Search results for: nursing team

Authors: Kamal Ahmed, Othman Ayman, Refat Mostafa

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The post-construction phase represents a critical milestone in the project lifecycle. This is because design errors and omissions, as well as construction defects, are examined during this phase. The traditional procurement approaches that are commonly adopted in construction projects separate design from construction, which ultimately inhibits contractors, suppliers and other parties from providing the design team with constructive comments and feedback to improve the project design. As a result, a lack of considering maintainability aspects during the design process results in increasing maintenance and operation costs as well as reducing building performance. This research aims to investigate the role of Early Supplier Involvement (ESI) in the design process as an approach to enhancing building maintainability. In order to achieve this aim, a research methodology consisting of a literature review, case studies and a survey questionnaire was designed to accomplish four objectives. Firstly, a literature review was used to examine the concepts of building maintenance, maintainability, the design process and ESI. Secondly, three case studies were presented and analyzed to investigate the role of ESI in enhancing building maintainability during the design process. Thirdly, a survey questionnaire was conducted with a representative sample of Architectural Design Firms (ADFs) in Egypt to investigate their perception and application of ESI towards enhancing building maintainability during the design process. Finally, the research developed a framework to facilitate ESI in the design process in ADFs in Egypt. Data analysis showed that the ‘Difficulty of trusting external parties and sharing information with transparency’ was ranked the highest challenge of ESI in ADFs in Egypt, followed by ‘Legal competitive advantage restrictions’. Moreover, ‘Better estimation for operation and maintenance costs’ was ranked the highest contribution of ESI towards enhancing building maintainability, followed by ‘Reduce the number of operation and maintenance problems or reworks’. Finally, ‘Innovation, technical expertise, and competence’ was ranked the highest supplier’s selection criteria, while ‘paying consultation fees for offering advice and recommendations to the design team’ was ranked the highest form of supplier’s remuneration. The proposed framework represents a synthesis that is creative in thought and adds value to the knowledge in a manner that has not previously occurred.

Keywords: maintenance, building maintainability, building life cycle cost (ICC), material supplier

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Authors: Samuel Attias, Elad Schiff, Zahi Arnon, Eran Ben-Arye, Yael Keshet, Ibrahim Matter, Boker Lital Keinan

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Background: Despite the extensive use of manual therapies, reflexology in particular, no validated tools have been developed to evaluate patients' beliefs, attitudes and expectations regarding reflexology. Such tools however are essential to improve the results of the reflexology treatment, by better adjusting it to the patients' attitudes and expectations. The tool also enables assessing correlations with clinical results of interventional studies using reflexology. Methods: The IBEAR (Inpatient Beliefs, Expectations and Attitudes toward Reflexology) tool contains 25 questions (8 demographic and 17 specifically addressing reflexology), and was constructed in several stages: brainstorming by a multidisciplinary team of experts; evaluation of each of the proposed questions by the experts' team; and assessment of the experts' degree of agreement per each question, based on a Likert 1-7 scale (1 – don't agree at all; 7 – agree completely). Cronbach's Alpha was computed to evaluate the questionnaire's reliability while the Factor analysis test was used for further validation (228 patients). The questionnaire was tested and re-tested (48h) on a group of 199 patients to assure clarity and reliability, using the Pearson coefficient and the Kappa test. It was modified based on these results into its final form. Results: After its construction, the IBEAR questionnaire passed the expert group's preliminary consensus, evaluation of the questions' clarity (from 5.1 to 7.0), inner validation (from 5.5 to 7) and structural validation (from 5.5 to 6.75). Factor analysis pointed to two content worlds in a division into 4 questions discussing attitudes and expectations versus 5 questions on belief and attitudes. Of the 221 questionnaires collected, a Cronbach's Alpha coefficient was calculated on nine questions relating to beliefs, expectations, and attitudes regarding reflexology. This measure stood at 0.716 (satisfactory reliability). At the Test-Retest stage, 199 research participants filled in the questionnaire a second time. The Pearson coefficient for all questions ranged between 0.73 and 0.94 (good to excellent reliability). As for dichotomic answers, Kappa scores ranged between 0.66 and 1.0 (mediocre to high). One of the questions was removed from the IBEAR following questionnaire validation. Conclusions: The present study provides evidence that the proposed IBEAR-16 questionnaire is a valid and reliable tool for the characterization of potential reflexology patients and may be effectively used in settings which include the evaluation of inpatients' beliefs, expectations, and attitudes toward reflexology.

Keywords: reflexology, attitude, expectation, belief, CAM, inpatient

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Authors: Michael Ray Brunt

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China has been the site of some of the most significant earthquakes in history; however, earthquake monitoring has long been the provenance of universities and research institutions. The China Digital Seismographic Network was initiated in 1983 and improved significantly during 1992-1993. Data from the CDSN is widely used by government and research institutions, and, generally, this data is not readily accessible to middle and high school students. An educational seismic network in China is needed to provide collaboration and research opportunities for students and engaging students around the country in scientific understanding of earthquake hazards and risks while promoting community awareness. In 2022, the Tsinghua International School (THIS) Seismology Team, made up of enthusiastic students and facilitated by two experienced teachers, was established. As a group, the team’s objective is to install seismographs in schools throughout China, thus creating an educational seismic network that shares data from the THIS Educational Seismic Network (THIS-ESN) and facilitates collaboration. The THIS-ESN initiative will enhance education and outreach in China about earthquake risks and hazards, introduce seismology to a wider audience, stimulate interest in research among students, and develop students’ programming, data collection and analysis skills. It will also encourage and inspire young minds to pursue science, technology, engineering, the arts, and math (STEAM) career fields. The THIS-ESN utilizes small, low-cost RaspberryShake seismographs as a powerful tool linked into a global network, giving schools and the public access to real-time seismic data from across China, increasing earthquake monitoring capabilities in the perspective areas and adding to the available data sets regionally and worldwide helping create a denser seismic network. The RaspberryShake seismograph is compatible with free seismic data viewing platforms such as SWARM, RaspberryShake web programs and mobile apps are designed specifically towards teaching seismology and seismic data interpretation, providing opportunities to enhance understanding. The RaspberryShake is powered by an operating system embedded in the Raspberry Pi, which makes it an easy platform to teach students basic computer communication concepts by utilizing processing tools to investigate, plot, and manipulate data. THIS Seismology Team believes strongly in creating opportunities for committed students to become part of the seismological community by engaging in analysis of real-time scientific data with tangible outcomes. Students will feel proud of the important work they are doing to understand the world around them and become advocates spreading their knowledge back into their homes and communities, helping to improve overall community resilience. We trust that, in studying the results seismograph stations yield, students will not only grasp how subjects like physics and computer science apply in real life, and by spreading information, we hope students across the country can appreciate how and why earthquakes bear on their lives, develop practical skills in STEAM, and engage in the global seismic monitoring effort. By providing such an opportunity to schools across the country, we are confident that we will be an agent of change for society.

Keywords: collaboration, outreach, education, seismology, earthquakes, public awareness, research opportunities

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Authors: Onur Ozveri, Korkut Karabag, Cagri Keles

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It is an important issue that the occurring of production downtime and repair costs when machines fail in the machine intensive production industries. In the case of failure of more than one machine at the same time, which machines will have the priority to repair, how to determine the optimal repair time should be allotted for this machines and how to plan the resources needed to repair are the key issues. In recent years, Business Process Management (BPM) technique, bring effective solutions to different problems in business. The main feature of this technique is that it can improve the way the job done by examining in detail the works of interest. In the industries, maintenance and repair works are operating as a process and when a breakdown occurs, it is known that the repair work is carried out in a series of process. Maintenance main-process and repair sub-process are evaluated with process management technique, so it is thought that structure could bring a solution. For this reason, in an international manufacturing company, this issue discussed and has tried to develop a proposal for a solution. The purpose of this study is the implementation of maintenance and repair works which is integrated with process management technique and at the end of implementation, analyzing the maintenance related parameters like quality, cost, time, safety and spare part. The international firm that carried out the application operates in a free region in Turkey and its core business area is producing original equipment technologies, vehicle electrical construction, electronics, safety and thermal systems for the world's leading light and heavy vehicle manufacturers. In the firm primarily, a project team has been established. The team dealt with the current maintenance process again, and it has been revised again by the process management techniques. Repair process which is sub-process of maintenance process has been discussed again. In the improved processes, the ABC equipment classification technique was used to decide which machine or machines will be given priority in case of failure. This technique is a prioritization method of malfunctioned machine based on the effect of the production, product quality, maintenance costs and job security. Improved maintenance and repair processes have been implemented in the company for three months, and the obtained data were compared with the previous year data. In conclusion, breakdown maintenance was found to occur in a shorter time, with lower cost and lower spare parts inventory.

Keywords: ABC equipment classification, business process management (BPM), maintenance, repair performance

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Authors: Mercedes Rodriguez Sanchez, Laura Luceño Casals

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With the rise of social media, creative people and brands everywhere are constantly generating content. The students with Bachelor's Degrees in Fashion Design use platforms such as Instagram or TikTok to look for inspiration and entertainment, as well as a way to develop their own ideas and share them with a wide audience. Information and Communications Technologies (ICT) have become a central aspect of higher education, virtually affecting every aspect of the student experience. Following the current trend, during the first semester of the second year, a collaborative project across two subjects –Design Management and History of Fashion Design– was implemented. After an introductory class focused on the relationship between fashion and cinema, as well as a brief history of 20th-century fashion, the students freely chose a work team and an iconic look from a movie costume. They researched the selected movie and its sociocultural context, analyzed the costume and the work of the designer, and studied the style, fashion magazines and most popular films of the time. Students then redesigned and recreated the costume, for which they were compelled to recycle the materials they had available at home as an unavoidable requirement of the activity. Once completed the garment, students delivered in-class, team-based presentations supported by the final design, a project summary poster and a making-of video, which served as a documentation tool of the costume design process. The methodologies used include Challenge-Based Learning (CBL), debates, Internet research, application of Information and Communications Technologies, and viewing clips of classic films, among others. After finishing the projects, students were asked to complete two electronic surveys to measure the acquisition of transversal and specific competencies of each subject. Results reveal that this activity helped the students' knowledge acquisition, a deeper understanding of both subjects and their skills development. The classroom dynamic changed. The multidisciplinary approach encouraged students to collaborate with their peers, while educators were better able to keep students' interest and promote an engaging learning process. As a result, the activity discussed in this paper confirmed the research hypothesis: it is positive to propose innovative teaching projects that combine academic research with playful learning environments.

Keywords: cinema, cooperative learning, fashion design, higher education, upcycling

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Authors: Humaira Saeed Malik, Salma Saad

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Introduction: Fowler's syndrome, first described by Clare Fowler in 1985, is a rare urological condition characterized by difficulty in urination due to the abnormal function of the urethral sphincter. It predominantly affects young women and leads to chronic urinary retention. The main concern in managing this condition is ensuring regular bladder emptying. Clam cystoplasty is a bladder augmentation surgery in which the bladder is clam-shelled open, and a segment of the intestine is used to increase the bladder's capacity and reduce bladder pressure. The Mitrofanoff procedure, a surgical creation of a continent urinary diversion, is often performed in patients with Fowler's syndrome who require long-term catheterization. This procedure involves creating a conduit (from the appendix or a segment of the small intestine) between the bladder and the skin, allowing for intermittent self-catheterization to manage urinary retention. Study: This case study examines a 39-year-old gravida 3, para 0+2 woman with a BMI of 40, Fowler's syndrome, type I diabetes, and post-traumatic stress disorder (PTSD), presenting at Dumfries and Galloway Royal Infirmary at 8 weeks of gestation. Diagnosed with Fowler's syndrome at 23, . A sacral nerve stimulator (SNS) device was initially placed but was subsequently removed after one year due to malfunction caused by trauma, subsequently she had undergone clam cystoplasty and the Mitrofanoff procedure for bladder management. Her pregnancy was complicated by vaginal bleeding at 10 weeks, treated with progesterone pessaries, and a urinary tract infection at 14 weeks, managed with antibiotics. Despite these challenges, she continued self-catheterization through the Mitrofanoff stoma and was placed on prophylactic antibiotics. Her diabetes was well-controlled on insulin, and a 20-week fetal anomaly scan was normal. The multidisciplinary team, including an obstetrician and a urologist, planned for serial growth scans and the initiation of low molecular weight heparin (LMWH) from 28 weeks due to the intermediate risk of venous thromboembolism (VTE) and to continue six weeks after delivery. A planned cesarean delivery at 37 weeks was arranged, with an MRI scan scheduled later in the pregnancy to assist in surgical planning, ensuring the preservation of the Mitrofanoff stoma's function. The surgery will occur in an elective setting and include a consultant urologist. Conclusion: Pregnancy in women with Fowler's syndrome who have undergone Clam cystoplasty and the Mitrofanoff procedure is rare, and management requires careful planning and a multidisciplinary approach. This case highlights the importance of individualized care plans and close monitoring of both mother and fetus. The patient's risk of recurrent UTIs, coupled with her diabetes and high BMI, necessitated coordinated care across specialties to ensure the best possible outcomes. The Mitrofanoff procedure proved effective in managing her urinary retention, allowing her to maintain self-catheterization during pregnancy. The multidisciplinary team approach was crucial in addressing her complex medical needs, involving obstetrics, urology, and endocrinology. This case adds valuable information to the limited literature on pregnancy management in patients with Fowler's syndrome who have undergone the Mitrofanoff procedure, highlighting the need for comprehensive, individualized care and the involvement of a multidisciplinary team to achieve the best results.

Keywords: fowler's syndrome, clam cystoplasty, mitrofanoff procedure, pregnancy

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Authors: Şule Yanık, Emel Ertürk-Mustul, Zerrin Turan, Hasan Gürgür

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It is known that there are policies that will support the early special education (ESE) for children requiring special care including the children with hearing loss (CHL) in many countries that give importance to early childhood (0-6 years) education, accordingly ESE services have been gradually increasing and these services provide positive contributions to the child and family. These services begin with medical diagnostics, provision of the use of assistive technologies for hearing and the orientation of children towards early education program (EEP) for the CHL. In 0-3 years of age EEP, education and support services are provided to the children and their families. In 3-6 years of age, children are supported in a pre-school education program (PSE) in which their peers and teachers are present. Therefore, the children with hearing loss and their families are going through a series of medical, educational and social transition process after diagnosed with hearing loss. Depending on their age and development, CHL also go through a transition period from hospital to home, from home to EEP and from EEP to PSE. It is seen that there is no legal regulation regarding the transition process in Turkey and hence different processes have been carried out in the transition process from EEP to PSE. The aim of this study is to reveal the problems confronted by the CHL during the transition period from EEP to PSE and the solution proposals for these problems. In this study, a document review was made by reviewing the national and international studies about transition processes of the CHL in Turkey from EEP to PSE. Accordingly, in the study carried out in two stages, firstly, a review of the body of literature was performed by creating key words related to the subject. Secondly, the problems confronted by the CHL in Turkey during the transition period from EEP to PSE and the solution proposals for these problems were demonstrated by analyzing the obtained data. According to the body of literature, it is seen that there are no laws concerning the transition processes of the children who require special care including the CHL in Turkey from EEP (sending) to PSE (receiving), and correspondingly numerous problems have been experienced during the transition period. It seems that the EEP adopts family-centered approaches for strengthening the families of the CHL. However, PSE program aims to prepare the children to school life by focusing on their social and academical development rather with the adoption of children-centered approaches. Therefore, while the families feel an inseparable part of the team in EEP, they indicated that they felt like a stranger in the school team after their children have started to PSE. Therefore, families find the transition processes worrisome and state that they are not satisfied with the process. We discovered that in the process of transition from EEP to PSE, families are not informed, there is a limited number of PSE options available, children cannot adapt to the new educational environment and cannot benefit from the existing PSE.

Keywords: early education program, early special education, children with hearing loss, transition

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Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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Authors: Yiqiao Yin

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Many scholars and educators have dedicated their lives in K12 education system and there has been an exploding amount of attention to implement technical foundations for Artificial Intelligence Education for high school and precollege level students. This paper focuses on the development and use of resources to support K-12 education in Artificial Intelligence (AI). The author and his team have more than three years of experience coaching students from pre-college level age from 15 to 18. This paper is a culmination of the experience and proposed online tools, software demos, and structured activities for high school students. The paper also addresses a portfolio of AI concepts as well as the expected learning outcomes. All resources are provided with online videos and Github repositories for immediate use.

Keywords: K12 education, AI4ALL, pre-college education, pre-college AI

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Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

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Authors: Gerhard Peter

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In this paper, we present an integrated framework that governs the introduction of social media into enterprises and its evaluation. It is argued that the framework should address the following issues: (1) the contribution of social media for increasing efficiency and improving the quality of working life; (2) the level on which this contribution happens (i.e., individual, team, or organisation); (3) a description of the processes for implementing and evaluating social media; and the role of (4) organisational culture and (5) management. We also report the results of a case study where the framework has been employed to introduce a social networking platform at a German enterprise. This paper only considers the internal use of social media.

Keywords: case study, enterprise 2.0, framework, introducing and evaluating social media, social media

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Authors: Liping Li, Wenan Tan, Na Wang

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With the rapid development of information technology, project management has gained more and more attention recently. Based on CDIO, this paper proposes some teaching reform ideas for software project management curriculum. We first change from Teacher-centered classroom to Student-centered and adopt project-driven, scenario animation show, teaching rhythms, case study and team work practice to improve students' learning enthusiasm. Results showed these attempts have been well received and very effective; as well, students prefer to learn with this curriculum more than before the reform.

Keywords: CDIO, teaching reform, engineering education, project-driven, scenario animation simulation

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Authors: Rajendra Chetty

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The paper aims to address two aspects of postgraduate studies: interdisciplinary research and creative models of supervision. Interdisciplinary research can be viewed as a key imperative to solve complex problems. While excellent research requires a context of disciplinary strength, the cutting edge is often found at the intersection between disciplines. Interdisciplinary research foregrounds a team approach and information, methodologies, designs, and theories from different disciplines are integrated to advance fundamental understanding or to solve problems whose solutions are beyond the scope of a single discipline. Our aim should also be to generate research that transcends the original disciplines i.e. transdisciplinary research. Complexity is characteristic of the knowledge economy, hence, postgraduate research and engaged scholarship should be viewed by universities as primary vehicles through which knowledge can be generated to have a meaningful impact on society. There are far too many ‘ordinary’ studies that fall into the realm of credentialism and certification as opposed to significant studies that generate new knowledge and provide a trajectory for further academic discourse. Secondly, the paper will look at models of supervision that are different to the dominant ‘apprentice’ or individual approach. A reflective practitioner approach would be used to discuss a range of supervision models that resonate well with the principles of interdisciplinarity, growth in the postgraduate sector and a commitment to engaged scholarship. The global demand for postgraduate education has resulted in increased intake and new demands to limited supervision capacity at institutions. Team supervision lodged within large-scale research projects, working with a cohort of students within a research theme, the journal article route of doctoral studies and the professional PhD are some of the models that provide an alternative to the traditional approach. International cooperation should be encouraged in the production of high-impact research and institutions should be committed to stimulating international linkages which would result in co-supervision and mobility of postgraduate students and global significance of postgraduate research. International linkages are also valuable in increasing the capacity for supervision at new and developing universities. Innovative co-supervision and joint-degree options with global partners should be explored within strategic planning for innovative postgraduate programmes. Co-supervision of PhD students is probably the strongest driver (besides funding) for collaborative research as it provides the glue of shared interest, advantage and commitment between supervisors. The students’ field serves and informs the co-supervisors own research agendas and helps to shape over-arching research themes through shared research findings.

Keywords: interdisciplinarity, internationalisation, postgraduate, supervision

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Authors: Kayode A. Olaniyi, Olabanji F. Omotoye, Adeola A. Ogunleye

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Computer system components such as the CPU, the Controllers, and the operating system, work together as a team, and storage or memory is the essential parts of this team apart from the processor. The memory and storage system including processor caches, main memory, and storage, form basic storage component of a computer system. The characteristics of the different types of storage are inherent in the design and the technology employed in the manufacturing. These memory characteristics define the speed, compatibility, cost, volatility, and density of the various storage types. Most computers rely on a hierarchy of storage devices for performance. The effective and efficient use of the memory hierarchy of the computer system therefore is the single most important aspect of computer system design and use. The memory hierarchy is becoming a fundamental performance and energy bottleneck, due to the widening gap between the increasing demands of modern computer applications and the limited performance and energy efficiency provided by traditional memory technologies. With the dramatic development in the computers systems, computer storage has had a difficult time keeping up with the processor speed. Computer architects are therefore facing constant challenges in developing high-speed computer storage with high-performance which is energy-efficient, cost-effective and reliable, to intercept processor requests. It is very clear that substantial advancements in redesigning the existing memory physical and logical structures to meet up with the latest processor potential is crucial. This research work investigates the importance of computer memory (storage) hierarchy in the design of computer systems. The constituent storage types of the hierarchy today were investigated looking at the design technologies and how the technologies affect memory characteristics: speed, density, stability and cost. The investigation considered how these characteristics could best be harnessed for overall efficiency of the computer system. The research revealed that the best single type of storage, which we refer to as ideal memory is that logical single physical memory which would combine the best attributes of each memory type that make up the memory hierarchy. It is a single memory with access speed as high as one found in CPU registers, combined with the highest storage capacity, offering excellent stability in the presence or absence of power as found in the magnetic and optical disks as against volatile DRAM, and yet offers a cost-effective attribute that is far away from the expensive SRAM. The research work suggests that to overcome these barriers it may then mean that memory manufacturing will take a total deviation from the present technologies and adopt one that overcomes the associated challenges with the traditional memory technologies.

Keywords: cache, memory-hierarchy, memory, registers, storage

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Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

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The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: anaemia, haemoglobinopathies, pregnancy, sickle cell disease

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Authors: Chien Chin-Wen

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Collaborative teaching has different teaching models and station teaching is one type of collaborative teaching. Station teaching is not commonly practiced in elementary school English education and introduced in language teacher education programs in Taiwan. In station teaching, each teacher takes a small part of instructional content, working with a small number of students. Students rotate between stations where they receive the assignments and instruction from different teachers. The teachers provide the same content to each group, but the instructional method can vary based upon the needs of each group of students. This study explores thirty-four Taiwanese pre-service elementary school English teachers’ knowledge about station teaching and their competence demonstrated in designing activities for and delivering of station teaching in an English remedial education to six sixth graders in a local elementary school in northern Taiwan. The participants simultaneously enrolled in this Elementary School English Teaching Materials and Methods class, a part of an elementary school teacher education program in a northern Taiwan city. The instructor (Jennifer, pseudonym) in this Elementary School English Teaching Materials and Methods class collaborated with an English teacher (Olivia, pseudonym) in Maureen Elementary School (pseudonym), an urban elementary school in a northwestern Taiwan city. Of Olivia’s students, four male and two female sixth graders needed to have remedial English education. Olivia chose these six elementary school students because they were in the lowest 5 % of their class in terms of their English proficiency. The thirty-four pre-service English teachers signed up for and took turns in teaching these six sixth graders every Thursday afternoon from four to five o’clock for twelve weeks. While three participants signed up as a team and taught these six sixth graders, the last team consisted of only two pre-service teachers. Each team designed a 40-minute lesson plan on the given language focus (words, sentence patterns, dialogue, phonics) of the assigned unit. Data in this study included the KWLA chart, activity designs, and semi-structured interviews. Data collection lasted for four months, from September to December 2014. Data were analyzed as follows. First, all the notes were read and marked with appropriate codes (e.g., I don’t know, co-teaching etc.). Second, tentative categories were labeled (e.g., before, after, process, future implication, etc.). Finally, the data were sorted into topics that reflected the research questions on the basis of their relevance. This study has the following major findings. First of all, the majority of participants knew nothing about station teaching at the beginning of the study. After taking the course Elementary School English Teaching Materials and Methods and after designing and delivering the station teaching in an English remedial education program to six sixth graders, they learned that station teaching is co-teaching, and that it includes activity designs for different stations and students’ rotating from station to station. They demonstrated knowledge and skills in activity designs for vocabulary, sentence patterns, dialogue, and phonics. Moreover, they learned to interact with individual learners and guided them step by step in learning vocabulary, sentence patterns, dialogue, and phonics. However, they were still incompetent in classroom management, time management, English, and designing diverse and meaningful activities for elementary school students at different English proficiency levels. Hence, language teacher education programs are recommended to integrate station teaching to help pre-service teachers be equipped with eight knowledge and competences, including linguistic knowledge, content knowledge, general pedagogical knowledge, curriculum knowledge, knowledge of learners and their characteristics, pedagogical content knowledge, knowledge of education content, and knowledge of education’s ends and purposes.

Keywords: co-teaching, competence, knowledge, pre-service teachers, station teaching

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Authors: Georgia C. Kosta, Christos S. Nicolaidis

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The present paper discusses the role of teams’ climate in the intrapreneurial process. Intrapreneurship, which corresponds for entrepreneurship in existing organizations, puts special emphasis on climate as an influential factor of the intrapreneurial behavior. Although climate exists at every level and in every subgroup of the organizational structure, research focuses mainly on the study of climate that characterizes organization as a whole. However, the climate of a work team may differ radically from the organizational climate, and in fact it can be far more influential. The paper provides a conceptual analysis of organizational climate from the intrapreneurial point of view, and sheds light upon teams’ climate role in the intrapreneurial posture.

Keywords: entrepreneurship, innovation, intrapreneurship, organizational climate, teams’ climate

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Authors: Ali Abdelsattar Elshabrawy

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The Egyptian government is struggling to build it's eGovernment project. They succeeded to build the Egyptian digital portal, which contain links for number of services provided by different ministries. For achieving such success, their are requirements necessary to build such a project such as: internet dissemination, IT literacy, Strategy, disqualification of paper based services. This paper is going to clarify the main obstacles to the Egyptian eGovernment project from both the supply and demand sides. Also will clarify the most critical requirements in this phase of the project lifecycle. This paper should be in great value for the project team and also for many other developing countries that share the same obstacles.

Keywords: the egyptian egovernment project lifecycle, supply side barriers, demand side barriers, egovernment project requirements

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Authors: A. Dean, M. Pitcher, L. Storer, K. Shanahan, I. Rio, B. Mann

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Purpose: Breast cancer survivors are at risk of specific physical and psycho-social issues, such as arm swelling, fatigue, and depression. Firstly, we investigate symptoms reported by Australia breast cancer survivors upon completion of definitive treatment. Secondly, we evaluate the appropriateness and effectiveness of a multi-centre pilot program nurse-led clinic to identify these issues and make timely referrals to available services. Methods: Patients post-definitive treatment (excluding ongoing hormonal therapy) for early breast cancer or ductal carcinoma in situ were invited to participate. An hour long appointment with a breast care nurse (BCN) was scheduled. In preparation, patients completed validated quality-of-life surveys (FACT-B, Menopause Rating Scale, Distress Thermometer). During the appointment, issues identified in the surveys were addressed and referrals to appropriate services arranged. Results: 183 of 274 (67%) eligible patients attended a nurse-led clinic. Mean age 56.8 years (range 29-87 years), 181/183 women, 105/183 post-menopausal. 96 (55%) participants reported significant level of distress; 31 (18%) participants reported extreme distress or depression. Distress stemmed from a lack of energy (56/175); poor quality of sleep (50/176); inability to work or participate in household activities (35/172) and problems with sex life (28/89). 166 referrals were offered; 94% of patients accepted the referrals. 65% responded to a follow-up survey: the majority of women either strongly agreed or agreed that the BCN was overwhelmingly supportive, helpful in making referrals, and compassionate towards them. 39% reported making lifestyle changes as a result of the BCN. Conclusion: Breast cancer survivors experience a unique set of challenges, including low mood, difficulty sleeping, problems with sex life and fear of disease recurrence. The nurse-led clinic model is an appropriate and effective method to ensure physical and psycho-social issues are identified and managed in a timely manner. This model empowers breast cancer survivors with information about their diagnosis and available services.

Keywords: early breast cancer, survivorship, breast care nursing, oncology nursing and cancer care

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Authors: Cassandra Hansen, Paul Doherty, Chris Ferner, German Whitley, Holly Torpey

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Wildfire is a natural and inevitable occurrence, yet changing climatic conditions have increased the severity, frequency, and risk to human populations in the wildland/urban interface (WUI) of the Western United States. Rapid dissemination of accurate wildfire information is critical to both the Incident Management Team (IMT) and the affected community. With the advent of increasingly sophisticated information systems, GIS can now be used as a web platform for sharing geographic information in new and innovative ways, such as virtual story map applications. Crowdsourced information can be extraordinarily useful when coupled with authoritative information. Information abounds in the form of social media, emergency alerts, radio, and news outlets, yet many of these resources lack a spatial component when first distributed. In this study, we describe how twenty-eight volunteer GIS professionals across nine Geographic Area Coordination Centers (GACC) sourced, curated, and distributed Volunteered Geographic Information (VGI) from authoritative social media accounts focused on disseminating information about wildfires and public safety. The combination of fire progression maps with VGI incident information helps answer three critical questions about an incident, such as: where the first started. How and why the fire behaved in an extreme manner and how we can learn from the fire incident's story to respond and prepare for future fires in this area. By adding a spatial component to that shared information, this team has been able to visualize shared information about wildfire starts in an interactive map that answers three critical questions in a more intuitive way. Additionally, long-term social and technical impacts on communities are examined in relation to situational awareness of the disaster through map layers and agency links, the number of views in a particular region of a disaster, community involvement and sharing of this critical resource. Combined with a GIS platform and disaster VGI applications, this workflow and information become invaluable to communities within the WUI and bring spatial awareness for disaster preparedness, response, mitigation, and recovery. This study highlights progression maps as the ultimate storytelling mechanism through incident case studies and demonstrates the impact of VGI and sophisticated applied cartographic methodology make this an indispensable resource for authoritative information sharing.

Keywords: storytelling, wildfire progression maps, volunteered geographic information, spatial and temporal

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Authors: Sadaf Abbas, HimGauri Sabnis

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Introduction: Peripartum cardiomyopathy is a rare but potentially life-threatening condition that presents as heart failure during the last month of pregnancy or within five months postpartum. The incidence of postpartum cardiomyopathy ranges from 1 in 1300 to 1 in 15,000 pregnancies. Risk factors include multiparty, advanced maternal age, multiple pregnancies, pre-eclampsia, and chronic hypertension. Study: A 30-year-old Para3+0 presented to the Emergency Department of St’Marry Hospital, Isle of Wight, on the seventh day postpartum, with acute shortness of breath (SOB), chest pain, cough, and a temperature of 38 degrees. The risk factors were smoking and class II obesity (BMI of 40.62). The patient had mild pre-eclampsia in the last pregnancy and was on labetalol and aspirin during an antenatal period, which was stopped postnatally. There was also a history of pre-eclampsia and haemolysis, elevated liver enzymes, low platelets (HELLP syndrome) in previous pregnancies, which led to preterm delivery at 35 weeks in the second pregnancy, and the first baby was stillborn at 24 weeks. On assessment, there was a national early warning score (NEWS score) of 3, persistent tachycardia, and mild crepitation in the lungs. Initial investigations revealed an enlarged heart on chest X-ray, and a CT pulmonary angiogram indicated bilateral basal pulmonary congestion without pulmonary embolism, suggesting fluid overload. Laboratory results showed elevated CRP and normal troponin levels initially, which later increased, indicating myocardial involvement. Echocardiography revealed a severely dilated left ventricle with an ejection fraction (EF) of 31%, consistent with severely impaired systolic function. The cardiology team reviewed the patient and admitted to the Coronary Care Unit. As sign and symptoms were suggestive of fluid overload and congestive cardiac failure, management was done with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), proton pump inhibitors, and supportive care. During admission, there was complications such as acute kidney injury, but then recovered well. Chest pain had resolved following the treatment. After being admitted for eight days, there was an improvement in the symptoms, and the patient was discharged home with a further plan of cardiac MRI and genetic testing due to a family history of sudden cardiac death. Regular appointment has been made with the Cardiology team to follow-up on the symptoms. Since discharge, the patient made a good recovery. A cardiac MRI was done, which showed severely impaired left ventricular function, ejection fraction (EF) of 38% with mild left ventricular dilatation, and no evidence of previous infarction. Overall appearance is of non-ischemic dilated cardiomyopathy. The main challenge at the time of admission was the non-availability of a cardiac radiology team, so the definitive diagnosis was delayed. The long-term implications include risk of recurrence, chronic heart failure, and, consequently, an effect on quality of life. Therefore, regular follow-up is critical in patient’s management. Conclusions: Peripartum cardiomyopathy is one of the cardiovascular diseases whose causes are still unknown yet and, in some cases, are uncontrolled. By raising awareness about the symptoms and management of this complication it will reduce morbidity and mortality rates and also the length of stay in the hospital.

Keywords: cardiomyopathy, cardiomegaly, pregnancy, puerperium

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Authors: Bernardino Vinoya, Cassandra D. Batton, Samantha Gayle M. Bonavente, Johnson O. Canoza, Lhea Flynn B. Capones, Camille S. Dispo, Johanna Neilvin T. Dontogan, Louise Angelica C. Lipana, Charlene Pearl P. Navalta, Rechelle Vhen W. Payo-os, Mary Reyna D. Ridao, Rushnol Jade P. Tupac, Pauline B. Sol

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Parenting is preparing children for life as productive adults and discipline strategies are needed to achieve it like non-aggressive, psychologically aggressive and physical discipline. The effects of disciplinary strategies on children are well explored as evidenced by existing studies, local and international laws and active international organizations which are all brimmed towards child protection but status quo shows a profound scarcity of studies engaged in the effects of disciplining the child on the parent. To know the deeper unexplored reasons and untold stories of the parent, mainly the lived experiences of parents in disciplining their children. Design is descriptive phenomelogical. Participants were chosen using snowball purposive sampling. Data were collected through interview with the general question, “Ano ang mga karanasan ninyo sa pagdidisiplina ng inyong anak (What are your experiences when disciplining your child?)”, followed with unstructured questions. Collaizi method was used in analyzing data. Data collected was verified through focused group discussion. Results show three main themes: Reason, Disciplinary Strategy, and Aftermath. The use of disciplinary strategy is influenced by the experiences of the parent, the triggers like the child’s misbehavior and parental desires or wishes for the child. Disciplinary strategy can either be physical punishment or verbal. Parent’s generally used both when children disrespects or disobeys. Parents also experience both positive and negative effects on their physical, social, emotional aspects after disciplining their children. As a result, parents use coping mechanisms to maintain ego stability. Disciplining a child is a cyclical process. Parents, just like the child will also experience both positive and negative outcomes after using different disciplinary strategies. Future researchers can replicate study or use triangulation in multi-site qualitative and quantitative studies, professors can teach findings on parents in the concepts of pediatric nursing and apply the findings in the clinical area particularly when dealing with families.

Keywords: parents, disciplinary strategy, parental effects, pediatric nursing

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Authors: Jeremy Dixon

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Safeguarding adults forms a core part of social work practice. The Government in England and Wales has made efforts to standardise practices through The Care Act 2014. The Act states that local authorities have duties to make inquiries in cases where an adult with care or support needs is experiencing or at risk of abuse and is unable to protect themselves from abuse or neglect. Despite the importance given to safeguarding adults within law there remains little research about how social workers conduct such decisions on the ground. This presentation reports on findings from a pilot research study conducted within two social work teams in a Local Authority in England. The objective of the project was to find out how social workers interpreted safeguarding duties as laid out by The Care Act 2014 with a particular focus on how workers assessed and managed risk. Ethnographic research methods were used throughout the project. This paper focusses specifically on decisions made by workers in the assessment team. The paper reports on qualitative observation and interviews with five workers within this team. Drawing on governmentality theory, this paper analyses the techniques used by workers to manage risk from a distance. A high proportion of safeguarding referrals came from care workers or managers in residential care homes. Social workers conducting safeguarding assessments were aware that they had a duty to work in partnership with these agencies. However, their duty to safeguard adults also meant that they needed to view them as potential abusers. In making judgments about when it was proportionate to refer for a safeguarding assessment workers drew on a number of common beliefs about residential care workers which were then tested in conversations with them. Social workers held the belief that residential homes acted defensively, leading them to report any accident or danger. Social workers therefore encouraged residential workers to consider whether statutory criteria had been met and to use their own procedures to manage risk. In addition social workers carried out an assessment of the workers’ motives; specifically whether they were using safeguarding procedures as a shortcut for avoiding other assessments or as a means of accessing extra resources. Where potential abuse was identified social workers encouraged residential homes to use disciplinary policies as a means of isolating and managing risk. The study has implications for understanding risk within social work practice. It shows that whilst social workers use law to govern individuals, these laws are interpreted against cultural values. Additionally they also draw on assumptions about the culture of others.

Keywords: adult safeguarding, governmentality, risk, risk assessment

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Authors: Irina Peterburgsky

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We have been working on finding internship positions for our math and computer science majors. Among many other positive outcomes of internship for students majoring in mathematics, there are: students see new applications of mathematics to real life and see new scientific problems; they learn new methods, tools, etc. that they have not seen in their classes; they appreciate the power of mathematics that increases their interest in learning mathematics; they make decisions to take more advanced math courses; students understand better what their potentials, strong points, and limitations are; learn what work ethic is; learn how to work as a member of a team at a workplace; understand better how to offer their help and how to ask for help; start building their professional relationship; build self-confidence as young professionals, and what is the most important - they get a better understanding of their goals in their future professional careers.

Keywords: internship, mathematics, positive outcoms for students, workplace

Procedia PDF Downloads 182

Authors: Brooke Sweeney, David White, Felix Amparano, Nick A. Clark, Amy R. Beck, Mathew Lindquist, Lora Edwards, Julie Vandal, Jennifer Lisondra, Katie Cox, Renee Arensberg, Allen Cummins, Jazmine Cedeno, Jason D. Fraser, Kelsey Dean, Helena H. Laroche, Cristina Fernandez

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Background: National organizations call for standardized pre-surgical requirements and education to optimize postoperative outcomes. Since 2017 our surgery program has used defined protocols and educational curricula pre- and post-surgery. In response to patient outcomes, our educational content was refined to include quizzes to assess patient knowledge and surgical preparedness. We aim to optimize adolescent pre-bariatric surgery preparedness by improving overall aggregate pre-surgical assessment performance from 68% to 80% within 12 months. Methods: A multidisciplinary improvement team was developed within the weight management clinic (WMC) of our tertiary care, free-standing children’s hospital. A manual has been utilized since 2017, with limitations in consistent delivery and patient uptake of information. The curriculum has been improved to include quizzes administered during WMC visits prior to bariatric surgery. The initial outcome measure is the pre-surgical quiz score of adolescents preparing for bariatric surgery. Process measure was the number of questions answered correctly to test the questions. Baseline performance was determined by a patient assessment survey of pre-surgical preparedness at patient visits. Plan-Do-Study-Act cycles (PDSA) included: 1) creation and implementation of a refined curriculum, 2) development of 5 new quizzes based upon learning objectives, and 3) improving provider-lead teaching and quiz administration within clinic workflow. Run charts assessed impact over time. Results: A total of 346 quiz questions were administered to 34 adolescents. The outcome measure improved from a baseline mean of 68% to 86% following PDSA 2 cycles, and it was sustained. Conclusion/Implication: Patient/family comprehension of surgical preparedness improved with standardized education via team member-led teaching and assessment using quizzes during pre-surgical clinic visits. The next steps include launching redesigned teaching materials with modules correlated to quizzes and assessment of comprehension and outcomes post-surgically.

Keywords: bariatric surgery, adolescent, clinic, pre-bariatric training

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Authors: Tomasz Holecki, Hanna Dobrowolska

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In the Polish health care system, nurses and midwives are obliged to regularly update their professional knowledge. It is all regulated by the Law on the nurse and midwife’s profession and the code of ethics. The professional self-governing body (County Chamber of Nurses and Midwives) is obliged to organize ongoing training for them so that maintaining accessibility and availability to the high quality of educational services could be possible at all levels of post-graduate education. The aim of this study is an analysis of post-graduate education organized by the County Chamber of Nurses and Midwives in the city of Katowice, Poland, as a professional self-governing body operating in the area of Silesian province inhabited by almost 5 million citizens which bring together more than 30 thousand professionally active nurses and midwives. In the years 2000-2017, the self-government of nurses and midwives trained over 50,000 people. The education and supervision system over the labour of nurses and midwives establishes exercising control by a self-governing body. In practice, this means that conducting activities aimed at creating legal regulations and organizational conditions, as well as the practical implementation of courses, belongs to the professional self-government of nurses and midwives. The most of specialization courses that were provided from their own funds came from membership fees. The biggest group was participants of specializations in the fields of cardiac, anesthesia, and preventive nursing. The smallest group of people participated in such specializations as neonatal, emergency, and obstetrics nursing. The most popular specialist courses were in the fields of the electrocardiogram and cardiopulmonary resuscitation, whereas the least popular were the ones in the fields of protective vaccinations of neonates. So-called 'soft training-courses' in the fields of improvement of social skills and management were also provided. The research shows that a vast majority of nurses and midwives are interested in raising their professional qualifications. Specialist courses and selected fields of qualification courses received the most concrete attention. In light of conducted research, one can assert that cooperation inside the community of nurses and midwives provides access to high-quality education and training services regularly used by a wide circle of them. The presented results exemplify a level of real interest in specialist and qualification training-courses and also show sources of financing them.

Keywords: nurses and midwives, ongoing training, postgraduate education, specialist training-courses

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Authors: Hugo Reis, Isabel Rabiais

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The main purpose of the present study is to understand the nurse’s responsibility in preventing the septic shock in an oncological patient with febrile neutropenia submitted to chemotherapy. In order to do it, an integrative review of literature has been conducted. In the research done in many databases, it was concluded that only 7 out of 5202 articles compiled the entire inclusion standard present in the strict protocol of research, being this made up by all different methodologies. On the research done in the 7 articles it has resulted 8 text macro-units associated to different nursing interventions: ‘Health Education’; ‘Prophylactic Therapy Administration’; ‘Scales Utilization’; ‘Patient Evaluation’; ‘Environment Control’; ‘Performance of Diagnostic Auxiliary Exams’; ‘Protocol Enforcement/Procedure Guidelines’; ‘Antibiotic Therapy Administration’. Concerning the prevalence/result’s division there can be identified many conclusions: the macro-units ‘Patient Evaluation’, ‘Performance of Diagnostic Auxiliary Exams’, and ‘Antibiotic Therapy Administration’ present themselves to be the most prevalent in the research – 6 in 7 occurrences (approximately 85.7%). Next, the macro-unit ‘Protocol Enforcement/Procedure Guidelines’ presents itself as an important expression unit – being part of 5 out of the 7 analyzed studies (approximately 71.4%). The macro-unit ‘Health Education’, seems to be in the same way, an important expression unit – 4 out of the 7 (or approximately 57%). The macro-unit ‘Scales Utilization’, represents a minor part in the research done – it’s in only 2 out of the 7 cases (approximately 28.6%). On the other hand, the macro-units ‘Prophylactic Therapy Administration’ and ‘Environment Control’ are the two categories with fewer results in the research - 1 out of the 7 cases, the same as approximately 14.3% of the research results. Every research done to the macro-unit ‘Antibiotic Therapy Administration’ agreed to refer that the intervention should be strictly done, in a period of time less than one hour after diagnosing the fever, with the purpose of controlling the quick spread of infection – minimizing its seriousness. Identifying these interventions contributes, concluding that, to adopt strategies in order to prevent the phenomenon that represents a daily scenario responsible for the cost´s increase in health institutions, being at the same time responsible for the high morbidity rates and mortality increase associated with this specific group of patients.

Keywords: febrile neutropenia, oncology nursing, patient, septic shock

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Authors: Yiu K. C. Jacky, Tang S. K. Eric, W. Y. Tsang, C. Y. Li, C. K. Leung

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Objectives : (1) To enhance the competence of nurses on using IPMOE for drug administration; (2) To ensure the transition on implementation of IPMOE in safer and smooth way hospital-wide. Methodology: (1) Well-structured Governance: To make provision for IPMOE implementation, multidisciplinary governance structure at Corporate and Local levels are well established. (2) Staff Engagement: A series of staff engagement events were conducted including Staff Forum, IPMOE Hospital Visit, Kick-off Ceremony and establishment of IPMOE Webpage for familiarizing the forthcoming implementation with frontline staff. (3) Well-organized training program: from Workshop to Workplace Two different IPMOE training programs were tailor-made which aimed at introducing the core features of administration module. Fifty-five identical training classes and six train-the-trainer workshops were organized at 2-3Q 2015. Lending Scheme on IPMOE hardware for hands-on practicing was launched and further extended the training from workshop to workplace. (4) Standard Guidelines and Workflow: the related workflow and guidelines are developed which facilitates users to acquire the competence towards IPMOE and fully familiarize with the standardized contingency plan. (5) Facilities and Equipment: The installations of IPMOE hardware were promptly arranged for rollout. Besides, IPMOE training venue was well-established for staff training. (6) Risk Management Strategy: UCH Medication Safety Forum is organized in December 2015 for sharing “Tricks & Tips” on IPMOE which further disseminate at webpage for arousal of medication safety. Hospital-wide annual audit on drug administration was planned to figure out the compliance and deliberate the rooms for improvement. Results: Through the comprehensive training plan, over 1,000 UCH nurses attended the training program with positive feedback. They agreed that their competence on using IPMOE was enhanced. By the end of November 2015, 28 wards (over 1,000 Inpatient-bed) involving departments of M&G, SUR, O&T and O&G have been successfully rolled out IPMOE in 5-month. A smooth and safe transition of implementation of IPMOE was achieved. Eventually, we all get prepared for embedding IPMOE into daily nursing and work altogether for medication safety at UCH.

Keywords: drug administration, inpatient medication order entry system, medication safety, nursing informatics

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Authors: Arun Prasad Jaganathan

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In today's rapidly evolving technological landscape, the need for efficient and proactive maintenance management solutions has become increasingly evident across various industries. Traditional approaches often suffer from drawbacks such as reactive strategies, leading to potential downtime, increased costs, and decreased operational efficiency. In response to these challenges, this paper proposes an AI-enabled approach to object-based maintenance management aimed at enhancing reliability and efficiency. The paper contributes to the growing body of research on AI-driven maintenance management systems, highlighting the transformative impact of intelligent technologies on enhancing object reliability and operational efficiency.

Keywords: AI, machine learning, predictive maintenance, object-based maintenance, expert team scheduling

Procedia PDF Downloads 58