Search results for: readmission outcomes
3337 Internal Migration and Poverty Dynamic Analysis Using a Bayesian Approach: The Tunisian Case
Authors: Amal Jmaii, Damien Rousseliere, Besma Belhadj
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We explore the relationship between internal migration and poverty in Tunisia. We present a methodology combining potential outcomes approach with multiple imputation to highlight the effect of internal migration on poverty states. We find that probability of being poor decreases when leaving the poorest regions (the west areas) to the richer regions (greater Tunis and the east regions).Keywords: internal migration, potential outcomes approach, poverty dynamics, Tunisia
Procedia PDF Downloads 3053336 Comprehensive Geriatric Assessments: An Audit into Assessing and Improving Uptake on Geriatric Wards at King’s College Hospital, London
Authors: Michael Adebayo, Saheed Lawal
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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality
Procedia PDF Downloads 793335 Character Development Outcomes: A Predictive Model for Behaviour Analysis in Tertiary Institutions
Authors: Rhoda N. Kayongo
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As behavior analysts in education continue to debate on how higher institutions can continue to benefit from their social and academic related programs, higher education is facing challenges in the area of character development. This is manifested in the percentages of college completion rates, teen pregnancies, drug abuse, sexual abuse, suicide, plagiarism, lack of academic integrity, and violence among their students. Attending college is a perceived opportunity to positively influence the actions and behaviors of the next generation of society; thus colleges and universities have to provide opportunities to develop students’ values and behaviors. Prior studies were mainly conducted in private institutions and more so in developed countries. However, with the complexity of the nature of student body currently due to the changing world, a multidimensional approach combining multiple factors that enhance character development outcomes is needed to suit the changing trends. The main purpose of this study was to identify opportunities in colleges and develop a model for predicting character development outcomes. A survey questionnaire composed of 7 scales including in-classroom interaction, out-of-classroom interaction, school climate, personal lifestyle, home environment, and peer influence as independent variables and character development outcomes as the dependent variable was administered to a total of five hundred and one students of 3rd and 4th year level in selected public colleges and universities in the Philippines and Rwanda. Using structural equation modelling, a predictive model explained 57% of the variance in character development outcomes. Findings from the results of the analysis showed that in-classroom interactions have a substantial direct influence on character development outcomes of the students (r = .75, p < .05). In addition, out-of-classroom interaction, school climate, and home environment contributed to students’ character development outcomes but in an indirect way. The study concluded that in the classroom are many opportunities for teachers to teach, model and integrate character development among their students. Thus, suggestions are made to public colleges and universities to deliberately boost and implement experiences that cultivate character within the classroom. These may contribute tremendously to the students' character development outcomes and hence render effective models of behaviour analysis in higher education.Keywords: character development, tertiary institutions, predictive model, behavior analysis
Procedia PDF Downloads 1283334 More Precise: Patient-Reported Outcomes after Stroke
Authors: Amber Elyse Corrigan, Alexander Smith, Anna Pennington, Ben Carter, Jonathan Hewitt
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Background and Purpose: Morbidity secondary to stroke is highly heterogeneous, but it is important to both patients and clinicians in post-stroke management and adjustment to life after stroke. The consideration of post-stroke morbidity clinically and from the patient perspective has been poorly measured. The patient-reported outcome measures (PROs) in morbidity assessment help improve this knowledge gap. The primary aim of this study was to consider the association between PRO outcomes and stroke predictors. Methods: A multicenter prospective cohort study assessed 549 stroke patients at 19 hospital sites across England and Wales during 2019. Following a stroke event, demographic, clinical, and PRO measures were collected. Prevalence of morbidity within PRO measures was calculated with associated 95% confidence intervals. Predictors of domain outcome were calculated using a multilevel generalized linear model. Associated P -values and 95% confidence intervals are reported. Results: Data were collected from 549 participants, 317 men (57.7%) and 232 women (42.3%) with ages ranging from 25 to 97 (mean 72.7). PRO morbidity was high post-stroke; 93.2% of the cohort report post-stroke PRO morbidity. Previous stroke, diabetes, and gender are associated with worse patient-reported outcomes across both the physical and cognitive domains. Conclusions: This large-scale multicenter cohort study illustrates the high proportion of morbidity in PRO measures. Further, we demonstrate key predictors of adverse outcomes (Diabetes, previous stroke, and gender) congruence with clinical predictors. The PRO has been demonstrated to be an informative and useful stroke when considering patient-reported outcomes and has wider implications for considerations of PROs in clinical management. Future longitudinal follow-up with PROs is needed to consider association of long-term morbidity.Keywords: morbidity, patient-reported outcome, PRO, stroke
Procedia PDF Downloads 1273333 Pharmacodynamic Enhancement of Repetitive rTMS Treatment Outcomes for Major Depressive Disorder
Authors: A. Mech
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Repetitive transcranial magnetic stimulation has proven to be a valuable treatment option for patients who have failed to respond to multiple courses of antidepressant medication. In fact, the American Psychiatric Association recommends TMS after one failed treatment course of antidepressant medication. Genetic testing has proven valuable for pharmacokinetic variables, which, if understood, could lead to more efficient dosing of psychotropic medications to improve outcomes. Pharmacodynamic testing can identify biomarkers, which, if addressed, can improve patients' outcomes in antidepressant therapy. Monotherapy treatment of major depressive disorder with methylated B vitamin treatment has been shown to be safe and effective in patients with MTHFR polymorphisms without waiting for multiple trials of failed medication treatment for depression. Such treatment has demonstrated remission rates similar to antidepressant clinical trials. Combining pharmacodynamics testing with repetitive TMS treatment with NeuroStar has shown promising potential for enhancing remission rates and durability of treatment. In this study, a retrospective chart review (ongoing) of patients who obtained repetitive TMS treatment enhanced by dietary supplementation guided by Pharmacodynamic testing, displayed a greater remission rate (90%) than patients treated with only NeuroStar TMS (62%).Keywords: improved remission rate, major depressive disorder, pharmacodynamic testing, rTMS outcomes
Procedia PDF Downloads 483332 Maternal and Neonatal Outcomes in Women Undergoing Bariatric Surgery: A Systematic Review and Meta-Analysis
Authors: Nicolas Galazis, Nikolina Docheva, Constantinos Simillis, Kypros Nicolaides
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Background: Obese women are at increased risk for many pregnancy complications, and bariatric surgery (BS) before pregnancy has shown to improve some of these. Objectives: To review the current literature and quantitatively assess the obstetric and neonatal outcomes in pregnant women who have undergone BS. Search Strategy: MEDLINE, EMBASE and Cochrane databases were searched using relevant keywords to identify studies that reported on pregnancy outcomes after BS. Selection Criteria: Pregnancy outcome in firstly, women after BS compared to obese or BMI-matched women with no BS and secondly, women after BS compared to the same or different women before BS. Only observational studies were included. Data Collection and Analysis: Two investigators independently collected data on study characteristics and outcome measures of interest. These were analysed using the random effects model. Heterogeneity was assessed and sensitivity analysis was performed to account for publication bias. Main Results: The entry criteria were fulfilled by 17 non-randomised cohort or case-control studies, including seven with high methodological quality scores. In the BS group, compared to controls, there was a lower incidence of preeclampsia (OR, 0.45, 95% CI, 0.25-0.80; p=0.007), GDM (OR, 0.47, 95% CI, 0.40-0.56; P<0.001) and large neonates (OR 0.46, 95% CI 0.34-0.62; p<0.001) and a higher incidence of small neonates (OR 1.93, 95% CI 1.52-2.44; p<0.001), preterm birth (OR 1.31, 95% CI 1.08-1.58; p=0.006), admission for neonatal intensive care (OR 1.33, 95% CI 1.02-1.72; p=0.03) and maternal anaemia (OR 3.41, 95% CI 1.56-7.44, p=0.002). Conclusions: BS as a whole improves some pregnancy outcomes. Laparoscopic adjustable gastric banding does not appear to increase the rate of small neonates that was seen with other BS procedures. Obese women of childbearing age undergoing BS need to be aware of these outcomes.Keywords: bariatric surgery, pregnancy, preeclampsia, gestational diabetes, birth weight
Procedia PDF Downloads 4023331 Evaluating Learning Outcomes in the Implementation of Flipped Teaching Using Data Envelopment Analysis
Authors: Huie-Wen Lin
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This study integrated various teaching factors -based on the idea of a flipped classroom- in a financial management course. The study’s aim was to establish an effective teaching implementation strategy and evaluation mechanism with respect to learning outcomes, which can serve as a reference for the future modification of teaching methods. This study implemented a teaching method in five stages and estimated the learning efficiencies of 22 students (in the teaching scenario and over two semesters). Subsequently, data envelopment analysis (DEA) was used to compare, for each student, between the learning efficiencies before and after participation in the flipped classroom -in the first and second semesters, respectively- to identify the crucial external factors influencing learning efficiency. According to the results, the average overall student learning efficiency increased from 0.901 in the first semester to 0.967 in the second semester, which demonstrate that the flipped classroom approach can improve teaching effectiveness and learning outcomes. The results also revealed a difference in learning efficiency between male and female students.Keywords: data envelopment analysis, flipped classroom, learning outcome, teaching and learning
Procedia PDF Downloads 1493330 The Role of Leadership in Enhancing Health Information Systems to Improve Patient Outcomes in China
Authors: Nisar Ahmad, Xuyi, Ali Akbar
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As healthcare systems worldwide strive for improvement, the integration of advanced health information systems (HIS) has emerged as a pivotal strategy. This study aims to investigate the critical role of leadership in the implementation and enhancement of HIS in Chinese hospitals and how such leadership can drive improvements in patient outcomes and overall healthcare satisfaction. We propose a comprehensive study to be conducted across various hospitals in China, targeting healthcare professionals as the primary population. The research will leverage established theories of transformational leadership and technology acceptance to underpin the analysis. In our approach, data will be meticulously gathered through surveys and interviews, focusing on the experiences and perceptions of healthcare professionals regarding HIS implementation and its impact on patient care. The study will utilize SPSS and SmartPLS software for robust data analysis, ensuring precise and comprehensive insights into the correlation between leadership effectiveness and HIS success. We hypothesize that strong, visionary leadership is essential for the successful adoption and optimization of HIS, leading to enhanced patient outcomes and increased satisfaction with healthcare services. By applying advanced statistical methods, we aim to identify key leadership traits and practices that significantly contribute to these improvements. Our research will provide actionable insights for policymakers and healthcare administrators in China, offering evidence-based recommendations to foster leadership that champions HIS and drives continuous improvement in healthcare delivery. This study will contribute to the global discourse on health information systems, emphasizing the future role of leadership in transforming healthcare environments and outcomes.Keywords: health information systems, leadership, patient outcomes, healthcare satisfaction
Procedia PDF Downloads 203329 A Descriptive Study on Comparison of Maternal and Perinatal Outcome of Twin Pregnancies Conceived Spontaneously and by Assisted Conception Methods
Authors: Aishvarya Gupta, Keerthana Anand, Sasirekha Rengaraj, Latha Chathurvedula
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Introduction: Advances in assisted reproductive technology and increase in the proportion of infertile couples have both contributed to the steep increase in the incidence of twin pregnancies in past decades. Maternal and perinatal complications are higher in twins than in singleton pregnancies. Studies comparing the maternal and perinatal outcomes of ART twin pregnancies versus spontaneously conceived twin pregnancies report heterogeneous results making it unclear whether the complications are due to twin gestation per se or because of assisted reproductive techniques. The present study aims to compare both maternal and perinatal outcomes in twin pregnancies which are spontaneously conceived and after assisted conception methods, so that targeted steps can be undertaken in order to improve maternal and perinatal outcome of twins. Objectives: To study perinatal and maternal outcome in twin pregnancies conceived spontaneously as well as with assisted methods and compare the outcomes between the two groups. Setting: Women delivering at JIPMER (tertiary care institute), Pondicherry. Population: 380 women with twin pregnancies who delivered in JIPMER between June 2015 and March 2017 were included in the study. Methods: The study population was divided into two cohorts – one conceived by spontaneous conception and other by assisted reproductive methods. Association of various maternal and perinatal outcomes with the method of conception was assessed using chi square test or Student's t test as appropriate. Multiple logistic regression analysis was done to assess the independent association of assisted conception with maternal outcomes after adjusting for age, parity and BMI. Multiple logistic regression analysis was done to assess the independent association of assisted conception with perinatal outcomes after adjusting for age, parity, BMI, chorionicity, gestational age at delivery and presence of hypertension or gestational diabetes in the mother. A p value of < 0.05 was considered as significant. Result: There was increased proportion of women with GDM (21% v/s 4.29%) and premature rupture of membranes (35% v/s 22.85%) in the assisted conception group and more anemic women in the spontaneous group (71.27% v/s 55.1%). However assisted conception per se increased the incidence of GDM among twin gestations (OR 3.39, 95% CI 1.34 – 8.61) and did not influence any of the other maternal outcomes. Among the perinatal outcomes, assisted conception per se increased the risk of having very preterm (<32 weeks) neonates (OR 3.013, 95% CI 1.432 – 6.337). The mean birth weight did not significantly differ between the two groups (p = 0.429). Though there were higher proportion of babies admitted to NICU in the assisted conception group (48.48% v/s 36.43%), assisted conception per se did not increase the risk of admission to NICU (OR 1.23, 95% CI 0.76 – 1.98). There was no significant difference in perinatal mortality rates between the two groups (p = 0.829). Conclusion: Assisted conception per se increases the risk of developing GDM in women with twin gestation and increases the risk of delivering very preterm babies. Hence measures should be taken to ensure appropriate screening methods for GDM and suitable neonatal care in such pregnancies.Keywords: assisted conception, maternal outcomes, perinatal outcomes, twin gestation
Procedia PDF Downloads 1993328 Outcomes of Combined Penetrating keratoplasty and Vitreo-Retinal Surgery in Management of Endophthalmitis with Obscured Corneal Clarity
Authors: Abhishek Dave, Manisha Singh
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Purpose: The study aims to evaluate the outcomes of combined Penetrating keratoplasty (PKP) and Vitreo-Retinal (VR) surgery in patients having endophthalmitis with poor corneal clarity. Methods: PKP with VR Surgery was performed in 43 eyes. This is a retrospective analysis of their preoperative, intraoperative and microbiological characteristics and anatomical and functional outcomes. Results: Corneal opacification was due to corneal ulcer in 30 (69.7%), graft infection in 8 (18.6%), bullous keratopathy in 4 and corneal scar in 1 eye. Postoperative visual acuity improved in 20 (46.5%), not changed in 14 (32.5%) and deteriorated in 9 eyes (20.9%). Poor anatomic success was seen in 15 (34.88%) eyes (9-phthisis bulbi, 6-eviscerated). Graft remained clear in 24 eyes (1 year). Microbiology revealed bacteria in 26, fungus in 14 and no growth in 3 eyes. Six out of 11 patients having poor vision in the fellow eye, too, achieved functional success. Conclusion: PKP with VR surgery is a complex but globe-salvaging procedure for poor prognosis eyes, which otherwise would need evisceration.Keywords: penetrating keratoplasty, VR surgery, endophthalmitis, corneal ulcer
Procedia PDF Downloads 423327 The Development of Learning Outcomes and Learning Management Process of Basic Education along Thailand, Laos, and Cambodia Common Border for the ASEAN Community Preparation
Authors: Ladda Silanoi
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One of the main purposes in establishment of ASEAN Community is educational development. All countries in ASEAN shall then prepare for plans and strategies for country development. Therefore, Thailand set up the policy concerning educational management for all educational institutions to understand about ASEAN Community. However, some educational institutions lack of precision in determining the curriculums of ASEAN Community, especially schools in rural areas, for example, schools along the common border with Laos, and Cambodia. One of the effective methods to promote the precision in ASEAN Community is to design additional learning courses. The important process of additional learning courses design is to provide learning outcomes of ASEAN Community for course syllabus determination. Therefore, the researcher is interested in developing teachers in the schools of common border with Laos, and Cambodia to provide learning outcomes and learning process. This research has the objective of developing the learning outcomes and learning process management of basic education along Thailand, Laos, and Cambodia Common Border for the ASEAN Community Preparation. Research methodology consists of 2 steps. Step 1: Delphi Technique was used to provide guidelines in development of learning outcomes and learning process. Step 2: Action Research procedures was employed to study the result of additional learning courses design. Result of the study: By using Delphi technique, consensus is expected to be achieved, from 50 experts in the study within 3 times of the survey. The last survey found that experts’ opinions were compatible on every item (inter-quartile range = 0) leading to the arrangement of training courses in step of Action Research. The result from the workshop found that teachers in schools of Srisaket and Bueng Kan provinces could be able to provide learning outcomes of all courses.Keywords: learning outcome and learning process, basic education, ASEAN Community preparation, Thailand Laos and Cambodia common border
Procedia PDF Downloads 4243326 The Influence of Teacher’s Non-Verbal Communication on Ondo State Secondary School Students’ Learning Outcomes in English Language
Authors: Bola M. Tunde-Awe
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The study investigated the influence of teacher’s non-verbal communication on secondary school students’ learning outcomes in English language. The study was a survey research. Participants were three hundred Senior Secondary School II students randomly selected from ten schools in Akoko South West Local Government Area of Ondo State, Nigeria. The instrument used for data collection was a questionnaire containing twenty items on a four-point Likert scale which measured teacher’s use of three types of non-verbal communication modes: body movement, eye contact and spatial distance. The data collected was analysed using simple percentage. Findings revealed that teacher’s use of these non-verbal communication modes enhanced learners’ learning outcomes in English language: a total of 271 (90.33%) participants affirmed that teacher’s body language influenced their learning of English; 224 (74.66%) maintained the same stand for eye contact; while 202 (67.33%) affirmed that teacher’s spatial distance had positive influence. Consequent upon these findings, it was recommended that teachers of English language should constantly utilize non-verbal communication in their instructional delivery. Also, non-verbal communication modes should be included in teacher education programme to equip prospective pre-service teachers with the art of non-verbal communication.Keywords: non-verbal communication, body language, eye contact, spatial distance, learning outcomes
Procedia PDF Downloads 4123325 The Long-Run Effects of In-Utero Exposure to Malaria: Evidence from the Brazilian Eradication Campaign
Authors: Henrique Veras De Paiva Fonseca
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This paper investigates the long-term relationship between early life exposure to malaria and adult socioeconomic outcomes in Brazil. The identification strategy relies on exogenous variation in the risk of malaria outbreaks in different states and seasons of the year to identify early life exposure according to the timing and location of birth. Furthermore, Brazil has undergone a successful campaign of malaria eradication during the late 1950s, which allows for comparing outcomes of birth cohorts born just prior to and just after eradication to identify the extent of in utero exposure. Instrumental variables estimates find consistent negative treatment effects of in utero exposure to malaria on socioeconomic outcomes, such as educational attainment and health status. The effects are stronger for exposure during the first trimester of pregnancy than during other periods of gestation. Additionally, consistent with previous findings, men are more likely to exhibit larger long-term effects.Keywords: malaria, exposure, eradication, instrumental variables, education, health
Procedia PDF Downloads 1643324 Bridging the Divide: Mixed-Method Analysis of Student Engagement and Outcomes in Diverse Postgraduate Cohorts
Authors: A.Knox
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Student diversity in postgraduate classes puts major challenges on educators seeking to encourage student engagement and desired to learn outcomes. This paper outlines the impact of a set of teaching initiatives aimed at addressing challenges associated with teaching and learning in an environment characterized by diversity in the student cohort. The study examines postgraduate students completing the core capstone unit within a specialized business degree. Although relatively small, the student cohort is highly diverse in terms of cultural backgrounds represented, prior learning and/or qualifications, as well as duration and type of work experience relevant to the degree, is completed. The wide range of cultures, existing knowledge and experience create enormous challenges with respect to students’ learning needs and outcomes. Subsequently, a suite of teaching innovations has been adopted to enhance curriculum content/delivery and the design of assessments. This paper explores the impact of these specific teaching and learning practices, examining the ways they have supported students’ diverse needs and enhanced students’ learning outcomes. Data from surveys and focus groups are used to assess the effectiveness of these practices. The results highlight the effectiveness of peer-assisted learning, cultural competence-building, and advanced assessment options in addressing diverse student needs and enhancing student engagement and learning outcomes. These findings suggest that such practices would benefit students’ learning in environments marked by diversity in the student cohort. Specific recommendations are offered for other educators working with diverse classes.Keywords: assessment design, curriculum content, curriculum delivery, student diversity
Procedia PDF Downloads 1043323 Apply Activity-Based Costing Management System by Key Success Paths to Promote the Competitive Advantages and Operation Performance
Authors: Mei-Fang Wu, Shu-Li Wang, Feng-Tsung Cheng
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Highly developed technology and highly competitive global market highlight the important role of competitive advantages and operation performances in sustainable company operation. Activity-Based Costing (ABC) provides accurate operation cost and operation performance information. Rich literature provide relevant research with cases study on Activity-Based Costing application, and yet, there is no research studying on cause relationship between key success factors of applying Activity-Based Costing and its specific outcomes, such as profitability or share market. These relationships provide the ways to handle the key success factors to achieve the specific outcomes for ensuring to promote the competitive advantages and operation performances. The main purposes of this research are exploring the key success paths by Key Success Paths approach which will lead the ways to apply Activity-Base Costing. The Key Success Paths is the innovative method which is exploring the cause relationships and explaining what are the effects of key success factors to specific outcomes of Activity-Based Costing implementation. The cause relationships between key success factors and successful specific outcomes are Key Success Paths (KSPs). KSPs are the guidelines to lead the cost management strategies to achieve the goals of competitive advantages and operation performances. The research findings indicate that good management system design may impact the good outcomes of Activity-Based Costing application and achieve to outstanding competitive advantage, operating performance and profitability as well by KSPs exploration.Keywords: activity-based costing, key success factors, key success paths approach, key success paths, key failure paths
Procedia PDF Downloads 3823322 Effect of Institution Volume on Mortality and Outcomes in Osteoporotic Hip Fracture Care
Authors: J. Milton, C. Uzoigwe, O. Ayeko, B. Offorha, K. Anderson, R. G. Middleton
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Background: We used the UK National Hip Fracture database to determine the effect of institution hip fracture case volume on hip fracture healthcare outcomes in 2019. Using logistic regression for each healthcare outcome, we compared the best performing 50 units with the poorest performing 50 units in order to determine if the unit volume was associated with performance for each particular outcome. Method: We analysed 175 institutions treating a total of 67,673 patients over the course of a year. Results: The number of hip fractures seen per unit ranged between 86 and 952. Larger units tendered to perform health assessments more consistently and mobilise patients more expeditiously post-operatively. Patients treated at large institutions had shorter lengths of stay. With regard to most other outcomes, there was no association between unit case volume and performance, notably compliance with the Best Practice Tariff, time to surgery, proportion of eligible patients undergoing total hip arthroplasty, length of stay, delirium risk, and pressure sore risk assessments. Conclusion: There is no relationship between unit volume and the majority of health care outcomes. It would seem that larger institutions tend to perform better at parameters that are dependent upon personnel numbers. However, where the outcome is contingent, even partially, on physical infrastructure capacity, there was no difference between larger and smaller units.Keywords: institution volume, mortality, neck of femur fractures, osteoporosis
Procedia PDF Downloads 873321 Inpatient Glycemic Management Strategies and Their Association with Clinical Outcomes in Hospitalized SARS-CoV-2 Patients
Authors: Thao Nguyen, Maximiliano Hyon, Sany Rajagukguk, Anna Melkonyan
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Introduction: Type 2 Diabetes is a well-established risk factor for severe SARS-CoV-2 infection. Uncontrolled hyperglycemia in patients with established or newly diagnosed diabetes is associated with poor outcomes, including increased mortality and hospital length of stay. Objectives: Our study aims to compare three different glycemic management strategies and their association with clinical outcomes in patients hospitalized for moderate to severe SARS-CoV-2 infection. Identifying optimal glycemic management strategies will improve the quality of patient care and improve their outcomes. Method: This is a retrospective observational study on patients hospitalized at Adventist Health White Memorial with severe SARS-CoV-2 infection from 11/1/2020 to 02/28/2021. The following inclusion criteria were used: positive SARS-CoV-2 PCR test, age >18 yrs old, diabetes or random glucose >200 mg/dL on admission, oxygen requirement >4L/min, and treatment with glucocorticoids. Our exclusion criteria included: ICU admission within 24 hours, discharge within five days, death within five days, and pregnancy. The patients were divided into three glycemic management groups: Group 1, managed solely by the Primary Team, Group 2, by Pharmacy; and Group 3, by Endocrinologist. Primary outcomes were average glucose on Day 5, change in glucose between Days 3 and 5, and average insulin dose on Day 5 among groups. Secondary outcomes would be upgraded to ICU, inpatient mortality, and hospital length of stay. For statistics, we used IBM® SPSS, version 28, 2022. Results: Most studied patients were Hispanic, older than 60, and obese (BMI >30). It was the first CV-19 surge with the Delta variant in an unvaccinated population. Mortality was markedly high (> 40%) with longer LOS (> 13 days) and a high ICU transfer rate (18%). Most patients had markedly elevated inflammatory markers (CRP, Ferritin, and D-Dimer). These, in combination with glucocorticoids, resulted in severe hyperglycemia that was difficult to control. Average glucose on Day 5 was not significantly different between groups primary vs. pharmacy vs. endocrine (220.5 ± 63.4 vs. 240.9 ± 71.1 vs. 208.6 ± 61.7 ; P = 0.105). Change in glucose from days 3 to 5 was not significantly different between groups but trended towards favoring the endocrinologist group (-26.6±73.6 vs. 3.8±69.5 vs. -32.2±84.1; P= 0.052). TDD insulin was not significantly different between groups but trended towards higher TDD for the endocrinologist group (34.6 ± 26.1 vs. 35.2 ± 26.4 vs. 50.5 ± 50.9; P=0.054). The endocrinologist group used significantly more preprandial insulin compared to other groups (91.7% vs. 39.1% vs. 65.9% ; P < 0.001). The pharmacy used more basal insulin than other groups (95.1% vs. 79.5% vs. 79.2; P = 0.047). There were no differences among groups in the clinical outcomes: LOS, ICU upgrade, or mortality. Multivariate regression analysis controlled for age, sex, BMI, HbA1c level, renal function, liver function, CRP, d-dimer, and ferritin showed no difference in outcomes among groups. Conclusion: Given high-risk factors in our population, despite efforts from the glycemic management teams, it’s unsurprising no differences in clinical outcomes in mortality and length of stay.Keywords: glycemic management, strategies, hospitalized, SARS-CoV-2, outcomes
Procedia PDF Downloads 4383320 Breech Versus Cephalic Elective Caesarean Deliveries – A Comparison of Immediate Neonatal Outcomes
Authors: Genevieve R. Kan, Jolyon Ford
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Background: Caesarean section has become the routine route of delivery for breech fetuses, but breech cesarean deliveries are hypothesized to have poorer immediate neonatal outcomes when compared to cephalic deliveries. In accordance with this, in many Australian hospitals, the pediatric team is routinely required to attend every elective breech cesarean section in case urgent resuscitation is required. Our study aimed to determine whether term elective breech deliveries indeed had worse immediate neonatal outcomes at delivery, which will justify the necessity of pediatric staff presence at every elective breech cesarean delivery and influence the workload for the pediatric team. Objective: Elective breech cesarean deliveries were compared to elective cephalic cesarean deliveries at 37 weeks gestation or above to evaluate the immediate neonatal outcomes (Apgar scores <7 at 5 minutes, and Special Care Nursery admissions on Day 1 of life) of each group. Design: A retrospective cohort study Method: This study examined 2035 elective breech and cephalic singleton cesarean deliveries at term over 5 years from July 2017 to July 2022 at Frankston Hospital, a metropolitan hospital in Melbourne, Australia. There were 260 breech deliveries and 1775 cephalic deliveries. De-identified patient data were collected retrospectively from the hospital’s electronically integrated pregnancy and birth records to assess demographics and neonatal outcomes. Results: Apgar scores <7 at 5 minutes of life were worse in the breech group compared to the cephalic group (3.4% vs 1.6%). Special Care Nursery admissions on Day 1 of life were also higher for the breech cohort compared to the cephalic cohort (9.6% vs 8.7%). Conclusions: Our results support the expected findings that breech deliveries are associated with worse immediate neonatal outcomes. It, therefore, suggests that routine attendance at elective breech cesarean deliveries by the pediatric team is indeed required to assist with potentially higher needs for neonatal resuscitation and special care nursery admission.Keywords: breech, cesarean section, Apgar scores, special care nursery admission
Procedia PDF Downloads 1003319 Rehabilitation of CP Using Pediatric Functional Independent Measure (WeeFIM) as Indicator Instruments Suitable for CP: Saudi's Perspective
Authors: Bara M. Yousef
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Kingdome of Saudi Arabia (KSA). High numbers of traffic accidents with sever, moderate and mild level of impairments admits to Sultan bin Abdulaziz humanitarian city. Over a period of 4 months the city received 111 male and 79 female subjects with CP, who received 4-6 weeks of rehabilitation and using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings shed the light on the fact that nearly 85% of people at admission got better after rehabilitation program services at individual sever moderate and mild and has arrange of (59 out of 128 WeeFIM score) and by the time of discharge they leave the city with better FIM score close to (72 out of 128 WeeFIM score) for the entire study sample. WeeFIM score is providing fair evidence to rehabilitation specialists to assess their outcomes. However there is a need to implement other instruments and compare it to WeeFIM in order to reach better outcomes at discharge level.Keywords: Cerepral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, disability
Procedia PDF Downloads 2203318 Effects of Main Contractors’ Service Quality on Subcontractors’ Behaviours and Project Outcomes
Authors: Zhuoyuan Wang, Benson T. H. Lim, Imriyas Kamardeen
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Effective service quality management has long been touted as a means of improving project and organisational performance. Particularly, in construction projects, main contractors are often seen as a broker between clients and subcontractors, and their service quality is thus associated with the overall project affinity and outcomes. While a considerable amount of research has focused on the aspect of clients-main contractors, very little research has been done to explore the effect of contractors’ service quality on subcontractors’ behaviours and so project outcomes. In addressing this gap, this study surveyed 97 subcontractors in the Chinese Construction industry and data was analysed using the Partial Least Square (PLS) Structural Equation Modelling (SEM) technique. The overall findings reveal that subcontractors categorised main contractors’ service quality into three dimensions: assurance; responsiveness; reliability and empathy. Of these, it is found that main contractors’ ‘assurance’ and ‘responsiveness’ positively influence subcontractors’ intention to engage in contractual behaviours. The results further show that the subcontractors’ intention to engage in organizational citizenship behaviours is associated with how flexible and committed the main contractors are in reliability and empathy. Collectively, both subcontractors’ contractual and organizational citizenship behaviours positively influence the overall project outcomes. In conclusion, the findings inform contractors different strategies towards managing and gaining subcontractors’ behaviour commitment in a socially connected, yet complex and uncertain, business environment.Keywords: construction firms, organisational citizenship behaviour, service quality, social exchange theory
Procedia PDF Downloads 2023317 The Improvement in Clinical Outcomes with the Histological Presence of Nidus Following Radiofrequency Ablation (RFA) for Osteoid Osteoma (OO)
Authors: Amirul Adlan, Motaz AlAqeel, Scott Evans, Vaiyapuri sumathi, Mark Davies, Rajesh Botchu
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Background & Objectives: Osteoid osteoma (OO) is a benign tumor of the bone commonly found in childhood and adolescence, causing bone pain, especially during the night. CT-guided radiofrequency ablation (RFA) is currently the mainstay treatment for OO. There is currently no literature reporting the outcomes of OO following RFA based on the histological presence of a nidus seen on a biopsy taken at the time of RFA. The primary aim of this study was to compare the clinical outcomes of OO between the group of patients with the presence of nidus on biopsy samples from RFA with those without nidus. Secondly, we aimed to examine other factors that may affect the outcomes of OO, reflecting our experience as a tertiary orthopedic oncology center. Methods: We retrospectively reviewed 88 consecutive patients diagnosed with osteoid osteoma treated with RFA between November 2005 and March 2015, consisting of 63 males (72%) and 25 females (28%). Sixty-six patients (75%) had nidus present in their biopsy samples. Patients’ mean age was 17.6 years (4-53). The median duration of follow-up was 12.5 months (6-20.8). Lesions were located in the appendicular skeleton in seventy-nine patients (90%), while nine patients (10%) had an OO in the axial skeleton. Outcomes assessed were based on patients’ pain alleviation (partial, complete, or no pain improvement) and the need for further interventions. Results: Pain improvement in the patient group with nidus in the histology sample was significantly better than in the group without nidus (OR 7.4, CI 1.35-41.4, p=0.021). The patient group with nidus on biopsy demonstrated less likelihood of having a repeat procedure compared to the group without nidus(OR 0.092, CI 0.016-0.542, p=0.008). Our study showed significantly better outcomes in pain improvement in appendicular lesions compared to the axially located lesions (p = 0.005). Patients with spinal lesions tend to have relatively poor pain relief than those with appendicular or pelvic lesions (p=0.007). Conclusions: Patients with nidus on histology had better pain alleviation compared to patients without nidus. The histological presence of nidus significantly reduces the chance of repeat interventions. The pain alleviation of osteoid osteoma following RFA is better in patients with appendicular lesions than spinal or axially located lesions.Keywords: osteoid osteoma, benign tumour, radiofrequency ablation, oncology
Procedia PDF Downloads 1453316 Long-Term Health and Quality of Life Outcomes Following War-Related Traumatic Lower-Limb Amputation; A Study on Community Re-Integrated Army Veterans in Sri Lanka
Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana
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Background: Civil war in Sri Lanka ended a decade ago, leaving thousands of army veterans permanently disabled following lower-limb amputations. Quantifying long-term functional health and psychological wellbeing will inform the development of tailored home-based rehabilitation intervention. Objectives: To assess the long-term health and quality of life of Sri Lankan soldiers with traumatic lower-limb amputation.Methods and Materials: A comparative cross-sectional study was conducted in five districts of Sri Lanka. Using stratified random sample technique, two groups of 85 participants were selected; group 1, community re-integrated male army veterans with unilateral lower-limb amputation, and group 2, age and sex matched normal healthy individuals. Long-term health and quality of life (QoL) outcomes were assessed and compared between the two groups using self-administered Short-Form Health Survey-36 questionnaire (SF-36) previously validated for use in Sri Lanka. Results: Group 1 were active prosthetic users who had undergone amputation > ten years ago (Mean±SD: 21.7±5.9). The most prevalent comorbidities for group 1 and 2 were hypertension and diabetes (22.4% and 30.6% and 9.4% and 9.8%, respectively). In group 1, injury-associated long-term health outcomes included knee osteoarthritis (18.8%), knee pain (20.0%), and back pain (69.4%). Scores of physical health and psychological wellbeing were 53.1 (IQR 64.4- 43.8) and 63.5 (IQR 73.3- 51.4) for each group, respectively. Scores revealed the highest QoL related to social functioning (75 (IQR 87.5- 62.5)) and the poorest aspects of QoL related to general health (40 (IQR 50- 35)). Prevalence of comorbidities was significantly higher, and QoL outcomes were significantly lower among soldiers compared to normal healthy individuals (p<0.05).Conclusion: Higher prevalence of comorbidities, poor physical health, and lower QoL outcomes were more prevalent in soldiers with lower-limb amputation when compared to healthy counterparts.Keywords: community-based, disability, health outcomes, quality of life, soldiers
Procedia PDF Downloads 1233315 Effects of Zinc and Vitamin A Supplementation on Prognostic Markers and Treatment Outcomes of Adults with Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis
Authors: Fasil Wagnew, Kefyalew Addis Alene, Setegn Eshetie, Tom Wingfield, Matthew Kelly, Darren Gray
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Introduction: Undernutrition is a major and under-appreciated risk factor for TB, which is estimated to be responsible for 1.9 million TB cases per year globally. The effectiveness of micronutrient supplementation on TB treatment outcomes and its prognostic markers such as sputum conversion and serum zinc, retinol, and hemoglobin levels has been poorly understood. This systematic review and meta-analysis aimed to determine the association between zinc and vitamin A supplementation and TB treatment outcomes and its prognostic markers. Methods: A systematic literature search for randomized controlled trials (RCTs) was performed in PubMed, Embase, and Scopus databases. Meta-analysis with a random effect model was performed to estimate risk ratio (RR) and mean difference (MD), with a 95% confidence interval (CI), for dichotomous and continuous outcomes, respectively. Results: Our search identified 2,195 records. Of these, nine RCTs consisting of 1,375 participants were included in the final analyses. Among adults with pulmonary TB, zinc (RR: 0.94, 95%CI: 0.86, 1.03), vitamin A (RR: 0.90, 95%CI: 0.80, 1.01), and combined zinc and vitamin A (RR: 0.98, 95%CI: 0.89, 1.08) supplementation were not significantly associated with TB treatment success. Combined zinc and vitamin A supplementation was significantly associated with increased sputum smear conversion at 2 months (RR: 1.16, 95%CI: 1.03, 1.32), serum zinc levels at 2 months (MD of 0.86umol/l, 95% CI: 0.14, 1.57), serum retinol levels at 2 months (MD: 0.06umol/l, 95 % CI: 0.04, 0.08) and 6 months (MD: 0.12umol/l, 95 % CI: 0.10, 0.14), and serum hemoglobin level at 6 months (MD: 0.29 ug/dl, 95% CI: 0.08 to 0.51), among adults with TB. Conclusions: Providing zinc and vitamin A supplementation to adults with pulmonary TB during treatment may increase early sputum smear conversion, serum zinc, retinol, and hemoglobin levels. However, the use of zinc, vitamin A, or both were not associated with TB treatment success.Keywords: zinc and vitamin A supplementation, tuberculosis, treatment outcomes, meta-analysis, RCT
Procedia PDF Downloads 1633314 Effectiveness of the Lacey Assessment of Preterm Infants to Predict Neuromotor Outcomes of Premature Babies at 12 Months Corrected Age
Authors: Thanooja Naushad, Meena Natarajan, Tushar Vasant Kulkarni
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Background: The Lacey Assessment of Preterm Infants (LAPI) is used in clinical practice to identify premature babies at risk of neuromotor impairments, especially cerebral palsy. This study attempted to find the validity of the Lacey assessment of preterm infants to predict neuromotor outcomes of premature babies at 12 months corrected age and to compare its predictive ability with the brain ultrasound. Methods: This prospective cohort study included 89 preterm infants (45 females and 44 males) born below 35 weeks gestation who were admitted to the neonatal intensive care unit of a government hospital in Dubai. Initial assessment was done using the Lacey assessment after the babies reached 33 weeks postmenstrual age. Follow up assessment on neuromotor outcomes was done at 12 months (± 1 week) corrected age using two standardized outcome measures, i.e., infant neurological international battery and Alberta infant motor scale. Brain ultrasound data were collected retrospectively. Data were statistically analyzed, and the diagnostic accuracy of the Lacey assessment of preterm infants (LAPI) was calculated -when used alone and in combination with the brain ultrasound. Results: On comparison with brain ultrasound, the Lacey assessment showed superior specificity (96% vs. 77%), higher positive predictive value (57% vs. 22%), and higher positive likelihood ratio (18 vs. 3) to predict neuromotor outcomes at one year of age. The sensitivity of Lacey assessment was lower than brain ultrasound (66% vs. 83%), whereas specificity was similar (97% vs. 98%). A combination of Lacey assessment and brain ultrasound results showed higher sensitivity (80%), positive (66%), and negative (98%) predictive values, positive likelihood ratio (24), and test accuracy (95%) than Lacey assessment alone in predicting neurological outcomes. The negative predictive value of the Lacey assessment was similar to that of its combination with brain ultrasound (96%). Conclusion: Results of this study suggest that the Lacey assessment of preterm infants can be used as a supplementary assessment tool for premature babies in the neonatal intensive care unit. Due to its high specificity, Lacey assessment can be used to identify those babies at low risk of abnormal neuromotor outcomes at a later age. When used along with the findings of the brain ultrasound, Lacey assessment has better sensitivity to identify preterm babies at particular risk. These findings have applications in identifying premature babies who may benefit from early intervention services.Keywords: brain ultrasound, lacey assessment of preterm infants, neuromotor outcomes, preterm
Procedia PDF Downloads 1353313 Environmental, Climate Change, and Health Outcomes in the World
Authors: Felix Aberu
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The high rate of greenhouse gas (CO₂) emission and increased concentration of Carbon Dioxide in the atmosphere are not unconnected to both human and natural activities. This has caused climate change and global warming in the world. The adverse effect of these climatic changes has no doubt threatened human existence. Hence, this study examined the effects of environmental and climate influence on mortality and morbidity rates, with particular reference to the world’s leading CO₂ emission countries, using both the pre-estimation, estimation, and post-estimation techniques for more dependable outcomes. Hence, the System Generalized Method of Moments (SGMM) was adopted as the main estimation technique for the data analysis from 1996 to 2023. The coefficient of carbon emissions confirmed a positive and significant relationship among CO₂ emission, mortality, and morbidity rates in the world’s leading CO₂ emissions countries, which implies that carbon emission has contributed to mortality and morbidity rates in the world. Therefore, significant action should be taken to facilitate the expansion of environmental protection and sustainability initiatives in any CO₂ emissions nations of the world.Keywords: environmental, mortality, morbidity, health outcomes, carbon emissions
Procedia PDF Downloads 483312 Early Childhood Education and Learning Outcomes in Lower Primary Schools, Uganda
Authors: John Acire, Wilfred Lajul, Ogwang Tom
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Using a qualitative research technique, this study investigates the influence of Early Childhood Education (ECE) on learning outcomes in lower primary schools in Gulu City, Uganda. The study, which is based on Vygotsky's sociocultural theory of human learning, fills gaps in the current literature on the influence of ECE on learning outcomes. The aims of the study include analyzing the state of learning outcomes, investigating ECE practices, and determining the influence of these practices on learning outcomes in lower primary schools. The findings highlight the critical significance of ECE in promoting children's overall development. Nursery education helps children improve their handwriting, reading abilities, and general cognitive development. Children who have received nursery education have improved their abilities to handle pencils, form letters, and engage in social interactions, highlighting the significance of fine motor skills and socializing. Despite the good elements, difficulties in implementing ECE practices were found, such as differences in teaching styles, financial limits, and potential weariness due to prolonged school hours. The study suggests focused interventions to improve the effectiveness of ECE practices, ensure their connection with educational goals and maximize their influence on children's development. The study's findings show that respondents agree on the importance of nursery education in supporting holistic development, socialization, language competency, and conceptual comprehension. Challenges in nursery education, such as differences in teaching techniques and insufficient resources, highlight the need for comprehensive measures to address these challenges. Furthermore, parental engagement in home learning activities was revealed as an important factor affecting early education outcomes. Children who were engaged at home performed better in lower primary, emphasizing the value of a supportive family environment. Finally, the report suggests measures to enhance parental participation, changes in teaching methods through retraining, and age-appropriate enrolment. Future studies might concentrate on the involvement of parents, ECE policy practice, and the influence of ECE teachers on lower primary school learning results. These ideas are intended to help create a more favorable learning environment by encouraging holistic development and preparing children for success in succeeding academic levels.Keywords: early childhood education, learning outcomes in lower primary schools, early childhood education practices, how ECE practices influence learning outcomes in lower primary schools
Procedia PDF Downloads 323311 Son Preference in Afghanistan and Its Impact on Fertility Outcomes
Authors: Saha Naseri
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Introduction/Objective: Son preference, a preference for sons over daughters, is a practice deeply-rooted in gender inequality that is widespread in many societies and across different religions and cultures. In this study, we are aiming to study the effects of son preference on fertility outcomes (birth interval and current contraceptive use) in Afghanistan, where have been perceived with high rates of son preference. The objectives of the study are to examine the association between the sex of the previous child and the duration of the subsequent birth interval and to evaluate the effect of son preference on current contraceptive use. Methodology: Afghanistan Demographic and Health Survey (DHS) (2015) was used to study the impact of son preference on fertility outcomes among married women. The data collected from 28,661 on currently-married women, aged between 15 and 49 years who have at least one child, have used to conduct this quantitative study. Outcomes of interest are birth interval and current contraceptive use. Simple and multiple regression analysis have been conducted to assess the effect of son preference on these fertility outcomes. Results: The present study has highlighted that son preference somehow exists among married women in Afghanistan. It is indicated that the sex of the first birth is significantly associated with the succeeding birth interval. Having a female child as the first baby was associated with a shorter average succeeding birth interval by 1.8 months compared to a baby boy (p-value = 0.000). For the second model, the results identified that women who desire for more sons have 7% higher odds to be current contraceptive user compared to those who have no preference (p-value = 0.03). The latter results do not indicate the son preference. However, one limitation for this result was the timeliness of the questions asked since contraceptive use in the current time was asked along with a question on ‘future’ desired sex composition. Moreover, women may have just given birth and want to reach a certain time span of birth interval before planning for another child, even if it was a boy, which might have affected the results. Conclusion: Overall, this study has demonstrated that there is a positive relationship between son preference and one main fertility behaviors, birth interval. The second fertility outcome, current contraceptive use, was not a good indicator to measure son preference. Based on the finding, recommendations will be made for appropriate interventions addressing gender norms and related fertility decisions.Keywords: Afghanistan, birth interval, contraceptive, son preference
Procedia PDF Downloads 1643310 Swallowing Outcomes in Supraglottic Cancer Patients after Trans-Oral Robotic Surgery (TORS) Provided with Early Dysphagia Management Using Standardized Functional and Objective Measures
Authors: Hitesh Gupta, Surender Dabas
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TORS is increasingly gaining widespread use and has been explored as minimally invasive surgery for the treatment of supraglottic cancer (SGC). Being a central critical role of Supraglottis in deglutition, swallowing outcomes post TORS remain a most important factor. Available published studies show inconsistent swallowing outcomes and are deficient in standardized outcome measures, description of swallowing recovery and rehabilitation. So, the objective of this study is to find out swallowing outcomes in SGC patients after TORS provided with early dysphagia management using standardized measures. Prospectively 16 patients were recruited in the study who underwent TORS for primary tumor of Supraglottis, involving one or more sub-sites or invading to sites other than Supraglottis at the BLK Super Specialty Hospital, New Delhi from March 2019 to June 2020. All patients were evaluated for dysphagia with subsequent swallowing rehabilitation on post operative day 3 in the hospital or at the time of discharge, whichever was earlier. Functional oral intake scale (FOIS) and penetration-aspiration score (PAS) were used as outcome measures to quantify swallowing recovery at one month and six month post operatively. Post TORS, patients achieved functional swallow in less than one month, where resection was limited to Supraglottis, while the recovery was delayed in patients with extended resection to tongue base or hypopharynx. Overall, out of Total 16 cases including all supraglottis sub-catagories, 13 (81%) could remove their NG tube (FOIS ≥5 and PAS=1 ) within 6 months. In which 8 cases(62%) achieved functional swallow in less than one month. Swallowing outcomes post TORS supraglottic laryngectomy are favorable if provided with early dysphagia management (or swallowing rehabilitation).Keywords: dysphagia, supraglottic cancer, swallowing, TORS
Procedia PDF Downloads 1003309 LORA: A Learning Outcome Modelling Approach for Higher Education
Authors: Aqeel Zeid, Hasna Anees, Mohamed Adheeb, Mohamed Rifan, Kalpani Manathunga
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To achieve constructive alignment in a higher education program, a clear set of learning outcomes must be defined. Traditional learning outcome definition techniques such as Bloom’s taxonomy are not written to be utilized by the student. This might be disadvantageous for students in student-centric learning settings where the students are expected to formulate their own learning strategies. To solve the problem, we propose the learning outcome relation and aggregation (LORA) model. To achieve alignment, we developed learning outcome, assessment, and resource authoring tools which help teachers to tag learning outcomes during creation. A pilot study was conducted with an expert panel consisting of experienced professionals in the education domain to evaluate whether the LORA model and tools present an improvement over the traditional methods. The panel unanimously agreed that the model and tools are beneficial and effective. Moreover, it helped them model learning outcomes in a more student centric and descriptive way.Keywords: learning design, constructive alignment, Bloom’s taxonomy, learning outcome modelling
Procedia PDF Downloads 1793308 Conservative Treatment Versus Percutaneous Wire Fixation in treatment of Distal Radial Fracture in Elderly
Authors: Abdelfatah Elsenosy, Mahmoud Ebrahim
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Background: Distal radius fractures are commonly encountered in orthopedic practice, especially in elderly patients. A number of clinical papers have supported the idea that anatomic restoration of the distal end of the radius is essential to gain superior results. Aim and objectives: The aim of the study is to systematically review the literature for the management of distal end radius in elderly persons (conservative treatment versus percutaneous wire fixation) as regards radiological and functional outcomes. Subjects and methods: Studies were identified from the Medline, Cochrane, EMBASE, and Google Scholar databases were searched until 2019 using combinations of the following search terms: distal radius fracture, conservative treatment, non-operative treatment, and nonsurgical treatment, surgical treatment, operative, elderly, and older. Reference lists of relevant studies were manually searched. Results: There was no statistical significance difference between CI and PKF groups’ frequency of complication in all of the selected studies. Based on the results, we recommend more analysis regarding every parameter of the radiographic and functional results and specific complications related to each fixation need to be accomplished, which requires more Randomized controlled trials (RCTs) with high quality. Conclusion: Surgical treatment seems to be more effective distal radius fracture compared with conservative treatment when the radiographic outcomes were analyzed, and no significant differences were detected in the functional outcomes and complication rate.Keywords: radius, fracture, surgical, RCTs, conservative, radiographic, outcomes, orthopedic
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