Search results for: medical record

Authors: Manganyi Patricia Siphiwe

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Work environments are characterised by performance pressure and mechanisation, which lead to job stress and the dehumanisation of work spaces. The personnel’s competence to accomplish job responsibilities and high job demands lead to a substantial load of health. Therefore, providing employees with conducive working environments is essential. In order to attain it, the employer should ensure that responsive and institutional safe systems are in place. The employer’s responses to employees’ needs are of significance to a healthy and developmental work environment. Denying employees a developmental and flourishing workplace is to deprive a workplace of being humane. Stressors coming from various aspects in the workplace can yield undue pressure and undesired responses for the workforces. Against the profiled background, this paper examines the causes and consequences of workplace stress within the Emergency Medical sector. The paper utilised a qualitative methodology and in-depth interviews for data collection with the purposively sampled emergency medical personnel. The findings showed that workplace stress has been associated with high demands and lack of support which has an adverse effect on biopsychosocial wellbeing of employees. This paper, therefore, recommends an engaged involvement of social workers through work organisational initiatives, such as Employee Assistance Programmes (EAP) and related labour relations policy activities to promote positive and developmental working environments.

Keywords: stress, employee, workplace, wellbeing

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Authors: Sushil Kumar Singh, Vivek Tewarson, Sarvesh Kumar, Shobhit Kumar

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Objective: ‘Beating Heart coronary artery bypass grafting on Intermittent Pump Support’ is a more reliable method of coronary revascularization that takes advantage of off and on-pump CABG while eliminating the disadvantage of both techniques. Methods: From January 2015 to December 2021, a new technique, “Intermittent On pump beating heart CABG” using a suction stabilizer was used by putting aortic and venous cannulas electively in all the patients. Patients were supported by a pump intermittently, as and when required (Group 1, n=254). Retrospective data were collected from our record of the patients who underwent off-pump CABG electively by the same surgeon and team (Group 2, n=254). Results: Significant advantage was noted in Group 1 patients in terms of the number of grafts (3.31 ± 1.16 vs. 2.30 ±0.66), grafting of lateral vessels (316 vs.202), mean operating time (1.37 ± 0.23 hrs vs. 2.22 ± 0.45 hrs) and postoperative blood loss (406.30 ± 257.90 ml vs. 567.41 ± 265.20 ml).CPB support time was less than 15 minutes in the majority of patients (n=179, 70.37 %), with a mean of 16.81 minutes. It was required, particularly during the grafting of lateral vessels. A rise in enzymes level (CRP, CKMB, Trop I, and NTPro BNP) was noted in Group 1 patients. But, these did not affect the postoperative course in patients. There was no mortality in Group 1 patients, while four patients in Group 2 died. Coclusions: Intermittent on-pump CABG technique is a promising method of surgical revascularization for all patients requiring CABG. It has shown its superiority in terms of safety, the number of grafts, operating time, and better perioperative course.

Keywords: cardiopulmonary bypass, CABG, beating heart CABG, on-pump CABG

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Authors: Abdesselam Babouri, Ahcène Lemzadmi, M Rahmane, B. Belhadi, N. Abouchi

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Medical monitoring aims at monitoring and remotely controlling the vital physiological parameters of the patient. The physiological sensors provide repetitive measurements of these parameters in the form of electrical signals that vary continuously over time. Various measures allow informing us about the health of the person's physiological data (weight, blood pressure, heart rate or specific to a disease), environmental conditions (temperature, humidity, light, noise level) and displacement and movements (physical efforts and the completion of major daily living activities). The collected data will allow monitoring the patient’s condition and alerting in case of modification. They are also used in the diagnosis and decision making on medical treatment and the health of the patient. This work presents the implementation of a monitoring system to be used for the control of physiological parameters.

Keywords: clinical monitoring, physiological parameters, biomedical sensors, personal health

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Authors: Glyn Atwal, Douglas Bryson

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The rapid expansion of a consumer class in India has also coincided with an increasing awareness of social and environmental issues. The overall objective of this study explores to what extent Corporate Social Responsibility (CSR) can lead to luxury brand avoidance within an Indian context. In-depth interviews were conducted with luxury consumers in New Delhi. The demographic breakdown of those interviewed was 16 males and 9 females, aged between 21 and 44. Antecedents of brand avoidance could be sorted according to two main categories. The first category was consumer dissatisfaction due to poor product or service performance. Customer service, particularly within the hospitality sector, was identified as a defining source of brand avoidance. The second category was negative stereotypes of brand users. A salient finding was that no single participant explicitly identified CSR as a source of brand avoidance. However, the interviews revealed that luxury consumers are in fact concerned about CSR issues but assume that international luxury brands have a positive record on CSR performance. Interestingly, participants placed greater emphasis on the broader interpretation of ‘corporate reputation’ rather than specific social or environmental issues to determine the CSR performance of a luxury brand. The findings reported in this exploratory study suggest that Indian luxury consumers do value the overall CSR performance of luxury brands expressed as a brand responsibility or brand reputation, and this is a potential source of brand avoidance. International luxury brands need, therefore, consider developing but also communicating a positive CSR strategy in order to reduce the risk of customers forming negative opinions about the brand.

Keywords: brand avoidance, CSR, luxury

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Authors: Jan C. Droste, Justine Burns, Nithin Narayan

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Introduction: Life-threatening detrimental effects of inappropriate adrenaline (epinephrine) administration, e.g., by giving the wrong dose, in the context of anaphylaxis management is well documented in the medical literature. Half of the fatal anaphylactic reactions in the UK are iatrogenic, and the median time to a cardio-respiratory arrest can be as short as 5 minutes. It is therefore imperative that hospital doctors of all grades have active and accurate knowledge of the correct route, site, and dosage of administration of adrenaline. Given this time constraint and the potential fatal outcome with inappropriate management of anaphylaxis, it is alarming that surveys over the last 15 years have repeatedly shown only a minority of doctors to have accurate knowledge of adrenaline administration as recommended by the UK Resuscitation Council guidelines (2008 updated 2012). This comparison of survey results of the medical workforce over several years in a small NHS District General Hospital was conducted in order to establish the effect of the employment of multiple educational methods regarding adrenaline administration in anaphylaxis in adults. Methods: Between 2010 and 2017, several education methods and tools were used to repeatedly inform the medical workforce (doctors and advanced clinical practitioners) in a single district general hospital regarding the treatment of anaphylaxis in adults. Whilst the senior staff remained largely the same cohort, junior staff had changed fully in every survey. Examples included: (i) Formal teaching -in Grand Rounds; during the junior doctors’ induction process; advanced life support courses (ii) In-situ simulation training performed by the clinical skills simulation team –several ad hoc sessions and one 3-day event in 2017 visiting 16 separate clinical areas performing an acute anaphylaxis scenario using actors- around 100 individuals from multi-disciplinary teams were involved (iii) Hospital-wide distribution of the simulation event via the Trust’s Simulation Newsletter (iv) Laminated algorithms were attached to the 'crash trolleys' (v) A short email 'alert' was sent to all medical staff 3 weeks prior to the survey detailing the emergency treatment of anaphylaxis (vi) In addition, the performance of the surveys themselves represented a teaching opportunity when gaps in knowledge could be addressed. Face to face surveys were carried out in 2010 ('pre-intervention), 2015, and 2017, in the latter two occasions including advanced clinical practitioners (ACP). All surveys consisted of convenience samples. If verbal consent to conduct the survey was obtained, the medical practitioners' answers were recorded immediately on a data collection sheet. Results: There was a sustained improvement in the knowledge of the medical workforce from 2010 to 2017: Answers improved regarding correct drug by 11% (84%, 95%, and 95%); the correct route by 20% (76%, 90%, and 96%); correct site by 40% (43%, 83%, and 83%) and the correct dose by 45% (27%, 54%, and 72%). Overall, knowledge of all components -correct drug, route, site, and dose-improved from 13% in 2010 to 62% in 2017. Conclusion: This survey comparison shows knowledge of the medical workforce regarding adrenaline administration for treatment of anaphylaxis in adults can be considerably improved by employing a variety of educational methods.

Keywords: adrenaline, anaphylaxis, epinephrine, medical education, patient safety

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Authors: M. Hadavi, Z. Hashemi

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Learning strategies play an important role in the development of language skills. Vocabulary learning strategies as the backbone of these strategies have become a major part of English language teaching. This study is a comparative analysis of Vocabulary Learning Strategies (VLS) use and preference among freshmen and senior EFL medical sciences students with different fields of study. 449 students (236 freshman and 213 seniors) participated in the study. 64.6% were female and 35.4% were male. The instrument utilized in this research was a questionnaire consisting of 41 items related to the students’ approach to vocabulary learning. The items were classified under eight sections as dictionary strategies, guessing strategies, study preferences, memory strategies, autonomy, note- taking strategies, selective attention, and social strategies. The participants were asked to answer each item with a 5-point Likert-style frequency scale as follows:1) I never or almost never do this, 2) I don’t usually do this, 3) I sometimes do this, 4) I usually do this, and 5)I always or almost always do this. The results indicated that freshmen students and particularly surgical technology students used more strategies compared to the seniors. Overall guessing and dictionary strategies were the most frequently used strategies among all the learners (p=0/000). The mean and standard deviation of using VLS in the students who had no previous history of participating in the private English language classes was less than the students who had attended these type of classes (p=0/000). Female students tended to use social and study preference strategies whereas male students used mostly guessing and dictionary strategies. It can be concluded that the senior students under instruction from the university have learned to rely on themselves and choose the autonomous strategies more, while freshmen students use more strategies that are related to the study preferences.

Keywords: vocabulary leaning strategies, medical sciences, students, linguistics

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Authors: Naeemeh Silvari

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The tourism industry is important for different nations in two ways. Apart from economic benefits, it provides a basis for getting acquainted with the culture of different regions of the world. Depending on the capacities and contexts of their geography, countries try to attract more people to their country in different ways. Health tourism has been an important branch of the tourism industry in recent years, and many countries around the world are trying to make progress in this field and attract many tourists from around the world. Iran, like many developing countries in the Middle East and East Asia, is trying to improve and develop tourist attractions in the field of health. Due to the cheapness of providing medical services to tourists, many people have traveled to Iran for medical and health care. However, there is a long way to go before recognizing and reaching the desired position in this field. Due to the direct relationship between tourism and culture, the negative attitude towards the context of Iran has caused foreign travelers not to choose this country as their tourist destination. In this article, we tried to study the change in their attitude towards Iran by using semi-structured interviews of foreign travelers who traveled to Iran for treatment and medical services. The text of the interviews was coded and analyzed by MAX QDA software. Many of the people in the sample were from Middle Eastern and Arabic-speaking countries. Influenced by the media, they felt rejected by the Iranians before the trip. During their stay in Iran and in connection with the health care staff, in the first stage, they pointed out that many of their anxieties about the kind of treatment of Iranians have been allayed. In addition to the satisfaction with the medical services provided, they considered the atmosphere of Iranians' interaction with foreign travelers to be relatively appropriate, and some stated that Iran would be the destination of their leisure trip in the future. At the end of the research, policymakers were suggested that in order to resolve cultural contradictions rooted in values, they should first be recognized and seek to use other opportunities to resolve contradictions and form interactions with other cultures.

Keywords: cultural conflict, health tourism, cultural prejudice, advertising and media

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Authors: Shir Daphna-Tekoah, Nurit Eitan-Gutman, Uri Balla

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Background: Systemic documentation is essential in social work practice. Collaboration between an institution of higher education and social work health care services enabled adaptation of the medical documentation model of SOAP in the field of social work, by creating the ISOAPS model (Introduction, Subjective, Objective, Assessment, Plan, Summary) model. Aims: The article describes the ISOAPS model and its implementation in the field of social work, as a tool for standardization of documentation and the enhancement of multidisciplinary collaboration. Methods: We examined the changes in standardization using a mixed methods study, both before and after implementation of the model. A review of social workers’ documentation was carried out by medical staff and social workers in the Clalit Healthcare Services, the largest provider of public and semi-private health services in Israel. After implementation of the model, semi-structured qualitative interviews were undertaken. Main findings: The percentage of reviewers who evaluated their documentation as correct increased from 46%, prior to implementation, to 61% after implementation. After implementation, 81% of the social workers noted that their documentation had become standardized. The training process prepared them for the change in documentation and most of them (83%) started using the model on a regular basis. The qualitative data indicate that the use of the ISOAPS model creates uniform documentation, improves standards and is important to teach social work students. Conclusions: The ISOAPS model standardizes documentation and promotes communication between social workers and medical staffs. Implications for practice: In the intricate realm of healthcare, efficient documentation systems are pivotal to ensuring coherent interdisciplinary communication and patient care. The ISOAPS model emerges as a quintessential instrument, meticulously tailored to the nuances of social work documentation. While it extends its utility across the broad spectrum of social work, its specificity is most pronounced in the medical domain. This model not only exemplifies rigorous academic and professional standards but also serves as a testament to the potential of contextualized documentation systems in elevating the overall stature of social work within healthcare. Such a strategic documentation tool can not only streamline the intricate processes inherent in medical social work but also underscore the indispensable role that social workers play in the broader healthcare ecosystem.

Keywords: ISOAPS, professional documentation, medial social-work, social work

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Authors: Ru-Yin Yang, Chi Wu, Cheng-Yu Tsai, Yin-Tzu Lin, Wen-Te Liu

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Background: Sleep breathing disorder (SDB) is a condition demonstrated by recurrent episodes of the airway obstruction leading to intermittent hypoxia and quality fragmentation during sleep time. However, the procedures for SDB severity examination remain complicated and costly. Objective: The objective of this study is to establish a simplified examination method for SDB by the respiratory impendence pattern sensor combining the signal processing and machine learning model. Methodologies: We records heart rate variability by the electrocardiogram and respiratory pattern by impendence. After the polysomnography (PSG) been done with the diagnosis of SDB by the apnea and hypopnea index (AHI), we calculate the episodes with the absence of flow and arousal index (AI) from device record. Subjects were divided into training and testing groups. Neuron network was used to establish a prediction model to classify the severity of the SDB by the AI, episodes, and body profiles. The performance was evaluated by classification in the testing group compared with PSG. Results: In this study, we enrolled 66 subjects (Male/Female: 37/29; Age:49.9±13.2) with the diagnosis of SDB in a sleep center in Taipei city, Taiwan, from 2015 to 2016. The accuracy from the confusion matrix on the test group by NN is 71.94 %. Conclusion: Based on the models, we established a prediction model for SDB by means of the wearable sensor. With more cases incoming and training, this system may be used to rapidly and automatically screen the risk of SDB in the future.

Keywords: sleep breathing disorder, apnea and hypopnea index, body parameters, neuron network

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Authors: Mahdi Babaee, Arnaud Castel

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One of the main hurdles for commercial adaptation of geopolymer concrete (GPC) as a low-embodied-carbon alternative for Portland cement concrete (PCC) is the durability aspects and its long-term performance in aggressive/corrosive environments. GPC is comparatively a new engineering material and in the absence of a track record of successful durability performance, proper experimental studies to investigate different durability-related characteristics of GPC seem inevitable. In this context, this paper aims to study the bulk electrical resistivity of geopolymer mortars fabricated of blends of low-calcium fly ash (FA) and ground granulated blast-furnace slag (GGBS). Bulk electrical resistivity is recognized as one of the most important parameters influencing the rate of corrosion of reinforcing bars during the propagation phase of corrosion. To investigate the effect of alkali concentration on the resistivity of the samples, 100x200 mm mortar cylinders were cast at different alkali concentration levels, whereas the modulus ratio (the molar ratio of SiO2/Na2O) was fixed for the mixes, and the bulk electrical resistivity was then measured. Also, the effect of the binder composition was assessed with respect to the ratio of FA to GGBS used. Results show a superior performance of samples with higher GGBS content. Lower concentration of the solution has increased the resistivity by reducing the amount of mobile alkali ions in the pore solution. Moreover, GGBS-based samples showed a much sharper increase in the electrical resistivity with decreasing the moisture content.

Keywords: bulk resistivity, corrosion, durability, geopolymer concrete

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Authors: N. W. Paul, M. Banerjee

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Discussing the nexus between global health policy and local practices, this article addresses the recent Ebola outbreak as a role model for narrative co-constructions of epidemic risk. We will demonstrate in how far a theory-driven and methodologically rooted analysis of narrativity can help to improve mechanisms of prevention and intervention whenever epidemic risk needs to be addressed locally in order to contribute to global health. Analyzing the narrative transformation of Ebola, we will also address issues of transcultural problem-solving and of normative questions at stake. In this regard, we seek to contribute to a better understanding of a key question of global health and justice as well as to the underlying ethical questions. By highlighting and analyzing the functions of narratives, this paper provides a translational approach to refine our practices by which we address epidemic risk, be it on the national, the transnational or the global scale.

Keywords: ebola, epidemic risk, medical ethics, medical humanities

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Authors: P. Vosynek, T. Návrat, M. Peč, J. Pořízka, P. Diviš

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Changes of mechanical properties and response behavior of bones is an important external sign of medical problems like osteoporosis, bone remodeling after fracture or surgery, osteointegration, or bone tissue loss of astronauts in space. Measuring of mechanical behavior of bones in physiological and osteoporotic states, quantified by different degrees of protein (collagen) and mineral loss, is thus an important topic in biomechanical research. This contribution deals with the relation between mechanical properties of the turkey long bone–tibia in physiological, demineralized, and deproteinized state. Three methods for comparison were used: densitometry, three point bending and harmonic response analysis. The results help to find correlations between the methods and estimate their possible application in medical practice.

Keywords: bone properties, long bone, osteoporosis, response behavior

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Authors: Christiana Wulty Diku

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This research mapped and documented archaeological heritage resources with associated indigenous knowledge in Lawra, an understudied Municipality in the Upper West Region of Ghana. Since the inception of Archaeology as a discipline in the 1930s at the University of Ghana, the Lawra Municipality has rarely been investigated archaeologically. Consequently, the unconsciousness and ignorance of indigenes on the relevance of these resources to national development has destroyed many significant archaeological sites, with agriculture and infrastructural developmental activities endangering countless of them. Drawing from a community archaeological approach, a collaborative archaeological investigation between local groups, communities and professionals (archaeologists) was conducted to recover these lost histories of settlements in the municipality, salvage and protect endangered archaeological heritage resources and sites from agricultural, exploitative and developmental activities. This was geared towards expanding on the limited research on northern Ghana and deepening our understanding on the existing symbiotic relationship between people and their heritage resources in past and present times. The study deploying ethnographic, archaeological and physical survey techniques as methods in six field seasons beginning from August 2013 to April 2023. This resulted in the reconstruction of the settlement history of Lawra with chronological dates, compilation of inventory on significant archaeological heritage resources with associated indigenous knowledge, mitigation of endangered archaeological sites and heritage resources through surface collections and the development of a photographic record, with associated metadata for purposes of preservation and future research.

Keywords: archaeological heritage resources, indigenous knowledge, lawra municipality, community archaeology

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Authors: Ainolnaim Azizol, Valerie Ross

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Music is as old as mankind and rituals using music such as Kavadi have been associated with social, cultural, and spiritual practices in many traditional and modern societies. Recent literature has provided scientific evidence that music affects psychological and physical changes through stimulation of brainwave. Despite such advances, the scientific study of the sonic qualities peculiar to traditional instruments and how it impacts on ritualistic activities is still lacking. This study addresses one such phenomenon. Devotees in Kavadi rituals are known to be in a state of trance state and do not experience pain nor suffer injury despite the hundreds of needles pierced through their skins. Although scientists have sought to understand how this is possible, lesser is known about the music that is used to prepare devotees to enter into the trance state. This study fills this gap of knowledge by providing scientific evidence through the identification and mapping of the sonic spectrum or sound fingerprint of the instruments and the repertoire used in these ritualistic forms in their ethnographic environment and in audio-controlled situations. The objectives are to identify and categorize the different types of traditional music used in Kavadi rituals; to record, transcribe and digitally score the musical repertoire used in the oral tradition of Kavadi rituals; to map the sonic spectrum of ritual music using spectromography and advanced music analytical software a mixed methodology will be used. This comprises ethnographic field studies using interviews, participant observation, audio-video recordings and audio-methodology using spectromography and advanced audio-technology for sonic mapping and the transcription of audio recordings into digital scores.

Keywords: sonic, traditional, ritual, Kavadi, music

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Authors: Maria Florencia Ferrer, Saulo Fabiano Amancio-Vieira

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The use of the blockchain in the public sector is present today and no longer the future of disruptive institutional and technological models. There are still some cultural barriers and resistance to the proper use of its potential. This research aims to present the strengths and weaknesses of using a public-permitted and distributed network in the context of the public sector. Therefore, bibliographical/documentary research was conducted to raise the main aspects of the studied platform, focused on the use of the main demands of the public sector. The platform analyzed was LACChain, which is a global alliance composed of different actors in the blockchain environment, led by the Innovation Laboratory of the Inter-American Development Bank Group (IDB Lab) for the development of the blockchain ecosystem in Latin America and the Caribbean. LACChain provides blockchain infrastructure, which is a distributed ratio technology (DLT). The platform focuses on two main pillars: community and infrastructure. It is organized as a consortium for the management and administration of an infrastructure classified as public, following the ISO typologies (ISO / TC 307). It is, therefore, a network open to any participant who agrees with the established rules, which are limited to being identified and complying with the regulations. As benefits can be listed: public network (open to all), decentralized, low transaction cost, greater publicity of transactions, reduction of corruption in contracts / public acts, in addition to improving transparency for the population in general. It is also noteworthy that the platform is not based on cryptocurrency and is not anonymous; that is, it is possible to be regulated. It is concluded that the use of record platforms, such as LACChain, can contribute to greater security on the part of the public agent in the migration process of their informational applications.

Keywords: blockchain, LACChain, public sector, technological disruptions

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Authors: Shashi Sharma, Uaday Singh, V. K. Katiyar

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Blood flow through a stenosed tube, which is of great interest to mechanical engineers as well as medical researchers. If stenosis exists in an artery, normal blood flow is disturbed. The deposition of fatty substances, cholesterol, cellular waste products in the inner lining of an artery results to plaque formation .The present study deals with a mathematical model for blood flow in constricted arteries. Blood is considered as a Newtonian, incompressible, unsteady and laminar fluid flowing in a cylindrical rigid tube along the axial direction. A time varying pressure gradient is applied in the axial direction. An analytical solution is obtained using the numerical inversion method for Laplace Transform for calculating the velocity profile of fluid as well as particles.

Keywords: blood flow, stenosis, Newtonian fluid, medical biology and genetics

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Authors: Ali Kassem, Yaser Kamal, Mohamed Abdel Wahab, Mohamed Hussen

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Introduction: Atherosclerosis is one of the leading causes of death all over the world. Recently, there is an increasing interest in Carotid Intima-Medial Thickness (CIMT) and Ankle Brachial Index (ABI) as non-invasive tools for identifying subclinical atherosclerosis. We aim to examine the role of CIMT and ABI as predictors of the severity of angiographically documented coronary artery disease (CAD). Methods: A cross-sectional study conducted on 60 patients who were investigated by coronary angiography at Sohag University Hospital, Egypt. CIMT: After the carotid arteries were located by transverse scans, the probe was rotated 90 ° to obtain and record longitudinal images of bilateral carotid arteries ABI: Each patient was evaluated in the supine position after resting for 5 min. ABI was measured in each leg using a Doppler Ultrasound while the patient remained in the same position. The lowest ABI obtained for either leg was taken as the ABI measurement for the patient. Results: Patients with carotid mean IMT ≥ 0.9 mm had significantly more severe coronary artery disease than patients without thickening (mean IMT > 0.9 mm). Similarly, patients with low ABI (< 0.9) had significantly more severe coronary artery disease than patients with ABI ≥ 0.9. When the patients were divided into 4 groups (group A, n = 15, mean IMT < 0.9 mm, ABI ≥ 0.9; group B, n = 25, mean IMT < 0.9 mm, low ABI; group C, n = 5, mean IMT ≥ 0.9 mm, ABI ≥ 0.9; group D, n = 19, mean IMT ≤ 0.9 mm, low ABI), the presence of significant coronary stenosis (> 50%) of the groups were significantly different (group A, n = 5: (33.3%); group B, n = 11: (52.4%); group C, n = 4: (60%); group D, n=15, (78.9%), P = 0.001). Conclusion: CIMT and ABI provide useful information on the severity of CAD. Early and aggressive intervention should be considered in patients with CAD and abnormalities in one or both of these non-invasive modalities.

Keywords: ankle brachial index, carotid intima media thickness, coronary artery disease, predictors of severity

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Authors: Shilpa Murthy, Hazlina Binti Abu Bakar, Juliet Mathew, Chandrashekhar Thummala Hlly Sreerama Reddy, Pathiyil Ravi Shankar

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Simulation is defined as a technique that replaces or expands real experiences with guided experiences that interactively imitate real-world processes or systems. Simulation enables learners to train in a safe and non-threatening environment. For decades, simulation has been considered an integral part of clinical teaching and learning strategy in medical education. The several types of simulation used in medical education and the clinical environment can be applied to several models, including full-body mannequins, task trainers, standardized simulated patients, virtual or computer-generated simulation, or Hybrid simulation that can be used to facilitate learning. Simulation allows healthcare practitioners to acquire skills and experience while taking care of patient safety. The recent COVID pandemic has also led to an increase in simulation use, as there were limitations on medical student placements in hospitals and clinics. The learning is tailored according to the educational needs of students to make the learning experience more valuable. Simulation in the pre-clinical years has challenges with resource constraints, effective curricular integration, student engagement and motivation, and evidence of educational impact, to mention a few. As instructors, we may have more reliance on the use of simulation for pre-clinical students while the students’ confidence levels and perceived competence are to be evaluated. Our research question was whether the implementation of simulation-based learning positively influences preclinical medical students' confidence levels and perceived competence. This study was done to align the teaching activities with the student’s learning experience to introduce more low-fidelity simulation-based teaching sessions for pre-clinical years and to obtain students’ input into the curriculum development as part of inclusivity. The study was carried out at International Medical University, involving pre-clinical year (Medical) students who were started with low-fidelity simulation-based medical education from their first semester and were gradually introduced to medium fidelity, too. The Student Satisfaction and Self-Confidence in Learning Scale questionnaire from the National League of Nursing was employed to collect the responses. The internal consistency reliability for the survey items was tested with Cronbach’s alpha using an Excel file. IBM SPSS for Windows version 28.0 was used to analyze the data. Spearman’s rank correlation was used to analyze the correlation between students’ satisfaction and self-confidence in learning. The significance level was set at p value less than 0.05. The results from this study have prompted the researchers to undertake a larger-scale evaluation, which is currently underway. The current results show that 70% of students agreed that the teaching methods used in the simulation were helpful and effective. The sessions are dependent on the learning materials that are provided and how the facilitators engage the students and make the session more enjoyable. The feedback provided inputs on the following areas to focus on while designing simulations for pre-clinical students. There are quality learning materials, an interactive environment, motivating content, skills and knowledge of the facilitator, and effective feedback.

Keywords: low-fidelity simulation, pre-clinical simulation, students satisfaction, self-confidence

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Authors: Chong-Yang Qiao

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Mobile augmented reality (MAR) tracking targets from the surroundings and aids operators for interactive data and procedures visualization, potential equipment and system understandably. Operators remotely communicate and coordinate with each other for the continuous tasks, information and data exchange between control room and work-site. In the routine work, distributed control system (DCS) monitoring and work-site manipulation require operators interact in real-time manners. The critical question is the improvement of user experience in cooperative works through applying Augmented Reality in the traditional industrial field. The purpose of this exploratory study is to find the cognitive model for the multiple task performance by MAR. In particular, the focus will be on the comparison between different tasks and environment factors which influence information processing. Three experiments use interface and interaction design, the content of start-up, maintenance and stop embedded in the mobile application. With the evaluation criteria of time demands and human errors, and analysis of the mental process and the behavior action during the multiple tasks, heuristic evaluation was used to find the operators performance with different situation factors, and record the information processing in recognition, interpretation, judgment and reasoning. The research will find the functional properties of MAR and constrain the development of the cognitive model. Conclusions can be drawn that suggest MAR is easy to use and useful for operators in the remote collaborative works.

Keywords: mobile augmented reality, remote collaboration, user experience, cognition model

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Authors: Ramachandra C. G., Amarnath. M., Prashanth Pai M., Nagesh S. N.

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The machine's performance level drops down over a period of time due to the wear and tear of its components. The early detection of an emergent fault becomes very vital in order to obtain uninterrupted production in a plant. Maintenance is an activity that helps to keep the machine's performance at an anticipated level, thereby ensuring the availability of the machine to perform its intended function. At present, a number of modern maintenance techniques are available, such as preventive maintenance, predictive maintenance, condition-based maintenance, total productive maintenance, etc. Condition-based maintenance or condition monitoring is one such modern maintenance technique in which the machine's condition or health is checked by the measurement of certain parameters such as sound level, temperature, velocity, displacement, vibration, etc. It can recognize most of the factors restraining the usefulness and efficacy of the total manufacturing unit. This research work is conducted on a Batch Mill in a tire production unit located in the Southern Karnataka region. The health of the mill is assessed using amplitude of vibration as a parameter of measurement. Most commonly, the vibration level is assessed using various points on the machine bearing. The normal or standard level is fixed using reference materials such as manuals or catalogs supplied by the manufacturers and also by referring vibration standards. The Rio-Vibro meter is placed in different locations on the batch-off mill to record the vibration data. The data collected are analyzed to identify the malfunctioning components in the batch off the mill, and corrective measures are suggested.

Keywords: availability, displacement, vibration, rio-vibro, condition monitoring

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Authors: Jitender Sodhi, Shweta Talati, A. K. Gupta, Pankaj Arora

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Background:Equipment donation to hospitals in resource-limited settings can significantly benefit services in these settings albeit requires important ethical, practical and financial issues to be considered before accepting donations. Objective: To understand the decision making process leading to acceptance/ rejection/ deferment of equipment donation from the perspective of a public sector teaching tertiary care hospital. Design: Retrospective, record based study. Setting: 2000-bedded public sector teaching tertiary care hospital in North India. Methods: A total of 30 cases of equipment donation from March 2010-October 2013, were analysed for their decision process leading to acceptance/rejection/deferment.Each case was studied retrospectively and data pertaining to the agenda and decision taken was collected. Results: A total of 30 cases of equipment donation received from March 2010- October 2013 were screened, out of which 17 (56.6%) were for diagnostic purpose and 13 (43.3%) for therapeutic purpose. Out of 30 cases, 16 (53.3%) were accepted and 8 (26.6%) were rejected. The remaining 6 cases included 3 (10%) which required further clarification and other 3 (10%) which were out of the domain of committee. Conclusion: This study highlights the importance of equipment donation in resource limited settings and considerations involved while making decisions for acceptance/rejections/defermentof such donations.

Keywords: equipment donation, teaching hospital, decision-making, North India

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Authors: Yina Donald Orga

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Osun Osogbo festival is one of the biggest art festivals in Nigeria with over 235, 518 tourist visits in 2014. The purpose of this study is to generate data on the tourists’ perception of Osun Osogbo Festival in Osogbo, Osun State Nigeria. Based on the population of 199, 860 tourist visits at Osun Osogbo festival in 2013, Krejcie and Morgan sample size table was used to select 768 tourists/respondents. Likert questionnaire were used to elicit data from the respondents. Descriptive statistic was used to describe the characteristics of respondents and analyse the tourists’ perception of the festival. The findings from data analysed suggest that the trend of domestic and international tourist visits in the past ten years for the festival had shown a consistent increase since 2004 except in 2007 and 2008 and continue to increase up to 2013. This is an indication that the tourists are satisfied with traditional, historical and authenticity features of the festival. Also, findings from the study revealed that the tourists are not satisfied with the number of toilets at Osun Sacred Grove, crowd control of visitors during the festival, medical personnel to cater for visitors during the festival, etc. In view of the findings of the study, the following recommendations are suggested; provision of more toilets at Osun Sacred grove, Osogbo Heritage Council to recruit festival guides to help control the huge crowd at the festival, the Government of State of Osun in conjunction with Red Cross Society should engage adequate medical personnel to cater for medical needs of visitors at the festival, etc.

Keywords: festival, perception, positive, tourists

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Authors: ShuYing Chung, Minchuan Huang, Iping Chen

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Taking the medical staff in an emergency ward of a medical center in Central Taiwan as the research object, the questionnaire data were collected by anonymous and voluntary reporting methods with structured questionnaire to explore the actual situation, willingness and attitude of organ donation. Only 80 valid questionnaires were collected. Among the 8 questions, the average correct rate was 5.9 + 1.2, and the correct rate was 73.13%. The willingness of organ donation that 7.5% of the people are not willing; 92.5% of the people are willing, of which 62.5% have considered but have not yet decided; 21.3% are willing but have not signed the consent of organ donation; They have signed the consent of organ donation 8.7%. The average total score (standard deviation) of attitude towards organ donation was 36.2. There is no significant difference between the demographic variables and the awareness and willingness of organ donation, but there is a significant correlation between the marital status and the attitude of organ donation.

Keywords: clinical psychology, organ donation, doctors affecting psychological disorders, commitment

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Authors: Soumya Sajjan

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Liver cancer is the most common cancer disease worldwide in men and women, and is one of the few cancers still on the rise. Liver disease is the 4th leading cause of death. According to new NHS (National Health Service) figures, deaths from liver diseases have reached record levels, rising by 25% in less than a decade; heavy drinking, obesity, and hepatitis are believed to be behind the rise. In this study, we focus on Development of Diagnostic Classifier for Ultrasound liver lesion. Ultrasound (US) Sonography is an easy-to-use and widely popular imaging modality because of its ability to visualize many human soft tissues/organs without any harmful effect. This paper will provide an overview of underlying concepts, along with algorithms for processing of liver ultrasound images Naturaly, Ultrasound liver lesion images are having more spackle noise. Developing classifier for ultrasound liver lesion image is a challenging task. We approach fully automatic machine learning system for developing this classifier. First, we segment the liver image by calculating the textural features from co-occurrence matrix and run length method. For classification, Support Vector Machine is used based on the risk bounds of statistical learning theory. The textural features for different features methods are given as input to the SVM individually. Performance analysis train and test datasets carried out separately using SVM Model. Whenever an ultrasonic liver lesion image is given to the SVM classifier system, the features are calculated, classified, as normal and diseased liver lesion. We hope the result will be helpful to the physician to identify the liver cancer in non-invasive method.

Keywords: segmentation, Support Vector Machine, ultrasound liver lesion, co-occurance Matrix

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Authors: Jui-Hung Hung, Ching-Liang Hsieh, Yi-Wen Lin

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Modern medicine highly emphasizes the importance of palliative treatment. The inception of palliative and hospice care recently developed into the concept of caring for the patients’ and families’ physical, psychological and spiritual problems. There are several benefits related to palliative care such as reducing medical expenses, decreasing patients’ suffer, and supporting patient go through the finale of the life. Nowadays, in Taiwan, over 60-70% terminal cancer patients were covered in hospice care, and the coverage rate increased annually. Acupuncture is a well-known therapy used more than thousand years to relieve symptoms of cancer patient. Many reports showed that, even in the Western society, many reputable medical centers can provide Acupuncture therapy for patients. Accordingly, using Acupuncture for cancer patient care is a global trend. There are increased evidences indicate that Acupuncture can relieve the symptoms for cancer patients including pain, reduce the dosage of anesthetic, improve the cancer-related fatigue, relieve the chemotherapy-related nausea and vomiting, ease anxiety mood and even improving the quality of life. Furthermore, some trials show that Acupuncture may help relieve xerostomia, hot flash, sleep disorders, and some GI discomfort and so on. Acupuncture therapy has many advantages for clinical use with effective, low-cost, minimal side effect, suitable for cancer patients and even for elderly population. Especially in nowadays, there are more diversified challenges in modern medicine, all of them will make the higher medical budget. We suggest that Acupuncture will be one of methods for palliative care for cancer patients.

Keywords: Acupuncture, cancer, integrative medicine, palliative care

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Authors: Nadeem Qaiser, Sherjeel Munsif Khan, Muhammad Mustafa Hussian, Vincent Tung

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One of the emerging fields in the detection of chronic diseases is based on the point-of-care (POC) early monitoring of the symptoms and thus provides a state-of-the-art personalized healthcare system. Nowadays, wearable and flexible sensors are being used for analyzing sweat, glucose, blood pressure, and other skin conditions. However, localized jaw-bone swelling called parotid-swelling caused by some viruses has never been tracked before. To track physical motion or deformations, strain sensors, especially piezoresistive ones, are widely used. This work, for the first time, reports carbon nanotubes (CNTs)-based piezoresistive sensing patch that is highly flexible and stretchable and can record muscle deformations in real-time. The developed patch offers an excellent gauge factor for in-plane stretching and spatial expansion with low hysteresis. To calibrate the volumetric muscle expansion, we fabricated the pneumatic actuator that experienced volumetric expansion and thus redefined the gauge factor. Moreover, we employ a Bluetooth-low-energy system that can send information about muscle activity in real-time to a smartphone app. We utilized COMSOL calculations to reveal the mechanical robustness of the patch. The experiments showed the sensing patch's greater cyclability, making it a patch for personal healthcare and an excellent choice for monitoring the real-time POC monitoring of the human muscle swelling.

Keywords: piezoresistive strain sensor, FEM simulations, CNTs sensor, flexible

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Authors: Oum Elkhir Mahmoudi, Nebiha Ben Haj Ali

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Micropaleontological, sedimentological and statistical studies were carried out on the late Paleoceneearly Eocene succession of Sra Ouertaine and Dyr El Kef in Northern open phosphatic Basin of Tunisia. Based on the abundance and stratigraphic distribution of planktic foraminiferal species, five planktic zones have been recognized from the base to the top of the phosphatic layers. The El Acarinina sibaiyaensis Zone, the E2 Pseudohastigerina wilcoxensis Zone, the E3 Morozovella marginodentata Zone, the E4 Morozovella formosa Zones and the E5 Morozovella subbotinae Zone. The placement of Paleocene-Eocene boundary (PETM) is just below the base of the phosphatic interval. The ETM-2 event may be detectable in the analyzed biotic record of Sra Ouertaine. Based on benthic assemblages, abundances, cluster and multivariate statistical analyses, two biofacies were recognized for each section. The recognized ecozones are typical of warm and shallow water inner neritic setting (dominance of epifaunal fauna Anomalinoides, Dentalina and Cibicidoides associated with Frondicularia phosphatica, Trochamminoides globigeriniformis and Eponides elevatus). The paleoenvironment is eutrophic (presence of several bolivinitids and verneuilinids). For the Dyr El Kef section and P5 and E2 of Sra Ouertaine section, our records indicate that paleoenvironment is influenced by coastal upwelling without oxygen-deficiency, the paleodepth is estimated to be around 50 m. The paleoecosystem is diversified and balanced with a general tendency to stressed condition. While the upper part of Sra Ouertaine section is more eutrophic, influenced by coastal upwelling with oxygen-deficiency, the paleodepth is estimated to be less than 50 m and the ecosystem is unsettled.

Keywords: Tunisia, early Eocene, foraminifera, chronostratigraphy

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Authors: Shiyin He, Zheng Huang

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In this paper, deep learning methods are applied in bio-medical field to detect and count different types of cells in an automatic way instead of manual work in medical practice, specifically in bone marrow examination. The process is mainly composed of two steps, detection and recognition. Mask-Region-Convolutional Neural Networks (Mask-RCNN) was used for detection and image segmentation to extract cells and then Convolutional Neural Networks (CNN), as well as Deep Residual Network (ResNet) was used to classify. Result of cell detection network shows high efficiency to meet application requirements. For the cell recognition network, two networks are compared and the final system is fully applicable.

Keywords: cell detection, cell recognition, deep learning, Mask-RCNN, ResNet

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Authors: Oanthata Jester Sealetsa, Richie Moalosi

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Musculoskeletal Disorders (MSDs) are reported to be amongst the leading contributing factors of low productivity in many industries across the world, and the most affected being New Emerging Economies (NEC) such as Botswana. This is due to lack of expertise and resources to deal with existing ergonomics challenges. This study was aimed to evaluate occupational postures and the prevalence of musculoskeletal disorders among diamond polishers in a diamond company in Botswana. A case study was conducted with about 106 diamond polishers in Gaborone, Botswana. A case study was chosen because it can investigate and explore an issue thoroughly and deeply, and record behaviour over time so changes in behaviour can be identified. The Corlett and Bishop Body Map was used to determine frequency of MSDs symptoms in different body parts of the workers. This was then followed by the use of the Rapid Entire Body Assessment (REBA) to evaluate the occupational postural risks of MSDs. Descriptive statistics, chi square, and logistic regression were used for data analysis. The results of the study reveal that workers experienced pain in the upper back, lower back, shoulders, neck, and wrists with the most pain reported in the upper back (44.6%) and lower back (44.2%). However, the mean REBA score of 6.07 suggests that sawing, bruiting and polishing were the most dangerous processes in diamond polishing. The study recommends that a redesign of the diamond polishing workstations is necessary to accommodate the anthropometry characteristic of Batswana (people from Botswana) to prevent the development of MSDs.

Keywords: assessment, Botswana, diamond polishing, ergonomics, musculoskeletal disorders, occupational postural risks

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Authors: Afnan Khoja, Ittisak Subrungruang, Kritchaya Ritruechai, Linda Jones, David Wall

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Background: Some characteristics might be stated as an objective of the curriculum and some might be hidden. The hidden curriculum is the unwritten and unintended lessons and perspectives that students absorb in school. Though, the hidden characteristics are expected that tutors hope students might have in order to become medical educators. We suspected our faculty hoped we would develop skills, know and develop beyond the written outcomes. Our research question aimed to explore the hidden curriculum; as part of our learning; we had to design and report findings. Summary of Work: We undertook semi-structured interviews with a sample of the centre for medical education faculty at Dundee. Participants answered the question , of what are the hidden characteristics that they hope Dundee MMed graduates might have after graduation. Thematic analysis was carried out on the interview scripts. Summary of Results: A thematic analysis was carried out on the interview transcripts. Three main themes were identified from all respondents' comments. These were lifelong learners, being flexible and problem solvers. In addition individual respondents also described sense of humour, collaboration, humility, role model, inquisitiveness, optimism, and ability to express oneself clearly. Discussion: Tutors put great value on three behaviours lifelong learner, flexible, and problem solver, which are part of professional characteristics in leadership. Therefore, leadership characteristics is incorporated as the outcomes of hidden characteristics that tutors would like to see. Conclusion: Tutors in the Master's program of medical education at the University of Dundee hope that medical education students should present the three main hidden characteristics, which are lifelong learner, flexible, and problem solver after graduation. Take-home Messages: These hidden characteristics are considered as informal unless a change has been made to the formal curriculum. Therefore, to reach the tutors’ expectations, further studies might be held to make this personal characteristics transformation more accessible.

Keywords: characteristics, hidden curriculum, transformation, informal

Procedia PDF Downloads 89