Search results for: early childhood professionals

Authors: j.o. NJOKU1, g.c Soronnadi-ONONIWU2, e.j. ACRRA3, c.c AGOHA4, t.c ANYAWU5

Abstract:

The High Impact Biostratigrapgic Study of parts of Anambra basin was carried out using samples from two exploration wells (Amama-1 and Bara-1), Amama-1 (219M–1829M) and Bara-1 (317M-1594M). Palynological and Paleontological analyses were carried out on 100 ditch cutting samples. The faunal and floral succession were of terrestrial and marine origin as described and logged. The well penetrated four stratigraphic units in Anambra Basin (the Nkporo, Mamu, Ajali and Nsukka) the wells yielded well preserved formanifera and palynormorphs. The well yielded 53 species of foram and 69 species of palynomorphs, with 12 genera Bara-1 (25 Species of foram and 101 species of palynormorphs). Amama-1permitted the recognition of 21 genera with 31 formainiferal assemblage zones, 32 pollen and 37 spores assemblage zones, and dinoflagellate cyst, biozonation, ranging from late Campanian – early Paleocene. Bara-1 yielded (60 pollen, 41 spore assemblage zone and 18 dinoflagellate cyst).The zones, in stratigraphically ascending order for the foraminifera and palynomorphs are as follows. Amama Biozone A-Globotruncanella havanensis zone: Late Campanian –Maastrichtian (695 – 1829m) Biozone B-Morozovella velascoensis zone: Early Paleocene(165–695m) Bara-1 Biozone A-Globotruncanella havanensis zone: Late Campanian(1512m) Biozone B-Bolivina afra, B. explicate zone: Maastrichtian (634–1204m) Biozone C - Indeterminate (305 – 634m) palynomorphs Amama-1 A.Ctenolophonidites costatus zone:Early Maastrichtian (1829m) B-Retidiporites miniporatus Zone: Late Maastrichtian (1274m) Constructipollenites ineffectus Zone: Early Paleocene(695m) Bara-1 Droseridites senonicus Zone: Late Campanian (994– 1600m) B. Ctenolophonidites costatus Zone: Early Maastrichtian (713–994m) C. Retidiporites miniporatus Zone: Late Maastrichtian (305 –713m) The paleo – environment of deposition were determined to range from non-marine to outer netritic. A detailed categorization of the palynormorphs into terrestrially derived palynormorphs and marine derived palynormorphs based on the distribution of three broad vegetational types; mangrove, fresh water swamps and hintherland communities were used to evaluate sea level fluctuations with respect to sediments deposited in the basins and linked with a particular depositional system tract. Amama-1 recorded 4 maximum flooding surface(MFS) at depth 165-1829, dated b/w 61ma-76ma and three sequence boundary(SB) at depth1048m - 1533m and 1581 dated b/w 634m - 1387m, dated 69.5ma - 82ma and four sequence boundary(SB) at 552m-876m, dated 68ma-77.5ma respectively. The application of ecostratigraphic description is characterised by the prominent expansion of the hinterland component consisting of the Mangrove to Lowland Rainforest and Afromontane – Savannah vegetation.

Keywords: formanifera, palynomorphs. campanian, maastritchian, ecostratigraphic, anambra

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Authors: E. Oliver, A. Cebolla, A. Dominguez, A. Gonzalez-Segura, E. de la Cruz, S. Albertini, L. Ferrini, K. Kronika, T. Nilsen, R. Baños

Abstract:

The main objective of MEAL is to develop a pedagogical tool aimed to help teachers and nutritionists (students and professionals) to acquire, train, promote and deliver to children basic nutritional education and healthy eating behaviours competencies. MEAL is focused on eating behaviours and not only in nutritional literacy, and will use new technologies like Information and Communication Technologies (ICTs) and serious games (SG) platforms to consolidate the nutritional competences and habits.

Keywords: nutritional education, pedagogical ICT platform, serious games, training course

Procedia PDF Downloads 524

Authors: Kleopatra Chatzigiosi

Abstract:

The paper delves into the spatial and mythological examination of the choral chant of Dithyramb in the 7th BC, its connections to Dionysus, and its role in the origin of drama, exploring harmonious and symbolic aspects of early Greek culture. The primary aim is to analyze the development of Dithyramb in relation to harmonic systems and early musical scales, linking them to circular time and celestial movements. Additionally, the study seeks to unveil the mythological ties of Dithyramb with ancient rituals worshipping Mother Earth Cybele. The methodology involves researching etymology and mythology related to Dithyramb based on Pindar's works and proposing a harmonious design for the performance space of Dithyramb through harmonic spirals inspired by ancient practices. Ιt is also included a comparative study with similar choral traditions from other ancient cultures, providing a broader context for the findings of the work. The research uncovers the symbolic significance of Dithyramb as a dramatized representation of harmonic phenomena, leading to human deification within a context of Sacred Architecture, highlighting the intricate connections between music, rituals, and divine worship in ancient Greek culture. The study enriches understanding of the harmonic and symbolic underpinnings of ancient Greek choral traditions, shedding light on the complex interplay between music, mythology, and ritual practices in the development of early theatrical performances. Data was collected through an in-depth analysis of ancient texts, specifically Pindar's Dithyrambs, to trace the etymology and mythological origins of Dithyramb and its associated symbolism. The analysis involved scrutinizing ancient sources to draw connections between Dithyramb, harmonic systems, celestial movements, and mythological narratives, culminating in a comprehensive exploration of the cultural and symbolic significance of this choral tradition. The study addresses how the choral chant of Dithyramb evolved harmoniously within the ancient Greek cultural framework, its connections to celestial phenomena and ritual practices, and the symbolic implications of its mythological associations within a sacred architectural context. The research illuminates the profound cultural, symbolic, and harmonic dimensions of the choral chant of Dithyramb, offering valuable insights into the intersections between music, mythology, and ritual in ancient Greece, enriching scholarly understanding of early theatrical traditions.

Keywords: circular choral chant of dithyramb, “exarchon”( leader), great “eniautos” (year), harmony labyrinth

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Authors: H. Akhloufi, M. Hulscher, J. M. Prins, I. H. Van Der Sijs, D. Melles, A. Verbon

Abstract:

Background: A timely switch from intravenous to oral antibiotic therapy has many advantages, such as reduced incidence of IV-line related infections, a decreased hospital length of stay and less workload for healthcare professionals with equivalent patient safety. Additionally, numerous studies have demonstrated significant decreases in costs of a timely intravenous to oral antibiotic therapy switch, while maintaining efficacy and safety. However, a considerable variation in iv to oral antibiotic switch therapy criteria has been described in literature. Here, we report the development of a set of iv to oral switch criteria that are generally applicable in all hospitals. Material/methods: A RAND-modified Delphi procedure, which was composed of 3 rounds, was used. This Delphi procedure is a widely used structured process to develop consensus using multiple rounds of questionnaires within a qualified panel of selected experts. The international expert panel was multidisciplinary and composed out of clinical microbiologists, infectious disease consultants and clinical pharmacists. This panel of 19 experts appraised 6 major intravenous to oral antibiotic switch therapy criteria and operationalized these criteria using 41 measurable conditions extracted from the literature. The procedure to select a concise set of iv to oral switch criteria included 2 questionnaire rounds and a face-to-face meeting. Results: The procedure resulted in the selection of 16 measurable conditions, which operationalize 6 major intravenous to oral antibiotic switch therapy criteria. The following 6 major switch therapy criteria were selected: (1) Vital signs should be good or improving when bad. (2) Signs and symptoms related to the infection have to be resolved or improved. (3) The gastrointestinal tract has to be intact and functioning. (4) The oral route should not be compromised. (5) Absence of contra-indicated infections. (6) An oral variant of the antibiotic with good bioavailability has to exist. Conclusions: This systematic stepwise method which combined evidence and expert opinion resulted in a feasible set of 6 major intravenous to oral antibiotic switch therapy criteria operationalized by 16 measurable conditions. This set of early antibiotic iv to oral switch criteria can be used in daily practice in all adult hospital patients. Future use in audits and as rules in computer assisted decision support systems will lead to improvement of antimicrobial steward ship programs.

Keywords: antibiotic resistance, antibiotic stewardship, intravenous to oral, switch therapy

Procedia PDF Downloads 354

Authors: Diego De Almeida Pereira, Diana Borchenko

Abstract:

Artificial neural networks are used for many applications as they are able to learn complex nonlinear relationships between input and output data. As the number of neurons and layers in a neural network increases, it is possible to represent more complex behaviors. The present study proposes that artificial neural networks are a valuable tool for architecture and engineering professionals concerned with understanding how buildings influence human and social well-being based on theories of environmental psychology.

Keywords: environmental psychology, architecture, neural networks, human and social well-being

Procedia PDF Downloads 494

Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

Abstract:

Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

Procedia PDF Downloads 98

Authors: Jessica BrodeFrank, Beka Bryer, Lacey Wilson, Sierra Van Ryck deGroot

Abstract:

Museums are enjoying quite the moment in pop culture. From discussions of labor in Bob’s Burger to introducing cultural repatriation in The Black Panther, discussions of various museum issues are making their way to popular media. “Talking Back to Hollywood” analyzes the impact museums have on movies and television. The paper will highlight a series of cultural cameos and discuss what each reveals about critical themes in museums: repatriation, labor, obfuscated histories, institutional legacies, artificial intelligence, and holograms. Using a mixed methods approach to include surveys, descriptive research, thematic analysis, and context analysis, the authors of this paper will explore how we, as the museum staff, might begin to cite museums and movies together as texts. Drawing from their experience working in museums and public history, this contingent of mid-career professionals will highlight the impact museums have had on movies and television and the didactic lessons these portrayals can provide back to cultural heritage professionals. From tackling critical themes in museums such as repatriation, labor conditions/inequities, obfuscated histories, curatorial choice and control, institutional legacies, and more, this paper is grounded in the cultural zeitgeist of the 2000s and the message these media portrayals send to the public and the cultural heritage sector. In particular, the paper will examine how portrayals of AI, holograms, and more technology can be used as entry points for necessary discussions with the public on mistrust, misinformation, and emerging technologies. This paper will not only expose the legacy and cultural understanding of the museum field within popular culture but also will discuss actionable ways that public historians can use these portrayals as an entry point for discussions with the public, citing literature reviews and quantitative and qualitative analysis of survey results. As Hollywood is talking about museums, museums can use that to better connect to the audiences who feel comfortable at the cinema but are excluded from the museum.

Keywords: museums, public memory, representation, popular culture

Procedia PDF Downloads 83

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

Abstract:

Background and significance: Patients with eating disorders have traditionally been an underserviced population within the publicly-funded Canadian healthcare system. This situation was worsened by the COVID-19 pandemic and accompanying public health measures, such as “lockdowns” which led to increased isolation, changes in routine, and other disruptions. Illness severity and prevalence rose significantly with corresponding increases in patient suffering and poor outcomes. In Ontario, Canada, the provincial government responded by increasing funding for the treatment of eating disorders, including the launch of a new day program at an intermediate, regional health centre that already housed an outpatient treatment service. The funding was received in March 2022. The care team sought to optimize this opportunity by designing a program that would fit well within the resource-constrained context in Ontario. Methods: This case study will detail how the team consulted the literature and sought patient and family input to design a program that optimizes patient outcomes and supports for patients and families while they await treatment. Early steps include a review of the literature, expert consultation and patient and family focus groups. Interprofessional consensus was sought at each step with the team adopting a shared leadership and patient-centered approach. Methods will include interviews, observations and document reviews to detail a rich description of the process undertaken to design the program, including evaluation measures adopted. Interim findings pertaining to the early stages of the program-building process will be detailed as well as early lessons and ongoing evolution of the program and design process. Program implementation and outcome evaluation will continue throughout 2022 and early 2023 with further publication and presentation of study results expected in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to the design and implementation of eating disorder treatment services that combine outpatient and day treatment services in a resource-constrained context.

Keywords: eating disorders, day program, interprofessional, outpatient, adolescents, transitional aged youth

Procedia PDF Downloads 107

Authors: Jude Harrison

Abstract:

Child protection is a complex and sensitive practice. The core responsibility is the care and protection of children and young people who have been subject to or who are at risk from abuse and neglect. The work involves investigating allegations of harm, preparing for and making representations to the legal system, and case planning and management across a continuum of complicated care interventions. Professionals’ learning for child protection practice is evident in a range of literature investigating multiple learning processes such as university preparation, student placements, professional supervision, training, and other post-qualifying professional development experiences at work. There is, however, very limited research into how caseworkers learn in and through their daily practice. Little is known, therefore, about how learning at work unfolds for caseworkers, the dimensions in which it can be understood or the ways in which it can be best facilitated and supported. Compounding this, much of the current child protection learning literature reflects an orthodox conception of learning as mentalistic and individualised, in which knowledge is typically understood as abstract theory or as technical skill or competency. This presentation outlines key findings from a PhD research study that explored learning at work for statutory child protection caseworkers from an alternative interpretation of learning using a practice theory approach. Practice theory offers an interpretation of learning as performative and grounded in situated experience. The findings of the study show that casework practice is both a mode and site of learning. The study was ethnographic in design based and followed 17 child protection caseworkers via in-depth interviews, observations and participant reflective journaling. Inductive and abductive analysis was used to organise and interpret the data and expand analysis, leading to themes. Key findings show learning to be a sociomaterial property of doing; the social ontological character of learning; and teleoaffectivity as a feature of learning. The findings contribute to theoretical and practical understandings of learning and practice in child protection, child welfare and the professional learning literature more broadly. The findings have potential to contribute to policy directions at state, territory and national levels to enhance child protection practice and systems.

Keywords: adiult learning, workplace learning, child welfare, sociomaterial, practice theory

Procedia PDF Downloads 73

Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

Abstract:

Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma

Procedia PDF Downloads 155

Authors: J. O. Njoku, G. C. Soronnadi-Ononiwu, E. J. Acrra, C. C. Agoha, T. C. Anyawu

Abstract:

The high impact ecostratigraphic and biostratigrapgic study of parts of Anambra basin was carried out using samples from two exploration wells (Amama-1 and Bara-1), Amama-1 (219M–1829M) and Bara-1 (317M-1594M). Palynological and paleontological analyses were carried out on 100 ditch-cutting samples. The faunal and floral succession were of terrestrial and marine origin as described and logged. The well penetrated four stratigraphic units in Anambra Basin (the Nkporo, Mamu, Ajali and Nsukka) the wells yielded well preserved formanifera and palynormorphs. The well yielded 53 species of foram and 69 species of palynomorphs, with 12 genera Bara-1 (25 Species of foram and 101 species of palynormorphs). Amama-1 permitted the recognition of 21 genera with 31 formainiferal assemblage zones, 32 pollen and 37 spores assemblage zones, and dinoflagellate cyst, biozonation, ranging from late Campanian – early Paleocene. Bara-1 yielded (60 pollen, 41 spore assemblage zone and 18 dinoflagellate cyst). The zones, in stratigraphically ascending order for the foraminifera and palynomorphs are as follows: Amama Biozone A-Globotruncanella havanensis zone: Late Campanian –Maastrichtian (695 – 1829m) Biozone B-Morozovella velascoensis zone: Early Paleocene(165–695m) Bara-1 Biozone A-Globotruncanella havanensis zone: Late Campanian(1512m) Biozone B-Bolivina afra, B. explicate zone: Maastrichtian (634–1204m) Biozone C - Indeterminate (305 – 634m) palynomorphs Amama-1 A. Ctenolophonidites costatus zone: Early Maastrichtian (1829m) B-Retidiporites miniporatus Zone: Late Maastrichtian (1274m) Constructipollenites ineffectus Zone: Early Paleocene(695m) Bara-1 Droseridites senonicus Zone: Late Campanian (994– 1600m) B. Ctenolophonidites costatus Zone: Early Maastrichtian (713–994m) C. Retidiporites miniporatus Zone: Late Maastrichtian (305 –713m) The paleo-environment of deposition were determined to range from non-marine to outer netritic. A detailed categorization of the palynormorphs into terrestrially derived palynormorphs and marine derived palynormorphs based on the distribution of three broad vegetational types; mangrove, fresh water swamps and hintherland communities were used to evaluate sea level fluctuations with respect to sediments deposited in the basins and linked with a particular depositional system tract. Amama-1 recorded 4 maximum flooding surface(MFS) at depth 165-1829, dated b/w 61ma-76ma and three sequence boundary(SB) at depth1048m - 1533m and 1581 dated b/w 634m - 1387m, dated 69.5ma - 82ma and four sequence boundary(SB) at 552m-876m, dated 68ma-77.5ma respectively. The application of ecostratigraphic description is characterised by the prominent expansion of the hinterland component consisting of the Mangrove to Lowland Rainforest and Afromontane – Savannah vegetation.

Keywords: foraminifera, palynomorphs, Campanian, Maastritchian, ecostratigraphic, Anambra

Procedia PDF Downloads 24

Authors: J.O. Njoku, G.C Soronnadi-Ononiwu, E.J. Acrra, C.C AGOHA, T.C ANYAWU

Abstract:

The High Impact Ecostratigraphic And Biostratigrapgic Study of parts of Anambra basin was carried out using samples from two exploration wells (Amama-1 and Bara-1), Amama-1 (219M–1829M) and Bara-1 (317M-1594M). Palynological and Paleontological analyses were carried out on 100 ditch cutting samples. The faunal and floral succession were of terrestrial and marine origin as described and logged. The well penetrated four stratigraphic units in Anambra Basin (the Nkporo, Mamu, Ajali and Nsukka) the wells yielded well preserved formanifera and palynormorphs. The well yielded 53 species of foram and 69 species of palynomorphs, with 12 genera Bara-1 (25 Species of foram and 101 species of palynormorphs). Amama-1permitted the recognition of 21 genera with 31 formainiferal assemblage zones, 32 pollen and 37 spores assemblage zones, and dinoflagellate cyst, biozonation, ranging from late Campanian – early Paleocene. Bara-1 yielded (60 pollen, 41 spore assemblage zone and 18 dinoflagellate cyst).The zones, in stratigraphically ascending order for the foraminifera and palynomorphs are as follows. Amama Biozone A-Globotruncanella havanensis zone: Late Campanian –Maastrichtian (695 – 1829m) Biozone B-Morozovella velascoensis zone: Early Paleocene(165–695m) Bara-1 Biozone A-Globotruncanella havanensis zone: Late Campanian(1512m) Biozone B-Bolivina afra, B. explicate zone: Maastrichtian (634–1204m) Biozone C - Indeterminate (305 – 634m) palynomorphs Amama-1 A.Ctenolophonidites costatus zone:Early Maastrichtian (1829m) B-Retidiporites miniporatus Zone: Late Maastrichtian (1274m) Constructipollenites ineffectus Zone: Early Paleocene(695m) Bara-1 Droseridites senonicus Zone: Late Campanian (994– 1600m) B. Ctenolophonidites costatus Zone: Early Maastrichtian (713–994m) C. Retidiporites miniporatus Zone: Late Maastrichtian (305 –713m) The paleo – environment of deposition were determined to range from non-marine to outer netritic. A detailed categorization of the palynormorphs into terrestrially derived palynormorphs and marine derived palynormorphs based on the distribution of three broad vegetational types; mangrove, fresh water swamps and hintherland communities were used to evaluate sea level fluctuations with respect to sediments deposited in the basins and linked with a particular depositional system tract. Amama-1 recorded 4 maximum flooding surface(MFS) at depth 165-1829, dated b/w 61ma-76ma and three sequence boundary(SB) at depth1048m - 1533m and 1581 dated b/w 634m - 1387m, dated 69.5ma - 82ma and four sequence boundary(SB) at 552m-876m, dated 68ma-77.5ma respectively. The application of ecostratigraphic description is characterised by the prominent expansion of the hinterland component consisting of the Mangrove to Lowland Rainforest and Afromontane – Savannah vegetation.

Keywords: formanifera, palynomorphs. Campanian, Maastritchian, Ecostratigraphic, Anambra

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Authors: Asif Khaliq, Sayeeda A. Sayed

Abstract:

The drug information centers provide drug related information to the requesters that include physicians, pharmacist, nurses and other allied health care professionals. The International Pharmacist Federation (FIP) describes basic functions of a drug and poison information centers as drug evaluation, therapeutic counseling, pharmaceutical advice, research, pharmaco-vigilence and toxicology. Continuous advancement in the field of medicine has expanded the medical literature, which has increased demand of a drug and poison information center for the guidance, support and facilitation of physicians. The objective of the study is to determine the need of drug and poison information centers in public and private hospitals of Karachi, Pakistan. A cross sectional study was conducted during July 2013 to April 2014 using a self-administered, multi-itemed questionnaire. Non Probability Convenient sampling was used to select the study participants. A total of 307 physicians from public and private hospitals of Karachi participated in the study. The need for 24/7 Drug and poison information center was highlighted by 92 % of physicians and 67% physicians suggested opening a drug information center at the hospital. It was reported that 70% physicians take at least 15 minutes for searching the information about the drug while managing a case. Regarding the poisoning case management, 52% physicians complaint about the unavailability of medicines in hospitals; and mentioned the importance of medicines for safe and timely management of patients. Although 73% physicians attended continued medical education (CME) sessions, 92 % physicians insisted on the need of 24/7 Drug and poison information center. The scarcity of organized channel for obtaining the information about drug and poisons is one of the most crucial problems for healthcare workers in Pakistan. The drug and poison information center is an advisory body that assists health care professional and patients in provision of appropriate drug and hazardous substance information. Drug and poison information center is one of the integral needs for running an effective health care system. Provision of a 24 /7 drug information centers with specialized staff offer multiple benefits to the hospitals while reducing treatment delays, addressing awareness gaps of all stakeholders and ensuring provision of quality health care.

Keywords: drug and poison information centers, Pakistan, physicians, public and private hospitals

Procedia PDF Downloads 327

Authors: Sumattana Glangkarn, Vorapoj Promasatayaprot

Abstract:

Background: Proportion of population ageing in Thailand has been increased rapidly in the past decades according to living longer and the fertility rates have decreased. The most important challenge related to this situation is to consider how to improve quality and years of healthy of life. This study aimed to implement the older persons’ long term care (LTC) system for elderly care by family and community. Method: The Consolidated Framework for Implementation Research (CFIR) was employed for guiding and evaluating an implementation process in ageing care. The CFIR composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Results: most elderly participants were couples, educating primary school and living with children and grandchildren. More than half of them had chronic diseases such as diabetes mellitus and hypertension. Factor analysis revealed factors related to health care of older participants which consisted of exercise, diet, accidental prevention, relaxation, self-care capacity, joyfulness, family relationship, and personal hygiene. A pre-implementation phase showed intervention characteristics included facilities and services of the LTC policy from the Ministry of Public Health. The complexities of the LTC and relative advantages were explained. Community leaders, public health volunteers, care givers and health professionals had participated in the LTC activities. Outer and inner settings consisted of context of community, culture, and readiness. Characteristics of the individuals related to knowledge, self-efficacy, perceptions, and believes. The process consisted of planning, acting, observing, and reflecting. The implementation outcomes and service outcomes had been evaluated during-implementation phase. Conclusion: the participation of caregivers, community leaders, public health volunteers, and health professionals had supported the LTC services. Thus, family and community care could improve quality of life of the ageing.

Keywords: ageing, CFIR, long term care, implementation

Procedia PDF Downloads 174

Authors: Saimir Heta, Kers Kapaj, Rialda Xhizdari, Ilma Robo

Abstract:

Despite the existence of different dental specialties, the dentist-patient relationship is unique, in the very fact that the treatment is performed by one doctor and the patient identifies the malpractice presented as part of that doctor's practice; this is in complete contrast to cases of medical treatments where the patient can be presented to a team of doctors, to treat a specific pathology. The rules of dental ethics are almost the same as the rules of medical ethics. The appearance of dental malpractice affects exactly this two-party relationship, created on the basis of professionalism, without deviations in this direction, between the dentist and the patient, but with very narrow individual boundaries, compared to cases of medical malpractice. Main text: Malpractice can have different reasons for its appearance, starting from professional negligence, but also from the lack of professional knowledge of the dentist who undertakes the dental treatment. It should always be seen in perspective that we are not talking about the individual - the dentist who goes to work with the intention of harming their patients. Malpractice can also be a consequence of the impossibility, for anatomical or physiological reasons of the tooth under dental treatment, to realize the predetermined dental treatment plan. On the other hand, the dentist himself is an individual who can be affected by health conditions, or have vices that affect the systemic health of the dentist as an individual, which in these conditions can cause malpractice. So, depending on the reason that led to the appearance of malpractice, the method of treatment from a legal point of view also varies, for the dentist who committed the malpractice, evaluating the latter if the malpractice came under the conditions of applying the rules of dental ethics. Conclusions: The deviation from the predetermined dental plan is the minimum sign of malpractice and the latter should not be definitively related only to cases of difficult dental treatments. The identification of the reason for the appearance of malpractice is the initial element, which makes the difference in the way of its treatment, from a legal point of view, and the involvement of the dentist in the assessment of the malpractice committed, must be based on the legislation in force, which must be said to have their specific changes in different states. Malpractice should be referred to, or included in the lectures or in the continuing education of professionals, because it serves as a method of obtaining professional experience in order not to repeat the same thing several times, by different professionals.

Keywords: dental ethics, malpractice, negligence, legal basis, continuing education, dental treatments

Procedia PDF Downloads 60

Authors: Lamia Bouzgarrou, Amira Omrane, Malika Azzouzi, Asma Kheder, Amira Saadallah, Ilhem Boussarsar, Kamel Rejeb

Abstract:

Introduction: Increasing the women’s labor force participation is a political issue in countries with developed economies and those with low growth prospects. However, in the labor market, women continue to face several obstacles, either for the integration or for the maintenance at work. This study aims to assess the prevalence of premature withdrawal from working life -due to invalidity or medical justified early retirement- among active women in the Tunisian center and to identify its determinants. Material and methods: We conducted a cross-sectional study, over one year, focusing on the agreement for invalidity or early retirement for premature usury of the body- delivered by the medical commission of the National Health Insurance Fund (CNAM) in the central Tunisian district. We exhaustively selected women's files. Data related to Socio-demographic characteristics, professional and medical ones, were collected from the CNAM's administrative and medical files. Results: During the period of one year, 222 women have had an agreement for premature departure of their professional activity. Indeed, 149 women (67.11%) benefit of from invalidity agreement and 20,27% of them from favorable decision for early retirement. The average age was 50 ± 6 years with extremes of 23 and 62 years, and 18.9% of women were under 45 years. Married women accounted for 69.4% and 59.9% of them had at least one dependent child in charge. The average professional seniority in the sector was 23 ± 8 years. The textile-clothing sector was the most affected, with 70.7% of premature departure. Medical reasons for withdrawal from working life were mainly related to neuro-degenerative diseases in 46.8% of cases, rheumatic ones in 35.6% of cases and cardiovascular diseases in 22.1% of them. Psychiatric and endocrine disorders motivated respectively 17.1% and 13.5% of these departures. The evaluation of the sequels induced by these pathologies concluded to an average permanent partial disability equal to 61.4 ± 17.3%. The analytical study concluded that the agreement of disability or early retirement was correlated with the insured ‘age (p = 10-3), the professional seniority (p = 0.003) and the permanent partial incapacity (PPI) rate assessed by the expert physician (p = 0.04). No other social or professional factors were correlated with this decision. Conclusion: Despite many advances in labour law and Tunisian legal text on employability, women still exposed to several social and professional inequalities (payment inequality, precarious work ...). Indeed, women are often pushed to accept working in adverse conditions, thus they are more vulnerable to develop premature wear on the body and being forced to premature departures from the world of work. These premature withdrawals from active life are not only harmful to the concerned women themselves, but also associated with considerable costs for the insurance organism and the society. In order to ensure maintenance at work for women, a political commitment is imperative in the implementation of global prevention strategies and the improvement of working conditions, particularly in our socio-cultural context.

Keywords: Active Women , Early Retirement , Invalidity , Maintenance at Work

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Authors: Andriana E. Tran, Anna Chur-Hansen

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Sexual health is an important aspect of overall wellbeing. This study aimed to explore the sexual health experiences of men aged 50 years and over from the perspective of health care professional participants who were specializing in sexual health care and who consulted with older men. A total of ten interviews were conducted. Eleven themes were identified regarding men’s experiences with sexual health care as reported by participants. 1) Biologically focused: older male clients focus largely on the biological aspect of their sexual health without consideration of other factors which might affect their functioning. 2) Psychological concerns: there is an interaction between mental and sexual health but older male clients do not necessarily see this. 3) Medicalization of sexual functioning: advances in medicine that aid with erectile difficulties which consequently mean that older men tend to favor a medical solution to their sexual concerns. 4) Masculine identity: sexual health concerns are linked to older male clients’ sense of masculinity. 5) Penile functionality: most concerns that older male clients have center on their penile functionality. 6) Relationships: many male clients seek sexual help as they believe it improves relationships. Conversely, having supportive partners may mean older male clients focus less on the physicality of sex. 7) Grief and loss: men experience grief and loss – the loss of their sexual functioning, grief from loss of a long-term partner, and loss of intimacy and privacy when moving from independent living to residential care. 8) Social stigma: older male clients experience stigma around aging sexuality and sex in general. 9) Help-seeking behavior: older male clients will usually seek mechanistic solution for biological sexual concerns, such as medication used for penile dysfunction. 10) Dismissed by health care professionals: many older male clients seek specialist sexual health care without the knowledge of their doctors as they feel dismissed due to lack of expertise, lack of time, and the doctor’s personal attitudes and characteristics. Finally, 11) Lack of resources: there is a distinct lack of resources and training to understand sexuality for healthy older men. These findings may inform future research, professional training, public health campaigns and policies for sexual health in older men.

Keywords: ageing, biopsychosocial model, men's health, sexual health

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Authors: Aileen F. Wang

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Mammography has been one of the most reliable methods for early detection and diagnosis of breast cancer. However, mammography misses about 17% and up to 30% of breast cancers due to the subtle and unstable appearances of breast cancer in their early stages. Recent computer-aided diagnosis (CADx) technology using Zernike moments has improved detection accuracy. However, it has several drawbacks: it uses manual segmentation, Zernike moments are not robust, and it still has a relatively high false negative rate (FNR)–17.6%. This project will focus on the development of a novel breast cancer detection algorithm to automatically segment the breast mass and further reduce FNR. The algorithm consists of automatic segmentation of a single breast mass using Point Region Growing Segmentation, reconstruction of the segmented breast mass using Pseudo-Zernike moments, and classification of the breast mass using the root mean square (RMS). A comparative study among the various algorithms on the segmentation and reconstruction of breast masses was performed on randomly selected mammographic images. The results demonstrated that the newly developed algorithm is the best in terms of accuracy and cost effectiveness. More importantly, the new classifier RMS has the lowest FNR–6%.

Keywords: computer aided diagnosis, mammography, point region growing segmentation, pseudo-zernike moments, root mean square

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Authors: Vaibhav Baliyan, Shweta Mehrotra, S. S. Parihar

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The agricultural productivity is challenged by climate change and depletion in natural resources, including water and land, which significantly affects the crop yield. Wheat is a thermo-sensitive crop and is prone to heat stress. High temperature decreases crop duration, yield attributes, and, subsequently, grain yield and biomass production. Terminal heat stress affects grain filling duration, grain yield, and yield attributes, thus causing a reduction in wheat yield. A field experiment was conducted at Indian Agricultural Research Institute, New Delhi, for two consecutive rabi seasons (2017-18 and 2018-19) on six varieties of wheat (early sown - HD 2967, HD 3086, HD 2894 and late sown - WR 544, HD 3059, HD 3117 ) with three moisture regimes (100%, 80%, and 60% ETc, and no irrigation) and six sowing dates in three replications to investigate the effect of different moisture regimes and sowing dates on growth, yield and water use efficiency of wheat for development of best management practices for mitigation of terminal heat stress. HD3086 and HD3059 gave higher grain yield than others under early sown and late sown conditions, respectively. Maximum soil moisture extraction was recorded from 0-30 cm soil depth across the sowing dates, irrigation regimes, and varieties. Delayed sowing resulted in reducing crop growth period and forced maturity, in turn, led to significant deterioration in all the yield attributing characters and, there by, reduction in yield, suggesting that terminal heat stress had greater impact on yield. Early sowing and irrigation at 80% ETc resulted in improved growth and yield attributes and water use efficiency in both the seasons and helped to some extent in reducing the risk of terminal heat stress of wheat grown on sandy loam soils of semi-arid regions of India.

Keywords: sowing, irrigation, yield, heat stress

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Authors: Congping Lin

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Intracellular transport in fungi has a number of important roles in, e.g., filamentous fungal growth and cellular metabolism. Two basic mechanisms for intracellular transport are motor-driven trafficking along microtubules (MTs) and diffusion. Mathematical modelling has been actively developed to understand such intracellular transport and provide unique insight into cellular complexity. Based on live-cell imaging data in Ustilago hyphal cells, probabilistic models have been developed to study mechanism underlying spatial organization of molecular motors and organelles. In particular, anther mechanism - stochastic motility of dynein motors along MTs has been found to contribute to half of its accumulation at hyphal tip in order to support early endosome (EE) recycling. The EE trafficking not only facilitates the directed motion of peroxisomes but also enhances their diffusive motion. Considering the importance of spatial organization of early endosomes in supporting peroxisome movement, computational and experimental approaches have been combined to a whole-cell level. Results from this interdisciplinary study promise insights into requirements for other membrane trafficking systems (e.g., in neurons), but also may inform future 'synthetic biology' studies.

Keywords: intracellular transport, stochastic process, molecular motors, spatial organization

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Authors: Simon B. N. Thompson

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Cortisol is essential to the regulation of the immune system and yawning is a pathological symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved and with yawning is highly correlated with cortisol levels in healthy people. Saliva samples from 59 participants were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, together with EMG data and questionnaire data: Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details. Exclusion criteria: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with yawning. Further research is exploring the use of cortisol as an early diagnostic tool for MS. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, multiple sclerosis, yawning, thompson cortisol hypothesis

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Authors: O. Wright, N. Perkins, M. Donn, M. Halstead

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This research responded to anecdotal evidence that suggested inefficiencies within the Architect and Acoustician relationship may lead to ineffective acoustic design decisions.  The acoustician spoken to believed that he was approached too late in the design phase. The approached architect valued acoustical qualities, yet, struggled to interpret common measurement parameters. The preliminary investigation of these opinions indicated a gap in the current New Zealand Architectural discourse and currently informs the creation of a 2016 Master of Architecture (Prof) thesis research. Little meaningful information about acoustic intervention in the early design phase could be found from past literature. In the information that was sourced, authors focus on software as an incorporation tool without investigating why the flaws in the relationship originally exist. To further explore this relationship, a survey was designed. It underwent three phases to ensure its consistency, and was delivered to a group of 51 acousticians from one international Acoustics company. The results were then separated between New Zealand and off-shore to identify trends. The survey results suggest that 75% of acousticians meet the architect less than 5 times per project. Instead of regular contact, a mediated method is adopted though a mix of telecommunication and written reports. Acousticians tend to be introduced later into New Zealand building project than the corresponding off-shore building. This delay corresponds to an increase in remedial action for each of the building types in the survey except Auditoria and Office Buildings. 31 participants have had their specifications challenged by an architect. Furthermore, 71% of the acousticians believe that architects do not have the knowledge to understand why the acoustic specifications are in place. The issues raised in this investigation align to the colloquial evidence expressed by the two consultants. It identifies a larger gap in the industry were acoustics is remedially treated rather than identified as a possible design driver. Further research through design is suggested to understand the role of acoustics within architectural design and potential tools for its inclusion during, not after, the design process.

Keywords: architectural acoustics, early-design, interdisciplinary communication, remedial response

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Authors: Sakeh N. Mohd, Bahari M. N. Abdul, Abdullah S. N. Akmar

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Oil palm production generates high export earnings to many countries especially in Southeast Asian region. Infection by necrotrophic fungus, Ganoderma boninense on oil palm results in basal stem rot which compromises oil palm production leading to significant economic loss. There are no reliable disease treatments nor promising resistant oil palm variety has been cultivated to eradicate the disease up to date. Thus, understanding molecular mechanisms underlying early interactions of oil palm with Ganoderma boninense may be vital to promote preventive or control measure of the disease. In the present study, four months old oil palm seedlings were infected via artificial inoculation of Ganoderma boninense on rubber wood blocks. Roots of six biological replicates of treated and untreated oil palm seedlings were harvested at 0, 3, 7 and 11 days post inoculation. Next-generation sequencing was performed to generate high-throughput RNA-Seq data and identify differentially expressed genes (DEGs) during early oil palm-Ganoderma boninense interaction. Based on de novo transcriptome assembly, a total of 427,122,605 paired-end clean reads were assembled into 30,654 unigenes. DEGs analysis revealed upregulation of 173 transcription factors on Ganoderma boninense-treated oil palm seedlings. Sixty-one transcription factors were categorized as DEGs according to stringent cut-off values of genes with log2 ratio [Number of treated oil palm seedlings/ Number of untreated oil palm seedlings] ≥ |1.0| (corresponding to 2-fold or more upregulation) and P-value ≤ 0.01. Transcription factors in response to biotic stress will be screened out from abiotic stress using reverse transcriptase polymerase chain reaction. Transcription factors unique to biotic stress will be verified using real-time polymerase chain reaction. The findings will help researchers to pinpoint defense response mechanism specific against Ganoderma boninense.

Keywords: Ganoderma boninense, necrotrophic, next-generation sequencing, transcription factors

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Authors: Mustafa Hyder, Khalid Mahmood Iraqi, Sameen Mustafa

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They say if the leader limps, all the others will start limping too. Therefore, a very dynamic leadership at all levels within the IT Community is critical to the success of an organization. This paper is an attempt to study the relationship between Information Technology (IT) with leadership and assesses its relevancy in today's fast-paced hi-tech globalized environment. The paper strives to look into the essential qualities and knowledge as needed by today's IT leader, in contrast to essential characteristics common to all the leaders-past, present, and future.

Keywords: leadership, autocratic leaders, characteristics of IT leaders, skills of IT professionals, IT leadership

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Authors: Ahmed Sami Hammami, Mohamed Jellazi

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Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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Authors: Anne Davies

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Numerous students matriculating into university programs are surprised to find they are underprepared for the academic challenges of undergraduate studies. In many cases, they are unaware of their weaknesses as a scholar and unsure of how to develop their skills to succeed academically. Hypothesis: Early proactive intervention from faculty and staff members can mitigate academic issues and promote better student success outcomes. Method: After three weeks in their first semester, first-year students struggling-academically were recruited to attend individual weekly remediation sessions to develop effective learning practices. A causal-comparative methodology was used to evaluate their progress as compared to prior students with similar academic performances. Observations: Students welcomed the intervention from faculty and staff to remediate their individual needs. Those who received help in the third week had better outcomes than previous students with comparable performances who did not receive any interventional support. At the end of the semester, most students were back on track to complete their chosen degree programs. Conclusions: Early intervention by faculty and staff can improve the success of students in maintaining their status in their programs. In the future, this program will be incorporated into all first-year experience courses.

Keywords: Academic outcomes, program retention, remediation, undergraduate students

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Authors: Parisa Mansour

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Introduction: Early diagnosis of coronavirus disease (COVID-19) is extremely important to isolate and treat patients in time, thus preventing the spread of the disease, improving prognosis and reducing mortality. High-resolution computed tomography (HRCT) chest imaging and artificial intelligence (AI)-based analysis of HRCT chest images can play a central role in the treatment of patients with COVID-19. Objective: To investigate different chest HRCT findings in different stages of COVID-19 pneumonia and to evaluate the potential role of artificial intelligence in the quantitative assessment of lung parenchymal involvement in COVID-19 pneumonia. Materials and Methods: This retrospective observational study was conducted between May 1, 2020 and August 13, 2020. The study included 2169 patients with COVID-19 who underwent chest HRCT. HRCT images showed the presence and distribution of lesions such as: ground glass opacity (GGO), compaction, and any special patterns such as septal thickening, inverted halo, mark, etc. HRCT findings of the breast at different stages of the disease (early: andlt) 5 days, intermediate: 6-10 days and late stage: >10 days). A CT severity score (CTSS) was calculated based on the extent of lung involvement on HRCT, which was then correlated with clinical disease severity. Use of artificial intelligence; Analysis of CT pneumonia and quot; An algorithm was used to quantify the extent of pulmonary involvement by calculating the percentage of pulmonary opacity (PO) and gross opacity (PHO). Depending on the type of variables, statistically significant tests such as chi-square, analysis of variance (ANOVA) and post hoc tests were applied when appropriate. Results: Radiological findings were observed in HRCT chest in 1438 patients. A typical pattern of COVID-19 pneumonia, i.e., bilateral peripheral GGO with or without consolidation, was observed in 846 patients. About 294 asymptomatic patients were radiologically positive. Chest HRCT in the early stages of the disease mostly showed GGO. The late stage was indicated by such features as retinal enlargement, thickening and the presence of fibrous bands. Approximately 91.3% of cases with a CTSS = 7 were asymptomatic or clinically mild, while 81.2% of cases with a score = 15 were clinically severe. Mean PO and PHO (30.1 ± 28.0 and 8.4 ± 10.4, respectively) were significantly higher in the clinically severe categories. Conclusion: Because COVID-19 pneumonia progresses rapidly, radiologists and physicians should become familiar with typical TC chest findings to treat patients early, ultimately improving prognosis and reducing mortality. Artificial intelligence can be a valuable tool in treating patients with COVID-19.

Keywords: chest, HRCT, covid-19, artificial intelligence, chest HRCT

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Authors: Shreya Poddar

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Legal drafting and revising are recognized as highly demanding tasks for legal professionals. This paper introduces an approach to automate and refine these processes through the use of advanced Artificial Intelligence (AI). The method employs Large Language Models (LLMs), with a specific focus on 'Chain of Thoughts' (CoT) and knowledge injection via prompt engineering. This approach differs from conventional methods that depend on comprehensive training or fine-tuning of models with extensive legal knowledge bases, which are often expensive and time-consuming. The proposed method incorporates knowledge injection directly into prompts, thereby enabling the AI to generate more accurate and contextually appropriate legal texts. This approach substantially decreases the necessity for thorough model training while preserving high accuracy and relevance in drafting. Additionally, the concept of guardrails is introduced. These are predefined parameters or rules established within the AI system to ensure that the generated content adheres to legal standards and ethical guidelines. The practical implications of this method for legal work are considerable. It has the potential to markedly lessen the time lawyers allocate to document drafting and revision, freeing them to concentrate on more intricate and strategic facets of legal work. Furthermore, this method makes high-quality legal drafting more accessible, possibly reducing costs and expanding the availability of legal services. This paper will elucidate the methodology, providing specific examples and case studies to demonstrate the effectiveness of 'Chain of Thoughts' and knowledge injection in legal drafting. The potential challenges and limitations of this approach will also be discussed, along with future prospects and enhancements that could further advance legal work. The impact of this research on the legal industry is substantial. The adoption of AI-driven methods by legal professionals can lead to enhanced efficiency, precision, and consistency in legal drafting, thereby altering the landscape of legal work. This research adds to the expanding field of AI in law, introducing a method that could significantly alter the nature of legal drafting and practice.

Keywords: AI-driven legal drafting, legal automation, futureoflegalwork, largelanguagemodels

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Authors: Nelomi Anandagoda, Leanne J. Eveson

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During the COVID-19 pandemic, the surge in in-patient admissions across the medical directorate of a district general hospital necessitated the implementation of an incident rota. Conscious of the impact on training and professional development, the idea of developing a virtual teaching programme was conceived. The programme initially aimed to provide junior doctors, specialist nurses, pharmacists, and allied healthcare professionals from medical specialties and those re-deployed from other specialties (e.g., ophthalmology, GP, surgery, psychiatry) the knowledge and skills to manage the deteriorating patient with COVID-19. The programme was later developed to incorporate the general internal medicine curriculum. To facilitate continuing medical education whilst maintaining social distancing during this period, a virtual platform was used to deliver teaching to junior doctors across two large district general hospitals and two community hospitals. Teaching sessions were recorded and uploaded to a common platform, providing a resource for participants to catch up on and re-watch teaching sessions, making strides towards reducing discrimination against the professional development of less than full-time trainees. Thus, creating a learning environment, which is inclusive and accessible to adult learners in a self-directed manner. The negative impact of the pandemic on the well-being of healthcare professionals is well documented. To support the multi-disciplinary team, the virtual teaching programme evolved to included sessions on well-being, resilience, and work-life balance. Providing teaching for learners across the multi-disciplinary team (MDT) has been an eye-opening experience. By challenging the concept that learners should only be taught within their own peer groups, the authors have fostered a greater appreciation of the strengths of the MDT and showcased the immense wealth of expertise available within the trust. The inclusive nature of the teaching and the ease of joining a virtual teaching session has facilitated the dissemination of knowledge across the MDT, thus improving patient care on the frontline. The weekly teaching programme has been running for over eight months, with ongoing engagement, interest, and participation. As described above, the teaching programme has evolved to accommodate the needs of its learners. It has received excellent feedback with an appreciation of its inclusive, multi-disciplinary, and holistic nature. The COVID-19 pandemic provided a catalyst to rapidly develop novel methods of working and training and widened access/exposure to the virtual technologies available to large organisations. By merging pedagogical expertise and technology, the authors have created an effective online learning environment. Although the authors do not propose to replace face-to-face teaching altogether, this model of virtual multidisciplinary team, cross-site teaching has proven to be a great leveler. It has made high-quality teaching accessible to learners of different confidence levels, grades, specialties, and working patterns.

Keywords: cross-site, cross-speciality, inter-disciplinary, multidisciplinary, virtual teaching

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Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova

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Objectives. Gastrointestinal involvement is one of the most common manifestations of systemic sclerosis (SSc). The aim of our study was to assess the frequency of gastrointestinal manifestations in SSc patients (pts) with interstitial lung disease (ILD) and their changes to rituximab (RTX) therapy. Methods. There were 103 pts with SSc in this study. The mean follow-up period was 12.6±10.7 months. The mean age was 47±12.9 years, females - 87 pts (84%), and the diffuse cutaneous subset of the disease 55 pts (53%). The mean disease duration was 6.2±5.5 years. All pts had ILD and were positive for ANA. 67% of them were positive for anti-topoisomerase-1. All patients received prednisolone at a dose of 11.3±4.5 mg/day, and immunosuppressants at inclusion received 47% of them. Pts received RTX due to the ineffectiveness of previous therapy for ILD. The cumulative mean dose of RTX was 1.7±0.6 grams. 90% of pts received omeprazole at a dose of 20-40 mg/day. Results. At inclusion, dysphagia was observed in 76 pts (74%), early satiety or vomiting in 32 pts (31%), and diarrhea in 20 pts (19%). We didn't observe any changes in gastrointestinal manifestation during RTX therapy. There was a decrease in the number of pts with dysphagia from 76 (74%) to 66 (64%), but it was insignificant. The number of pts with early satiety or vomiting and diarrhea didn't change. Conclusion. In our study, gastrointestinal involvement was observed in most of the pts with SSc-ILD. We didn't find any significant changes in gastrointestinal manifestations during RTX therapy. RXT does not worsen gastrointestinal manifestations in SSc-ILD.

Keywords: systemic sclerosis, dysphagia, rituximab, gastrointestinal manifestations

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