Search results for: clinical psychology training
6485 Impact of Locally Synthesized Carbon Nanotubes against Some Local Clinical Bacterial Isolates
Authors: Abdul Matin, Muazzama Akhtar, Shahid Nisar, Saddaf Mazzar, Umer Rashid
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Antibiotic resistance is an increasing concern worldwide now a day. Neisseria gonorrhea and Staphylococcus aureus are known to cause major human sexually transmitted and respiratory diseases respectively. Nanotechnology is an emerging discipline and its application in various fields especially in medical sciences is gigantic. In the present study, we synthesized multi-walled carbon nanotubes (MWNTs) using acid oxidation method and solubilized MWNTs were with length predominantly >500 nm and diameters ranging from 40 to 50 nm. The locally synthesized MWNTs were used against gram positive and negative bacteria to determine their impact on bacterial growth. Clinical isolates of Neisseria gonorrhea (isolate: 4C-11) and Staphylococcus aureus (isolate: 38541) were obtained from local hospital and normally cultured in LB broth at 37°C. Both clinical strains can be obtained on request from University of Gujarat. Spectophometric assay was performed to determine the impact of MWNTs on bacterial growth in vitro. To determine the effect of MWTNs on test organisms, various concentration of MWNTs were used and recorded observation on various time intervals to understand the growth inhibition pattern. Our results demonstrated that MWNTs exhibited toxic effects to Staphylococcus aureus while showed very limited growth inhibition to Neisseria gonorrhea, which suggests the resistant potential of Neisseria against nanoparticles. Our results clearly demonstrate the gradual decrease in bacterial numbers with passage of time when compared with control. Maximum bacterial inhibition was observed at maximum concentration (50 µg/ml). Our future work will include further characterization and mode of action of our locally synthesized MWNTs. In conclusion, we investigated and reported for the first time the inhibitory potential of locally synthesized MWNTs on local clinical isolates of Staphylococcus aureus and Neisseria gonorrhea.Keywords: antibacterial activity, multi walled carbon nanotubes, Neisseria gonorrhea, spectrophotometer assay, Staphylococcus aureus
Procedia PDF Downloads 3106484 Fixing the Identity Gap in Fashion: Magazines' Role in Consumption of Clothes
Authors: Kateryna Pilyarchuk
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A dress has, since times immemorial, been used to communicate the wearer’s identity. When a new trend is born, fashionistas buy it not only with the purpose to beautify themselves, but also to acquire the collective identity. Fashion has become a means of narrating one’s stance and status. Thus, when one spends money on a brand, one pays for some unmaterial components associated with it. This paper will present some ways in which fashion magazines promote consumerism by drawing on women’s craving for collective identity and need to fill in their identity gap by means of a purchase. By applying the method of critical discursive psychology, it will present layers of ideology and positions that become visible in framing of the message in U.S. Harper’s Bazaar. In this context, fashion decisions that are presented to its readers will be critically evaluated from the gender perspective. It will be demonstrated that what is presented as a postfeminist choice in the neoliberal society is still, to a considerable extent, oppressive and driven by the male gaze. As the findings show, the contemporary female identities in fashion are still built on the principles of traditional femininity. Magazines and fashion discourse train women that they should fear being left out of fashion and, by extension, out of the category of the sexually appealing (from the male perspective).Keywords: collective identity, critical discursive psychology, fashion discourse, identity gap
Procedia PDF Downloads 1406483 An Immersive Serious Game for Firefighting and Evacuation Training in Healthcare Facilities
Authors: Anass Rahouti, Guillaume Salze, Ruggiero Lovreglio, Sélim Datoussaïd
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In healthcare facilities, training the staff for firefighting and evacuation in real buildings is very challenging due to the presence of a vulnerable population in such an environment. In a standard environment, traditional approaches, such as fire drills, are often used to train the occupants and provide them with information about fire safety procedures. However, those traditional approaches may be inappropriate for a vulnerable population and can be inefficient from an educational viewpoint as it is impossible to expose the occupants to scenarios similar to a real emergency. Immersive serious games could be used as an alternative to traditional approaches to overcome their limitations. Serious games are already being used in different safety domains such as fires, earthquakes and terror attacks for several building types (e.g., office buildings, train stations, tunnels, etc.). In this study, we developed an immersive serious game to improve the fire safety skills of staff in healthcare facilities. An accurate representation of the healthcare environment was built in Unity3D by including visual and audio stimuli inspired from those employed in commercial action games. The serious game is organised in three levels. In each of them, the trainee is presented with a specific fire emergency and s/he can perform protective actions (e.g., firefighting, helping non-ambulant occupants, etc.) or s/he can ignore the opportunity for action and continue the evacuation. In this paper, we describe all the steps required to develop such a prototype, as well as the key questions that need to be answered, to develop a serious game for firefighting and evacuation in healthcare facilities.Keywords: fire safety, healthcare, serious game, training
Procedia PDF Downloads 4496482 Training Hearing Parents in SmiLE Therapy Supports the Maintenance and Generalisation of Deaf Children's Social Communication Skills
Authors: Martina Curtin, Rosalind Herman
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Background: Deaf children can experience difficulties with understanding how social interaction works, particularly when communicating with unfamiliar hearing people. Deaf children often struggle with integrating into a mainstream, hearing environments. These negative experiences can lead to social isolation, depression and other mental health difficulties later in life. smiLE Therapy (Schamroth, 2015) is a video-based social communication intervention that aims to teach deaf children skills to confidently communicate with unfamiliar hearing people. Although two previous studies have reported improvements in communication skills immediately post intervention, evidence for maintenance of gains or generalisation of skills (i.e., the transfer of newly learnt skills to untrained situations) has not to date been demonstrated. Parental involvement has been shown to support deaf children’s therapy outcomes. Therefore, this study added parent training to the therapy children received to investigate the benefits to generalisation of children’s skills. Parents were also invited to present their perspective on the training they received. Aims: (1) To assess pupils’ progress from pre- to post-intervention in trained and untrained tasks, (2) to investigate if training parents improved their (a) understanding of their child’s needs and (b) their skills in supporting their child appropriately in smiLE Therapy tasks, (3) to assess if parent training had an impact on the pupil’s ability to (a) maintain their skills in trained tasks post-therapy, and (b) generalise their skills in untrained, community tasks. Methods: This was a mixed-methods, repeated measures study. 31 deaf pupils (aged between 7 and 14) received an hour of smiLE Therapy per week, for 6 weeks. Communication skills were assessed pre-, post- and 3-months post-intervention using the Communication Skills Checklist. Parents were then invited to attend two training sessions and asked to bring a video of their child communicating in a shop or café. These videos were used to assess whether, after parent training, the child was able to generalise their skills to a new situation. Finally, parents attended a focus group to discuss the effectiveness of the therapy, particularly the wider impact, i.e., more child participation within the hearing community. Results: All children significantly improved their scores following smiLE therapy and maintained these skills to high level. Children generalised a high percentage of their newly learnt skills to an untrained situation. Parents reported improved understanding of their child’s needs, their child’s potential and in how to support them in real-life situations. Parents observed that their children were more confident and independent when carrying out communication tasks with unfamiliar hearing people. Parents realised they needed to ‘let go’ and embrace their child’s independence and provide more opportunities for them to participate in their community. Conclusions: This study adds to the evidence base on smiLE Therapy; it is an effective intervention that develops deaf children’s ability to interact competently with unfamiliar, hearing, communication partners. It also provides preliminary evidence of the benefits of parent training in helping children to generalise their skills to other situations. These findings will be of value to therapists wishing to develop deaf children’s communication skills beyond the therapy setting.Keywords: deaf children, generalisation, parent involvement, social communication
Procedia PDF Downloads 1296481 Antihypertensive Effect of Formulated Apium graveolens: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Authors: Maryam Shayani Rad, Seyed Ahmad Mohajeri, Mohsen Mouhebati, Seyed Danial Mousavi
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High blood pressure is one of the most important and serious health-threatening because of no symptoms in most people, which can lead to sudden heart attack, heart failure, and stroke. Nowadays, herbal medicine is one of the best and safest strategies for treatment that have no adverse effects. Apium graveolens (celery) can be used as an alternative treatment for many health conditions such as hypertension. Natural compounds reduce blood pressure via different mechanisms in which Apium graveolens extract provides potent calcium channel blocking properties. A randomized, double-blind, placebo-controlled, cross-over clinical trial was done to evaluate the efficacy of formulated Apium graveolens extract with a maximum yield of 3-n-butylphthalide to reduce systolic and diastolic blood pressure in patients with hypertension. 54 hypertensive patients in the range of 20-68 years old were randomly assigned to the treatment group (26 cases) and the placebo control group (26 cases) and were crossed over after washout duration. The treatment group received at least 2 grams of formulated powder in hard capsules orally, before each meal, 2 times daily. The control group received 2 grams of placebo in hard capsules orally, exactly as the same as shape, time, and doses of treatment group. Treatment was administrated in 12 weeks with 4 weeks washout period at the middle of the study, meaning 4 weeks drug consumption for the treatment group, 4 weeks washout and 4 weeks placebo consumption, and vice versa for the placebo control group. The clinical assessment was done 4 times, including at the beginning and ending of the drug and placebo consumption period by 24-hour ambulatory blood pressure monitoring (ABPM) holter, which measured blood pressure every 15 minutes continuously. There was a statistically significant decrease in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the end of drug duration compared to baseline. The changes after 4 weeks on average was about 12.34 mm Hg for the SBP (P < 0.005) and 7.83 mm Hg for the DBP (P < 0.005). The results from this clinical trial study showed this Apium graveolens extract formulation in the mentioned dosage had a significant effect on blood pressure-lowering for hypertensive patients.Keywords: Apium graveolens extract, clinical trial, cross-over, hypertension
Procedia PDF Downloads 2046480 Impact of Blended Learning in Interior Architecture Programs in Academia: A Case Study of Arcora Garage Academy from Turkey
Authors: Arzu Firlarer, Duygu Gocmen, Gokhan Uysal
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There is currently a growing trend among universities towards blended learning. Blended learning is becoming increasingly important in higher education, with the aims of better accomplishing course learning objectives, meeting students’ changing needs and promoting effective learning both in a theoretical and practical dimension like interior architecture discipline. However, the practical dimension of the discipline cannot be supported in the university environment. During the undergraduate program, the practical training which is tried to be supported by two different internship programs cannot fully meet the requirements of the blended learning. The lack of education program frequently expressed by our graduates and employers is revealed in the practical knowledge and skills dimension of the profession. After a series of meetings for curriculum studies, interviews with the chambers of profession, meetings with interior architects, a gap between the theoretical and practical training modules is seen as a problem in all interior architecture departments. It is thought that this gap can be solved by a new education model which is formed by the cooperation of University-Industry in the concept of blended learning. In this context, it is considered that theoretical and applied knowledge accumulation can be provided by the creation of industry-supported educational environments at the university. In the application process of the Interior Architecture discipline, the use of materials and technical competence will only be possible with the cooperation of industry and participation of students in the production/manufacture processes as observers and practitioners. Wood manufacturing is an important part of interior architecture applications. Wood productions is a sustainable structural process where production details, material knowledge, and process details can be observed in the most effective way. From this point of view, after theoretical training about wooden materials, wood applications and production processes are given to the students, practical training for production/manufacture planning is supported by active participation and observation in the processes. With this blended model, we aimed to develop a training model in which theoretical and practical knowledge related to the production of wood works will be conveyed in a meaningful, lasting way by means of university-industry cooperation. The project is carried out in Ankara with Arcora Architecture and Furniture Company and Başkent University Department of Interior Design where university-industry cooperation is realized. Within the scope of the project, every week the video of that week’s lecture is recorded and prepared to be disseminated by digital medias such as Udemy. In this sense, the program is not only developed by the project participants, but also other institutions and people who are trained and practiced in the field of design. Both academicians from University and at least 15-year experienced craftsmen in the wood metal and dye sectors are preparing new training reference documents for interior architecture undergraduate programs. These reference documents will be a model for other Interior Architecture departments of the universities and will be used for creating an online education module.Keywords: blended learning, interior design, sustainable training, effective learning.
Procedia PDF Downloads 1316479 Combat Capability Improvement Using Sleep Analysis
Authors: Gabriela Kloudova, Miloslav Stehlik, Peter Sos
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The quality of sleep can affect combat performance where the vigilance, accuracy and reaction time are a decisive factor. In the present study, airborne and special units are measured on duty using actigraphy fingerprint scoring algorithm and QEEG (quantitative EEG). Actigraphic variables of interest will be: mean nightly sleep duration, mean napping duration, mean 24-h sleep duration, mean sleep latency, mean sleep maintenance efficiency, mean sleep fragmentation index, mean sleep onset time, mean sleep offset time and mean midpoint time. In an attempt to determine the individual somnotype of each subject, the data like sleep pattern, chronotype (morning and evening lateness), biological need for sleep (daytime and anytime sleepability) and trototype (daytime and anytime wakeability) will be extracted. Subsequently, a series of recommendations will be included in the training plan based on daily routine, timing of the day and night activities, duration of sleep and the number of sleeping blocks in a defined time. The aim of these modifications in the training plan is to reduce day-time sleepiness, improve vigilance, attention, accuracy, speed of the conducted tasks and to optimize energy supplies. Regular improvement of the training supposed to have long-term neurobiological consequences including neuronal activity changes measured by QEEG. Subsequently, that should enhance cognitive functioning in subjects assessed by the digital cognitive test batteries and improve their overall performance.Keywords: sleep quality, combat performance, actigraph, somnotype
Procedia PDF Downloads 1566478 Application of Applied Behavior Analysis Treatment to Children with Down Syndrome
Authors: Olha Yarova
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This study is a collaborative project between the American University of Central Asia and parent association of children with Down syndrome ‘Sunterra’ that took place in Bishkek, Kyrgyzstan. The purpose of the study was to explore whether principles and techniques of applied behavior analysis (ABA) could be used to teach children with Down syndrome socially significant behaviors. ABA is considered to be one of the most effective treatment for children with autism, but little research is done on the particularity of using ABA to children with Down syndrome. The data for the study was received during clinical observations; work with children with Down syndrome and interviews with their mothers. The results show that many ABA principles make the work with children with Down syndrome more effective. Although such children very rarely demonstrate aggressive behavior, they show a lot of escape-driven and attention seeking behaviors that are reinforced by their parents and educators. Thus functional assessment can be done to assess the function of problem behavior and to determine appropriate treatment. Prompting and prompting fading should be used to develop receptive and expressive language skills, and enhance motor development. Even though many children with Down syndrome work for praise, it is still relevant to use tangible reinforcement and to know how to remove them. Based on the results of the study, the training for parents of children with Down syndrome will be developed in Kyrgyzstan, country, where children with Down syndrome are not accepted to regular kindergartens and where doctors in maternity hospitals tell parents that their child will never talk, walk and recognize themKeywords: down syndrome, applied behavior analysis, functional assessment, problem behavior, reinforcement
Procedia PDF Downloads 2666477 Verification and Validation of Simulated Process Models of KALBR-SIM Training Simulator
Authors: T. Jayanthi, K. Velusamy, H. Seetha, S. A. V. Satya Murty
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Verification and Validation of Simulated Process Model is the most important phase of the simulator life cycle. Evaluation of simulated process models based on Verification and Validation techniques checks the closeness of each component model (in a simulated network) with the real system/process with respect to dynamic behaviour under steady state and transient conditions. The process of Verification and validation helps in qualifying the process simulator for the intended purpose whether it is for providing comprehensive training or design verification. In general, model verification is carried out by comparison of simulated component characteristics with the original requirement to ensure that each step in the model development process completely incorporates all the design requirements. Validation testing is performed by comparing the simulated process parameters to the actual plant process parameters either in standalone mode or integrated mode. A Full Scope Replica Operator Training Simulator for PFBR - Prototype Fast Breeder Reactor has been developed at IGCAR, Kalpakkam, INDIA named KALBR-SIM (Kalpakkam Breeder Reactor Simulator) wherein the main participants are engineers/experts belonging to Modeling Team, Process Design and Instrumentation and Control design team. This paper discusses the Verification and Validation process in general, the evaluation procedure adopted for PFBR operator training Simulator, the methodology followed for verifying the models, the reference documents and standards used etc. It details out the importance of internal validation by design experts, subsequent validation by external agency consisting of experts from various fields, model improvement by tuning based on expert’s comments, final qualification of the simulator for the intended purpose and the difficulties faced while co-coordinating various activities.Keywords: Verification and Validation (V&V), Prototype Fast Breeder Reactor (PFBR), Kalpakkam Breeder Reactor Simulator (KALBR-SIM), steady state, transient state
Procedia PDF Downloads 2516476 Efficacy of Cool's and Rhythmic Stabilization Exercises on Scapular up Ward Rotation and Ut/Sa Ratio in Patients with Shoulder Impingement Syndrome
Authors: Mohammed Moustafa, Khaled Ayad, Waleed Reda
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Shoulder impingement syndrome is the most common disorder of the shoulder, resulting in functional loss and disability. Objective: This study was designed to compare between the effects of scapular muscle training versus rhythmic stabilization exercises in treatment of shoulder impingement syndrome. Methods: Thirty patients participated in this study; they were assigned randomly into two experimental groups. The first experimental group (A) consisted of 15 patients with a mean age (21.87±2.72) years; they received graduated rhythmic stabilization exercises and stretching of the posterior capsule. The second experimental group (B) consisted of 15 patients with a mean age (22.27±2.94) years; they received scapular muscle training exercises in addition to stretching of the posterior capsule. Treatment was given three times per week, every other day, for four consecutive weeks. Patients have been evaluated pretreatment and post treatment for shoulder pain severity and functional disability. Results: Both groups showed highly statistical significant reduction in pain severity and functional disability measured post-treatment when compared with their corresponding values in pretreatment assessment. Conclusion: Both of rhythmic stabilization exercises and scapular muscle training are effective interventions to reduce shoulder pain severity and functional disability.Keywords: impingement syndrome, scapular exercises, rhythmic stabilization exercises, posterior capsule stretch
Procedia PDF Downloads 2326475 The Challenge of Teaching French as a Foreign Language in a Multilingual Community
Authors: Carol C. Opara, Olukemi E. Adetuyi-Olu-Francis
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The teaching of French language, like every other language, has its numerous challenges. A multilingual community, however, is a linguistic environment housing diverse languages, each with its peculiarity, both pros, and cones. A foreign language will have to strive hard for survival in an environment where various indigenous languages, as well as an established official language, exist. This study examined the challenges and prospects of the teaching of French as a foreign language in a multilingual community. A 22-item questionnaire was used to elicit information from 40 Nigerian Secondary school teachers of French. One of the findings of this study showed that the teachers of the French language are not motivated. Also, the linguistic environment is not favourable for the teaching and learning of French language in Nigeria. One of the recommendations was that training and re-training of teachers of French should be of utmost importance to the Nigerian Federal Ministry of Education.Keywords: challenges, french as foreign language, multilingual community, teaching
Procedia PDF Downloads 2006474 Comparing Community Health Agents, Physicians and Nurses in Brazil's Family Health Strategy
Authors: Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta
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Background: Existing shortcomings of current health-service delivery include poor teamwork, competencies that do not address consumer needs, and episodic rather than continuous care. Brazil’s Sistema Único de Saúde (Unified Health System, UHS) is acknowledged worldwide as a model for delivering community-based care through Estratégia Saúde da Família (FHS; Family Health Strategy) interdisciplinary teams, comprised of Community Health Agents (in Portuguese, Agentes Comunitário de Saude, ACS), nurses, and physicians. FHS teams are mandated to collectively offer clinical care, disease prevention services, vector control, health surveillance and social services. Our study compares medical providers (nurses and physicians) and community-based providers (ACS) on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on similarities and differences across care providers to develop interprofessional training for community-based primary care. Methods: Cross-sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Brazil. We compared providers’ demographic characteristics (age, race, and gender) and job context variables (caseload, work experience, work proximity to community, the length of commute, and familiarity with the community). Providers perceptions were compared to their work environment (work conditions and work resources), professional skills (consumer-input, interdisciplinary collaboration, efficacy of FHS teams, work-methods and decision-making autonomy), and cognitive capacities (knowledge and skills, skill variety, confidence and perseverance). Descriptive and bi-variate analysis, such as Pearson Chi-square and Analysis of Variance (ANOVA) F-tests, were performed to draw comparisons across providers. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Majority of nurses and ACS identified as mixed races (ACS, n=85; nurses, n=27); most physicians identified as males (n=16; 52%), and white (n=18; 58%). Physicians were less likely to incorporate consumer-input and demonstrated greater decision-making autonomy than nurses and ACS. ACS reported the highest levels of knowledge and skills but the least confidence compared to nurses and physicians. ACS, nurses, and physicians were efficacious that FHS teams improved the quality of health in their catchment areas, though nurses tend to disagree that interdisciplinary collaboration facilitated their work. Conclusion: To our knowledge, there has been no study comparing key demographic and cognitive variables across ACS, nurses and physicians in the context of their work environment and professional training. We suggest that global health systems can leverage upon the diverse perspectives of providers to implement a community-based primary care model grounded in interprofessional training. Our study underscores the need for in-service trainings to instill reflective skills of providers, improve communication skills of medical providers and curative skills of ACS. Greater autonomy needs to be extended to community based providers to offer care integral to addressing consumer and community needs.Keywords: global health systems, interdisciplinary health teams, community health agents, community-based care
Procedia PDF Downloads 2246473 General Architecture for Automation of Machine Learning Practices
Authors: U. Borasi, Amit Kr. Jain, Rakesh, Piyush Jain
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Data collection, data preparation, model training, model evaluation, and deployment are all processes in a typical machine learning workflow. Training data needs to be gathered and organised. This often entails collecting a sizable dataset and cleaning it to remove or correct any inaccurate or missing information. Preparing the data for use in the machine learning model requires pre-processing it after it has been acquired. This often entails actions like scaling or normalising the data, handling outliers, selecting appropriate features, reducing dimensionality, etc. This pre-processed data is then used to train a model on some machine learning algorithm. After the model has been trained, it needs to be assessed by determining metrics like accuracy, precision, and recall, utilising a test dataset. Every time a new model is built, both data pre-processing and model training—two crucial processes in the Machine learning (ML) workflow—must be carried out. Thus, there are various Machine Learning algorithms that can be employed for every single approach to data pre-processing, generating a large set of combinations to choose from. Example: for every method to handle missing values (dropping records, replacing with mean, etc.), for every scaling technique, and for every combination of features selected, a different algorithm can be used. As a result, in order to get the optimum outcomes, these tasks are frequently repeated in different combinations. This paper suggests a simple architecture for organizing this largely produced “combination set of pre-processing steps and algorithms” into an automated workflow which simplifies the task of carrying out all possibilities.Keywords: machine learning, automation, AUTOML, architecture, operator pool, configuration, scheduler
Procedia PDF Downloads 456472 Effect of Formative Evaluation with Feedback on Students Economics Achievement in Secondary Education
Authors: Salihu Abdullahi Galle
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Students' performance in Economics in schools and on standardized exams in Nigeria has been worrying throughout the years, owing to some teachers' use of conventional and lecture teaching methods. Other obstacles include a lack of training, standardized testing pressure, and aversion to change, all of which can have an impact on students' cognitive ability in Economics and future careers. The researchers employed formative evaluation with feedback (FEFB) to support the teaching and learning process by providing constant feedback to both teachers and students. The researchers employed a quasi-experimental research design to examine two teaching methods (FEFB and traditional). The pre-test and post-test interaction effects were evaluated between students in the experimental group (FEFB) and those in the conventional group. The interaction effects of pre-test and post-test on male and female in the two groups were also examined, with 90 participants. The findings show that students exposed to a FEFB-based teaching approach outperform pupils taught in a traditional classroom setting, and there is no gender interaction effect between the two groups. In light of these findings, the researchers urge that Economics teachers employ FEFB during teaching and learning to ensure timely feedback, and that policymakers ensure that Economics teachers receive training and re-training on FEFB approaches.Keywords: formative evaluation with feedback (FEFB), students, economics achievement, secondary education
Procedia PDF Downloads 396471 Interdisciplinarity as a Regular Pedagogical Practice in the Classrooms
Authors: Catarina Maria Neto Da Cruz, Ana Maria Reis D’Azevedo Breda
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The world is changing and, consequently, the young people need more sophisticated tools and skills to lead with the world’s complexity. The Organisation for Economic Co-operation and Development Learning Framework 2030 suggests an interdisciplinary knowledge as a principle for the future of education systems. In the curricular document Portuguese about the profile of students leaving compulsory education, the critical thinking and creative thinking are pointed out as skills to be developed, which imply the interconnection of different knowledge, applying it in different contexts and learning areas. Unlike primary school teachers, teachers specialized in a specific area lead to more difficulties in the implementation of interdisciplinary approaches in the classrooms and, despite the effort, the interdisciplinarity is not a common practice in schools. Statement like "Mathematics is everywhere" is unquestionable, however, many math teachers show difficulties in presenting such evidence in their classes. Mathematical modelling and problems in real contexts are promising in the development of interdisciplinary pedagogical practices and in Portugal there is a continuous training offer to contribute to the development of teachers in terms of their pedagogical approaches. But when teachers find themselves in the classroom, without a support, do they feel able to implement interdisciplinary practices? In this communication we will try to approach this issue through a case study involving a group of Mathematics teachers, who attended a training aimed at stimulating interdisciplinary practices in real contexts, namely related to the COVID-19 pandemic.Keywords: education, mathematics, teacher training, interdisciplinarity
Procedia PDF Downloads 826470 Neonatal Sepsis in Dogs Attend in Veterinary Hospital of the Sao Paulo State University, Botucatu, Brazil – Incidence, Clinical Aspects and Mortality
Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Vivane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado
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Neonatal sepsis is a systemic response to the acute generalized infection caused by one or more bacterial agents, representing the main infectious cause of neonatal mortality in dogs during the first three weeks of life. This study aims to describe the incidence of sepsis in neonate dogs, as well as the main clinical signs and mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. Seven hundred thirty-five neonates, 14% (98/703) presented neonatal sepsis. The main sources of infection for the neonates were intrauterine (72.5%, 71/98), lactogenic (13.2%, 13/98), umbilical (5.1%, 5/98) and unidentified sources (9.2%, 9/98). The main non-specific clinical signs observed in the newborns were weakness, depression, impaired or absent reflexes, hypothermia, hypoglycemia, dehydration, reduced muscle tonus and diarrhea. The newborns also manifested clinical signs of severe infection, such as hyperemia in the abdominal and anal regions, omphalitis, hematuria, abdomen and extremities with purplish-blue coloration necrosing injuries in the pads, bradycardia, dyspnea, epistaxis, hypotension and evolution to septic shock. Infections acquired during intrauterine life led to the onset of the clinical signs at the time of birth, with fast evolution during the first hours of life. On the other hand, infections acquired via milk or umbilical cord presented clinical signs later. The total mortality rate was 5.4% (38/703) and the mortality rate among the neonates with sepsis was 38.7% (38/98). The early mortality rate (0 to 2 days) accounted for 86.9% (33/38) and the late mortality rate (3 to 30 days) for 13.1% (5/38) of the deaths among the newborns with sepsis. The main bacterial agents observed were Staphylococcus spp., Streptococcus spp., Proteus spp. Mannheimia spp. and Escherichia coli. Neonatal sepsis evolves quickly and may lead to high mortality in a litter. The prognosis is usually favorable if the diagnosis is reached early and the antibiotic therapy instituted as soon as possible, even before the results of blood cultures and antibiograms. The therapeutic recommendations should meet the special physiological conditions of a neonate in terms of metabolism and excretion of medication. Therefore, it is of utmost importance that the veterinarian is knowledgeable regarding neonatology to provide effective intervention and improve the survival rates of these patients.Keywords: Neonatal infection , bacteria, puppies, newborn
Procedia PDF Downloads 1076469 A Clinical Study of Correlation between Pterygium and Dry Eye
Authors: Megha Ramnik Kotecha
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To study whether there is any clinical correlation between pterygium and dry eye and to evaluate the status of tear film in patients with pterygium. Methods: 100 eyes with pterygium were compared with 100 control eyes without pterygium. Patients between 20 – 70 years were included in the study. Detailed history was taken and Schirmer’s test and TBUT were performed on all to evaluate the status of dry eye. Schirmer’s test ˂10 mm and TBUT ˂10 seconds was considered abnormal. Results: Maximum number (52) of patients affected with dry eye in both the groups were in the age group 31-40 years which statistically showed age as a significant factor of association for both pterygium and dry eye (P<0.01).Schirmer’s test was slightly reduced in patients with pterygium(18.73±5.69 mm). TBUT was significantly reduced in the case group (12.26±2.24sec).TBUT decreased maximally in 51-60 yrs age group (13.00±2.77sec) with pterygium showing a tear film unstability. On comparision of pterygia and controls with normal and abnormal tear film, Odd’s Ratio was 1.14 showing risk of dry eye in pterygia patients to be 1.14 times higher than controls. Conclusion: Whether tear dysfunction is a precursor to pterygium growth or pterygium causes tear dysfunction is still not clear. Research and clinical evidence, however, suggest that there is a relationship between the two. This study is, therefore, undertaken to investigate the correlation between pterygium and dry eye. The patients with pterygia were compared with normals to evaluate their status regarding dryness. A close relationship exists between ocular irritation symptoms and functional evidence of tear instability. Schirmer’s test and TBUT should routinely be used in the outpatient department to diagnose dry eye in patients with pterygium and these patients should be promptly treated to prevent any sight threatening complications.Keywords: dry eye, pterygium, Schirmer's test, tear break up time (TBUT)
Procedia PDF Downloads 2916468 Empirical Evaluation of Gradient-Based Training Algorithms for Ordinary Differential Equation Networks
Authors: Martin K. Steiger, Lukas Heisler, Hans-Georg Brachtendorf
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Deep neural networks and their variants form the backbone of many AI applications. Based on the so-called residual networks, a continuous formulation of such models as ordinary differential equations (ODEs) has proven advantageous since different techniques may be applied that significantly increase the learning speed and enable controlled trade-offs with the resulting error at the same time. For the evaluation of such models, high-performance numerical differential equation solvers are used, which also provide the gradients required for training. However, whether classical gradient-based methods are even applicable or which one yields the best results has not been discussed yet. This paper aims to redeem this situation by providing empirical results for different applications.Keywords: deep neural networks, gradient-based learning, image processing, ordinary differential equation networks
Procedia PDF Downloads 1536467 Rewritten Oedipus Complex: Huo Datong’s Complex of Generation
Authors: Xinyu Chen
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This article reviews Chinese psychoanalytic theorist, Dr. Huo Datong’s notion, the complex of generation, around which Huo conceptualizes a localized set to recapitulate the unconscious structure of Chinese people. Psychoanalysis underwent constant localization influenced by the socio-cultural milieu and endeavored by scholars receiving training backgrounds from different psychoanalytic schools. Dr. Huo Datong is one of the representatives with a Sino-French background of psychoanalytic training, whose enterprise has demonstrated psychoanalysis's cultural and ideological accommodability. Insufficient academic attention has been paid to this concept as the core of Huo’s re-framework. This notion is put forward by sharing a western psychoanalytic reading of Chinese mythologies to contour Chinese unconsciousness. Regarding Huo’s interpretation of the Chinese kinship network as the basis to propose an omnipotent symbolic mother rather than an Oedipal father, this article intends to review this notion in terms of its mythological root to evaluate the theoretical practicality.Keywords: psychoanalysis, China, Huo Datong, mythology
Procedia PDF Downloads 2416466 Active Learning through a Game Format: Implementation of a Nutrition Board Game in Diabetes Training for Healthcare Professionals
Authors: Li Jiuen Ong, Magdalin Cheong, Sri Rahayu, Lek Alexander, Pei Ting Tan
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Background: Previous programme evaluations from the diabetes training programme conducted in Changi General Hospital revealed that healthcare professionals (HCPs) are keen to receive advance diabetes training and education, specifically in medical, nutritional therapy. HCPs also expressed a preference for interactive activities over didactic teaching methods to enhance their learning. Since the War on Diabetes was initiated by MOH in 2016, HCPs are challenged to be actively involved in continuous education to be better equipped to reduce the growing burden of diabetes. Hence, streamlining training to incorporate an element of fun is of utmost importance. Aim: The nutrition programme incorporates game play using an interactive board game that aims to provide a more conducive and less stressful environment for learning. The board game could be adapted for training of community HCPs, health ambassadors or caregivers to cope with the increasing demand of diabetes care in the hospital and community setting. Methodology: Stages for game’s conception (Jaffe, 2001) were adopted in the development of the interactive board game ‘Sweet Score™ ’ Nutrition concepts and topics in diabetes self-management are embedded into the game elements of varying levels of difficulty (‘Easy,’ ‘Medium,’ ‘Hard’) including activities such as a) Drawing/ sculpting (Pictionary-like) b)Facts/ Knowledge (MCQs/ True or False) Word definition) c) Performing/ Charades To study the effects of game play on knowledge acquisition and perceived experiences, participants were randomised into two groups, i.e., lecture group (control) and game group (intervention), to test the difference. Results: Participants in both groups (control group, n= 14; intervention group, n= 13) attempted a pre and post workshop quiz to assess the effectiveness of knowledge acquisition. The scores were analysed using paired T-test. There was an improvement of quiz scores after attending the game play (mean difference: 4.3, SD: 2.0, P<0.001) and the lecture (mean difference: 3.4, SD: 2.1, P<0.001). However, there was no significance difference in the improvement of quiz scores between gameplay and lecture (mean difference: 0.9, 95%CI: -0.8 to 2.5, P=0.280). This suggests that gameplay may be as effective as a lecture in terms of knowledge transfer. All the13 HCPs who participated in the game rated 4 out of 5 on the likert scale for the favourable learning experience and relevance of learning to their job, whereas only 8 out of 14 HCPs in the lecture reported a high rating in both aspects. 16. Conclusion: There is no known board game currently designed for diabetes training for HCPs.Evaluative data from future training can provide insights and direction to improve the game format and cover other aspects of diabetes management such as self-care, exercise, medications and insulin management. Further testing of the board game to ensure learning objectives are met is important and can assist in the development of awell-designed digital game as an alternative training approach during the COVID-19 pandemic. Learning through gameplay increases opportunities for HCPs to bond, interact and learn through games in a relaxed social setting and potentially brings more joy to the workplace.Keywords: active learning, game, diabetes, nutrition
Procedia PDF Downloads 1686465 Cultural Intelligence for the Managers of Tomorrow: A Data-Based Analysis of the Antecedents and Training Needs of Today’s Business School Students
Authors: Justin Byrne, Jose Ramon Cobo
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The growing importance of cross- or intercultural competencies (used here interchangeably) for the business and management professionals is now a commonplace in both academic and professional literature. This reflects two parallel developments. On the one hand, it is a consequence of the increased attention paid to a whole range of 'soft skills', now seen as fundamental in both individuals' and corporate success. On the other hand, and more specifically, the increasing demand for interculturally competent professionals is a corollary of ongoing processes of globalization, which multiply and intensify encounters between individuals and companies from different cultural backgrounds. Business schools have, for some decades, responded to the needs of the job market and their own students by providing students with training in intercultural skills, as they are encouraged to do so by the major accreditation agencies on both sides of the Atlantic. Adapting Early and Ang's (2003) formulation of Cultural Intelligence (CQ), this paper aims to help fill the lagunae in the current literature on intercultural training in three main ways. First, it offers an in-depth analysis of the CQ of a little studied group: contemporary Millenial and 'Generation Z' Business School students. The level of analysis distinguishes between the four different dimensions of CQ, cognition, metacognition, motivation and behaviour, and thereby provides a detailed picture of the strengths and weaknesses in CQ of the group as a whole, as well as of different sub-groups and profiles of students. Secondly, by crossing these individual-level findings with respondents' socio-cultural and educational data, this paper also proposes and tests hypotheses regarding the relative impact and importance of four possible antecedents of intercultural skills identified in the literature: prior international experience; intercultural training, foreign language proficiency, and experience of cultural diversity in habitual country of residence. Third, we use this analysis to suggest data-based intercultural training priorities for today's management students. These conclusions are based on the statistical analysis of individual responses of some 300 Bachelor or Masters students in a major European Business School provided to two on-line surveys: Ang, Van Dyne, et al's (2007) standard 20-question self-reporting CQ Scale, and an original questionnaire designed by the authors to collate information on respondent's socio-demographic and educational profile relevant to our four hypotheses and explanatory variables. The data from both instruments was crossed in both descriptive statistical analysis and regression analysis. This research shows that there is no statistically significant and positive relationship between the four antecedents analyzed and overall CQ level. The exception in this respect is the statistically significant correlation between international experience, and the cognitive dimension of CQ. In contrast, the results show that the combination of international experience and foreign language skills acting together, does have a strong overall impact on CQ levels. These results suggest that selecting and/or training students with strong foreign language skills and providing them with international experience (through multinational programmes, academic exchanges or international internships) constitutes one effective way of training culturally intelligent managers of tomorrow.Keywords: business school, cultural intelligence, millennial, training
Procedia PDF Downloads 1536464 International E-Learning for Assuring Ergonomic Working Conditions of Orthopaedic Surgeons: First Research Outcomes from Train4OrthoMIS
Authors: J. Bartnicka, J. A. Piedrabuena, R. Portilla, L. Moyano - Cuevas, J. B. Pagador, P. Augat, J. Tokarczyk, F. M. Sánchez Margallo
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Orthopaedic surgeries are characterized by a high degree of complexity. This is reflected by four main groups of resources: 1) surgical team which is consisted of people with different competencies, educational backgrounds and positions; 2) information and knowledge about medical and technical aspects of surgery; 3) medical equipment including surgical tools and materials; 4) space infrastructure which is important from an operating room layout point of view. These all components must be integrated and build a homogeneous organism for achieving an efficient and ergonomically correct surgical workflow. Taking this as a background, there was formulated a concept of international project, called “Online Vocational Training course on ergonomics for orthopaedic Minimally Invasive” (Train4OrthoMIS), which aim is to develop an e-learning tool available in 4 languages (English, Spanish, Polish and German). In the article, there is presented the first project research outcomes focused on three aspects: 1) ergonomic needs of surgeons who work in hospitals around different European countries, 2) the concept of structure of e-learning course, 3) the definition of tools and methods for knowledge assessment adjusted to users’ expectation. The methodology was based on the expert panels and two types of surveys: 1) on training needs, 2) on evaluation and self-assessment preferences. The major findings of the study allowed describing the subjects of four training modules and learning sessions. According to peoples’ opinion there were defined most expected test methods which are single choice test and right after quizzes: “True or False” and “Link elements”. The first project outcomes confirmed the necessity of creating a universal training tool for orthopaedic surgeons regardless of the country in which they work. Because of limited time that surgeons have, the e-learning course should be strictly adjusted to their expectation in order to be useful.Keywords: international e-learning, ergonomics, orthopaedic surgery, Train4OrthoMIS
Procedia PDF Downloads 1756463 The Factors for Developing Trainers in Auto Parts Manufacturing Factories at Amata Nakon Industrial Estate in Cholburi Province
Authors: Weerakarj Dokchan
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The purposes of this research are to find out the factors for developing trainers in the auto part manufacturing factories (AMF) in Amata Nakon Industrial Estate Cholburi. Population in this study included 148 operators to complete the questionnaires and 10 trainers to provide the information on the interview. The research statistics consisted of percentage, mean, standard deviation and step-wise multiple linear regression analysis.The analysis of the training model revealed that: The research result showed that the development factors of trainers in AMF consisted of 3 main factors and 8 sub-factors: 1) knowledge competency consisting of 4 sub-factors; arrangement of critical thinking, organizational loyalty, working experience of the trainers, analysis of behavior, and work and organization loyalty which could predict the success of the trainers at 55.60%. 2) Skill competency consisted of 4 sub-factors, arrangement of critical thinking, organizational loyalty and analysis of behavior and work and the development of emotional quotient. These 4 sub-factors could predict the success of the trainers in skill aspect 55.90%. 3) The attitude competency consisted of 4 sub-factors, arrangement of critical thinking, intention of trainee computer competency and teaching psychology. In conclusion, these 4 sub-factors could predict the success of the trainers in attitude aspect 58.50%.Keywords: the development factors, trainers development, trainer competencies, auto part manufacturing factory (AMF), AmataNakon Industrial Estate Cholburi
Procedia PDF Downloads 2956462 The Effect of Technology on Hospitality, Tourism Marketing and Management
Authors: Reda Moussa Massoud Embark
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Tourism and hospitality graduate development is key to the future state of the tourism and hospitality industry. Meanwhile, Information and Communication Technology is increasingly becoming the engine for improving productivity and business opportunities in the travel and hospitality industry. Given the challenges and fierce global competition that have arisen in today's hospitality industry, it was important to shed light on strategic management. In addition, five-star hotels play a key role in supporting the tourism industry and investments in Egypt. Therefore, this study aims to examine the extent to which strategic management practices are implemented in five-star hotels in Egypt and to examine the differences between resort and inner-city hotels in terms of the implementation of strategic management processes. The influence of different hotel types on the implementation of the strategic management process is examined. A simple random sampling technique is used to select a sample of the target population, including hotels in the cities of Sharm el-Sheikh, Cairo and Hurghada. The data collection tool used in this study is an interviewer-administered questionnaire. Finally, combining the study results with the literature review allowed to present a set of recommendations to be addressed to hoteliers in the area of strategic management practices. Education and training in tourism and hospitality must take these changes into account in order to improve the ability of future managers to use a variety of tools and strategies to make their organizations more efficient and competitive. Therefore, this study aims to examine the types and effectiveness of training courses offered by tourism and hospitality departments in Egypt and to assess the importance of these training courses from the perspective of the graduate. The survey is aimed at graduates who have completed three different majors in the past decade: tourism and hospitality. Findings discussed the nature, level and effectiveness of the training provided at these faculties and the extent to which the training programs were valued by graduates working in different fields, and finally recommended specific practices to improve learning effectiveness increase and increase perceived employee benefits in the tourism and hospitality industry.Keywords: marketing channels, crisis, hotel, international, tour, operators, online travel agencies, e-tourism, hotel websites, tourism, web-tourism, strategic-management, strategic tools, five-star hotels, resorts, downtown hotels, Egyptian Markets.
Procedia PDF Downloads 606461 Identification and Antibiotic Resistance Rates of Proteus Mirabilis Strains from Various Clinical Specimens in a University Hospital, 2013-2015
Authors: Recep Keşli, Gülşah Aşık, Cengiz Demir, Onur Türkyılmaz
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Objective: Proteus mirabilis (P. mirabilis) is one of Gram-negative pathogens in human and it causes urinary tract and nosocomial infections. P. mirabilis is susceptible to β-lactams, aminoglycosides, fluoroquinolones, and trimethoprim/sulfamethoxazole. It was aimed to investigate the resistance status to antimicrobial agents of Proteus mirabilis strains produced from samples sent to Afyon Kocatepe University, ANS Research and Practice Hospital, Microbiology Laboratory from different clinics and polyclinics during the period of 24 months. Methods: Between October 2013 and September 2015, a total of 30 Proteus were isolated from clinical samples of patients were hospitalized in intensive care units and in various departments of Afyon Kocatepe University, ANS Research and Practice Hospital. Identification of the bacteria was determined by conventional methods and VITEK 2 system (bioMérieux, France) was used additionally. Antibacterial susceptibility tests were performed by Kirby Bauer disc (Oxoid, Hempshire, England) diffusion method following the recommendations of CLSI. Results: Of the total 30 Proteus strains isolated from clinical samples, 19 from urine, 7 from wound, 4 from tracheal aspiration materials were isolated. Antimicrobial resistant for these strains were determined to 24,3% for meropenem, 26.2% for imipenem, 20.2% for amikacin 10.5% for cefepim, 33.3% for ciprofloxacin and levofloxacine, 31.6% for ceftazidime, 20% for ceftriaxone, 15.2% for gentamicin and 26.6% for amoxicillin-clavulanate, 26.2% trimethoprim-sulfamethoxale. Conclusion: In the present study, the highest number of clinical isolates of P. mirabilis were isolated from urine (63,3%), followed by the others (36,6%). The distribution of samples P. mirabilis strains to the clinics were as fallows; 16,8% intensive care unit (ICU), 29,9% polyclinics, 53,3% hospital service units The most effective antibiotic on the total of strains were found to be cefepim, the least effective antibiotics on the total of strains were found to be trimethoprim-sulfamethoxale.Keywords: proteus mirabilis, antibiotic resistance, intensive care unit, Proteus spp.
Procedia PDF Downloads 2706460 Absolute Lymphocyte Count as Predictor of Pneumocystis Pneumonia in Patients With Unknown HIV Status at a Private Tertiary Hospital
Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura
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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP
Procedia PDF Downloads 3466459 Artificial Neural Networks Application on Nusselt Number and Pressure Drop Prediction in Triangular Corrugated Plate Heat Exchanger
Authors: Hany Elsaid Fawaz Abdallah
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This study presents a new artificial neural network(ANN) model to predict the Nusselt Number and pressure drop for the turbulent flow in a triangular corrugated plate heat exchanger for forced air and turbulent water flow. An experimental investigation was performed to create a new dataset for the Nusselt Number and pressure drop values in the following range of dimensionless parameters: The plate corrugation angles (from 0° to 60°), the Reynolds number (from 10000 to 40000), pitch to height ratio (from 1 to 4), and Prandtl number (from 0.7 to 200). Based on the ANN performance graph, the three-layer structure with {12-8-6} hidden neurons has been chosen. The training procedure includes back-propagation with the biases and weight adjustment, the evaluation of the loss function for the training and validation dataset and feed-forward propagation of the input parameters. The linear function was used at the output layer as the activation function, while for the hidden layers, the rectified linear unit activation function was utilized. In order to accelerate the ANN training, the loss function minimization may be achieved by the adaptive moment estimation algorithm (ADAM). The ‘‘MinMax’’ normalization approach was utilized to avoid the increase in the training time due to drastic differences in the loss function gradients with respect to the values of weights. Since the test dataset is not being used for the ANN training, a cross-validation technique is applied to the ANN network using the new data. Such procedure was repeated until loss function convergence was achieved or for 4000 epochs with a batch size of 200 points. The program code was written in Python 3.0 using open-source ANN libraries such as Scikit learn, TensorFlow and Keras libraries. The mean average percent error values of 9.4% for the Nusselt number and 8.2% for pressure drop for the ANN model have been achieved. Therefore, higher accuracy compared to the generalized correlations was achieved. The performance validation of the obtained model was based on a comparison of predicted data with the experimental results yielding excellent accuracy.Keywords: artificial neural networks, corrugated channel, heat transfer enhancement, Nusselt number, pressure drop, generalized correlations
Procedia PDF Downloads 776458 A Randomised Simulation Study to Assess the Impact of a Focussed Crew Resource Management Course on UK Medical Students
Authors: S. MacDougall-Davis, S. Wysling, R. Willmore
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Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.Keywords: crew resource management, non-technical skills, training, simulation
Procedia PDF Downloads 1296457 Klippel Feil Syndrome: A Case Report and Review of Literature
Authors: Rim Frikha, Nouha Bouayed Abdelmoula, Afifa Sellami, Salima Daoud, Tarek Rebai
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Klippel-Feil Syndrome (KFS) is characterized by congenital vertebral fusion of the cervical spine resulting from faulty segmentation along the embryo's developing axis. A wide spectrum of associated anomalies may be present. This heterogeneity has complicated elucidation of the genetic etiology and management of the syndrome. We report a case of an isolated Klippel-Feil Syndrome with C5-C6 fusion on the cervical spine. It‘s the rarest form of congenital fused cervical vertebrae which is predisposed to the risk of spinal cord injury and neurologic problems. The aim of this paper was to review clinical heterogeneity; radiographic abnormalities and genetic etiology in Klippel-Feil Syndrome. We insist in comprehensive evaluation and delineation of diagnostic and prognostic classes.Keywords: Klippel–Feil anomaly, genetic, clinical heterogeneity, radiographic abnormalities
Procedia PDF Downloads 4776456 Uncovering Anti-Hypertensive Obesity Targets and Mechanisms of Metformin, an Anti-Diabetic Medication
Authors: Lu Yang, Keng Po Lai
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Metformin, a well-known clinical drug against diabetes, is found with potential anti-diabetic and anti-obese benefits, as reported in increasing evidences. However, the current clinical and experimental investigations are not to reveal the detailed mechanisms of metformin-anti-obesity/hypertension. We have used the bioinformatics strategy, including network pharmacology and molecular docking methodology, to uncover the key targets and pathways of bioactive compounds against clinical disorders, such as cancers, coronavirus disease. Thus, in this report, the in-silico approach was utilized to identify the hug targets, pharmacological function, and mechanism of metformin against obesity and hypertension. The networking analysis identified 154 differentially expressed genes of obesity and hypertension, 21 interaction genes, and 6 hug genes of metformin treating hypertensive obesity. As a result, the molecular docking findings indicated the potent binding capability of metformin with the key proteins, including interleukin 6 (IL-6) and chemokine (C-C motif) Ligand 2 (CCL2), in hypertensive obesity. The metformin-exerted anti-hypertensive obesity action involved in metabolic regulation, inflammatory reaction. And the anti-hypertensive obesity mechanisms of metformin were revealed, including regulation of inflammatory and immunological signaling pathways for metabolic homeostasis in tissue and microenvironmental melioration in blood pressure. In conclusion, our identified findings with bioinformatics analysis have demonstrated the detailed hug and pharmacological targets, biological functions, and signaling pathways of metformin treating hypertensive obesity.Keywords: metformin, obesity, hypertension, bioinformatics findings
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