Search results for: patient education

Authors: Mohammad Amini, Aliakbar Alijarahi

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This research that is collected and title as ‘ the search of possibility of running six sigma process in IT education center ‘ goals to test possibility of running the six sigma process and using in IT education center system. This process is a good method that is used for reducing process, errors. To evaluate running off six sigma in the IT education center, some variables relevant to this process is selected. These variables are: - The amount of support from organization master boss to process. - The current specialty. - The ability of training system for compensating reduction. - The amount of match between current culture whit six sigma culture . - The amount of current quality by comparing whit quality gain from running six sigma. For evaluation these variables we select four question and to gain the answers, we set a questionnaire from with 28 question and distribute it in our typical society. Since, our working environment is a very competition, and organization needs to decree the errors to minimum, otherwise it lasts their customers. The questionnaire from is given to 55 persons, they were filled and returned by 50 persons, after analyzing the forms these results is gained: - IT education center needs to use and run this system (six sigma) for improving their process qualities. - The most factors need to run the six sigma exist in the IT education center, but there is a need to support.

Keywords: education, customer, self-action, quality, continuous improvement process

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Authors: Esra Yuksel, Dilek Duman, Levent Yeniay, Sezgin Ulukaya

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Sentinel lymph node biopsy (SLNB) is a minimal invasive technique with lower morbidity in axillary staging of breast cancer. Isosulfan blue stain is frequently used in SLNB and regarded as safe. The present case report aimed to report severe decrement in SpO2 following isosulfan blue administration, as well as skin and urine signs and inconsistency with clinical picture in a 67-year-old ,77 kg, ASA II female case that underwent SLNB under general anesthesia. Ten minutes after subcutaneous administration of 10 ml 1% isosulfan blue by the surgeons into the patient, who were hemodynamically stable, SpO2 first reduced to 87% from 99%, and then to 75% in minutes despite 100% oxygen support. Meanwhile, blood pressure and EtCO2 monitoring was unremarkable. After specifying that anesthesia device worked normally, airway pressure did not increase and the endotracheal tube has been placed accurately, the blood sample was taken from the patient for arterial gas analysis. A severe increase was thought in MetHb concentration since SpO2 persisted to be 75% although the concentration of inspired oxygen was 100%, and solution of 2500 mg ascorbic acid in 500 ml 5% Dextrose was given to the patient via intravenous route until the results of arterial blood gas were obtained. However, arterial blood gas results were as follows: pH: 7.54, PaCO2: 23.3 mmHg, PaO2: 281 mmHg, SaO2: %99, and MetHb: %2.7. Biochemical analysis revealed a blood MetHb concentration of 2%.However, since arterial blood gas parameters were good, hemodynamics of the patient was stable and methemoglobin concentration was not so high, the patient was extubated after surgery when she was relaxed, cooperated and had adequate respiration. Despite the absence of respiratory or neurological distress, SpO2 value was increased only up to 85% within 2 hours with 5 L/min oxygen support via face mask in the surgery room as the patient was extubated. At that time, the skin of particularly the upper part of her body has turned into blue, more remarkable on the face. The color of plasma of the blood taken from the patient for biochemical analysis was blue. The color of urine coming throughout the urinary catheter placed in intensive care unit was also blue. Twelve hours after 5 L/min. oxygen inhalation via a mask, the SpO2 reached to 90%. During monitoring in intensive care unit on the postoperative 1st day, facial color and urine color of the patient was still blue, SpO2 was 92%, and arterial blood gas levels were as follows: pH: 7.44, PaO2: 76.1 mmHg, PaCO2: 38.2 mmHg, SaO2: 99%, and MetHb 1%. During monitoring in clinic on the postoperative 2nd day, SpO2 was 95% without oxygen support and her facial and urine color turned into normal. The patient was discharged on the 3rd day without any problem.In conclusion, SLNB is a less invasive alternative to axillary dissection. However, false pulse oximeter reading due to pigment interference is a rare complication of this procedure. Arterial blood gas analysis should be used to confirm any fall in SpO2 reading during monitoring.

Keywords: isosulfan blue, pulse oximetry, SLNB, methemoglobinemia

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Authors: Nabil Sultan

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A great deal has been written on Massive Open Online Courses (MOOCs) since 2012 (considered by some as the year of the MOOCs). The emergence of MOOCs caused a great deal of interest amongst academics and technology experts as well as ordinary people. Some of the authors who wrote on MOOCs perceived it as the next big thing that will disrupt education. Other authors saw it as another fad that will go away once it ran its course (as most fads often do). But MOOCs did not turn out to be a fad and it is still around. Most importantly, they evolved into something that is beginning to look like a viable business model. This paper explores this phenomenon within the theoretical frameworks of disruptive innovations and jobs to be done as developed by Clayton Christensen and his colleagues and its implications for the future of higher education (HE).

Keywords: MOOCs, disruptive innovations, higher education, jobs theory

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Authors: Edu Marcelina, Sule Sheidu A., Nsor Eunice

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As open and distance education is gradually becoming an acceptable means of solving the problem of access in higher education, quality has now become one of the main concerns among institutions and stakeholders of open and distance learning (ODL) and the education sector in general. This study assessed the challenges of academic quality in the open and distance learning (ODL) education in Nigeria using Distance Learning Institute (DLI), University of Lagos and National Open University of Nigeria as a case. In carrying out the study, a descriptive survey research design was employed. A researcher-designed and validated questionnaire was used to elicit responses that translated to the quantitative data for this study. The sample comprised 665 students of the Distance Learning Institute (DLI), and National Open University of Nigeria (NOUN), carefully selected through the method of simple random sampling. Data collected from the study were analyzed using Chi-Square (X2) at 0.05 Level of significance. The results of the analysis revealed that; the use of ICT tools is a factor in ensuring quality in the Open and Distance Learning (ODL) operations; the quality of the materials made available to ODL students will determine the quality of education that will be received by the students; and the time scheduled for students for self-study, online lecturing/interaction and face to face study and the quality of education in Open and Distance Learning Institutions has a lot of impact on the quality of education the students receive. Based on the findings, a number of recommendations were made.

Keywords: open and distance learning, quality, ICT, face-to-face interaction

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Authors: Mir Afzal Tajik

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The 'Strengthening Teacher Education in Pakistan' (STEP) is an innovative programme jointly funded by the Government of Canada and the Aga Khan Foundation Canada and implemented by the Aga Khan University - Institute for Educational Development (AKU-IED) in partnership with the local governments, education departments and communities in the provinces of Balochistan, Sindh and Gilgit-Baltistan in Pakistan. One of the key components of the programme is the professional development of teachers, headteachers and teacher educators through a variety of teacher education programmes including a two-year Masters of Education (MEd) Programme offered by AKU-IED. A number of teachers, headteachers and teacher educators from these provinces have been developed through the MEd Programme. This paper discusses a qualitative research study conducted to explore the nature, relevance, rigor and richness of the experiences of the MEd graduates, and how these experiences have fostered their own professional development and their ability to bring about positive changes in their schools. The findings of the study provide useful insights into the graduates’ self-actualization, the transformation of their professional beliefs and practices, the difference they have made in their schools, and the challenges they face. The study also provides recommendations for policy and practice related to teacher education programmes.

Keywords: STEP, teacher education, Pakistan, Canada, Aga Khan foundation

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Authors: Ek-Uma Imkome, Jintana Yunibhand, Waraporn Chaiyawat

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Background: Persons with schizophrenia patient and misusing methamphetamines suffering from social dysfunction that impact on their quality of life. Knowledge of factors related to social dysfunction will guide the effective intervention. Objectives: To determine the direct effect, indirect effect and total effect of an acerbate Psychotics’ Symptoms, Social Support, Stressful life events, Medication use self-efficacy impact on social dysfunction in Thai schizophrenic patient and methamphetamine misuse. Methods: Data were collected from schizophrenic and methamphetamine misuse patient by self report. A linear structural relationship was used to test the hypothesized path model. Results: The hypothesized model was found to fit the empirical data and explained 54% of the variance of the psychotic symptoms (X² = 114.35, df = 92, p-value = 0.05, X² /df = 1.24, GFI = 0.96, AGFI = 0.92, CFI = 1.00, NFI = 0.99, NNFI = 0.99, RMSEA = 0.02). The highest total effect on social dysfunction was psychotic symptoms (0.67, p<0.05). Medication use self-efficacy had a direct effect on psychotic symptoms (-0.25, p<0.01), and social support had direct effect on medication use self efficacy (0.36, p <0.01). Conclusions: Psychotic symptoms and stressful life events were the significance factors that influenced direct on social dysfunctioning. Therefore, interventions that are designed to manage these factors are crucial in order to enhance social functioning in this population.

Keywords: psychotic symptoms, methamphetamine, schizophrenia, stressful life events, social dysfunction, social support, medication use self efficacy

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Authors: Selvavinayagan Babiharan

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This research aims to develop a deep learning platform to enhance mathematics education for secondary students in Sri Lanka. The platform will be designed to incorporate interactive and user-friendly features to engage students in active learning and promote their mathematical skills. The proposed platform will be developed using TensorFlow and Keras, two widely used deep learning frameworks. The system will be trained on a large dataset of math problems, which will be collected from Sri Lankan school curricula. The results of this research will contribute to the improvement of mathematics education in Sri Lanka and provide a valuable tool for teachers to enhance the learning experience of their students.

Keywords: information technology, education, machine learning, mathematics

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Authors: Ram A. Giri, Amna Bedri, Abdou Niane

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Exclusion in education on the basis of language in multilingual contexts operates at multiple levels. Learners of diverse ethnolinguistic backgrounds are often expected to learn through English and are pushed further down the learning ladder if they also have to access education through Information and Communication Technology (ICT). The paper explores marginalized children’s lived experiences in accessing technology and English in four low-income countries in Africa and Asia. Based on the findings of the first phase of a multinational qualitative research study, we report on the factors or barriers that affect children’s access, opportunities and motivation for learning through technology and English. ICT and English - the language of ICT and education - can enhance learning and can even be essential. However, these two important keys to education can also function as barriers to accessing quality education, and therefore as zones of exclusion. This paper looks into how marginalized children (aged 13-15) engage in learning through ICT and English and to what extent the restrictive access and opportunities contribute to the widening of the already existing gap in education. By applying the conceptual frameworks of “access and accessibility of learning” and “zones of exclusion,” the paper elucidates how the barriers prevent children’s effective engagement with learning and addresses such questions as to how marginalized children access technology and English for learning; whether the children value English, and what their motivation and opportunity to learn it are. In addition, the paper will point out policy and pedagogic implications.

Keywords: exclusion, inclusion, inclusive education, marginalization

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Authors: Nwachukwu Ihiejeto Celestine

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Rural poverty in Nigeria has been the bake of the society. It has been a canker worm which has eaten deep into the fabric of Nigerian society. Different models and principles have been applied to eradicate it, such as operation feed the nation, green revolution, NAPEP etc. Little or nothing has been done in the area of entrepreneurship education to tame this monster. It is based on this that the author wants to x-ray the role entrepreneurship education which studies “the process of identifying, bringing a vision to life” could play in the eradication of rural poverty in Nigeria. This will go along in providing appropriate principles for poverty alleviation and eradication in Nigeria. Some selected states in the eastern Geo-political region could be x-rayed in this circumstance. It is hoped that policy makers etc will find the work cogent in formulating and implementing policy decisions.

Keywords: poverty, entrepreneurship, education, Nigeria

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Authors: Shang-Sin Shiu, Shu-I Chin, Hsiu-Ju Chen, Ru-Yu Lien

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The Hospice and Palliative Care Act has undergone three revisions, making it less challenging for terminal patients to withdraw life support systems. However, the adequacy of care before withdraw is a crucial factor in end-of-life medical treatment. The author observed that intensive care unit (ICU) nursing staff often rely on simple flowcharts or word of mouth, leading to inadequate preparation and failure to meet patient needs before withdraw. This results in confusion or hesitation among those executing the process. Therefore, there is a motivation to improve the withdraw of patient care processes, establish standardized procedures, ensure the accuracy of removal execution, enhance end-of-life care self-efficacy for nursing staff, and improve the overall quality of care. The investigation identified key issues: the lack of applicable guidelines for ICU care for withdraw from life-sustaining, insufficient education and training on withdraw and end-of-life care, scattered locations of withdraw-related tools, and inadequate self-efficacy in withdraw from life-sustaining care. Solutions proposed include revising withdraw care processes and guidelines, integrating tools and locations, conducting educational courses, and forming support groups. After the project implementation, the accuracy of removal cognition improved from 78% to 96.5%, self-efficacy in end-of-life care after removal increased from 54.7% to 93.1%, and the correctness of care behavior progressed from 27.7% to 97.8%. It is recommended to regularly conduct courses on removing life support system care and grief consolation to enhance the quality of end-of-life care.

Keywords: the intensive care unit (ICU) patients, nursing staff, withdraw life support systems, self-efficacy

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Authors: Regina R. Gunawan, Indwiani Astuti, H. Raden Danarto

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Cancer is the leading cause of death worldwide. Cancer is caused by mutations that alter the function of normal human genes and give rise to cancer genes. MicroRNA (miRNA) is a small non-coding RNA that regulates the gen through complementary bond towards mRNA target and cause mRNA degradation. miRNA works by either promoting or suppressing cell proliferation. miRNA level expression in cancer may offer another value of miRNA as a biomarker in cancer diagnostic. miRNA-21 is believed to have a role in carcinogenesis by enhancing proliferation, anti-apoptosis, cell cycle progression and invasion of tumor cells. Hsa-miR-21-5p marker has been identified in Prostate Cancer (PCa) and Benign Prostatic Hyperplasia (BPH) patient’s urine. This research planned to explore the diagnostic performance of miR-21 to differentiate PCa and BPH patients. In this study, urine samples were collected from 20 PCa patients and 20 BPH patients. miR-21 relative expression against the reference gene was analyzed and compared between the two. miRNA expression was analyzed using the comparative quantification method to find the fold change. miR-21 validity in identifying PCa patients was performed by quantifying the sensitivity and specificity with the contingency table. miR-21 relative expression against miR-16 in PCa patient and in BPH patient has 12,98 differences in fold change. From a contingency table of Cq expression of miR-21 in identifying PCa patients from BPH patient, Cq miR-21 has 100% sensitivity and 75% specificity. miR-21 relative expression can be used in discriminating PCa from BPH by using a urine sample. Furthermore, the expression of miR-21 has higher sensitivity compared to PSA (Prostate specific antigen), therefore miR-21 has a high potential to be analyzed and developed more.

Keywords: benign prostate hyperplasia, biomarker, miRNA-21, prostate cancer

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Authors: Vladimir Simovic, Matija Varga, Tonco Marusic

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This research paper shows matrix technology models and examples of information systems in education (in the Republic of Croatia and in the Germany) in support of business, education (when learning and teaching) and e-learning. Here we researched and described the aims and objectives of the main process in education and technology, with main matrix classes of data. In this paper, we have example of matrix technology with detailed description of processes related to specific data classes in the processes of education and an example module that is support for the process: ‘Filling in the directory and the diary of work’ and ‘evaluation’. Also, on the lower level of the processes, we researched and described all activities which take place within the lower process in education. We researched and described the characteristics and functioning of modules: ‘Fill the directory and the diary of work’ and ‘evaluation’. For the analysis of the affinity between the aforementioned processes and/or sub-process we used our application model created in Visual Basic, which was based on the algorithm for analyzing the affinity between the observed processes and/or sub-processes.

Keywords: designing, education management, information systems, matrix technology, process affinity

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Authors: Adzongo Philomena Ibuh, Aloga O. Austin

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The purpose of the study was to examine lifelong education for teachers as a tool for achieving effective teaching and learning. Lifelong education enhances social inclusion, personal development, citizenship, employability, teaching and learning, community and the nation, and the challenges of lifelong education were also discussed. Descriptive survey design was adopted for the study. A simple random sampling technique was used to select 80 teachers as sample from a population of 105 senior secondary school teachers in Makurdi local government area of Benue state. A 20-item self designed questionnaire subjected to expert validation and reliability was used to collect data. The reliability Alpha coefficient of 0.87 was established using Crombach Alpha technique, mean scores and standard deviation were used to answer the 2 research questions while chi-square was used to analyze data for the 2 hypotheses. The findings of the study revealed that, lifelong education for teachers can be used to achieve as a tool for achieving effective teaching and learning, and the study recommended among others that government, organizations and individuals should in collaboration put lifelong education programmes for teachers on the priority list. The paper concluded that the strategic position of lifelong education for teachers towards enhanced teaching and learning makes it imperative for all hands to be on deck to support the programme financially and otherwise.

Keywords: effective teaching and learning, lifelong education, teachers, tool

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Authors: Md. Shakhawat Hossain, Jimma Hossain, Md. Naushad Ali

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Acute pancreatitis is a dangerous medical emergency in the practice of gastroenterology. Management of acute pancreatitis needs multidisciplinary approach with support starts from emergency to ICU. So, there is a chance of mismanagement in every steps, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management. The present study is intended to determine the clinico-pathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid tertiary care hospital to image the real scenario of management in a low resource place. A total 100 patients of acute pancreatitis were studied in this prospective study, held in the Department of Gastroenterology, Rangpur medical college hospital, Bangladesh from July 2017 to July 2018 within one year. Regarding severity, 85 % of the patients were mild, whereas 13 were moderately severe, and 2 had severe acute pancreatitis according to the revised Atlanta criteria. The most common etiologies of acute pancreatitis in our study were gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Others are non-adherence of patient party, and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% of patients as per current guideline. Conclusion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, modified guidelines for assessment and management of acute pancreatitis should be prepared for low resource setting.

Keywords: acute pancreatitis, challenges of management, severity, prognosis

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Authors: Waleed Afandi

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Artificial intelligence (AI) has rapidly transformed various sectors, including education. This paper explores the integration of AI in education, emphasizing its potential to revolutionize learning processes, enhance teaching methodologies, and personalize education. We examine the historical context of AI in education, current applications, and the potential challenges and ethical considerations associated with its implementation. By reviewing a wide range of literature, this study aims to provide a comprehensive understanding of how AI can be leveraged to improve educational outcomes and the future directions of AI-driven educational innovations. Additionally, the paper discusses the impact of AI on student engagement, teacher support, and administrative efficiency. Case studies highlighting successful AI applications in diverse educational settings are presented, showcasing the practical benefits and real-world implications. The analysis also addresses potential disparities in access to AI technologies and suggests strategies to ensure equitable implementation. Through a balanced examination of the promises and pitfalls of AI in education, this study seeks to inform educators, policymakers, and technologists about the optimal pathways for integrating AI to foster an inclusive, effective, and innovative educational environment.

Keywords: artificial intelligence, education, personalized learning, teaching methodologies, educational outcomes, AI applications, student engagement, teacher support, administrative efficiency, equity in education

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Authors: Alyaa Farouk Abdelfattah Ibrahim, Samah Mohamed, Huda Jrady, Mashail Alrashidi, Alaa Mohammad, Fatimah Alotaibi, Maram Almutiri

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Participation in volunteering was associated with better mental and physical health, self-esteem, and life satisfaction. The main motivator for students in particular is the chance to gain work-related experiences, improve skills, and build on qualifications that may help them achieve their educational goals and further their careers. This study aimed to assess the effect of summer training volunteering practices in healthcare on self-confidence of nursing students in Riyadh. In a crossectional study design, 150 nursing students at King Saud bin Abdul-Aziz University for health sciences in Riyadh were included in the study. Bio-socio-demographic, self-confidence, patients’ care and skills questionnaires were used for data collection. Results: Participants’ age ranged between 20 and 26 years. The majority were from the educational level seven (80%). 40.7 % of them reported volunteering in summer training programs; 70.37% of them volunteered at least once and for a duration of at least one month. Nursing students from level 6 were less likely to have self-confidence in their patients’ care skills than those in level 7. Students who volunteered were more likely to be more interested in becoming social, professional, and independent healthcare workers. There was no difference regarding experience in clinical skills and education by volunteering status. Clinical skills improved by a level of education in this group. Conclusion: Professional self-confidence and clinical performance are related in this group of nursing students. Monitoring, arranging, and encouraging volunteering activities for nursing students are important to help them broaden their interests, their self-confidence in their capabilities, and advancement in their chosen profession. Mostly, volunteering enhanced knowledge in patient safety and quality of care and attempts to secure volunteering opportunities should be a priority on the nursing education agenda.

Keywords: volunteering, health care volunteering, nursing students, summer training

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Authors: Babatunde Kasim Oladele

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One of the major objectives of the Nigeria national policy on education is the provision of equal educational opportunities to all citizens at different levels of education. With regards to higher education, an aspect of the policy encourages distance learning to be organized and delivered by tertiary institutions in Nigeria. This study therefore, determines how much of the Government resources are committed, how the resources are utilized and what alternative sources of funding are available for this system of education. This study investigated the trends in recurrent costs between 2004/2005 and 2013/2014 at University of Ibadan Distance Learning Centre (DLC). A descriptive survey research design was employed for the study. Questionnaire was the research instrument used for the collection of data. The population of the study was 280 current distance learning education students, 70 academic staff and 50 administrative staff. Only 354 questionnaires were correctly filled and returned. Data collected were analyzed and coded using the frequencies, ratio, average and percentages were used to answer all the research questions. The study revealed that staff salaries and allowances of academic and non-academic staff represent the most important variable that influences the cost of education. About 55% of resources were allocated to this sector alone. The study also indicates that costs rise every year with increase in enrolment representing a situation of diseconomies of scale. This study recommends that Universities who operates distance learning program should strive to explore other internally generated revenue option to boost their revenue. University of Ibadan, being the premier university in Nigeria, should be given foreign aid and home support, both financially and materially, to enable the institute to run a formidable distance education program that would measure up in planning and implementation with those of developed nation.

Keywords: open education, distance education, University of Ibadan, Nigeria, cost of education

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Authors: Herlin Vallejo, Jhon Osorio

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Quality is a concept that has gained importance in different scenarios over time, especially in the area of health. The nursing staff is one of the actors that contributes most to the care process and the satisfaction of the users in the evaluation of quality. However, until now, there are few tools to measure the quality of care in specialized performance scenarios. Patients receiving ambulatory cancer treatments can face various problems, which can increase their level of distress, so improving the quality of outpatient care for cancer patients should be a priority for oncology nursing. The experience of the patient in relation to the care in these services has been little investigated. The purpose of this study was to understand the perception that patients have about quality care in outpatient chemotherapy services. A qualitative, exploratory, descriptive study was carried out in 9 patients older than 18 years, diagnosed with cancer, who were treated at the Institute of Cancerology, in outpatient chemotherapy rooms, with a minimum of three months of treatment with curative intention and which had given your informed consent. The total of participants was determined by the theoretical saturation, and the selection of these was for convenience. Unstructured interviews were conducted, recorded and transcribed. The analysis of the information was done under the technique of content analysis. Three categories emerged that reflect the perception that patients have regarding quality care: patient-centered care, care with love and effects of care. Patients highlighted situations that show that care is centered on them, incorporating elements of patient-centered care from the institutional, infrastructure, qualities of care and what for them, in contrast, means inappropriate care. Care with love as a perception of quality care means for patients that the nursing staff must have certain qualities, perceive caring with love as a family affair, limits on care with love and the nurse-patient relationship. Quality care has effects on both the patient and the nursing staff. One of the most relevant effects was the confidence that the patient develops towards the nurse, besides to transform the unreal images about cancer treatment with chemotherapy. On the other hand, care with quality generates a commitment to self-care and is a facilitator in the transit of oncological disease and chemotherapeutic treatment, but from the perception of a healing transit. It is concluded that care with quality from the perception of patients, is a construction that goes beyond the structural issues and is related to an institutional culture of quality that is reflected in the attitude of the nursing staff and in the acts of Care that have positive effects on the experience of chemotherapy and disease. With the results, it contributes to better understand how quality care is built from the perception of patients and to open a range of possibilities for the future development of an individualized instrument that allows evaluating the quality of care from the perception of patients with cancer.

Keywords: nursing care, oncology service hospital, quality management, qualitative studies

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Authors: Fiona Jensen, Barb Goodwin, Nancy Kleiman, Rhonda Usunier

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Background: Clinical simulation is now a common component in many health profession curricula in preparation for clinical practice. In the Rady Faculty of Health Sciences (RFHS) college leads in simulation and interprofessional (IP) education, planned an eight hour simulated hospital day shift, where seventy students from six health professions across two campuses, learned with each other in a safe, realistic environment. Learning about interprofessional collaboration, an expected competency for many health professions upon graduation, was a primary focus of the simulation event. Method: Faculty representatives from the Colleges of Nursing, Medicine, Pharmacy and Rehabilitation Sciences (Physical Therapy, Occupation Therapy, Respiratory Therapy) and Pharmacy worked together to plan the IP event in a simulation facility in the College of Nursing. Each college provided a faculty mentor to guide the same profession students. Students were placed in interprofessional teams consisting of a nurse, physician, pharmacist, and then sharing respiratory, occupational, and physical therapists across the team depending on the needs of the patients. Eight patient scenarios were role played by health profession students, who had been provided with their patient’s story shortly before the event. Each team was guided by a facilitator. Results and Outcomes: On the morning of the event, all students gathered in a large group to meet mentors and facilitators and have a brief overview of the six competencies for effective collaboration and the session objectives. The students assuming their same profession roles were provided with their patient’s chart at the beginning of the shift, met with their team, and then completed professional specific assessments. Shortly into the shift, IP team rounds began, facilitated by the team facilitator. During the shift, each patient role-played a spontaneous health incident, which required collaboration between the IP team members for assessment and management. The afternoon concluded with team rounds, a collaborative management plan, and a facilitated de-brief. Conclusions: During the de-brief sessions, students responded to set questions related to the session learning objectives and expressed many positive learning moments. We believe that we have a sustainable simulation IP collaborative learning opportunity, which can be embedded into curricula, and has the capacity to grow to include more health profession faculties and students. Opportunities are being explored in the RFHS at the administrative level, to offer this event more frequently in the academic year to reach more students. In addition, a formally structured event evaluation tool would provide important feedback and inform the qualitative feedback to event organizers and the colleges about the significance of the simulation event to student learning.

Keywords: simulation, collaboration, teams, interprofessional

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Authors: Saba Ebrahimi, Saeed Ahmadian, Hedie Ashrafi

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Selecting appropriate patients for surgery is one of the main issues in thoracic surgery (TS). Both short-term and long-term risks and benefits of surgery must be considered in the patient selection criteria. There are some limitations in the existing datasets of TS patients because of missing values of attributes and imbalanced distribution of survival classes. In this study, a novel ensemble architecture of deep learning networks is proposed based on stacking different linear and non-linear layers to deal with imbalance datasets. The categorical and numerical features are split using different layers with ability to shrink the unnecessary features. Then, after extracting the insight from the raw features, a novel biased-kernel layer is applied to reinforce the gradient of the minority class and cause the network to be trained better comparing the current methods. Finally, the performance and advantages of our proposed model over the existing models are examined for predicting patient survival after thoracic surgery using a real-life clinical data for lung cancer patients.

Keywords: deep learning, ensemble models, imbalanced classification, lung cancer, TS patient selection

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Authors: Donatien Callon, Ian Lalonde, Mathieu Nadeau, Alexandre Girard

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Patient transfer is a challenging, critical task because it exposes caregivers to injury risks. Available transfer devices, like floor lifts, lead to improvements but are far from perfect. They do not eliminate the caregivers’ risk of musculoskeletal disorders, and they can be burdensome to use due to their poor maneuverability. This paper presents a new motorized floor lift with a single central motorized wheel connected to an instrumented handle. Admittance controllers are designed to 1) improve the device maneuverability, 2) reduce the required caregiver effort, and 3) ensure the security and comfort of patients. Two controller designs, one with a linear admittance law and a non-linear admittance law with variable damping, were developed and implemented on a prototype. Tests were performed on seven participants to evaluate the performance of the assistance system and the controllers. The experimental results show that 1) the motorized assistance with the variable damping controller improves maneuverability by 28%, 2) reduces the amount of effort required to push the lift by 66%, and 3) provides the same level of patient comfort compared to a standard unassisted floor lift.

Keywords: floor lift, human robot interaction, admittance controller, variable admittance

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Authors: Tadesse Melaku Abegaz

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Background: there was paucity of data on the self-reported adverse drug reactions (ADRs), level of adherence and clinical outcomes with antidepressants among major depressive disorder (MDD) patients in Ethiopia. Hence, the present study sought to determine the level of adherence for and clinical outcome with antidepressants and the magnitude of ADRs. Methods: A prospective cross-sectional study was employed on MDD patients from September 2016 to January 2017 at Gondar university hospital psychiatry clinic. All patients who were available during the study period were included under the study population. The Naranjo adverse drug reaction probability scale was employed to assess the adverse drug reaction. The rate of medication adherence was determined using morisky medication adherence measurement scale eight. Clinical Outcome of patients was measured by using patient health questionnaire. Multivariable logistic carried out to determine factors for adherence and patient outcome. Results: two hundred seventy patients were participated in the study. More than half of the respondents were males 122(56.2%). The mean age of the participants was 30.94 ± 8.853. More than one-half of the subjects had low adherence to their medications 124(57.1%). About 186(85.7%) of patients encountered ADR. The most common ADR was weight gain 29(13.2). Around 198(92.2%) ADRs were probable and 19(8.8%) were possible. Patients with long standing MDD had high risk of non-adherence COR: 2.458[4.413-4.227], AOR: 2.424[1.185-4.961]. More than one-half 125(57.6) of respondents showed improved outcome. Optimal level of medication adherence was found to be associated with reduced risk of progression of the diseases COR: 0.37[0.110-5.379] and AOR: 0.432[0.201-0.909]. Conclusion: Patient reported adverse drug reactions were more prevalent in major depressive disorder patients. Adherence to medications was very poor in the setup. However, the clinical outcome was relatively higher. Long standing depression was associated with non-adherence. In addition, clinical outcome of patients were affected by non-adherence. Therefore, adherence enhancing interventions should be provided to improve medication adherence and patient outcome.

Keywords: adverse drug reactions, clinical outcomes, Ethiopia, prospective study, medication adherence

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Authors: Marketa Kotova, Jana Kolarova, Ludek Zalud, Petr Dobsak

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A game for training of breath (TRABR) for continuous monitoring of pulmonary ventilation during the patients’ therapy focuses especially on monitoring of their ventilation processes. It is necessary to detect, monitor and differentiate abdominal and thoracic breathing during the therapy. It is a fun form of rehabilitation where the patient plays and also practicing isolated breathing. Finally the game to practice breath was designed to evaluate whether the patient uses two types of breathing or not.

Keywords: pulmonary ventilation, thoracic breathing, abdominal breathing, breath monitoring using pressure sensors, game TRABR TRAining of BReath)

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Authors: Yael Cohen Azaria, Sara Zamir

Abstract:

This study examined what motivated Israeli Arab students to choose to study for a degree in education and society and the influence of this academic choice on them while they were studying. The study follows the qualitative paradigm of data collection and analysis, in a case study of a homogeneous group of Arab students in a Jewish multicultural academic institution. 33 students underwent semi-structured in-depth interviews. Findings show that the choice stemmed from a desire to lead social change within their own society; to imitate an educational role-model and to realize a dream of higher education. Among the female students, this field suits the role of the woman in Arab society. The interviewees claimed that the influence of their studies was that they felt more openness towards others and those who are different; they felt pride and self-confidence in their abilities, and the women mentioned that they felt empowered.

Keywords: education, higher education, Israeli Arabs, minorities

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Authors: Pei-Ru Yang, Yu-Chen Lin, Jia-Min Wu

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Background: A 58-year-old man with a history of osteoporosis and diabetes presented with chronic pain in his left knee due to severe knee joint degeneration. The knee replacement surgery was recommended by the doctor. But the patient suffered from low pain tolerance and wondered if virtual reality could relieve acute postoperative wound pain. Methods: We used the PICO (patient, intervention, comparison, and outcome) approach to generate indexed keywords and searched systematic review articles from 2017 to 2021 on the Cochran Library, PubMed, and Clinical Key databases. Results: The initial literature results included 38 articles, including 12 Cochrane library articles and 26 PubMed articles. One article was selected for further analysis after removing duplicates and off-topic articles. The eight trials included in this article were published between 2013 and 2019 and recruited a total of 723 participants. The studies, conducted in India, Lebanon, Iran, South Korea, Spain, and China, included adults who underwent hemorrhoidectomy, dental surgery, craniotomy or spine surgery, episiotomy repair, and knee surgery, with a mean age (24.1 ± 4.1 to 73.3 ± 6.5). Virtual reality is an emerging non-drug postoperative analgesia method. The findings showed that pain control was reduced by a mean of 1.48 points (95% CI: -2.02 to -0.95, p-value < 0.0001) in minor surgery and 0.32 points in major surgery (95% CI: -0.53 to -0.11, p-value < 0.03), and the overall postoperative satisfaction has improved. Discussion: Postoperative pain is a common clinical problem in surgical patients. Research has confirmed that virtual reality can create an immersive interactive environment, communicate with patients, and effectively relieve postoperative pain. However, virtual reality requires the purchase of hardware and software and other related computer equipment, and its high cost is a disadvantage. We selected the best literature based on clinical questions to answer the patient's question and used share decision making (SDM) to help the patient make decisions based on the clinical situation after knee replacement surgery to improve the quality of patient-centered care.

Keywords: knee replacement surgery, postoperative pain, share decision making, virtual reality

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Authors: Rammah Abdlbagi, Similoluwa Biyi, Aakash Pai

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Introduction: Short-term ureteric stents are commonly placed after ureteroscopy procedures. The removal usually entails having a flexible cystoscopy, which entails a further invasive procedure. There are often delays in removing the stent as departments have limited cystoscopy availability. However, if stents with extraction strings are used, the patient or a clinician can remove them. The aim of the study is to assess the safety and effectiveness of the use of a stent with a string. Method: A retrospective, single-institution study was conducted over a three-month period. Twenty consecutive patients had ureteric stents with string insertion. Ten of the patients had a stent removal procedure previously with flexible cystoscopy. A validated questionnaire was used to assess outcomes. Primary outcomes included: dysuria, hematuria, urinary frequency, and disturbance of the patient’s daily activities. Secondary outcomes included pain experience during the stent removal. Result: Fifteen patients (75%) experienced hematuria and frequency. Two patients experienced pain and discomfort during the stent removal (10%). Two patients had experienced a disturbance in their daily activity (10%). All patients who had stent removal before using flexible cystoscopy preferred the removal of the stent using a string. None of the patients had stent displacement. The median stent dwell time was five days. Conclusion: Patient reported outcomes measures for the indwelling period of a stent with extraction string are equivalent to the published data on stents. Extraction strings mean that the stent dwell time can be reduced. The removal of the stent on extraction strings is more tolerable than the conventional stent.

Keywords: ureteric stent, string flexible cystoscopy, stent symptoms, validated questionnaire

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Authors: Piyapat Chitpirom, Teerakiat Jareonsettasin, Chintida Vichitsophaphan

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The Foundation of Virtuous Youth was established and supported by the Crown Property Bureau, with the intention to instill goodness in Thai youth. The Centre for Educational Psychology is one of the three units under the foundation. We aim to develop programmes that can be used to improve the quality of education in schools. Translation of the King’s message in keeping with the modern research from various sources, our team create 6 programmes: (1) Teacher-Student Relationship (2) Growth Mindset (3) Socratic Teaching (4) Peer Tutoring (5) Parental Involvement (6) Inclusion. After nine months of implementing the programmes in the schools, we found that there were more cooperation between student-student, teacher-student, teacher-parent, and student-parent and the school regained trust from the community. Our ideas were accepted well by the government as our director was promoted to be the Vice Minister of Education in order to implement our programmes into national education system. We consider that the key of our success is that we do practical things. We are still continuing, improving, and learning from our work with hope that the quality of Thai education will improve in near future.

Keywords: education reform, educational psychology, effective teaching, teacher-student relationship

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Authors: Galit Harel

Abstract:

Deborah was referred for psychoanalytic psychotherapy following a suicide attempt and depression. She began a fascinating journey spanning more than 10 years. During therapy, many questions arose concerning the suicidal episode, which she could not register consciously. The author tried to understand the reasons for her depression and the attempted suicide through the unconscious process in the therapeutic relationship and through the music and poetry that she brought to sessions. In this paper, the author describes the process of listening for the signifiers of semiotic and symbolic language, both metaphoric and metonymic, as revealed in poetry and music according to the theories of Kristeva and Lacan. The poetry enabled the patient to retrieve childhood memories, experience the movement from unconscious to conscious, and mourn through the experience of transference and countertransference in the therapeutic relationship. Also illustrated is the transition from singing the music to more symbolic language, turning the patient’s sensory experience into language, and connecting her personal experience with the culture of her past. The patient’s mourning and the lost love objects are discussed through the prism of classical and object relations theories.

Keywords: depression, lost love object, psychoanalytic psychotherapy, suicide attempt, symbolization of desire

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Authors: Christine K. Fulmer

Abstract:

Social work education is competency based in nature. There is an expectation that graduates of social work programs throughout the world are to be prepared to practice at a level of competence, which is beneficial to both the well-being of individuals and community. Experiential learning is one way to prepare students for competent practice. The use of Problem-Based Learning (PBL) is a form experiential education that has been successful in a number of disciplines to bridge the gap between the theoretical concepts in the classroom to the real world. PBL aligns with the constructivist theoretical approach to learning, which emphasizes the integration of new knowledge with the beliefs students already hold. In addition, the basic tenants of PBL correspond well with the practice behaviors associated with social work practice including multi-disciplinary collaboration and critical thinking. This paper makes an argument for utilizing PBL in social work education.

Keywords: social work education, problem-based learning, pedagogy, experiential learning, constructivist theoretical approach

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Authors: Etta Conteh, Tracy Macintosh

Abstract:

Introduction: Restraints are often used in the Emergency Department when it is necessary for a patient to be restrained in order to decrease their agitation and better treat them. Chemical and physical restraints may be used on these patients at the discretion of the medical provider. Racism and injustice are rampant within our country, and medicine and healthcare are not spared. While racism and racial bias in medicine and healthcare have been studied, information on the differences in the use of restraints by race are scarce. Objective: The objective of this study is to determine if African Americans and Hispanic-American patients are restrained at higher rates compared to their White counterparts. Methods: This study will be carried out through a retrospective analysis utilizing the Hospital Corporation of America (HCA) national Emergency Department (ED) and inpatient database with patient visits from 2016-2019. All patient visits, with patients aged 18 years or older, will be reviewed, looking specifically for the race and the use and type of restraints. Other factors, such a pre-existing psychiatric condition, will be used for sub-analysis. Rationale: The outcome of this project will demonstrate the absence or presence of a racial disparity in the use of restraints in the Emergency Department. These results can be used as a foundation for improving racial equity in healthcare treatment.

Keywords: emergency medicine, public health, racism, restraint use

Procedia PDF Downloads 255