Search results for: nursing record
693 Efficacy of Hemi-Facetectomy in Treatment of Lumbar Foraminal Stenosis
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
Procedia PDF Downloads 340692 Nurse-Identified Barriers and Facilitators to Delivering End-of-Life Care in a Cardiac Intensive Care Unit: A Qualitative Study
Authors: Elena Ivany, Leanne Aitken
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Little is known about the delivery of end-of-life care in cardiac intensive care unit (CICU) settings. The aims of this study were to highlight the nurse-identified barriers and facilitators to delivering end-of-life care in the CICU, and to identify whether any of the barriers and/or facilitators are specific to the CICU setting. This was an exploratory qualitative study utilizing semi-structured individual interviews as the data collection method and inductive thematic analysis to structure the data. Six CICU nurses took part in the study. Five key themes were identified, each theme including both barriers and facilitators. The five key themes are as follows: patient-centered care, emotional challenges, reaching concordance, nursing contribution and the surgical intensive care unit.Keywords: end-of-life, cardiovascular disease, cardiac surgery, critical care
Procedia PDF Downloads 247691 Internalising Islamic Principles of Theocracy as a Pedestal for Good Governance in Nigeria
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
Procedia PDF Downloads 138690 Knowledge, Attitude, and Practices of Nurses on the Pain Assessment and Management in Level 3 Hospitals in Manila
Authors: Florence Roselle Adalin, Misha Louise Delariarte, Fabbette Laire Lagas, Sarah Emanuelle Mejia, Lika Mizukoshi, Irish Paullen Palomeno, Gibrianne Alistaire Ramos, Danica Pauline Ramos, Josefina Tuazon, Jo Leah Flores
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Pain, often a missed and undertreated symptom, affects the quality of life of individuals. Nurses are key players in providing effective pain management to decrease morbidity and mortality of patients in pain. Nurses’ knowledge and attitude on pain greatly affect their ability on assessment and management. The Pain Society of the Philippines recognized the inadequacy and inaccessibility of data on the knowledge, skills, and attitude of nurses on pain management in the country. This study may be the first of its kind in the county, giving it the potential to contribute greatly to nursing education and practice through providing valuable baseline data. Objectives: This study aims to describe the level of knowledge and attitude, and current practices of nurses on pain assessment and management; and determine the relationship of nurses’ knowledge and attitude with years of experience, training on pain management and clinical area of practice. Methodology: A survey research design was employed. Four hospitals were selected through purposive sampling. A total of 235 Medical-Surgical Unit and Intensive Care Unit (ICU) nurses participated in the study. The tool used is a combination of demographic survey, Nurses’ Knowledge and Attitude Survey Regarding Pain (NKASRP), Acute Pain Evidence Based Practice Questionnaire (APEBPQ) with self-report questions on non-pharmacologic pain management. The data obtained was analysed using descriptive statistics, two sample T-tests for clinical areas and training; and Pearson product correlation to identify relationship of level of knowledge and attitude with years of experience. Results and Analysis: The mean knowledge and attitude score of the nurses was 47.14%. Majority answered ‘most of the time’ or ‘all the time’ on 84.12% of practice items on pain assessment, implementation of non-pharmacologic interventions, evaluation and documentation. Three of 19 practice items describing morphine and opioid administration in special populations were only done ‘a little of the time’. Most utilized non-pharmacologic interventions were deep breathing exercises (79.66%), massage therapy (27.54%), and ice therapy (26.69%). There was no significant relationship between knowledge scores and years of clinical experience (p = 0.05, r= -0.09). Moreover, there was not enough evidence to show difference in nurses’ knowledge and attitude scores in relation to presence of training (p = 0.41) or areas (Medical-Surgical or ICU) of clinical practice (p = 0.53). Conclusion and Recommendations: Findings of the study showed that the level of knowledge and attitude of nurses on pain assessment and management is suboptimal; and no relationship between nurses’ knowledge and attitude and years of experience. It is recommended that further studies look into the nursing curriculum on pain education, culture-specific pain management protocols and evidence-based practices in the country.Keywords: knowledge and attitude, nurses, pain management, practices on pain management
Procedia PDF Downloads 337689 Dueling Burnout: The Dual Role Nurse
Authors: Melissa Dorsey
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Moral distress and compassion fatigue plague nurses in the Cardiothoracic Intensive Care Unit (CTICU) and cause an unnecessary level of turnover. Dueling Burnout describes an initiative that was implemented in the CTICU to reduce the level of burnout the nurses endure by encouraging dual roles with collaborating departments. Purpose: Critical care nurses are plagued by burnout, moral distress, and compassion fatigue due to the intensity of care provided. The purpose of the dual role program was to decrease these issues by providing relief from the intensity of the critical care environment while maintaining full-time employment. Relevance/Significance: Burnout, moral distress, and compassion fatigue are leading causes of Cardiothoracic Critical Care (CTCU) turnover. A contributing factor to burnout is the workload related to serving as a preceptor for a constant influx of new nurses (RN). As a result of these factors, the CTICU averages 17% nursing turnover/year. The cost, unit disruption, and, most importantly, distress of the clinical nurses required an innovative approach to create an improved work environment and experience. Strategies/Implementation/Methods: In May 2018, a dual role pilot was initiated for nurses. The dual role constitutes .6 full-time equivalent hours (FTE) worked in CTICU in combination with .3 FTE worked in the Emergency Department (ED). ED nurses who expressed an interest in cross-training to CTICU were also offered the dual role opportunity. The initial hypothesis was that full-time employees would benefit from a change in clinical setting leading to increased engagement and job satisfaction. The dual role also presents an opportunity for professional development through the expansion of clinical skills in another specialty. Success of the pilot led to extending the dual role to areas beyond the ED. Evaluation/Outcomes/Results: The number of dual role clinical nurses has grown to 22. From the dual role cohort, only one has transferred out of CTICU. This is a 5% turnover rate for this group of nurses as compared to the average turnover rate of 17%. A role satisfaction survey conducted with the dual role cohort found that because of working in a dual role, 76.5% decreased their intent to leave, 100% decreased their level of burnout, and 100% reported an increase in overall job satisfaction. Nurses reported the ability to develop skills that are transferable between departments. Respondents emphasized the appreciation gained from working in multiple environments; the dual role served to transform their care. Conclusions/Implications: Dual role is an effective strategy to retain experienced nurses, decrease burnout and turnover, improve collaboration, and provide flexibility to meet staffing needs. The dual role offers RNs an expansion of skills, relief from high acuity and orientee demands, while improving job satisfaction.Keywords: nursing retention, burnout, pandemic, strategic staffing, leadership
Procedia PDF Downloads 170688 Musical Culture of Sea Gypsies in Bulon Archipelago
Authors: Rewadee Ungpho
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The research on the musical culture of Sea Gypsies in Bulon archipelago, Satun Province, is considered as an anthropology research. Research objectives were to study the history and information culture and also to find the basis information for the restoration and preservation of the music culture of Sea Gypsies who live in Bulon archipelago. Findings of the research are as follows: 1) Musical characteristics of Sea Gypsies in Bulon archipelago is still traditional. It does not mix with any external musical influence such as musical instruments, language, and other musical characteristics. There are various kind of songs which can play a complete melody and rhythm, including a total of 8 songs as follows; Lagu-Ayam-Dide, Lagu-Sitipayong, Lagu-Bulong-pute, Lagu-Chemamat, Laguduwo, Lagu-Ma-I-nang, Lagu-Mana-Ikan. 2) The roles of culture/music in Bulon archipelago correlate with Urak Lawoi society. They use music in the ceremony of votive offering, in the floating ceremony held in Lipe Island and in various festivals. Therefore, music is a spiritual sacrifice and a spiritual instrument that conveys an Urak Lawoi, which makes the Urak Lawoi still unique and has a sense of ethnic identity. 3) The inheritance of Urak Lawoi music is still being made in a traditional way, as an oral tradition with no record. The teaching and learning must be one on one, and it required length of time to practice and accumulate the knowledge. Due to above mentioned reasons, a few people attend in the inheritance. Those who are interested may not be able to practice constantly. As a result, there is only a few, or even none, descendants left.Keywords: sea gypsy, music, Bulon archipelago, ethnomusicology
Procedia PDF Downloads 366687 First Record of Eotragus noyei from the Middle Siwalik Dhok Pathan Formation of Pakistan
Authors: Abdul M. Khan, Hafiza I. Naz, Ayesha Iqbal, Muhammad Akhtar
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The fossil remains described in this study have been recovered during fieldwork by the authors from the Dhok Pathan Formation of Middle Siwaliks Pakistan in December, 2015. The sample comprises maxillary and mandibular fragments along with isolated upper and lower teeth. The morphometric analysis of the specimens led us to recognize the sample as belonging to Eotragus noyei, which has been considered as the smallest and the oldest bovid in the Siwaliks. Eotragus noyei is characterized by brachydont teeth, finely rugose enamel, more inclined buccal walls of the molars and small lingual cingula. The inclination of the metaconal area has caused rotation of the metastyle in relation to the antero-posterior tooth axis and thus situated more lingually. The protocone in second upper premolar is well developed and situated posteriorly and also has an anterior lingual constriction. The metaconule in the third upper molar is smaller than the protocone. The dentition in Eotragus noyei is smaller in size as compared to Eotragus sansaniensis and Eotragus lampangensis. In Eotragus noyei the buccal walls in molars are more inclined while in Eotragus sansaniensis they are less inclined. The genus Eotragus has been reported previously in the Lower and Middle Siwaliks of Pakistan; however, the recognition of the present sample as Eotragus noyei has extended the range of this species from Lower to the Middle Siwaliks of Pakistan.Keywords: Boselaphini, Chakwal, Dhok Pathan, late miocene
Procedia PDF Downloads 288686 Mindfulness, Reinvestment, and Rowing under Pressure: Evidence for Moderated Moderation of the Anxiety-Performance Relationship
Authors: Katherine Sparks, Christopher Ring
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This study aimed to investigate whether dispositional sport-specific mindfulness moderated the moderation effect of conscious processing on the relationship between anxiety and rowing race performance. Using a sport-specific (Rowing-Specific) Reinvestment Scale (RSRS) to measure state conscious processing, we examined the effects of trait sport-related mindfulness on the conscious processes of rowers under competitive racing pressure at a number of UK regattas. 276 rowers completed a survey post competitive race. The survey included the RSRS, mindfulness, a perceived performance rating scale, demographic and race information to identify and record the rower’s actual race performance. Results from the research demonstrated that high levels of dispositional mindfulness are associated with a superior performance under pressure. In relation to the moderating moderation effect, conscious processing amplifies the detrimental effects of anxiety on performance. However, mindfulness, mindful awareness, and mindful non-judgement all proved to attenuate this amplification effect by moderating the conscious processing moderation on the anxiety-performance relationship. Therefore, this study provides initial support for the speculation that dispositional mindfulness can help prevent the deleterious effects of rowing-specific reinvestment under pressure.Keywords: mindful, reinvestment, under pressure, performance, rowing
Procedia PDF Downloads 149685 Enhance Engineering Learning Using Cognitive Simulator
Authors: Lior Davidovitch
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Traditional training based on static models and case studies is the backbone of most teaching and training programs of engineering education. However, project management learning is characterized by dynamics models that requires new and enhanced learning method. The results of empirical experiments evaluating the effectiveness and efficiency of using cognitive simulator as a new training technique are reported. The empirical findings are focused on the impact of keeping and reviewing learning history in a dynamic and interactive simulation environment of engineering education. The cognitive simulator for engineering project management learning had two learning history keeping modes: manual (student-controlled), automatic (simulator-controlled) and a version with no history keeping. A group of industrial engineering students performed four simulation-runs divided into three identical simple scenarios and one complicated scenario. The performances of participants running the simulation with the manual history mode were significantly better than users running the simulation with the automatic history mode. Moreover, the effects of using the undo enhanced further the learning process. The findings indicate an enhancement of engineering students’ learning and decision making when they use the record functionality of the history during their engineering training process. Furthermore, the cognitive simulator as educational innovation improves students learning and training. The practical implications of using simulators in the field of engineering education are discussed.Keywords: cognitive simulator, decision making, engineering learning, project management
Procedia PDF Downloads 244684 Ground Motion Modelling in Bangladesh Using Stochastic Method
Authors: Mizan Ahmed, Srikanth Venkatesan
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Geological and tectonic framework indicates that Bangladesh is one of the most seismically active regions in the world. The Bengal Basin is at the junction of three major interacting plates: the Indian, Eurasian, and Burma Plates. Besides there are many active faults within the region, e.g. the large Dauki fault in the north. The country has experienced a number of destructive earthquakes due to the movement of these active faults. Current seismic provisions of Bangladesh are mostly based on earthquake data prior to the 1990. Given the record of earthquakes post 1990, there is a need to revisit the design provisions of the code. This paper compares the base shear demand of three major cities in Bangladesh: Dhaka (the capital city), Sylhet, and Chittagong for earthquake scenarios of magnitudes 7.0MW, 7.5MW, 8.0MW and 8.5MW using a stochastic model. In particular, the stochastic model allows the flexibility to input region specific parameters such as shear wave velocity profile (that were developed from Global Crustal Model CRUST2.0) and include the effects of attenuation as individual components. Effects of soil amplification were analysed using the Extended Component Attenuation Model (ECAM). Results show that the estimated base shear demand is higher in comparison with code provisions leading to the suggestion of additional seismic design consideration in the study regions.Keywords: attenuation, earthquake, ground motion, Stochastic, seismic hazard
Procedia PDF Downloads 241683 Nurse Participation for the Economical Effectiveness in Medical Organizations
Authors: Alua Masalimova, Dameli Sulubecova, Talgat Isaev, Raushan Magzumova
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The usual relation to nurses of heads of medical organizations in Kazakhstan is to use them only for per performing medical manipulations, but new economic conditions require the introduction of nursing innovations. There is an increasing need for managers of hospital departments and regions of ambulatory clinics to ensure comfortable conditions for doctors, nurses, aides, as well as monitoring marketing technology (the needs and satisfaction of staff work, the patient satisfaction of the department). It is going to the past the nursing activities as physician assistant performing his prescriptions passively. We are suggesting a model for the developing the head nurse as the manager on the example of Blood Service. We have studied in the scientific-production center of blood transfusion head nurses by the standard method of interviewing for involvement in coordinating the flow of information, promoting the competitiveness of the department. Results: the average age of the respondents 43,1 ± 9,8, female - 100%; manager in the Organization – 9,3 ± 10,3 years. Received positive responses to the knowledge of the nearest offices in providing similar medical service - 14,2%. The cost of similar medical services in other competitive organizations did not know 100%, did a study of employee satisfaction Division labour-85,7% answered negatively, the satisfaction donors work staff studied in 50.0% of cases involved in attracting paid Services Division showed a 28.5% of the respondent. Participation in management decisions medical organization: strategic planning - 14,2%, forming analysis report for the year – 14,2%, recruitment-30.0%, equipment-14.2%. Participation in the social and technical designing workplaces Division staff showed 85,0% of senior nurses. Participate in the cohesion of the staff of the Division method of the team used the 10.0% of respondents. Further, we have studied the behavioral competencies for senior sisters: customer focus – 20,0% of respondents have attended, the ability to work in a team – 40,0%. Personal qualities senior nurses were apparent: sociability – 80,0%, the ability to manage information – 40,0%, to make their own decisions - 14,2%, 28,5% creativity, the desire to improve their professionalism – 50,0%. Thus, the modern market conditions dictate this organization, which works for the rights of economic management; include the competence of the post of the senior nurse knowledge and skills of Marketing Management Department. Skills to analyses the information collected and use of management offers superior medical leadership organization. The medical organization in the recruitment of the senior nurse offices take into account personal qualities: flexibility, fluency of thinking, communication skills and ability to work in a team. As well as leadership qualities, ambition, high emotional and social intelligence, that will bring out the medical unit on competitiveness within the country and abroad.Keywords: blood service, head nurse, manager, skills
Procedia PDF Downloads 234682 Occupational Stress in Nurses of a Maternity Ward in Lubango, Angola
Authors: Lídia Chienda, Tchilissila A. Simoes
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Angola is known for the low quality of maternal health services, registering one of the highest maternal and child mortality of Africa. Working in these health facilities may be of great challenge for health professionals. In this study, we aimed to identify the presence of occupational stress in 76 nurses working in a maternity ward in Lubango, Southern Angola. The participants completed the Health Professional Stress Questionnaire and reported a moderate and high level of stress. To these individuals, 'receiving a low salary,' 'inadequate/insufficient salary,' 'overwork or very demanding work' and 'working long hours in a row' seemed to be the main indicators of occupational stress. Moreover, there was an influence of the work overload, the remuneration earned, the career, and family conflicts in the occupational stress index. These results contributed to a better understanding of the difficulties Angolan nurses are facing and the need to implement policies that envisage the wellbeing of this population.Keywords: Africa, maternity wards, nursing, occupational stress
Procedia PDF Downloads 183681 Re-Os Application to Petroleum System: Implications from the Geochronology and Oil-Source Correlation of Duvernay Petroleum System, Western Canadian Sedimentary Basin
Authors: Junjie Liu, David Selby, Mark Obermajer, Andy Mort
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The inaugural application of Re-Os dating, which is based on the beta decay of 187Re to 187Os with a long half-life of 41.577 ± 0.12 Byr and initially used for sulphide minerals and organic rich rocks, to petroleum systems was performed on bitumen of the Polaris Mississippi Valley Type Pb-Zn deposit, Canada. To further our understanding of the Re-Os system and its application to petroleum systems, here we present a study on Duvernay Petroleum System, Western Canadian Sedimentary Basin. The Late Devonian Duvernay Formation organic-rich shales are the only source of the petroleum system. The Duvernay shales reached maturation only during the Laramide Orogeny (80 – 35 Ma) and the generated oil migrated short distances into the interfingering Leduc reefs and overlying Nisku carbonates with no or little secondary alteration post oil-generation. Although very low in Re and Os, the asphaltenes of Duvernay-sourced Leduc and Nisku oils define a Laramide Re-Os age. In addition, the initial Os isotope compositions of the oil samples are similar to that of the Os isotope composition of the Duvernay Formation at the time of oil generation, but are very different to other oil-prone intervals of the basin, showing the ability of the Os isotope composition as an inorganic oil-source correlation tool. In summary, the ability of the Re-Os geochronometer to record the timing of oil generation and trace the source of an oil is confirmed in the Re-Os study of Duvernay Petroleum System.Keywords: Duvernay petroleum system, oil generation, oil-source correlation, Re-Os
Procedia PDF Downloads 304680 Design and Implementation of the Embedded Control System for the Electrical Motor Based Cargo Vehicle
Authors: Syed M. Rizvi, Yiqing Meng, Simon Iwnicki
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With an increased demand in the land cargo industry, it is predicted that the freight trade will rise to a record $1.1 trillion in revenue and volume in the following years to come. This increase is mainly driven by the e-commerce model ever so popular in the consumer market. Many innovative ideas have stemmed from this demand and change in lifestyle likes of which include e-bike cargo and drones. Rural and urban areas are facing air quality challenges to keep pollution levels in city centre to a minimum. For this purpose, this paper presents the design and implementation of a non-linear PID control system, employing a micro-controller and low cost sensing technique, for controlling an electrical motor based cargo vehicle with various loads, to follow a leading vehicle (bike). Within using this system, the cargo vehicle will have no load influence on the bike rider on different gradient conditions, such as hill climbing. The system is being integrated with a microcontroller to continuously measure several parameters such as relative displacement between bike and the cargo vehicle and gradient of the road, and process these measurements to create a portable controller capable of controlling the performance of electrical vehicle without the need of a PC. As a result, in the case of carrying 180kg of parcel weight, the cargo vehicle can maintain a reasonable spacing over a short length of sensor travel between the bike and itself.Keywords: cargo, e-bike, microcontroller, embedded system, nonlinear pid, self-adaptive, inertial measurement unit (IMU)
Procedia PDF Downloads 201679 An Historical Revision of Change and Configuration Management Process
Authors: Expedito Pinto De Paula Junior
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Current systems such as artificial satellites, airplanes, automobiles, turbines, power systems and air traffic controls are becoming increasingly more complex and/or highly integrated as defined in SAE-ARP-4754A (Society Automotive Engineering - Certification considerations for highly-integrated or complex aircraft systems standard). Among other processes, the development of such systems requires careful Change and Configuration Management (CCM) to establish and maintain product integrity. Understand the maturity of CCM process based in historical approach is crucial for better implementation in hardware and software lifecycle. The sense of work organization, in all fields of development is directly related to the order and interrelation of the parties, changes in time, and record of these changes. Generally, is observed that engineers, administrators and managers invest more time in technical activities than in organization of work. More these professionals are focused in solving complex problems with a purely technical bias. CCM process is fundamental for development, production and operation of new products specially in the safety critical systems. The objective of this paper is open a discussion about the historical revision based in standards focus of CCM around the world in order to understand and reflect the importance across the years, the contribution of this process for technology evolution, to understand the mature of organizations in the system lifecycle project and the benefits of CCM to avoid errors and mistakes during the Lifecycle Product.Keywords: changes, configuration management, historical, revision
Procedia PDF Downloads 192678 Jejunostomy and Protective Ileostomy in a Patient with Massive Necrotizing Enterocolitis: A Case Report
Authors: Rafael Ricieri, Rogerio Barros
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Objective: This study is to report a case of massive necrotizing enterocolitis in a six-month-old patient, requiring ileostomy and protective jejunostomy as a damage control measure in the first exploratory laparotomy surgery in massive enterocolitis without a previous diagnosis. Methods: This study is a case report of success in making and closing a protective jejunostomy. However, the low number of publications on this staged and risky measure of surgical resolution encouraged the team to study the indication and especially the correct time for closing the patient's protective jejunostomy. The main study instrument will be the six-month-old patient's medical record. Results: Based on the observation of the case described, it was observed that the time for the closure of the described procedure (protective jejunostomy) varies according to the level of compromise of the health status of your patient and of an individual of each person. Early closure, or failure to close, can lead to a favorable problem for the patient since several problems can result from this closure, such as new intestinal perforations, hydroelectrolyte disturbances. Despite the risk of new perforations, we suggest closing the protective jejunostomy around the 14th day of the procedure, thus keeping the patient on broad-spectrum antibiotic therapy and absolute fasting, thus reducing the chances of new intestinal perforations. Associated with the closure of the jejunostomy, a gastric tube for decompression is necessary, and care in an intensive care unit and electrolyte replacement is necessary to maintain the stability of the case.Keywords: jejunostomy, ileostomy, enterocolitis, pediatric surgery, gastric surgery
Procedia PDF Downloads 76677 Machine Learning for Classifying Risks of Death and Length of Stay of Patients in Intensive Unit Care Beds
Authors: Itamir de Morais Barroca Filho, Cephas A. S. Barreto, Ramon Malaquias, Cezar Miranda Paula de Souza, Arthur Costa Gorgônio, João C. Xavier-Júnior, Mateus Firmino, Fellipe Matheus Costa Barbosa
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Information and Communication Technologies (ICT) in healthcare are crucial for efficiently delivering medical healthcare services to patients. These ICTs are also known as e-health and comprise technologies such as electronic record systems, telemedicine systems, and personalized devices for diagnosis. The focus of e-health is to improve the quality of health information, strengthen national health systems, and ensure accessible, high-quality health care for all. All the data gathered by these technologies make it possible to help clinical staff with automated decisions using machine learning. In this context, we collected patient data, such as heart rate, oxygen saturation (SpO2), blood pressure, respiration, and others. With this data, we were able to develop machine learning models for patients’ risk of death and estimate the length of stay in ICU beds. Thus, this paper presents the methodology for applying machine learning techniques to develop these models. As a result, although we implemented these models on an IoT healthcare platform, helping clinical staff in healthcare in an ICU, it is essential to create a robust clinical validation process and monitoring of the proposed models.Keywords: ICT, e-health, machine learning, ICU, healthcare
Procedia PDF Downloads 91676 Drama in the Classroom: Work and Experience with Standardized Patients and Classroom Simulation of Difficult Clinical Scenarios
Authors: Aliyah Dosani, Kerri Alderson
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Two different simulations using standardized patients were developed to reinforce content and foster undergraduate nursing students’ practice and development of interpersonal skills in difficult clinical situations in the classroom. The live actor simulations focused on fostering interpersonal skills, traditionally considered by students to be simple and easy. However, seemingly straightforward interactions can be very stressful, particularly in women’s complex social/emotional situations. Supporting patients in these contexts is fraught with complexity and high emotion, requiring skillful support, assessment and intervention by a registered nurse. In this presentation, the personal and professional perspectives of the development, incorporation, and execution of the live actor simulations will be discussed, as well as the inclusion of student perceptions, and the learning gained by the involved faculty.Keywords: adult learning, interpersonal skill development, simulation learning, teaching and learning
Procedia PDF Downloads 133675 Gingival Tissue Appearance Changes According Hormonal Oscillations at Female Patients
Authors: Ilma Robo, Saimir Heta, Vera Ostreni, Elsaida Agrushi, Eduart Kapaj
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Introduction: Cyclic hormonal fluctuations are known from literature to have a clinically visible effects on gingival tissue reactions, to the diagnosed processes of gingival inflammation. Materials and methods: At a total of 47 female patients, ad-hock presented at the University Clinic, were recorded data on effect of hormonal oscillations at periodontal treatment protocol. Oral examination was performed on soft tissue of gingiva and the oral mucous membrane, always respecting the air-drying procedure and then checking with free eye differences in oral mucosal relief. After the patients were informed about the study protocol, the purpose of the study and the ongoing procedure, verbal consensus was required. Results: The study was conducted in a total of 47 patients, out of which 13 patients were under the gingivitis classification, and 24 patients under the periodontal classification. Patients included in the study are divided by age, cycle week respectively 1,2,3 and 4.The younger age of female patients is more prone to the appearance of gingivitis, which is further aggravated by the effects of sexual hormones and the effect of the controlled or non-regulated fluctuations of the latter. Conclusions: The healing process is more fuel-intensive in the absence of high hormone levels, as they are these pro-inflammatory hormones, both in or near the ho Younger women are more open to volunteering in studies that record individual and study data that may last in time.Keywords: gingiva, hormonal oscillations, female patients, mucosa, periodontal non-surgical treatment
Procedia PDF Downloads 74674 Socioeconomic Status and Mortality in Older People with Angina: A Population-Based Cohort Study in China
Authors: Weiju Zhou, Alex Hopkins, Ruoling Chen
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Background: China has increased the gap in income between richer and poorer over the past 40 years, and the number of deaths from people with angina has been rising. It is unclear whether socioeconomic status (SES) is associated with increased mortality in older people with angina. Methods: Data from a cohort study of 2,380 participants aged ≥ 65 years, who were randomly recruited from 5-province urban communities were examined in China. The cohort members were interviewed to record socio-demographic and risk factors and document doctor-diagnosed angina at baseline and were followed them up in 3-10 years, including monitoring vital status. Multivariate Cox regression models were employed to examine all-cause mortality in relation to low SES. Results: The cohort follow-up identified 373 deaths occurred; 41 deaths in 208 angina patients. Compared to participants without angina (n=2,172), patients with angina had increased mortality (multivariate adjusted hazard ratio (HR) was 1.41, 95% CI 1.01-1.97). Within angina patients, the risk of mortality increased with low satisfactory income (2.51, 1.08-5.85) and having financial problem (4.00, 1.07-15.00), but significantly with levels of education and occupation. In non-angina participants, none of these four SES indicators were associated with mortality. There was a significant interaction effect between angina and low satisfactory income on mortality. Conclusions: In China, having low income and financial problem increase mortality in older people with angina. Strategies to improve economic circumstances in older people could help reduce inequality in angina survival.Keywords: angina, mortality, older people, socio-economic status
Procedia PDF Downloads 114673 Vision-Based Daily Routine Recognition for Healthcare with Transfer Learning
Authors: Bruce X. B. Yu, Yan Liu, Keith C. C. Chan
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We propose to record Activities of Daily Living (ADLs) of elderly people using a vision-based system so as to provide better assistive and personalization technologies. Current ADL-related research is based on data collected with help from non-elderly subjects in laboratory environments and the activities performed are predetermined for the sole purpose of data collection. To obtain more realistic datasets for the application, we recorded ADLs for the elderly with data collected from real-world environment involving real elderly subjects. Motivated by the need to collect data for more effective research related to elderly care, we chose to collect data in the room of an elderly person. Specifically, we installed Kinect, a vision-based sensor on the ceiling, to capture the activities that the elderly subject performs in the morning every day. Based on the data, we identified 12 morning activities that the elderly person performs daily. To recognize these activities, we created a HARELCARE framework to investigate into the effectiveness of existing Human Activity Recognition (HAR) algorithms and propose the use of a transfer learning algorithm for HAR. We compared the performance, in terms of accuracy, and training progress. Although the collected dataset is relatively small, the proposed algorithm has a good potential to be applied to all daily routine activities for healthcare purposes such as evidence-based diagnosis and treatment.Keywords: daily activity recognition, healthcare, IoT sensors, transfer learning
Procedia PDF Downloads 124672 The Impact of Web Based Education on Cancer Patients’ Clinical Outcomes
Authors: F. Arıkan, Z. Karakus
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Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.Keywords: cancer patients, e-learning, nursing, web based education
Procedia PDF Downloads 417671 Effect of Punch and Die Profile Radii on the Maximum Drawing Force and the Total Consumed Work in Deep Drawing of a Flat Ended Cylindrical Brass
Authors: A. I. O. Zaid
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Deep drawing is considered to be the most widely used sheet metal forming processes among the particularly in automobile and aircraft industries. It is widely used for manufacturing a large number of the body and spare parts. In its simplest form it may be defined as a secondary forming process by which a sheet metal is formed into a cylinder or alike by subjecting the sheet to compressive force through a punch with a flat end of the same geometry as the required shape of the cylinder end while it is held by a blank holder which hinders its movement but does not stop it. The punch and die profile radii play In this paper, the effects of punch and die profile radii on the autographic record, the minimum thickness strain location where the cracks normally start and cause the fracture, the maximum deep drawing force and the total consumed work in the drawing flat ended cylindrical brass cups are investigated. Five punches and five dies each having different profile radii were manufactured for this investigation. Furthermore, their effect on the quality of the drawn cups is also presented and discussed. It was found that the die profile radius has more effect on the maximum drawing force and the total consumed work than the punch profile radius.Keywords: punch and die profile radii, deep drawing process, maximum drawing force, total consumed work, quality of produced parts, flat ended cylindrical brass cups
Procedia PDF Downloads 331670 Synthesising Highly Luminescent CdTe Quantum Dots Using Cannula Hot Injection Method
Authors: Erdem Elibol, Musa Cadırcı, Nedim Tutkun
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Recently, colloidal quantum dots (CQDs) have drawn increasing attention due to their unique size tunability, which makes them potential candidates for numerous applications including photovoltaic, LEDs, and imaging. However, the main challenge to exploit CQDs properly is that there has not been an effective method to produce them with highly crystalline form and narrow size dispersion. Hot injection method is one of the widely used techniques to produce high-quality nanoparticles. In this method, the key parameter is to reduce the time for injection of the precursors into each other, which yields fast and constant nucleation rate and hence to highly monodisperse QDs. In conventional hot injection method, the injection of precursors is carried out using standard lab syringes with long needles. However, this technique is relatively slow and thus will result in poor optical properties in QDs. In this work, highly luminescent CdTe QDs were synthesised by transferring hot precursors into each other using cannula method. Unlike regular syringe technique, with the help of high pressure difference between two precursors’ flasks and wide cross-section of cannula, the hot cannulation process is too short which yields narrow size distribution and high quantum yield of CdTe QDs. Here QDs with full width half maximum (FWHM) of 28 nm was achieved. In addition, the photoluminescence quantum yield of our samples was measured to be about 21 ± 0.9 which is at least twice the previous record values for CdTe QDs wherein syringe was used to transfer precursors.Keywords: CdTe, hot injection method, luminescent, quantum dots
Procedia PDF Downloads 312669 Rabies Surveillance Data Analysis in Addis Ababa, Ethiopia during 2012/13: Retrospective Cross Sectional Study
Authors: Fantu Lombamo Untiso, Sylvia Murphy, Emily Pieracci
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Background: Rabies is a highly fatal viral disease of all warm-blooded animals including human globally. However, effective rabies control program still remains to be a reality and needs to be strengthened. Objective: Reviewing of recorded data and analyzing it to generate information on the status of rabies in Addis Ababa in the year 2012/13. Methods: A retrospective data were used from the Ethiopian Public Health Institute rabies case record book registered in the year 2012/13. Results: Among 1357 suspected rabid animals clinically examined; only 8.84% were positive for rabies. Out of 216 animal brains investigated in the laboratory with Fluorescent Antibody Technique, 55.5% were confirmed rabies positive. Among the laboratory confirmed positive rabies cases, high percentage of the animals came from Yeka (20%) and lower number from Kirkos subcity (3.3%). Out of 1149 humans who came to the institute seeking anti-rabies post-exposure prophylaxis, 85.65% and 7.87% of them were exposed to suspected dogs and cats respectively. 3 human deaths due to rabies were reported in the year after exposure to dog bite of unknown vaccination status. Conclusion: The principal vector of rabies in Addis Ababa is dog. Effective rabies management and control based on confirmed cases and mass-immunization and control of stray dog populations is recommended.Keywords: Addis Ababa, exposure, rabies, surveillance
Procedia PDF Downloads 167668 Financial Benefits after the Implementation of Antimicrobial Copper in Intensive Care Units (ICUs)
Authors: P. Efstathiou, E. Kouskouni, S. Papanikolaou, K. Karageorgou, Z. Manolidou, Tseroni Maria, A. Efstathiou, V. Karyoti, I. Agrafa
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Aim: Aim of this study was to evaluate the reduction on Intensive Care Unit (ICU) microbial flora after the antimicrobial copper alloy (Cu+) implementation as well as the effect on financial-epidemiological operation parameters. Methods: Medical, epidemiological and financial data in two time periods, before and after the implementation of copper (Cu 63% - Zn 37%, low lead) were recorded and analyzed in a general ICU. The evaluated parameters were: the importance of patients' admission (Acute Physiology and Chronic Health Evaluation - APACHE II and Simplified Acute Physiology Score - SAPS), microbial flora's record in the ICU before and after the implementation of Cu+ as well as the impact on epidemiological and ICU's operation financial parameters. Results: During December 2010 and March 2011 and respectively during December 2011 and March 2012 comparative results showed statistically significant reduction on the microbial flora (CFU/ml) by 95% and the use of antimicrobial medicine (per day per patient) by 30% (p = 0,014) as well as patients hospitalization time and cost. Conclusions: The innovative implementation of antimicrobial copper in ICUs contributed to their microbial flora significant reduction and antimicrobial drugs use reduction with the apparent positive effect (decrease) in both patient’s hospitalization time and cost. Under the present circumstances of economic crisis, survey results are of highest importance and value.Keywords: antimicrobial copper, financial benefits, ICU, cost reduction
Procedia PDF Downloads 459667 Contributing Factors Affecting the Safety in Construction Sites of Bangladesh
Authors: Farzana Rahman, Mohammed Hossain Ezaz, Dipak Halder, Proshanta Mondal
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Site safety is an important function regardless of project size. A key goal, which must be met for a successful project, is to finish the project with a good safety record. Construction safety is an important issue in all over the world. Today, developed countries strictly follow the safety procedure to avoid any hazard, accident or fatality. However, for a least developed country like Bangladesh, still accidents and fatalities are quite high due to lack of safety management. With the increased volume of construction work in Bangladesh, the need for proper attention in safety issues has become essential for human, economic and other consideration. Recently lots of accidents are taking place in construction sites of Bangladesh causing severe injury to death to the workers and pedestrians. There are a number of reasons/factors that these high numbers are widespread to the construction industry that are not found in most other businesses. The objective of this research work is to identify and explore the various factor that affect the construction site safety in Bangladesh. A questionnaire surveys was conducted to the reputed construction companies of Bangladesh to examine the present safety situation in construction sites. Nine factors were selected for the survey. The finding shows that 78% of organizations’ from the respondents are conscious about the safety procedure and they usually provide safety measures for the workers. Promotion of safety measures at the working site results in a better working environment, higher productivity and greater contentment among the workers.Keywords: construction sites, fatalities, safety issues, safety situation
Procedia PDF Downloads 557666 A Retrospective Study of Suicidal Deaths in Madinah for Ten Years
Authors: Radah Yousuf, Ashraf Shebl
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Suicide is a tragic event with strong emotional repercussions for its survivors and for families of its victims. There were thousands of cases all over the world. There are many risk factors include mental disorders such as depression, and substance abuse, including alcoholism and use of benzodiazepines. Other suicides are impulsive acts due to stress such as from financial difficulties, troubles with relationships, or from bullying. The aim of work in this study is making a survey from archives of the suicidal cases, which had a medicolegal examination, in forensic medicine center in Al Madinah Almunawarah-KSA, for ten years in the period between 1428-1438h. In each case, some data are collected such as age, sex, time and place of an act, method of suicide, the presence of the witness, medical history. This study demonstrates that suicide is more common in male than female, and the 4th decade was the most period of age. The most common method of suicide was hanging followed by falling from the height. These results indicated that cultural and religious beliefs that discourage suicide and support self-preservation instinct, and suicide education programs provide information to students in high school, builds awareness, one of the most important issues in solving that problem. From the forensic view, circumstantial evidence of every forensic case must take and record, full history about the social, medical and psychological problems, attend the scene of death is a very important, complete medicolegal investigation for every case, and full autopsy with very skilled techniques and facilities can help in diagnosing what type of crimes.Keywords: suicide, age, sex, hanging
Procedia PDF Downloads 138665 Co-Articulation between Consonant and Vowel in Cantonese Syllables
Authors: Wai-Sum Lee
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This study investigates C-V and V-C co-articulation in Cantonese monosyllables of the CV, VC or CVC structure, with C = one of the three stop consonants [p, t, k] and V = one of the three corner vowels [i, a, u]. Five repetitions of each test syllable on a randomized list were elicited from Cantonese young adult speakers in their early-20s. A research tool, EMA AG500, was used to record the synchronized audio signals and articulatory data at three different locations of the tongue – tongue tip, tongue middle, and tongue back – and the positions of the upper and lower lips during the test syllables. The main findings based on the articulatory data collected from two male Cantonese speakers are as follows: (i) For the syllable-initial [p-], strong co-articulation is observed when [p-] preceding the high vowel [i] or [u], but not the low vowel [a]. As for the syllable-final [-p], it is strongly co-articulated with the preceding vowel, even when the vowel is [a]. (ii) The co-articulation between the initial [t-] and the following vowel of any type is weak. In the syllable-final position, the degree of co-articulatory resistance of [-t] is also large when following the vowel [u], but [-t] is largely co-articulated with the preceding vowel when the vowel is [i] or [a]. (iii) The strength of co-articulation differs when the initial [k-] precedes the different types of vowel. A stronger co-articulation between [k-] and [i] than between [k-] and [u], and the strength of co-articulation is much reduced between [k-] and [a]. However, in the syllable-final position, there is strong co-articulation between [-k] and the preceding vowel [a]. (iv) Among the three types of stop consonants in the syllable-initial position, the decreasing degree of co-articulatory resistance (CR) is [t-] > [k-] > [p-], and the degree of CR is reduced during all three types of stop in the syllable-final position. In general, the data on co-articulation between consonant and vowel in the Cantonese monosyllables are similar to those in other languages reported in previous studies.Keywords: Cantonese, co-articulation, consonant, vowel
Procedia PDF Downloads 238664 Challenging the Stereotypes: A Critical Study of Chotti Munda, His Arrow, and Sula
Authors: Khushboo Gokani, Renu Josan
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Mahasweta Devi and Toni Morrison are the two stalwarts of the Indian-English and the Afro-American literature respectively. The writings of these two novelists are authentic and powerful records of the lives of the people because much of their personal experiences have gone into the making of their works. Devi, a representative force of the Indian English literature, is also a social activist working with the tribals of Bihar, Jharkhand, Orissa and West Bengal. Most of her works echo the lives and struggles of the subalterns as is evident in her 'best-beloved book' Chotti Munda and His Arrow. The novelist focuses on the struggle of the tribals against the colonial and the feudal powers to create their identity, thereby, embarking on the ideological project called Setting the Record Straight. The Nobel laureate Toni Morrison, on the other hand, brings to the fore the crucial issues of gender, race, and class in many of her significant works. In one of her representative works, Sula, the protagonist emerges as a non-conformist and directly confronts the notion of a ‘good woman’ nurtured by the community of the Blacks. In addition to this, the struggle of the Blacks against the White domination, also become an important theme of the text. The thrust of the paper lies in making a critical analysis of the portrayal of the heroic attempts of the subaltern protagonist and the artistic endeavor of the novelists in challenging the stereotypes.Keywords: the struggle of the muted groups, subaltern, center and periphery, challenging the stereotypes
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