Search results for: occupational injuries

Authors: Junaid Hamid Bhat

Abstract:

Background: Musculoskeletal disorders are one of the main causes of occupational illness. Mechanisms and the factors like repetitive work, physical effort and posture, endangering the risk of musculoskeletal disorders would now appear to have been properly identified. Teacher’s exposure to work-related musculoskeletal disorders appears to be insufficiently described in the literature. Little research has investigated the prevalence and risk factors of musculoskeletal disorders in teaching profession. Very few studies are available in this regard and there are no studies evident in India. Purpose: To determine the prevalence of musculoskeletal disorders and to identify and measure the association of such risk factors responsible for developing musculoskeletal disorders among school teachers. Methodology: An observational cross sectional study was carried out. 500 school teachers from primary, middle, high and secondary schools were selected, based on eligibility criteria. A signed consent was obtained and a self-administered, validated questionnaire was used. Descriptive statistics was used to compute the statistical mean and standard deviation, frequency and percentage to estimate the prevalence of musculoskeletal disorders among school teachers. The data analysis was done by using SPSS version 16.0. Results: Results indicated higher pain prevalence (99.6%) among school teachers during the past 12 months. Neck pain (66.1%), low back pain (61.8%) and knee pain (32.0%) were the most prevalent musculoskeletal complaints of the subjects. Prevalence of shoulder pain was also found to be high among school teachers (25.9%). 52.0% subjects reported pain as disabling in nature, causing sleep disturbance (44.8%) and pain was found to be associated with work (87.5%). A significant association was found between musculoskeletal disorders and sick leaves/absenteeism. Conclusion: Work-related musculoskeletal disorders particularly neck pain, low back pain, and knee pain, is highly prevalent and risk factors are responsible for the development of same in school teachers. There is little awareness of musculoskeletal disorders among school teachers, due to work load and prolonged/static postures. Further research should concentrate on specific risk factors like repetitive movements, psychological stress, and ergonomic factors and should be carried out all over the country and the school teachers should be studied carefully over a period of time. Also, an ergonomic investigation is needed to decrease the work-related musculoskeletal disorder problems. Implication: Recall bias and self-reporting can be considered as limitations. Also, cause and effect inferences cannot be ascertained. Based on these results, it is important to disseminate general recommendations for prevention of work-related musculoskeletal disorders with regards to the suitability of furniture, equipment and work tools, environmental conditions, work organization and rest time to school teachers. School teachers in the early stage of their careers should try to adapt the ergonomically favorable position whilst performing their work for a safe and healthy life later. Employers should be educated on practical aspects of prevention to reduce musculoskeletal disorders, since changes in workplace and work organization and physical/recreational activities are required.

Keywords: work related musculoskeletal disorders, school teachers, risk factors funding, medical and health sciences

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Authors: Eric Mwenda, Shadrack Ngene

Abstract:

Human-wildlife conflicts (HWCs) are the main threat to conservation in Africa. This is because wildlife needs overlap with those of humans. In Kenya, about 70% of wildlife occurs outside protected areas. As a result, wildlife and human range overlap, causing HWCs. The HWCs in Kenya occur in the drylands adjacent to protected areas. The top five counties with the highest incidences of HWC are Taita Taveta, Narok, Lamu, Kajiado, and Laikipia. The common wildlife species responsible for HWCs are elephants, buffaloes, hyenas, hippos, leopards, baboons, monkeys, snakes, and crocodiles. To ensure individuals affected by the conflicts are compensated, Kenya has developed a model of HWC compensation claims data collection and payment. We collected data on HWC from all eight Kenya Wildlife Service (KWS) Conservation Areas from 2009 to 2019. Additional data was collected from stakeholders' consultative workshops held in the Conservation Areas and a literature review regarding payment of injuries and ongoing insurance schemes being practiced in areas. This was followed by the description of the claims administration process and calculation of the pricing of the compensation claims. We further developed a digital platform for data capture and processing of all reported conflict cases and payments. Our product recognized four categories of HWC (i.e., human death and injury, property damage, crop destruction, and livestock predation). Personal bodily injury and human death were provided based on the Continental Scale of Benefits. We proposed a maximum of Kenya Shillings (KES) 3,000,000 for death. Medical, pharmaceutical, and hospital expenses were capped at a maximum of KES 150,000, as well as funeral costs at KES 50,000. Pain and suffering were proposed to be paid for 12 months at the rate of KES 13,500 per month. Crop damage was to be based on farm input costs at a maximum of KES 150,000 per claim. Livestock predation leading to death was based on Tropical Livestock Unit (TLU), which is equivalent to KES 30,000, whick includes Cattle (1 TLU = KES 30,000), Camel (1.4 TLU = KES 42,000), Goat (0.15 TLU = 4,500), Sheep (0.15 TLU = 4,500), and Donkey (0.5 TLU = KES 15,000). Property destruction (buildings, outside structures and harvested crops) was capped at KES 150,000 per any one claim. We conclude that it is possible to use an administrator to collect data on HWC compensation claims and make payments using technology. The success of the new approach will depend on a piloting program. We recommended that a pilot scheme be initiated for eight months in Taita Taveta, Kajiado, Baringo, Laikipia, Narok, and Meru Counties. This will test the claims administration process as well as harmonize data collection methods. The results of this pilot will be crucial in adjusting the scheme before country-wide roll out.

Keywords: human-wildlife conflicts, compensation, human death and injury, crop destruction, predation, property destruction

Procedia PDF Downloads 55

Authors: Abdulwhab Alotaibi, Abdullah Alzahrani, Ziyad Bokhari, Abdulelah Alghamdi

Abstract:

First described in 1975 by Dr. Miller, Medical dressings are uncommon but possible cause of hand digital ischemia due the tourniquet-like effect. The incident of this complication has been reported across wide range of age-groups, yet it seems like that the pediatric population are specifically vulnerable. Multiple dressing types were reported to have caused ischemic injury, such as elastic wrap, tubular gauze, and self-adherent dressings. We present a case of medical dressing induced digital ischemia in patient with Congenital insensitivity to pain and anhidrosis (CIPA), which further challenge the discovery of the condition. An 8-year-old girl known case of CIPA. Brought by her mother to the ER after nail bed injury, which she managed by application of elastic wrap that was left for 24 hours. When the mother found out she immediately removed the elastic band, and noticed the fingertip was black and cold with tense bullae. The color then changed later when she arrived to the ER to dark purple with bluish discoloration on the tip. On examination there was well demarcated tense bullae on the distal right fifth finger. Neurovascular intact, pulse oximetry on distal digit 100%, capillary refill time was delayed. She was seen under Plastic surgery and conservative management recommended, and patient was discharged with safety netting. Two days later the patient came as follow-up visit at which her condition demonstrated significant improvement, the bullae has since ruptured leaving behind sloughed skin, capillary refill and pulse oximetry were both within normal limits, sensory function couldn’t be assessed but her motor function and ROM were normal, topical bacitracin and bandage dressings were applied for the eroded skin. Patient was scheduled for a follow-up in 2 weeks. Preventatively it’s advisable to avoid the commonly implicated dressings such as elastic, tubular gauze or self-adherent wraps in hand or digital injuries when possible, but in cases where the use of these dressings is of necessity the appropriate precautions must be taken, Dr. Makarewich proposed the following 5 measures to help minimize the incidence of the injury: 1-Unwrapping 12 inches of the dressing before rolling the injured finger. 2-Wrapping from distal to proximal with minimal tension to avoid vascular embarrassment. 3-The use of 5-25 inch to overlap the entire wrap. 4-Maintaining light pressure over the wrap to allow adherence of the dressing. 5-Minimization of the number of layers used to wrap the affected digit. Also assessing the capillary refill after the application can help in determining the patency of the supplying blood vessels. It’s also important to selectively determine if the patient is a candidate for conservative management, as tailored approach can help in maximizing the positive outcomes for our patients.

Keywords: congenital insensitivity to pain, digital ischemia, medical dressing, conservative management

Procedia PDF Downloads 63

Authors: James G. Matthew, Seonmin Huh, Frank X. Bennett

Abstract:

English for Specific Purposes, ESP, aims to equip learners with necessary English language skills. Many ESP programs address language skills for job performance, including reading job related documents and oral proficiency. Within ESP is English for occupational purposes, EOP, which centers around developing communicative competence for the globalized workplace. Many ESP and EOP courses lack the content needed to assist students to progress at work, resulting in the need to create lexical compilation for different professions. It is important to teach communicative competence and soft skills for real job-related problem situations and address the complexities of the real world to help students to be successful in their professions. ESP and EOP research is therefore trying to balance both profession-specific educational contents as well as international multi-disciplinary language skills for the globalized workforce. The current study will build upon the existing discussion by developing pedagogy to assist students in their career through developing a strong practical command of relevant English vocabulary. Our research question focuses on the pedagogy two professors incorporated in their English for employment courses. The current study is a qualitative case study on the modes of teaching delivery for EOP in South Korea. Two foreign professors teaching at two different universities in South Korea volunteered for the study to explore their teaching practices. Both professors’ curriculums included the components of employment-related concept vocabulary, business presentations, CV/resume and cover letter preparation, and job interview preparation. All the pre-made recorded video lectures, live online class sessions with students, teachers’ lesson plans, teachers’ class materials, students’ assignments, and midterm and finals video conferences were collected for data analysis. The study then focused on unpacking representative patterns in their teaching methods. The professors used their strengths as native speakers to extend the class discussion from narrow and restricted conversations to giving students broader opportunities to practice authentic English conversation. The methods of teaching utilized three main steps to extend the conversation. Firstly, students were taught concept vocabulary. Secondly, the vocabulary was then combined in speaking activities where students had to solve scenarios, and the students were required to expand on the given forms of words and language expressions. Lastly, the students had conversations in English, using the language learnt. The conversations observed in both classes were those of authentic, expanded English communication and this way of expanding concept vocabulary lessons into extended conversation is one representative pedagogical approach that both professors took. Extended English conversation, therefore, is crucial for EOP education.

Keywords: concept vocabulary, english as a foreign language, english for employment, extended conversation

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Authors: Alireza Barari, Ahmad Abdi

Abstract:

Introduction: Plyometric training (PT) is popular among individuals involved in dynamic sports, and is executed with a goal to improve muscular performance. Cytokines are considered as immunoregulatory molecules for regulation of immune function and other body responses. In addition, the pro-inflammatory cytokines, TNF-α andIL-1β, have been reported to be increased during and after exercises. If some of the cytokines which cause responses such as inflammation of cells in skeletal muscles, with manipulating of training program or optimizing nutrition, it can be avoided or limited from those injuries caused by cytokines release. Its shows that mistletoe extracts show immune-modulating effects. Materials and methods: present study was to investigate the effect of six weeks PT with or without mistletoe supplementation (MS)(10 mg/kg) on cytokine responses and performance in male basketball players. This study is semi-experimental. Statistic society of this study was basketball player’s male students of Mahmoud Abad city. Statistic samples are concluded of 32 basketball players with an age range of 14–17 years was selected from randomly. Selection of samples in four groups of 8 individuals Participants were randomly assigned to either an experimental group (E, n=16) that performed plyometric exercises with (n=8) or without (n=8) MS, or a control group that rested (C, n=16) with (n=8) or without (n=8) MS. Plants were collected in June from the Mazandaran forest in north of Iran. Then they dried in exposure to air without any exposition to sunlight, on a clean textile. For better drying the plants were high and down until they lost their water. Each subject consumed 10 mg/kg/day of extract for six weeks of intervention. Pre and post-testing was performed in the afternoon of the same day. Blood samples (10 ml) were collected from the intermediate cubital vein of the subjects. Serum concentration of IL-1β and TNF-α were measured by ELISA method. Data analysis was performed using pretest to posttest changes that assessed by t-test for paired samples. After the last plyometric training program, the second blood samples were in the next day. Group differences at baseline were evaluated using One-way ANOVA (post-hock Tukey) test is used for analysis and comparison of three group’s variables. Results: PT with or without MS improved the one repetition maximum leg and chest press, Sargeant test and power in RAST (P < 0.05). However there were no statistically significant differences between groups in Vo2max measures (P > 0.05). PT resulted in a significant increase in plasma IL-1β concentration from 1.08±0.4 mg/ml in pre-training to 1.68±0.18 mg/ml in post-training (P=0.006). While the MS significantly decreased the training-induced increment of IL-1β (P=0.007). In contrast, neither PT nor MS had any effect on TNF-α levels (P > 0.05). Discussion: The results of this investigation indicate that PT improved muscular performance and increases the IL-1β concentration. Increasing of IL-1β after exercise in damaged skeletal muscle has shown of the role of this cytokine in inflammation processes and damaged skeletal muscle repair. However mistletoe supplementation ameliorates the increment of IL-1β levels, indicating the beneficial effect of mistletoe on immune response following plyometric training.

Keywords: mistletoe supplementation, training, IL-1β, TNF-α

Procedia PDF Downloads 651

Authors: S. A. Abeykoon

Abstract:

This study explores the empowerment potential of the mobile phone, the widely penetrated and greatly affordable communication technology in Sri Lanka, for female heads of households in Trincomalee District, Sri Lanka-an area recovering from the effects of a 30-year civil war and the 2004 Boxing Day Tsunami. It also investigates how the use of mobile phones by these women is shaped and appropriated by the gendered power relations and inequalities in their respective communities and by their socio-economic factors and demographic characteristics. This qualitative study is based on the epistemology of constructionism; interpretivist, functionalist and critical theory approaches; and the process of action research. The data collection was conducted from September 2014 to November 2014 in two Divisional Secretaries of the Trincomalee District, Sri Lanka. A total of 30 semi-structured depth interviews and six focus groups with the female heads of households of Sinhalese, Tamil and Muslim ethnicities were conducted using purposive, representative and snowball sampling methods. The Grounded theory method was used to analyze transcribed interviews, focus group discussions and field notes that were coded and categorized in accordance with the research questions and the theoretical framework of the study. The findings of the study indicated that the mobile phone has mainly enabled the participants to balance their income earning activities and family responsibilities and has been useful in maintaining their family and social relationships, occupational duties and in making decisions. Thus, it provided them a higher level of security, safety, reassurance and self-confidence in carrying out their daily activities. They also practiced innovative strategies for the effective and efficient use of their mobile expenses. Although participants whose husbands or relatives have migrated were more tended to use smart phones, mobile literacy level of the majority of the participants was at a lower level limited to making and receiving calls and using SMS (Short Message Service) services. However, their interaction with the mobile phone was significantly shaped by the gendered power relations and their multiple identities based on their ethnicity, religion, class, education, profession and age. Almost all the participants were precautious of giving their mobile numbers to and have been harassed with ‘nuisance calls’ from men. For many, ownership and use of their mobile phone was shaped and influenced by their children and migrated husbands. Although these practices limit their use of the technology, there were many instances that they challenged these gendered harassments. While man-made and natural destructions have disempowered and victimized the women in the Sri Lankan society, they have also liberated women making them stronger and transforming their agency and traditional gender roles. Therefore, their present position in society is reflected in their mobile phone use as they assist such women to be more self-reliant and liberated, yet making them disempowered at some time.

Keywords: mobile phone, gender power relations, empowerment, female heads of households

Procedia PDF Downloads 336

Authors: Afentoula Mavrodi, Andreas Georgiou, Georgios Tsiotras, Vassilis Aletras

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Placing a monetary value on a quality-adjusted-life-year (QALY) is of utmost importance in economic evaluation. Identifying the population’s preferences is critical in order to understand some of the reasons driving variations in the assigned monetary value. Yet, evidence of the motives behind value assignment to a QALY by the general public is limited. Developing an instrument that would capture the population’s motives could be proven valuable to policy-makers, to guide them in allocating different values to a QALY based on users’ motivations. The aim of this study was to identify the most relevant motives and develop an appropriate instrument to assess them. To design the instrument, we employed: a) the EQ-5D-3L tool to assess participants’ current health status, and b) the Willingness-to-Pay (WTP) approach, within the Contingent Valuation (CV) Method framework, to elicit the monetary value. Advancing the open-ended approach adopted to assess solely protest bidders’ motives; a variety of follow-up item-specific statements were designed (deductive approach), aiming to evaluate motives of both protest bidders and participants willing to pay for the hypothetical treatment under consideration. The initial design of the survey instrument was the outcome of an extensive literature review. This instrument was revised based on 15 semi-structured interviews that took place in September 2018 and a pilot study held during two months (October-November) in 2018. Individuals with different educational, occupational and economical backgrounds and adequate verbal skills were recruited to complete the semi-structured interviews. The follow-up motivation statements of both protest bidders and those willing to pay were revised and rephrased after the semi-structured interviews. In total 4 statements for protest bidders and 3 statements for those willing to pay for the treatment were chosen to be included in the survey tool. Using the CATI (Computer Assisted Telephone Interview) method, a randomly selected sample of 97 persons living in Thessaloniki, Greece, completed the questionnaire on two occasions over a period of 4 weeks. Based on pilot study results, a test-retest reliability assessment was performed using the intra-class correlation coefficient (ICC). All statements formulated for protest bidders showed acceptable reliability (ICC values of 0.84 (95% CI: 0.67, 0.92) and above). Similarly, all statements for those willing to pay for the treatment showed high reliability (ICC values of 0.86 (95% CI: 0.78, 0.91) and above). Overall, the instrument designed in this study was reliable with regards to the item-specific statements assessing participants’ motivation. Validation of the instrument will take place in a future study. For a holistic WTP per QALY instrument, participants’ motivation must be addressed broadly. The instrument developed in this study captured a variety of motives and provided insight with regards to the method through which the latter are evaluated. Last but not least, it extended motive assessment to all study participants and not only protest bidders.

Keywords: contingent valuation method, instrument, motives, quality-adjusted life-year, willingness-to-pay

Procedia PDF Downloads 136

Authors: Bei Shan Lin, Chun Mei Lu, Ya Ping Chen, Li Chen Lu

Abstract:

This study explores the ethical issues concerning the use of physical restraint in geriatric care. Physical restraint use in a medical care setting is seen as a controversial form of treatment that has occurred over decades. There is no doubt that people nowadays are living longer than previous generations. The ageing process is inevitable. Common disease such as impaired comprehension, memory loss, and trouble expressing one’s self contribute to the difficulty that these older patients have in adapting to medical institution. For these reasons, physical restraint is often used in reducing the risk of falling, managing wandering behaviour, preventing agitation, and promoting patient compliance in geriatric care. It can mean that physical restraints are considered as a common practice that is used in the care of older patients. It is most commonly used for three specific purposes, including procedural restraint, restraint to prevent falls, and behavioural restraints. Although there have been well documented instances of morbidity and mortality recognised as being potential risks associated with physical restraint use, it continues to be permitted and used in healthcare, often in the name of safety. However, there is insufficient evidence supporting the effectiveness of physical restraint use reducing injuries from falls and controlling challenging behaviour in geriatric care settings. There is barely any empirical evidence of either a scientific basis or clinical trials have evaluated the improvement in patient safety following physical restraint. In difficult clinical situations, guidelines and practical suggestions for Healthcare professionals to comply requirements can help those making appropriate decisions and to facilitate better judgement regarding physical restraint use. The following recommendations are given for physical restraint use in long-term care settings: an interdisciplinary team approach to assess, evaluate, and treat underlying diseases to determine if treatment can ease issues precipitating physical restraint use; a clearly stated purpose of treatment plan should be made after weighing up the risk of physical restraint use against the risk of without physical restraint use; a care plan for physical restraint has to include individualised treatment planning, informed consent, identification and remedial action to avoid negative consequences, regular assessment and modification, reduction and removal of risks; patients and their families must have the opportunity to consider and give voluntary informed consent prior to physical restraint utilisation; patients, family members, and Healthcare professionals should be educated on use and adverse consequences of physical restraints in order to make raise awareness of potential risks and to take appropriate steps to prevent unnecessary harm; after physical restraint removal, Healthcare professionals should discuss with patients and family members about their experience, feelings, and any anxieties regarding the treatment. Physical restraint should always be considered a last resort as deprive patient’s freedom, control, and individuality. Healthcare professionals should emphasise on providing individualized care, interdisciplinary decision-making process, and creative and collaborative alternatives to promote older patient’s rights, dignity and overall well-being as much as possible.

Keywords: ethics healthcare, geriatric care, healthcare, physical restraint

Procedia PDF Downloads 133

Authors: Sachil Kumar, Anoop Kumar Verma, Wahid Ali, Uma Shankar Singh

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Globally approximately 55.3 million people die each year. In the India there were 95 lakh annual deaths in 2013. The number of deaths resulted from homicides, suicides and unintentional injuries in the same period was about 5.7 lakh. The ever-increasing crime rate necessitated the development of methods for determining time since death. An erroneous time of death window can lead investigators down the wrong path or possibly focus a case on an innocent suspect. In this regard a research was carried out by analyzing the temperature dependent degradation of a Cardiac Troponin-T protein (cTnT) in the myocardium postmortem as a marker for time since death. Cardiac tissue samples were collected from (n=6) medico-legal autopsies, (in the Department of Forensic Medicine and Toxicology, King George’s Medical University, Lucknow India) after informed consent from the relatives and studied post-mortem degradation by incubation of the cardiac tissue at room temperature (20±2 OC), 12 0C, 25 0C and 37 0C for different time periods ((~5, 26, 50, 84, 132, 157, 180, 205, and 230 hours). The cases included were the subjects of road traffic accidents (RTA) without any prior history of disease who died in the hospital and their exact time of death was known. The analysis involved extraction of the protein, separation by denaturing gel electrophoresis (SDS-PAGE) and visualization by Western blot using cTnT specific monoclonal antibodies. The area of the bands within a lane was quantified by scanning and digitizing the image using Gel Doc. The data shows a distinct temporal profile corresponding to the degradation of cTnT by proteases found in cardiac muscle. The disappearance of intact cTnT and the appearance of lower molecular weight bands are easily observed. Western blot data clearly showed the intact protein at 42 kDa, two major (27 kDa, 10kDa) fragments, two additional minor fragments (32 kDa) and formation of low molecular weight fragments as time increases. At 12 0C the intensity of band (intact cTnT) decreased steadily as compared to RT, 25 0C and 37 0C. Overall, both PMI and temperature had a statistically significant effect where the greatest amount of protein breakdown was observed within the first 38 h and at the highest temperature, 37 0C. The combination of high temperature (37 0C) and long Postmortem interval (105.15 hrs) had the most drastic effect on the breakdown of cTnT. If the percent intact cTnT is calculated from the total area integrated within a Western blot lane, then the percent intact cTnT shows a pseudo-first order relationship when plotted against the log of the time postmortem. These plots show a good coefficient of correlation of r = 0.95 (p=0.003) for the regression of the human heart at different temperature conditions. The data presented demonstrates that this technique can provide an extended time range during which Postmortem interval can be more accurately estimated.

Keywords: degradation, postmortem interval, proteolysis, temperature, troponin

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Authors: Ramalan Musa Yerima

Abstract:

The paper titled “loading by number” explained a strategy developed recently by Zonal Commanding Officer of the Federal Road Safety Corps of Nigeria, covering Sokoto, Kebbi and Zamfara States of Northern Nigeria. The strategy is aimed at reducing competition, which will invariably leads to the reduction in speed, reduction in dangerous driving, reduction in crash rate, reduction in injuries, reduction in property damages and reduction in death through road traffic crashes (RTC). This research paper presents a study focused on enhancing the safety of commercial vehicles. The background of this study highlights the alarming statistics related to commercial vehicle crashes in Nigeria with focus on Sokoto, Kebbi and Zamfara States, which often result in significant damage to property, loss of lives, and economic costs. The significance and aims is to investigate and propose effective strategy to enhance the safety of commercial vehicles. The study recognizes the pressing need for heightened safety measures in commercial transportation, as it impacts not only the well-being of drivers and passengers but also the overall public safety. To achieve the objectives, an examination of accident data, including causes and contributing factors, was performed to identify critical areas for improvement. The major finding of the study reveals that when competition comes into play within the realm of commercial driving, it has detrimental effects on road safety and resource management. Commercial drivers are pushed to complete their routes quickly, deliver goods on time or they pushed themselves to arrive quickly for more passengers and new contracts. This competitive environment, fuelled by internal and external pressures such as tight deadlines, poverty and greed, often leads to sad endings. The study recommend that if a strategy called loading by number is integrated with other multiple safety measures such as driver training programs, regulatory enforcement, and infrastructure improvements, commercial vehicle safety can be significantly enhanced. "Loading by Number” approach is design to ensure that the sequence of departure of drivers from motor park ‘A’ would be communicated to motor park officials of park ‘B’, which would be considered sequentially when giving them returning passengers, regardless of the first to arrive. In conclusion, this paper underscores the significance of improving the safety measures of commercial vehicles, as they are often larger and heavier than other vehicles on the road. Whenever they are involved in accidents, the consequences can be more severe. Commercial vehicles are also frequently involved in long-haul or interstate transportation, which means they cover longer distances and spend more time on the road. This increased exposure to driving conditions increases the probability of accidents occurring. By implementing the suggested measures, policymakers, transportation authorities, and industry stakeholders can work collectively towards ensuring a safer commercial transportation system.

Keywords: commercial, safety, strategy, transportation

Procedia PDF Downloads 61

Authors: William Elnemer, Nauman Hussain, Samir Al-Ali, Henry Shu, Diane Ghanem, Babar Shafiq

Abstract:

Introduction: The incidence of infection in open tibial shaft injuries varies depending on the severity of the injury, with rates ranging from 1.8% for Gustilo-Anderson type I to 42.9% for type IIIB fractures. The timely administration of antibiotics upon presentation to the emergency department (ED) is an essential component of fracture management, and evidence indicates that prompt delivery of antibiotics is associated with improved outcomes. The objective of this study is to identify factors that contribute to the expedient administration of antibiotics. Methods: This is a retrospective study of open tibial shaft fractures at an academic Level I trauma center. Current Procedural Terminology (CPT) codes identified all patients treated for open tibial shaft fractures between 2015 and 2021. Open fractures were identified by reviewing ED and provider notes, and with ballistic fractures were considered open. Chart reviews were performed to extract demographics, fracture characteristics, postoperative outcomes, time to operative room, time to antibiotic order, and delivery. Univariate statistical analysis compared patients who received early antibiotics (EA), which were delivered within one hour of ED presentation, and those who received late antibiotics (LA), which were delivered outside of one hour of ED presentation. A multivariate analysis was performed to investigate patient, fracture, and transport/ED characteristics contributing to faster delivery of antibiotics. The multivariate analysis included the dependent variables: ballistic fracture, activation of Delta Trauma, Gustilo-Andersen (Type III vs. Type I and II), AO-OTA Classification (Type C vs. Type A and B), arrival between 7 am and 11 pm, and arrival via Emergency Medical Services (EMS) or walk-in. Results: Seventy ED patients with open tibial shaft fractures were identified. Of these, 39 patients (55.7%) received EA, while 31 patients (44.3%) received LA. Univariate analysis shows that the arrival via EMS as opposed to walk-in (97.4% vs. 74.2%, respectively, p = 0.01) and activation of Delta Trauma (89.7% vs. 51.6%, respectively, p < 0.001) was significantly higher in the EA group vs. the LA group. Additionally, EA cases had significantly shorter intervals between the antibiotic order and delivery when compared to LA cases (0.02 hours vs. 0.35 hours, p = 0.007). No other significant differences were found in terms of postoperative outcomes or fracture characteristics. Multivariate analysis shows that a Delta Trauma Response, arrival via EMS, and presentation between 7 am and 11 pm were independent predictors of a shorter time to antibiotic administration (Odds Ratio = 11.9, 30.7, and 5.4, p = 0.001, 0.016, and 0.013, respectively). Discussion: Earlier antibiotic delivery is associated with arrival to the ED between 7 am and 11 pm, arrival via EMS, and a coordinated Delta Trauma activation. Our findings indicate that in cases where administering antibiotics is critical to achieving positive outcomes, it is advisable to employ a coordinated Delta Trauma response. Hospital personnel should be attentive to the rapid administration of antibiotics to patients with open fractures who arrive via walk-in or during late-night hours.

Keywords: antibiotics, emergency department, fracture management, open tibial shaft fractures, orthopaedic surgery, time to or, trauma fractures

Procedia PDF Downloads 65

Authors: Ramalan Musa Yerima

Abstract:

The paper titled “Loading by number” explained a strategy developed recently by the Zonal Commanding Officer of the Federal Road Safety Corps of Nigeria, covering Sokoto, Kebbi and Zamfara States of Northern Nigeria. The strategy is aimed at reducing competition, which will invariably lead to a reduction in speed, reduction in dangerous driving, reduction in crash rate, reduction in injuries, reduction in property damages and reduction in death through road traffic crashes (RTC). This research paper presents a study focused on enhancing the safety of commercial vehicles. The background of this study highlights the alarming statistics related to commercial vehicle crashes in Nigeria with a focus on Sokoto, Kebbi and Zamfara States, which often result in significant damage to property, loss of lives, and economic costs. The significance and aims is to investigate and propose an effective strategy to enhance the safety of commercial vehicles. The study recognizes the pressing need for heightened safety measures in commercial transportation, as it impacts not only the well-being of drivers and passengers but also the overall public safety. To achieve the objectives, an examination of accident data, including causes and contributing factors, was performed to identify critical areas for improvement. The major finding of the study reveals that when competition comes into play within the realm of commercial driving, it has detrimental effects on road safety and resource management. Commercial drivers are pushed to complete their routes quickly and deliver goods on time, or they push themselves to arrive quickly for more passengers and new contracts. This competitive environment, fuelled by internal and external pressures such as tight deadlines, poverty and greed, often leads to sad endings. The study recommends that if a strategy called loading by number is integrated with other multiple safety measures, such as driver training programs, regulatory enforcement, and infrastructure improvements, commercial vehicle safety can be significantly enhanced. "Loading by Number” approach is designed to ensure that the sequence of departure of drivers from the motor park ‘A’ would be communicated to motor park officials of park ‘B’, which would be considered sequentially when giving them returning passengers, regardless of the first to arrive. In conclusion, this paper underscores the significance of improving the safety measures of commercial vehicles, as they are often larger and heavier than other vehicles on the road. Whenever they are involved in accidents, the consequences can be more severe. Commercial vehicles are also frequently involved in long-haul or interstate transportation, which means they cover longer distances and spend more time on the road. This increased exposure to driving conditions increases the probability of accidents occurring. By implementing the suggested measures, policymakers, transportation authorities, and industry stakeholders can work collectively toward ensuring a safer commercial transportation system.

Keywords: commercial, safety, strategy, transport

Procedia PDF Downloads 63

Authors: Pawel Kiper, Alfonc Baba, Mahmoud Alhelou, Giorgia Pregnolato, Michela Agostini, Andrea Turolla

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Impairment of cervical spine mobility is often related to pain triggered by musculoskeletal disorders or direct traumatic injuries of the spine. To date, these disorders are assessed with goniometers and inclinometers, which are the most popular devices used in clinical settings. Nevertheless, these technologies usually allow measurement of no more than two-dimensional range of motion (ROM) quotes in static conditions. Conversely, the wide use of motion tracking systems able to measure 3 to 6 degrees of freedom dynamically, while performing standard ROM assessment, are limited due to technical complexities in preparing the setup and high costs. Thus, motion tracking systems are primarily used in research. These systems are an integral part of virtual reality (VR) technologies, which can be used for measuring spine mobility. To our knowledge, the accuracy of VR measure has not yet been studied within virtual environments. Thus, the aim of this study was to test the reliability of a protocol for the assessment of sensorimotor function of the cervical spine in a population of healthy subjects and to compare whether using immersive or non-immersive VR for visualization affects the performance. Both VR assessments consisted of the same five exercises and random sequence determined which of the environments (i.e. immersive or non-immersive) was used as first assessment. Subjects were asked to perform head rotation (right and left), flexion, extension and lateral flexion (right and left side bending). Each movement was executed five times. Moreover, the participants were invited to perform head reaching movements i.e. head movements toward 8 targets placed along a circular perimeter each 45°, visualized one-by-one in random order. Finally, head repositioning movement was obtained by head movement toward the same 8 targets as for reaching and following reposition to the start point. Thus, each participant performed 46 tasks during assessment. Main measures were: ROM of rotation, flexion, extension, lateral flexion and complete kinematics of the cervical spine (i.e. number of completed targets, time of execution (seconds), spatial length (cm), angle distance (°), jerk). Thirty-five healthy participants (i.e. 14 males and 21 females, mean age 28.4±6.47) were recruited for the cervical spine assessment with immersive and non-immersive VR environments. Comparison analysis demonstrated that: head right rotation (p=0.027), extension (p=0.047), flexion (p=0.000), time (p=0.001), spatial length (p=0.004), jerk target (p=0.032), trajectory repositioning (p=0.003), and jerk target repositioning (p=0.007) were significantly better in immersive than non-immersive VR. A regression model showed that assessment in immersive VR was influenced by height, trajectory repositioning (p<0.05), and handedness (p<0.05), whereas in non-immersive VR performance was influenced by height, jerk target (p=0.002), head extension, jerk target repositioning (p=0.002), and by age, head flex/ext, trajectory repositioning, and weight (p=0.040). The results of this study showed higher accuracy of cervical spine assessment when executed in immersive VR. The assessment of ROM and kinematics of the cervical spine can be affected by independent and dependent variables in both immersive and non-immersive VR settings.

Keywords: virtual reality, cervical spine, motion analysis, range of motion, measurement validity

Procedia PDF Downloads 166

Authors: N. Uaphongsathorn, C. Worawong, S. Thaewpia

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Background and significance: The population is aging in Thai society, the elderly dependent is at great risk of various functional, psychological, and socio-economic problems as well as less access to health care. They may require long term care at home to maximize their functional abilities and activities of daily living and to improve their quality of life during their own age. Therefore, there is a need to develop a home-based long term care to meet the long term care needs of elders dependent. Methods: The research purpose was to develop long term care model among the elderly dependent in Chaiyaphum province in Northeast region of Thailand. Action Research which is composing of planning, action, observation, and reflection phases was used. Research was carried out for 12 months in all sub-districts of 6 districts in Chaiyaphum province. Participants (N = 1,010) participating in the processes of model development were comprised of 3 groups: a) a total of 110 health care professionals, b) a total of 600 health volunteers and family caregivers and c) a total of 300 the elderly dependent with chronically medical illnesses or disabilities. Descriptive statistics and content analysis were used to analyze data. Findings: Results have shown that the most common health problems among elders dependent with physical disabilities to function independently were cardiovascular disease, dementia, and traffic injuries. The development of home-based long term care model among elders dependent in Chaiyaphum province was composed of six key steps. They are: a) initiating policies supporting formal and informal caregivers for the elder dependent in all sub-districts, b) building network and multidisciplinary team, c) developing 3-day care manager training program and 3-day care provider training program d) training case managers and care providers for the elderly dependent through team and action learning, e) assessing, planning and providing care based on care individual’s needs of the elderly dependent, and f) sharing experiences for good practice and innovation for long term care at homes in district urban and rural areas. Among all care managers and care providers, the satisfaction level for training programs was high with a mean score of 3.98 out of 5. The elders dependent and family caregivers addressed that long term care at home could contribute to improving life’s daily activities, family relationship, health status, and quality of life. Family caregivers and volunteers have feeling a sense of personal satisfaction and experiencing providing meaningful care and support for elders dependent. Conclusion: In conclusion, a home-based long term care is important to Thai elders dependent. Care managers and care providers play a large role and responsibility to provide appropriate care to meet the elders’ needs in both urban and rural areas in Thai society. Further research could be rigorously studied with a larger group of populations in similar socio-economic and cultural contexts.

Keywords: elderly people, care manager, care provider, long term care

Procedia PDF Downloads 302

Authors: Maryam Nazari

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COVID-19 is a respiratory disease triggered by the novel coronavirus, SARS-CoV-2, that has reached pandemic status today. Acute inflammation and immune cells infiltration into lung injuries result in multi-organ failure. The presence of other non-communicable diseases (NCDs) with systemic inflammation derived from COVID-19 may exacerbate the patient's situation and increase the risk for adverse effects and mortality. This pandemic is a novel situation and the scientific community at this time is looking for vaccines or drugs to treat the pathology. One of the biggest challenges is focused on reducing inflammation without compromising the correct immune response of the patient. In this regard, addressing the nutritional factors should not be overlooked not only as a matter of avoiding the presence of NCDs with severe infections but also as an adjunctive way to modulate the inflammatory status of the patients. Despite the pivotal role of nutrition in modifying immune response, due to the novelty of the COVID-19 disease, information about the effects of specific dietary agents is limited in this area. From the macronutrients point of view, protein deficiency (quantity or quality) has negative effects on the number of functional immunoglobulins and gut-associated lymphoid tissue (GALT). High biological value proteins or some amino acids like arginine and glutamine are well known for their ability to augment the immune system. Among lipids, fish oil has the ability to inactivate enveloped viruses, suppress pro-inflammatory prostaglandin production and block platelet-activating factors and their receptors. In addition, protectin D1, which is an Omega-3 PUFAs derivation, is a novel antiviral drug. So it seems that these fatty acids can reduce the severity and/or improve recovery of patients with COVID-19. Carbohydrates with lower glycemic index and fibers are associated with lower levels of inflammatory cytokines (CRP, TNF-α, and IL-6). Short-Chain Fatty acids not only exert a direct anti-inflammatory effect but also provide appropriate gut microbial, which is important in gastrointestinal issues related to COVID-19. From the micronutrients point of view, Vitamins A, C, D, E, iron, magnesium, zinc, selenium and copper play a vital role in the maintenance of immune function. Inadequate status in these nutrients may result in decreased resistance against COVID-19 infection. There are specific bioactive compounds in the diet that interact with the ACE2 receptor, which is the gateway for SARS and SARS-CoV-2, and thus controls the viral infection. Regarding this, the potential benefits of probiotics, resveratrol (a polyphenol found in grape), oleoylethanolamide (derived from oleic acid), and natural peroxisome proliferator-activated receptor γ agonists in foodstuffs (like curcumin, pomegranate, hot pepper) are suggested. Yet, it should be pointed out that most of these results have been reported in animal models and further human studies are needed to be verified.

Keywords: Covid-19, inflammation, nutrition, dietary agents

Procedia PDF Downloads 174

Authors: Amy Williamson, Kerry Armstrong, Jason Edwards, Patricia Obst

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Australian national policy endorses a responsive approach to work health and safety (WHS) regulation, combining positive motivators (education and guidance), with compliance monitoring and enforcement to encourage and secure compliance with legislation. Despite theoretical support for responsive regulation, there is limited evidence regarding how to achieve best results in practice. Using positive psychology as a novel paradigm, this study aims to investigate how non-punitive regulatory interactions can be improved to further encourage regulatory compliance in the construction industry. As part of a larger project, semi-structured interviews were conducted with 35 inspectorate staff and 11 managers in the Australian (Queensland) construction industry. Using an inductive, grounded approach, an in-depth qualitative investigation was conducted to identify the positive psychological principles which underpin effective use of the non-punitive aspects of responsive regulation. Results highlighted the importance of effective engagement between inspectors and industry managers. This involved the need to interact cooperatively and encourage compliance with WHS legislation. Several strategies were identified that assisted regulatory interactions and the ability of inspectors to engage. The importance of communication and interpersonal skills was reported to be critical to any interaction, regardless of the nature of the visit and regulatory tools used. In particular, the use of clear and open communication fostered trust and rapport which facilitated more positive interactions. The importance of respect and empathy was also highlighted. The need for provision of guidance and direction on how to achieve compliance was also reported. This related to ensuring companies understand their WHS obligations, providing specific advice regarding how to rectify a breach and meet compliance requirements, and ensuring sufficient follow up to confirm that compliance is successfully achieved. In the absence of imminent risk, allowing companies the opportunity to comply before further action is taken was also highlighted. Increased proactive engagement with industry to educate and promote the vision of safety at work was also reported. Finally, provision of praise and positive feedback was reported to assist interactions and encourage the continuation of good practices. Evidence from positive psychology and organisational psychology was obtained to support the use of each strategy in practice. In particular, the area of positive leadership provided a useful framework to consider the factors and conditions that drive positive interactions within the context of work health and safety and the specific relationship between inspectors and industry managers. This study provides fresh insight into key psychological principles which support non-punitive regulatory interactions in the area of workplace health and safety. The findings of this research contribute to a better understanding of how inspectors can enhance the efficacy of their regulatory interactions to improve compliance with legislation. Encouraging and assisting compliance through effective non-punitive activity offers a sustainable pathway for promoting safety and preventing fatalities and injuries in the construction industry.

Keywords: engagement, non-punitive approaches to compliance, positive interactions in the workplace, work health and safety compliance

Procedia PDF Downloads 151

Authors: Evonne Kaplan-Liss, Val Lantz-Gefroh

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Arts and humanities are often incorporated into medical education to help deepen understanding of the human condition and the ability to communicate from a place of compassion. However, a gap remains in our knowledge of compassionate communication training for postgraduate medical professionals (as opposed to students and residents); how training opportunities include and impact the artists themselves, and how train-the-trainer models can support learners to become teachers. In this report, the authors present results from a pilot evaluation of the UC San Diego Health: Sanford Compassionate Communication Fellowship, a 60-hour experiential program that uses theater, narrative reflection, poetry, literature, and journalism techniques to train a multidisciplinary cohort of medical professionals and artists in compassionate communication. In the culminating project, fellows design and implement their own projects as teachers of compassionate communication in their respective workplaces. Qualitative methods, including field notes and 30-minute Zoom interviews with each fellow, were used to evaluate the impact of the fellowship. The cohort included both artists (n=2) and physicians representing a range of specialties (n=7), such as occupational medicine, palliative care, and pediatrics. The authors coded the data using thematic analysis for evidence of how the multidisciplinary nature of the fellowship impacted the fellows’ experiences. The findings show that the multidisciplinary cohort contributed to a greater appreciation of compassionate communication in general. Fellows expressed that the ability to witness how those in different fields approached compassionate communication enhanced their learning and helped them see how compassion can be expressed in various contexts, which was both “exhilarating” and “humbling.” One physician expressed that the fellowship has been “really helpful to broaden my perspective on the value of good communication.” Fellows shared how what they learned in the fellowship translated to increased compassionate communication, not only in their professional roles but in their personal lives as well. A second finding was the development of a supportive community. Because each fellow brought their own experiences and expertise, there was a sense of genuine ability to contribute as well as a desire to learn from others. A “brave space” was created by the fellowship facilitators and the inclusion of arts-based activities: a space that invited vulnerability and welcomed fellows to make their own meaning without prescribing any one answer or right way to approach compassionate communication. This brave space contributed to a strong connection among the fellows and reports of increased well-being, as well as multiple collaborations post-fellowship to carry forward compassionate communication training at their places of work. Results show initial evidence of the value of a multidisciplinary fellowship for promoting compassionate communication for both artists and physicians. The next steps include maintaining the supportive fellowship community and collaborations with a post-fellowship affiliate faculty program; scaling up the fellowship with non-physicians (e.g., nurses and physician assistants); and collecting data from family members, colleagues, and patients to understand how the fellowship may be creating a ripple effect outside of the fellowship through fellows’ compassionate communication.

Keywords: compassionate communication, communication in healthcare, multidisciplinary learning, arts in medicine

Procedia PDF Downloads 69

Authors: Gulhan Sen

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Disasters could result in many deaths and injuries. In these difficult times, accessible resources are limited, demand and supply balance is distorted, and there is a need to make urgent interventions. Disproportionateness between accessible resources and intervention capacity makes triage a necessity in every stage of disaster response. Healthcare professionals, who are in charge of triage, have to evaluate swiftly and make ethical decisions about which patients need priority and urgent intervention given the limited available resources. For such critical times in disaster triage, 'doing the greatest good for the greatest number of casualties' is adopted as a code of practice. But there is no guide for healthcare professionals about ethical decision-making during disasters, and this study is expected to use as a source in the preparation of the guide. This study aimed to examine whether the qualities healthcare professionals in Izmir related to disaster triage were adequate and whether these qualities influence their capacity to make ethical decisions. The researcher used a survey developed for data collection. The survey included two parts. In part one, 14 questions solicited information about socio-demographic characteristics and knowledge levels of the respondents on ethical principles of disaster triage and allocation of scarce resources. Part two included four disaster scenarios adopted from existing literature and respondents were asked to make ethical decisions in triage based on the provided scenarios. The survey was completed by 215 healthcare professional working in Emergency-Medical Stations, National Medical Rescue Teams and Search-Rescue-Health Teams in Izmir. The data was analyzed with SPSS software. Chi-Square Test, Mann-Whitney U Test, Kruskal-Wallis Test and Linear Regression Analysis were utilized. According to results, it was determined that 51.2% of the participants had inadequate knowledge level of ethical principles of disaster triage and allocation of scarce resources. It was also found that participants did not tend to make ethical decisions on four disaster scenarios which included ethical dilemmas. They stayed in ethical dilemmas that perform cardio-pulmonary resuscitation, manage limited resources and make decisions to die. Results also showed that participants who had more experience in disaster triage teams, were more likely to make ethical decisions on disaster triage than those with little or no experience in disaster triage teams(p < 0.01). Moreover, as their knowledge level of ethical principles of disaster triage and allocation of scarce resources increased, their tendency to make ethical decisions also increased(p < 0.001). In conclusion, having inadequate knowledge level of ethical principles and being inexperienced affect their ethical decision-making during disasters. So results of this study suggest that more training on disaster triage should be provided on the areas of the pre-impact phase of disaster. In addition, ethical dimension of disaster triage should be included in the syllabi of the ethics classes in the vocational training for healthcare professionals. Drill, simulations, and board exercises can be used to improve ethical decision making abilities of healthcare professionals. Disaster scenarios where ethical dilemmas are faced should be prepared for such applied training programs.

Keywords: disaster triage, medical ethics, ethical principles of disaster triage, ethical decision-making

Procedia PDF Downloads 245

Authors: Noam Markovitz

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People with physical disabilities constitute a very large and simultaneously a diverse group of general population, as the term physical disabilities is extensive and covers a wide range of disabilities. Therefore, individuals with physical disabilities are often faced with a new, threatening and stressful reality leading possibly to a multi-crisis in their lives due to the great changes they experience in somatic, socio-economic, occupational and psychological level. The current study seeks to advance understanding of the complex adaptation to physical disabilities by expanding the dynamic-adaptational model of the pursuit of happiness in a hostile world with a new conception of physical self-integrity. Physical self-integrity incorporates an objective dimension, namely physical self-functioning (PSF), and a subjective dimension, namely physical self-concept (PSC). Both of these dimensions constitute an experience of wholeness in the individual’s identification with her or his physical body. The model guiding this work is dialectical in nature and depicts two systems in the individual’s sense of happiness: subjective well-being (SWB) and meaning in life (MIL). Both systems serve as self-adaptive agents that moderate the complementary system of the hostile-world scenario (HWS), which integrates one’s perceived threats to one’s integrity. Thus, in situations of increased HWS, the moderation may take a form of joint activity in which SWB and MIL are amplified or a form of compensation in which one system produces a stronger effect while the other system produces a weaker effect. The current study investigated PSC in relations to SWB and MIL through pleasantness and meanings that are physically or metaphorically grounded in one’s body. In parallel, PSC also relates to HWS by activating representations of inappropriateness, deformation and vulnerability. In view of possibly dialectical positions of opposing and complementary forces within the current model, the current field study that aims to explore PSC as appearing in an independent, cross-sectional, design addressing the model’s variables in a focal group of people with physical disabilities. This study delineated the participation of the PSC in the adaptational functions of SWB and MIL vis-à-vis HWS-related life adversities. The findings showed that PSC could fully complement the main variables of the pursuit of happiness in a hostile world model. The assumed dialectics in the form of a stronger relationship between SWB and MIL in the face of physical disabilities was not supported. However, it was found that when HWS increased, PSC and MIL were strongly linked, whereas PSC and SWB were weakly linked. This highlights the compensatory role of MIL. From a conceptual viewpoint, the current investigation may clarify the role of PSC as an adaptational agent of the individual’s positive health in complementary senses of bodily wholeness. Methodologically, the advantage of the current investigation is the application of an integrative, model-based approach within a specially focused design with a particular relevance to PSC. Moreover, from an applicative viewpoint, the current investigation may suggest how an innovative model may be translated to therapeutic interventions used by clinicians, counselors and practitioners in improving wellness and psychological well-being, particularly among people with physical disabilities.

Keywords: older adults, physical disabilities, physical self-concept, pursuit of happiness in a hostile-world

Procedia PDF Downloads 150

Authors: S. Kudlacik-Kramarczyk, M. Kedzierska, B. Tyliszczak

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Recently, the continuous development of medicine and related sciences has been observed. Particular emphasis is directed on the development of biomaterials, i.e., non-toxic, biocompatible and biodegradable materials that may improve the effectiveness of treatment as well as the comfort of patients. This is particularly important in the case of cancer treatment. Currently, there are many methods of cancer treatment based primarily on chemotherapy and the surgical removal of the tumor, but it is worth noting that these therapies also cause many side effects. Among women, the most common cancer is breast cancer. It may be completely cured, but the consequence of treatment is partial or complete breast mastectomy and radiation therapy, which results in severe skin burns. The skin of the patient after radiation therapy is very burned, and therefore requires intensive care and high frequency of dressing changes. The traditional dressing adheres to the burn wounds and does not absorb adequate amount of exudate from injuries and the patient is forced to change the dressing every 2 hours. Therefore, the main purpose was to develop an innovative combination of dressing material with drug carriers that may be used in anti-cancer therapy. The innovation of this solution is the combination of these two products into one system, i.e., a transdermal system with the possibility of a controlled release of the drug- cytostatic. Besides, the possibility of modifying the hydrogel matrix with aloe vera juice provides this material with new features favorable from the point of view of healing processes of burn wounds resulting from the radiation therapy. In this study, hydrogel materials containing protein spheres with the active substance have been obtained as a result of photopolymerization process. The reaction mixture consisting of the protein (albumin) spheres incorporated with cytostatic, chitosan, adequate crosslinking agent and photoinitiator has been subjected to the UV radiation for 2 minutes. Prepared materials have been subjected to the numerous studies including the analysis of cytotoxicity using murine fibroblasts L929. Analysis was conducted based on the mitochondrial activity test (MTT reduction assay) which involves the determining the number of cells characterized by proper metabolism. Hydrogel materials obtained using different amount of crosslinking agents have been subjected to the cytotoxicity analysis. According to the standards, tested material is defined as cytotoxic when the viability of cells after 24 h incubation with this material is lower than 70%. In the research, hydrogel polymer materials containing protein spheres incorporated with the active substance, i.e. a cytostatic, have been developed. Such a dressing may support the treatment of cancer due to the content of the anti-cancer drug - cytostatic, and may also provide a soothing effect on the healing of the burn wounds resulted from the radiation therapy due to the content of aloe vera juice in the hydrogel matrix. Based on the conducted cytotoxicity studies, it may be concluded that the obtained materials do not adversely affect the tested cell lines, therefore they can be subjected to more advanced analyzes.

Keywords: hydrogel polymers, cytostatics, drug carriers, cytotoxicity

Procedia PDF Downloads 132

Authors: Jonathan D. Recchi

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Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.

Keywords: de-escalation, nursing, emergency department, workplace violence

Procedia PDF Downloads 103

Authors: Aikaterini-Melpomeni Papadopoulou, Kyriaki Apergi, Margarita-Vasiliki Panagopoulou, Olga Malisova

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Introduction: Adequate hydration is a vital factor that enhances concentration, memory, and decision-making abilities throughout the workday. Various factors may affect hydration status in workplace settings, and many variables, such as age, gender and activity level affect hydration needs. Employees frequently overlook their hydration needs amid busy schedules and demanding tasks, leading to dehydration that can negatively affect cognitive function, productivity, and overall well-being In addition, dietary habits, including fluid intake and food choices, can either support or hinder optimal hydration. However, factors that affect hydration balance among workers in Greece have not been adequately studied. Objective: This study aims to evaluate the hydration status of the working population in Greece and investigate the various factors that impact hydration status in workplace settings, considering demographic, dietary, and occupational influences in a Greek sample of employees from diverse working environments Materials & Methods: The study included 212 participants (46.2% women) from the working population in Greece. Water intake from both solid and liquid foods was recorded using a semi-quantified drinking frequency questionnaire the validated Water Balance Questionnaire was used to evaluate hydration status. The calculation of water from solid and liquid foods was based on data from the USDA National Nutrient Database. Water balance was calculated subtracting the total fluid loss from the total fluid intake in the body. Furthermore, the questionnaire including additional questions on drinking habits and work-related factors.volunteers answered questions of different categories such as a) demographic socio-economic b) work style characteristics c) health, d) physical activity, e) food and fluid intake, f) fluid excretion and g) trends on fluid and water intake. Individual and multivariate regression analyses were performed to assess the relationships between demographic, work-related factors, and hydration balance. Results: Analysis showed that demographic factors like gender, age, and BMI, as well as certain work-related factors, had a weak and statistically non-significant effect on hydration balance. However, the use of a bottle or water container during work hours (b = 944.93, p < 0.001) and engaging in intense physical activity outside of work (b = -226.28, p < 0.001) were found to have a significant impact. Additionally, the consumption of beverages other than water (b = -416.14, p = 0.059) could negatively impact hydration balance. On average, the total consumption of the sample is 3410 ml of water daily, with men consuming approximately 440 ml / day more water (3470 ml / day) compared to women (3030 ml / day) with this difference also being statistically significant. Finally, the water balance, defined as the difference between water intake and water excretion, was found to be negative on average for the entire sample. Conclusions: This study is among the first to explore hydration status within the Greek working population. Findings indicate that awareness of adequate hydration and individual actions, such as using a water bottle during work, may influence hydration balance.

Keywords: hydration, working population, water balance, workplace behavior

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Authors: Violet Petit-Steeghs, Jochem J. R. Van Roon, Jacqueline E. W. Broerse

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Last decennia the retirement age in Europe is gradually increasing. As a result, people have to continue working for a longer period of time. Health problems due to increased sedentary behavior and mental conditions like burn-out, pose a threat in fulfilling employees’ working life. In order to stimulate the ability and willingness to work in the present and future, it is important to stay vital. Vitality is regarded in literature as a sense of energy, motivation and resilience. It is assumed that by increasing their vitality, employees will stay healthier and be more satisfied with their job, leading to a more sustainable employment and less absenteeism in the future. The aim of this project is to obtain insights into the experiences and barriers of employees, and specifically office workers, with regard to their vitality. These insights are essential in order to develop appropriate measures in the future. To get more insights in the experiences of office workers on their vitality, 8 focus group discussions were organized with 6-10 office workers from 4 different employers (an university, a national construction company and a large juridical and care service organization) in the Netherlands. The discussions were transcribed and analyzed via open coding. This project is part of a larger consortium project Provita2, and conducted in collaboration with University of Technology Eindhoven. Results showed that a range of interdependent factors form a complex network that influences office workers’ vitality. These factors can be divided in three overarching groups: (1) personal (2) organizational and (3) environmental factors. Personal intrinsic factors, relating to the office worker, comprise someone’s physical health, coping style, life style, needs, and private life. Organizational factors, relating to the employer, are the workload, management style and the structure, vision and culture of the organization. Lastly, environmental factors consist of the air, light, temperature at the workplace and whether the workplace is inspiring and workable. Office workers experienced barriers to improve their own vitality due to a lack of autonomy. On the one hand, because most factors were not only intrinsic but extrinsic, like work atmosphere or the temperature in the room. On the other hand, office workers were restricted in adapting both intrinsic as well as extrinsic factors. Restrictions to for instance the flexibility of working times and the workload, can set limitations for improving vitality through personal factors like physical activity and mental relaxation. In conclusion, a large range of interdependent factors influence the vitality of office workers. Office workers are often regarded to have a responsibility to improve their vitality, but are limitedly autonomous in adapting these factors. Measures to improve vitality should therefore not only focus on increasing awareness among office workers, but also on empowering them to fulfill this responsibility. A holistic approach that takes the complex mutual dependencies between the different factors and actors (like managers, employees and HR personnel) into account is highly recommended.

Keywords: occupational health, perspectives office workers, sustainable employment, vitality at work, work & wellbeing

Procedia PDF Downloads 138

Authors: Sigal Portnoy, Yael Kaufman-Cohen, Yafa Levanon

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Introduction: Rehabilitation following wrist fractures often includes exercising flexion-extension movements with a dynamic splint. However, during daily activities, we combine most of our wrist movements with radial and ulnar deviations. Also, the multi-plane wrist motion, named the ‘dart throw motion’ (DTM), was found to be a more stable motion in healthy individuals, in term of the motion of the proximal carpal bones, compared with sagittal wrist motion. The aim of this study was therefore to explore the pathomechanics of the wrist in a common multi-plane movement pattern (DTM) and design a novel splint for rehabilitation following distal radius fractures. Methods: First, a multi-axis electro-goniometer was used to quantify the plane angle of motion of the dominant and non-dominant wrists during various activities, e.g. drinking from a glass of water and answering a phone in 43 healthy individuals. The following protocols were then implemented with a population following distal radius fracture. Two dynamic scans were performed, one of the sagittal wrist motion and DTM, in a 3T magnetic resonance imaging (MRI) device, bilaterally. The scaphoid and lunate carpal bones, as well as the surface of the distal radius, were manually-segmented in SolidWorks and the angles of motion of the scaphoid and lunate bones were calculated. Subsequently, a patient-specific splint was designed using 3D scans of the hand. The brace design comprises of a proximal attachment to the arm and a distal envelope of the palm. An axle with two wheels is attached to the proximal part. Two wires attach the proximal part with the medial-palmar and lateral-ventral aspects of the distal part: when the wrist extends, the first wire is released and the second wire is strained towards the radius. The opposite occurs when the wrist flexes. The splint was attached to the wrist using Velcro and constrained the wrist movement to the desired calculated multi-plane of motion. Results: No significant differences were found between the multi-plane angles of the dominant and non-dominant wrists. The most common daily activities occurred at a plane angle of approximately 20° to 45° from the sagittal plane and the MRI studies show individual angles of the plane of motion. The printed splint fitted the wrist of the subjects and constricted movement to the desired multi-plane of motion. Hooks were inserted on each part to allow the addition of springs or rubber bands for resistance training towards muscle strengthening in the rehabilitation setting. Conclusions: It has been hypothesized that activation of the wrist in a multi-plane movement pattern following distal radius fractures will accelerate the recovery of the patient. Our results show that this motion can be determined from either the dominant or non-dominant wrists. The design of the patient-specific dynamic splint is the first step towards assessing whether splinting to induce combined movement is beneficial to the rehabilitation process, compared to conventional treatment. The evaluation of the clinical benefits of this method, compared to conventional rehabilitation methods following wrist fracture, are a part of a PhD work, currently conducted by an occupational therapist.

Keywords: distal radius fracture, rehabilitation, dynamic magnetic resonance imaging, dart throw motion

Procedia PDF Downloads 299

Authors: Yijie Wang, Tianyue Wang

Abstract:

In the past two decades, there has been a great ‘piano lesson frenzy’ among Chinese middle-class families, with a large number of parents adding piano training to children’s extra-curriculum lists. Superficially, the frenzy reflects a rather ‘leisurely’ attitude: parents typically claim that pianos lessons are ‘just for fun’ and will hopefully render children’s life more exciting. However, a closer scrutiny reveals that there is great social-status anxiety hidden beneath this ‘leisurely’ surface. Based on pre-interviews of six Chinese middle-class parents who have enthusiastically signed their children up for piano lessons, several tentative analysis are made: 1. Owing to a series of historical and social factors, the Chinese middle-class have yet to establish their cultural norms in the past few decades, resulting in great confusion concerning how to cultivate cultural tastes in their offspring. And partly due to the fact that the middle-class status of the past Chinese generation is mostly self-acquired rather than inherited, parents are much less confident about their cultural resources—which require long-time accumulation—than material ones. Both factors combine to lead to a sort of blind, overcompensating enthusiasm in culture-related education, and the piano frenzy is but a demonstration. 2. The piano has been chosen to be the object of the frenzy partly because of its inherent characteristics as well as socially-constructed ones. Costly, large in size, imported from another culture and so forth, the piano has acquired the meaning of being exclusive, high-end and exotic, which renders it a token of top-tier status among Chinese people, and piano lessons for offspring have therefore become parents’ paths towards a kind of ‘symbolic elevation’. A child playing piano is an exhibition as well as psychological assurance of the families’ middle-class status. 3. A closer look at children’s piano training process reveals that there is much more anxiety than leisurely elements involved. Despite parents’ claim that ‘piano is mainly for kids to have fun,’ the whole process is evidently of a rather ‘ascetic’ nature, with the demands of diligence and senses of time urgency throughout, and techniques rather than flair or styles are emphasized. This either means that the apparent ‘piano-for-fun’ stance is unauthentic and is only other motives in disguise, or that the Chinese middle-class parents are not yet capable of shaking off the sense of anxiety even if they sincerely intend to. 4. When viewed in relation to Chinese formal school system as well as the job market at large, it can be said that by signing children up for piano lessons, parents are consciously or unconsciously seeking to prepare for, or reduce the risks of, their children’s future social mobility. In face of possible failures in the highly-crucial, highly-competitive formal school system, piano-playing as an extra-curriculum activity may be conveniently transferred into an alternative career path. Besides, in contemporary China, as the occupational structure goes through change, and the school-related certificates decline in value, aspects such as a person’s overall deportment, which can be gained or proved by piano-learning, have been gaining in significance.

Keywords: extra-curriculum activities, middle class, piano lesson frenzy, status anxiety

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Authors: Salima Bijapuri, Shweta Bhatbolan, Sejalben Patel

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Ergonomics concerns the fitting of the environment and the equipment to the worker. Ergonomic principles can be employed in different dimensions of the industrial sector. Participation of all the stakeholders is the key to the formulation of a multifaceted and comprehensive approach to lessen the burden of occupational hazards. Taking responsibility for one’s own work activities by acquiring sufficient knowledge and potential to influence the practices and outcomes is the basis of participatory ergonomics and even hastens the process to identify workplace hazards. The study was aimed to check how participatory ergonomics can be effective in the management of work-related musculoskeletal disorders. Method: A mega kitchen was identified in a twin city of Karnataka, India. Consent was taken, and the screening of workers was done using observation methods. Kitchen work was structured to include different tasks, which included preparation, cooking, distributing, and serving food, packing food to be delivered to schools, dishwashing, cleaning and maintenance of kitchen and equipment, and receiving and storing raw material. Total 100 workers attended the education session on participatory ergonomics and its role in implementing the correct ergonomic practices, thus preventing WRMSDs. Demographic details and baseline data on related musculoskeletal pain and discomfort were collected using the Nordic pain questionnaire and VAS score pre- and post-study. Monthly visits were made, and the education sessions were reiterated on each visit, thus reminding, correcting, and problem-solving of each worker. After 9 months with a total of 4 such education session, the post education data was collected. The software SPSS 20 was used to analyse the collected data. Results: The majority of them (78%), depending on the availability and feasibility, participated in the intervention workshops were arranged four times. The average age of the participants was 39 years. The percentage of female participants was 79.49%, and 20.51% of participants comprised of males. The Nordic Musculoskeletal Questionnaire (NMQ) showed that knee pain was the most commonly reported complaint (62%) from the last 12 months with a mean VAS of 6.27, followed by low back pain. Post intervention, the mean VAS Score was reduced significantly to 2.38. The comparison of pre-post scores was made using Wilcoxon matched pairs test. Upon enquiring, it was found that, the participants learned the importance of applying ergonomics at their workplace which inturn was beneficial for them to handle any problems arising at their workplace on their own with self confidence. Conclusion: The participatory ergonomics proved effective with workers of mega kitchen, and it is a feasible and practical approach. The advantage of the given study area was that it had a sophisticated and ergonomically designed workstation; thus it was the lack of education and practical knowledge to use these stations was of utmost need. There was a significant reduction in VAS scores with the implementation of changes in the working style, and the knowledge of ergonomics helped to decrease physical load and improve musculoskeletal health.

Keywords: ergonomic awareness session, mega kitchen, participatory ergonomics, work related musculoskeletal disorders

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Authors: Tesfaye Dagne, Dagmawit Solomon, Firmaye Bogale, Yosef Gebreyohannes, Samson Mideksa, Mamuye Hadis, Desalegn Ararso, Ermias Woldie, Tsegaye Getachew, Sabit Ababor, Zelalem Kebede

Abstract:

Globally, road traffic accident (RTA) is causing millions of deaths and injuries every year. It is one of the leading causes of death among people of all age groups and the problem is worse among young reproductive age group. Moreover the problem is increasing with an increasing number of vehicles. The majority of the problem happen in low and middle income countries (LMIC), even if the number of vehicles in these countries is low compared to their population. So, the objective of this paper is to summarize the best available evidence on interventions that can reduce road traffic accidents in low and middle income countries (LMIC). Method: A rapid evidence synthesis approach adapted from the SURE Rapid Response Service was applied to search, appraise and summarize the best available evidence on effective intervention in reducing road traffic injury. To answer the question under review, we searched for relevant studies from databases including PubMed, the Cochrane Library, TRANSPORT, Health system evidence, Epistemonikos, and SUPPORT summary. The following key terms were used for searching: Road traffic accident, RTA, Injury, Reduc*, Prevent*, Minimiz*, “Low and middle-income country”, LMIC. We found 18 articles through a search of different databases mentioned above. After screening for the titles and abstracts of the articles, four of them which satisfy the inclusion criteria were included in the final review. Then we appraised and graded the methodological quality of systematic reviews that are deemed to be highly relevant using AMSTAR. Finding: The identified interventions to reduce road traffic accidents were legislation and enforcement, public awareness/education, speed control/ rumble strips, road improvement, mandatory motorcycle helmet, graduated driver license, street lighting. Legislation and Enforcement: Legislation focusing on mandatory motorcycle helmet usage, banning cellular phone usage when driving, seat belt laws, decreasing the legal blood alcohol content (BAC) level from 0.06 g/L to 0.02 g/L bring the best result where enforcement is there. Public Awareness/Education: focusing on seat belt use, child restraint use, educational training in health centers and schools/universities, and public awareness with media through the distribution of videos, posters/souvenirs, and pamphlets are effective in the short run. Speed Control: through traffic calming bumps, or speed bumps, rumbled strips are effective in reducing accidents and fatality. Mandatory Motorcycle Helmet: is associated with reduction in mortality. Graduated driver’s license (GDL): reduce road traffic injury by 19%. Street lighting: is a low-cost intervention which may reduce road traffic accidents.

Keywords: evidence synthesis, injury, rapid review, reducing, road traffic accident

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Authors: N. Rambabu, H. Gururaj, Reynold Washington, Oommen George

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Motivation: Under the USAID Strengthening Health Outcomes through Private Sector (SHOPS-TB) initiative, Karnataka Health Promotion Trust (KHPT) with technical support of Abt associates is implementing a TB prevention and care model in Karnataka State, South India. KHPT is the interface agency between the public and private sectors, and providers and the target community facilitating early TB case detection and enhancing treatment compliance through private health care providers (pHCP) engagement in RNTCP. The project coverage is 0.84 million urban poor from 663 slums in 12 districts of Karnataka. Problem Statement: India with the highest burden of global TB (26%) and two million cases annually, accounts for approximately one fifth of the global incidence. WHO estimates 300,000 people die from TB annually in India. India expanded the coverage of Directly Observed Treatment, Short-course chemotherapy (DOTS) to the entire country as early as 2006. However, the performance of RNTCP has not been uniform across states. While the national annual new smear-positive (NSP) case notification rate is 53, it is much lower at 47 in Karnataka. A third of TB patients in India reside in urban slums. Approach: Under SHOPS, KHPT actively engages with communities through key opinion leaders and community structures. Interpersonal communication, by Outreach workers through house-to-house visits and at aggregation points, is the primary method used for communication about TB and its management and to increase demand for sputum examination and DOTS. pHCP are mapped, trained and mentored by KHPT. ORWs also provide patient and family counseling on TB treatment, side effects and adherence, screen close contacts of index patients especially children under 6 years of age and screen co-morbidities including HIV, diabetes and malnutrition and risk factors including alcoholism, tobacco use, occupational hazards making appropriate accompanied or documented referrals. A treatment ‘buddy’ system for the patients involving close friends or family members, ICT-based support, DOTS Prerana (inspiration) groups of TB patients, family members and community, DOTS Mitra (friend) helpline services are also used for care and support services. Results: The intervention educated 39988 slum dwellers, referred 1731 chest symptomatics, tested 1061 patients and initiated 248 patients on anti-TB treatment within three months of intervention through continuous community engagement. Conclusions: The intervention’s potential to increase access to preferred health care providers, reduce patient and health system delays in diagnosis and initiation of treatment, improve health seeking behaviour and enhance compliance of pHCPs to standard treatment protocols is being monitored. Initial results are promising.

Keywords: DOTS, KHPT, health outcomes, public and private sector

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Authors: Hilal Turkoglu Sasmazel, Ozan Ozkan, Seda Surucu

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Tissue engineering is the field of treating defects caused by injuries, trauma or acute/chronic diseases by using artificial scaffolds that mimic the extracellular matrix (ECM), the natural biological support for the tissues and cells within the body. The main aspects of a successful artificial scaffold are (i) large surface area in order to provide multiple anchorage points for cells to attach, (ii) suitable porosity in order to achieve 3 dimensional growth of the cells within the scaffold as well as proper transport of nutrition, biosignals and waste and (iii) physical, chemical and biological compatibility of the material in order to obtain viability throughout the healing process. By hybrid scaffolds where two or more different materials were combined with advanced fabrication techniques into complex structures, it is possible to combine the advantages of individual materials into one single structure while eliminating the disadvantages of each. Adding this to the complex structure provided by advanced fabrication techniques enables obtaining the desired aspects of a successful artificial tissue scaffold. In this study, fibroblast compatibility of poly(ε-caprolactone) (PCL)/chitosan core-shell electrospun hybrid scaffolds with proper mechanical, chemical and physical properties successfully developed in our previous study was investigated. Standard 7-day cell culture was carried out with L929 fibroblast cell line. The viability of the cells cultured with the scaffolds was monitored with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) viability assay for every 48 h starting with 24 h after the initial seeding. In this assay, blank commercial tissue culture polystyrene (TCPS) Petri dishes, single electrospun PCL and single electrospun chitosan mats were used as control in order to compare and contrast the performance of the hybrid scaffolds. The adhesion, proliferation, spread and growth of the cells on/within the scaffolds were observed visually on the 3rd and the 7th days of the culture period with confocal laser scanning microscopy (CSLM) and scanning electron microscopy (SEM). The viability assay showed that the hybrid scaffolds caused no toxicity for fibroblast cells and provided a steady increase in cell viability, effectively doubling the cell density for every 48 h for the course of 7 days, as compared to TCPS, single electrospun PCL or chitosan mats. The cell viability on the hybrid scaffold was ~2 fold better compared to TCPS because of its 3D ECM-like structure compared to 2D flat surface of commercially cell compatible TCPS, and the performance was ~2 fold and ~10 fold better compared to single PCL and single chitosan mats, respectively, even though both fabricated similarly with electrospinning as non-woven fibrous structures, because single PCL and chitosan mats were either too hydrophobic or too hydrophilic to maintain cell attachment points. The viability results were verified with visual images obtained with CSLM and SEM, in which cells found to achieve characteristic spindle-like fibroblast shape and spread on the surface as well within the pores successfully at high densities.

Keywords: chitosan, core-shell, fibroblast, electrospinning, PCL

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Authors: Sana Fatima, Paul Sadler, Jon Cooper, David Mendel, Ayesha Jameel

Abstract:

Background: Neurodiversity refers to intrinsic differences between human minds and encompasses dyspraxia, dyslexia, attention deficit hyperactivity disorder, dyscalculia, autism spectrum disorder, and Tourette syndrome. There is increasing recognition of neurodiversity in relation to disability/diversity in medical education and the associated impact on training, career progression, and personal and professional wellbeing. In addition, documented and anecdotal evidence suggests that medical educators and training providers in all four nations (UK) are increasingly concerned about understanding neurodiversity and identifying and providing support for neurodivergent trainees. Summary of Work: A national Neurodiversity Task and Finish group were established to survey Health Education England local office Professional Support teams about insights into infrastructure, training for educators, triggers for assessment, resources, and intervention protocols. This group drew from educational leadership, professional and personal neurodiverse expertise, occupational medicine, employer human resource, and trainees. An online, exploratory survey was conducted to gather insights from supervisors and trainers across England using the Professional Support Units' platform. Summary of Results: This survey highlighted marked heterogeneity in the identification, assessment, and approaches to support and management of neurodivergent trainees and highlighted a 'deficit' approach to neurodiversity. It also demonstrated a paucity of educational and protocol resources for educators and supervisors in supporting neurodivergent trainees. Discussions and Conclusions: In phase one, we focused on faculty development. An educational repository for all supervising trainees using a thematic approach was formalised. This was guided by our survey findings specific for neurodiversity and took a triple 'A' approach: awareness, assessment, and action. This is further supported by video material incorporating stories in training as well as mobile workshops for trainers for more immersive learning. The subtle theme from both the survey and Task and finish group suggested a move away from deficit-focused methods toward a positive holistic, interdisciplinary approach within a biopsychosocial framework. Contributions: 1. Faculty Knowledge and basic understanding of neurodiversity are key to supporting trainees with known or underlying Neurodiverse conditions. This is further complicated by challenges around non-disclosure, varied presentations, stigma, and intersectionality. 2. There is national (and international) inconsistency in the approach to how trainees are managed once a neurodiverse condition is suspected or diagnosed. 3. A carefully constituted and focussed Task and Finish group can rapidly identify national inconsistencies in neurodiversity and implement rapid educational interventions. 4. Nuanced findings from surveys and discussion can reframe the approach to neurodiversity; from a medical model to a more comprehensive, asset-based, biopsychosocial model of support, fostering a cultural shift, accepting 'diversity' in all its manifestations, visible and hidden.

Keywords: neurodiversity, professional support, human considerations, workplace wellbeing

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