey, person centered care, quality initiatives

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1299 A Retrospective Study of Pain Management Strategies for Pediatric Hypospadias Surgery in a Tertiary Care Hospital in Western Rajasthan

Authors: Darshana Rathod, Kirtikumar Rathod, Kamlesh Kumari, Abhilasha Motghare

Abstract:

Background and Aims: Hypospadias is one of the common congenital anomalies in males. Various modalities are used for pain management, including caudal, penile, pudendal, ring blocks, and systemic analgesics. There has yet to be a consensus regarding the most effective and safe analgesic method for controlling pain in these children. We planned this study to determine our institute's pain management practices for hypospadias surgeries. Material and Methods: This retrospective cohort study reviewed 150 children with hypospadias undergoing surgery from January 2020 to December 2023. Data regarding the mode of pain management, postoperative opioid requirement, PACU discharge, and complications was collected from the records. Results: For postoperative pain, 33 (22%) children received caudal block, 60 (40%) penile block, and 57 (38%) were managed by intravenous analgesics. A significant difference was found in the three groups, with the IV analgesic group requiring significantly higher opioid boluses in PACU [43 (75.4%) required two boluses (p < 0.05)]. The difference in PACU discharge time among the three groups was statistically significant (p< 0.05), with IV analgesics groups having the highest (55 mins [47, 60]), the Caudal group at 35mins (30, 40), and the dorsal penile block group at 35mins (25, 40). There was no significant difference in complications like edema, meatal stenosis, urethra-cutaneous fistula, or wound dehiscence among all three groups. Conclusion: Intravenous analgesics and regional blocks like caudal and penile blocks are the common pain management modalities in our institute. The regional blocks are effective in managing pain in the postoperative period and are not significantly associated with complications.

Keywords: caudal block, hypospadias, pain management, penile block

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1298 Invention of Novel Technique of Process Scale Up by Using Solid Dosage Form

Authors: Shashank Tiwari, S. P. Mahapatra

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The aim of this technique is to reduce the steps of process scales up, save time & cost of the industries. This technique will minimise the steps of process scale up. The new steps are, Novel Lab Scale, Novel Lab Scale Trials, Novel Trial Batches, Novel Exhibit Batches, Novel Validation Batches. In these steps, it is not divided to validation batches in three parts but the data of trials batches, Exhibit Batches and Validation batches are use and compile for production and used for validation. It also increases the batch size of the trial, exhibit batches. The new size of trials batches is not less than fifty Thousand, the exhibit batches increase up to two lack and the validation batches up to five lack. After preparing the batches all their data & drugs use for stability & maintain the validation record and compile data for the technology transfer in production department for preparing the marketed size batches.

Keywords: batches, technique, preparation, scale up, validation

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1297 A Language Training Model for Pilots in Training

Authors: Aysen Handan Girginer

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This study analyzes the possible causes of miscommunication between pilots and air traffic controllers by looking into a number of variables such as pronunciation, L1 interference, use of non-standard vocabulary. The purpose of this study is to enhance the knowledge of the aviation LSP instructors and to apply this knowledge to the design of new curriculum. A 16-item questionnaire was administered to 60 Turkish pilots who work for commercial airlines in Turkey. The questionnaire consists of 7 open-ended and 9 Likert-scale type questions. The analysis of data shows that there are certain pit holes that may cause communication problems for pilots that can be avoided through proper English language training. The findings of this study are expected to contribute to the development of new materials and to develop a language training model that is tailored to the needs of students of flight training department at the Faculty of Aeronautics and Astronautics. The results are beneficial not only to the instructors but also to the new pilots in training. Specific suggestions for aviation students’ training will be made during the presentation.

Keywords: curriculum design, materials development, LSP, pilot training

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1296 Sexual and Reproductive Rights After the Signing of the Peace Process: A Territorial Commitment

Authors: Rocio Murad, Juan Carlos Rivillas, Nury Alejandra Rodriguez, Daniela Roldán

Abstract:

In Colombia, around 5 million women have suffered forced displacement and all forms of gender-based violence, mostly adolescents and young women, single mothers, or widows with children affected by the war. After the signing of the peace agreements, the department of Antioquia has been one of the most affected by the armed conflict, from a territorial and gender perspective in the period. The objective of the research was to analyze the situation of sexual and reproductive rights in the department of Antioquia from a territorial and gender perspective in the period after the signing of the Peace Agreement. A mixed methodology was developed. The quantitative component conducted a cross-sectional descriptive study of barriers to access to contraceptive methods, safe abortion and gender-based violence based on microdata from the 2015 National Demographic and Health Survey. In the qualitative component, a case study was developed in Dabeiba, a municipality of Antioquia prioritized in order to deepen the experiences before, during and after the armed conflict in sexual and reproductive rights; using three research techniques: Focused observation, Semi-structured interviews, and Documentary review. The results showed that there is a gradient of greater vulnerability to greater effects of the conflict and that the subregion of Urabá Antioqueño, to which Dabeiba belongs, has the highest levels of vulnerability in relation to departmental data. In this subregion, the percentage of women with an unmet need for contraceptive methods (9%), women with unintended pregnancies (31%), of women between 15 and 19 years of age who are already mothers or are pregnant with their first child (32%) and the percentage of women victims of physical violence (42%) and sexual violence (13%) by their partners are significantly higher. Women, particularly rural and indigenous women, were doubly affected due to the existence of violence that is specifically directed at them or that has a greater impact on their life projects. There was evidence of insufficient, fragmented and disjointed social and institutional action in relation to women's rights and the existence of androcentric and patriarchal social imaginaries through which women and the feminine are undervalued. These results provide evidence of violations of sexual and reproductive rights in contexts of armed conflict and make it possible to identify mechanisms to guarantee the re-establishment of the rights of the victims, particularly women and girls. Among the mechanisms evidenced are: working for the elimination of gender stereotypes; supporting the formation and strengthening of women's social organizations; working for the concerted definition and articulated implementation of actions necessary to respond to sexual and reproductive health needs; and working for the recognition of reproductive violence as specific and different from sexual violence in the context of armed conflict. Also, it was evidenced that it is necessary to implement prevention, attention and reparation actions.

Keywords: sexual and reproductive rights, Colombia, armed conflict, violence against women

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1295 Metastatic Papillary Thyroid Carcinoma in Pleural Effusion- A Very Rare Case

Authors: Mohammed A. Abutalib

Abstract:

Papillary thyroid carcinoma (PTC) accounts for the most common type of thyroid cancer, a well-differentiated type. PTC is featured by biologically low-grade and less aggressive tumors with a survival rate of 10 years in most of the diagnosed cases. PTC can be presented with the involvement of cervical lymph nodes in about 50% of the patients, yet the distant spread is very uncommon. Herein, we discussed an early 50-year-old male patient with a history of PTC that presented to the emergency department complaining of shortness of breath and a radiological finding of hydrothorax. Cytologic examination, together with immune-histochemical staining and molecular studies of pleural effusion aspiration, concluded the definitive diagnosis of metastatic papillary thyroid carcinoma in the pleural space. PTC seldom causes metastatic niches in the pleural space, and this is a rare clinical presentation; nevertheless, a differential diagnosis of thyroid metastasis needs to be excluded.

Keywords: thyroid cancer, malignant pleural effusion, cytology aspiration, papillary thyroid carcinoma

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1294 Status of Radiation Protection at Radiation Oncology, BPKM Cancer Hospital, Nepal

Authors: Surendra B. Chand, P. P. Chaurasia, M. P. Adhikari, R. N. Yadav

Abstract:

Objective: The objective of this work was to evaluate all the safety procedures toward the radiation protection for workers in the radiation oncology department. Materials and Methods: The annual thermoluminescent dosimeters (TLDs) reports for five years of the staffs were evaluated, radiation surveys were done in the control consoles, radiotherapy machines room and waiting areas of all machines using Aloka survey meter. Results: The five years TLD reports shows that the whole body dose of the individual staffs is found within the annual dose limit except the accidental exposures. Radiation exposures in the working areas are also safe limits. Conclusion: The radiation safety practices for radiation protection are satisfactory and the radiation workers of the departments are found working within the safe limit.

Keywords: radiation protection, safety, ICRP, dose limits, TLD, radiation devices

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1293 Musculoskeletal Pain, Work Characteristics and Presenteeism among Hotel Employees

Authors: Ruey-Yu Chen, Yao-Tsung Chang, Ching-Ying Yeh, Yu-Ting Huang

Abstract:

Musculoskeletal problems in the hotel sector have been little studied. The aim of this study was to examine relationships of musculoskeletal pain and work characteristics with presenteeism, i.e., feeling sick but going to work anyway. Data of a self-reported questionnaire were collected from 1,101 employees, who joined the study on a voluntary basis from four hotels in northern Taiwan. The results showed that respondents who were female, were younger, had a higher educational level, and worked in the real-service department had higher presenteeism. There were significant positive associations between presenteeism and heavy loads, frequent beatings or hits of hard objects, improper bench height, employees’ lower limb and lower back pain. Our study results imply that knowledge of work characteristics and employees' musculoskeletal problems could be advantageously used to reduce presenteeism in the workplace.

Keywords: musculoskeletal pain, absenteeism, presenteeism, hotel employees

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1292 From Scalpel to Leadership: The Landscape for Female Neurosurgeons in the UK

Authors: Anda-veronica Gherman, Dimitrios Varthalitis

Abstract:

Neurosurgery, like many surgical specialties, undoubtedly exhibits a significant gender gap, particularly in leadership positions. While increasing women representation in neurosurgery is important, it is crucial to increase their presence in leadership positions. Across the globe and Europe there are concerning trends of only 4% of all neurosurgical departments being chaired by women. This study aims to explore the situation regarding gender disparities in leadership in the United Kingdom and to identify possible contributing factors as well as discussing future strategies to bridge this gap. Methods: A literature review was conducted utilising PubMed as main database with search keywords including ‘female neurosurgeon’, ‘women neurosurgeon’, ‘gender disparity’, ‘leadership’ and ‘UK’. Additionally, a manual search of all neurosurgical departments in the UK was performed to identify the current female department leads and training director leads. Results: The literature search identified a paucity of literature addressing specifically leadership in female neurosurgeons within the UK, with very few published papers specifically on this topic. Despite more than half of medical students in the UK being female, only a small proportion pursue a surgical career, with neurosurgery being one of the least represented specialties. Only 27% of trainee neurosurgeons are female, and numbers are even lower at a consultant level, where women represent just 8%.Findings from published studies indicated that only 6.6% of leadership positions in neurosurgery are occupied by women in the UK. Furthermore, our manual searches across UK neurosurgical departments revealed that around 5% of department lead positions are currently held by women. While this figure is slightly higher than the European average of 4%, it remains lower compared to figures of 10% in other North-West European countries. The situation is slightly more positive looking at the training directors, with 15% being female. Discussion: The findings of this study highlight a significant gender disparity in leadership positions within neurosurgery in the UK, which may have important implications, perpetuating the lack of diversity on the decision-making process, limiting the career advancement opportunities of women and depriving the neurosurgical field from the voices, opinions and talents of women. With women representing half of the population, there is an undeniable need for more female leaders at the policy-making level. There are many barriers that can contribute to these numbers, including bias, stereotypes, lack of mentorship and work-like balance. A few solutions to overcome these barriers can be training programs addressing bias and impostor syndrome, leadership workshops tailored for female needs, better workplace policies, increased in formal mentorship and increasing the visibility of women in neurosurgery leadership positions through media, speaking opportunities, conferences, awards etc. And lastly, more research efforts should focus on the leadership and mentorship of women in neurosurgery, with an increased number of published papers discussing these issues.

Keywords: female neurosurgeons, female leadership, female mentorship, gender disparities

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1291 Evaluation of Competency Training Effectiveness in Chosen Sales Departments

Authors: L. Pigon, S. Kot, J. K. Grabara

Abstract:

Nowadays, with organizations facing the challenges of increasing competitiveness, human capital accumulated by the organization is one of the elements that strongly differentiate between companies. Efficient management in the competition area requires to manage the competencies of their employees to be suitable to the market fluctuations. The aim of the paper was to determine how employee training to improve their competencies is verified. The survey was conducted among 37 respondents involved in selection of training providers and training programs in their enterprises. The results showed that all organizations use training survey as a basic method for evaluation of training effectiveness. Depending on the training contents and organization, the questionnaires contain various questions. Most of these surveys are composed of the three basic blocks: the trainer's assessment, the evaluation of the training contents, the assessment of the materials and the place of the organisation. None of the organization surveys conducted regular job-related observations or examined the attitudes of the training participants.

Keywords: human capital, competencies, training effectiveness, sale department

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1290 Future-Proofing the Workforce: A Case Study of Integrated Human Capability Frameworks to Support Business Success

Authors: Penelope Paliadelis, Asheley Jones, Glenn Campbell

Abstract:

This paper discusses the development of co-designed capability frameworks for two large multinational organizations led by a university department. The aim was to create evidence-based, integrated capability frameworks that could define, identify, and measure human skill capabilities independent of specific work roles. The frameworks capture and cluster human skills required in the workplace and capture their application at various levels of mastery. Identified capability gaps inform targeted learning opportunities for workers to enhance their employability skills. The paper highlights the value of this evidence-based framework development process in capturing, defining, and assessing desired human-focused capabilities for organizational growth and success.

Keywords: capability framework, human skills, work-integrated learning, credentialing, digital badging

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1289 Zamzam Water as Corrosion Inhibitor for Steel Rebar in Rainwater and Simulated Acid Rain

Authors: Ahmed A. Elshami, Stephanie Bonnet, Abdelhafid Khelidj

Abstract:

Corrosion inhibitors are widely used in concrete industry to reduce the corrosion rate of steel rebar which is present in contact with aggressive environments. The present work aims to using Zamzam water from well located within the Masjid al-Haram in Mecca, Saudi Arabia 20 m (66 ft) east of the Kaaba, the holiest place in Islam as corrosion inhibitor for steel in rain water and simulated acid rain. The effect of Zamzam water was investigated by electrochemical impedance spectroscopy (EIS) and Potentiodynamic polarization techniques in Department of Civil Engineering - IUT Saint-Nazaire, Nantes University, France. Zamzam water is considered to be one of the most important steel corrosion inhibitor which is frequently used in different industrial applications. Results showed that zamzam water gave a very good inhibition for steel corrosion in rain water and simulated acid rain.

Keywords: Zamzam water, corrosion inhibitor, rain water, simulated acid rain

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1288 Considering the Relationship between Architecture and Philosophy: Toyo Ito’s Conceptual Architecture

Authors: Serap Durmus

Abstract:

The aim of this paper is to exemplify the relation of architecture and philosophy over the Japanese architect Toyo Ito’s conceptual architecture. The study is practiced in ‘Architecture and Philosophy Readings’ elective course with 22 sophomore architecture students in Karadeniz Technical University Department of Architecture. It is planned as a workshop, which discusses the design philosophy of Toyo Ito’s buildings and the reflections of concept in his intellectual architecture. So, the paper contains Toyo Ito’s philosophy, his discourses and buildings and also thinking similarities with philosopher Gilles Deleuze. Thus, the workshop of course is about architecture and philosophy relationship. With this aspect, a holistic graphic representation is aimed for Toyo Ito who thinks that everything composes a whole. As a result, it can be said that architect and philosopher interaction in architecture and philosophy relation supports creative thinking. Conceptual architecture of Toyo Ito has philosophical roots and his philosophy can be read over his buildings and can be represent totally via a holistic pattern.

Keywords: architecture, conceptual architecture, Gilles Deleuze, philosophy, Toyo Ito

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1287 Biomechanical Assessment of Esophageal Elongation

Authors: Marta Kozuń, Krystian Toczewski, Sylwester Gerus, Justyna Wolicka, Kamila Boberek, Jarosław Filipiak, Dariusz Patkowski

Abstract:

Long gap esophageal atresia is a congenital defect and is a challenge for pediatric surgeons all over the world. There are different surgical techniques in use to treat atresia. One of them is esophageal elongation but the optimal suture placement technique to achieve maximum elongation with low-risk complications is still unknown. The aim of the study was to characterize the process of esophageal elongation from the biomechanical point of view. Esophagi of white Pekin Duck was used as a model based on the size of this animal which is similar to a newborn (2.5-4kg). The specimens were divided into two groups: the control group (CG) and the group with sutures (SG). The esophagi of the control group were mounted in the grips of the MTS Tytron 250 testing machine and tensile test until rupture was performed. The loading speed during the test was 10mm/min. Then the SG group was tested. Each esophagus was cut into two equal parts and that were fused together using surgical sutures. The distance between both esophagus parts was 20mm. Ten both ends were mounted on the same testing machine and the tensile test with the same parameters was conducted. For all specimens, force and elongation were recorded. The biomechanical properties, i.e., the maximal force and maximal elongation, were determined on the basis of force-elongation curves. The maximal elongation was determined at the point of maximal force. The force achieved with the suture group was 10.1N±1.9N and 50.3N±11.6N for the control group. The highest elongation was also obtained for the control group: 18mm±3mm vs. 13.5mm ±2.4mm for the suture group. The presented study expands the knowledge of elongation of esophagi. It is worth emphasizing that the duck esophagus differs from the esophagus of a newborn, i.e., its wall lacks striated muscle cells. This is why the parts of animal esophagi used in the research are may characterized by different biomechanical properties in comparison with newborn tissue.

Keywords: long gap atresia treatment, esophageal elongation, biomechanical properties, soft tissue

Procedia PDF Downloads 100