Search results for: medical education

Authors: Md. Ashikur Rahman

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Optimal breastfeeding practice is essential to reducing childhood morbidity and mortality and helps to achieve Millennium Development Goal (MDG). A cross-sectional study was conducted in a rural area in Dhaka district to explore the barrier to optimal breastfeeding practices. The population of this study constitutes all nursing mothers having children aged 0-6 months, and they were selected purposively. The study adopted a structured and in-depth interview procedure consisting of open and closed-ended questions. Four hundred rural nursing mothers constituted the sample of the structured interview, while 15 were involved in the in-depth interview. Among the respondent's majority (67%) were in the age group 17-25 years, with a mean age of 24.44 years. Most (39.5%) of the mothers were housewives with a secondary level of education (46.5%). About 32% of mothers started breastfeeding within one hour after birth. But delayed initiation was reported in 31.5% of mothers, whereas 36.8% of mothers forgot the exact time of initiation of breastfeeding. The main reason not to practice colostrum was mothers tried to breastfeed, but there was no milk, stated 13.8% of mothers. In addition, about one-third (34.3%) of the respondents practiced pre-lacteal feeding, and among them, 12.8% introduced sugar with water. Reasons given by the mothers for bottle-feeding was that baby was not satisfied with breast milk only; 22.0% of mothers indicated this cause. The main influence to take formula milk by their mother and mothers-in-law was stated by 18.8% of mothers. Some mothers stated that major constraints to EBF were the perception of not having enough milk (25.5 %) and babies crying seems to be hungry (8.8%). One-third of the mothers (31.5%) felt uncomfortable during breastfeeding. Access to antenatal and postnatal counseling in the study area also was a key obstacle to optimal breastfeeding practices. In a qualitative survey, some mothers believed that there was no difference between breast milk and formula milk. Colostrum feeding, pre-lacteal feeding, early initiation of breastfeeding, and exclusive breastfeeding were strongly associated with family type, family member, birth order, religion, husbands' occupation, delivery attendants and delivery type, postnatal care, and health care facilities. To reduce the barriers to the successful practice of exclusive breastfeeding, there is a need for a grass-roots approach to educating and counseling nursing mothers with identifying factors influencing or discouraging the optimal practice.

Keywords: exclusive, breast feeding, practices, Bangladesh

Procedia PDF Downloads 82

Authors: Marie Kristel A. Gabawa

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The accessibility of health programs, specifically family planning programs and maternal and child health care (FP/MCH), are generally low in urban poor communities. Moreover, most of FP/MCH programs are directed toward medical terms that are usually not included in ideation of the body of urban poor dwellers. This study aims to explore the beliefs on reproduction that will encompass, but not limited to, beliefs on conception, pregnancy, and maternal and child health care. The site of study will be the 2 barangays of North Bay Boulevard South 1 (NBBS1) and North Bay Boulevard South 2 (NBBS2). These 2 barangays are the nearest residential community within the Navotas Fish Port Complex (NFPC). Data gathered will be analyzed using grounded-theory method of analysis, with the theories of cultural materialism and equity feminism as foundation. Survey questionnaires, key informant interviews, and focus group discussions will be utilized in gathering data. Further, the presentation of data will be recommended to health program initiators and use the data gathered as a tool to customize FP/MCH programs to the perception and beliefs of women residing in NBBS1and NBBS2, and to aid any misinformation for FP/MCH techniques.

Keywords: beliefs on reproduction, fish port community, family planning, maternal and child health care, Navotas

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Authors: L. Siva Rama Krishna, Sriram Venkatesh, M. Sastish Kumar, M. Uma Maheswara Chary

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Rapid Prototyping (RP) is a technology that produces models and prototype parts from 3D CAD model data, CT/MRI scan data, and model data created from 3D object digitizing systems. There are several RP process like Stereolithography (SLA), Solid Ground Curing (SGC), Selective Laser Sintering (SLS), Fused Deposition Modelling (FDM), 3D Printing (3DP) among them SLS and FDM RP processes are used to fabricate pattern of custom cranial implant. RP technology is useful in engineering and biomedical application. This is helpful in engineering for product design, tooling and manufacture etc. RP biomedical applications are design and development of medical devices, instruments, prosthetics and implantation; it is also helpful in planning complex surgical operation. The traditional approach limits the full appreciation of various bony structure movements and therefore the custom implants produced are difficult to measure the anatomy of parts and analyse the changes in facial appearances accurately. Cranioplasty surgery is a surgical correction of a defect in cranial bone by implanting a metal or plastic replacement to restore the missing part. This paper aims to do a comparative study on the dimensional error of CAD and SLS RP Models for reconstruction of cranial defect by comparing the virtual CAD with the physical RP model of a cranial defect.

Keywords: rapid prototyping, selective laser sintering, cranial defect, dimensional error

Procedia PDF Downloads 321

Authors: Marwa Mamdouh Shaban, Nagat Saied Habib, Shireen Ezz El-Din Taha, Eman Mahmoud Seif El-Naser

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Background: Dental nurses and dentists were constantly exposed to a number of specific work related health risk factors which develop and intensify with years. Awareness regarding these work-related health risk factors and implementation of preventive health care measures could provide a safe work environment for all dental nurses and dentists. Aim of the study: to assess the work-related health risk factors among dental nurses and dentists and preventive health care measures applied among dental nurses and dentists. Research design: A descriptive design was utilized. Sample: Convenience sample of 50 dental nurses and 150 dentists were included in the current study. Setting: This study was conducted at the dental clinics at faculty of oral and dental medicine, Al-Kasr Al Ainy Hospital. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a-Socio-demographic data sheet, b-Work-related health risk factors questionnaire, and c-structured observational checklist. Results: The most common work risk factors prevailing among dental nurses were emotional exhaustion (82%), low back pain (76%) and latex allergy (62%) and the most common work risk factors prevailing among dentists were percutaneous exposure incident (100%), emotional exhaustion (100%) and low back pain (93.3%). Also, statistically significant negative correlation (r=-0.274, at p = 0.045) between the incidence of chemical health risk factors and application of chemical preventive measures among dental nurses. A statistically significant negative correlation (r=-0.177, at p = 0.030) between the incidences of mechanical health risk factors among dentists and application of mechanical preventive measures. Conclusion: The studied dental nurses and dentists exposed to many work related health risk factors as latex allergy, percutaneous exposure incidents, low back pain and emotional exhaustion related to inappropriate application of preventive health care measures. Recommendation: Raise awareness of dental nurses and dentists about work-related health risk factors, design and implement health education program for preventive health care measures.

Keywords: work-related risk factors, preventive measures, nurses, dentists

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Authors: Edwina Owusu Panin, Derrick Antwi

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Autism and cerebral palsy are fraternal twins in the world of communication and social interaction challenges. Caring for autistic and cerebral palsied female teenagers in Ghana can be difficult and stressful for parents. We highlight the findings of dealing with stress, where female teenagers are more daunting than male teenagers, related to the demand for a lot of attention linked to the puberty transition. This brief examines the challenges that parents face in caring for teenagers with autism and cerebral palsy in Ghana and the stress that can develop from parental care. The article also highlights the importance of identifying and addressing mental health and self-care issues in parents of disabled female teenagers, as these issues can significantly affect the well-being of both parents and their children. Parents of teenagers with disabilities often face a variety of challenges, including managing their children's care and medical needs, navigating the educational system, and addressing social and emotional needs. These challenges can be even more disheartening in Ghana, where resources and support for families of children with disabilities are limited. In a nutshell, the challenges of caring for female teenagers with autism and cerebral palsy can be significant in Ghana. The article outlines methods that parents in Ghana can take to manage their stress and provide a brighter future for their female teenagers. Parents are better able to cope with the challenges of parenting and provide the best care possible for their female teenagers with disabilities.

Keywords: autism, cerebral palsy, female teenagers, parental care

Procedia PDF Downloads 75

Authors: Ann Devitt, Mairead Brady, Markus Lamest, Stephen Gomez

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This study set out to explore the use of an online collaborative serious game for student learning in a postgraduate introductory marketing module. The simulation game aimed to bridge the theory-practice divide in marketing by allowing students to apply theory in a safe, simulated marketplace. This study addresses the following research questions: Does an online marketing simulation game engage students higher order cognitive skills? Does collaborative activity required develop students’ “soft” skills, such as communication and negotiation? What specific affordances of the online simulation promote learning? This qualitative case study took place in 2014 with 40 postgraduate students on a Business Masters Programme. The two-week intensive module combined lectures with collaborative activity on a marketing simulation game, MMX from Pearsons. The game requires student teams to compete against other teams in a marketplace and design a marketing plan to maximize key performance indicators. The data for this study comprise essays written by students after the module reflecting on their learning on the module. A thematic analysis was conducted of the essays using the following a priori theme sets: 6 levels of the cognitive domain of Blooms taxonomy; 5 principles of Cooperative Learning; affordances of simulation environments including experiential learning; motivation and engagement; goal orientation. Preliminary findings would strongly suggest that the game facilitated students identifying the value of theory in practice, in particular for future employment; enhanced their understanding of group dynamics and their role within that; and impacted very strongly, both positively and negatively on motivation. In particular the game mechanics of MMX, which hinges on the correct identification of a target consumer group, was identified as a key determinant of extrinsic and intrinsic motivation for learners. The findings also suggest that the situation of the simulation game within a broader module which required post-game reflection was valuable in identifying key learning of marketing concepts in both the positive and the negative experiences of the game.

Keywords: simulation, marketing, serious game, cooperative learning, bloom's taxonomy

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Authors: W. Ling, Mohamed Saufi Bin Awang

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Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.

Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis

Procedia PDF Downloads 176

Authors: Twinkle Sara Joseph

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Virtual reality technology has emerged as a revolutionary power that can transform the education sector in many ways. VR environments can break the boundaries of the traditional classroom setting by immersing the students in realistic 3D environments where they can interact with virtual characters without fearing being judged. Communication skills are essential for every profession, and studies suggest the importance of implementing basic-level communication courses at both the school and graduate levels. Interpersonal communication is a skill that gains prominence as it is required in every profession. Traditional means of training have limitations for trainees as well as participants. The fear of being judged, the audience interaction, and other factors can affect the performance of a participant in a traditional classroom setting. Virtual reality offers a unique opportunity for its users to participate in training that does not set any boundaries that prevent the participants from performing in front of an audience. Specialised applications designed in VR headsets offer a range of training and exercises for participants without any time, space, or audience limitations. The present study aims at measuring the effectiveness of VR training in improving interpersonal communication skills among students. The study uses a mixed-method approach, in which a pre-and post-test will be designed to measure effectiveness. A preliminary selection process involving a questionnaire and a screening test will identify suitable candidates based on their current communication proficiency levels. Participants will undergo specialised training through the VR application Virtual Speech tailored for interpersonal communication and public speaking, designed to operate without the traditional constraints of time, space, or audience. The training's impact will subsequently be measured through situational exercises to engage the participants in interpersonal communication tasks, thereby assessing the improvement in their skills. The significance of this study lies in its potential to provide empirical evidence supporting VR technology's role in enhancing communication skills, thereby offering valuable insights for integrating VR-based methodologies into educational frameworks to prepare students more effectively for their professional futures.

Keywords: virtual reality, VR training, interpersonal communication, communication skills, 3D environments

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Authors: Iqra Yaseen

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One of the well-known areas of computer science and engineering, image processing in the context of computer vision has been essential to automation. In remote sensing, medical science, and many other fields, it has made it easier to uncover previously undiscovered facts. Grading of diverse items is now possible because of neural network algorithms, categorization, and digital image processing. Its use in the classification of agricultural products, particularly in the grading of seeds or grains and their cultivars, is widely recognized. A grading and sorting system enables the preservation of time, consistency, and uniformity. Global population growth has led to an increase in demand for food staples, biofuel, and other agricultural products. To meet this demand, available resources must be used and managed more effectively. Image processing is rapidly growing in the field of agriculture. Many applications have been developed using this approach for crop identification and classification, land and disease detection and for measuring other parameters of crop. Vegetation localization is the base of performing these task. Vegetation helps to identify the area where the crop is present. The productivity of the agriculture industry can be increased via image processing that is based upon Unmanned Aerial Vehicle photography and satellite. In this paper we use the machine learning techniques like Convolutional Neural Network, deep learning, image processing, classification, You Only Live Once to UAV imaging dataset to divide the crop into distinct groups and choose the best way to use it.

Keywords: image processing, UAV, YOLO, CNN, deep learning, classification

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Authors: Igna Brajević Gizdić, Gorka Vuletić

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Introduction: Addiction is a chronic brain relapsing disorder. Opioid Substitution Therapy (OST) using buprenorphine as a medical treatment option shows as a promising option for achieving and maintaining abstinence in opioid-addicted patients. This research aimed to determine and evaluate the quality of life (QoL) in opiate-addicted patients after five years of buprenorphine therapy. Method: The total sample included 44 buprenorphine-maintained opiate addicts in outpatient treatment. The participants were administered the QoL questionnaire (WHOQOL-BREF) at two-time points (T1 and T2) with an interval of at least five years. WHOQOL-BREF contains a total of 26 questions. The first two questions, related to overall QoL and general health status, and the remaining questions (3–26), which represented four domains—physical, psychological, social, and environmental health—were evaluated separately. Results: The results indicated no significant differences in overall self-assessed QoL nor in individual domains after five years (T2) of abstinence with OST buprenorphine- maintenance. Conclusion: These findings indicated no improvement in QoL of buprenorphine-maintenance opiate addicts in outpatient treatment. However, this might be due to the smaller sample size and participants' overall high scores in QoL at T1. This study suggests the importance of expectations when considering the QoL and general health of buprenorphine-maintenance opiate addicts in outpatient treatment.

Keywords: abstinence, addicts, buprenorphine, opioid substitution therapy, quality of life

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Authors: Hamid Reza Behnood, Esmaeel Ayati, Tom Brijs, Mohammadali Pirayesh Neghab

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Investment projects in road safety planning can benefit from an effectiveness evaluation regarding their expected safety outcomes. The objective of this study is to develop a decision support system (DSS) to support policymakers in taking the right choice in road safety planning based on the efficiency of previously implemented safety measures in a set of regions in Iran. The measures considered for each region in the study include performance indicators about (1) police operations, (2) treated black spots, (3) freeway and highway facility supplies, (4) speed control cameras, (5) emergency medical services, and (6) road lighting projects. To this end, inefficiency measure is calculated, defined by the proportion of fatality rates in relation to the combined measure of road safety performance indicators (i.e., road safety measures) which should be minimized. The relative inefficiency for each region is modeled by the Data Envelopment Analysis (DEA) technique. In a next step, a fuzzy decision-making system is constructed to convert the information obtained from the DEA analysis into a rule-based system that can be used by policy makers to evaluate the expected outcomes of certain alternative investment strategies in road safety.

Keywords: performance indicators, road safety, decision support system, data envelopment analysis, fuzzy reasoning

Procedia PDF Downloads 336

Authors: Tanja Ecken, Laura Fricke, Anika Wehling, Maren M. Michaelsen, Tobias Esch

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Studies and applied experiences evidence severe and traumatic accidents not only require physical rehabilitation and recovery but also necessitate a psychological adaption and reorganization to the changed living conditions. Neurobiological models underpinning the experience of happiness and satisfaction postulate life shocks to potentially enhance the experience of happiness and life satisfaction, i.e., posttraumatic growth (PTG). This present study aims to provide an in-depth understanding of the underlying psychological processes of PTG and to outline its consequences on subjective happiness and life satisfaction. To explore the aforementioned, Esch’s ABC Model was used as guidance for the development of a questionnaire assessing changes in happiness and life satisfaction and for a schematic model postulating the development of PTG in the context of paraplegia. Two-stage qualitative interview procedures explored participants’ experiences of paraplegia. Specifically, narrative, semi-structured interviews (N=28) focused on the time before and after the accident, the availability of supportive resources, and potential changes in the perception of happiness and life satisfaction. Qualitative analysis (Grounded Theory) indicated an initial phase of reorganization was followed by a gradual psychological adaption to novel, albeit reduced, opportunities in life. Participants reportedly experienced a ‘compelled’ slowing down and elements of mindfulness, subsequently instilling a sense of gratitude and joy in relation to life’s presumed trivialities. Despite physical limitations and difficulties, participants reported an enhanced ability to relate to oneself and others and a reduction of perceived everyday nuisances. Concluding, PTG can be experienced in response to severe, traumatic life events and has the potential to enrich the lives of affected persons in numerous, unexpected and yet challenging ways. PTG appears to be a spectrum comprised of an interplay of internal and external resources underpinned by neurobiological processes. Participants experienced PTG irrelevant of age, gender, marital status, income or level of education.

Keywords: post traumatic growth, happiness, life satisfaction, traumatic life events, paraplegia, ABC model, trauma

Procedia PDF Downloads 57

Authors: Teo Hao Jing, Shane Ho Ken Wae, Lee Jin Yu, Burra Venkata Durga Kumar

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Current distributed healthcare systems face the challenge of interoperability of health data. Storing electronic health records (EHR) in local databases causes them to be fragmented. This problem is aggravated as patients visit multiple healthcare providers in their lifetime. Existing solutions are unable to solve this issue and have caused burdens to healthcare specialists and patients alike. Blockchain technology was found to be able to increase the interoperability of health data by implementing digital access rules, enabling uniformed patient identity, and providing data aggregation. Consortium blockchain was found to have high read throughputs, is more trustworthy, more secure against external disruptions and accommodates transactions without fees. Therefore, this paper proposes a blockchain-based model for data management applications. In this model, a consortium blockchain is implemented by using a delegated proof of stake (DPoS) as its consensus mechanism. This blockchain allows collaboration between users from different organizations such as hospitals and medical bureaus. Patients serve as the owner of their information, where users from other parties require authorization from the patient to view their information. Hospitals upload the hash value of patients’ generated data to the blockchain, whereas the encrypted information is stored in a distributed cloud storage.

Keywords: blockchain technology, data management applications, healthcare, interoperability, delegated proof of stake

Procedia PDF Downloads 129

Authors: Fernanda Ludmilla Rossi Rocha, Thamiris Cavazzani Vegro, Silvia Helena Henriques Camelo, Carmen Silvia Gabriel, Andrea Bernardes

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Introduction: Organizations are cultural, symbolic and imaginary systems composed by values and norms. These values and norms represent the organizational culture, which determines the behavior of the workers, guides the work practices and impacts the quality of care and the safety culture of health services worldwide. Objective: To analyze the organizational culture of a public and a private hospital in Brazil. Method: Descriptive study with quantitative approach developed in a public and in a private hospital of Brazil. Sample was composed by 281 nursing workers, of which 73 nurses and 208 nursing auxiliaries and technicians. The data collection instrument comprised the Brazilian Instrument for Assessing Organizational Culture. Data were collected from March to December 2013. Results: At the public hospital, the results showed an average score of 2.85 for the values concerning cooperative professionalism (CP); 3.02 for values related to hierarchical rigidity and the centralization of power (HR); 2.23 for individualistic professionalism and competition at work (IP); 2.22 for values related to satisfaction, well-being and motivation of workers (SW); 3.47 for external integration (EI); 2.03 for rewarding and training practices (RT); 2.75 for practices related to the promotion of interpersonal relationships (IR) About the private hospital, the results showed an average score of 3.24 for the CP; 2.83 for HR; 2.69 for IP; 2.71 for SW; 3.73 for EI; 2.56 for RT; 2.83 for IR at the hospital. Discussion: The analysis of organizational values of the studied hospitals shows that workers find the existence of hierarchical rigidity and the centralization of power in the institutions; believed there was cooperation at workplace, though they perceived individualism and competition; believed that values associated with the workers’ well-being, satisfaction and motivation were seldom acknowledged by the hospital; believed in the adoption of strategic planning actions within the institution, but considered interpersonal relationship promotion, continuous education and the rewarding of workers to be little valued by the institution. Conclusion: This work context can lead to professional dissatisfaction, compromising the quality of care and contributing to the occurrence of occupational diseases.

Keywords: nursing management, organizational culture, quality of care, interpersonal relationships

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Authors: Mai Ali

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Advancing beyond the junior stage of a paediatrician’s career is a crucial step where they accumulate essential skills and knowledge. This process prepares them for the challenges they'll encounter throughout their profession, particularly in dealing with paediatric emergencies. This can be especially demanding for trainees specializing in fields like endocrinology, particularly in the management of Diabetic Ketoacidosis (DKA) in the UK. In different societal contexts, junior doctors, whether specializing in pediatrics or other medical fields, are generally expected to possess a fundamental level of knowledge and skills necessary for managing diabetic ketoacidosis (DKA) emergencies. These physicians consistently concurred in recognizing prevalent problems in the healthcare facilities they examined. Such issues include the lack of established guidelines for DKA treatment and the inadequate availability of comprehensive training opportunities. The abstract underscores the critical importance of junior paediatricians acquiring expertise in managing paediatric emergencies, with a specific focus on DKA. Commonly, issues like the lack of standardized protocols and training deficiencies are recurring themes across healthcare facilities. This research proposal aims to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom when handling DKA in various clinical contexts. The primary goal is to assess their competency and suggest effective strategies for comprehensive DKA training improvement.

Keywords: junior pediatrician, DKA, standardized protocols, level of competence

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Authors: Elham Falatoonitoosi, Vikki Schaffer, Don Kerr

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Over-development for tourism and its consequences on residents’ well-being turn into a critical issue in tourism destinations. Learning about undesirable impacts of tourism has led many people to seek more sustainable and responsible tourism. The main objective of this research is to understand how and to what extent sustainable tourism development enhances locals’ well-being regarding stakeholder perception. The research was conducted in a coastal-hinterland tourism region through two sequential phases. At the first phase, a unique set of 19 sustainable tourism indicators resulted from a triplex model was used to examine the sustainability effects on the main factors of residents’ well-being including equity and living condition, life satisfaction, health condition, and education quality. The triplex model including i) systematic literature search, ii) convergent interviewing, and iii) DEMATEL aimed to develop sustainability indicators, specify them for a particular destination, and identify the dominant sustainability issues acting as key predictors in sustainable development. At the second phase, a hierarchical multiple regression was used to examine the relationship between sustainable development and local residents’ well-being. A number of 167 participants from five different groups of stakeholders perceived the importance level of each sustainability indicators regarding well-being factors on 5-point Likert scale. Results from the first phase indicated that sustainability training, government support, tourism sociocultural effects, tourism revenue, and climate change are the top dominant sustainability issues in the regional sustainable development. Results from the second phase showed that sustainable development considerably improves the overall residents’ well-being and has positive relationships with all well-being factors except life satisfaction. It explains that it was difficult for stakeholders to recognize a link between sustainable development and their overall life satisfaction and happiness. Among well-being’s factors, health condition was influenced the most by sustainability indicators that indicate stakeholders believed sustainability development can promote public health, health sector performance, quality of drinking water, and sanitation. For the future research, it is highly recommended to analysis the effects of sustainable tourism development on the other features of a tourism destination’s well-being including residents sociocultural empowerment, local economic growth, and attractiveness of the destination.

Keywords: residents' well-being, stakeholder perception, sustainability indicators, sustainable tourism

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Authors: Kazunari Ozaki, Mitsuru Kageyama, Kenki Miyazawa, Yoshio Nakamura

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Background: Kampo (Japanese Traditional medicine) is a medicine traditionally practiced in Japan, based on ancient Chinese medicine. Most Kampo doctors have used decoction of crude drug pieces for treatment. 93% of the Kampo drugs sold in Japan are Kampo products nowadays. Of all Kampo products, 81% of them are Kampo extract formulations for prescription, which is prepared in powdered or granulated form from medicinal crude drug extracts mixed with appropriate excipient. Physicians with medical license for Western medicine prescribe these Kampo extract formulations for prescription in Japan. Objectives: Our study aims at presenting a brief history of Kampo extract formulations for prescription in Japan. Methods: Systematic searches for relevant studies were conducted using not only printed journals but also electronic journals from the bibliographic databases, such as PubMed/Medline, Ichushi-Web, and university/institutional websites, as well as search engines, such as Google and Google Scholar. Results: The first commercialization of Kampo extract formulations for general use (or OTC (over-the-counter) Kampo extract formulation) was achieved after 1957. The number of drugs has been subsequentially increased, reaching 148 Kampo extract formulation for prescription currently. Conclusion: We provide a history of Kampo extract formulations for prescription in Japan. The originality of this research is that it analyzes the background history of Kampo in parallel with relevant transitions in the government and insurance systems.

Keywords: health insurance system, history, Kampo, Kampo extract formulation for prescription, OTC Kampo extract formulation, pattern corresponding prescription (Ho-sho-so-tai) system

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Authors: Adnan Sahin, Ufuk Uylas, Ercument Pasaoglu, Tarik Caga, Enver Ihtiyar, Serdar Erkasap, Ersin Ates, Fatih Yasar

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Background: In this study, it was evaluated the demographic features, etiological factors and the management of acute pancreatitis. Methods: 106 patient hospitalized due to acute pancreatitis were retrospectively examined from 1 January 2015 to 31 December 2015 in Department of General Surgery of ESOGUMF. The data of gender, signs and symptoms, etiological factors, WBC, AST, ALT, Amilase, USG and CT findings treatment options ERCP, and complications, mortality rate were analysed. Results: The mean age of patients were 58.8 (53 men and 53 women). The causes of acute pancreatitis were as follows: gallbladder stone was 89, hyperlipidemia was 5 and idiopathic were 16 patients. Severe pancreatitis was developed in 16 patients in the biliary pancreatitis group and ERCP was performed. Cholecystectomy was performed to all biliary pancreatitis group patients after acute pancreatitis subside. The mean hospital stay period was 9.33 (2-37) day. Discussion and conclusion: Severe acute pancreatitis is a mortal disease. The most common etiological cause of acute pancreatitis is biliary origin. The first line treatment modality of acute pancreatitis is medical. Cholecystectomy should be planned to the all-biliary caused acute pancreatitis patients after the attack subside. ERCP is a useful treatment modality in the case of clinical worsening and suspicion of acute cholangitis. ERCP procedure used 16 patients in our series and these patients have a good morbidity and mean hospital period is lower than the others. We suppose that ERCP procedure should be planned selectively and conservatively.

Keywords: acute pancreatitis, ERCP, morbidity, treatment

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Authors: Allyson Dale, Max Hlywa

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The Canadian public expects the highest moral standards from Canadian Armed Forces (CAF) members and Department of National Defence (DND) employees. The Chief, Professional Conduct and Culture (CPCC) stood up in April 2021 with the mission of ensuring that the defence culture and members’ conduct are aligned with the ethical principles and values that the organization aspires towards. The Defence Ethics Program (DEP), which stood up in 1997, is a values-based ethics program for individuals and organizations within the DND/CAF and now falls under CPCC. The DEP is divided into five key functional areas, including policy, communications, collaboration, training and education, and advice and guidance. The main focus of the DEP is to foster an ethical culture within defence so that members and organizations perform to the highest ethical standards. The measurement of organizational ethics is often complex and challenging. In order to monitor whether the DEP is achieving its intended outcomes, a performance measurement framework (PMF) was developed using the Director General Military Personnel Research and Analysis (DGMPRA) PMF development process. This evidence-based process is based on subject-matter expertise from the defence team. The goal of this presentation is to describe each stage of the DGMPRA PMF development process and to present and discuss the products of the DEP PMF (e.g., logic model). Specifically, first, a strategic framework was developed to provide a high-level overview of the strategic objectives, mission, and vision of the DEP. Next, Key Performance Questions were created based on the objectives in the strategic framework. A logic model detailing the activities, outputs (what is produced by the program activities), and intended outcomes of the program were developed to demonstrate how the program works. Finally, Key Performance Indicators were developed based on both the intended outcomes in the logic model and the Key Performance Questions in order to monitor program effectiveness. The Key Performance Indicators measure aspects of organizational ethics such as ethical conduct and decision-making, DEP collaborations, and knowledge and awareness of the Defence Ethics Code while leveraging ethics-related items from multiple DGMPRA surveys where appropriate.

Keywords: defence ethics, ethical culture, organizational performance, performance measurement framework

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Authors: Fatema Salman, Ridha Hammam, Fatima Khairallah, Fatima Aradi, Nafeesa Abdulla, Mohammed Alsafar

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Purpose: This study aims at measuring the extent of nurses’ knowledge and attitudes toward the use of physical restraints in different hospital wards at Salmaniya Medical Complex (SMC). Background: The habitual use of physical restraint is a widespread practice among nurses working in the clinical settings. Restraints inflict many deleterious consequences on patients physically and psychologically which in turn increases their morbidity and mortality risk and jeopardizes care quality. Nurses’ knowledge and attitudes toward physical restraints are crucial determinants of the persistence of this practice. Literature review: the evidence of lack of knowledge among nurses regarding the use of physical restraints is overwhelming in various clinical settings, especially in two main areas which are the negative consequences and the available alternatives to physical restraints. Studies explored nurses’ attitudes toward physical restraints yielded inconsistent findings. Equally comparable, some studies found that nurses hold positive attitudes toward the use of physical restraints while some others reported just the opposite. Methods: Self-administered knowledge and attitudes scales to 106 nurses working in the SMC. Findings: nurses hold the moderate level of knowledge about restraints (M=58%) with weak negative attitudes (M = -20%) toward using it. Significant moderately-strong negative correlation (r= -0.57, r2= 0.32, p= 0.000) was uncovered between nurses knowledge and their attitudes which provided an empirical explanation of this phenomenon (use of physical restraints). Recommendations: Induction of awareness program that especially focuses on the negative consequences and encourages the use of alternatives is an evident need. This effort necessarily should be adjoined with policy and procedure adjustments.

Keywords: attitudes, knowledge, nurses, restraints

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Authors: Md Nur Uddin

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The Rohingya people are one of the world's most oppressed and persecuted refugee populations, having been stateless for over six generations and still are. In recent years, more than half-million Rohingya Muslims have fled Myanmar (Burma) for neighboring nations. This article discusses the Status and Rights of Rohingya Migrants in Bangladesh, with a focus on the living conditions of this vulnerable population. A lot of information has been studied about Rohingya refugees states that violence in Rakhine state has sent an estimated 615,500 Rohingya across the border into Bangladesh's Cox's Bazar since August 25, 2017. In Cox's Bazar, a total of 33,131 Rohingya refugees are housed in two registered camps, with an additional 854,024 living in informal settlements nearby. The living conditions of Rohingya refugees in overcrowded camps remain dismal. Mental health is bad, cleanliness is poor, malnutrition is common, and physical and sexual abuse is endemic. A coordinated diplomatic effort involving Bangladesh and Myanmar, as well as international mediators such as the Organization of Islamic Countries and the United Nations, is essential to adequately resolve this complex matter. Bangladeshi officials must ensure the safety of the Rohingyas in the camps and use available humanitarian aid to give the refugees basic amenities such as food, shelter, sanitation, and medical treatment. UNHCR officials should keep an eye on the actual repatriation process to ensure that refugees who have expressed a desire to stay in Bangladesh are not deported against their choice.

Keywords: international refugee laws, united nations, Rohingya, stateless, humanitarian

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Authors: Amina Akhtar, Rory O'Connor

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Introduction: There remains significant morbidity and mortality in young pedestrians hit by motor vehicles, even in the era of pedestrian crossings and speed limits. The aim of this study was to compare incidence and injury severity of motor vehicle-related pedestrian trauma according to time of day and season in a young population, based on the supposition that injuries would be more prevalent during dusk and dawn and during autumn and winter. Methods: Data was retrieved for patients between 10-25 years old from the National Trauma Audit and Research Network (TARN) database who had been involved as pedestrians in motor vehicle accidents between 2015-2020. The incidence of injuries, their severity (using the Injury Severity Score [ISS]), hospital transfer time, and mortality were analysed according to the hours of daylight, darkness, and season. Results: The study identified a seasonal pattern, showing that autumn was the predominant season and led to 34.9% of injuries, with a further 25.4% in winter in comparison to spring and summer, with 21.4% and 18.3% of injuries, respectively. However, visibility alone was not a sufficient factor as 49.5% of injuries occurred during the time of darkness, while 50.5% occurred during daylight. Importantly, the greatest injury rate (number of injuries/hour) occurred between 1500-1630, correlating to school pick-up times. A further significant relationship between injury severity score (ISS) and daylight was demonstrated (p-value= 0.0124), with moderate injuries (ISS 9-14) occurring most commonly during the day (72.7%) and more severe injuries (ISS>15) occurred during the night (55.8%). Conclusion: We have identified a relationship between time of day and the frequency and severity of pedestrian trauma in young people. In addition, particular time groupings correspond to the greatest injury rate, suggesting that reduced visibility coupled with school pick-up times may play a significant role. This could be addressed through a targeted public health approach to implementing change. We recommend targeted public health measures to improve road safety that focus on these times and that increase the visibility of children combined with education for drivers.

Keywords: major trauma, paediatric trauma, road traffic accidents, diurnal pattern

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Authors: Azeez Yusuf, Alan Casey

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Silver nanoparticles (AgNP) are one of the most widely investigated metallic nanoparticles due to their promising antibacterial activities. In recent years, AgNP research has shifted beyond antimicrobial use to potential applications in the medical arena. This shift coupled with the extensive commercial applications of AgNP will further increase human exposure, and the subsequent risk of adverse effects that may result from repeated exposures and inefficient delivery meaning research into improved AgNP delivery is of paramount importance. In this study, AgNP were encapsulated in a natural bio-surfactant, dipalmitoylphosphatyidyl choline (DPPC), in an attempt to enhance the intracellular delivery and simultaneously mediate the associated cytotoxicity of the AgNP. It was noted that as a result of the encapsulation, liposomal-AgNP (Lipo-AgNP) at 0.625 μg/ml induced significant cell death in THP1 cell lines a notably lower dose than that of the uncoated AgNP induced cytotoxicity. The induced cytotoxicity was shown to result in an increased level of DNA fragmentation resulting in a cell cycle interruption at the S phase of the cell cycle. It was shown that the predominate form of cell death upon exposure to both uncoated and Lipo-AgNP was apoptosis, however, a ROS-independent activation of the executioner caspases 3/7 occurred when exposed to the Lipo-AgNP. These findings showed that encapsulation of AgNP enhances AgNP cytotoxicity and mediates an ROS-independent induction of apoptosis.

Keywords: silver nanoparticles, AgNP, cytotoxicity, encapsulation, liposome

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Authors: Farhaz Amyn Rajabali, Collins Odour

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Mathematics has been there for over 4000 years and has been one of the very first educational topics explored by human civilization. Throughout the years, it has become a complex study and has derived so many other subjects. With advancements in ICT, most of the computation in mathematics is done using powerful computers. In many different countries, the children in primary and secondary schools face difficulties in learning mathematics, and this has many reasons behind it, one being the students don’t engage much with the mathematical concepts hence failing to understand them deeply. The objective of this system is to help the students understand this mathematical concept interactively, which in return will encourage the love for learning and increase thorough understanding of many concepts. Research was conducted among a group of samples and about 50% of respondents replied that they had never used an augmented reality application before. This means that the chances for this system to be accepted in the market are high due to its innovative idea. Around 60% of people did recommend the use of this system to learn mathematics. The study also showed several challenges in an educational system, including but not limited to lack of resources which was chosen by 30% of respondents, the challenge to read from textbooks (34.6%) and how hard it is to visualize concepts (46.2%). The survey question asked what benefits the users see using augmented reality to learn mathematics. The responses that were picked the most were increased student engagement and using real-world examples to understand concepts, both being 65.4% and followed by easy access to learning material at 61.5%, and increased knowledge retention at 50%. This shows that there are plenty of issues with an education system that can be addressed by software applications; now that the newer generation is so enthusiastic about electronic devices, it can actually be used to deliver good knowledge and skills to the upcoming students and mitigate most of the challenges faced currently. The study concludes that the implementation of the system is a best practice for the educational system especially leveraging a new technology that has the ability to attract the attention of many young students and use it to deliver information. It will also give rise to awareness of new technology and on multiple ways it can be implemented. Addressing the educational sector in developing countries using information technology is an imperative task since these kids studying now is the future of the country and will use what they learn and understand during their childhood will help them to make decisions about their lives in the future which will not only affect them personally but also affect the whole society in general.

Keywords: AR, mathematics, system development, augmented reality

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Authors: Monica Karlsson

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The positive effect of a supportive written context on comprehension and retention when faced with a previously unknown idiomatic expression is today an indisputable fact, especially if relevant clues are given in close proximity of the item in question. Also, giving learners a chance of visualizing the meaning of an idiom by offering them its source domain and/or by elaborating etymologically, i.e. providing a mental picture in addition to the spoken/written form (referred to as dual coding), seems to enhance comprehension and retention even further, especially if the idiom is of a more transparent kind. For example, by explaining that walk the plank has a maritime origin and a canary in a coal mine comes from the time when canaries were kept in cages to warn miners if gas was leaking out at which point the canaries succumbed immediately, learners’ comprehension and retention have been shown to increase. The present study aims to investigate whether contextualization of an audiovisual kind could help increase comprehension and retention of L2 idioms. 40 Swedish first-term university students studying English as part of their education to become middle-school teachers participated in the investigation, which tested 24 idioms, all of which were ascertained to be previously unknown to the informants. While half of the learners were subjected to a test in which they were asked to watch scenes from various TV programmes, each scene including one idiomatic expression in a supportive context, the remaining 20 students, as a point of reference, were only offered written contexts, though equally supportive. Immediately after these sessions, both groups were given the same idioms in a decontextualized form and asked to give their meaning. After five weeks, finally, the students were subjected to yet another decontextualized comprehension test. Furthermore, since mastery of idioms in one’s L1 appears to correlate to a great extent with a person’s ability to comprehend idioms in an L2, all the informants were also asked to take a test focusing on idioms in their L1. The result on this test is thus seen to indicate each student’s potential for understanding and memorizing various idiomatic expressions from a more general perspective. Preliminary results clearly show that audiovisual contextualization indeed has a positive effect on learners’ retention. In addition, preliminary results also show that those learners’ who were able to recall most meanings were those who had a propensity for idiom comprehension in their L1.

Keywords: English, L2, idioms, audiovisual context

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Authors: Himer Khalid, Alami Ilyass, Kharchoufa Loubna, Elachouri Mostafa

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It has been estimated by the World Health Organization that 80% of the world's population relies on traditional medicine to meet their daily health requirements. In Morocco reliance on such medicine is partly owing to the high cost of conventional medicine and the inaccessibility of modern health care facilities. There was high agreement in the use of plants as medicine in Oriental Morocco. Our objective is to evaluate the informant’s knowledge on medicinal plants by the local population and to document the uses of medicinal plants by this community, for the treatment of different illnesses. Using an ethnopharmacological approach, we collected information concerning the traditional medicinal knowledge and the medicinal plants used, by interviewing successfully 458 informants living in oriental Morocco (from Debdou, Taourirt, Guersif a,d Laayoune districts). The data were analyzed by statistical methods (Component Analysis “CA”, Factorial Analysis “FA”) and other methods such as through Informant’s Consensus Factor (ICF) and Use Value (UV). Our results indicate that, more than 60% of the population in these regions relies on medicinal plants for the treatment of different ailments with predominance of women consumers. 135 plant species belonging to 61 families were documented. These plants were used by the population for the treatment of a group of illness (about 14 principal ailments). We conclude that, in oriental Morocco, till now, the population has some traditional knowledge commonly used as medical tradition. These wealthy heritage needs conservation and evaluation.

Keywords: Morocco, medicinal plants, traditional knowledge, wealthy heritage

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Authors: Robbi Beyer, Tiffanye Vargas, Margaret Flores

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Within the United States, youths with hidden disabilities (specific learning disabilities, attention deficit hyperactivity disorder, emotional behavioral disorders, mild intellectual disabilities and speech/language disorders) can often be part of the kindergarten through twelfth grade school population. Because individuals with hidden disabilities have no apparent physical disability, learning difficulties may be overlooked and these youths may be mistakenly labeled as unmotivated, or defiant because they don't understand and follow directions, or maintain enough attention to remember and perform. These behaviors are considered especially challenging for youth sport coaches to manage and they often find it difficult to successfully select and deliver effective accommodations for the athletes. These deficits can be remediated and compensated through the use of research-validated strategies and instructional methods. However, while these techniques are commonly included in teacher preparation, they rarely, if ever, are included in coaching preparation. Therefore, the purpose of this presentation is to summarize consecutive research studies that examined coaching education within the United States for youth athletes with hidden disabilities. Each study utilized a questionnaire format to collect data from coaches on attitudes, efficacy and solutions for addressing challenging behaviors. Results indicated that although the majority of coaches’ attitudes were positive and they perceived themselves confident in working with athletes who have hidden disabilities, there were significant differences in the understanding of appropriate teaching strategies and techniques for this population. For example, when asked to describe a videotaped situation of why an athlete is not performing correctly, coaches often found the athlete to be at fault, as opposed to considering the possibility of faulty directions, or the need for accommodations in teaching/coaching style. When considering coaches’ preparation, 83% of participants declared they were inadequately prepared to coach athletes with hidden disabilities and 92% strongly supported improved preparation for coaches. The comprehensive examination of coaches’ perceptions and efficacy in working with youth athletes with hidden disabilities has provided valuable insight and highlights the need for continued research in this area.

Keywords: health, hidden disabilties, physical activity, youth recreational sports

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Authors: Briar Schulz

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The use of phototherapy within the counselling room offers significant advantages in extending far beyond typical "talk therapy" avenues. The benefits of using this approach are numerous and include: efficiency in recalling pertinent information in addition to utilizing a visual lens that often captures opulent detail that can be eluded in traditional dialogue. The goal of this presentation is to provide conference attendees with an opportunity to understand the therapeutic benefits and creative possibilities of incorporating photography into the clinical counselling process. This includes practical strategies for using in specific case studies, where studies of phototherapy have previously been limited. Ethical considerations and limitations to the process will also be addressed. Attendees will observe the benefits of using phototherapy with six longitudinal case studies including: a 30 year old female, with anorexia nervosa; a 22 year old self-harming individual with obsessive compulsive disorder; a 24 year old client with developmental delays, and bipolar disorder; a 14 year old client with Autism; and two clients with rare medical conditions struggling with depression and anxiety, one 21 years old and the other 16 years old. Aspects of each case will be linked to various theoretical modalities to highlight the efficiency and benefits of phototherapy in drawing important clinical conclusions. Furthermore, the use of phototherapy within these clinical areas remains a relatively unexplored area of the literature, and possibilities for future research will be highlighted. Finally, conference attendees will have the opportunity to try various phototherapy strategies within the interactive portion of this presentation. .

Keywords: Atypical, Case studies, Phototherapy, Photovoice

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Authors: Bin Mohamed Ebrahim, Aminesh Singla, Henry Pleass

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Aim: There is an ongoing gap in renal transplantation between organs available for donation and recipients on the waiting list. Live donors with pre-existing or a history of renal calculi were thought to be a relative contraindication due to safety concerns for donors. We aim to review current literature assessing outcomes of donors who were found to have a history of renal calculi. Methods: Ovid and Embase were searched between 1960 to 2021 using key terms and Medical Subject Headings (MeSH) – nephrolithiasis, renal stones, renal transplantation and renal graft. Articles included conference proceedings and journal articles and were not excluded based on patient numbers. Studies were excluded if the specific organ was not identified, duplicated reports found or if post-transplant outcomes were not recorded. Outcomes were donor’s renal function or renal calculi recurrence postoperatively. Results: Upon reviewing 344 articles, 14 manuscripts met inclusion criteria. A total of 152 live donors were identified as having pre-existing or with a history of renal calculi at pre-operative workup. The mean stone size was 2.6 4mm (1 – 16) with a mean follow-up duration of 31.8 months (1 – 96). Seven studies had both outcomes. None showed renal complications or stone recurrence. The remaining studies contained 2 out of 84 patients having recurrent nephrolithiasis. Conclusion: Data suggests minimal morbidity involved for live renal donors with a history of nephrolithiasis. This should encourage surgeons to continue recruiting such donors for kidney transplantation.

Keywords: renal transplantation, renal graft, nephrolithiasis, renal calculi, live donor

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Authors: L. Ereku, R. E. Mackay, A. Naveenathayalan, K. Ajayi, W. Balachandran

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Over the past decade the increase of sexually transmitted infections (STIs) especially in the developing world due to high cost and lack of sufficient medical testing have given rise to the need for a rapid, low cost point of care medical diagnostic that is disposable and most significantly reproduces equivocal results achieved within centralised laboratories. This paper present the development of a disposable PDMS microfluidic cartridge incorporating blisters filled with reagents required for isothermal DNA amplification in clinical diagnostics and point-of-care testing. In view of circumventing the necessity for external complex microfluidic pumps, designing on-chip pressurised fluid reservoirs is embraced using finger actuation and blister storage. The fabrication of the blisters takes into consideration three proponents that include: material characteristics, fluid volume and structural design. Silicone rubber is the chosen material due to its good chemical stability, considerable tear resistance and moderate tension/compression strength. The case of fluid capacity and structural form go hand in hand as the reagent need for the experimental analysis determines the volume size of the blisters, whereas the structural form has to be designed to provide low compression stress when deformed for fluid expulsion. Furthermore, the top and bottom section of the blisters are embedded with miniature polar opposite magnets at a defined parallel distance. These magnets are needed to lock or restrain the blisters when fully compressed so as to prevent unneeded backflow as a result of elasticity. The integrated chip is bonded onto a large microscope glass slide (50mm x 75mm). Each part is manufactured using a 3D printed mould designed using Solidworks software. Die-casting is employed, using 3D printed moulds, to form the deformable blisters by forcing a proprietary liquid silicone rubber through the positive mould cavity. The set silicone rubber is removed from the cast and prefilled with liquid reagent and then sealed with a thin (0.3mm) burstable layer of recast silicone rubber. The main microfluidic cartridge is fabricated using classical soft lithographic techniques. The cartridge incorporates microchannel circuitry, mixing chamber, inlet port, outlet port, reaction chamber and waste chamber. Polydimethylsiloxane (PDMS, QSil 216) is mixed and degassed using a centrifuge (ratio 10:1) is then poured after the prefilled blisters are correctly positioned on the negative mould. Heat treatment of about 50C to 60C in the oven for about 3hours is needed to achieve curing. The latter chip production stage involves bonding the cured PDMS to the glass slide. A plasma coroner treater device BD20-AC (Electro-Technic Products Inc., US) is used to activate the PDMS and glass slide before they are both joined and adequately compressed together, then left in the oven over the night to ensure bonding. There are two blisters in total needed for experimentation; the first will be used as a wash buffer to remove any remaining cell debris and unbound DNA while the second will contain 100uL amplification reagents. This paper will present results of chemical cell lysis, extraction using a biopolymer paper membrane and isothermal amplification on a low-cost platform using the finger actuated blisters for reagent storage. The platform has been shown to detect 1x105 copies of Chlamydia trachomatis using Recombinase Polymerase Amplification (RPA).

Keywords: finger actuation, point of care, reagent storage, silicone blisters

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