Search results for: feeding practice
4107 Impact of Preksha Meditation on Academic Anxiety of Female Teenagers
Authors: Neelam Vats, Madhvi Pathak Pillai, Rajender Lal, Indu Dabas
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The pressure of scoring higher marks to be able to get admission in a higher ranked institution has become a social stigma for school students. It leads to various social and academic pressures on them, causing psychological anxiety. This undue stress on students sometimes may even steer to aggressive behavior or suicidal tendencies. Human mind is always surrounded by the some desires, emotions and passions, which usually disturbs our mental peace. In such a scenario, we look for a solution that helps in removing all the obstacles of mind and make us mentally peaceful and strong enough to be able to deal with all kind of pressure. Preksha meditation is one such technique which aims at bringing the positive changes for overall transformation of personality. Hence, the present study was undertaken to assess the impact of Preksha Meditation on the academic anxiety on female teenagers. The study was conducted on 120 high school students from the capital city of India. All students were in the age group of 13-15 years. They also belonged to similar social as well as economic status. The sample was equally divided into two groups i.e. experimental group (N = 60) and control group (N = 60). Subjects of the experimental group were given the intervention of Preksha Meditation practice by the trained instructor for one hour per day, six days a week, for three months for the first experimental stage and another three months for the second experimental stage. The subjects of the control group were not assigned any specific type of activity rather they continued doing their normal official activities as usual. The Academic Anxiety Scale was used to collect data during multi-level stages i.e. pre-experimental stage, post-experimental stage phase-I, and post-experimental stage phase-II. The data were statistically analyzed by computing the two-tailed-‘t’ test for inter group comparison and Sandler’s ‘A’ test with alpha = or p < 0.05 for intra-group comparisons. The study concluded that the practice for longer duration of Preksha Meditation practice brings about very significant and beneficial changes in the pattern of academic anxiety.Keywords: academic anxiety, academic pressure, Preksha, meditation
Procedia PDF Downloads 1314106 The Art of Looking (Back): The Female Gaze in Portrait de la Jeune Fille en Feu and Little Women
Authors: Louisa Browne Kirk
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In recent press interviews to promote Portrait de la jeune fille en feu (2019, translated to Portrait of a Lady on Fire in English), director and screenwriter Céline Sciamma and actors Adèle Haenel and Noémie Merlant repeatedly state that they understand the film as (if not uniquely, then unusually) produced via and supportive of ‘the female gaze’. Such a way of seeing stands in opposition to ‘the male gaze’, first theorised by Laura Mulvey as the way in which the female figure is a bearer, not maker, of meaning, a silent signifier through and against whom the male creator/viewer produces his fantasies and obsessions. What, then, is the female gaze? How does a woman produce meaning in and through film? Portrait de la jeune fille en feu and another very recent film, Little Women (2019, directed by Greta Gerwig), are unlikely companion films that understand the female gaze to be the act of one woman looking at another woman, a looking that is mediated through the production of art. In Sciamma’s film this looking is sexual and mediated through painting and in Gerwig’s film looking is familial and mediated through writing. In the schema of these films, art, love, looking and meaning are produced through collaboration. The painted and the painter, the written and the writer, are no longer rendered as subject and object but as dual creators, both always seeing and seen. The gaze of the cinematic woman, mediated through shared artistic practice, is ‘the desire-that-gives’.Keywords: female gaze, Gerwig, Sciamma, shared artistic practice
Procedia PDF Downloads 1824105 Medical Ethics: Knowledge, Attitude and Practices among Young Healthcare Professionals – A Survey from Islamabad, Pakistan
Authors: Asima Mehaboob Khan, Rizwan Taj
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Purpose: This study aims to estimate the knowledge, attitude and practices of medical ethics among young healthcare professionals. Method: A qualitative descriptive study was conducted among young healthcare professionals from both public and private sector medical institutions. Using the convenience sampling technique, 272 healthcare professionals participated in this study. A pre-structured modified questionnaire was used to collect the data. Descriptive analyses were executed for each variable. Result: About 76.47% of healthcare professional considers the importance of adequate knowledge of medical ethics, and 82.24% declared lecture, seminars and clinical discussion as the source of their medical knowledge of biomedical ethics. About 42.44% of healthcare professionals exhibited a negative attitude toward medical ethics, 57.72% showed a mildly positive attitude, whereas 1.10% and 0.74% indicated a moderately positive attitude and a highly positive attitude towards medical ethics. Similarly, the level of practice according to medical ethics is also very poor among young healthcare professionals. 34.56% of healthcare professionals deviated from medical ethics during their clinical practices, whereas 0.74% showed a good level of medical practice according to medical ethics. Conclusion: It is concluded in this research study that young healthcare professionals have adequate theoretical knowledge of medical ethics but are not properly trained to perform their clinical practices according to the guidelines of medical ethics. Furthermore, their professional attitude is poorly developed to maintain medical ethics during their clinical practices.Keywords: knowledge, attitude, practices, medical ethics
Procedia PDF Downloads 1054104 Improving Health Workers’ Well-Being in Cittadella Hospital (Province of Padua), Italy
Authors: Emanuela Zilli, Suana Tikvina, Davide Bonaldo, Monica Varotto, Scilla Rizzardi, Barbara Ruzzante, Raffaele Napolitano, Stefano Bevilacqua, Antonella Ruffatto
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A healthy workplace increases productivity, creativity and decreases absenteeism and turnover. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work-related stress that are often unsustainable. The Hospital of Cittadella (in the province of Padua) has 400 beds and serves a territory of 300,000 inhabitants. The hospital itself counts 1.250 healthcare employees (healthcare professionals). This year, the Medical Board of Directors has requested additional staff; however, the economic situation of Italy can not sustain additional hires. At the same time, we have initiated projects that aim to increase well-being, decrease stress and encourage activities that promote self-care. One of the projects that the hospital has organized is the psychomotor practice. It is held by therapists and trainers who operate according to the traditional method. According to the literature, the psychomotor practice is specifically intended for the staff operating in the Intensive Care Unit, Emergency Department and Pneumology Ward. The project consisted of one session of 45 minutes a week for 3 months. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue, creating a more mindful and sustainable lifestyle. In addition, a Qigong course was held every two weeks for 5 months. It is an ancient Chinese practice designed to optimize the energy within the body, reducing stress levels and increasing general well-being. Finally, Tibetan singing crystal bowls sessions, held by a music therapist, consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Sound therapy uses the vibrations created from the crystal bowls to balance the vibrations within the body to promote relaxation. In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and, consequently, user satisfaction of the services provided.Keywords: health promotion, healthcare workers management, Weel being and organizational performance, Psychomotor practice
Procedia PDF Downloads 684103 Processing and Characterization of Cereal Bar Containing Cassava Flour
Authors: E. L. Queiroz, S. M. A. Souza, R. T. S. Santos
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The cereal bars have emerged as a healthy alternative in the food sector, by presenting a remarkable functional appeal, being a product of high nutritional value. Cereals have an important function in feeding because they have features that particularize them as their variety, smooth flavour and aroma and easy digestion and absorption in the body. Brazil is the largest producer of cassava in the world, and the flour produced from this raw material is a source of nutrients for much of the low-income population, however it is little explored industrially. The northeast region of Brazil has great potential for honey production, which is a source of vitamins, proteins, minerals and organic acids but it is much used as a medicine. Aiming to combine the production of healthy food with the sustainable utilization and enhancement of family farming products, was created a cereal bar using regional raw materials of desirable nutritional characteristics: honey, umbu pulp and cassava flour. The cereal bar was characterized by physicochemical analyzes quantifying the content of lipids, proteins, moisture and ashes, microbiological and sensory evaluation showed that the cereal bar is a safe, and nutritious food with good sensory properties.Keywords: cassava flour, cereal bar, honey, insoluble fibre
Procedia PDF Downloads 4694102 The Effects of Three Levels of Contextual Inference among adult Athletes
Authors: Abdulaziz Almustafa
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Considering the critical role permanence has on predictions related to the contextual interference effect on laboratory and field research, this study sought to determine whether the paradigm of the effect depends on the complexity of the skill during the acquisition and transfer phases. The purpose of the present study was to investigate the effects of contextual interference CI by extending previous laboratory and field research with adult athletes through the acquisition and transfer phases. Male (n=60) athletes age 18-22 years-old, were chosen randomly from Eastern Province Clubs. They were assigned to complete blocked, random, or serial practices. Analysis of variance with repeated measures MANOVA indicated that, the results did not support the notion of CI. There were no significant differences in acquisition phase between blocked, serial and random practice groups. During the transfer phase, there were no major differences between the practice groups. Apparently, due to the task complexity, participants were probably confused and not able to use the advantages of contextual interference. This is another contradictory result to contextual interference effects in acquisition and transfer phases in sport settings. One major factor that can influence the effect of contextual interference is task characteristics as the nature of level of difficulty in sport-related skill.Keywords: contextual interference, acquisition, transfer, task difficulty
Procedia PDF Downloads 4664101 Design of S-Shape GPS Application Electrically Small Antenna
Authors: Riki H. Patel, Arpan Desai, Trushit Upadhyaya, Shobhit K. Patel
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The micro strip antennas area has seen some inventive work in recent years and is now one of the most dynamic fields of antenna theory. A novel and simple printed wideband monopole antenna is presented. Printed on a single dielectric substrate and easily fed by using a 50 ohm microstip line, low-profile antenna structure with two parallel S-shaped meandered line of same size. In this research, S–form micro strip patch antenna is designed from measuring the prototypes of the proposed antenna one available bands with 10db return loss bandwidths of about GPS application (GPS L2 1490 MHz) and covering the 1400 to 1580 MHz frequency band at 1.5 GHz The simulated results for main parameters such as return loss, impedance bandwidth, radiation patterns and gains are also discussed herein. The modeling study shows that such antennas, in simplicity design and supply, and can satisfy GPS application. Two parallel slots are incorporated to disturb the surface flow path, introducing local inductive effect. This antenna is fed by a coaxial feeding tube.Keywords: bandwidth, electrically small antenna, microstrip, patch antenna, GPS
Procedia PDF Downloads 4964100 The Application of Animal Welfare for Madura Cow Racing Competition in Madura Island
Authors: Mustopa, Setyawan Wahyu Pradana
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This study aims to determine the application of animal welfare in Madura cow racing competition at Sumenep district, Madura Island. This study conducted by survey and discussion methods with 3 Madura cow owners in the competition. The animal welfare is going to be proved by observing the condition of the cage, the cleanliness of it, feeding and water, the health of the cow, also owner treatments for their Madura cow that will be served as a racer. Observations made using stable conditions ACRES form with assessment scores ranged from 1 = very poor, 2 = poor, 3 = regular, 4 = good and 5 = very good, animal welfare conditions seen by conducting observations and interviews with Madura cow owners. The result shows that the Madura cow competition has fulfilled the criteria of animal welfare application. Application of animal welfare principle by the owner of Madura cow terms of ACRES (Animal Concerns Research and Education Society) below standard, the average score obtained was 2.06, which is mean in a poor ratings. Besides considering the animal welfare application, Madura cow owners also do special treatments for their Madura cow with purpose to produce racers that are healthy and fast. Therefore, if the cow wins in Madura cow racing competition, it will purchase a high-value price.Keywords: animal welfare, competition, Madura cow, racing
Procedia PDF Downloads 2714099 Confidence in Practice of Debate at Senior High School Student in Jakarta, Indonesia
Authors: Arista Mayang Sari Slamet
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This study was conducted to see the shape or behavior that shows the attitude of confidence in the practice of debate on science program students in Senior High School. This research is a descriptive qualitative study by explaining the forms of behavior of each indicator (there are ten indicators) confidence of Santrock. Data collection using interviews with Indonesian language teachers, direct observation, and documents. In this study, it was found that there is one item that is not visible indicator of the high school students of class X, which is the fourth item ‘Sitting with others in social activities’. This is caused by the forum examined are debating forum, so there is a social activity can’t be seen. The result of this study there are two students who do not show the behavior of confidence, their name is Dea and Audria (from the pro team). This indicates that the head of a pro team dominated the debate. The time for the debate is 45 minutes. Therefore all students in both of team can’t demonstrate their debate skill. In each team is only dominated by one student. The most common forms of confidence behavior are expressing opinion, look at the other person (speaker), and keeping eye contact with the other person. This indicates that the attitude of confidence by looking at the other person makes them more confident about their opinion. The most uncommon indicators is to direct or instruct to the other person. This shows that the attitude of self-confidence shown by the students isn’t lead.Keywords: confidence, debate, senior high school, Jakarta
Procedia PDF Downloads 1614098 Outbound Tourism in Developed Countries: Analysis of the Trends, Behavior and the Transformation of the Moroccan Demand for International Travels
Authors: M. Boukhrouk, R. Ed-Dali
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Outbound tourism in Morocco, as in the majority of developing countries, reveals some of the aspects of inequality between the north and the south. Considered by some researchers as one of the facets of the development crisis, access to tourism and especially international tourism is a chance for a small minority with financial means, while the vast portions of the population dream rather of immigrating to a developed country for the sake of improving their standard of living. The right to travel is also limited by visa requirements, procedures in host countries, security and technical measures and creates discrimination in the practice of tourism. These conditions do not seem to be favorable to the democratization of the practice of international tourism for the populations of the southern countries. This paper is a contribution to the reading of the trends of outbound tourism in developing countries through the example of Morocco. It highlights the different aspects of Moroccan outbound tourism, destinations and the behavior of tourists through an analysis of the offer of a sample of 50 travel agencies. In the same vein, it offers a reading grid of the possibilities offered for the development of outbound tourism and the various existing obstacles to the democratization of international outbound tourism in the southern countries. This reading reveals the transformation in the behavior of Moroccan international tourists as well as the profound changes in Moroccan society, through a model of statistical analysis.Keywords: demand, Hajj, Morocco, outbound tourism, tendency, Umrah
Procedia PDF Downloads 1764097 Preventing the Drought of Lakes by Using Deep Reinforcement Learning in France
Authors: Farzaneh Sarbandi Farahani
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Drought and decrease in the level of lakes in recent years due to global warming and excessive use of water resources feeding lakes are of great importance, and this research has provided a structure to investigate this issue. First, the information required for simulating lake drought is provided with strong references and necessary assumptions. Entity-Component-System (ECS) structure has been used for simulation, which can consider assumptions flexibly in simulation. Three major users (i.e., Industry, agriculture, and Domestic users) consume water from groundwater and surface water (i.e., streams, rivers and lakes). Lake Mead has been considered for simulation, and the information necessary to investigate its drought has also been provided. The results are presented in the form of a scenario-based design and optimal strategy selection. For optimal strategy selection, a deep reinforcement algorithm is developed to select the best set of strategies among all possible projects. These results can provide a better view of how to plan to prevent lake drought.Keywords: drought simulation, Mead lake, entity component system programming, deep reinforcement learning
Procedia PDF Downloads 914096 Perspectives of Healthcare Workers on Healthcare-Associated Infections and Infection Control in a Tertiary Care Hospital in Abha, Saudi Arabia
Authors: Esther Paul, Ibrahim A. M. Alzaydani, Al Hakami, Caryl Beynon
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Research Objectives and Goal: The main aim of the current study was to explore the perspectives of healthcare workers on Healthcare-associated infections (HAI) and infection control measures in a tertiary care Hospital in Abha, Saudi Arabia. As per our knowledge, this is perhaps the first qualitative study on HAI to be done in Saudi Arabia. The goal of the study was to understand the perspectives of the healthcare workers on the current protocol and guidelines for HAI and infections control measures in the hospital, the effectiveness of the current protocol for HAI and infection control measures and ways of reducing the incidence of HAI and improve infection control measures. Methods used: A qualitative research design was used to collect the data from 25 healthcare workers consisting of doctors and nurses, recruited by Snowball strategy via semi-structured interviews which were audio-recorded and transcribed verbatim immediately. An interview guide consisting of open-ended questions about the existing HAI and infection control practices in the healthcare facility, the awareness of the healthcare workers about HAI and the need for safe infection control measures were used to collect the data. The transcribed data were analyzed using the thematic analysis method. Results: Using thematic analysis four themes were identified.1.Knowledge of HAI and infection control 2. Infection control measures in practice 3. The gap in infection control measures and HAI 4. Required Implementations. The first theme covered the participants' knowledge on HAI, its definition, the types of HAI and the infection control measures.Most of the participants were aware of HAI and had some idea of the definition of HAI, its significance and the dangers posed by HAI, but few residents had no idea of the types of HAI. The second theme was focussed on the infection control measures in practice. Most of the participants were aware of the importance of infection control measures like hand hygiene, catheter care, and waste disposal. The nurses were responsible for most of the disinfection and sterilization measures and practiced it effectively. However, some doctors and residents had no inkling about these measures. The third theme emphasized that although most of the participants were aware of HAI and infection control measures and were in practice. There were some lacunae regarding their knowledge of the different types of HAI, Personal Protective Equipment practices, communication among the healthcare personnel and the hospital administrations and the means of waste disposal. The fourth and the final theme identified that most of the participants felt the need for implementations of changes regarding existing protocols, workshops/seminars, methods of waste disposal and sterilization and disinfection practices. Conclusion: The current qualitative study concluded that there is a need for better educational programs and hands-on training for all the healthcare personnel including the paramedical staff as well. The residents should have adequate knowledge of infection control practices to guide the nurses and should share the responsibility with the nurses in the practice of effective infection control measuresKeywords: healthcare-associated infections, infection control measures, perspectives, qualitative
Procedia PDF Downloads 2184095 Chemical, Biochemical and Sensory Evaluation of a Quadrimix Complementary Food Developed from Sorghum, Groundnut, Crayfish and Pawpaw Blends
Authors: Ogechi Nzeagwu, Assumpta Osuagwu, Charlse Nkwoala
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Malnutrition in infants due to poverty, poor feeding practices, and high cost of commercial complementary foods among others is a concern in developing countries. The study evaluated the proximate, vitamin and mineral compositions, antinutrients and functional properties, biochemical, haematological and sensory evaluation of complementary food made from sorghum, groundnut, crayfish and paw-paw flour blends using standard procedures. The blends were formulated on protein requirement of infants (18 g/day) using Nutrisurvey linear programming software in ratio of sorghum(S), groundnut(G), crayfish(C) and pawpaw(P) flours as 50:25:10:15(SGCP1), 60:20:10:10 (SGCP2), 60:15:15:10 (SGCP3) and 60:10:20:10 (SGCP4). Plain-pap (fermented maize flour)(TCF) and cerelac (commercial complementary food) served as basal and control diets. Thirty weanling male albino rats aged 28-35 days weighing 33-60 g were purchased and used for the study. The rats after acclimatization were fed with gruel produced with the experimental diets and the control with water ad libitum daily for 35days. Effect of the blends on lipid profile, blood glucose, haematological (RBC, HB, PCV, MCV), liver and kidney function and weight gain of the rats were assessed. Acceptability of the gruel was conducted at the end of rat feeding on forty mothers of infants’ ≥ 6 months who gave their informed consent to participate using a 9 point hedonic scale. Data was analyzed for means and standard deviation, analysis of variance and means were separated using Duncan multiple range test and significance judged at 0.05, all using SPSS version 22.0. The results indicated that crude protein, fibre, ash and carbohydrate of the formulated diets were either comparable or higher than values in cerelac. The formulated diets (SGCP1- SGCP4) were significantly (P>0.05) higher in vitamin A and thiamin compared to cerelac. The iron content of the formulated diets SGCP1- SGCP4 (4.23-6.36 mg/100) were within the recommended iron intake of infants (0.55 mg/day). Phytate (1.56-2.55 mg/100g) and oxalate (0.23-0.35 mg/100g) contents of the formulated diets were within the permissible limits of 0-5%. In functional properties, bulk density, swelling index, % dispersibility and water absorption capacity significantly (P<0.05) increased and compared favourably with cerelac. The essential amino acids of the formulated blends were within the amino acid profile of the FAO/WHO/UNU reference protein for children 0.5 -2 years of age. Urea concentration of rats fed with SGCP1-SGCP4 (19.48 mmol/L),(23.76 mmol/L),(24.07 mmol/L),(23.65 mmol/L) respectively was significantly higher than that of rat fed cerelac (16.98 mmol/L); however, plain pap had the least value (9.15 mmol/L). Rats fed with SGCP1-SGCP4 (116 mg/dl), (119 mg/dl), (115 mg/dl), (117 mg/dl) respectively had significantly higher glucose levels those fed with cerelac (108 mg/dl). Liver function parameters (AST, ALP and ALT), lipid profile (triglyceride, HDL, LDL, VLDL) and hematological parameters of rats fed with formulated diets were within normal range. Rats fed SGCP1 gained more weight (90.45 g) than other rats fed with SGCP2-SGCP4 (71.65 g, 79.76 g, 75.68 g), TCF (20.13 g) and cerelac (59.06 g). In all the sensory attributes, the control was preferred with respect to the formulated diets. The formulated diets were generally adequate and may likely have potentials to meet nutrient requirements of infants as complementary food.Keywords: biochemical, chemical evaluation, complementary food, quadrimix
Procedia PDF Downloads 1704094 Humanitarianism as the New Face of Religion Practice: A Nigerian Experience
Authors: Nicholas Okpe
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As the world gets more and more engulfed in both man-made and natural disasters, the call for religious intervention becomes intrinsically louder to the extent that any religious inclination that does not devolve into societal or humanitarian adventures makes no meaning. Wars, conflicts, environmental disturbances have thrown new challenges hitherto unknown to the doorsteps of religious groups for intervention as the last hope of humanity. In Nigeria, since the last two decades, many things have fallen apart that have led to humanitarian crisis from the North to the South and from the East to the West. Over five million Nigerians live in internally displaced camps all over the country due to the various forms of social unrest as well as natural disasters, especially floods. These problems have brought forth the signifance of various religious groups who through their interventions have often shown to be the hope of the people. This paper examines the latent potentials of religion in not only making people to cope with difficult situations they find themselves in, but also giving sucure to the many who otherwise are despondent and at the edge of life. Many religious groups have well developed plans of interventions in various humanitarian situations. The efforts of religions such as christianity, Islam and the indigenous African religion is exrayed and assessed for proper evaluation. The paper finds out that the most potent and effective means of attending to humanitarian crisis today in Nigeria is through the various religious organization as governments at various levels have lost credibility in such exercises.Keywords: humanitarianism, religion. nigeria, society, practice
Procedia PDF Downloads 424093 Comparison of Patient Satisfaction and Observer Rating of Outpatient Care among Public Hospitals in Shanghai
Authors: Tian Yi Du, Guan Rong Fan, Dong Dong Zou, Di Xue
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Background: The patient satisfaction survey is becoming of increasing importance for hospitals or other providers to get more reimbursement and/or more governmental subsidies. However, when the results of patient satisfaction survey are compared among medical institutions, there are some concerns. The primary objectives of this study were to evaluate patient satisfaction in tertiary hospitals of Shanghai and to compare the satisfaction rating on physician services between patients and observers. Methods: Two hundred outpatients were randomly selected for patient satisfaction survey in each of 28 public tertiary hospitals of Shanghai. Four or five volunteers were selected to observe 5 physicians’ practice in each of above hospitals and rated observed physicians’ practice. The outpatients that the volunteers observed their physician practice also filled in the satisfaction questionnaires. The rating scale for outpatient survey and volunteers’ observation was: 1 (very dissatisfied) to 6 (very satisfied). If the rating was equal to or greater than 5, we considered the outpatients and volunteers were satisfied with the services. The validity and reliability of the measure were assessed. Multivariate regressions for each of the 4 dimensions and overall of patient satisfaction were used in analyses. Paired t tests were applied to analyze the rating agreement on physician services between outpatients and volunteers. Results: Overall, 90% of surveyed outpatients were satisfied with outpatient care in the tertiary public hospitals of Shanghai. The lowest three satisfaction rates were seen in the items of ‘Restrooms were sanitary and not crowded’ (81%), ‘It was convenient for the patient to pay medical bills’ (82%), and ‘Medical cost in the hospital was reasonable’ (84%). After adjusting the characteristics of patients, the patient satisfaction in general hospitals was higher than that in specialty hospitals. In addition, after controlling the patient characteristics and number of hospital visits, the hospitals with higher outpatient cost per visit had lower patient satisfaction. Paired t tests showed that the rating on 6 items in the dimension of physician services (total 14 items) was significantly different between outpatients and observers, in which 5 were rated lower by the observers than by the outpatients. Conclusions: The hospital managers and physicians should use patient satisfaction and observers’ evaluation to detect the room for improvement in areas such as social skills cost control, and medical ethics.Keywords: patient satisfaction, observation, quality, hospital
Procedia PDF Downloads 3244092 Nurses’ Views on ‘Effective Nurse Leader’ Characteristics in Iraq
Authors: S. Abed, S. O’Neill
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This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.Keywords: health care, nurse education, nursing in Iraq, nurse leadership
Procedia PDF Downloads 2754091 Influence of Engaging Female Caregivers in Households with Adolescent Girls on Adopting Equitable Family Eating Practices: A Quasi-Experimental Study
Authors: Hanna Gulema, Meaza Demissie, Alemayehu Worku, Tesfaye Assebe Yadeta, Yemane Berhane
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Background: In patriarchal societies, female caregivers decide on food allocation within a family based on prevailing gender and age norms, which may lead to inequality that does not favor young adolescent girls. This study evaluated the effect of a community-based social norm intervention involving female caregivers in West Hararghe, Ethiopia. The intervention was engaging female caregivers along with other adult influential community members to deliberate and act on food allocation social norms in a process referred to as Social Analysis and Action (SAA). Method: We used data from a large quasi-experimental study to compare family eating practices between those who participated in the Social Analyses and Action intervention and those who did not. The respondents were female caregivers in households with young adolescent girls (ages 13 and 14 years). The study’s outcome was the practice of family eating together from the same dish. The difference in difference (DID) analysis with the Mixed effect logistic regression model was used to examine the effect of the intervention. Result: The results showed improved family eating practices in both groups, but the improvement was greater in the intervention group. The DID analysis showed an 11.99 percentage points greater improvement in the intervention arm than in the control arm. The mixed-effect regression produced an adjusted odds ratio of 2.08 (95% CI [1.06–4.09]) after controlling selected covariates, p-value 0.033. Conclusions: The involvement of influential adult community members significantly improves the family practice of eating together in households where adolescent girls are present in our study. The intervention has great potential to minimize household food allocation inequalities and thus improve the nutritional status of young adolescents. Further studies are necessary to evaluate the effectiveness of the intervention in different social norm contexts to formulate policy and guidelines for scale-up.Keywords: family eating practice, social norm intervention, adolescence girls, caregiver
Procedia PDF Downloads 694090 Confirming the Factors of Professional Readiness in Athletic Training
Authors: Philip A. Szlosek, M. Susan Guyer, Mary G. Barnum, Elizabeth M. Mullin
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In the United States, athletic training is a healthcare profession that encompasses the prevention, examination, diagnosis, treatment, and rehabilitation of injuries and medical conditions. Athletic trainers work under the direction of or in collaboration with a physician and are recognized by the American Medical Association as allied healthcare professionals. Internationally, this profession is often known as athletic therapy. As healthcare professionals, athletic trainers must be prepared for autonomous practice immediately after graduation. However, new athletic trainers have been shown to have clinical areas of strength and weakness.To better assess professional readiness and improve the preparedness of new athletic trainers, the factors of athletic training professional readiness must be defined. Limited research exists defining the holistic aspects of professional readiness needed for athletic trainers. Confirming the factors of professional readiness in athletic training could enhance the professional preparation of athletic trainers and result in more highly prepared new professionals. The objective of this study was to further explore and confirm the factors of professional readiness in athletic training. Authors useda qualitative design based in grounded theory. Participants included athletic trainers with greater than 24 months of experience from a variety of work settings from each district of the National Athletic Trainer’s Association. Participants took the demographic questionnaire electronically using Qualtrics Survey Software (Provo UT). After completing the demographic questionnaire, 20 participants were selected to complete one-on-one interviews using GoToMeeting audiovisual web conferencing software. IBM Statistical Package for the Social Sciences (SPSS, v. 21.0) was used to calculate descriptive statistics for participant demographics. The first author transcribed all interviews verbatim and utilized a grounded theory approach during qualitative data analysis. Data were analyzed using a constant comparative analysis and open and axial coding. Trustworthiness was established using reflexivity, member checks, and peer reviews. Analysis revealed four overarching themes, including management, interpersonal relations, clinical decision-making, and confidence. Management was categorized as athletic training services not involving direct patient care and was divided into three subthemes, including administration skills, advocacy, and time management. Interpersonal Relations was categorized as the need and ability of the athletic trainer to properly interact with others. Interpersonal relations was divided into three subthemes, including personality traits, communication, and collaborative practice. Clinical decision-making was categorized as the skills and attributes required by the athletic trainer whenmaking clinical decisions related to patient care. Clinical decision-making was divided into three subthemes including clinical skills, continuing education, and reflective practice. The final theme was confidence. Participants discussed the importance of confidence regarding relationships building, clinical and administrative duties, and clinical decision-making. Overall, participants explained the value of a well-rounded athletic trainer and emphasized that athletic trainers need communication and organizational skills, the ability to collaborate, and must value self-reflection and continuing education in addition to having clinical expertise. Future research should finalize a comprehensive model of professional readiness for athletic training, develop a holistic assessment instrument for athletic training professional readiness, and explore the preparedness of new athletic trainers.Keywords: autonomous practice, newly certified athletic trainer, preparedness for professional practice, transition to practice skills
Procedia PDF Downloads 1494089 The Implementation of Corporate Social Responsibility to Contribute the Isolated District and the Drop behind District to Overcome the Poverty, Study Cases: PT. Kaltim Prima Coal (KPC) Sanggata, East Borneo, Indonesia
Authors: Sri Suryaningsum
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The achievement ‘Best Practice Model’ holds by the government on behalf of the success implementation corporate social responsibility program that held on PT. Kaltim Prima Coal which had operation located in the isolated district in Sanggata, it could be the reference for the other companies to improve the social welfare in surrounding area, especially for the companies that have operated in the isolated area in Indonesia. The rule of Kaltim Prima Coal as the catalyst in the development progress to push up the independence of district especially for the district which has located in surrounding mining operation from village level to the regency level, those programs had written in the 7 field program in Corporate Social Responsibility, it was doing by stakeholders. The stakeholders are village government, sub-district government, Regency and citizen. One of the best programs that implement at PT. Kaltim Prima Coal is Regarding Resettlement that was completed based on Asian Development Bank Resettlement Best Practice and International Financial Corporation Resettlement Action Plan. This program contributed on the resettlement residences to develop the isolated and the neglected district.Keywords: CSR, isolated, neglected, poverty, mining industry
Procedia PDF Downloads 2474088 The Background of Ornamental Design Practice: Theory and Practice Based Research on Ornamental Traditions
Authors: Jenna Pyorala
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This research looks at the principles and purposes ornamental design has served in the field of textile design. Ornamental designs are characterized by richness of details, abundance of elements, vegetative motifs and organic forms that flow harmoniously in complex compositions. Research on ornamental design is significant, because ornaments have been overlooked and considered as less meaningful and aesthetically pleasing than minimalistic, modern designs. This is despite the fact that in many parts of the world ornaments have been an important part of the cultural identification and expression for centuries. Ornament has been claimed to be superficial and merely used as a decorative way to hide the faults of designs. Such generalization is an incorrect interpretation of the real purposes of ornament. Many ornamental patterns tell stories, present mythological scenes or convey symbolistic meanings. Historically, ornamental decorations have been representing ideas and characteristics such as abundance, wealth, power and personal magnificence. The production of fine ornaments required refined skill, eye for intricate detail and perseverance while compiling complex elements into harmonious compositions. For this reason, ornaments have played an important role in the advancement of craftsmanship. Even though it has been claimed that people in the western design world have lost the relationship to ornament, the relation to it has merely changed from the practice of a craftsman to conceptualisation of a designer. With the help of new technological tools the production of ornaments has become faster and more efficient, demanding less manual labour. Designers who commit to this style of organic forms and vegetative motifs embrace and respect nature by representing its organically growing forms and by following its principles. The complexity of the designs is used as a way to evoke a sense of extraordinary beauty and stimulate intellect by freeing the mind from the predetermined interpretations. Through the study of these purposes it can be demonstrated that complex and richer design styles are as valuable a part of the world of design as more modern design approaches. The study highlights the meaning of ornaments by presenting visual examples and literature research findings. The practice based part of the project is the visual analysis of historical and cultural ornamental traditions such as Indian Chikan embroidery, Persian carpets, Art Nouveau and Rococo according to the rubric created for the purpose. The next step is the creation of ornamental designs based on the key elements in different styles. Theoretical and practical parts are woven together in this study that respects respect the long traditions of ornaments and highlight the importance of these design approaches to the field, in contrast to the more commonly preferred styles.Keywords: cultural design traditions, ornamental design, organic forms from nature, textile design
Procedia PDF Downloads 2264087 Integrating Sustainable Construction Principles into Curriculum Design for Built Environment Professional Programs in Nigeria
Authors: M. Yakubu, M. B. Isah, S. Bako
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This paper presents the findings of a research which sought to investigate the readiness to integrate sustainable construction principles into curriculum design for built environment professional programs in the Nigerian Universities. Developing the knowledge and understanding that construction professionals acquire of sustainable construction practice leads to considerable improvement in the environmental performance of the construction sector. Integrating sustainable environmental issues within the built environment education curricula provide the basis of this research. An integration of sustainable development principles into the universities built environment professional programmes are carried out with a view of finding solutions to the key issues identified. The perspectives of academia have been assessed and findings tested for validity through the analysis of primary quantitative data that has been collected. The secondary data generated has shown that there are significant differences in the approach to curriculum design within the built environment professional programmes, and this reveals that there is no ‘best practice’ that is clearly identifiable. Sequel to the above, this research reveals that engaging all stakeholders would be a useful component of built environment curriculum development, and that the curriculum be negotiated with interested parties. These parties have been identified as academia, government, construction industry and built environment professionals.Keywords: built environment, curriculum development, sustainable construction, sustainable development
Procedia PDF Downloads 4204086 Socio Economic Impact and Status of the Islamic Perspective of Veil
Authors: Shagufta Jahangir, Nadeemullah, Yaqoob, Raisa Jahangir
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The Persian language word ‘Purdah’ and in Arabic ‘Hajab’ is used for veil. Veil has been used by women for being escaped from men. In one way or the other veil has been continuously used in ancient as well as modern civilizations by women. Developed nations have blamed the use of veil an obstacle in the process of development. Therefore, modern nations have struggled to get rid of the use of veil. They argue that it is a sign of slavery for women and it is an obstacle in the path of development. The modern secular Muslims considered veil as the biggest obstacle for social and economic development. It makes a woman helpless, as being zanjir in her feet. It has become an obstacle in the process of development for women. It is also considered as a tool for segregation among men and women. The so called Muslims of the modern era are trying to introduce changes in religion by imitation the modern nations of the world. In particular ways for Muslim woman use of veil in Islam is must. It is a right provided her by religion. It provides her strength. In the Holy Quran word ‘Hajab’ is used 5 times. Islam is against domination and forceful practice of veil, as a part of teaching of Islam it is being adopted by women as a protection. This article aims at: (1) historical background of veil (2) Its existence in civilizations, (3) Meaning and interpretation of veil in Islamic context, (4) Economic impact of it on women (5) Discussion on its practice in Islamic (eastern) and other (European) circles and conclusions followed by concerted bibliography.Keywords: veil, economic development, civilizations, obstacle, secular Muslims, segregation
Procedia PDF Downloads 3284085 Motherhood Practices and Symbolic Capital: A Study of Teen Mothers in Northeastern Thailand
Authors: Ampai Muensit, Maniemai Thongyou, Patcharin Lapanun
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Teen mothers have been viewed as ‘a powerless’ facing numerous pressures including poverty, immaturity of motherhood, and especially social blame.This paper argues that, to endure as an agent, they keep struggling to overcome all difficulties in their everyday life by using certain symbols to negotiate the situations they encounter, and to obtain a social position without surrendering to the dominating socio-cultural structure. Guided by Bourdieu’s theory of practice, this study looks at how teen mothers use symbolic capital in their motherhood practices. Although motherhood practices can be found in different contexts with various types of capital utilization, this paper focuses on the use of symbolic capitals in teen mothers’ practices within the contexts of the community. The study employs a qualitative methodology; data was collected from 12 informants through life history, in-depth interview, observation and the content analytical method was employed for data analysis. The findings show that child and motherhood were key symbolic capitals in motherhood practices. Employing such capitals teen mothers can achieve an acceptance from community – particularly from the new community. These symbolic capitals were the important sources of teen mothers’ power to turn the tide by changing their status – from “the powerless” to be “the agent”. The use of symbolic capitals also related to habitus of teen mothers in better compromising for an appropriate social position.Keywords: teen mother, motherhood practice, symbolic capital, community
Procedia PDF Downloads 2674084 Acute Respiratory Distress Syndrome (ARDS) Developed Clinical Pathway: Suggested Protocol
Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah
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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome
Procedia PDF Downloads 5344083 Socio-Technical Systems: Transforming Theory into Practice
Authors: L. Ngowi, N. H. Mvungi
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This paper critically examines the evolution of socio-technical systems theory, its practices, and challenges in system design and development. It examines concepts put forward by researchers focusing on the application of the theory in software engineering. There are various methods developed that use socio-technical concepts based on systems engineering without remarkable success. The main constraint is the large amount of data and inefficient techniques used in the application of the concepts in system engineering for developing time-bound systems and within a limited/controlled budget. This paper critically examines each of the methods, highlight bottlenecks and suggest the way forward. Since socio-technical systems theory only explains what to do, but not how doing it, hence engineers are not using the concept to save time, costs and reduce risks associated with new frameworks. Hence, a new framework, which can be considered as a practical approach is proposed that borrows concepts from soft systems method, agile systems development and object-oriented analysis and design to bridge the gap between theory and practice. The approach will enable the development of systems using socio-technical systems theory to attract/enable the system engineers/software developers to use socio-technical systems theory in building worthwhile information systems to avoid fragilities and hostilities in the work environment.Keywords: socio-technical systems, human centered design, software engineering, cognitive engineering, soft systems, systems engineering
Procedia PDF Downloads 2864082 Online Faculty Professional Development: An Approach to the Design Process
Authors: Marie Bountrogianni, Leonora Zefi, Krystle Phirangee, Naza Djafarova
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Faculty development is critical for any institution as it impacts students’ learning experiences and faculty performance with regards to course delivery. With that in mind, The Chang School at Ryerson University embarked on an initiative to develop a comprehensive, relevant faculty development program for online faculty and instructors. Teaching Adult Learners Online (TALO) is a professional development program designed to build capacity among online teaching faculty to enhance communication/facilitation skills for online instruction and establish a Community of Practice to allow for opportunities for online faculty to network and exchange ideas and experiences. TALO is comprised of four online modules and each module provides three hours of learning materials. The topics focus on online teaching and learning experience, principles and practices, opportunities and challenges in online assessments as well as course design and development. TALO offers a unique experience for online instructors who are placed in the role of a student and an instructor through interactivities involving discussions, hands-on assignments, peer mentoring while experimenting with technological tools available for their online teaching. Through exchanges and informal peer mentoring, a small interdisciplinary community of practice has started to take shape. Successful participants have to meet four requirements for completion: i) participate actively in online discussions and activities, ii) develop a communication plan for the course they are teaching, iii) design one learning activity/or media component, iv) design one online learning module. This study adopted a mixed methods exploratory sequential design. For the qualitative phase of this study, a thorough literature review was conducted on what constitutes effective faculty development programs. Based on that review, the design team identified desired competencies for online teaching/facilitation and course design. Once the competencies were identified, a focus group interview with The Chang School teaching community was conducted as a needs assessment and to validate the competencies. In the quantitative phase, questionnaires were distributed to instructors and faculty after the program was launched to continue ongoing evaluation and revisions, in hopes of further improving the program to meet the teaching community’s needs. Four faculty members participated in a one-hour focus group interview. Major findings from the focus group interview revealed that for the training program, faculty wanted i) to better engage students online, ii) to enhance their online teaching with specific strategies, iii) to explore different ways to assess students online. 91 faculty members completed the questionnaire in which findings indicated that: i) the majority of faculty stated that they gained the necessary skills to demonstrate instructor presence through communication and use of technological tools provided, ii) increased faculty confidence with course management strategies, iii) learning from peers is most effective – the Community of Practice is strengthened and valued even more as program alumni become facilitators. Although this professional development program is not mandatory for online instructors, since its launch in Fall 2014, over 152 online instructors have successfully completed the program. A Community of Practice emerged as a result of the program and participants continue to exchange thoughts and ideas about online teaching and learning.Keywords: community of practice, customized, faculty development, inclusive design
Procedia PDF Downloads 1754081 Integrating Knowledge into Health Care Systems: A Case Study Investigation on UAE Health Care
Authors: Alya Al Ghufli, Kelaithim Al Tunaiji, Sara Al Ali, Khalid Samara
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It is well known that health care systems encompass a variety of key knowledge sources that need to be integrated and shared amongst all types of users to attain higher-levels of motivation and productivity. The development of Health Integrated Systems (HIS) is often seen as a crucial step in strengthening the integration of knowledge to help serve the information needs of health care users. As an emergent economy, the United Arab Emirates (UAE) is regarded as a new arrival in the area of health information systems. As a new nation, there may be several challenges in terms of organisational climate and the sufficient skills and knowledge activities for effective use of HIS. In this regard, the lack of coordination, attitudes and practice of health-related systems can eventually result in unnecessary data and generally poor use of the system. This paper includes results from a qualitative preliminary study carried out from a case study investigation in a single large primary health care organisation in the United Arab Emirates (UAE) comprising various health care users. The study explored health care user’s perceptions about health integration and the impact it has on their practice. The main sources of information were semi-structured interviews and non-obtrusive observations. The authors conclude by presenting various recommendations for the development of HIS and knowledge activities and areas for further study.Keywords: health integrated systems, knowledge sharing, knowledge activities, health information systems
Procedia PDF Downloads 4364080 Gamification Teacher Professional Development: Engaging Language Learners in STEMS through Game-Based Learning
Authors: Karen Guerrero
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Kindergarten-12th grade teachers engaged in teacher professional development (PD) on game-based learning techniques and strategies to support teaching STEMSS (STEM + Social Studies with an emphasis on geography across the curriculum) to language learners. Ten effective strategies have supported teaching content and language in tandem. To provide exiting teacher PD on summer and spring breaks, gamification has integrated these strategies to engage linguistically diverse student populations to provide informal language practice while students engage in the content. Teachers brought a STEMSS lesson to the PD, engaged in a wide variety of games (dice, cards, board, physical, digital, etc.), critiqued the games based on gaming elements, then developed, brainstormed, presented, piloted, and published their game-based STEMSS lessons to share with their colleagues. Pre and post-surveys and focus groups were conducted to demonstrate an increase in knowledge, skills, and self-efficacy in using gamification to teach content in the classroom. Provide an engaging strategy (gamification) to support teaching content and language to linguistically diverse students in the K-12 classroom. Game-based learning supports informal language practice while developing academic vocabulary utilized in the game elements/content focus, building both content knowledge through play and language development through practice. The study also investigated teacher's increase in knowledge, skills, and self-efficacy in using games to teach language learners. Mixed methods were used to investigate knowledge, skills, and self-efficacy prior to and after the gamification teacher training (pre/post) and to understand the content and application of developing and utilizing game-based learning to teach. This study will contribute to the body of knowledge in applying game-based learning theories to the K-12 classroom to support English learners in developing English skills and STEMSS content knowledge.Keywords: gamification, teacher professional development, STEM, English learners, game-based learning
Procedia PDF Downloads 924079 Coming Closer to Communities of Practice through Situated Learning: The Case Study of Polish-English, English-Polish Undergraduate BA Level Language for Specific Purposes of Translation Class
Authors: Marta Lisowska
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The growing trend of market specialization imposes upon translators the need for proficiency in the working knowledge of specialist discourse. The notion of specialization differs from a broad general category to a highly specialized narrow field. The specialised discourse is used in the channel of communication based upon distinctive features typical for communities of practice whose co-existence is codified and hermetically locked against outsiders. Consequently, any translator deprived of professional discourse competence and social skills is incapable of providing competent translation product from source language into target language. In this paper, we report on research that explores the pedagogical practices aiming to bridge the dichotomy between the professionals and the specialist translators, while accounting for the reality of the world of professional communities entered by undergraduates on two levels: the text-based generic, and the social one. Drawing from the functional social constructivist approach, seen here as situated learning, this paper reports on the case of English-Polish, Polish-English undergraduate BA Level LSP of law translation class run in line with the simulated classroom-based and the reality-based (apprenticeship) approach. This blended method serves the purpose of introducing the young trainees to the professional world. The research provides new insights into how the LSP translation undergraduates become legitimized through discursive and social participation and engagement. The undergraduates, situated peripherally at the outset, experience their own transformation towards becoming members of these professional groups. With subjective evaluation, the trainees take a stance on this dual mode class and development of their skills. Comparing and contrasting their own work done in line with two models of translation teaching: authentic and near-authentic, the undergraduates answer research questions devised by a questionnaire survey The responses take us closer to how students feel about their LSP translation competence development. The major findings show how the trainees perceive the benefits and hardships of their functional translation class. In terms of skills, they related to communication as the most enhanced one; they highly valued the fact of being ‘exposed’ to a variety of texts (cf. multi literalism), team work, learning how to schedule work, IT skills boost and the ability to learn how to work individually. Another finding indicates that students struggled most with specialized language, and co-working with other students. The short-term research shows the momentum when the undergraduate LSP translation trainees entered the path of transformation i.e. gained consciousness of ‘how it is’ to be a participant-translator of real-life communities of practice, gaining pragmatic dint of the social and linguistic skills understood here as discursive competence (text > genre > discourse > professional practice). The undergraduates need to be aware of the work they have to do and challenges they are to face before arriving at the expert level of professional translation competence.Keywords: communities of practice in LSP translation teaching, learning LSP translation as situated experience, peripheral participation, professional discourse for LSP translation teaching, professional translation competence
Procedia PDF Downloads 954078 Survival Analysis after a First Ischaemic Stroke Event: A Case-Control Study in the Adult Population of England.
Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski
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Stroke is associated with a significant risk of morbidity and mortality. There is scarcity of research on the long-term survival after first-ever ischaemic stroke (IS) events in England with regards to effects of different medical therapies and comorbidities. The objective of this study was to model the all-cause mortality after an IS diagnosis in the adult population of England. Using a retrospective case-control design, we extracted the electronic medical records of patients born prior to or in year 1960 in England with a first-ever ischaemic stroke diagnosis from January 1986 to January 2017 within the Health and Improvement Network (THIN) database. Participants with a history of ischaemic stroke were matched to 3 controls by sex and age at diagnosis and general practice. The primary outcome was the all-cause mortality. The hazards of the all-cause mortality were estimated using a Weibull-Cox survival model which included both scale and shape effects and a shared random effect of general practice. The model included sex, birth cohort, socio-economic status, comorbidities and medical therapies. 20,250 patients with a history of IS (cases) and 55,519 controls were followed up to 30 years. From 2008 to 2015, the one-year all-cause mortality for the IS patients declined with an absolute change of -0.5%. Preventive treatments to cases increased considerably over time. These included prescriptions of statins and antihypertensives. However, prescriptions for antiplatelet drugs decreased in the routine general practice since 2010. The survival model revealed a survival benefit of antiplatelet treatment to stroke survivors with hazard ratio (HR) of 0.92 (0.90 – 0.94). IS diagnosis had significant interactions with gender and age at entry and hypertension diagnosis. IS diagnosis was associated with high risk of all-cause mortality with HR= 3.39 (3.05-3.72) for cases compared to controls. Hypertension was associated with poor survival with HR = 4.79 (4.49 - 5.09) for hypertensive cases relative to non-hypertensive controls, though the detrimental effect of hypertension has not reached significance for hypertensive controls, HR = 1.19(0.82-1.56). This study of English primary care data showed that between 2008 and 2015, the rates of prescriptions of stroke preventive treatments increased, and a short-term all-cause mortality after IS stroke declined. However, stroke resulted in poor long-term survival. Hypertension, a modifiable risk factor, was found to be associated with poor survival outcomes in IS patients. Antiplatelet drugs were found to be protective to survival. Better efforts are required to reduce the burden of stroke through health service development and primary prevention.Keywords: general practice, hazard ratio, health improvement network (THIN), ischaemic stroke, multiple imputation, Weibull-Cox model.
Procedia PDF Downloads 186