Search results for: predictors of delay

Authors: Mona Afifi, Yara Al Qahtani, Afnan Al Dosari, Amnah Hamdi

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Background: First aid is the care provided outside the hospital. It is important in saving lives. Delay in helping the victims may result in serious complication or even death. Many people die in Saudi Arabia because they don’t get proper first aid interventions. According to Traffic Safety council in KSA (2012), in the year of 2011 there was 7153 deaths from car accident in KAS. Subjects and method: Quasi-experimental research design was utilized to assess the effect of a structured 45-minute educational session on 82 undergraduate nursing students’ knowledge about first aid. Two tools were developed for the purpose of the current study. First tool containing the sociodemographic data including age, gender, level, and previous participation in a first aid course, and 55 statements specific to different situations that requires first aid. Concept and Knowledge of First Aid has 9 questions, cardiopulmonary resuscitation has 12 questions, Bleeding and Shock have 7 questions, Road Traffic Accidents has 5 questions, Fracture and Trauma have 4 questions, wound has 5 questions, sunstroke has 4 questions, bits and stings has 4 questions and burn has 5 questions. The second tool was to evaluate the campaign session. Result: The overall knowledge score showed significant difference between the pre and post awareness session (59.58 and 93.00 respectively, p=.000). Mean score shows significant difference in pre-tests between third and fourth year nursing students indicating that knowledge of fourth year students is higher compared to third year students with the mean knowledge scores of 69.56 and 60.88 respectively (p=0.006). Conclusion: Results of the current study indicate that the level of the knowledge in the post test session was higher than in the pre session. Also results showed that the fourth year student`s knowledge in pre-test was better compared to previous year.

Keywords: first aid, awareness campaign, undergraduate nursing students, knowledge

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Authors: Duangduen L. Bhanthumnavin, Duchduen E. Bhanthumnavin

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Widening gap between new academic knowledge in all areas and habit of exploring and exploiting this precious information by students causes an alarm and need for urgent prevention. At present, all advanced nations are committed to WHO’s Sustainable Development Goals (SDGs), which require some objective achievements by the year 2030 and further. The responsibility has been enforced on university lecturers, in addition to the higher education learning outcomes (HELO). The two groups of goals (SDGs and HELO) can be realized if most university instructors are capable of inculcating some important psychological characteristics and behavioral change in the new generations. Thus, this study aimed at pinpointing the significant factors for additional teaching skills of instructors regardless of the area of study. University lecturers from various parts of Thailand, with the total of 540 persons, participated in this cross-sectional study. Based on interactionism model of behavior antecedents, it covers psychological situational factors, as well as their interaction. Most measuring instruments were summated rating with 10 or more items, each accompanied by a six-point rating scale. All these measures were constructed with acceptable standards. Most of the respondents were volunteers who gave their written responses in a meeting room or conference hall. By applying Multiple Regression Analysis in the total sample as well as in the subsamples of these university instructors, about 70 to 73 predictive percentages with 4 to 6 significant predictors were found. The major dependent variable was instructor’s teaching behavior for inculcating the psycho-moral strength for academic exploration and knowledge application. By performing ANOVA, the less-active instructors were identified as the ones with lower education (Master’s level or lower), the minimal research producers, and the ones with less in-service trainings. The preventive factors for these three groups of instructors were intention to increase the students’ psychological development as well as moral development in their regular teaching classes. In addition, social support from their supervisors and coworkers was also necessary. Recommendations for further research and training are offered and welcomed.

Keywords: psychological inculcation, at-risk instructors, preventive measures, undergraduate teaching

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Authors: Choppala Pratheek, Vineet Ahuja

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Background: Crohn's disease (CD) recurrence following surgery is a common challenge, and current detection methods rely on risk factors identified in Western populations. This study aimed to investigate the risk factors and rates of postoperative CD recurrence in a tuberculosis-endemic region like India. Retrospective data was collected from a structured database from a specialty IBD clinic by reviewing case files from January 2005 to December 2021. Inclusion criteria involved CD patients diagnosed based on the ECCO-ESGAR consensus guidelines, who had undergone at least one intestinal resection and had a minimum follow-up period of one year at the IBD clinic. Results: A total of 90 patients were followed up for a median period of 45 months (IQR, 20.75 - 72.00). Out of the 90 patients, 61 received ATT prior to surgery, with a mean delay in diagnosis of 2.5 years, although statistically non-significant (P=0.078). Clinical recurrence occurred in 50% of patients, with the cumulative rate increasing from 13.3% at one year to 40% at three years. Among 63 patients who underwent endoscopy, 65.7% showed evidence of endoscopic recurrence, with the cumulative rate increasing from 31.7% at one year to 55.5% at four years. Smoking was identified as a significant risk factor for early endoscopic recurrence (P=0.001) by Cox regression analysis, but no other risk factors were identified. Initiating post-operative medications prior to clinical recurrence delayed its onset (P=0.004). Subgroup analysis indicated that endoscopic monitoring aided in the early identification of recurrence (P=0.001). The findings contribute to enhancing post-operative CD management strategies in such regions where the disease burden is escalating.

Keywords: crohns, post operative, tuberculosis-endemic, risk factors

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Authors: Thyagi Ponnamperuma

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Background: Comorbidity between posttraumatic stress disorder (PTSD) and other psychological problems is common. Recent studies focused to investigate the underlying relationship between PTSD and comorbid psychopathologies. Among adolescents, higher rates of emotional and behavioral problems (EBP) have been reported following trauma, often coexisted with PTSD. The current study, thus, examined the relationship of posttraumatic stress symptoms to EBP in adolescents exposed to a variety of traumatic events. Further, the study investigated the relationship of trauma and comorbid PTSS to the self-perceived negative impact of EBP on daily functioning. Methods: Participants were 729 Sri Lankan adolescents (age 12 to 16 years; 54.9% female) living in areas impacted in varying degrees by the 2004 tsunami. In 2008, school-based screening was conducted and completed measures of, trauma exposure, PTSS, EBP, and related functional impairment. Results: Participants reported a high prevalence of trauma exposure (n = 438), including interpersonal violence (n = 155). DSM-IV criteria for full or partial PTSD were met by 23.7% of the trauma-exposed sample. Across all participants, 13.4% and 16.7% displayed clinically relevant levels of EBP and functional impairment, respectively. Among the trauma-exposed, 7% met criteria for both EBP and PTSD. EBP total scores and caseness were significantly higher in trauma-exposed adolescents with PTSD than in either those without PTSD or the non-traumatized control group. In subscale analysis, higher prevalence of serious emotional, conduct, and hyperactivity problems were reported in the PTSD positive group; the PTSD negative group did not differ significantly from the control group on any of the problem scales. In regression analyses, PTSS (β = .28, p < .001) and interpersonal violence (β = .13, p = .033) were significant predictors of EBP, cumulative trauma (β = .11, p = .076) showed no significant effect. Further, PTSS exacerbated the impact of EBP on daily functioning (β = 0.29, p = .023). Conclusion: PTSS were closely linked to EBP in adolescents, even years after the traumatic experience. PTSD and emotional and behavioral problems together pose a heightened risk for impaired daily functioning. Longitudinal studies are needed to clarify the causal pathway.

Keywords: adolescents, comorbidity, emotional and behavioral problems, functional impairment, posttraumatic stress, traumatic events

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Authors: Douglas Nyathi, Mxolisi Sibanda, Joram Ndlovuu, Thulani Dube, Innocent T. Mahiya

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Communication of sexual matters between the parents and adolescents has been seen as one of the strategies that could play a cardinal role in encouraging adolescents to be responsible and delay sexual debut or avoid unprotected sexual intercourse. The increasing rate of teenage pregnancies and new HIV/AIDS infections among adolescents in Sub-Saharan Africa makes the phenomenon worth analysis. The purpose of this paper is to interrogate the dynamics of parent-adolescent communication on sexual and reproductive health in Sub-Sahara. Specifically the paper focuses on barriers to communication between parents and adolescents on sexual and reproductive health and its policy implications. It emanates from the paper that communication on sexual and reproductive health at household level is triggered by death of a relative from a sexual related illness, suspicion on sexual activity, radio programmes and in some instances fliers. Literature engagement reveals that communication between parents and adolescents on sexual and reproductive health is made difficult by economic factors (poverty, lack of privacy and low self-esteem), household demographics (age, sex, class, death), socio-cultural factors (beliefs and religious values) as well as social media. We argue that there is need to use broadcast mediato come up with radio and television programmes that create family environments in which sexual and reproductive health issues are discussed. We also recommend that government departments and Non-Governmental Organisations concerned with sexuality issues need to undertake studies that can help dismantle taboos, prejudices and stereotypes that impede sexual and reproductive health communication between parents and adolescents.

Keywords: parent, adolecsent, communication, sexual and reproductive health

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Authors: Lydie Audrey Amboua Schouame, Sylvie Kwedi Nolna, Antoine Socpa, Alexandre Benjamin Nkoum

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Background: Despite the struggle of the Cameroonian Ministry of Public Health against informal health centers (IHCs) because of their illegality, IHCs are booming in Cameroon and a large part of the population uses them. In 2017, more than 3.000 IHCs were counted across the country. Most of these IHCs have antenatal clinics and they screen pregnant women for HIV. However, there is no data on the Prevention of Mother-To-Child Transmission of HIV (PMTCT) in this informal health sector in Cameroon. This study aimed to investigate the initiation of Antiretroviral treatment (ART) in pregnant women screened HIV positive in IHCs and associated factors. Methods: From January 01, 2018, to June 30, 2020, we carried out a cohort study of pregnant women attending their first antenatal visit and screened HIV positive in informal health centers in the cities of Douala and Ebolowa in Cameroon. Consenting participants were interviewed at two points: at least one week after delivery of the HIV result and three months later. The collected data were entered into Kobo collected and analyzed in SPSS V23.0 software. Results: A total of 182 HIV-infected pregnant women were enrolled in the study. The median age at enrollment was 30 years (IQR, 24-34) and the median gestational age at first ANC was 25 weeks (IQR, 19-31). Overall 61% (111/182) had a secondary level of education, 65% (118/182) were married/in a common-law relationship and 69% (126/182) had no income activity. At their first ANC, 91% (166/182) were naïve to ARV treatment. Among them, only 45% (74/166) initiated ART. The median delay in initiating ARV treatment was 5 days (IQR, 0-25). Of those who have started ART, only 64% (48/74) remained on treatment 3 months later. Conclusion: In order to eliminate mother-to-child transmission of HIV, attention should be paid to IHCs.

Keywords: informal health centers, human immunodeficiency, antiretroviral treatment, pregnant women

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Authors: Ayesha Sanjana Kawser Parsha

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S-acylation is an irreversible bond in which cysteine residues are linked to fatty acids palmitate (74%) or stearate (22%), either at the COOH or NH2 terminal, via a thioester linkage. There are several experimental methods that can be used to identify the S-palmitoylation site; however, since they require a lot of time, computational methods are becoming increasingly necessary. There aren't many predictors, however, that can locate S- palmitoylation sites in Arabidopsis Thaliana with sufficient accuracy. This research is based on the importance of building a better prediction tool. To identify the type of machine learning algorithm that predicts this site more accurately for the experimental dataset, several prediction tools were examined in this research, including the GPS PALM 6.0, pCysMod, GPS LIPID 1.0, CSS PALM 4.0, and NBA PALM. These analyses were conducted by constructing the receiver operating characteristics plot and the area under the curve score. An AI-driven deep learning-based prediction tool has been developed utilizing the analysis and three sequence-based input data, such as the amino acid composition, binary encoding profile, and autocorrelation features. The model was developed using five layers, two activation functions, associated parameters, and hyperparameters. The model was built using various combinations of features, and after training and validation, it performed better when all the features were present while using the experimental dataset for 8 and 10-fold cross-validations. While testing the model with unseen and new data, such as the GPS PALM 6.0 plant and pCysMod mouse, the model performed better, and the area under the curve score was near 1. It can be demonstrated that this model outperforms the prior tools in predicting the S- palmitoylation site in the experimental data set by comparing the area under curve score of 10-fold cross-validation of the new model with the established tools' area under curve score with their respective training sets. The objective of this study is to develop a prediction tool for Arabidopsis Thaliana that is more accurate than current tools, as measured by the area under the curve score. Plant food production and immunological treatment targets can both be managed by utilizing this method to forecast S- palmitoylation sites.

Keywords: S- palmitoylation, ROC PLOT, area under the curve, cross- validation score

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Authors: Ewa Mojs, Katarzyna Wiechec, Maia Kubiak, Wlodzimierz Samborski

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Interactions between mother’s psychological condition and child’s health status are complex and derive from the nature of the mother-child relationship. The aim of the study was to analyze the issue of anxiety amongst mothers of short children in the aspect of growth hormone therapy. The study was based on a group of 101 mothers of originally short-statured children – 70 with growth hormone deficiency (GHD) treated with recombinant human growth hormone (rhGH) and 31 undergoing the diagnostic process, without any treatment. Collected medical data included child's gender, height and weight, chronological age, bone age delay, and rhGH therapy duration. For all children, the height SDS and BMI SDS were calculated. To evaluate anxiety in mothers, the Spielberger State-Trait Anxiety Inventory (STAI) was used. Obtained results revealed low trait anxiety levels, with no statistically significant differences between the groups. State anxiety levels were average when mothers of all children were analyzed together, but when divided into groups, statistical differences appeared. Mothers of children without diagnosis and treatment had significantly higher levels of state anxiety than mothers of children with GHD receiving appropriate therapy. These results show, that the occurrence of growth failure in children is not related to high maternal trait anxiety, but the lack of diagnosis and lack of appropriate treatment generates higher levels of maternal state anxiety than the process of rh GH therapy in the offspring. Commencement of growth hormone therapy induce a substantial reduction of the state anxiety in mothers, and the duration of treatment causes its further decrease.

Keywords: anxiety, development, growth hormone deficiency, motherhood

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Authors: Hyeona Kim, Kichang Lee, Seunghee Lee, Jeongsu An, Kyungjun Min

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Contrast videofluoroscopy is the diagnostic imaging technique for evaluating cat with dysphagia. Generally, videofluoroscopic studies have been done with the cat restrained in lateral recumbency. It is different from the neutral position such as standing or sternal recumbency which is actual swallowing posture. We hypothesized that measurement of esophageal transit and peristalsis would be affected by body position. This experimental study analyzed the imaging findings of barium esophagram in 5 cats. Each cat underwent videofluoroscopy during swallowing of liquid barium and barium-soaked kibble in standing position and lateral recumbency. Esophageal transit time and the number of esophageal peristaltic waves were compared among body positions. Transit time in the cervical esophagus (0.57s), cranial thoracic esophagus (2.5s), and caudal thoracic esophagus(1.10s) was delayed when cats were in lateral recumbency for liquid barium. For kibble, transit time was more delayed than that of liquid through the entire esophagus in lateral recumbency. Liquid and kibble frequently started to delay at thoracic inlet region, transit time in the thoracic esophagus was significantly delayed than the cervical esophagus. In standing position, 60.2% of liquid swallows stimulated primary esophageal peristalsis. In lateral recumbency, 50.5% of liquid swallows stimulated primary esophageal peristalsis. Other variables were not significantly different. Lateral body positioning increases entire esophageal transit time and thoracic esophageal transit time is most significantly delayed. Thus, lateral recumbency decreases the number of primary esophageal peristalsis.

Keywords: barium esophagram, body positioning, cat, videofluoroscopy

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Authors: G. Ramya

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Value engineering is a systematic approach, widely used to optimize the design or process or product in the designing stage. It used to achieve the client's obligation by increasing the functionality and attain the targeted cost in the cost planning. Value engineering effectiveness and benefits decrease along with the progress of the project since the change in the scope of the work and design will account for more cost all along the lifecycle of the project. Integrating the value engineering with other project management activities will promote cost minimization, client satisfaction, and ensure early completion of the project in time. Previous research studies suggested that value engineering can integrate with other project delivery activities, but research studies unable to frame a model that collaborates the project management activities with the job plan of value engineering approach. I analyzed various project management activities and their synergy between each other. The project management activities and processes like a)risk analysis b)lifecycle cost analysis c)lean construction d)facility management e)Building information modelling f)Contract administration, collaborated, and project delivery model planned along with the RIBA plan of work. The key outcome of the research is a value-driven project delivery model, which will succeed in dealing with the economic impact, constraints and conflicts arise due to the COVID-19 outbreak in the Indian construction sector. Benefits associated with the structured framework is construction project delivery that ensures early contractor involvement, mutual risk sharing, and reviving the project with a cost overrun and delay back on track ,are discussed. Keywords: Value-driven project delivery model, Integration, RIBA plan of work Themes: Design Economics

Keywords: value-driven project delivery model, Integration, RIBA

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Authors: Farzan Farhangian, Behnam Shakibafar, Bobda Cedric, Rene Jr. Landry

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Among the air navigation technologies, many of them are capable of increasing aviation sustainability as well as accuracy improvement in Alternative Positioning, Navigation, and Timing (APNT), especially avionics Distance Measuring Equipment (DME), Very high-frequency Omni-directional Range (VOR), etc. The integration of these air navigation solutions could make a robust and efficient accuracy in air mobility, air traffic management and autonomous operations. Designing a proper RF front-end, power amplifier and software-defined transponder could pave the way for reaching an optimized avionics navigation solution. In this article, the possibility of reaching an optimum front-end to be used with single low-cost Software-Defined Radio (SDR) has been investigated in order to reach a software-defined DME architecture. Our software-defined approach uses the firmware possibilities to design a real-time software architecture compatible with a Multi Input Multi Output (MIMO) BladeRF to estimate an accurate time delay between a Transmission (Tx) and the reception (Rx) channels using the synchronous scheduled communication. We could design a novel power amplifier for the transmission channel of the DME to pass the minimum transmission power. This article also investigates designing proper pair pulses based on the DO-178B avionics standard. Various guidelines have been tested, and the possibility of passing the certification process for each standard term has been analyzed. Finally, the performance of the DME was tested in the laboratory environment using an IFR6000, which showed that the proposed architecture reached an accuracy of less than 0.23 Nautical mile (Nmi) with 98% probability.

Keywords: avionics, DME, software defined radio, navigation

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Authors: Katalin Szöllősi, László Szabó

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Introduction and purpose: Even though female sexual dysfunctions are common among women in the postpartum period, the profile of these disturbances has not been well investigated in Hungary yet. The aim of the study was to evaluate the postpartum female sexual functions in Hungary. This research sought to investigate the possible predictor factors which can influence postpartum female sexual functions. Method and sample: This was a cross-sectional study, including patients from two maternity clinics in Budapest. 113 women were recruited into our study 3 months after their childbirth. 53 had vaginal birth, 60 had a caesarian section. Data were collected from medical reports in addition by using self-developed questions and validated questionnaires in order to measure important predictors which may be responsible for postpartum sexual dysfunctions such as mode of delivery, parity, urinary incontinence and body image. Sexual functions were evaluated by the Hungarian version of the Female Sexual Function Index (FSFI). The Hungarian version of Body Image Questionnaire-Short Form14 (BSQ-SF14) was applied for assessing body image. Results: 82,3% of the participants began to have sexual intercourse within three months postpartum. 53,98% of the participants reported sexual dysfunctions (cut-off FSFI score 26,55). According to our results mode of delivery, parity, hemorrhoids, time of intercourse, resumption was not associated with female sexual dysfunctions. We found correlation at a tendential level between urinary incontinence and sexual dysfunctions (p=0,003, R=0,26). We found a negative correlation at a tendential level between the total score of BSQ-SF14 and FSFI (p=0,03, R=-0,269). Only 32,74% of women reported discussing sexual life with health care professionals. However, 67,25% of them would have had the need to be asked about their postpartum health issues. Conclusions and recommendations: The prevalence of female sexual dysfunctions were relatively high after childbirth. We found that incontinence and body image was associated with sexual dysfunctions; other risk factors remained unknown. Despite regular contact with health care professionals, women rarely get any information about postpartum sexual health issues. The high prevalence of dysfunctions indicates the need for further investigation to address other risk factors and proper counselling of women after childbirth.

Keywords: body image, postpartum, sexual dysfunction, urinary incontinence

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Authors: R. M. Bashir, Sabo Elizabeth

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Electronic learning is an increasingly popular learning approach in higher educational institutions due to vast growth of internet technology. An investigation on the assessment of e-learning facilities and information need by open and distance learning students in Jalingo, Nigeria was conducted. Structured questionnaires were administered to 70 students of the university. Information sourced from the respondents covered demographic, economic and institutional variables. Data collected for demographic variables were computed as frequency count and percentages. Information on assessment of e-learning facilities and information need among open and distance learning students was computed on a three or four point Likert Rating Scale. Findings indicated that there are more men compared to women, a large proportion of the respondents are married and there are more matured students. A high proportion of the students obtained qualifications higher than the secondary school certificate. The proportion of computer literate students was higher compared with those students that owned a computer. Inadequate e-books and reference materials, internet gadgets and inadequate books (hard copies) and reference material are factors that limit utilization of e-learning facilities. Inadequate computer facilities caused delay in examination schedule at the study center. Open and distance learning students required to a high extent information on university timetable and schedule of activities, books (hard and e-books) and reference materials and contact with course coordinators via internet for better learning and academic performance.

Keywords: open and distance learning, information required, electronic books, internet gadgets, Likert scale test

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Authors: Moujib Bahri, Ouafa Sakka, Kallel Rahim

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This study builds on the literature about the effects of corruption on economic growth at the firm level, which analyzes how the payment of bribes affect organizational performance. Traditionally, the literature distinguishes two points of view regarding the impact of corruption: grease view and sand view. The grease view is based on the idea that corruption can compensate for the negative effect of red tape on firms’ activities such as innovation and exports. Therefore, some firms will be motivated to pay some additional money to officials in order to reduce the delay related to bureaucratic procedures. On the contrary, the second point of view considers that corruption sands the wheels of the economy and distorts resource allocation because it increases agency and transaction costs and reduces the returns on the investment. We have tested the effect of corruption on innovation and export activities on a sample of 537 Tunisian manufacturing small and medium enterprises (SMEs) using structural equation modeling and path analysis. Tunisia has undergone a revolution in 2010 and since then, the country is experiencing a political instability and economic hardships. Our results do not support the greasing hypothesis suggesting that corruption can reduce the negative effect of bureaucratic delays and the hard access of companies to public services related to exports. Instead, our results support the sanding hypothesis according to which corruption hinders SMEs’ exports through its negative influence on innovation. Furthermore, our results show that the interaction between excessive bureaucratic red tape and corruption has a negative effect on exports. However, the interaction between political instability and corruption increases exports.

Keywords: corruption, exports, SMEs, economic conditions

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Authors: Christos Lampropoulos, Maria Konsta, Ifigenia Apostolou, Vicky Dradaki, Tamta Sirbilatze, Irini Dri, Christina Kordali, Vaggelis Lambas, Kostas Argyros, Georgios Mavras

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Objectives: Mediterranean diet has been associated with lower incidence of cardiovascular disease and cancer. The purpose of our study was to examine the hypothesis that Mediterranean diet may protect against mortality and reduce admission duration in elderly, hospitalized patients. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). The following data were taken into account in analysis: anthropometric and laboratory data, dietary habits (MedDiet score), patients’ nutritional status [Mini Nutritional Assessment (MNA) score], physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and admission duration difference respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 30% per each unit increase of MedDiet score (OR=0.7, 95% CI:0.6-0.8, p < 0.0001). Patients with cancer-related admission were 37.7 times more likely to die, compared to those with infection (OR=37.7, 95% CI:4.4-325, p=0.001). According to multivariate linear regression analysis, admission duration was inversely related to Mediterranean diet, since it is decreased 0.18 days on average for each unit increase of MedDiet score (b:-0.18, 95% CI:-0.33 - -0.035, p=0.02). Additionally, the duration of current admission increased on average 0.83 days for each previous hospital admission (b:0.83, 95% CI:0.5-1.16, p<0.0001). The admission duration of patients with cancer was on average 4.5 days higher than the patients who admitted due to infection (b:4.5, 95% CI:0.9-8, p=0.015). Conclusion: Mediterranean diet adequately protects elderly, hospitalized patients against mortality and reduces the duration of hospitalization.

Keywords: Mediterranean diet, malnutrition, nutritional status, prognostic factors for mortality

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Authors: Abdullah Arafat, Ali Al-Farhan, Amir Omair

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Objectives: To review and assess the effectiveness of the implemented modified five-levels triage and acuity scale triage system in AL-Yarmook Urgent Care Center (UCC), King Abdulaziz Residential city, Riyadh, Saudi Arabia. Method: The applied study design was an observational cross sectional design. A data collection sheet was designed and distributed to triage nurses; the data collection was done during triage process and was directly observed by the co-investigator. Triage system was reviewed by measuring three time intervals as quality indicators: time before triage (TBT), time before being seen by physician (TBP) and total length of stay (TLS) taking in consideration timing of presentation and level of triage. Results: During the study period, a total of 187 patients were included in our study. 118 visits were at weekdays and 68 visits at weekends. Overall, 173 patients (92.5%) were seen by the physician in timely manner according to triage guidelines while 14 patients (7.5%) were not seen at appropriate time.Overall, The mean time before seen the triage nurse (TBT) was 5.36 minutes, the mean time to be seen by physician (TBP) was 22.6 minutes and the mean length of stay (TLS) was 59 minutes. The data didn’t showed significant increase in TBT, TBP, and number of patients not seen at the proper time, referral rate and admission rate during weekend. Conclusion: The CTAS is adaptable to countries beyond Canada and worked properly. The applied CTAS triage system in Al-Yarmook UCC is considered to be effective and well applied. Overall, urgent cases have been seen by physician in timely manner according to triage system and there was no delay in the management of urgent cases.

Keywords: CTAS, emergency, Saudi Arabia, triage, urgent care

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Authors: Elham Falatoonitoosi, Vikki Schaffer, Don Kerr

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Over-development for tourism and its consequences on residents’ well-being turn into a critical issue in tourism destinations. Learning about undesirable impacts of tourism has led many people to seek more sustainable and responsible tourism. The main objective of this research is to understand how and to what extent sustainable tourism development enhances locals’ well-being regarding stakeholder perception. The research was conducted in a coastal-hinterland tourism region through two sequential phases. At the first phase, a unique set of 19 sustainable tourism indicators resulted from a triplex model was used to examine the sustainability effects on the main factors of residents’ well-being including equity and living condition, life satisfaction, health condition, and education quality. The triplex model including i) systematic literature search, ii) convergent interviewing, and iii) DEMATEL aimed to develop sustainability indicators, specify them for a particular destination, and identify the dominant sustainability issues acting as key predictors in sustainable development. At the second phase, a hierarchical multiple regression was used to examine the relationship between sustainable development and local residents’ well-being. A number of 167 participants from five different groups of stakeholders perceived the importance level of each sustainability indicators regarding well-being factors on 5-point Likert scale. Results from the first phase indicated that sustainability training, government support, tourism sociocultural effects, tourism revenue, and climate change are the top dominant sustainability issues in the regional sustainable development. Results from the second phase showed that sustainable development considerably improves the overall residents’ well-being and has positive relationships with all well-being factors except life satisfaction. It explains that it was difficult for stakeholders to recognize a link between sustainable development and their overall life satisfaction and happiness. Among well-being’s factors, health condition was influenced the most by sustainability indicators that indicate stakeholders believed sustainability development can promote public health, health sector performance, quality of drinking water, and sanitation. For the future research, it is highly recommended to analysis the effects of sustainable tourism development on the other features of a tourism destination’s well-being including residents sociocultural empowerment, local economic growth, and attractiveness of the destination.

Keywords: residents' well-being, stakeholder perception, sustainability indicators, sustainable tourism

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Authors: V. Nigam, V. Nambiar

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Aegle Marmelos leaf has been used as a remedy for various gastrointestinal infections and lowering blood sugar level in traditional system of medicine in India due to the presence of various constituents such as flavonoids, tannins and alkaloids (eg. Aegelin, Marmelosin, Luvangetin).The objective of the present study was to evaluate the total antioxidant activity, total and individual phenol content of the wild and cultivated variety of Aegle marmelos leaves to assess the role of this plant in ethanomedicine in India. The methanolic extracts of the leaves were screened for total antioxidant capacity through Ferric Reducing Antioxidant Potential (FRAP) and 1, 1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging assay; Total Phenol content (TPC) through spectrophotometric technique based on Folin Ciocalteau assay and for qualitative estimation of phenols, High performance Liquid Chromatography was used. The TPC of wild and cultivated variety was 7.6% and 6.5% respectively whereas HPLC analysis for quantification of individual polyphenol revealed the presence of gallic acid, chlorogenic acid and Ferullic acid in wild variety whereas gallic acid, Ferullic acid and pyrocatechol in cultivated variety. FRAP values and IC 50 value (DPPH) for wild and cultivated variety was 14.65 μmol/l and 11.80μmol/l; 437 μg/ml and 620μg/ml respectively and thus it can be used as potential inhibitor of free radicals. The wild variety was having more antioxidant capacity than the cultivated one it can be exploited further for its therapeutic application. As Aegle marmelos is rich in antioxidant, it can be used as food additives to delay the oxidative deterioration of foods and as nutraceutical in medicinal formulation against degenerative diseases like diabetes.

Keywords: antioxidant activity, aegle marmelos, antidiabetic, nutraceutical

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Authors: Fatiha Mohammed Arab, Benoit Augier, Francois Deniset, Pascal Casari, Jacques Andre Astolfi

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For the top high performance foiling yachts, cavitation is often a limiting factor for take-off and top speed. This work investigates solutions to delay the onset of cavitation thanks to structural morphing. The structural morphing is based on compliant leading and trailing edge, with effect similar to flaps. It is shown here that the commonly accepted effect of flaps regarding the control of lift and drag forces can also be used to postpone the inception of cavitation. A numerical and experimental study is conducted in order to assess the effect of the geometric parameters of hydrofoil on their hydrodynamic performances and in cavitation inception. The effect of a 70% trailing edge and a 30% leading edge of NACA 0012 is investigated using Xfoil software at a constant Reynolds number 106. The simulations carried out for a range flaps deflections and various angles of attack. So, the result showed that the lift coefficient increase with the increase of flap deflection, but also with the increase of angle of attack and enlarged the bucket cavitation. To evaluate the efficiency of the Xfoil software, a 2D analysis flow over a NACA 0012 with leading and trailing edge flap was studied using Fluent software. The results of the two methods are in a good agreement. To validate the numerical approach, a passive adaptive composite model is built and tested in the hydrodynamic tunnel at the Research Institute of French Naval Academy. The model shows the ability to simulate the effect of flap by a LE and TE structural morphing due to hydrodynamic loading.

Keywords: cavitation, flaps, hydrofoil, panel method, xfoil

Procedia PDF Downloads 170

Authors: Noor Us Saher

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Oceans and Marine areas have a great importance, mainly regarding food resources, fishery products and reliance of livelihood. Aquatic pollution is common due to the incorporation of various chemicals mainly entering from urbanization, industrial and commercial facilities, such as oil and chemical spills. Many hazardous wastes and industrial effluents contaminate the nearby areas and initiate to affect the marine environment. These contaminated conditions may become worse in those aquatic environments situated besides the world’s largest cities, which are hubs of various commercial activities. Heavy metal contamination is one of the most important predicaments for marine environments and during past decades this problem has intensified due to an increase in urbanization and industrialization. Coastal regions of Pakistan are facing severe threats from various organic and inorganic pollutants, especially the estuarine and coastal areas of Karachi city, the most populated and industrialized city situated along the coastline. Metal contamination causes severe toxicity in biota resulting the degradation of Marine environments and depletion of fishery resources and sustainability. There are several abiotic (air, water and sediment) and biotic (fauna and flora) indicators that indicate metal contamination. However, all these indicators have certain limitations and complexities, which delay their implementation for rehabilitation and conservation in the marine environment. The inadequate evidences have presented on this significant topic till the time and this study discussed metal pollution and its consequences along the marine environment of Pakistan. This study further helps in identification of possible hazards for the ecological system and allied resources for management strategies and decision making for sustainable approaches.

Keywords: coastal and estuarine environment, heavy metals pollution, pollution indicators, Pakistan

Procedia PDF Downloads 244

Authors: G. Cinelli, T. Tollefsen, P. Bossew, V. Gruber, R. Braga, M. A. Hernández-Ceballos, M. De Cort

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In 2006, the Joint Research Centre (JRC) of the European Commission started the project of the 'European Atlas of Natural Radiation'. The Atlas aims at preparing a collection of maps of Europe displaying the levels of natural radioactivity caused by different sources (indoor and outdoor radon, cosmic radiation, terrestrial radionuclides, terrestrial gamma radiation, etc). The overall goal of the project is to estimate, in geographical resolution, the annual dose that the public may receive from natural radioactivity, combining all the information from the different radiation components. The first map which has been developed is the European map of indoor radon (Rn) since in most cases Rn is the most important contribution to exposure. New versions of the map are realised when new countries join the project or when already participating countries send new data. We show the latest status of this map which currently includes 25 European countries. Second, the JRC has undertaken to map a variable which measures 'what earth delivers' in terms of Rn. The corresponding quantity is called geogenic radon potential (RP). Due to the heterogeneity of data sources across the Europe there is need to develop a harmonized quantity which at the one hand adequately measures or classifies the RP, and on the other hand is suited to accommodate the variety of input data used to estimate this target quantity. Candidates for input quantities which may serve as predictors of the RP, and for which data are available across Europe, to different extent, are Uranium (U) concentration in rocks and soils, soil gas radon and soil permeability, terrestrial gamma dose rate, geological information and indoor data from ground floor. The European Geogenic Radon Map gives the possibility to characterize areas, on European geographical scale, for radon hazard where indoor radon measurements are not available. Parallel to ongoing work on the European Indoor Radon, Geogenic Radon and Cosmic Radiation Maps, we made progress in the development of maps of terrestrial gamma radiation and U, Th and K concentrations in soil and bedrock. We show the first, preliminary map of the terrestrial gamma dose rate, estimated using the data of ambient dose equivalent rate available from the EURDEP system (about 5000 fixed monitoring stations across Europe). Also, the first maps of U, Th, and K concentrations in soil and bedrock are shown in the present work.

Keywords: Europe, natural radiation, mapping, indoor radon

Procedia PDF Downloads 287

Authors: C. Hipp

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The EU Regulation (EC) No 261/2004 under which air passengers can claim compensation in the event of denied boarding, cancellation or long delay of flights has to be regarded as a substantial progress for the consumer protection in the field of air transport since it went into force in February 2005. Nevertheless, different reviews of its effective functioning demonstrate that most passengers affected by service disruptions do not enforce their complaints and claims towards the airline. The main cause of this is not only the unclear legal situation due to the fact that the regulation itself suffers from many undetermined terms and loopholes it is also attributable to the strategy of the airlines which do not handle the complaints of the passengers or exclude their duty to compensate them. Economically contemplated, reasons like the long duration of a trial and the cost risk in relation to the amount of compensation make it comprehensible that passengers are deterred from enforcing their rights by filing a lawsuit. The paper focusses on the alternative dispute resolution namely the recently established conciliation bodies which deal with air passenger rights. In this paper, the Conciliation Body for Public Transport in Germany (Schlichtungsstelle für den öffentlichen Personenverkehr – SÖP) is examined as a successful example of independent consumer arbitration service. It was founded in 2009 and deals with complaints in the field of air passenger rights since November 2013. According to the current situation one has to admit that due to its structure and operation it meets on the one hand the needs of the airlines by giving them an efficient tool of their customer relation management and on the other hand that it contributes to the enforcement of air passenger rights effectively.

Keywords: air passenger rights, alternative dispute resolution, consumer protection, EU law regulation (EC) 261/2004

Procedia PDF Downloads 226

Authors: Keiko Shimazu, Yasuhiro Maida, Tetsuya Sugata, Daisuke Tamakoshi, Kenji Makabe, Haruki Suzuki

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In this paper, we report how to acquire serious victims’ locations in the Acute Stage of Large-scale Disasters, in an Emergency Information Network System designed by us. The background of our concept is based on the Great East Japan Earthquake occurred on March 11^th, 2011. Through many experiences of national crises caused by earthquakes and tsunamis, we have established advanced communication systems and advanced disaster medical response systems. However, Japan was devastated by huge tsunamis swept a vast area of Tohoku causing a complete breakdown of all the infrastructures including telecommunications. Therefore, we noticed that we need interdisciplinary collaboration between science of disaster medicine, regional administrative sociology, satellite communication technology and systems engineering experts. Communication of emergency information was limited causing a serious delay in the initial rescue and medical operation. For the emergency rescue and medical operations, the most important thing is to identify the number of casualties, their locations and status and to dispatch doctors and rescue workers from multiple organizations. In the case of the Tohoku earthquake, the dispatching mechanism and/or decision support system did not exist to allocate the appropriate number of doctors and locate disaster victims. Even though the doctors and rescue workers from multiple government organizations have their own dedicated communication system, the systems are not interoperable.

Keywords: crisis management, disaster mitigation, messing, MGRS, military grid reference system, satellite communication system

Procedia PDF Downloads 232

Authors: Mohammed Abdullah Alshahrani

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The research focuses on investigating the use of partial least squares (PLS) methodology for addressing challenges associated with high-dimensional correlated data. Recent technological advancements have led to experiments producing data characterized by a large number of variables compared to observations, with substantial inter-variable correlations. Such data patterns are common in chemometrics, where near-infrared (NIR) spectrometer calibrations record chemical absorbance levels across hundreds of wavelengths, and in genomics, where thousands of genomic regions' copy number alterations (CNA) are recorded from cancer patients. PLS serves as a widely used method for analyzing high-dimensional data, functioning as a regression tool in chemometrics and a classification method in genomics. It handles data complexity by creating latent variables (components) from original variables. However, applying PLS can present challenges. The study investigates key areas to address these challenges, including unifying interpretations across three main PLS algorithms and exploring unusual negative shrinkage factors encountered during model fitting. The research presents an alternative approach to addressing the interpretation challenge of predictor weights associated with PLS. Sparse estimation of predictor weights is employed using a penalty function combining a lasso penalty for sparsity and a Cauchy distribution-based penalty to account for variable dependencies. The results demonstrate sparse and grouped weight estimates, aiding interpretation and prediction tasks in genomic data analysis. High-dimensional data scenarios, where predictors outnumber observations, are common in regression analysis applications. Ordinary least squares regression (OLS), the standard method, performs inadequately with high-dimensional and highly correlated data. Copy number alterations (CNA) in key genes have been linked to disease phenotypes, highlighting the importance of accurate classification of gene expression data in bioinformatics and biology using regularized methods like PLS for regression and classification.

Keywords: partial least square regression, genetics data, negative filter factors, high dimensional data, high correlated data

Procedia PDF Downloads 43

Authors: Robert Jedrys, Zdzislaw Kobos, Justyna Skrzynska, Zbigniew Wochynski

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Professions connected to aviation require an assessment of the suitability of health, psychological and psychomotor skills and overall physical fitness of the organism, who applies. Assessment of the physical condition is conducted by the committees consisting of aero-medical specialists in clinical medicine and aviation. In addition, psychological predispositions should be evaluated by specialized psychologists familiar with the specifics of the tasks and requirements for the various positions in aviation. Both, physical abilities and general physical fitness of candidates for aviation shall be assessed during the selection exams, which also test the ability to deal with stress what is very important in aviation. Hence, the mentioned exams in physical education not only help to judge on the ranking in candidates in terms of their efficiency and performance, but also allows to evaluate the functioning under stress measured using psychological tests. Moreover, before-test stress is a predictors of successfulness in the next stages of education and practical training in the aviation. The aim of the study was to evaluate the influence of temperamental traits on strategies used for coping with stress during selection exams in physical education, deciding on admission to aviation school. The study involved 30 candidates for fighter pilot training in aviation school . To evaluate the temperament 'The Formal Characteristics of Behavior-Temperament Inventory' (FCB-TI) by B. Zawadzki and J.Strelau was used. To determine the pattern of coping with stress 'The Coping Inventory for Stressful Situations' (CISS) to N. S. Endler and J. D. A. Parker were engaged. Study of temperament and styles of coping with stress was conducted directly before the exam selection of physical education. The results were analyzed with 'Statistica 9' program. The studies showed that:-There is a negative correlation between such a temperament feature as 'perseverance' and preferred style of coping with stress concentrated on the task (r = -0.590; p < 0.004); -There is a positive correlation between such a feature of temperament as 'emotional reactivity,' and preference to deal with a stressful situation with ‘style centered on emotions’ (r = 0.520; p <0.011); -There is a negative correlation between such a feature of temperament as ‘strength’ and ‘style of coping with stress concentrated on emotions’ (r = -0.580; p < 0.004). Studies indicate that temperament traits determine the perception of stress and preferred coping styles used during the selection, as during the exams in physical education.

Keywords: aviation, physical education, stress, temperamental traits

Procedia PDF Downloads 250

Authors: Shan Zhang, Peter Suechting

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Predicting trade patterns is critical to decision-making in public and private domains, especially in the current context of trade disputes among major economies. In the past, U.S. recycling has relied heavily on strong demand for recyclable materials overseas. However, starting in 2017, a series of new recycling policies (bans and higher inspection standards) was enacted by multiple countries that were the primary importers of recyclables from the U.S. prior to that point. As the global trade flow of recycling shifts, some new importers, mostly developing countries in South and Southeast Asia, have been overwhelmed by the sheer quantities of scrap materials they have received. As the leading exporter of recyclable materials, the U.S. now has a pressing need to build its recycling industry domestically. With respect to the global trade in scrap materials used for recycling, the interest in this paper is (1) predicting how the export of recyclable materials from the U.S. might vary over time, and (2) predicting how international trade flows for recyclables might change in the future. Focusing on three major recyclable materials with a history of trade, this study uses data-driven and machine learning (ML) algorithms---supervised (shrinkage and tree methods) and unsupervised (neural network method)---to decipher the international trade pattern of recycling. Forecasting the potential trade values of recyclables in the future could help importing countries, to which those materials will shift next, to prepare related trade policies. Such policies can assist policymakers in minimizing negative environmental externalities and in finding the optimal amount of recyclables needed by each country. Such forecasts can also help exporting countries, like the U.S understand the importance of healthy domestic recycling industry. The preliminary result suggests that gravity models---in addition to particular selection macroeconomic predictor variables--are appropriate predictors of the total export value of recyclables. With the inclusion of variables measuring aspects of the political conditions (trade tariffs and bans), predictions show that recyclable materials are shifting from more policy-restricted countries to less policy-restricted countries in international recycling trade. Those countries also tend to have high manufacturing activities as a percentage of their GDP.

Keywords: environmental economics, machine learning, recycling, international trade

Procedia PDF Downloads 161

Authors: Chia Yu Chen, Shu Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Shu Jiuan Chen, Yen Ling Liu

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Aim: It remains undetermined that whether increased work stress may affect the job satisfaction and career loyalty among nursing staffs in the operating room. The long-term goal of this study is to lengthen the professional life of operating room nurses by attenuating the work stress and enhancing their contentment in work. Method: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in the southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses. Chi-square test was used to analyze the categorical data and Pearson correlation was used to analyze the association between two numerical datasets (SPSS version 20.0). Results: The response rate was 80% (80/100) and a total of 73 (73%) completed forms were eventually proceeded for analysis. The average scores for work stress and job satisfaction of the operating room nurses were 145.96±32.91 and 47.38±6.07, respectively. The correlation coefficients of work stress versus job satisfaction and organizational identity were (r=-0.338, p=0.003 and r=-0.354, p=0.002), respectively. There were more nurses who took rotating shift quitted works from the operating room than those who took only dayshift (2＝5.176, p<0.05). Nurses who reported of having lower job satisfaction were associated with significantly higher turnover intention (t=3.714, p< 0.01). Following multivariate regression analysis, rotating shift and low job satisfaction were identified as the two independent predictors of intention to quit from working in the operating room. Conclusion: Our study clearly demonstrates that increased work stress significantly attenuates job satisfaction and organizational identity. Rotating shift is associated with higher work stress, lower job satisfaction, and higher turnover intention, which is consistent with the previous surveys carried out in the department of medical technology. Therefore, improvement of working quality in the operating rooms is essential to increase the retain intention of the well-trained nursing staffs. Further investigation into types of work shifts and other strategies of attenuating stress in workplace is currently undertaken in order to improve the job satisfaction and to decrease turnover intention in the operating room.

Keywords: rotating shift, work stress, job satisfaction, turnover intention

Procedia PDF Downloads 191

Authors: González A. Julio, Ramírez L. Leonardo, Puerta A. Gabriel

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Telemedicine services use a large amount of data, most of which are diagnostic images in Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7) formats. Metadata is generated from each related image to support their identification. This study presents the use of decision trees for the optimization of information search processes for diagnostic images, hosted on the cloud server. To analyze the performance in the server, the following quality of service (QoS) metrics are evaluated: delay, bandwidth, jitter, latency and throughput in five test scenarios for a total of 26 experiments during the loading and downloading of DICOM images, hosted by the telemedicine group server of the Universidad Militar Nueva Granada, Bogotá, Colombia. By applying decision trees as a data mining technique and comparing it with the sequential search, it was possible to evaluate the search times of diagnostic images in the server. The results show that by using the metadata in decision trees, the search times are substantially improved, the computational resources are optimized and the request management of the telemedicine image service is improved. Based on the experiments carried out, search efficiency increased by 45% in relation to the sequential search, given that, when downloading a diagnostic image, false positives are avoided in management and acquisition processes of said information. It is concluded that, for the diagnostic images services in telemedicine, the technique of decision trees guarantees the accessibility and robustness in the acquisition and manipulation of medical images, in improvement of the diagnoses and medical procedures in patients.

Keywords: cloud storage, decision trees, diagnostic image, search, telemedicine

Procedia PDF Downloads 195

Authors: Zhi Hao Chow, Cian Mulligan, Jack Walsh, Antonio Garzon Vico, Dimitar Krastev

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Drug development is resource-intensive, time-consuming, and increasingly expensive with each developmental stage. The success rates of drug development are also relatively low, and the resources committed are wasted with each failed candidate. As such, a reliable method of predicting the success of drug development is in demand. The hypothesis was that some examples of failed drug candidates are pushed through developmental pipelines based on false confidence and may possess common linguistic features identifiable through sentiment analysis. Here, the concept of using text analysis to discover such features in research publications and investor reports as predictors of success was explored. R studios were used to perform text mining and lexicon-based sentiment analysis to identify affective phrases and determine their frequency in each document, then using SPSS to determine the relationship between our defined variables and the accuracy of predicting outcomes. A total of 161 publications were collected and categorised into 4 groups: (i) Cancer treatment, (ii) Neurodegenerative disease treatment, (iii) Vaccines, and (iv) Others (containing all other drugs that do not fit into the 3 categories). Text analysis was then performed on each document using 2 separate datasets (BING and AFINN) in R within the category of drugs to determine the frequency of positive or negative phrases in each document. A relative positivity and negativity value were then calculated by dividing the frequency of phrases with the word count of each document. Regression analysis was then performed with SPSS statistical software on each dataset (values from using BING or AFINN dataset during text analysis) using a random selection of 61 documents to construct a model. The remaining documents were then used to determine the predictive power of the models. Model constructed from BING predicts the outcome of drug performance in clinical trials with an overall percentage of 65.3%. AFINN model had a lower accuracy at predicting outcomes compared to the BING model at 62.5% but was not effective at predicting the failure of drugs in clinical trials. Overall, the study did not show significant efficacy of the model at predicting outcomes of drugs in development. Many improvements may need to be made to later iterations of the model to sufficiently increase the accuracy.

Keywords: data analysis, drug development, sentiment analysis, text-mining

Procedia PDF Downloads 151

Authors: Awole Seid, Yosef Zenebe, Hadgu Gerensea, Kebede Haile Misgina

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Background: Clinical competence is one of the ultimate goals of nursing education. Clinical skills are more than successfully performing tasks; it incorporates client assessment, identification of deficits and the ability to critically think to provide solutions. Assessment of clinical competence, particularly identifying gaps that need improvement and determining the educational needs of nursing students have great importance in nursing education. Thus this study aims determining clinical self-efficacy of final year school of nursing students in three universities of Tigray Region. Methods: A cross-sectional study was conducted on 224 final year school of nursing students from department of nursing, psychiatric nursing, and midwifery on three universities of Tigray region. Anonymous self-administered questionnaire was administered to generate data collected on June, 2017. The data were analyzed using SPSS version 20. The result is described using tables and charts as required. Logistic regression was employed to test associations. Result: The mean age of students was 22.94 + 1.44. Generally, 21% of students have been graduated in the department in which they are not interested. The study demonstrated 28.6% had poor and 71.4% had good perceived clinical self-efficacy. Beside this, 43.8% of psychiatric nursing and 32.6% of comprehensive nursing students have poor clinical self-efficacy. Among the four domains, 39.3% and 37.9% have poor clinical self- efficacy with regard to ‘Professional development’ and ‘Management of care’. Place of the institution [AOR=3.480 (1.333 - 9.088), p=0.011], interest during department selection [AOR=2.202 (1.045 - 4.642), p=.038], and theory-practice gap [AOR=0.224 (0.110 - 0.457), p=0.000] were significantly associated with perceived clinical self-efficacy. Conclusion: The magnitude of students with poor clinically self efficacy was high. Place of institution, theory-practice gap, students interest to the discipline were the significant predictors of clinical self-efficacy. Students from youngest universities have good clinical self-efficacy. During department selection, student’s interest should be respected. The universities and other stakeholders should improve the capacity of surrounding affiliate teaching hospitals to set and improve care standards in order to narrow the theory-practice gap. School faculties should provide trainings to hospital staffs and monitor standards of clinical procedures.

Keywords: clinical self-efficacy, nursing students, Tigray, northern Ethiopia

Procedia PDF Downloads 164