Search results for: clinical psychology training

Authors: Muhammad Arif Khan, Haroon Idrees, Imran Aziz, Sidra Mushtaq

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The purpose of this study is to investigate the current level of knowledge mapping skills of the public sector employees in Pakistan. National Institute of Management is one of the premiere public sector training organization for mid-career public sector employees in Pakistan. This study is conducted on participants of fourteen weeks long training course called Mid-Career Management Course (MCMC) which is mandatory for public sector employees in order to ascertain how to enhance their knowledge mapping skills. Methodology: Researcher used both qualitative and quantitative approach to conduct this study. Primary data about current level of participants’ understanding of knowledge mapping was collected through structured questionnaire. Later on, Participant Observation method was used where researchers acted as part of the group to gathered data from the trainees during their performance in training activities and tasks. Findings: Respondents of the study were examined for skills and abilities to organizing ideas, helping groups to develop conceptual framework, identifying critical knowledge areas of an organization, study large networks and identifying the knowledge flow using nodes and vertices, visualizing information, represent organizational structure etc. Overall, the responses varied in different skills depending on the performance and presentations. However, generally all participants have demonstrated average level of using both the IT and Non-IT K-mapping tools and techniques during simulation exercises, analysis paper de-briefing, case study reports, post visit presentation, course review, current issue presentation, syndicate meetings, and daily synopsis. Research Limitations: This study is conducted on a small-scale population of 67 public sector employees nominated by federal government to undergo 14 weeks extensive training program called MCMC (Mid-Career Management Course) at National Institute of Management, Peshawar, Pakistan. Results, however, reflects only a specific class of public sector employees i.e. working in grade 18 and having more than 5 years of work. Practical Implications: Research findings are useful for trainers, training agencies, government functionaries, and organizations working for capacity building of public sector employees.

Keywords: knowledge management, km in public sector, knowledge management and professional development, knowledge management in training, knowledge mapping

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Authors: M. Sazali Said, Rahim Jamian, Shahrizan Yusoff, Shahruzaman Sulaiman, Jum'Azulhisham Abdul Shukor

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This case study focuses on the role of Universiti Kuala Lumpur Malaysian Spanish Institute (UniKL MSI) to produce technologist in order to reduce the shortage of skilled workers especially in the automotive industry. The purpose of the study therefore seeks to examine the effectiveness of Technical Education and Vocational Training (TEVT) curriculum of UniKL MSI to produce graduates that could immediately be productively employed by the automotive industry. The approach used in this study is through performance evaluation of students attending the Industrial Training Attachment (INTRA). The sample of study comprises of 37 students, 16 university supervisors and 26 industrial supervisors. The research methodology involves the use of quantitative and qualitative methods of data collections through the triangulation approach. The quantitative data was gathered from the students, university supervisors and industrial supervisors through the use of questionnaire. Meanwhile, the qualitative data was obtained from the students and university supervisors through the use of interview and observation. Both types of data have been processed and analyzed in order to summarize the results in terms of frequency and percentage by using a computerized spread sheet. The result shows that industrial supervisors were satisfied with the students’ performance. Meanwhile, university supervisors rated moderate effectiveness of the UniKL MSI curriculum in producing graduates with appropriate skills and in meeting the industrial needs. During the period of study, several weaknesses in the curriculum have been identified for further continuous improvements. Recommendations and suggestions for curriculum improvement also include the enhancement of technical skills and competences of students towards fulfilling the needs and demand of the automotive industries.

Keywords: technical education and vocational training (TEVT), industrial training attachment (INTRA), curriculum improvement, automotive industry

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Authors: Raheleh Saifiabolhassan

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After the post-industrial era, when a wide variety of foods and drinks are readily available everywhere, the motive has shifted from meeting basic nutritional needs to enjoy the eating experience. Today, behavioral environmental studies are an essential branch of science when it comes to understanding, analyzing, and evaluating how humans react to the environment. Similarly, these studies explore customer-influencing factors and the effectiveness of restaurant designs. To facilitate a pleasant dining experience, the authors focused on acoustics, flexibility, and lighting. In this study, 2700 square feet of surface area was used to plan a restaurant (called Mesineh) based on behavioral science, considering many factors related to the interaction between the building and the users, such as flexibility and privacy, acoustics, and light. Environment psychology considerations in architectural design have been lacking for several decades. To fill this gap, the author evaluated environmental psychology standards and applied them to Mesineh's design. A sense of nostalgia will be felt by customers of the Mesineh restaurant thanks to its interior design, which combines historical elements with contemporary elements. Additionally, vernacular Persian architectural elements were incorporated into a modern context to fulfill the behavioral science component of interior design.

Keywords: Mesineh restaurant, interior design, behavioral sciences, environment psychology, traditional persian architecture

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Authors: Elias Nemer, Greg Vines

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Time-frequency transformation and spectral representations of audio signals are commonly used in various machine learning applications. Training networks on frequency features such as the Mel-Spectrogram or Cochleogram have been proven more effective and convenient than training on-time samples. In practical realizations, these features are created on a different processor and/or pre-computed and stored on disk, requiring additional efforts and making it difficult to experiment with different features. In this paper, we provide a PyTorch framework for creating various spectral features as well as time-frequency transformation and time-domain filter-banks using the built-in trainable conv1d() layer. This allows computing these features on the fly as part of a larger network and enabling easier experimentation with various combinations and parameters. Our work extends the work in the literature developed for that end: First, by adding more of these features and also by allowing the possibility of either starting from initialized kernels or training them from random values. The code is written as a template of classes and scripts that users may integrate into their own PyTorch classes or simply use as is and add more layers for various applications.

Keywords: neural networks Mel-Spectrogram, chromagram, cochleogram, discrete Fourrier transform, PyTorch conv1d()

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Authors: Giuliana Murfet, Heidi Behrens

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Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

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Authors: Gift Udoh, Diane S. Rohlman, Benjamin Sindt

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BACKGROUND: There is concern regarding the widespread use of pesticides and impacts on public health. Farmers in Nigeria frequently apply pesticides, including organophosphate pesticides which are known neurotoxicants. They receive little guidance on how much to apply or information about safe handling practices. Pesticide poisoning is one of the major hazards that farmers face in Nigeria. Farmers continue to use highly neurotoxic pesticides for agricultural activities. Because farmers receive little or no information on safe handling and how much to apply, they continue to develop severe and mild illnesses caused by high exposures to pesticides. The project aimed to reduce pesticide exposure among rural farmers in Nigeria by identifying hazards associated with pesticide use and developing and pilot testing training to reduce exposures to pesticides utilizing the hierarchy of controls system. METHODS: Information on pesticide knowledge, behaviors, barriers to safety, and prevention methods was collected from farmers in Nigeria through workplace observations, questionnaires, and interviews. Pre and post-surveys were used to measure farmer’s knowledge before and after the delivery of pesticide safety training. Training topics included the benefits and risks of using pesticides, routes of exposure and health effects, pesticide label activity, use and selection of PPE, ways to prevent exposure and information on local resources. The training was evaluated among farmers and changes in knowledge, attitudes and behaviors were collected prior to and following the training. RESULTS: The training was administered to 60 farmers, a mean age of 35, with a range of farming experience (<1 year to > 50 years). There was an overall increase in knowledge after the training. In addition, farmers perceived a greater immediate risk from exposure to pesticides and their perception of their personal risk increased. For example, farmers believed that pesticide risk is greater to children than to adults, recognized that just because a pesticide is put on the market doesn’t mean it is safe, and they were more confident that they could get advice about handling pesticides. Also, there was greater awareness about behaviors that can increase their exposure (mixing pesticides with bare hands, eating food in the field, not washing hands before eating after applying pesticides, walking in fields recently sprayed, splashing pesticides on their clothes, pesticide storage). CONCLUSION: These results build on existing evidence from a 2022 article highlighting the need for pesticide safety training in Nigeria which suggested that pesticide safety educational programs should focus on community-based, grassroots-style, and involve a family-oriented approach. Educating farmers on agricultural safety while letting them share their experiences with their peers is an effective way of creating awareness on the dangers associated with handling pesticides. Also, for rural communities, especially in Nigeria, pesticide safety pieces of training may not be able to reach some locations, so intentional scouting of rural farming communities and delivering pesticide safety training will improve knowledge of pesticide hazards. There is a need for pesticide information centers to be situated in rural farming communities or agro supply stores, which gives rural farmers information.

Keywords: pesticide exposure, pesticide safety, nigeria, rural farming, pesticide education

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Authors: Nicholus M. Warstadt, Andres D. Mallipudi, Oluwadamilola Idowu, Joshua Rodriguez, Madison M. Hunt, Soma Pathak, Laura P. Weber

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Endotracheal intubation is a core procedure performed by emergency physicians. This procedure is a high risk, and failure results in substantial morbidity and mortality. Fiberoptic intubation (FOI) is the standard of care in difficult airway protocols, yet no widespread practice exists for training emergency medicine (EM) residents in the technical acquisition of FOI skills. Simulation on mannequins is commonly utilized to teach advanced airway techniques. As part of a program to introduce FOI into our ED, residents received hands-on training in FOI as part of our weekly resident education conference. We hypothesized that prior to the hands-on training, residents had little experience with FOI and were uncomfortable with using fiberoptic as a modality. We further hypothesized that resident comfort with FOI would increase following the training. The education intervention consisted of two hours of focused airway teaching and skills acquisition for PGY 1-4 residents. One hour was dedicated to four case-based learning stations focusing on standard, pediatric, facial trauma, and burn airways. Direct, video, and fiberoptic airway equipment were available to use at the residents’ discretion to intubate mannequins at each station. The second hour involved direct instructor supervision and immediate feedback during deliberate practice for FOI of a mannequin. Prior to the hands-on training, a pre-survey was sent via email to all EM residents at NYU Grossman School of Medicine. The pre-survey asked how many FOI residents have performed in the ED, OR, and on a mannequin. The pre-survey and a post-survey asked residents to rate their comfort with FOI on a 5-point Likert scale ("extremely uncomfortable", "somewhat uncomfortable", "neither comfortable nor uncomfortable", "somewhat comfortable", and "extremely comfortable"). The post-survey was administered on site immediately following the training. A two-sample chi-square test of independence was calculated comparing self-reported resident comfort on the pre- and post-survey (α ≤ 0.05). Thirty-six of a total of 70 residents (51.4%) completed the pre-survey. Of pre-survey respondents, 34 residents (94.4%) had performed 0, 1 resident (2.8%) had performed 1, and 1 resident (2.8%) had performed 2 FOI in the ED. Twenty-five residents (69.4%) had performed 0, 6 residents (16.7%) had performed 1, 2 residents (5.6%) had performed 2, 1 resident (2.8%) had performed 3, and 2 residents (5.6%) had performed 4 FOI in the OR. Seven residents (19.4%) had performed 0, and 16 residents (44.4%) had performed 5 or greater FOI on a mannequin. 29 residents (41.4%) attended the hands-on training, and 27 out of 29 residents (93.1%) completed the post-survey. Self-reported resident comfort with FOI significantly increased in post-survey compared to pre-survey questionnaire responses (p = 0.00034). Twenty-one of 27 residents (77.8%) report being “somewhat comfortable” or “extremely comfortable” with FOI on the post-survey, compared to 9 of 35 residents (25.8%) on the pre-survey. We show that dedicated FOI training is associated with increased learner comfort with such techniques. Further direction includes studying technical competency, skill retention, translation to direct patient care, and optimal frequency and methodology of future FOI education.

Keywords: airway, emergency medicine, fiberoptic intubation, medical simulation, skill acquisition

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Authors: Jeroen S. de Bruin, Karin Schindler, Christian Schuh

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With increasingly more mobile health applications appearing due to the popularity of smartphones, the possibility arises that these data can be used to improve the medical diagnostic process, as well as the overall quality of healthcare, while at the same time lowering costs. However, as of yet there have been no reports of a successful combination of patient-generated data from smartphones with data from clinical routine. In this paper, we describe how these two types of data can be combined in a secure way without modification to hospital information systems, and how they can together be used in a medical expert system for automatic nutritional classification and triage.

Keywords: mobile health, data integration, expert systems, disease-related malnutrition

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Authors: Madiha Zahid, Afifa Khanam

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The present study aims to investigate the effect of reflective teaching practices on prospective teachers’ performance. Reflective teaching practice helps teachers to plan, implement and improve their performance by rethinking about their strengths and weaknesses. An action research was conducted by the researcher. All prospective teachers of sixth semester in a women university’s teacher education program were the population of the study. From 40 students, 20 students were taken as experimental group, and the rest of 20 students were taken as control group. During the action research a cyclic process of producing a module, training teachers for the reflective practices and then observing them during their class for reflective practice was done by the researchers. The research used a set of rubrics and checklists for assessing prospective teachers’ performance during their class. Finally, the module was modified with the help of findings. It was found that the training has improved the performance of teachers as they revised and modified their teaching strategies through reflective practice. However, they were not able to train their students for reflective practice as per expectation. The study has implications for teacher training programs to include reflective practice modules as part of their course work for making them better teachers.

Keywords: reflective practices, prospective teacher, effect, performance

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Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa, Annabella Habinka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to a lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. We aimed at; i) increase awareness and understanding of teledermatology among prison health workers and ii) improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons. Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prison staff with AD. We conducted five days of training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient-Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: We have the very first iconographic atlas of the main dermatoses in pigmented African skin. We increased; i) the proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80%; ii) the proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year; iii) increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year and iv)Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year. Our study contributes to the use, evaluation, and verification of the use of teledermatology to increase access to specialist dermatology services to the most hard to reach areas and vulnerable populations such as that of prisoners.

Keywords: teledermatology, prisoners, reaching, un-reachable

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Authors: Vallejo Michael, Acuña Edgar, Roa Juan David, Peñuela Rosa, Parra Alejandra, Casallas Daniela, Rodriguez Sheyla

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Congenital Zika Virus Syndrome is an entity composed by a variety of birth defects presented in newborns that have been exposed to the Zika Virus during pregnancy. The syndrome characteristic features are severe microcephaly, cerebral tissue abnormalities, ophthalmological abnormalities such as uveitis and chorioretinitis, arthrogryposis, clubfoot deformity and muscular tone abnormalities. The confirmatory test is the Reverse transcription polymerase chain reaction (RT-PCR) associated to the physical findings. Here we present the case of a newborn with microcephaly whose mother presented a confirmed Zika Virus infection during the third trimester of pregnancy, despite of the evident findings and the history of Zika infection the RT-PCR in amniotic and cerebrospinal fluid of the newborn was negative. RT-PCR has demonstrated a low sensibility in samples with low viral loads, reason why, we propose a clinical diagnosis in patients with clinical history of Zika Virus infection during pregnancy accompanied by evident clinical manifestations of the child.

Keywords: congenital, Zika virus, microcephaly, reverse transcriptase polymerase chain reaction

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Authors: Elena Antonova Unlu, Cigdem Sagin Simsek

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The research presents two studies examining the impact of formal interpreting training (FIT) on Working Memory Capacity (WMC) of student-interpreters. In Study 1, the storage and processing capacities of the working memory (WM) of last-year student-interpreters were compared with those of last-year Foreign Language Education (FLE) students. In Study 2, the impact of FIT on the WMC of student-interpreters was examined via comparing their results on WM tasks at the beginning and the end of their FIT. In both studies, Digit Span Task (DST) and Reading Span Task (RST) were utilized for testing storage and processing capacities of WM. The results of Study 1 revealed that the last-year student-interpreters outperformed the control groups on the RST but not on the DST. The findings of Study 2 were consistent with Study 1 showing that after FIT, the student-interpreters performed better on the RST but not on the DST. Our findings can be considered as evidence supporting the view that FIT has a beneficial effect not only on the interpreting skills of student-interpreters but also on the central executive and processing capacity of their WM.

Keywords: working memory capacity, formal interpreting training, student-interpreters, cross-sectional and longitudinal data

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Authors: Kruttika Bhuse

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Aim: Synergism between periodontists and orthodontists (periodontal accelerated osteogenic orthodontics- PAOO) creates crucial opportunities to enhance clinical outcomes of combined therapies regarding both disciplines and has made adult orthodontics a reality. Thus, understanding the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. Wilckodontics can be an attractive treatment option and be a “win-win” situation for both the dental surgeon and patient by reducing the orthodontic treatment time in adults. Materials and methods: In this review, data related to the clinical aspects, steps of procedure, biomechanics of bone, indications and contraindications and final outcome of wilckodontic shall be discussed. 50 supporting articles from various international journals and 70 clinical cases were reviewed to get a better understanding to design this wilckodontic - meta analysis. Various journals like the Journal Of Clinical And Diagnostic Research, Journal Of Indian Society Of Periodontology, Journal Of Periodontology, Pubmed, Boston Orthodontic University Journal, Good Practice Orthodontics Volume 2, have been referred to attain valuable information on wilckodontics which was then compiled in this single review study. Result: As a promising adjuvant technique based on the transient nature of demineralization-remineralisation process in healthy tissues, wilckodontics consists of regional acceleratory phenomenon by alveolar corticotomy and bone grafting of labial and palatal/lingual surfaces, followed by orthodontic force. The surgical wounding of alveolar bone potentiates tissue reorganization and healing by a way of transient burst of localized hard and soft tissue remodelling.This phenomenon causes bone healing to occur 10-50 times faster than normal bone turnover. Conclusion: This meta analysis helps understanding that the biomechanics of bone remodelling may increase the clinical applications of corticotomy facilitated orthodontics with or without alveolar augmentation. The main benefits being reduced orthodontic treatment time, increased bone volume and post-orthodontic stability.

Keywords: periodontal osteogenic accelerated orthodontics, alveolar corticotomy, bone augmentation, win-win situation

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Authors: Rasoul Eslami, Reza Gharakhanlou

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NT-4/5 and TrkB have been proposed to be involved in the coordinated adaptations of the neuromuscular system to elevated level of activity. Despite the persistence of this neurotrophin and its receptor expression in adult skeletal muscle, little attention has been paid to the functional significance of this complex in the mature neuromuscular system. Therefore, the purpose of this research was to study the effect of one session of resistance exercise on mRNA expression of NT4/5 and TrkB proteins in slow and fast muscles of Wistar Rats. Male Wistar rats (10 mo of age, preparation of Pasteur Institute) were housed under similar living conditions in cages (in groups of four) at room temperature under a controlled light/dark (12-h) cycle with ad libitum access to food and water. A number of sixteen rats were randomly divided to two groups (resistance exercise (T) and control (C); n=8 for each group). The resistance training protocol consisted of climbing a 1-meter–long ladder, with a weight attached to a tail sleeve. Twenty-four hours following the main training session, rats of T and C groups were anaesthetized and the right soleus and flexor hallucis longus (FHL) muscles were removed under sterile conditions via an incision on the dorsolateral aspect of the hind limb. For NT-4/5 and TrkB expression, quantitative real time RT-PCR was used. SPSS software and independent-samples t-test were used for data analysis. The level of significance was set at P < 0.05. Data indicate that resistance training significantly (P<0.05) decreased mRNA expression of NT4/5 in soleus muscle. However, no significant alteration was detected in FHL muscle (P>0.05). Our results also indicate that no significant alterations were detected for TrkB mRNA expression in soleus and FHL muscles (P>0.05). Decrease in mRNA expression of NT4/5 in soleus muscle may be as result of post-translation regulation following resistance training. Also, non-alteration in TrkB mRNA expression was indicated in probable roll of P75 receptor.

Keywords: neurotrophin-4/5 (NT-4/5), TrkB receptor, resistance training, slow and fast muscles

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Authors: Ya-Ju Ju, Li-Chen Yang, Yi-Chun Du, Rong-Ju Cherng

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Introduction: It is estimated that 5-6% of school-aged children may be diagnosed to have developmental coordination disorder (DCD). Children with DCD are characterized with motor skill difficulty which cannot be explained by any medical or intellectual reasons. Such motor difficulties limit children’s participation to sports activity, further affect their physical fitness, cardiopulmonary function and balance, and may lead to obesity. The purpose of the project was to develop an exergaming system for children with DCD aiming to improve their physical fitness, cardiopulmonary function and balance ability. Methods: This study took five steps to build up the system: system planning, tasks selection, tasks programming, system integration and usability test. The system basically adopted virtual reality technique to integrate self-developed training programs. The training programs were developed to brainstorm among team members and after literature review. The selected tasks for training in the system were a combination of fundamental movement tor skill. Results and Discussion: Based on the theory of motor development, we design the training task from easy ones to hard ones, from single tasks to dual tasks. The tasks included walking, sit to stand, jumping, kicking, weight shifting, side jumping and their combination. Preliminary study showed that the tasks presented an order of development. Further study is needed to examine its effect on motor skill and cardiovascular fitness in children with DCD.

Keywords: virtual reality, virtual reality system, developmental coordination disorder, children

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Authors: Jiangbo Shi, Zeyu Gao, Chen Li

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Nuclei segmentation is a fundamental task in digital pathology analysis and can be automated by deep learning-based methods. However, the development of such an automated method requires a large amount of data with precisely annotated masks which is hard to obtain. Training with weakly labeled data is a popular solution for reducing the workload of annotation. In this paper, we propose a novel meta-learning-based nuclei segmentation method which follows the label correction paradigm to leverage data with noisy masks. Specifically, we design a fully conventional meta-model that can correct noisy masks by using a small amount of clean meta-data. Then the corrected masks are used to supervise the training of the segmentation model. Meanwhile, a bi-level optimization method is adopted to alternately update the parameters of the main segmentation model and the meta-model. Extensive experimental results on two nuclear segmentation datasets show that our method achieves the state-of-the-art result. In particular, in some noise scenarios, it even exceeds the performance of training on supervised data.

Keywords: deep learning, histopathological image, meta-learning, nuclei segmentation, weak annotations

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Authors: Aneena Suresh, C. S. Sidharth

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Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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Authors: Mohd Afif Md Nasir, Faizal Amin Nur Yunus, Jamaluddin Hashim, Abd Samad Hassan Basari, A. Halim Sahelan

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The aim of this study is to identify the suitability of Virtual Learning Environment (VLE) in welding simulator application towards Computer-Based Training (CBT) in developing skills upon new students at the Advanced Technology Training Center (ADTEC), Batu Pahat, Johor, Malaysia and GIATMARA, Batu Pahat, Johor, Malaysia. The purpose of the study is to create a computer-based skills development approach in welding technology among new students in ADTEC and GIATMARA, as well as cultivating the elements of general skills among them. This study is also important in elevating the number of individual knowledge workers (K-workers) working in manufacturing industry in order to achieve a national vision which is to be an industrial nation in the year of 2020. The design of the study is a survey type of research which uses questionnaires as the instruments and 136 students from ADTEC and GIATMARA were interviewed. Descriptive analysis is used to identify the frequency and mean values. The findings of the study shows that the welding technology skills have developed in the students as a result of the application of VLE simulator at a high level and the respondents agreed that the skills could be embedded through the application of the VLE simulator. In summary, the VLE simulator is suitable in welding skills development training in terms of exposing new students with the relevant characteristics of welding skills and at the same time spurring the students’ interest towards learning more about the skills.

Keywords: computer-based training (CBT), knowledge workers (K-workers), virtual learning environment, welding simulator, welding technology

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Authors: Nasibullina A., Leonov D.

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The ultrasonography method is actively used for the early diagnosis of various le-sions in the human body, including the mammary gland. The incidence of breast cancer has increased by more than 20%, and mortality by 14% since 2008. The correctness of the diagnosis often directly depends on the qualifications and expe-rience of a diagnostic medical sonographer. That is why special attention should be paid to the practical training of future specialists. Anatomical phantoms are ex-cellent teaching tools because they accurately imitate the characteristics of real hu-man tissues and organs. The purpose of this work is to create a breast phantom for practicing ultrasound diagnostic skills in grayscale and elastography imaging, as well as ultrasound-guided biopsy sampling. We used silicone-like compounds ranging from 3 to 17 on the Shore scale hardness units to simulate soft tissue and lesions. Impurities with experimentally selected concentrations were added to give the phantom the necessary attenuation and reflection parameters. We used 3D modeling programs and 3D printing with PLA plastic to create the casting mold. We developed a breast phantom with inclusions of varying shape, elasticity and echogenicity. After testing the created phantom in B-mode and elastography mode, we performed a survey asking 19 participants how realistic the sonograms of the phantom were. The results showed that the closest to real was the model of the cyst with 9.5 on the 0-10 similarity scale. Thus, the developed breast phantom can be used for ultrasonography, elastography, and ultrasound-guided biopsy training.

Keywords: breast ultrasound, mammary gland, mammography, training phantom, tissue-mimicking materials

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Authors: Sheikh Shams Azam, Manoj Raju, Venkatesh Pagidimarri, Vamsi Kasivajjala

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Over the past decade, there has been a steep rise in the data-driven analysis in major areas of medicine, such as clinical decision support system, survival analysis, patient similarity analysis, image analytics etc. Most of the data in the field are well-structured and available in numerical or categorical formats which can be used for experiments directly. But on the opposite end of the spectrum, there exists a wide expanse of data that is intractable for direct analysis owing to its unstructured nature which can be found in the form of discharge summaries, clinical notes, procedural notes which are in human written narrative format and neither have any relational model nor any standard grammatical structure. An important step in the utilization of these texts for such studies is to transform and process the data to retrieve structured information from the haystack of irrelevant data using information retrieval and data mining techniques. To address this problem, the authors present Q-Map in this paper, which is a simple yet robust system that can sift through massive datasets with unregulated formats to retrieve structured information aggressively and efficiently. It is backed by an effective mining technique which is based on a string matching algorithm that is indexed on curated knowledge sources, that is both fast and configurable. The authors also briefly examine its comparative performance with MetaMap, one of the most reputed tools for medical concepts retrieval and present the advantages the former displays over the latter.

Keywords: information retrieval, unified medical language system, syntax based analysis, natural language processing, medical informatics

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Authors: Jasmine Renner, Alice Njuguna

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The booming technological revolution is driving a change in the mode of delivery systems especially for e-learning and distance learning in higher education. The report and findings of the study; an assessment of digital platforms, student online learning, teaching pedagogies, research and training at Kenya College of Accounting University (hereinafter 'KCA') was undertaken as a joint collaboration project between the Carnegie African Diaspora Fellowship and input from the staff, students and faculty at KCA University. The participants in this assessment/research met for selected days during a six-week period during which, one-one consultations, surveys, questionnaires, foci groups, training, and seminars were conducted to ascertain 'online learning and teaching, curriculum development, research and training at KCA.' The project was organized into an eight-week project workflow with each week culminating in project activities designed to assess digital online teaching and learning at KCA. The project also included the training of distance learning instructors at KCA and the evaluation of KCA’s distance platforms and programs. Additionally, through a curriculum audit and redesign, the project sought to enhance the curriculum development activities related to of distance learning at KCA. The findings of this assessment/research represent the systematic deliberate process of gathering, analyzing and using data collected from DL students, DL staff and lecturers and a librarian personnel in charge of online learning resources and access at KCA. We engaged in one-on-one interviews and discussions with staff, students, and faculty and collated the findings to inform practices that are effective in the ongoing design and development of eLearning earning at KCA University. Overall findings of the project led to the following recommendations. First, there is a need to address infrastructural challenges that led to poor internet connectivity for online learning, training needs and content development for faculty and staff. Second, there is a need to manage cultural impediments within KCA; for example fears of vital change from one platform to another for effectiveness and Institutional goodwill as a vital promise of effective online learning. Third, at a practical and short-term level, the following recommendations based on systematic findings of the research conducted were as follows: there is a need for the following to be adopted at KCA University to promote the effective adoption of online learning: a) an eLearning compatible faculty lab, b) revision of policy to include an eLearn strategy or strategic management, c) faculty and staff recognitions engaged in the process of training for the adoption and implementation of eLearning and d) adequate website resources on eLearning. The report and findings represent a comprehensive approach to a systematic assessment of online teaching and learning, research and training at KCA.

Keywords: e-learning, digital platforms, student online learning, online teaching pedagogies

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Authors: Donna-Marie Phyllis Lanton

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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that population

Keywords: muscle mass, muscle strength, older adults, PARIHS framework

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Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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Authors: Jui-Chen Huang

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This research used artificial intelligence method to explore elderly’s opinions on the reuse of telecare, its effect on their service quality, satisfaction and the relationship between customer perceived value and intention to reuse. This study conducted a questionnaire survey on the elderly. A total of 124 valid copies of a questionnaire were obtained. It adopted Backpropagation Network (BPN) to propose an effective and feasible analysis method, which is different from the traditional method. Two third of the total samples (82 samples) were taken as the training data, and the one third of the samples (42 samples) were taken as the testing data. The training and testing data RMSE (root mean square error) are 0.022 and 0.009 in the BPN, respectively. As shown, the errors are acceptable. On the other hand, the training and testing data RMSE are 0.100 and 0.099 in the regression model, respectively. In addition, the results showed the service quality has the greatest effects on the intention to reuse, followed by the satisfaction, and perceived value. This result of the Backpropagation Network method is better than the regression analysis. This result can be used as a reference for future research.

Keywords: artificial intelligence, backpropagation network (BPN), elderly, reuse, telecare

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Authors: Ching-Ting Hsu, Wei-Hua Ho, Yi-Chun Chang

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Video object tracking is one of the popular research topics in computer graphics area. The trajectory can be applied in security, traffic control, even the sports training. The trajectory for sports training can be utilized to analyze the athlete’s performance without traditional sensors. There are many relevant works which utilize mean shift algorithm with background subtraction. This kind of the schemes should select a kernel function which may affect the accuracy and performance. In this paper, we consider the motion information in the pre-coded bitstream. The proposed algorithm extracts the trajectory by composing the motion vectors from the pre-coded bitstream. We gather the motion vectors from the overlap area of the object and calculate mean of the overlapped motion vectors. We implement and simulate our proposed algorithm in H.264 video codec. The performance is better than relevant works and keeps the accuracy of the object trajectory. The experimental results show that the proposed trajectory extraction can extract trajectory form the pre-coded bitstream in high accuracy and achieve higher performance other relevant works.

Keywords: H.264, video bitstream, video object tracking, sports training

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Authors: Elriena Eksteen, Yolandi Willemse, Dawie D. J. Malan, Suria Ellis

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It is important to understand which competencies are needed for managerial and administrative effectiveness of school sport managers with regard to the design, delivery and direction of school sport programmes. The purpose of this study was to determine the competencies and training needs for secondary school sport managers in the North West Province. Data were gathered from 79 school sport managers in the North West Province by means of a validated self-compiled questionnaire. Descriptive statistics, factor analysis and a dependent t-test were used to compare which competencies school sport managers perceive as important in their work with the competencies they actually perform. Functional competencies and core competencies were both found to be important for managing school sport effectively. There were statistically significant differences between the perceived importance of competencies and the frequency with which competencies were actually performed. Respondents attached greater importance to functional and core competencies than the proportion of time spent actually performing them. Furthermore, results indicated the need to train teachers in managing sport finance, sport facilities and human resources, as well as presenting workshops in public relations, sport marketing and sport organisation.

Keywords: competencies, functional competencies, core competencies, school sport manager, training needs

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Authors: Maria Khan

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Framing good core Human Resource Management (HRM) functions like recruitment, selection, training and development, which if executed effectively, can become a strategic advantage for a company. HRM policies related to mid-level managers can depend on the type of top management. This may be due to the difference in perception of effective HRM policies of an expatriate and local leadership. This comparative case study assesses how local mid-level managers are managed in leading multinational telecom companies in Pakistan. Core HRM functions related to managers were analysed through field research based on semi-structured interviews with relevant Human Resource Managers. Results suggest that recruitment and selection practices are not too different and are in compliance with best HRM practices. However, there is a difference in the effective implementation of Training and Development policies. Changing global management trends and skill development dictate that MNCs continuously develop the local talent effectively for local and international success.

Keywords: recruitment, selection, training, development, core HRM, human resource management, subsidiary, international staffing, managers, MNC, expatriate

Procedia PDF Downloads 314

Authors: Lik Hang Gary Wong

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Background: Practice learning is crucial for preparing the healthcare profession to meet the real challenge upon graduation. Students are required to demonstrate their competence in managing interpersonal challenges, such as teamwork with other professionals and communicating well with the service users, during the placement. Such competence precedes clinical practice, and it may eventually affect students' actual performance in a clinical context. Unfortunately, there were limited studies investigating how such competence affects students' performance in practice learning. Objectives: The aim of this study is to investigate how self-rated interpersonal competence affects students' actual performance during clinical placement. Methods: 40 occupational therapy students from Hong Kong were recruited in this study. Prior to the clinical placement (level two or above), they completed an online survey that included the Interpersonal Communication Competence Scale (ICCS) measuring self-perceived competence in interpersonal communication. Near the end of their placement, the clinical educator rated students’ performance with the Student Practice Evaluation Form - Revised edition (SPEF-R). The SPEF-R measures the eight core competency domains required for an entry-level occupational therapist. This study adopted the cross-sectional observational design. Pearson correlation and multiple regression are conducted to examine the relationship between students' interpersonal communication competence and their actual performance in clinical placement. Results: The ICCS total scores were significantly correlated with all the SPEF-R domains, with correlation coefficient r ranging from 0.39 to 0.51. The strongest association was found with the co-worker communication domain (r = 0.51, p < 0.01), followed by the information gathering domain (r = 0.50, p < 0.01). Regarding the ICCS total scores as the independent variable and the rating in various SPEF-R domains as the dependent variables in the multiple regression analyses, the interpersonal competence measures were identified as a significant predictor of the co-worker communication (R² = 0.33, β = 0.014, SE = 0.006, p = 0.026), information gathering (R² = 0.27, β = 0.018, SE = 0.007, p = 0.011), and service provision (R² = 0.17, β = 0.017, SE = 0.007, p = 0.020). Moreover, some specific communication skills appeared to be especially important to clinical practice. For example, immediacy, which means whether the students were readily approachable on all social occasions, correlated with all the SPEF-R domains, with r-values ranging from 0.45 to 0.33. Other sub-skills, such as empathy, interaction management, and supportiveness, were also found to be significantly correlated to most of the SPEF-R domains. Meanwhile, the ICCS scores correlated differently with the co-worker communication domain (r = 0.51, p < 0.01) and the communication with the service user domain (r = 0.39, p < 0.05). It suggested that different communication skill sets would be required for different interpersonal contexts within the workplace. Conclusion: Students' self-perceived interpersonal communication competence could predict their actual performance during clinical placement. Moreover, some specific communication skills were more important to the co-worker communication but not to the daily interaction with the service users. There were implications on how to better prepare the students to meet the future challenge upon graduation.

Keywords: interpersonal competence, clinical education, healthcare professional education, occupational therapy, occupational therapy students

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Authors: John Pomerat, Aviv Segev

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Recently, deep learning has had many theoretical breakthroughs. For deep learning to be successful in the industry, however, there need to be practical algorithms capable of handling many real-world hiccups preventing the immediate application of a learning algorithm. Although AI promises to revolutionize the healthcare industry, getting access to patient data in order to train learning algorithms has not been easy. One proposed solution to this is data- sharing. In this paper, we propose an alternative protocol, based on multi-party computation, to train deep learning models while maintaining both the privacy and security of training data. We examine three methods of training neural networks in this way: Transfer learning, average ensemble learning, and series network learning. We compare these methods to the equivalent model obtained through data-sharing across two different experiments. Additionally, we address the security concerns of this protocol. While the motivating example is healthcare, our findings regarding multi-party computation of neural network training are purely theoretical and have use-cases outside the domain of healthcare.

Keywords: neural network aggregation, multi-party computation, transfer learning, average ensemble learning

Procedia PDF Downloads 151

Authors: Júlia Alarcon Pinto, Carlos João Schaffhausser, Gustavo Alarcon Pinto

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Introduction: The deaf people in Brazil communicate through the Brazilian Sign Language (LIBRAS), which is restricted to this minority and people that received training. However, there is a lack of prepared professionals in the health system to deal with these patients. Therefore, effective communication, health education, quality of support and assistance are compromised. It is of utmost importance to develop measures that ensure the inclusion of deaf parents and children since there are frequent doubts about sphincter training and an absence of tools to promote effective communication between doctors and their patients. Objective: Use of an efficient, rapid and cheap communication method to promote social inclusion and patient education of deaf parents and children during pediatrics appointments. Results; The application demonstrates how to express phrases and symptoms within seconds and this allows patients to fully understand the information provided during the appointment and are capable to evaluate the signs of readiness, learn the correct approaches with the child, what are the adequate instruments, possible obstacles and the importance to execute medical orientations in order to achieve success in the process. Consequently, patients feel more satisfied, secured and embraced by professionals in the health system care. Conclusion: It is of utmost importance to use efficient and cheap methods that support patient care and education in order to promote health and social inclusion.

Keywords: application, deaf patients, social inclusion, sphincter training

Procedia PDF Downloads 114