Search results for: surgical skills
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3890

Search results for: surgical skills

3110 Staphylococcus Aureus Septic Arthritis and Necrotizing Fasciitis in a Patient With Undiagnosed Diabetes Mellitus.

Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

Abstract:

Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

Procedia PDF Downloads 315
3109 A Project-Orientated Training Concept to Prepare Students for Systems Engineering Activities

Authors: Elke Mackensen

Abstract:

Systems Engineering plays a key role during industrial product development of complex technical systems. The need for systems engineers in industry is growing. However, there is a gap between the industrial need and the academic education. Normally the academic education is focused on the domain specific design, implementation and testing of technical systems. Necessary systems engineering expertise like knowledge about requirements analysis, product cost estimation, management or social skills are poorly taught. Thus, there is the need of new academic concepts for teaching systems engineering skills. This paper presents a project-orientated training concept to prepare students from different technical degree programs for systems engineering activities. The training concept has been initially implemented and applied in the industrial engineering master program of the University of Applied Sciences Offenburg.

Keywords: educational systems engineering training, requirements analysis, system modelling, SysML

Procedia PDF Downloads 346
3108 A Model for Academic Coaching for Success and Inclusive Excellence in Science, Technology, Engineering, and Mathematics Education

Authors: Sylvanus N. Wosu

Abstract:

Research shows that factors, such as low motivation, preparation, resources, emotional and social integration, and fears of risk-taking, are the most common barriers to access, matriculation, and retention into science, technology, engineering, and mathematics (STEM) disciplines for underrepresented (URM) students. These factors have been shown to impact students’ attraction and success in STEM fields. Standardized tests such as the SAT and ACT often used as predictor of success, are not always true predictors of success for African and Hispanic American students. Without an adequate academic support environment, even a high SAT score does not guarantee academic success in science and engineering. This paper proposes a model for Academic Coaching for building success and inclusive excellence in STEM education. Academic coaching is framed as a process of motivating students to be independent learners through relational mentorship, facilitating learning supports inside and outside of the classroom or school environment, and developing problem-solving skills and success attitudes that lead to higher performance in the specific subjects. The model is formulated based on best strategies and practices for enriching Academic Performance Impact skills and motivating students’ interests in STEM. A scaled model for measuring the Academic Performance Impact (API) index and STEM is discussed. The study correlates API with state standardized test and shows that the average impact of those skills can be predicted by the Academic Performance Impact (API) index or Academic Preparedness Index.

Keywords: diversity, equity, graduate education, inclusion, inclusive excellence, model

Procedia PDF Downloads 201
3107 Career Guidance System Using Machine Learning

Authors: Mane Darbinyan, Lusine Hayrapetyan, Elen Matevosyan

Abstract:

Artificial Intelligence in Education (AIED) has been created to help students get ready for the workforce, and over the past 25 years, it has grown significantly, offering a variety of technologies to support academic, institutional, and administrative services. However, this is still challenging, especially considering the labor market's rapid change. While choosing a career, people face various obstacles because they do not take into consideration their own preferences, which might lead to many other problems like shifting jobs, work stress, occupational infirmity, reduced productivity, and manual error. Besides preferences, people should properly evaluate their technical and non-technical skills, as well as their personalities. Professional counseling has become a difficult undertaking for counselors due to the wide range of career choices brought on by changing technological trends. It is necessary to close this gap by utilizing technology that makes sophisticated predictions about a person's career goals based on their personality. Hence, there is a need to create an automated model that would help in decision-making based on user inputs. Improving career guidance can be achieved by embedding machine learning into the career consulting ecosystem. There are various systems of career guidance that work based on the same logic, such as the classification of applicants, matching applications with appropriate departments or jobs, making predictions, and providing suitable recommendations. Methodologies like KNN, Neural Networks, K-means clustering, D-Tree, and many other advanced algorithms are applied in the fields of data and compute some data, which is helpful to predict the right careers. Besides helping users with their career choice, these systems provide numerous opportunities which are very useful while making this hard decision. They help the candidate to recognize where he/she specifically lacks sufficient skills so that the candidate can improve those skills. They are also capable to offer an e-learning platform, taking into account the user's lack of knowledge. Furthermore, users can be provided with details on a particular job, such as the abilities required to excel in that industry.

Keywords: career guidance system, machine learning, career prediction, predictive decision, data mining, technical and non-technical skills

Procedia PDF Downloads 80
3106 Examining French Teachers’ Teaching and Learning Approaches in Some Selected Junior High Schools in Ghana

Authors: Paul Koffitse Agobia

Abstract:

In 2020 the Ministry of Education in Ghana and the National Council for Curriculum and Assessment (NaCCA) rolled out a new curriculum, Common Core Programme (CCP) for Basic 7 to 10, that lays emphasis on character building and values which are important to the Ghanaian society by providing education that will produce character–minded learners, with problem solving skills, who can play active roles in dealing with the increasing challenges facing Ghana and the global society. Therefore, learning and teaching approaches that prioritise the use of digital learning resources and active learning are recommended. The new challenge facing Ghanaian teachers is the ability to use new technologies together with the appropriate content pedagogical knowledge to help learners develop, aside the communication skills in French, the essential 21st century skills as recommended in the new curriculum. This article focusses on the pedagogical approaches that are recommended by NaCCA. The study seeks to examine French language teachers’ understanding of the recommended pedagogical approaches and how they use digital learning resources in class to foster the development of these essential skills and values. 54 respondents, comprised 30 teachers and 24 head teachers, were selected in 6 Junior High schools in rural districts (both private and public) and 6 from Junior High schools in an urban setting. The schools were selected in three regions: Volta, Central and Western regions. A class observation checklist and an interview guide were used to collect data for the study. The study reveals that some teachers adopt teaching techniques that do not promote active learning. They demonstrate little understanding of the core competences and values, therefore, fail to integrate them in their lessons. However, some other teachers, despite their lack of understanding of learning and teaching philosophies, adopted techniques that can help learners develop some of the core competences and values. In most schools, digital learning resources are not utilized, though teachers have smartphones or laptops.

Keywords: active learning, core competences, digital learning resources, pedagogical approach, values.

Procedia PDF Downloads 76
3105 Cardiac Arrest after Cardiac Surgery

Authors: Ravshan A. Ibadov, Sardor Kh. Ibragimov

Abstract:

Objective. The aim of the study was to optimize the protocol of cardiopulmonary resuscitation (CPR) after cardiovascular surgical interventions. Methods. The experience of CPR conducted on patients after cardiovascular surgical interventions in the Department of Intensive Care and Resuscitation (DIR) of the Republican Specialized Scientific-Practical Medical Center of Surgery named after Academician V. Vakhidov is presented. The key to the new approach is the rapid elimination of reversible causes of cardiac arrest, followed by either defibrillation or electrical cardioversion (depending on the situation) before external heart compression, which may damage sternotomy. Careful use of adrenaline is emphasized due to the potential recurrence of hypertension, and timely resternotomy (within 5 minutes) is performed to ensure optimal cerebral perfusion through direct massage. Out of 32 patients, cardiac arrest in the form of asystole was observed in 16 (50%), with hypoxemia as the cause, while the remaining 16 (50%) experienced ventricular fibrillation caused by arrhythmogenic reactions. The age of the patients ranged from 6 to 60 years. All patients were evaluated before the operation using the ASA and EuroSCORE scales, falling into the moderate-risk group (3-5 points). CPR was conducted for cardiac activity restoration according to the American Heart Association and European Resuscitation Council guidelines (Ley SJ. Standards for Resuscitation After Cardiac Surgery. Critical Care Nurse. 2015;35(2):30-38). The duration of CPR ranged from 8 to 50 minutes. The ARASNE II scale was used to assess the severity of patients' conditions after CPR, and the Glasgow Coma Scale was employed to evaluate patients' consciousness after the restoration of cardiac activity and sedation withdrawal. Results. In all patients, immediate chest compressions of the necessary depth (4-5 cm) at a frequency of 100-120 compressions per minute were initiated upon detection of cardiac arrest. Regardless of the type of cardiac arrest, defibrillation with a manual defibrillator was performed 3-5 minutes later, and adrenaline was administered in doses ranging from 100 to 300 mcg. Persistent ventricular fibrillation was also treated with antiarrhythmic therapy (amiodarone, lidocaine). If necessary, infusion of inotropes and vasopressors was used, and for the prevention of brain edema and the restoration of adequate neurostatus within 1-3 days, sedation, a magnesium-lidocaine mixture, mechanical intranasal cooling of the brain stem, and neuroprotective drugs were employed. A coordinated effort by the resuscitation team and proper role allocation within the team were essential for effective cardiopulmonary resuscitation (CPR). All these measures contributed to the improvement of CPR outcomes. Conclusion. Successful CPR following cardiac surgical interventions involves interdisciplinary collaboration. The application of an optimized CPR standard leads to a reduction in mortality rates and favorable neurological outcomes.

Keywords: cardiac surgery, cardiac arrest, resuscitation, critically ill patients

Procedia PDF Downloads 53
3104 Career Guidance System Using Machine Learning

Authors: Mane Darbinyan, Lusine Hayrapetyan, Elen Matevosyan

Abstract:

Artificial Intelligence in Education (AIED) has been created to help students get ready for the workforce, and over the past 25 years, it has grown significantly, offering a variety of technologies to support academic, institutional, and administrative services. However, this is still challenging, especially considering the labor market's rapid change. While choosing a career, people face various obstacles because they do not take into consideration their own preferences, which might lead to many other problems like shifting jobs, work stress, occupational infirmity, reduced productivity, and manual error. Besides preferences, people should evaluate properly their technical and non-technical skills, as well as their personalities. Professional counseling has become a difficult undertaking for counselors due to the wide range of career choices brought on by changing technological trends. It is necessary to close this gap by utilizing technology that makes sophisticated predictions about a person's career goals based on their personality. Hence, there is a need to create an automated model that would help in decision-making based on user inputs. Improving career guidance can be achieved by embedding machine learning into the career consulting ecosystem. There are various systems of career guidance that work based on the same logic, such as the classification of applicants, matching applications with appropriate departments or jobs, making predictions, and providing suitable recommendations. Methodologies like KNN, neural networks, K-means clustering, D-Tree, and many other advanced algorithms are applied in the fields of data and compute some data, which is helpful to predict the right careers. Besides helping users with their career choice, these systems provide numerous opportunities which are very useful while making this hard decision. They help the candidate to recognize where he/she specifically lacks sufficient skills so that the candidate can improve those skills. They are also capable of offering an e-learning platform, taking into account the user's lack of knowledge. Furthermore, users can be provided with details on a particular job, such as the abilities required to excel in that industry.

Keywords: career guidance system, machine learning, career prediction, predictive decision, data mining, technical and non-technical skills

Procedia PDF Downloads 70
3103 Robotics Technology Supported Pedagogic Models in Science, Technology, Engineering, Arts and Mathematics Education

Authors: Sereen Itani

Abstract:

As the world aspires for technological innovation, Innovative Robotics Technology-Supported Pedagogic Models in STEAM Education (Science, Technology, Engineering, Arts, and Mathematics) are critical in our global education system to build and enhance the next generation 21st century skills. Thus, diverse international schools endeavor in attempts to construct an integrated robotics and technology enhanced curriculum based on interdisciplinary subjects. Accordingly, it is vital that the globe remains resilient in STEAM fields by equipping the future learners and educators with Innovative Technology Experiences through robotics to support such fields. A variety of advanced teaching methods is employed to learn about Robotics Technology-integrated pedagogic models. Therefore, it is only when STEAM and innovations in Robotic Technology becomes integrated with real-world applications that transformational learning can occur. Robotics STEAM education implementation faces major challenges globally. Moreover, STEAM skills and concepts are communicated in separation from the real world. Instilling the passion for robotics and STEAM subjects and educators’ preparation could lead to the students’ majoring in such fields by acquiring enough knowledge to make vital contributions to the global STEAM industries. Thus, this necessitates the establishment of Pedagogic models such as Innovative Robotics Technologies to enhance STEAM education and develop students’ 21st-century skills. Moreover, an ICT innovative supported robotics classroom will help educators empower and assess students academically. Globally, the Robotics Design System and platforms are developing in schools and university labs creating a suitable environment for the robotics cross-discipline STEAM learning. Accordingly, the research aims at raising awareness about the importance of robotics design systems and methodologies of effective employment of robotics innovative technology-supported pedagogic models to enhance and develop (STEAM) education globally and enhance the next generation 21st century skills.

Keywords: education, robotics, STEAM (Science, Technology, Engineering, Arts and Mathematics Education), challenges

Procedia PDF Downloads 384
3102 Integration, a Tool to Develop Critical Thinking Skills of Undergraduate Veterinary Students

Authors: M. L. W. P. De Silva, R. A. C. Rabel, N. Smith, L. McIntyre, T. J Parkinson, K. A. N. Wijayawardhane

Abstract:

Curricular integration is an important concept in medical education for developing students’ ability to create connections between different medical disciplines. Problem-Based Learning (PBL) is one of the vehicles through which such integration can be achieved. During the recent review of the veterinary curriculum at the University of Peradeniya, a series of courses in Integrative Veterinary Science (IVS) were introduced, in which PBL was the primary teaching methodology. The objectives of this study were to evaluate students’ opinions on PBL as a teaching method: it should be noted that, within the context of secondary and tertiary education in Sri Lanka, this would be an entirely novel learning experience for the students. Opinions were sought at the conclusion of IVS sessions where students of semesters 2, 4, 6, and 7 (of an 8-semester program) were exposed to a two, 2-hour PBL-based case scenario. The PBL-based case scenario in semesters 2, 4, and 7 were delivered using material previously developed by an experienced PBL practitioner, whilst material for semester 6 was prepared de novo by a less experienced practitioner. Each student (semesters 2: n=38, 4: n=37, 6: n=55, and 7: n=40) completed a questionnaire which asked whether: (i) the course had improved their critical thinking skills; (ii) the learning environment was sufficiently comfortable to express/share student’s opinion; (iii) there was sufficient facilitator guidance; (iv) the online study environment enhanced learning; and (v) the students were overall satisfied with the PBL approach and IVS concept. Responses were given on a 5-point Likert-scale (strongly agree (SA), agree (A), neutral (N), disagree (D), and strongly disagree (SD)). SA and A responses were summed to provide an overall ‘satisfactory’ response. Results were subjected to frequency-distribution statistical analysis. A total of 88.5% of students gave SA+A scores to their overall satisfaction. The proportion of SA+A scores differed between different semesters, such that 95% of semester 2, 4, and 7 students gave SA+A scores, whereas only 69% of semester 6 students did so for their respective sessions. Overall, 96% of the students gave SA+A scores to the question relating to the improvement of critical thinking skills: semester 6 students’ scores were marginally, but not significantly, lower (91% SA+A) than those in other semesters. The difference of scores between semester 6 and the other semesters may be attributed to the different PBL-material used and/or the different experience levels of the practitioners that developed the study material. The use of PBL as a means of teaching IVS curriculum-integration courses was well-received by the students in terms of their overall satisfaction and their perceptions of improved critical thinking skills. Importantly, this was achieved in the face of a methodology that was entirely novel to the students. Finally, the delivery of the PBL medium was readily mastered by the practitioner to whom it was also a novel methodology.

Keywords: critical thinking skills, integration, problem based learning, veterinary education

Procedia PDF Downloads 133
3101 The Gender Digital Divide in Education: The Case of Students from Rural Area from Republic of Moldova

Authors: Bărbuță Alina

Abstract:

The inter-causal relationship between social inequalities and the digital divide raises the relation issue of gender and information and communication technologies (ICT) - a key element in achieving sustainable development. In preparing generations as future digital citizens and for active socio-economic participation, ICT plays a key role in respecting gender equality. Although several studies over the years have shown that gender plays an important role in digital exclusion, in recent years, many studies with a focus on economically developed or developing countries identify an improvement in these aspects and a gap narrowing. By measuring students' digital competencies level, this paper aims to identify and analyse the existing gender digital inequalities among students. Our analyses are based on a sample of 1526 middle school students residing in rural areas from Republic of Moldova (54.2% girls, mean age 14,00, SD = 1.02). During the online survey they filled in a questionnaire adapted from the (yDSI) ”The Youth Digital Skills Indicator”. The instrument measures the level of five digital competence areas indicated in The European Digital Competence Framework (DigiCom 2.3.). Our results, based on t-test, indicate that depending on gender, there are no statistically significant differences regarding the levels of digital skills in 3 areas: Information navigation and processing; Communication and interaction; Problem solving. However, were identified significant differences in the level of digital skills in the area of ”Digital content creation” [t(1425) = 4.20, p = .000] and ”Safety” [t(1421) = 2.49, p = .000], with higher scores recorded by girls. Our results contradicts the general stereotype regarding the low level of digital competence among girls, in our sample girls scores being on pear with boys and even bigger in knowledge related to digital content creation and online safety skills. Additional investigations related to boys competence on digital safety are necessary as the implication of their low scores on this dimension may suggest boys exposure to digital threats.

Keywords: digital divide, education, gender digital divide, digital literacy, remote learning

Procedia PDF Downloads 102
3100 Barriers and Opportunities in Apprenticeship Training: How to Complete a Vocational Upper Secondary Qualification with Intermediate Finnish Language Skills

Authors: Inkeri Jaaskelainen

Abstract:

The aim of this study is to shed light on what is it like to study in apprenticeship training using intermediate (or even lower level) Finnish. The aim is to find out and describe these students' experiences and feelings while acquiring a profession in Finnish as it is important to understand how immigrant background adult learners learn and how their needs could be better taken into account. Many students choose apprenticeships and start vocational training while their language skills in Finnish are still very weak. At work, students should be able to simultaneously learn Finnish and do vocational studies in a noisy, demanding, and stressful environment. Learning and understanding new things is very challenging under these circumstances, and sometimes students get exhausted and experience a lot of stress - which makes learning even more difficult. Students are different from each other, and so are their ways to learn. Both duties at work and school assignments require reasonably good general language skills, and, especially at work, language skills are also a safety issue. The empirical target of this study is a group of students with an immigrant background who studied in various fields with intensive L2 support in 2016–2018 and who by now have completed a vocational upper secondary qualification. The interview material for this narrative study was collected from those who completed apprenticeship training in 2019–2020. The data collection methods used are a structured thematic interview, a questionnaire, and observational data. Interviewees with an immigrant background have an inconsistent cultural and educational background - some have completed an academic degree in their country of origin while others have learned to read and write only in Finland. The analysis of the material utilizes thematic analysis, which is used to examine learning and related experiences. Learning a language at work is very different from traditional classroom teaching. With evolving language skills, at an intermediate level at best, rushing and stressing makes it even more difficult to understand and increases the fear of failure. Constant noise, rapidly changing situations, and uncertainty undermine the learning and well-being of apprentices. According to preliminary results, apprenticeship training is well suited to the needs of an adult immigrant student. In apprenticeship training, students need a lot of support for learning and understanding a new communication and working culture. Stress can result in, e.g., fatigue, frustration, and difficulties in remembering and understanding. Apprenticeship training can be seen as a good path to working life. However, L2 support is a very important part of apprenticeship training, and it indeed helps students to believe that one day they will graduate and even get employed in their new country.

Keywords: apprenticeship training, vocational basic degree, Finnish learning, wee-being

Procedia PDF Downloads 133
3099 An Analysis of Conversation Structure of Oprah Winfrey and Justin Bieber Utterances on The Oprah Winfrey Show

Authors: Najib Khumaidillah

Abstract:

A conversation needs skills to create the good flow of it. The skills also need to be paid attention by a host like Oprah Winfrey and Justin Bieber as an artist. This study is aimed at describing turn taking strategies and adjacency pairs used by the speakers. The data are from one segment of The Oprah Winfrey Show’s transcription with Justin Bieber. Those are analyzed by Stenstorm’s turn taking theories and adjacency pairs theories. From the analysis, it was found that both speakers use various turn taking strategies and adjacency pairs. These findings are hoped to be an example for non-native English speaker in doing English conversation and advance people’s comprehension of how to organize good conversation structure.

Keywords: adjacency pairs, conversation structure, the Oprah Winfrey show, turn taking

Procedia PDF Downloads 195
3098 Blended Cloud Based Learning Approach in Information Technology Skills Training and Paperless Assessment: Case Study of University of Cape Coast

Authors: David Ofosu-Hamilton, John K. E. Edumadze

Abstract:

Universities have come to recognize the role Information and Communication Technology (ICT) skills plays in the daily activities of tertiary students. The ability to use ICT – essentially, computers and their diverse applications – are important resources that influence an individual’s economic and social participation and human capital development. Our society now increasingly relies on the Internet, and the Cloud as a means to communicate and disseminate information. The educated individual should, therefore, be able to use ICT to create and share knowledge that will improve society. It is, therefore, important that universities require incoming students to demonstrate a level of computer proficiency or trained to do so at a minimal cost by deploying advanced educational technologies. The training and standardized assessment of all in-coming first-year students of the University of Cape Coast in Information Technology Skills (ITS) have become a necessity as students’ most often than not highly overestimate their digital skill and digital ignorance is costly to any economy. The one-semester course is targeted at fresh students and aimed at enhancing the productivity and software skills of students. In this respect, emphasis is placed on skills that will enable students to be proficient in using Microsoft Office and Google Apps for Education for their academic work and future professional work whiles using emerging digital multimedia technologies in a safe, ethical, responsible, and legal manner. The course is delivered in blended mode - online and self-paced (student centered) using Alison’s free cloud-based tutorial (Moodle) of Microsoft Office videos. Online support is provided via discussion forums on the University’s Moodle platform and tutor-directed and assisted at the ICT Centre and Google E-learning laboratory. All students are required to register for the ITS course during either the first or second semester of the first year and must participate and complete it within a semester. Assessment focuses on Alison online assessment on Microsoft Office, Alison online assessment on ALISON ABC IT, Peer assessment on e-portfolio created using Google Apps/Office 365 and an End of Semester’s online assessment at the ICT Centre whenever the student was ready in the cause of the semester. This paper, therefore, focuses on the digital culture approach of hybrid teaching, learning and paperless examinations and the possible adoption by other courses or programs at the University of Cape Coast.

Keywords: assessment, blended, cloud, paperless

Procedia PDF Downloads 248
3097 Importance of Field Hospitals in Trauma Management: An Experience from Nepal Earthquake

Authors: Krishna Gopal Lageju

Abstract:

On 25th April 2015, a 7.6 magnitude earthquake struck Gorkha district of Nepal, which resulted over 8,790 deaths and 22,300 injuries. In addition, almost one-third of the country’s healthcare service has been disrupted. A total of 1,211 health facilities became non-operational, due to 446 completely and other 765 partially damaged. Nearly 84 percent (375 out of 446) of the completely damaged health facilities are in the 14 most affected districts. As a result, the ability of health facilities to respond to health care needs has been harshly affected. In addition, 18 health workers lost their lives and 75 are injured, which added further challenges in the delivery of health services. Thus, to address the immediate health needs in the most devastated areas, Nepal Red Cross Society (NRCS) in coordination with IFRC and Nepal Government, 8 Field hospitals established with surgical capacities, where around 492 international Emergency Response Units (ERUs) Members are mobilized for 3 months period. More than 54,000 patients have been treated in the Red Cross operated field hospitals. Trauma cases accounted 9,180 (17%) of the total patients off which 1,285 (14%) are major surgical cases. Most of the case loads 44,830 (83%) are outpatients and 9,180 patients got inpatients service. Similarly, 112 births have been performed in the field hospitals. Inpatient mortality rate remained 1.5% (21 deaths), many of them are presented with critical injuries or illnesses. No outbreak has been seen during the ERU operation. Deployment of ERUs together with national health workers are very important to address the immediate health needs of the affected communities. This will ease for transition and handover of emergency service and equipments to local provider. Likewise, capacity building of local staff as on the job training on various clinical teachings would be another important issue to look at before phasing out such services.

Keywords: trauma management, critical injuries, earthquake, health

Procedia PDF Downloads 241
3096 An Augmented Reality Based Self-Learning Support System for Skills Training

Authors: Chinlun Lai, Yu-Mei Chang

Abstract:

In this paper, an augmented reality learning support system is proposed to replace the traditional teaching tool thus to help students improve their learning motivation, effectiveness, and efficiency. The system can not only reduce the exhaust of educational hardware and realistic material, but also provide an eco-friendly and self-learning practical environment in any time and anywhere with immediate practical experiences feedback. To achieve this, an interactive self-training methodology which containing step by step operation directions is designed using virtual 3D scenario and wearable device platforms. The course of nasogastric tube care of nursing skills is selected as the test example for self-learning and online test. From the experimental results, it is observed that the support system can not only increase the student’s learning interest but also improve the learning performance than the traditional teaching methods. Thus, it fulfills the strategy of learning by practice while reducing the related cost and effort significantly and is practical in various fields.

Keywords: augmented reality technology, learning support system, self-learning, simulation learning method

Procedia PDF Downloads 167
3095 MRCP as a Pre-Operative Tool for Predicting Variant Biliary Anatomy in Living Related Liver Donors

Authors: Awais Ahmed, Atif Rana, Haseeb Zia, Maham Jahangir, Rashed Nazir, Faisal Dar

Abstract:

Purpose: Biliary complications represent the most common cause of morbidity in living related liver donor transplantation and detailed preoperative evaluation of biliary anatomic variants is crucial for safe patient selection and improved surgical outcomes. Purpose of this study is to determine the accuracy of preoperative MRCP in predicting biliary variations when compared to intraoperative cholangiography in living related liver donors. Materials and Methods: From 44 potential donors, 40 consecutive living related liver donors (13 females and 28 males) underwent donor hepatectomy at our centre from April 2012 to August 2013. MRCP and IOC of all patients were retrospectively reviewed separately by two radiologists and a transplant surgeon.MRCP was performed on 1.5 Tesla MR magnets using breath-hold heavily T2 weighted radial slab technique. One patient was excluded due to suboptimal MRCP. The accuracy of MRCP for variant biliary anatomy was calculated. Results: MRCP accurately predicted the biliary anatomy in 38 of 39 cases (97 %). Standard biliary anatomy was predicted by MRCP in 25 (64 %) donors (100% sensitivity). Variant biliary anatomy was noted in 14 (36 %) IOCs of which MRCP predicted precise anatomy of 13 variants (93 % sensitivity). The two most common variations were drainage of the RPSD into the LHD (50%) and the triple confluence of the RASD, RPSD and LHD (21%). Conclusion: MRCP is a sensitive imaging tool for precise pre-operative mapping of biliary variations which is critical to surgical decision making in living related liver transplantation.

Keywords: intraoperative cholangiogram, liver transplantation, living related donors, magnetic resonance cholangio-pancreaticogram (MRCP)

Procedia PDF Downloads 397
3094 Psychological Distress Screening in Patients with Esophageal Cancer after Esophagectomy: A Scoping Review

Authors: Erietta-Christina Arnaoutaki, Stelios-Elion Bousi, Marinos Zachiotis, Simoni Zarkada, Alexandra Chrysagi, Mamdouh Fahad Alenazi, Dimitri Aristotle Raptis

Abstract:

Objective: This review aimed to evaluate the mental health status of patients with esophageal cancer following surgical treatment, as well as the role of psychological distress screening tests in this patient population. Methods: Studies reporting psychometric screening tools used in esophageal cancer patients after esophagectomy, published before January 2024 on PubMed, Scopus, and CENTRAL databases, were searched and analyzed. Results: Six non-randomized control trials were selected for inclusion in this scoping review, which involved 1059 patients undergoing esophagectomy for esophageal cancer. Among the included studies, five employed the Hospital Anxiety and Depression Scale (HADS) for anxiety and/or depression screening, while one used the MD Anderson Symptom Inventory for gastrointestinal cancer (MDASI-GI) for sadness screening. A range of time points was used to evaluate these patients: 102 patients were evaluated at 1 month, 230 patients at 3 months, 218 patients at 6 months, 653 patients at 12 months, and 154 patients at 24 months postoperatively. Analysis of data pooled from three studies employing the HADS revealed a prevalence of 19.45% for anxiety and 17.92% for depression at the 12-month follow-up and mean scores of 3.91 (3.12) and 3.56 (3.12) for the HADS anxiety (HADS-A) and depression (HADS-D) subscales respectively, at any time postoperatively. Conclusion: The findings show a neglected concern regarding the mental health of esophageal cancer survivors following surgical treatment. The use of psychometric screening tools is essential to address psychological distress and improve the quality of life of these patients.

Keywords: esophageal cancer, esophagectomy, psychological distress, anxiety, depression, psychometric tests, HADS, MDASI-GI

Procedia PDF Downloads 18
3093 Comparison of Visio-spatial Intelligence Between Amateur Rugby and Netball Players Using a Hand-Eye Coordination Specific Visual Test Battery

Authors: Lourens Millard, Gerrit Jan Breukelman, Nonkululeko Mathe

Abstract:

Aim: The research aims to investigate the differences in visio-spatial skills (VSS) between athletes and non-athletes, as well as variations across sports, presenting conflicting findings. Therefore, the objective of this study was to determine if there exist significant differences in visio-spatial intelligence skills between rugby players and netball players, and whether such disparities are present when comparing both groups to non-athletes. Methods: Participants underwent an optometric assessment, followed by an evaluation of VSS using six established tests: the Hart Near Far Rock, saccadic eye movement, evasion, accumulator, flash memory, and ball wall toss tests. Results: The results revealed that rugby players significantly outperformed netball players in speed of recognition, peripheral awareness, and hand-eye coordination (p=.000). Moreover, both rugby players and netball players performed significantly better than non-athletes in five of the six tests (p=.000), with the exception being the visual memory test (p=.809). Conclusion: This discrepancy in performance suggests that certain VSS are superior in athletes compared to non-athletes, highlighting potential implications for theories of vision, test selection, and the development of sport-specific VSS testing batteries. Furthermore, the use of a hand-eye coordination-specific VSS test battery effectively differentiated between different sports. However, this pattern was not consistent across all VSS tests, indicating that further research should explore the training methods employed by both sports, as these factors may contribute to the observed differences.

Keywords: visio-spatial intelligence (VSI), rugby vision, netball vision, visual skills, sport vision.

Procedia PDF Downloads 51
3092 The Educational, Social and Cultural Significance of Boys Choirs

Authors: Johannes Van Der Sandt

Abstract:

Worldwide, there are many boys choirs, but the Drakensberg Boys Choir is one of only a few of its kind: selected from a residential boys choir school using choral music as a significant vehicle for holistic education. With ongoing debates as to whether single-gender education is advantageous for boys, and research on the missing males in choirs problem, this presentation‘s purpose is to explore the perceived benefits and values for boys singing in the world-renowned Drakensberg Boys Choir, and to establish educational grounds for the existence of boys choirs. Semi-structured questionnaires were given to choristers, known as Drakies, to ascertain their perceptions of their choir membership. Their experiences are noted in terms of musical, social and behavioral skills gained. The main emerging themes in each category are discussed in order to lay claim to the assumption that boys choirs exist not only to entertain, and nor are their goals purely musical or pedagogical, but that they can be regarded as unique, cultural artifacts that aid boys‘ development into well-equipped and well-rounded young men.

Keywords: boys, choirs, choral, education, skills, values

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3091 Reaching Students Who “Don’t Like Writing” through Scenario Based Learning

Authors: Shahira Mahmoud Yacout

Abstract:

Writing is an essential skill in many vocational, academic environments, and notably workplaces, yet many students perceive writing as being something tiring and boring or maybe a “waste of time”. Studies in the field of foreign languages related this fact might be due to the lack of connection between what is learned in the university and what students come to encounter in real life situations”. Arabic learners felt they needed more language exposure to the context of their future professions. With this idea in mind, Scenario based learning (SBL) is reported to be an educational approach to motivate, engage and stimulate students’ interest and to achieve the desired writing learning outcomes. In addition, researchers suggested Scenario based learning (SBL)as an instructional approach that develops and enhances students skills through developing higher order thinking skills and active learning. It is a subset of problem-based learning and case-based learning. The approach focuses on authentic rhetorical framing reflecting writing tasks in real life situations. It works successfully when used to simulate real-world practices, providing context that reflects the types of situations professionals respond to in writing. It was claimed that using realistic scenarios customized to the course’s learning objectives as it bridged the gap for students between theory and application. Within this context, it is thought that scenario-based learning is an important approach to enhance the learners’ writing skills and to reflect meaningful learning within authentic contexts. As an Arabicforeign language instructor, it was noticed that students find difficulties in adapting writing styles to authentic writing contexts and addressing different audiences and purposes. This idea is supported by studieswho claimed that AFL students faced difficulties with transferring writing skills to situations outside of the classroom context. In addition, it was observed that some of the Arabic textbooks for teaching Arabic as a foreign language lacked topics that initiated higher order thinking skills and stimulated the learners to understand the setting, and created messages appropriate to different audiences, context, and purposes. The goals of this study are to 1)provide a rational for using scenario-based learning approach to improveAFL learners in writing skills, 2) demonstrate how to design/ implement a scenario-based learning technique aligned with the writing course objectives,3) demonstrate samples of scenario-based approach implemented in AFL writing class, and 4)emphasis the role of peer-review along with the instructor’s feedback, in the process of developing the writing skill. Finally, this presentation highlighted and emphasized the importance of using the scenario-based learning approach in writing as a means to mirror students’ real-life situations and engage them in planning, monitoring, and problem solving. This approach helped in making writing an enjoyable experience and clearly useful to students’ future professional careers.

Keywords: meaningful learning, real life contexts, scenario based learning, writing skill

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3090 Evidence-Triggers for Care of Patients with Cleft Lip and Palate in Srinagarind Hospital: The Tawanchai Center and Out-Patients Surgical Room

Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

Abstract:

Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

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3089 Linking Supervisor’s Goal Orientation to Post-Training Supportive Behaviors: The Mediating Role of Interest in the Development of Subordinates Skills

Authors: Martin Lauzier, Benjamin Lafreniere-Carrier, Nathalie Delobbe

Abstract:

Supervisor support is one of the main levers to foster transfer of training. Although past and current studies voice its effects, few have sought to identify the factors that may explain why supervisors offer support to their subordinates when they return from training. Based on Goal Orientation Theory and following the principles of supportive supervision, this study aims to improve our understanding of the factors that influence supervisors’ involvement in the transfer process. More specifically, this research seeks to verify the influence of supervisors’ goal orientation on the adoption of post-training support behaviors. This study also assesses the mediating role of the supervisors’ interest in subordinates’ development on this first relationship. Conducted in two organizations (Canadian: N₁ = 292; Belgian: N₂ = 80), the results of this study revealed three main findings. First, supervisors’ who adopt learning mastery goal orientation also tend to adopt more post-training supportive behaviors. Secondly, regression analyses (using the bootstrap method) show that supervisors' interest in developing their subordinates’ skills mediate the relationship between supervisors’ goal orientation and post-training supportive behaviors. Thirdly, the observed mediation effects are consistent in both samples, regardless of supervisors’ gender or age. Overall, this research is part of the limited number of studies that have focused on the determining factors supervisors’ involvement in the learning transfer process.

Keywords: supervisor support, transfer of training, goal orientation, interest in the development of subordinates’ skills

Procedia PDF Downloads 187
3088 Examining the Skills of Establishing Number and Space Relations of Science Students with the 'Integrative Perception Test'

Authors: Ni̇sa Yeni̇kalayci, Türkan Aybi̇ke Akarca

Abstract:

The ability of correlation the number and space relations, one of the basic scientific process skills, is being used in the transformation of a two-dimensional object into a three-dimensional image or in the expression of symmetry axes of the object. With this research, it is aimed to determine the ability of science students to establish number and space relations. The research was carried out with a total of 90 students studying in the first semester of the Science Education program of a state university located in the Turkey’s Black Sea Region in the fall semester of 2017-2018 academic year. An ‘Integrative Perception Test (IPT)’ was designed by the researchers to collect the data. Within the scope of IPT, the courses and workbooks specific to the field of science were scanned and the ones without symmetrical structure from the visual items belonging to the ‘Physics - Chemistry – Biology’ sub-fields were selected and listed. During the application, it was expected that students would imagine and draw images of the missing half of the visual items that were given incomplete in the first place. The data obtained from the test in which there are 30 images or pictures in total (f Physics = 10, f Chemistry = 10, f Biology = 10) were analyzed descriptively based on the drawings created by the students as ‘complete (2 points), incomplete/wrong (1 point), empty (0 point)’. For the teaching of new concepts in small aged groups, images or pictures showing symmetrical structures and similar applications can also be used.

Keywords: integrative perception, number and space relations, science education, scientific process skills

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3087 Effective Student Engaging Strategies to Enhance Academic Learning in Middle Eastern Classrooms: An Action Research Approach

Authors: Anjum Afrooze

Abstract:

The curriculum at General Sciences department in Prince Sultan University includes ‘Physical science’ for Computer Science, Information Technology and Business courses. Students are apathetic towards Physical Science and question, as to, ‘How this course is related to their majors?’ English is not a native language for the students and also for many instructors. More than sixty percent of the students come from institutions where English is not the medium of instruction, which makes student learning and academic achievement challenging. After observing the less enthusiastic student cohort for two consecutive semesters, the instructor was keen to find effective strategies to enhance learning and further encourage deep learning by engaging students in different tasks to empower them with necessary skills and motivate them. This study is participatory action research, in which instructor designs effective tasks to engage students in their learning. The study is conducted through two semesters with a total of 200 students. The effectiveness of this approach is studied using questionnaire at the end of each semester and teacher observation. Major outcomes of this study were overall improvement in students attitude towards science learning, enhancement of multiple skills like note taking, problem solving, language proficiency and also fortifying confidence. This process transformed instructor into engaging and reflecting practitioner. Also, these strategies were implemented by other instructors teaching the course and proved effective in opening a path to changes in related areas of the course curriculum. However, refinement in the strategies could be done based on student evaluation and instructors observation.

Keywords: group activity, language proficiency, reasoning skills, science learning

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3086 The Impact of Artificial Intelligence on the Behavior of Children and Autism

Authors: Sara Fayez Fawzy Mikhael

Abstract:

Inclusive education services for students with Autism remains in its early developmental stages in Thailand. Despite many more children with autism are attending schools since the Thai government introduced the Education Provision for People with Disabilities Act in 2008, the services students with autism and their families receive are generally lacking. This quantitative study used Attitude and Preparedness to Teach Students with Autism Scale (APTSAS) to investigate 110 primary school teachers’ attitude and preparedness to teach students with autism in the general education classroom. Descriptive statistical analysis of the data found that student behavior was the most significant factor in building teachers’ negative attitudes students with autism. The majority of teachers also indicated that their pre-service education did not prepare them to meet the learning needs of children with autism in particular, those who are non-verbal. The study is significant and provides direction for enhancing teacher education for inclusivity in Thailand.

Keywords: attitude, autism, teachers, thailandsports activates, movement skills, motor skills

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3085 Inquiry on the Improvement Teaching Quality in the Classroom with Meta-Teaching Skills

Authors: Shahlan Surat, Saemah Rahman, Saadiah Kummin

Abstract:

When teachers reflect and evaluate whether their teaching methods actually have an impact on students’ learning, they will adjust their practices accordingly. This inevitably improves their students’ learning and performance. The approach in meta-teaching can invigorate and create a passion for teaching. It thus helps to increase the commitment and love for the teaching profession. This study was conducted to determine the level of metacognitive thinking of teachers in the process of teaching and learning in the classroom. Metacognitive thinking teachers include the use of metacognitive knowledge which consists of different types of knowledge: declarative, procedural and conditional. The ability of the teachers to plan, monitor and evaluate the teaching process can also be determined. This study was conducted on 377 graduate teachers in Klang Valley, Malaysia. The stratified sampling method was selected for the purpose of this study. The metacognitive teaching inventory consisting of 24 items is called InKePMG (Teacher Indicators of Effectiveness Meta-Teaching). The results showed the level of mean is high for two components of metacognitive knowledge; declarative knowledge (mean = 4.16) and conditional (mean = 4.11) whereas, the mean of procedural knowledge is 4.00 (moderately high). Similarly, the level of knowledge in monitoring (mean = 4.11), evaluating (mean = 4.00) which indicate high score and planning (mean = 4.00) are moderately high score among teachers. In conclusion, this study shows that the planning and procedural knowledge is an important element in improving the quality of teachers teaching in the classroom. Thus, the researcher recommended that further studies should focus on training programs for teachers on metacognitive skills and also on developing creative thinking among teachers.

Keywords: metacognitive thinking skills, procedural knowledge, conditional knowledge, meta-teaching and regulation of cognitive

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3084 Advancements in Arthroscopic Surgery Techniques for Anterior Cruciate Ligament (ACL) Reconstruction

Authors: Islam Sherif, Ahmed Ashour, Ahmed Hassan, Hatem Osman

Abstract:

Anterior Cruciate Ligament (ACL) injuries are common among athletes and individuals participating in sports with sudden stops, pivots, and changes in direction. Arthroscopic surgery is the gold standard for ACL reconstruction, aiming to restore knee stability and function. Recent years have witnessed significant advancements in arthroscopic surgery techniques, graft materials, and technological innovations, revolutionizing the field of ACL reconstruction. This presentation delves into the latest advancements in arthroscopic surgery techniques for ACL reconstruction and their potential impact on patient outcomes. Traditionally, autografts from the patellar tendon, hamstring tendon, or quadriceps tendon have been commonly used for ACL reconstruction. However, recent studies have explored the use of allografts, synthetic scaffolds, and tissue-engineered grafts as viable alternatives. This abstract evaluates the benefits and potential drawbacks of each graft type, considering factors such as graft incorporation, strength, and risk of graft failure. Moreover, the application of augmented reality (AR) and virtual reality (VR) technologies in surgical planning and intraoperative navigation has gained traction. AR and VR platforms provide surgeons with detailed 3D anatomical reconstructions of the knee joint, enhancing preoperative visualization and aiding in graft tunnel placement during surgery. We discuss the integration of AR and VR in arthroscopic ACL reconstruction procedures, evaluating their accuracy, cost-effectiveness, and overall impact on surgical outcomes. Beyond graft selection and surgical navigation, patient-specific planning has gained attention in recent research. Advanced imaging techniques, such as MRI-based personalized planning, enable surgeons to tailor ACL reconstruction procedures to each patient's unique anatomy. By accounting for individual variations in the femoral and tibial insertion sites, this personalized approach aims to optimize graft placement and potentially improve postoperative knee kinematics and stability. Furthermore, rehabilitation and postoperative care play a crucial role in the success of ACL reconstruction. This abstract explores novel rehabilitation protocols, emphasizing early mobilization, neuromuscular training, and accelerated recovery strategies. Integrating technology, such as wearable sensors and mobile applications, into postoperative care can facilitate remote monitoring and timely intervention, contributing to enhanced rehabilitation outcomes. In conclusion, this presentation provides an overview of the cutting-edge advancements in arthroscopic surgery techniques for ACL reconstruction. By embracing innovative graft materials, augmented reality, patient-specific planning, and technology-driven rehabilitation, orthopedic surgeons and sports medicine specialists can achieve superior outcomes in ACL injury management. These developments hold great promise for improving the functional outcomes and long-term success rates of ACL reconstruction, benefitting athletes and patients alike.

Keywords: arthroscopic surgery, ACL, autograft, allograft, graft materials, ACL reconstruction, synthetic scaffolds, tissue-engineered graft, virtual reality, augmented reality, surgical planning, intra-operative navigation

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3083 Robot Technology Impact on Dyslexic Students’ English Learning

Authors: Khaled Hamdan, Abid Amorri, Fatima Hamdan

Abstract:

Involving students in English language learning process and achieving an adequate English language proficiency in the target language can be a great challenge for both teachers and students. This can prove even a far greater challenge to engage students with special needs (Dyslexia) if they have physical impairment and inadequate mastery of basic communicative language competence/proficiency in the target language. From this perspective, technology like robots can probably be used to enhance learning process for the special needs students who have extensive communication needs, who face continuous struggle to interact with their peers and teachers and meet academic requirements. Robots, precisely NAO, can probably provide them with the perfect opportunity to practice social and communication skills, and meet their English academic requirements. This research paper aims to identify to what extent robots can be used to improve students’ social interaction and communication skills and to understand the potential for robotics-based education in motivating and engaging UAEU dyslexic students to meet university requirements. To reach this end, the paper will explore several factors that come into play – Motion Level-involving cognitive activities, Interaction Level-involving language processing, Behavior Level -establishing a close relationship with the robot and Appraisal Level- focusing on dyslexia students’ achievement in the target language.

Keywords: dyslexia, robot technology, motion, interaction, behavior and appraisal levels, social and communication skills

Procedia PDF Downloads 372
3082 Cicadas: A Clinician-assisted, Closed-loop Technology, Mobile App for Adolescents with Autism Spectrum Disorders

Authors: Bruno Biagianti, Angela Tseng, Kathy Wannaviroj, Allison Corlett, Megan DuBois, Kyu Lee, Suma Jacob

Abstract:

Background: ASD is characterized by pervasive Sensory Processing Abnormalities (SPA) and social cognitive deficits that persist throughout the course of the illness and have been linked to functional abnormalities in specific neural systems that underlie the perception, processing, and representation of sensory information. SPA and social cognitive deficits are associated with difficulties in interpersonal relationships, poor development of social skills, reduced social interactions and lower academic performance. Importantly, they can hamper the effects of established evidence-based psychological treatments—including PEERS (Program for the Education and Enrichment of Relationship Skills), a parent/caregiver-assisted, 16-weeks social skills intervention—which nonetheless requires a functional brain capable of assimilating and retaining information and skills. As a matter of fact, some adolescents benefit from PEERS more than others, calling for strategies to increase treatment response rates. Objective: We will present interim data on CICADAS (Care Improving Cognition for ADolescents on the Autism Spectrum)—a clinician-assisted, closed-loop technology mobile application for adolescents with ASD. Via ten mobile assessments, CICADAS captures data on sensory processing abnormalities and associated cognitive deficits. These data populate a machine learning algorithm that tailors the delivery of ten neuroplasticity-based social cognitive training (NB-SCT) exercises targeting sensory processing abnormalities. Methods: In collaboration with the Autism Spectrum and Neurodevelopmental Disorders Clinic at the University of Minnesota, we conducted a fully remote, three-arm, randomized crossover trial with adolescents with ASD to document the acceptability of CICADAS and evaluate its potential as a stand-alone treatment or as a treatment enhancer of PEERS. Twenty-four adolescents with ASD (ages 11-18) have been initially randomized to 16 weeks of PEERS + CICADAS (Arm A) vs. 16 weeks of PEERS + computer games vs. 16 weeks of CICADAS alone (Arm C). After 16 weeks, the full battery of assessments has been remotely administered. Results: We have evaluated the acceptability of CICADAS by examining adherence rates, engagement patterns, and exit survey data. We found that: 1) CICADAS is able to serve as a treatment enhancer for PEERS, inducing greater improvements in sensory processing, cognition, symptom reduction, social skills and behaviors, as well as the quality of life compared to computer games; 2) the concurrent delivery of PEERS and CICADAS induces greater improvements in study outcomes compared to CICADAS only. Conclusion: While preliminary, our results indicate that the individualized assessment and treatment approach designed in CICADAS seems effective in inducing adaptive long-term learning about social-emotional events. CICADAS-induced enhancement of processing and cognition facilitates the application of PEERS skills in the environment of adolescents with ASD, thus improving their real-world functioning.

Keywords: ASD, social skills, cognitive training, mobile app

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3081 A Comparison of Clinical and Pathological TNM Staging in a COVID-19 Era

Authors: Sophie Mills, Leila L. Touil, Richard Sisson

Abstract:

Introduction: The TNM classification is the global standard for the staging of head and neck cancers. Accurate clinical-radiological staging of tumours (cTNM) is essential to predict prognosis, facilitate surgical planning and determine the need for other therapeutic modalities. This study aims to determine the accuracy of pre-operative cTNM staging using pathological TNM (pTNM) and consider possible causes of TNM stage migration, noting any variation throughout the COVID-19 pandemic. Materials and Methods: A retrospective cohort study examined records of patients with surgical management of head and neck cancer at a tertiary head and neck centre from November 2019 to November 2020. Data was extracted from Somerset Cancer Registry and histopathology reports. cTNM and pTNM were compared before and during the first wave of COVID-19, as well as with other potential prognostic factors such as tumour site and tumour stage. Results: 119 cases were identified, of which 52.1% (n=62) were male, and 47.9% (n=57) were female with a mean age of 67 years. Clinical and pathological staging differed in 54.6% (n=65) of cases. Of the patients with stage migration, 40.4% (n=23) were up-staged and 59.6% (n=34) were down-staged compared with pTNM. There was no significant difference in the accuracy of cTNM staging compared with age, sex, or tumour site. There was a statistically highly significant (p < 0.001) correlation between cTNM accuracy and tumour stage, with the accuracy of cTNM staging decreasing with the advancement of pTNM staging. No statistically significant variation was noted between patients staged prior to and during COVID-19. Conclusions: Discrepancies in staging can impact management and outcomes for patients. This study found that the higher the pTNM, the more likely stage migration will occur. These findings are concordant with the oncology literature, which highlights the need to improve the accuracy of cTNM staging for more advanced tumours.

Keywords: COVID-19, head and neck cancer, stage migration, TNM staging

Procedia PDF Downloads 109