Search results for: public health management

Authors: John Zanetich

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Due to their positive associations with student learning and retention, certain undergraduate opportunities are designated ‘high-impact.’ High-Impact Practices (HIPs) such as, learning communities, community based projects, research, internships, study abroad and culminating senior experience, share several traits bin common: they demand considerable time and effort, learning occurs outside of the classroom, and they require meaningful interactions between faculty and students, they encourage collaboration with diverse others, and they provide frequent and substantive feedback. As a result of experiential learning in these practices, participation in these practices can be life changing. High impact learning helps individuals locate tacit knowledge, and build mental models that support the accumulation of knowledge. On-going learning from experience and knowledge conversion provides the individual with a way to implicitly organize knowledge and share knowledge over a lifetime. Knowledge conversion is a knowledge management component which focuses on the explication of the tacit knowledge that exists in the minds of students and that knowledge which is embedded in the process and relationships of the classroom educational experience. Knowledge conversion is required when working with tacit knowledge and the demand for a learner to align deeply held beliefs with the cognitive dissonance created by new information. Knowledge conversion and tacit knowledge result from the fact that an individual's way of knowing, that is, their core belief structure, is considered generalized and tacit instead of explicit and specific. As a phenomenon, tacit knowledge is not readily available to the learner for explicit description unless evoked by an external source. The development of knowledge–related capabilities such as Aggressive Development of Tacit Knowledge (ADTK) can be used in experiential educational programs to enhance knowledge, foster behavioral change, improve decision making, and overall performance. ADTK allows the student in HIPs to use their existing knowledge in a way that allows them to evaluate and make any necessary modifications to their core construct of reality in order to amalgamate new information. Based on the Lewin/Schein Change Theory, the learner will reach for tacit knowledge as a stabilizing mechanism when they are challenged by new information that puts them slightly off balance. As in word association drills, the important concept is the first thought. The reactionary outpouring to an experience is the programmed or tacit memory and knowledge of their core belief structure. ADTK is a way to help teachers design their own methods and activities to unfreeze, create new learning, and then refreeze the core constructs upon which future learning in a subject area is built. This paper will explore the use of ADTK as a technique for knowledge conversion in the classroom in general and in HIP programs specifically. It will focus on knowledge conversion in curriculum development and propose the use of one-time educational experiences, multi-session experiences and sequential program experiences focusing on tacit knowledge in educational programs.

Keywords: tacit knowledge, knowledge management, college programs, experiential learning

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Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

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The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

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Authors: Judith Mwakalonge, Geophrey Mbatta, Saidi Siuhi, Gurcan Comert, Cuthbert Ruseruka

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Transportation agencies worldwide continuously monitor their roads' conditions to minimize road maintenance costs and maintain public safety and rideability quality. Existing methods for carrying out road condition surveys involve manual observations of roads using standard survey forms done by qualified road condition surveyors or engineers either on foot or by vehicle. Automated road condition survey vehicles exist; however, they are very expensive since they require special vehicles equipped with sensors for data collection together with data processing and computing devices. The manual methods are expensive, time-consuming, infrequent, and can hardly provide real-time information for road conditions. This study contributes to this arena by utilizing built-in vehicle technologies, drones, and deep learning to automate road condition surveys while using low-cost technology. A single model is trained to capture flexible pavement distresses (Potholes, Rutting, Cracking, and raveling), thereby providing a more cost-effective and efficient road condition monitoring approach that can also provide real-time road conditions. Additionally, data fusion is employed to enhance the road condition assessment with data from vehicles and drones.

Keywords: road conditions, built-in vehicle technology, deep learning, drones

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Authors: Loreta Kaklauskiene, Arturas Kaklauskas

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This employee productivity and work well-being effective system aims to maximise the work performance of personnel and boost well-being in offices. Affective computing, decision support, and knowledge-based systems were used in our research. The basis of this effective system is our European Patent application (No: EP 4 020 134 A1) and two Lithuanian patents (LT 6841, LT 6866). Our study examines ways to support efficient employee productivity and well-being by employing mass-customised, personalised office environment. Efficient employee performance and well-being are managed by changing mass-customised office environment factors such as air pollution levels, humidity, temperature, data, information, knowledge, activities, lighting colours and intensity, scents, media, games, videos, music, and vibrations. These aspects of management generate a customised, adaptive environment for users taking into account their emotional, affective, and physiological (MAP) states measured and fed into the system. This research aims to develop an innovative method and system which would analyse, customise and manage a personalised office environment according to a specific user’s MAP states in a cohesive manner. Various values of work spaces (e.g., employee utilitarian, hedonic, perceived values) are also established throughout this process, based on the measurements that describe MAP states and other aspects related to the office environment. The main contribution of our research is the development of a real-time mass-customised office environment to boost employee performance and well-being. Acknowledgment: This work was supported by Project No. 2020-1-LT01-KA203-078100 “Minimizing the influence of coronavirus in a built environment” (MICROBE) from the European Union’s Erasmus + program.

Keywords: effective decision support and a knowledge-based system, human resource management, employee productivity and work well-being, affective computing

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Authors: Yeukai Mupangavanhu

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The paper examines the concept of ubuntu and the extent to which it can play a role in ensuring fairness and justice in contractual relationships. Courts are expected to balance sanctity of contract and fairness. Public policy is currently a mechanism which is used by courts when balancing the above two competing interests. It, however, generally favours the freedom and sanctity of contract. The question which is addressed in this paper is whether the concept of ubuntu is an alternative mechanism that may be used to mitigate the sometimes harsh and unfair consequences of the doctrine of freedom and sanctity of contract. A comparative study and case analysis is the methodology that is used in this article. Unfairness in contracts is generally related to the problem of inequality in bargaining power underscored by deeply entrenched social and economic inequalities that are a consequence of apartheid and patriarchy. The transformative nature of the constitution demands the inclusion of African legal ideas and values in the legal order. There is a need for the harmonisation of western ideals which are based on the classical model of law of contract with relevant African principles. In order to attain a transformative legal order that promotes a societal transformation and enhances the lives of everyone courts cannot continue to frown upon African values. Ubuntu has the potential of steering the law of contract in a more equitable direction. The substantive rules of contract law undoubtedly need to be infused with the notion of ubuntu. The reconciliation of Western and African values is at the heart of legal transformation.

Keywords: fairness, sanctity of contract, contractual justice, transformative constitutionalism

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Authors: Tanu Sharma, Bikramjit Singh Bajwa, Inderpreet Kaur

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Monitoring of groundwater in Tarn-Taran, Bathinda, Faridkot and Mansa districts of Punjab state, India is essential where this freshwater resource is being over-exploited causing quality deterioration, groundwater depletion and posing serious threats to residents. The present integrated study was done to appraise quality and suitability of groundwater for drinking/irrigation purposes, hydro-geochemical characteristics, source identification and associated health risks. In the present study, groundwater of various districts of Punjab state was found to be heavily contaminated with As followed by U, thus posing high cancerous risks to local residents via ingestion, along with minor contamination of Fe, Mn, Pb and F−. Most health concerns in the study region were due to the elevated concentrations of arsenic in groundwater with average values of 130 µg L-1, 176 µg L-1, 272 µg L-1 and 651 µg L-1 in Tarn-Taran, Bathinda, Faridkot and Mansa districts, respectively, which is quite high as compared to the safe limit as recommended by BIS i.e. 10 µg L-1. In Tarn-Taran, Bathinda, Faridkot and Mansa districts, average uranium contents were found to be 37 µg L-1, 88 µg L-1, 61 µg L-1 and 104 µg L-1, with 51 %, 74 %, 61 % and 71 % samples, respectively, being above the WHO limit of 30 µg L-1 in groundwater. Further, the quality indices showed that groundwater of study region is suited for irrigation but not appropriate for drinking purposes. Hydro-geochemical studies revealed that most of the collected groundwater samples belonged to Ca2+ - Mg2+ - HCO3- type showing dominance of MgCO3 type which indicates the presence of temporary hardness in groundwater. Rock-water reactions and reverse ion exchange were the predominant factors for controlling hydro-geochemistry in the study region. Dissolution of silicate minerals caused the dominance of Na+ ions in the aquifers of study region. Multivariate statistics revealed that along with geogenic sources, contribution of anthropogenic activities such as injudicious application of agrochemicals and domestic waste discharge was also very significant. The results obtained abolished the myth that uranium is only root cause for large number of cancer patients in study region as arsenic and mercury were also present in groundwater at levels that were of health concern to groundwater.

Keywords: uranium, trace elements, multivariate data analysis, risk assessment

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Authors: Farah Ali, Laeeq Akbar Lodhi, Riaz Hussain, Muhammad Sufyan

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The present study was conducted to determine the macro mineral profile and biomarkers of oxidative stress in Cholistani cattle kept at a public farm and various villages in district Bahawalpur. For this purpose 90 blood samples were collected each from estrual, anestrous and repeat breeding cattle having different age and lactation number. Reproductive tract examination of all the cattle was carried out to determine the reproductive status. Blood samples without EDTA were collected for serum separation at day of estrus (normal cyclic), repeat breeder and anestrous cows. The serum calcium levels were significantly decreased (P<0.05) in anestrous (7.31±0.02 mg/dl) cattle as compared to estrus. However, these values were non-significantly different between repeat breeder and cattle having estrus phase. The concentrations of serum phosphorus were significantly higher (P<0.01) in normal estrual (4.99±0.08 mg/dl) as compared torepeat breeder (3.90±0.06 mg/dl) and anestrous (3.82±0.04 mg/dl) Cholistani cattle. Mean serum MDA (nmol/ml) levels of repeat breeder (2.68±0.18) and anestrous (2.54±0.22) were significantly(P<0.01) higher than the estrous (1.71±0.03) cattle. Moreover, the serum nitric oxide levels(µmol/L) were also increased significantly (P<0.01) in repeat breeder(58.28±4.01)and anestrous (61.40±9.40) than the normalestrous (31.67±6.71) cattle. The ratio of Ca: P in normal cyclic animals was lower (1.73:1) as compared to the anestrous animals (1.92:1). It can be concluded from the present study that the level of Ca: P should also be near to 1.5:1 for better reproductive performance.

Keywords: anestrus, cholistani cattle, minerals, oxidative stress, repeat breeder

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Authors: Hardisiswo Soedjana, Inne Caroline

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Deep dermal or full thickness burns are inevitably lead to post-burn contractures. These contractures remain to be one of the most concerning late complications of burn injuries. Surgical management includes releasing the contracture followed by resurfacing the defect accompanied by post-operative rehabilitation. Optimal treatment of post-burn contractures depends on the characteristics of the contractures. This study is aimed to describe clinical characteristics, problems, and management of post-burn contractures in adults and children. A retrospective analysis was conducted from medical records of patients suffered from contractures after burn injuries admitted to Hasan Sadikin general hospital between January 2016 and January 2018. A total of 50 patients with post burn contractures were included in the study. There were 17 adults and 33 children. Most patients were male, whose age range within 15-59 years old and 5-9 years old. Educational background was mostly senior high school among adults, while there was only one third of children who have entered school. Etiology of burns was predominantly flame in adults (82.3%); whereas flame and scald were the leading cause of burn injury in children (11%). Based on anatomical regions, hands were the most common affected both in adults (35.2%) and children (48.5%). Contractures were identified in 6-12 months since the initial burns. Most post-burn hand contractures were resurfaced with full-thickness skin graft (FTSG) both in adults and children. There were 11 patients who presented with recurrent contracture after previous history of contracture release. Post-operative rehabilitation was conducted for all patients; however, it is important to highlight that it is still challenging to control splinting and exercise when patients are discharged and especially the compliance in children. In order to improve quality of life in patients with history of deep burn injuries, prevention of contractures should begin right after acute care has been established. Education for the importance of splinting and exercise should be administered as comprehensible as possible for adult patients and parents of pediatric patients.

Keywords: burn, contracture, education, exercise, splinting

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Authors: Muluwerk Ayele Derebe

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Background: Antenatal care (ANC) is an essential element in the continuum of reproductive health care for preventing preventable pregnancy-related morbidity and mortality. Objective: The aim of this study is to assess the spatial pattern and predictors of ANC visits in Ethiopia. Method: This study was done using Ethiopian Demographic and Health Survey data of 2016 among 7,174 pregnant women aged 15-49 years which was a nationwide community-based cross-sectional survey. Spatial analysis was done using Getis-Ord Gi* statistics to identify hot and cold spot areas of ANC visits. Multilevel glmmTMB packages adjusted for spatial effects were used in R software. Spatial multilevel count regression was conducted to identify predictors of antenatal care visits for pregnant women, and proportional change in variance was done to uncover the effect of individual and community-level factors of ANC visits. Results: The distribution of ANC visits was spatially clustered Moran’s I = 0.271, p<.0.001, ICC = 0.497, p<0.001). The highest spatial outlier areas of ANC visit was found in Amhara (South Wollo, Weast Gojjam, North Shewa), Oromo (west Arsi and East Harariga), Tigray (Central Tigray) and Benishangul-Gumuz (Asosa and Metekel) regions. The data was found with excess zeros (34.6%) and over-dispersed. The expected ANC visit of pregnant women with pregnancy complications was higher at 0.7868 [ARR= 2.1964, 95% CI: 1.8605, 2.5928, p-value <0.0001] compared to pregnant women who had no pregnancy complications. The expected ANC visit of a pregnant woman who lived in a rural area was 1.2254 times higher [ARR=3.4057, 95% CI: 2.1462, 5.4041, p-value <0.0001] as compared to a pregnant woman who lived in an urban. The study found dissimilar clusters with a low number of zero counts for a mean number of ANC visits surrounded by clusters with a higher number of counts of an average number of ANC visits when other variables held constant. Conclusion: This study found that the number of ANC visits in Ethiopia had a spatial pattern associated with socioeconomic, demographic, and geographic risk factors. Spatial clustering of ANC visits exists in all regions of Ethiopia. The predictor age of the mother, religion, mother’s education, husband’s education, mother's occupation, husband's occupation, signs of pregnancy complication, wealth index and marital status had a strong association with the number of ANC visits by each individual. At the community level, place of residence, region, age of the mother, sex of the household head, signs of pregnancy complications and distance to health facility factors had a strong association with the number of ANC visits.

Keywords: Ethiopia, ANC, spatial, multilevel, zero inflated Poisson

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Authors: Ali Alotaibi, Francis Edum-Fotwe, Andrew Price /

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Mega construction projects create buildings and major infrastructure to respond to work and life requirements while playing a vital role in promoting any nation’s economy. However, the industry is often criticised for not balancing economic, environmental and social dimensions of their projects, with emphasis typically on one aspect to the detriment of the others. This has resulted in many negative impacts including environmental pollution, waste throughout the project lifecycle, low productivity, and avoidable accidents. The identification of comprehensive Social Responsibility (SR) indicators, which combine social, environmental and economic aspects, is urgently needed. This is particularly the case in the context of the Kingdom of Saudi Arabia (KSA), which often has mega public construction projects. The aim of this paper is to develop a set of wide-ranging SR indicators which encompass social, economic and environmental aspects unique to the KSA. A qualitative approach was applied to explore relevant indicators through a review of the existing literature, international standards and reports. A list of appropriate indicators was developed, and its comprehensiveness was corroborated by interviews with experts on mega construction projects working with SR concepts in the KSA. The findings present 39 indicators and their metrics, covering 10 economic, 12 environmental and 17 social aspects of SR mapped against their references. These indicators are a valuable reference for decision-makers and academics in the KSA to understand factors related to SR in mega construction projects. The indicators are related to mega construction projects within the KSA and require validation in a real case scenario or within a different industry to demonstrate their generalisability.

Keywords: social responsibility, construction projects, economic, social, environmental, indicators

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Authors: Syeda Mainaaz Unnisa, Deepa Suresh

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Due to the increase in usage of public domain channels, such as the internet, and communication technology, there is a concern about the protection of intellectual property and security threats. This interest has led to growth in researching and implementing techniques for information hiding. Steganography is the art and science of hiding information in a private manner such that its existence cannot be recognized. Communication using steganographic techniques makes not only the secret message but also the presence of hidden communication, invisible. Steganalysis is the art of detecting the presence of this hidden communication. Parallel to steganography, steganalysis is also gaining prominence, since the detection of hidden messages can prevent catastrophic security incidents from occurring. Steganalysis can also be incredibly helpful in identifying and revealing holes with the current steganographic techniques, which makes them vulnerable to attacks. Through the formulation of new effective steganalysis methods, further research to improve the resistance of tested steganography techniques can be developed. Feature-based steganalysis method for JPEG images calculates the features of an image using the L1 norm of the difference between a stego image and the calibrated version of the image. This calibration can help retrieve some of the parameters of the cover image, revealing the variations between the cover and stego image and enabling a more accurate detection. Applying this method to various steganographic schemes, experimental results were compared and evaluated to derive conclusions and principles for more protected JPEG steganography.

Keywords: cover image, feature-based steganalysis, information hiding, steganalysis, steganography

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Authors: Pier Andrea Marras, Daniela Lima, Pedro Matos Soares, Rita Maria Cardoso, Daniela Medas, Elisabetta Dore, Giovanni De Giudici

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Climate change effects on the hydrologic cycle are the main concern for the evaluation of water management strategies. Climate models project scenarios of precipitation changes in the future, considering greenhouse emissions. In this study, the EURO-CORDEX (European Coordinated Regional Downscaling Experiment) climate models were first evaluated in a Mediterranean island (Sardinia) against observed precipitation for a historical reference period (1976-2005). A weighted multi-model ensemble (ENS) was built, weighting the single models based on their ability to reproduce observed rainfall. Future projections (2071-2100) were carried out using the 8.5 RCP emissions scenario to evaluate changes in precipitations. ENS was then used as climate forcing for the SWAT model (Soil and Water Assessment Tool), with the aim to assess the consequences of such projected changes on streamflow and runoff of two small catchments located in the South-West Sardinia. Results showed that a decrease of mean rainfall values, up to -25 % at yearly scale, is expected for the future, along with an increase of extreme precipitation events. Particularly in the eastern and southern areas, extreme events are projected to increase by 30%. Such changes reflect on the hydrologic cycle with a decrease of mean streamflow and runoff, except in spring, when runoff is projected to increase by 20-30%. These results stress that the Mediterranean is a hotspot for climate change, and the use of model tools can provide very useful information to adopt water and land management strategies to deal with such changes.

Keywords: EURO-CORDEX, climate change, hydrology, SWAT model, Sardinia, multi-model ensemble

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Authors: Xiaoyu Sun

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In recent years, the rapid development of Artificial Intelligence (AI) has extensively promoted medicine, pharmaceutical, and other related fields. The medical research and development of artificial intelligence by scientific and commercial organizations are on the fast track. The ethics review is one of the critical procedures of registration to get the products approved and launched. However, the SOPs for ethics review is not enough to guide the healthy and rapid development of artificial intelligence in healthcare in China. Ethical Review Measures for Biomedical Research Involving Human Beings was enacted by the National Health Commission of the People's Republic of China (NHC) on December 1st, 2016. However, from a legislative design perspective, it was neither updated timely nor in line with the trends of AI international development. Therefore, it was great that NHC published a consultation paper on the updated version on March 16th, 2021. Based on the most updated laws and regulations in the States and EU, and in-depth-interviewed 11 subject matter experts in China, including lawmakers, regulators, and key members of ethics review committees, heads of Regulatory Affairs in SaMD industry, and data scientists, several suggestions were proposed on top of the updated version. Although the new version indicated that the Ethics Review Committees need to be created by National, Provincial and individual institute levels, the review authorities of different levels were not clarified. The suggestion is that the precise scope of review authorities for each level should be identified based on Risk Analysis and Management Model, such as the complicated leading technology, gene editing, should be reviewed by National Ethics Review Committees, it will be the job of individual institute Ethics Review Committees to review and approve the clinical study with less risk such as an innovative cream to treat acne. Furthermore, to standardize the research and development of artificial intelligence in healthcare in the age of AI, more clear guidance should be given to data security in the layers of data, algorithm, and application in the process of ethics review. In addition, transparency and responsibility, as two of six principles in the Rome Call for AI Ethics, could be further strengthened in the updated version. It is the shared goal among all countries to manage well and develop AI to benefit human beings. Learned from the other countries who have more learning and experience, China could be one of the most advanced countries in artificial intelligence in healthcare.

Keywords: biomedical research involving human beings, data security, ethics committees, ethical review, medical artificial intelligence

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Authors: E. Tan, O. McKay, T. Clarnette T., D. Croagh

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Background: Historically with pancreatic trauma, complete disruption of the main pancreatic duct (MPD), classified as Grade IV-V by the American Association for the Surgery of Trauma (AAST), necessitated a damage-control laparotomy. This was to avoid mortality, shorten diet upgrade timeframe, and hence shorter length of stay. However, acute pancreatic resection entailed complications of pancreatic fistulas and leaks. With the advance of imaging-guided interventions, non-operative management such as percutaneous and transpapillary drainage of traumatic peripancreatic collections have been trialled favourably. The aim of this case series is to evaluate the efficacy of endoscopic ultrasound-guided (EUS) transmural drainage in managing traumatic peripancreatic collections as a less invasive alternative to traditional approaches. This study also highlights the importance of anatomical knowledge regarding peripancreatic collection’s common location in the lesser sac, the pancreas relationship to adjacent organs, and the formation of the main pancreatic duct in regards to the feasibility of therapeutic internal drainage. Methodology: A retrospective case series was conducted at a single tertiary endoscopy unit, analysing patient data over a 5-year period. Inclusion criteria outlined patients age 5 to 80-years-old, traumatic pancreatic injury of at least Grade IV and haemodynamic stability. Exclusion criteria involved previous episodes of pancreatitis or abdominal trauma. Patient demographics and clinicopathological characteristics were retrospectively collected. Results: The study identified 7 patients with traumatic pancreatic injuries that were managed from 2018-2022; age ranging from 5 to 34 years old, with majority being female (n=5). Majority of the mechanisms of trauma were a handlebar injury (n=4). Diagnosis was confirmed with an elevated lipase and computerized tomotography (CT) confirmation of proximal pancreatic transection with MPD disruption. All patients sustained an isolated single organ grade IV pancreatic injury, except case 4 and 5 with other intra-abdominal visceral Grade 1 injuries. 6 patients underwent early ERCP-guided transpapillary drainage with 1 being unsuccessful for pancreatic duct stent insertion (case 1) and 1 complication of stent migration (case 2). Surveillance imaging post ERCP showed the stents were unable to bridge the disrupted duct and development of symptomatic collections with an average size of 9.9cm. Hence, all patients proceeded to EUS-guided transmural drainage, with 2/7 patients requiring repeat drainages (case 6 and 7). Majority (n=6) had a cystogastrostomy, whilst 1 (case 6) had a cystoenterostomy due to feasibility of the peripancreatic collection being adjacent to duodenum rather than stomach. However, case 6 subsequently required repeat EUS-guided drainage with cystogastrostomy for ongoing collections. Hence all patients avoided initial laparotomy with an average index length of stay of 11.7 days. Successful transmural drainage was demonstrated, with no long-term complications of pancreatic insufficiency; except for 1 patient requiring a distal pancreatectomy at 2 year follow-up due to chronic pain. Conclusion: The early results of this series support EUS-guided transmural drainage as a viable management option for traumatic peripancreatic collections, showcasing successful outcomes, minimal complications, and long-term efficacy in avoiding surgical interventions. More studies are required before the adoption of this procedure as a less invasive and complication-prone management approach for traumatic peripancreatic collections.

Keywords: endoscopic ultrasound, cystogastrostomy, pancreatic trauma, traumatic peripancreatic collection, transmural drainage

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Authors: Liudmila A.Guzikova

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Being federative state Russia includes more than 80 subjects which are widely diverse by climatic conditions, demographic characteristics, cultural traditions, intensity of migration, economic development and investment attraction and other parameters. Now, in the regions of the country all forms of housing problem are present - housing mismatch to sanitary and hygienic standards, overcrowding, forced residence in financially burdensome housing, homelessness, -although the extent of these symptoms varies widely. Heterogeneity of regional conditions in combination with specifics of regional housing situation requires to concentrate the study of housing problem on the regional level. Traditionally housing market and mortgage are considered as the instruments of housing problem solving. The question arises how the housing market and mortgage market contribute to solving the housing problem in the regions of Russia. Though the purchase of dwelling in ownership should not be regarded as a universal method of the housing problem solving, the purchase of dwelling both by own funds or by use of mortgage can reduce the problem and enhance public satisfaction of living conditions. The aim of the study is to identify differences and similarities in the development of regional housing markets and mortgage lending in the regions of Russia and to evaluate their impact on the status of the housing problem. To achieve the aim of the study the methods of correlation and regression analysis are used. The data of federal statistics constitutes the information base of research. The results of the study contribute to better understanding of the interrelations in housing sphere and can be used to work out social and economic development programs in the regions.

Keywords: housing market, housing problem, mortgage, regional economy

Procedia PDF Downloads 364

Authors: Jacqueline A. G. Sachett, Cláudia S. Nogueira, Diana C. P. Lima, Jessica T. S. Oliveira, Guilherme K. M. Salazar, Lílian K. Aguiar

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The Polo Amazon Telehealth offers several tools for professionals working in Primary Health Care as a second formative opinion, teleconsulting and training between the different areas, whether medicine, dentistry, nursing, physiotherapy, among others. These activities have a monthly schedule of free access to the municipalities of Amazonas registered. With this premise, and in partnership with the University of the State of Amazonas (UEA), is promoting the practice of the triad; teaching-research-extension in order to collaborate with the enrichment and acquisition of knowledge through educational practices carried out through teleconferences. Therefore, nursing is to join efforts and inserts as a collaborator of this project running, contributing to the education and training of these professionals who are part of the health system in full Amazon. The aim of this study is to report the experience of academic of Amazonas State University nursing course, about the experience in the extension project underway in Polo Telemedicine Amazon. This was a descriptive study, the experience report type, about the experience of nursing academic UEA, by extension 'Telenursing: teleconsulting and second formative opinion for FHS professionals in the state of Amazonas' project, held in Polo Telemedicine Amazon, through an agreement with the UEA and funded by the Foundation of Amazonas Research from July / 2012 to July / 2016. Initially developed active search of members of the Family Health Strategy professionals, in order to provide training and training teams to use the virtual clinic, as well as the virtual environment is the focus of this tool design. The election period was an aggravating factor for the implementation of teleconsulting proposal, due to change of managers in each municipality, requiring the stoppage until they assume their positions. From this definition, we established the need for new training. The first video conference took place on 03.14.2013 for learning and training in the use of Virtual Learning Environment and Virtual Clinic, with the participation of municipalities of Novo Aripuanã, São Paulo de Olivença and Manacapuru. During the whole project was carried out literature about what is being done and produced at the national level about the subject. By the time the telenursing project has received twenty-five (25) consultancy requests. The consultants sent by nursing professionals, all have been answered to date. Faced with the lived experience, particularly in video conferencing, face to cause difficulties issues, such as the fluctuation in the number of participants in activities, difficulty of participants to reconcile the opening hours of the units with the schedule of video conferencing, transmission difficulties and changes schedule. It was concluded that the establishment of connection between the Telehealth points is one of the main factors for the implementation of Telenursing and that this feature is still new for nursing. However, effective training and updating, may provide to these professional category subsidies to quality health care in the Amazon.

Keywords: Amazon, teleconsulting, telehealth, telenursing

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Authors: Işılay Tiarnagh Sheridan

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World EXPO, short version for the “exposition”, is a large universal public exhibition held since 1851. Within the 164 years, it was organized 34 times in 22 cities and as a result it has given birth to its very own culture unlike most of other international events. It has an outstanding power in transforming the places, in which it is held, into trademarks via changes in their urban tissues. For that, it is widely remembered with its cities instead of its countries. Within the scope of this change, some constructions were planned to be temporary, some planned to be permanent and some were thought to be temporary but kept afterwards becoming important monuments such as the Crystal Palace of London (though it was destroyed later by a fire) and the Eiffel Tower of Paris. These examples are the most prominent names upon considering World EXPOs. Yet, there are so many other legacies of these events within modern city fabric today that we don’t usually associate with its Expo history. Some of them are leading figures not only for the housing city but for other cities also, such as the first Metro line of Paris during 1900 World EXPO; some of them are listed as monuments of the cities such as Saint Louis Art Museum of 1904 World EXPO; some of them, like Melbourne Royal Exhibition Building of 1880 World’s EXPO, are among UNESCO World Heritage Sites and some of them are the masterpieces of modern architecture such as the famous Barcelona Pavilion, German pavilion of the 1929 World’s EXPO, of Ludwig Mies van der Rohe. Thus, the aim of this paper is to analyze the history of World’s EXPO and its eventual results in the birth of its own cultural heritage. Upon organizing these results, the paper aims to create a brief list of EXPO heritage monuments and sites so as to form a database for their further conservation needs.

Keywords: expo, heritage, world's fair, legacy

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Authors: Mary S. Ruppert-Stroescu, Minh Pham, Bruce Benjamin

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Sleep apnea is a condition where a person stops breathing and can lead to cardiovascular disease, hypertension, and stroke. In the United States, approximately forty percent of overnight sleep apnea detection tests are cancelled. The purpose of this study was to develop a textile-based sensing system that acquires biometric signals relevant to cardiovascular health, to transmit them wirelessly to a computer, and to quantitatively assess the signals for sleep apnea detection. Patient interviews, literature review and market analysis defined a need for a device that ubiquitously integrated into the patient’s lifestyle. A multi-disciplinary research team of biomedical scientists, apparel designers, and computer engineers collaborated to design a textile-based sensing system that gathers EKG, Sp02, and respiration, then wirelessly transmits the signals to a computer in real time. The electronic components were assembled from existing hardware, the Health Kit which came pre-set with EKG and Sp02 sensors. The respiration belt was purchased separately and its electronics were built and integrated into the Health Kit mother board. Analog ECG signals were amplified and transmitted to the Arduino™ board where the signal was converted from analog into digital. By using textile electrodes, ECG lead-II was collected, and it reflected the electrical activity of the heart. Signals were collected when the subject was in sitting position and at sampling rate of 250 Hz. Because sleep apnea most often occurs in people with obese body types, prototypes were developed for a man’s size medium, XL, and XXL. To test user acceptance and comfort, wear tests were performed on 12 subjects. Results of the wear tests indicate that the knit fabric and t-shirt-like design were acceptable from both lifestyle and comfort perspectives. The airflow signal and respiration signal sensors return good signals regardless of movement intensity. Future study includes reconfiguring the hardware to a smaller size, developing the same type of garment for the female body, and further enhancing the signal quality.

Keywords: sleep apnea, sensors, electronic textiles, wearables

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Authors: Joseph M. Rich, Vinay A. Duddalwar, Assad A. Oberai

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Prostate adenocarcinoma is the most common cancer in males, with osseous metastases as the commonest site of metastatic prostate carcinoma (mPC). Treatment monitoring is based on the evaluation and characterization of lesions on multiple imaging studies, including Computed Tomography (CT). Monitoring of the osseous disease burden, including follow-up of lesions and identification and characterization of new lesions, is a laborious task for radiologists. Deep learning algorithms are increasingly used to perform tasks such as identification and segmentation for osseous metastatic disease and provide accurate information regarding metastatic burden. Here, nnUNet was used to produce a model which can segment CT scan images of prostate adenocarcinoma vertebral bone metastatic lesions. nnUNet is an open-source Python package that adds optimizations to deep learning-based UNet architecture but has not been extensively combined with transfer learning techniques due to the absence of a readily available functionality of this method. The IRB-approved study data set includes imaging studies from patients with mPC who were enrolled in clinical trials at the University of Southern California (USC) Health Science Campus and Los Angeles County (LAC)/USC medical center. Manual segmentation of metastatic lesions was completed by an expert radiologist Dr. Vinay Duddalwar (20+ years in radiology and oncologic imaging), to serve as ground truths for the automated segmentation. Despite nnUNet’s success on some medical segmentation tasks, it only produced an average Dice Similarity Coefficient (DSC) of 0.31 on the USC dataset. DSC results fell in a bimodal distribution, with most scores falling either over 0.66 (reasonably accurate) or at 0 (no lesion detected). Applying more aggressive data augmentation techniques dropped the DSC to 0.15, and reducing the number of epochs reduced the DSC to below 0.1. Datasets have been identified for transfer learning, which involve balancing between size and similarity of the dataset. Identified datasets include the Pancreas data from the Medical Segmentation Decathlon, Pelvic Reference Data, and CT volumes with multiple organ segmentations (CT-ORG). Some of the challenges of producing an accurate model from the USC dataset include small dataset size (115 images), 2D data (as nnUNet generally performs better on 3D data), and the limited amount of public data capturing annotated CT images of bone lesions. Optimizations and improvements will be made by applying transfer learning and generative methods, including incorporating generative adversarial networks and diffusion models in order to augment the dataset. Performance with different libraries, including MONAI and custom architectures with Pytorch, will be compared. In the future, molecular correlations will be tracked with radiologic features for the purpose of multimodal composite biomarker identification. Once validated, these models will be incorporated into evaluation workflows to optimize radiologist evaluation. Our work demonstrates the challenges of applying automated image segmentation to small medical datasets and lays a foundation for techniques to improve performance. As machine learning models become increasingly incorporated into the workflow of radiologists, these findings will help improve the speed and accuracy of vertebral metastatic lesions detection.

Keywords: deep learning, image segmentation, medicine, nnUNet, prostate carcinoma, radiomics

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Authors: Natalia Alvarado, Myldred Hernandez-Gonzalez, Mary Laird, Madeline Phillips, Elizabeth Miller, Luis Mendez, Teresa Satterfield Linares

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Objectives: Focusing on the reported levels of depressive symptoms from Hispanic individuals in the U.S. during the ongoing COVID-19 pandemic, we analyze the psychological effects of being labeled an ‘essential worker/trabajador(a) esencial.’ We situate this attribute within the complex context of how an individual’s mental health is linked to work status and his/her community’s attitude toward such a status. Method: 336 Spanish-speaking adults (Mage = 34.90; SD = 11.00; 46% female) living in the U.S. participated in a mixed-method study. Participants completed a self-report Spanish-language survey consisting of COVID-19 prompts (e.g., Soy un trabajador esencial durante la pandemia. I am an ‘essential worker’ during the pandemic), civic engagement scale (CES) attitudes (e.g., Me siento responsable de mi comunidad. I feel responsible for my community) and behaviors (e.g., Ayudo a los miembros de mi comunidad. I help members of my community), and the Center for Epidemiological Studies Depression Scale (e.g., Me sentía deprimido/a. I felt depressed). The survey was conducted several months into the pandemic and before the vaccine distribution. Results: Regression analyses show that being labeled an essential worker was correlated to CES attitudes (b= .28, p < .001) and higher CES behaviors (b= .32, p < .001). Essential worker status also reported higher levels of depressive symptoms (b= .17, p < .05). In addition, we found that CES attitudes and CES behaviors were related to higher levels of depressive symptoms (b= .11, p <.05, b = .22, p < .001, respectively). These findings suggest that those who are on the frontlines during the COVID-19 pandemic suffer higher levels of depressive symptoms, despite their affirming community attitudes and behaviors. Discussion: Hispanics/Latinxs make up 53% of the high-proximity employees who must work in person and in close contact with others; this is the highest rate of any racial or ethnic category. Moreover, 31% of Hispanics are classified as essential workers. Our outcomes show that those labeled as trabajadores esenciales convey attitudes of remaining strong and resilient for COVID-19 victims. They also express community attitudes and behaviors reflecting a sense of responsibility to continue working to help others during these unprecedented times. However, we also find that the pressure of maintaining basic needs for others exacerbates mental health challenges and stressors, as many essential workers are anxious and stressed about their physical and economic security. As a result, community attitudes do not protect from depressive symptoms as Hispanic essential workers are failing to balance everyone’s needs, including their own (e.g., physical exhaustion and psychological distress). We conclude with a discussion on alternatives to the phrase ‘essential worker’ and of incremental steps that can be taken to address pandemic-related mental health issues targeting US Hispanic workers.

Keywords: COVID-19, essential worker, mental health, race and ethnicity

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Authors: Pinyada Santisarun, Yaowaret Tharawoot, Songyut Akkakoson

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This paper reports on a literature review sub-study of a larger research project which has been designed to identify the rhetorical organization of a travel writing genre, together with the use of lexical choices, syntactical structures, and graphological features, based on a randomly-selected corpus of Thailand travel listicles. Conducted as a library-based overview, this study aims to specify theoretical and practical elements for the said larger study. The materials for the review have been retrieved from various Internet sources, covering both public search engines and library databases. Generally, the article focuses on answering questions about the ‘what’ and the ‘how’ of such background elements widely discussed in the literature as the meaning of listicles, how the travel listicles’ patterns and regularities can be categorized to form a new genre, the effect of computer-mediated communication on the travel world, the travel language, and the current situation concerning the importance of travel listicles. The theoretical and practical data derived from this study provide valuable insights into the way in which the genre analysis and lexico-syntactical examination of Thailand travel listicles in the present authors’ larger research project can be properly conducted. The data gained can be added to the expanding body of knowledge in the field of the ESP genre.

Keywords: computer-mediated communication, digital writing, genre-based analysis, online travel writing, tourism language

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Authors: Nurul Hidayati

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Increasing public awareness of environmental pollution influences the search and development of technologies that help in clean up of organic and inorganic contaminants such as metals. Sludge waste of paper industries as toxic and hazardous material from specific source contains Pb, Zn, and Cu metal from waste soluble ink. An alternative and eco-friendly method of remediation technology is the use of biosurfactants and biosurfactant-producing microorganisms. Soil washing is among the methods available to remove heavy metal from sediments. The purpose of this research is to study effectiveness of biosurfactant with concentration = CMC for the removal of heavy metals, lead, zinc and copper in batch washing test under four different biosurfactant production by microbial origin. Pseudomonas putida T1(8), Bacillus subtilis 3K, Acinetobacter sp, and Actinobacillus sp was grown on mineral salt medium that had been already added with 2% concentration of molasses that it is a low cost application. The samples were kept in a shaker 120 rpm at room temperature for 3 days. Supernatants and sediments of sludge were separated by using a centrifuge and samples from supernatants were measured by atomic absorption spectrophotometer. The highest removal of Pb was up to 14,04% by Acinetobacter sp. Biosurfactant of Pseudomonas putida T1(8) have the highest removal for Zn and Cu up to 6,5% and 2,01% respectively. Biosurfactants have a role for removal process of the metals, including wetting, contact of biosurfactant to the surface of the sediments and detachment of the metals from the sediment. Biosurfactant has proven its ability as a washing agent in heavy metals removal from sediments, but more research is needed to optimize the process of removal heavy metals.

Keywords: biosurfactant, removal of heavy metals, sludge waste, paper industries

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Authors: S. Jeyarajan

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Concept of knowledge is discovered from conducted study for successive Competition in Sri Lankan Non-State Higher Educational Institutes. The Concept discovered out of collected Knowledge Management Practices from Emerald inside likewise reputed literatures and of Non-State Higher Educational sector. A test is conducted to reveal existences and its reason behind of these collected practices in Sri Lankan Non-State Higher Education Institutes. Further, unavailability of such study and uncertain on number of participants for data collection in the Sri Lankan context contributed selection of research method as qualitative method, which used attributes of Delphi Method to manage those likewise uncertainty. Data are collected under Dramaturgical Method, which contributes efficient usage of the Delphi method. Grounded theory is selected as data analysis techniques, which is conducted in intermixed discourse to manage different perspectives of data that are collected systematically through perspective and modified snowball sampling techniques. Data are then analysed using Grounded Theory Development Techniques in Intermix discourses to manage differences in Data. Consequently, Agreement in the results of Grounded theories and of finding in the Foreign Study is discovered in the analysis whereas present study conducted as Qualitative Research and The Foreign Study conducted as Quantitative Research. As such, the Present study widens the discovery in the Foreign Study. Further, having discovered reason behind of the existences, the Present result shows Concept for Knowledge from Sri Lankan Non-State sector to manage higher educational Institutes in successful manner.

Keywords: adherence of snowball sampling into perspective sampling, Delphi method in qualitative method, grounded theory development in intermix discourses of analysis, knowledge management for success of higher educational institutes

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Authors: Ntokozo C. Mthembu

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The notion of sustainable chemistry has become significant in the discourse for a global post-colonial era, including South Africa, especially when it comes to access to the general health system and related policies in relation to disease or ease of human life. In view of the stubborn vestiges of coloniality in the daily lives of indigenous African people in general, the fundamentals of present Western medical and traditional medicine systems and related policies in the democratic era were examined in this study. The situation of traditional healers in relation to current policy was also reviewed. The advent of democracy in South Africa brought about a variety of development opportunities and limitations, particularly with respect to indigenous African knowledge systems such as traditional medicine. There were high hopes that the limitations of previous narrow cultural perspectives would be rectified in the democratic era through development interventions, but some sections of society, such as traditional healers, remain marginalised. The Afrocentric perspective was explored in dissecting government interventions related to traditional medicine. This article highlights that multiple medical systems should be adopted and that health policies should be aligned in order to guarantee mutual respect and to address the remnants of colonialism in South Africa, Africa and the broader global community.

Keywords: traditional healing system, healers, pluralist healthcare system, post-colonial era

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Authors: Ki-Yeo Kim

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Trends in genetics are transforming in order to identify differential coexpressions of correlated gene expression rather than the significant individual gene. Moreover, it is known that a combined biomarker pattern improves the discrimination of a specific cancer. The identification of the combined biomarker is also necessary for the early detection of invasive oral squamous cell carcinoma (OSCC). To identify the combined biomarker that could improve the discrimination of OSCC, we explored an appropriate number of genes in a combined gene set in order to attain the highest level of accuracy. After detecting a significant gene set, including the pre-defined number of genes, a combined expression was identified using the weights of genes in a gene set. We used the Principal Component Analysis (PCA) for the weight calculation. In this process, we used three public microarray datasets. One dataset was used for identifying the combined biomarker, and the other two datasets were used for validation. The discrimination accuracy was measured by the out-of-bag (OOB) error. There was no relation between the significance and the discrimination accuracy in each individual gene. The identified gene set included both significant and insignificant genes. One of the most significant gene sets in the classification of normal and OSCC included MMP1, SOCS3 and ACOX1. Furthermore, in the case of oral dysplasia and OSCC discrimination, two combined biomarkers were identified. The combined genomic expression achieved better performance in the discrimination of different conditions than in a single significant gene. Therefore, it could be expected that accurate diagnosis for cancer could be possible with a combined biomarker.

Keywords: oral squamous cell carcinoma, combined biomarker, microarray dataset, correlated genes

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Authors: Daniel Ter Goon, Aanuoluwa O. Adedokun, Eyitayo Omolara Owolabi, Oladele Vincent Adeniyi, Anthony Idowu Ajayi

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Background: The unhealthy food choices and sedentary lifestyle of commercial drivers predisposes them to obesity and obesity related diseases. Yet, no attention has been paid to obesity burden among this high risk group in South Africa. This study examines the prevalence of obesity and its risk factors among commercial drivers in East London, South Africa. Methods: This cross-sectional study utilized the WHO STEP wise approach to screen for obesity among 403 drivers in Buffalo City Metropolitan Municipality (BCMM), South Africa. Anthropometric, blood pressure and blood glucose measurements were taken following a standard procedure. Overweight and obesity was defined as a body mass index (BMI) of 25.0 kgm⁻²–29.9 kg/m² and≥ 30 kg/ m², respectively. Bivariate and multivariate analysis were used to determine the prevalence and determinants of obesity. Result: The mean age of the participants was 43.3 (SD12.5) years, mean height (cm) and weight (kg) were 170.1(6.2cm) and 83(SD18.7), respectively. The prevalence of overweight and obesity was 34.0% and 38.0%, respectively. After adjusting for confounding factors, only age (OR 1.6, CI 1.0-2.7), hypertension (OR 3.6, CI 2.3-5.7) and non-smoking (OR 2.0, CI 1.3-3.1) were independent predictors of obesity. Conclusion: The prevalence of overweight and obesity is high among commercial drivers. Age, hypertension, and non-smoking were independent predictors of obesity among the sample. Measures aimed at promoting health and reducing obesity should be prioritized among this group.

Keywords: obesity and overweight, commercial taxi drivers, risk factors, South Africa

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Authors: Y. B. Kirankumar, J. D. Mallapur

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Wireless Sensor Network (WSN) is an emerging technology, which has great invention for various low cost applications both for mass public as well as for defence. The wireless sensor communication technology allows random participation of sensor nodes with particular applications to take part in the network, which results in most of the uncovered simulation area, where fewer nodes are located at far distances. The drawback of such network would be that the additional energy is spent by the nodes located in a pattern of dense location, using more number of nodes for a smaller distance of communication adversely in a region with less number of nodes and additional energy is again spent by the source node in order to transmit a packet to neighbours, thereby transmitting the packet to reach the destination. The proposed work is intended to develop Energy Efficient Node Placement Algorithm (EENPA) in order to place the sensor node efficiently in simulated area, where all the nodes are equally located on a radial path to cover maximum area at equidistance. The total energy consumed by each node compared to random placement of nodes is less by having equal burden on fewer nodes of far location, having distributed the nodes in whole of the simulation area. Calculating the network lifetime also proves to be efficient as compared to random placement of nodes, hence increasing the network lifetime, too. Simulation is been carried out in a qualnet simulator, results are obtained on par with random placement of nodes with EENP algorithm.

Keywords: energy, WSN, wireless sensor network, energy approach

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Authors: Josiel Delgadillo, Johnson Kinyua, Charles Mutigwe

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The purpose of sentiment analysis is to determine the sentiment strength (e.g., positive, negative, neutral) from a textual source for good decision-making. Natural language processing in domains such as financial markets requires knowledge of domain ontology, and pre-trained language models, such as BERT, have made significant breakthroughs in various NLP tasks by training on large-scale un-labeled generic corpora such as Wikipedia. However, sentiment analysis is a strong domain-dependent task. The rapid growth of social media has given users a platform to share their experiences and views about products, services, and processes, including financial markets. StockTwits and Twitter are social networks that allow the public to express their sentiments in real time. Hence, leveraging the success of unsupervised pre-training and a large amount of financial text available on social media platforms could potentially benefit a wide range of financial applications. This work is focused on sentiment analysis using social media text on platforms such as StockTwits and Twitter. To meet this need, SkyBERT, a domain-specific language model pre-trained and fine-tuned on financial corpora, has been developed. The results show that SkyBERT outperforms current state-of-the-art models in financial sentiment analysis. Extensive experimental results demonstrate the effectiveness and robustness of SkyBERT.

Keywords: BERT, financial markets, Twitter, sentiment analysis

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Authors: A. Al Hajeri, M. E. Minton, B. Haskins, F. H. Cummins

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The pre-hospital endotracheal intubation is fraught with difficulties; one solution offered has been video laryngoscopy (VL) which permits better visualization of the glottis than the standard method of direct laryngoscopy (DL). This method has resulted in a higher first attempt success rate and fewer failed intubations. However, VL has mainly been evaluated by experienced providers (experienced anesthetists), and as such the utility of this device for those whom infrequently intubate has not been thoroughly assessed. We sought to evaluate this equipment to determine whether in the hands of novice providers this equipment could prove an effective airway management adjunct. DL and two VL methods (C-Mac with distal screen/C-Mac with attached screen) were evaluated by simulating practice on a Laerdal airway management trainer manikin. Twenty Emergency Medical Technicians (basics) were recruited as novice practitioners. This group was used to eliminate bias, as these clinicians had no pre-hospital experience of intubation (although they did have basic airway skills). The following areas were assessed: Time taken to intubate, number of attempts required to successfully intubate, ease of use of equipment VL (attached screen) took on average longer for novice clinicians to successfully intubate and had a lower success rate and reported higher rating of difficulty compared to DL. However, VL (with distal screen) and DL were comparable on intubation times, success rate, gastric inflation rate and rating of difficulty by the user. This study highlights the routine use of VL by inexperienced clinicians would be of no added benefit over DL. Further studies are required to determine whether Emergency Medical Technicians (Paramedics) would benefit from this airway adjunct, and ascertain whether after initial mastery of VL (with a distal screen), lower intubation times and difficulty rating may be achievable.

Keywords: direct laryngoscopy, endotracheal intubation, pre-hospital, video laryngoscopy

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Authors: Madjid Nancy, Rakinaung Natalia, Lumowa Fresy

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Background: Bullying becomes one of the problems that concern the world of education, especially in adolescents, which has a negative impact on learning achievement, psychology, and physical health. The psychological impact is shame, depression, distress, fear, sadness, and anxiety, so that if prolonged leave can lead to depression in the victim. While the impact on physical health in the form of bruises on the hit area, blisters, swelling and in more severe cases will lead to death. Objectives: This study aims to explore the perception of bullying in adolescent students Sekolah Menengah Kejuruan (SMK) Negeri 1 Manado and the people associated with that adolescent students. Methods: This research uses descriptive qualitative research design and using thematic analysis, and supported by Urie Bronfenbrenner Ecological Framework. The data collection that will be used is by in-depth interview. Sampling using purposive sampling and snowball techniques. This research was conducted at SMK Negeri 1 Manado. Result: From the analysis obtained three themes with the categories: 1) the perception of bullying with categories are: Understanding of Bullying and The Impact of Bullying, 2) the originator of bullying with categories are: Fulfillment of Youth Development Tasks and Needs, Peers Influence, and Family Communication; 3) the effort to handle bullying with categories are: the Individual Coping and Teacher Role. Conclusion: This research get three themes, those are perception of bullying, bullying’s originator and the effort of handling bullying.

Keywords: adolscent, students, bullying, perception

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