Search results for: pediatric department
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1976

Search results for: pediatric department

596 Childhood Warscape, Experiences from Children of War Offer Key Design Decisions for Safer Built Environments

Authors: Soleen Karim, Meira Yasin, Rezhin Qader

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Children’s books present a colorful life for kids around the world, their current environment or what they could potentially have- a home, two loving parents, a playground, and a safe school within a short walk or bus ride. These images are only pages in a donated book for children displaced by war. The environment they live in is significantly different. Displaced children are faced with a temporary life style filled with fear and uncertainty. Children of war associate various structural institutions with a trauma and cannot enter the space, even if it is for their own future development, such as a school. This paper is a collaborative effort with students of the Kennesaw State University architecture department, architectural designers and a mental health professional to address and link the design challenges and the psychological trauma for children of war. The research process consists of a) interviews with former refugees, b) interviews with current refugee children, c) personal understanding of space through one’s own childhood, d) literature review of tested design methods to address various traumas. Conclusion: In addressing the built environment for children of war, it is necessary to address mental health and well being through the creation of space that is sensitive to the needs of children. This is achieved by understanding critical design cues to evoke normalcy and safe space through program organization, color, and symbiosis of synthetic and natural environments. By involving the children suffering from trauma in the design process, aspects of the design are directly enhanced to serve the occupant. Neglecting to involve the participants creates a nonlinear design outcome and does not serve the needs of the occupant to afford them equal opportunity learning and growth experience as other children around the world.

Keywords: activist architecture, childhood education, childhood psychology, adverse childhood experiences

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595 Shifting to Electronic Operative Notes in Plastic surgery

Authors: Samar Mousa, Galini Mavromatidou, Rebecca Shirley

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Surgeons carry out numerous operations in the busy burns and plastic surgery department daily. Writing an accurate operation note with all the essential information is crucial for communication not only within the plastics team but also to the multi-disciplinary team looking after the patient, including other specialties, nurses and GPs. The Royal college of surgeons of England, in its guidelines of good surgical practice, mentioned that the surgeon should ensure that there are clear (preferably typed) operative notes for every procedure. The notes should accompany the patient into recovery and to the ward and should give sufficient detail to enable continuity of care by another doctor. The notes should include the Date and time, Elective/emergency procedure, Names of the operating surgeon and assistant, Name of the theatre anesthetist, Operative procedure carried out, Incision, Operative diagnosis, Operative findings, Any problems/complications, Any extra procedure performed and the reason why it was performed, Details of tissue removed, added or altered, Identification of any prosthesis used, including the serial numbers of prostheses and other implanted materials, Details of closure technique, Anticipated blood loss, Antibiotic prophylaxis (where applicable), DVT prophylaxis (where applicable), Detailed postoperative care instructions and Signature. Fourteen random days were chosen in December 2021 to assess the accuracy of operative notes and post-operative care. A total of 163 operative notes were examined. The average completion rates in all domains were 85.4%. An electronic operative note template was designed to cover all domains mentioned in the Royal College of surgeons' good surgical practice. It is kept in the hospital drive for all surgeons to use.

Keywords: operative notes, plastic surgery, documentation, electronic

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594 Influence of Distribution of Body Fat on Cholesterol Non-HDL and Its Effect on Kidney Filtration

Authors: Magdalena B. Kaziuk, Waldemar Kosiba

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Background: In the XXI century we have to deal with the epidemic of obesity which is important risk factor for the cardiovascular and kidney diseases. Lipo proteins are directly involved in the atherosclerotic process. Non-high-density lipo protein (non-HDL) began following widespread recognition of its superiority over LDL as a measurement of vascular event risk. Non-HDL includes residual risk which persists in patients after achieved recommended level of LDL. Materials and Methods: The study covered 111 patients (52 females, 59 males, age 51,91±14 years), hospitalized on the intern department. Body composition was assessed using the bioimpendance method and anthropometric measurements. Physical activity data were collected during the interview. The nutritional status and the obesity type were determined with the Waist to Height Ratio and the Waist to Hip Ratio. A function of the kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using MDRD formula. Non-HDL was calculated as a difference between concentration of the Total and HDL cholesterol. Results: 10% of patients were found to be underweight; 23.9 % had correct body weight; 15,08 % had overweight, while the remaining group had obesity: 51,02 %. People with the android shape have higher non-HDL cholesterol versus with the gynoid shape (p=0.003). The higher was non-HDL, the lower eGFR had studied subjects (p < 0.001). Significant correlation was found between high non-HDL and incorrect dietary habits in patients avoiding eating vegetables, fruits and having low physical activity (p < 0.005). Conclusions: Android type of figure raises the residual risk of the heart disease associated with higher levels of non-HDL. Increasing physical activity in these patients reduces the level of non-HDL. Non-HDL seems to be the best predictor among all cholesterol measures for the cardiovascular events and worsening eGFR.

Keywords: obesity, non-HDL cholesterol, glomerular filtration rate, lifestyle

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593 The Predictors of Head and Neck Cancer-Head and Neck Cancer-Related Lymphedema in Patients with Resected Advanced Head and Neck Cancer

Authors: Shu-Ching Chen, Li-Yun Lee

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The purpose of the study was to identify the factors associated with head and neck cancer-related lymphoedema (HNCRL)-related symptoms, body image, and HNCRL-related functional outcomes among patients with resected advanced head and neck cancer. A cross-sectional correlational design was conducted to examine the predictors of HNCRL-related functional outcomes in patients with resected advanced head and neck cancer. Eligible patients were recruited from a single medical center in northern Taiwan. Consecutive patients were approached and recruited from the Radiation Head and Neck Outpatient Department of this medical center. Eligible subjects were assessed for the Symptom Distress Scale–Modified for Head and Neck Cancer (SDS-mhnc), Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Head and Neck Cancer (BCSQ-H&N), Body Image Scale–Modified (BIS-m), The MD Anderson Head and Neck Lymphedema Rating Scale (MDAHNLRS), The Foldi’s Stages of Lymphedema (Foldi’s Scale), Patterson’s Scale, UCLA Shoulder Rating Scale (UCLA SRS), and Karnofsky’s Performance Status Index (KPS). The results showed that the worst problems with body HNCRL functional outcomes. Patients’ HNCRL symptom distress and performance status are robust predictors across over for overall HNCRL functional outcomes, problems with body HNCRL functional outcomes, and activity and social functioning HNCRL functional outcomes. Based on the results of this period research program, we will develop a Cancer Rehabilitation and Lymphedema Care Program (CRLCP) to use in the care of patients with resected advanced head and neck cancer.

Keywords: head and neck cancer, resected, lymphedema, symptom, body image, functional outcome

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592 A Study of the Disorders of Sexual Functioning in Women with Type 2 Diabetes Mellitus in a Tertiary Care Hospital in India

Authors: Mehak Nagpal, T. S. Sathyanarayan Rao

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Background: Sexual functioning is a neglected aspect of health in women with diabetes, though it contributes greatly towards quality of life and feeling of wellbeing. Also women with DM are at higher risk than men of developing sexual dysfunction and depression. Materials and Methods: Cross-sectional comparison study. Sample size: 100 previously diagnosed type 2DM patients attending Outpatient Diabetic Clinic at Medicine department JSS Hospital Mysore; aged 20-65 years and 60 normal healthy female subjects for Control group. Data was collected with ethical approval over a period of 2 years. Tools Used: 1) Hamilton Depression Rating Scale (HAMD – 17 item) 2) Female Sexual Functioning Index (FSFI) 3) Arizona Sexual Experience Scale (ASEX-F) for female-for screening. 4) The Appraisal of Diabetes Scale (ADS). Results: Statistically significant differences were observed in prevalence rate and severity of depression between diabetic group (45% vs 11% syndromal depression) and controls. Depression scores correlated significantly with glycaemic control, adherence to treatment, BMI and the cognitive appraisal of diabetes. There was significantly greater impairment in the sexual functioning of women with type 2 diabetes mellitus as compared to controls; both prevalence (62% vs 38.3%) and severity (p value < 0.01). Arousal (74.2% vs 53.3%), Desire (76.3% vs 50%) and Satisfaction (76.7% vs 63.7%) were most affected and 64.5% were affected in 2 or more domains. A negative illness appraisal on ADS correlated significantly with poor glycaemic control, higher rates of depression and also more severe female sexual dysfunction (p value < 0.05). Conclusion: Diabetes specific factors that correlated significantly with FSD in this study included the psychological appraisal of diabetes, duration of diabetes, presence of complications and BMI.

Keywords: depression, female sexual dysfunction, India, type 2 diabetes mellitus

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591 Assessment of Heavy Metals in Irrigation Water Collected from Various Vegetables Growing Areas of Swat Valley

Authors: Islam Zeb

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The water of poor quality used for irrigation purposes has the potential to be the direct source of contamination and a vehicle for spreading contamination in the field. A number of wide-ranging review articles have been published that highlight irrigation water as a source of heavy metals toxicity which leads to chronic diseases in the human body. Here a study was planned to determine the microbial and heavy metals status of irrigation water collected from various locations of district Swat in various months. The analyses were carried out at the Environmental Horticulture Laboratory, Department of Horticulture, The University of Agriculture Peshawar, during the year 2018 – 19. The experiment was laid out in Randomized Complete Block Design (RCBD) with two factors and three replicates. Factor A consist of different locations and factor B represent various months. The result of heavy metals concentration in different regions, maximum Lead, Cadmium, Chromium, Nickel and Copper (4.27, 0.56, 0.81, 1.33 and 1.51 mg L-1 respectively) were noted for the irrigation water samples collected from Mingora while minimum Lead, Cadmium, Chromium, Nickel and Copper concentration (2.59, 0.30, 0.27, 0.40 and 0.54 mg L-1 respectively) were noted for the samples of matta. Whereas results of heavy metals content in irrigation water samples for various months maximum content of Lead, Cadmium, Chromium, Nickel and Copper (4.56, 0.63, 1.15, 1.31 and 1.48 mg L-1 respectively) were noted for the samples collected in Jan/Feb while lowest values for Lead, Cadmium, Chromium, Nickel and Copper (2.38, 0.24, 0.21, 0.41 and 0.52 mg L-1 respectively) were noted in the samples of July/August. A significant interaction was found for all the studied parameters. It was concluded that the concentration of heavy metal was maximum in irrigation water samples collected from the Mingora location during the month of Jan/Feb because Mingora is the most polluted area as compared to other studied regions, whereas the water content in winter goes to freeze and mostly contaminated water is used for irrigation purposes.

Keywords: irrigation water, various months, different regions, heavy metals contamination, Swat

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590 Using Problem-Based Learning on Teaching Early Intervention for College Students

Authors: Chen-Ya Juan

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In recent years, the increasing number of children with special needs has brought a lot of attention by many scholars and experts in education, which enforced the preschool teachers face the harsh challenge in the classroom. To protect the right of equal education for all children, enhance the quality of children learning, and take care of the needs of children with special needs, the special education paraprofessional becomes one of the future employment trends for students of the department of the early childhood care and education. Problem-based learning is a problem-oriented instruction, which is different from traditional instruction. The instructor first designed an ambiguous problem direction, following the basic knowledge of early intervention, students had to find clues to solve the problem defined by themselves. In the class, the total instruction included 20 hours, two hours per week. The primary purpose of this paper is to investigate the relationship of student academic scores, self-awareness, learning motivation, learning attitudes, and early intervention knowledge. A total of 105 college students participated in this study and 97 questionnaires were effective. The effective response rate was 90%. The student participants included 95 females and two males. The average age of the participants was 19 years old. The questionnaires included 125 questions divided into four major dimensions: (1) Self-awareness, (2) learning motivation, (3) learning attitudes, and (4) early intervention knowledge. The results indicated (1) the scores of self-awareness were 58%; the scores of the learning motivations was 64.9%; the scores of the learning attitudes was 55.3%. (2) After the instruction, the early intervention knowledge has been increased to 64.2% from 38.4%. (3) Student’s academic performance has positive relationship with self-awareness (p < 0.05; R = 0.506), learning motivation (p < 0.05; R = 0.487), learning attitudes (p < 0.05; R = 0.527). The results implied that although students had gained early intervention knowledge by using PBL instruction, students had medium scores on self-awareness and learning attitudes, medium high in learning motivations.

Keywords: college students, children with special needs, problem-based learning, learning motivation

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589 Confidence Levels among UK Emergency Medicine Doctors in Performing Emergency Lateral Canthotomy: Should it be a Key Skill in the ED

Authors: Mohanad Moustafa, Julia Sieberer, Rhys Davies

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Background: Orbital compartment syndrome (OCS) is a sight-threatening Ophthalmologic emergency caused by rapidly increasing intraorbital pressure. It is usually caused by a retrobulbar hemorrhage as a result of trauma. If not treated in a timely manner, permanent vision loss can occur. Lateral canthotomy and cantholysis are minor procedures that can be performed bedside with equipment available in the emergency department. The aim of the procedure is to release the attachments between the suspensory ligaments of the eye and the bony orbital wall, leading to a decrease in intraorbital pressure and preventing irreversible loss of vision. As most Ophthalmologists across the UK provide non-resident on-call service, this may lead to a delay in the treatment of OCS and stresses the need for Emergency medical staff to be able to provide this sight-saving procedure independently. Aim: To survey current training, experience, and confidence levels among Emergency Medicine doctors in performing emergency lateral canthotomy and to establish whether these variables change the following teaching from experienced ophthalmologists. RESULTS: Most EM registrars had little to no experience in performing lateral canthotomy and cantholysis. The majority of them showed a significant increase in their confidence to perform the procedure following ophthalmic-led teaching. The survey also showed that the registrars felt such training should be added to/part of the EM curriculum. Conclusion: The involvement of Ophthalmologists in the teaching of EM doctors to recognise and treat OCS independently may prevent delays in treatment and reduce the risk of permanent sight loss. This project showed potential in improving patient care and will lead to a National Survey of EM doctors across the UK.

Keywords: lateral canthotomy, retrobulbar hemorrhage, Ophthalmology, orbital compartment syndrome, sight loss, blindness

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588 Patient Perspectives on the Role of Orthopedic Nurse Practitioners: A Cross-Sectional Study

Authors: Merav Ben Natan, May Revach, Or Sade, Yaniv Yonay, Yaron Berkovich

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Background: The inclusion of nurse practitioners (NPs) specializing in orthopedics holds promise for enhancing the quality of care for orthopedic patients. Understanding patients’ perspectives on this role is crucial for evaluating the feasibility and acceptance of integrating NPs into orthopedic settings. This study aims to explore the receptiveness of orthopedic patients to treatment by orthopedic NPs and examines potential associations between patients’ willingness to engage with NPs, their familiarity with the NP role, perceptions of nursing, and satisfaction with orthopedic nursing care. Methods: This cross-sectional study involved patients admitted to an orthopedic department at a central Israeli hospital between January and February 2023. Data was collected using a validated questionnaire consisting of five sections, reviewed by content experts. Statistical analyses were conducted using SPSS and included descriptive statistics, independent samples t-tests, Pearson correlations, and linear regression. Results: Participants in the study showed a moderate willingness to receive treatment from orthopedic NPs, with more than two-thirds expressing strong openness. Patients were generally receptive to NPs performing various clinical tasks, though there was less enthusiasm for NPs’ involvement in medication management and preoperative evaluations. Positive attitudes towards nurses and familiarity with the NP role were significant predictors of patient receptiveness to NP treatment. Conclusion: Patient acceptance of orthopedic NPs varies across different aspects of care. While there is a general willingness to receive care from NPs, these nuanced preferences must be considered when implementing NPs in orthopedic settings. Awareness and positive perceptions of the NP role play crucial roles in shaping patients’ willingness to engage with NPs.

Keywords: orthopedic nurse practitioners, patient receptiveness, perceptions of nursing, clinical tasks

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587 Organization of the Purchasing Function for Innovation

Authors: Jasna Prester, Ivana Rašić Bakarić, Božidar Matijević

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Various prominent scholars and substantial practitioner-oriented literature on innovation orientation have shown positive effects on firm performance. There is a myriad of factors that influence and enhance innovation but it has been found in the literature that new product innovations accounted for an average of 14 percent of sales revenues for all firms. If there is one thing that has changed in innovation management during the last decade, it is the growing reliance on external partners. As a consequence, a new task for purchasing arises, as firms need to understand which suppliers actually do have high potential contributing to the innovativeness of the firm and which do not. Purchasing function in an organization is extremely important as it deals on an average of 50% or more of a firm's expenditures. In the nineties the purchasing department was largely seen as a transaction-oriented, clerical function but today purchasing integration provides a formal interface mechanism between purchasing and other firm functions that services other functions within the company. Purchasing function has to be organized differently to enable firm innovation potential. However, innovations are inherently risky. There are behavioral risk (that some partner will take advantage of the other party), technological risk in terms of complexity of products and processes of manufacturing and incoming materials and finally market risks, which in fact judge the value of the innovation. These risks are investigated in this work since it has been found in the literature that the higher the technological risk, higher will be the centralization of the purchasing function as an interface with other supply chain members. Most researches on organization of purchasing function were done by case study analysis of innovative firms. This work actually tends to prove or discard results found in the literature based on case study method. A large data set of 1493 companies, from 25 countries collected in the GMRG 4 survey served as a basis for analysis.

Keywords: purchasing function organization, innovation, technological risk, GMRG 4 survey

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586 Improving Digital Data Security Awareness among Teacher Candidates with Digital Storytelling Technique

Authors: Veysel Çelik, Aynur Aker, Ebru Güç

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Developments in information and communication technologies have increased both the speed of producing information and the speed of accessing new information. Accordingly, the daily lives of individuals have started to change. New concepts such as e-mail, e-government, e-school, e-signature have emerged. For this reason, prospective teachers who will be future teachers or school administrators are expected to have a high awareness of digital data security. The aim of this study is to reveal the effect of the digital storytelling technique on the data security awareness of pre-service teachers of computer and instructional technology education departments. For this purpose, participants were selected based on the principle of volunteering among third-grade students studying at the Computer and Instructional Technologies Department of the Faculty of Education at Siirt University. In the research, the pretest/posttest half experimental research model, one of the experimental research models, was used. In this framework, a 6-week lesson plan on digital data security awareness was prepared in accordance with the digital narration technique. Students in the experimental group formed groups of 3-6 people among themselves. The groups were asked to prepare short videos or animations for digital data security awareness. The completed videos were watched and evaluated together with prospective teachers during the evaluation process, which lasted approximately 2 hours. In the research, both quantitative and qualitative data collection tools were used by using the digital data security awareness scale and the semi-structured interview form consisting of open-ended questions developed by the researchers. According to the data obtained, it was seen that the digital storytelling technique was effective in creating data security awareness and creating permanent behavior changes for computer and instructional technology students.

Keywords: digital storytelling, self-regulation, digital data security, teacher candidates, self-efficacy

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585 A Reflection on the Professional Development Journey of Science Educators

Authors: M. Shaheed Hartley

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Science and mathematics are regarded as gateway subjects in South Africa as they are the perceived route to careers in science, engineering, technology and mathematics (STEM). One of the biggest challenges that the country faces is the poor achievement of learners in these two learning areas in the external high school exit examination. To compound the problem many national and international benchmark tests paint a bleak picture of the state of science and mathematics in the country. In an attempt to address this challenge, the education department of the Eastern Cape Province invited the Science Learning Centre of the University of the Western Cape to provide training to their science teachers in the form of a structured course conducted on a part-time basis in 2010 and 2011. The course was directed at improving teachers’ content knowledge, pedagogical strategies and practical and experimental skills. A total of 41 of the original 50 science teachers completed the course and received their certificates in 2012. As part of their continuous professional development, 31 science teachers enrolled for BEd Hons in science education in 2013 and 28 of them completed the course in 2014. These students graduated in 2015. Of the 28 BEd Hons students who completed the course 23 registered in 2015 for Masters in Science Education and were joined by an additional 3 students. This paper provides a reflection by science educators on the training, supervision and mentorship provided to them as students of science education. The growth and development of students through their own reflection and understanding as well as through the eyes of the lecturers and supervisors that took part in the training provide the evaluation of the professional development process over the past few years. This study attempts to identify the merits, challenges and limitations of this project and the lessons to be learnt on such projects. It also documents some of the useful performance indicators with a view to developing a framework for good practice for such programmes.

Keywords: reflection, science education, professional development, rural schools

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584 Design of a Standard Weather Data Acquisition Device for the Federal University of Technology, Akure Nigeria

Authors: Isaac Kayode Ogunlade

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Data acquisition (DAQ) is the process by which physical phenomena from the real world are transformed into an electrical signal(s) that are measured and converted into a digital format for processing, analysis, and storage by a computer. The DAQ is designed using PIC18F4550 microcontroller, communicating with Personal Computer (PC) through USB (Universal Serial Bus). The research deployed initial knowledge of data acquisition system and embedded system to develop a weather data acquisition device using LM35 sensor to measure weather parameters and the use of Artificial Intelligence(Artificial Neural Network - ANN)and statistical approach(Autoregressive Integrated Moving Average – ARIMA) to predict precipitation (rainfall). The device is placed by a standard device in the Department of Meteorology, Federal University of Technology, Akure (FUTA) to know the performance evaluation of the device. Both devices (standard and designed) were subjected to 180 days with the same atmospheric condition for data mining (temperature, relative humidity, and pressure). The acquired data is trained in MATLAB R2012b environment using ANN, and ARIMAto predict precipitation (rainfall). Root Mean Square Error (RMSE), Mean Absolute Error (MAE), Correction Square (R2), and Mean Percentage Error (MPE) was deplored as standardize evaluation to know the performance of the models in the prediction of precipitation. The results from the working of the developed device show that the device has an efficiency of 96% and is also compatible with Personal Computer (PC) and laptops. The simulation result for acquired data shows that ANN models precipitation (rainfall) prediction for two months (May and June 2017) revealed a disparity error of 1.59%; while ARIMA is 2.63%, respectively. The device will be useful in research, practical laboratories, and industrial environments.

Keywords: data acquisition system, design device, weather development, predict precipitation and (FUTA) standard device

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583 Model-Based Approach as Support for Product Industrialization: Application to an Optical Sensor

Authors: Frederic Schenker, Jonathan J. Hendriks, Gianluca Nicchiotti

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In a product industrialization perspective, the end-product shall always be at the peak of technological advancement and developed in the shortest time possible. Thus, the constant growth of complexity and a shorter time-to-market calls for important changes on both the technical and business level. Undeniably, the common understanding of the system is beclouded by its complexity which leads to the communication gap between the engineers and the sale department. This communication link is therefore important to maintain and increase the information exchange between departments to ensure a punctual and flawless delivery to the end customer. This evolution brings engineers to reason with more hindsight and plan ahead. In this sense, they use new viewpoints to represent the data and to express the model deliverables in an understandable way that the different stakeholder may identify their needs and ideas. This article focuses on the usage of Model-Based System Engineering (MBSE) in a perspective of system industrialization and reconnect the engineering with the sales team. The modeling method used and presented in this paper concentrates on displaying as closely as possible the needs of the customer. Firstly, by providing a technical solution to the sales team to help them elaborate commercial offers without omitting technicalities. Secondly, the model simulates between a vast number of possibilities across a wide range of components. It becomes a dynamic tool for powerful analysis and optimizations. Thus, the model is no longer a technical tool for the engineers, but a way to maintain and solidify the communication between departments using different views of the model. The MBSE contribution to cost optimization during New Product Introduction (NPI) activities is made explicit through the illustration of a case study describing the support provided by system models to architectural choices during the industrialization of a novel optical sensor.

Keywords: analytical model, architecture comparison, MBSE, product industrialization, SysML, system thinking

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582 Study of the Association between Salivary Microbiological Data, Oral Health Indicators, Behavioral Factors, and Social Determinants among Post-COVID Patients Aged 7 to 12 Years in Tbilisi City

Authors: Lia Mania, Ketevan Nanobashvili

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Background: The coronavirus disease COVID-19 has become the cause of a global health crisis during the current pandemic. This study aims to fill the paucity of epidemiological studies on the impact of COVID-19 on the oral health of pediatric populations. Methods: It was conducted an observational, cross-sectional study in Georgia, in Tbilisi (capital of Georgia), among 7 to 12-year-old PCR or rapid test-confirmed post-Covid populations in all districts of Tbilisi (10 districts in total). 332 beneficiaries who were infected with Covid within one year were included in the study. The population was selected in schools of Tbilisi according to the principle of cluster selection. A simple random selection took place in the selected clusters. According to this principle, an equal number of beneficiaries were selected in all districts of Tbilisi. By July 1, 2022, according to National Center for Disease Control and Public Health data (NCDC.Ge), the number of test-confirmed cases in the population aged 0-18 in Tbilisi was 115137 children (17.7% of all confirmed cases). The number of patients to be examined was determined by the sample size. Oral screening, microbiological examination of saliva, and administration of oral health questionnaires to guardians were performed. Statistical processing of data was done with SPSS-23. Risk factors were estimated by odds ratio and logistic regression with 95% confidence interval. Results: Statistically reliable differences between the averages of oral health indicators in asymptomatic and symptomatic covid-infected groups are: for caries intensity (DMF+def) t=4.468 and p=0.000, for modified gingival index (MGI) t=3.048, p=0.002, for simplified oral hygiene index (S-OHI) t=4.853; p=0.000. Symptomatic covid-infection has a reliable effect on the oral microbiome (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis); (n=332; 77.3% vs n=332; 58.0%; OR=2.46, 95%CI: 1.318-4.617). According to the logistic regression, it was found that the severity of the covid infection has a significant effect on the frequency of pathogenic and conditionally pathogenic bacteria in the oral cavity B=0.903 AOR=2.467 (CL 1.318-4.617). Symptomatic covid-infection affects oral health indicators, regardless of the presence of other risk factors, such as parental employment status, tooth brushing behaviors, carbohydrate meal, fruit consumption. (p<0.05). Conclusion: Risk factors (parental employment status, tooth brushing behaviors, carbohydrate consumption) were associated with poorer oral health status in a post-Covid population of 7- to 12-year-old children. However, such a risk factor as symptomatic ongoing covid-infection affected the oral microbiome in terms of the abundant growth of pathogenic and conditionally pathogenic bacteria (Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus epidermalis) and further worsened oral health indicators. Thus, a close association was established between symptomatic covid-infection and microbiome changes in the post-covid period; also - between the variables of oral health indicators and the symptomatic course of covid-infection.

Keywords: oral microbiome, COVID-19, population based research, oral health indicators

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581 The Role of Surgery to Remove the Primary Tumor in Patients with Metastatic Breast Cancer

Authors: A. D. Zikiryahodjaev, L. V. Bolotina, A. S. Sukhotko

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Purpose. To evaluate the expediency and timeliness of performance of surgical treatment as a component of multi-therapy treatment of patients with stage IV breast cancers. Materials and Methods. This investigation comparatively analyzed the results of complex treatment with or without surgery in patients with metastatic breast cancer. We analyzed retrospectively treatment experience of 196 patients with generalized breast cancer in the department of oncology and breast reconstructive surgery of P.A. Herzen Moscow Cancer Research Institute from 2000 to 2012. The average age was (58±1,1) years. Invasive ductul carcinoma was verified in128 patients (65,3%), invasive lobular carcinoma-33 (16,8%), complex form - 19 (9,7%). Complex palliative care involving drug and radiation therapies was performed in two patient groups. The first group includes 124 patients who underwent surgical intervention as complex treatment, the second group includes 72 patients with only medical therapy. Standard systemic therapy was given to all patients. Results. Overall, 3-and 5-year survival in fist group was 43,8 and 21%, in second - 15,1 and 9,3% respectively [p=0,00002 log-rank]. Median survival in patients with surgical treatment composed 32 months, in patients with only systemic therapy-21. The factors having influencing an influence on the prognosis and the quality of life outcomes for of patients with generalized breast cancer were are also studied: hormone-dependent tumor, Her2/neu hyper-expression, reproductive function status (age, menopause existence). Conclusion.Removing primary breast tumor in patients with generalized breast cancer improve long-term outcomes. Three- and five-year survival increased by 28,7 and 16,3% respectively, and median survival–for 11 months. These patients may benefit from resection of the breast tumor. One explanation for the effect of this resection is that reducing the tumor load influences metastatic growth.

Keywords: breast cancer, combination therapy, factors of prognosis, primary tumor

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580 Promoting Civic Health through Patient Voter Registration

Authors: Amit Syal, Madeline Grade, Alister Martin

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Background: Cross-sectional and longitudinal studies demonstrate an association between health and voting. Furthermore, voting enables populations to support policies that impact their health via social determinants like income, education, housing, and healthcare access. Unfortunately, many barriers exist which disproportionately affect the civic participation of certain minority groups. Health professionals have an important role to play in addressing the civic health of all patients and empowering underrepresented communities. Description: Vot-ER is a non-partisan, nonprofit organization that aims to reduce barriers to civic participation by helping patients register to vote while in healthcare settings. The initial approach involved iPad-based kiosks in the emergency department waiting rooms, allowing patients to register themselves while waiting. After the COVID-19 pandemic began, Vot-ER expanded its touchless digital approaches. Vot-ER provides healthcare workers across the country with “Healthy Democracy Kits” consisting of badge backers, posters, discharge paperwork, and other resources. These contain QR and text codes that direct users to an online platform for registering to vote or requesting a mail-in ballot, available in English or Spanish. Outcomes: From May to November 2020, Vot-ER helped prepare 46,320 people to vote. 13,192 individual healthcare providers across all 50 states signed up for and received Healthy Democracy Kits. 80 medical schools participated in the Healthy Democracy Campaign competition. Over 500 institutions ordered site-based materials. Conclusions: A healthy democracy is one in which all individuals in a community have equal and fair opportunities for their voices to be heard. Healthcare settings, such as hospitals, are appropriate and effective venues for increasing both voter registration and education.

Keywords: civic health, enfranchisement, physician, voting

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579 Employability Potential of Differently Abled in the Indian Apparel Industry

Authors: Gunjita Shami, Noopur Anand

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The pilot run of 50 days was undertaken to test employability potential of people with visual and hearing & speech impairment. Various roles in an apparel manufacturing set up like spreading of fabric for cutting, folding, sealing and labeling cartons, pasting size barcode stickers on packed garments, removing tickets from the garments in the finishing stage were studied. Their performance was quantified basis timesheets for all the days and improvement per day was quantified. Their final day output was compared to that of the able-bodied worker. For example in the carton making activity on day one visually impaired worker was making one box every three minutes which improved to four boxes per minute on day 28 displaying 91.6% improvement compared or an improvement of 3.6% per day which was comparable to the able-bodied seasoned workers, who were making 5 boxes per minute. The performance of persons with hearing and speech impairment in the finishing department was 10% higher than that of able-bodied seasoned workers in the same process. Overall in all the activities the differently abled showed day to day improvement of 65% while able bodied displayed improvement of 52%. On the first day performance of able-bodied worker was 75% better than that of differently abled while on the 50th day it was only 20% better. Therefore the performance of persons with disabilities was found comparable to the able bodied person. The results, though on a small scale, showed a big promise of employment of persons with disability in the apparel industry. Armed with the promising result a full-scale study has been undertaken to identify the roles suitable for certain kind of disability in apparel production, work-aids required to assist the differently abled to improve performance and measures to be undertaken to make production floor 'friendlier' for them. The results have been discussed in this paper which opens doors for integrating differently abled into the world projected and assumed for only able-bodied.

Keywords: apparel sector, differently abled, employability, performance, work-aid

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578 Role of Pulsed-Dye Laser in the Treatment of Inflammatory Acne Vulgaris

Authors: Shirajul Islam Khan, Muhammad Ashraful Alam Bhuiyan, Syeda Tania Begum

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Introduction: Acne vulgaris is one of the most common dermatologic conditions and affects the vast majority of people at some point during their lifetime, so effective treatment is of major importance. The failure of usual treatment modalities, teratogenic effects with some severe side effects, and resistance to P.Acne by Retinoides have been focusing on new therapeutic options for the treatment of acne. More recently, pulsed dye laser therapy has been reported to reduce acne lesion counts. The negligible morbidity of these treatment modalities and some other benefits of subsequent acne scar management lead this therapy more attractive. Objective: The objective of this study is to assess the efficacy and safety of pulsed dye laser therapy in the treatment of inflammatory acne vulgaris. Materials and Methods: A prospective clinical trial was done in the Department of Dermatology and Venereology, Combined Military Hospital (CMH), Dhaka, to find out the role of pulse dye laser in the treatment of inflammatory acne vulgaris. The study was carried out with 60 patients with mild to moderate acne vulgaris, and those were treated with pulsed dye laser therapy at baseline and after 4, 8, and 12 weeks. Results: Among 60 patients with inflammatory acne, 42(70%) were in the age group of less than 20 years, and 36(60%) were female. Regarding the number of inflammatory lesions, the baseline mean number (± SD) was 12.77 ± 4.01; after 4 weeks of treatment of inflammatory acne by pulsed dye laser was 7.80 ± 4.11; after 8 weeks of treatment, 6.10 ± 4.03 and after 12 weeks of treatment was 4.17 ± 4.02. After 4 weeks of treatment by pulse dye laser, the level of improvement was excellent at 3.3%, good at 10%, fair at 60%, and poor at 26.7%; after 8 weeks of treatment, excellent was 13.3%, good was 46.7%, the fair was 30% and poor 10% and after 12 weeks of treatment, excellent was 56.7%, good 13.3%, fair 23.3% and poor 6.7%. Regarding safety level, out of 60 patients of inflammatory acne vulgaris treated by pulsed dye laser, about 52(86.7%) patients did not observe any side effects. Conclusions: On the basis of the study results, it can be concluded that pulsed-dye laser is highly effective and well tolerated by patients in the treatment of inflammatory acne.

Keywords: pulsed-dye laser, inflammatory acne, acne vulgaris, retinoids

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577 Instructional Leadership, Information and Communications Technology Competencies and Performance of Basic Education Teachers

Authors: Jay Martin L. Dionaldo

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This study aimed to develop a causal model on the performance of the basic education teachers in the Division of Malaybalay City for the school year 2018-2019. This study used the responses of 300 randomly selected basic education teachers of Malaybalay City, Bukidnon. They responded to the three sets of questionnaires patterned from the National Education Association (2018) on instructional leadership of teachers, the questionnaire of Caluza et al., (2017) for information and communications technology competencies and the questionnaire on the teachers’ performance using the Individual Performance Commitment and Review Form (IPCRF) adopted by the Department of Education (DepEd). Descriptive statistics such as mean for the description, correlation for a relationship, regression for the extent influence, and path analysis for the model that best fits teachers’ performance were used. Result showed that basic education teachers have a very satisfactory level of performance. Also, the teachers highly practice instructional leadership practices in terms of coaching and mentoring, facilitating collaborative relationships, and community awareness and engagement. On the other hand, they are proficient users of ICT in terms of technology operations and concepts and basic users in terms of their pedagogical indicators. Furthermore, instructional leadership, coaching and mentoring, facilitating collaborative relationships and community awareness and engagement and information and communications technology competencies; technology operations and concept and pedagogy were significantly correlated toward teachers’ performance. Coaching and mentoring, community awareness and engagement, and technology operations and concept were the best predictors of teachers’ performance. The model that best fit teachers’ performance is anchored on coaching and mentoring of the teachers, embedded with facilitating collaborative relationships, community awareness, and engagement, technology operations, and concepts, and pedagogy.

Keywords: information and communications technology, instructional leadership, coaching and mentoring, collaborative relationship

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576 A Case Report: The Role of Gut Directed Hypnotherapy in Resolution of Irritable Bowel Syndrome in a Medication Refractory Pediatric Male Patient

Authors: Alok Bapatla, Pamela Lutting, Mariastella Serrano

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Background: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain associated with altered bowel habits in the absence of an underlying organic cause. Although the exact etiology of IBS is not fully understood, one of the leading theories postulates a pathology within the Brain-Gut Axis that leads to an overall increase in gastrointestinal sensitivity and pejorative changes in gastrointestinal motility. Research and clinical practice have shown that Gut Directed Hypnotherapy (GDH) has a beneficial clinical role in improving Mind-Gut control and thereby comorbid conditions such as anxiety, abdominal pain, constipation, and diarrhea. Aims: This study presents a 17-year old male with underlying anxiety and a one-year history of IBS-Constipation Predominant Subtype (IBS-C), who has demonstrated impressive improvement of symptoms following GDH treatment following refractory trials with medications including bisacodyl, senna, docusate, magnesium citrate, lubiprostone, linaclotide. Method: The patient was referred to a licensed clinical psychologist specializing in clinical hypnosis and cognitive-behavioral therapy (CBT), who implemented “The Standardized Hypnosis Protocol for IBS” developed by Dr. Olafur S. Palsson, Psy.D at the University of North Carolina at Chapel Hill. The hypnotherapy protocol consisted of a total of seven weekly 45-minute sessions supplemented with a 20-minute audio recording to be listened to once daily. Outcome variables included the GAD-7, PHQ-9 and DCI-2, as well as self-ratings (ranging 0-10) for pain (intensity and frequency), emotional distress about IBS symptoms, and overall emotional distress. All variables were measured at intake prior to administration of the hypnosis protocol and at the conclusion of the hypnosis treatment. A retrospective IBS Questionnaire (IBS Severity Scoring System) was also completed at the conclusion of the GDH treatment for pre-and post-test ratings of clinical symptoms. Results: The patient showed improvement in all outcome variables and self-ratings, including abdominal pain intensity, frequency of abdominal pain episodes, emotional distress relating to gut issues, depression, and anxiety. The IBS Questionnaire showed a significant improvement from a severity score of 400 (defined as severe) prior to GDH intervention compared to 55 (defined as complete resolution) at four months after the last session. IBS Questionnaire subset questions that showed a significant score improvement included abdominal pain intensity, days of pain experienced per 10 days, satisfaction with bowel habits, and overall interference of life affected by IBS symptoms. Conclusion: This case supports the existing research literature that GDH has a significantly beneficial role in improving symptoms in patients with IBS. Emphasis is placed on the numerical results of the IBS Questionnaire scoring, which reflects a patient who initially suffered from severe IBS with failed response to multiple medications, who subsequently showed full and sustained resolution

Keywords: pediatrics, constipation, irritable bowel syndrome, hypnotherapy, gut-directed hypnosis

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575 Evaluation of Surface Roughness Condition Using App Roadroid

Authors: Diego de Almeida Pereira

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The roughness index of a road is considered the most important parameter about the quality of the pavement, as it has a close relation with the comfort and safety of the road users. Such condition can be established by means of functional evaluation of pavement surface deviations, measured by the International Roughness Index (IRI), an index that came out of the international evaluation of pavements, coordinated by the World Bank, and currently owns, as an index of limit measure, for purposes of receiving roads in Brazil, the value of 2.7 m/km. This work make use of the e.IRI parameter, obtained by the Roadroid app. for smartphones which use Android operating system. The choice of such application is due to the practicality for the user interaction, as it possesses a data storage on a cloud of its own, and the support given to universities all around the world. Data has been collected for six months, once in each month. The studies begun in March 2018, season of precipitations that worsen the conditions of the roads, besides the opportunity to accompany the damage and the quality of the interventions performed. About 350 kilometers of sections of four federal highways were analyzed, BR-020, BR-040, BR-060 and BR-070 that connect the Federal District (area where Brasilia is located) and surroundings, chosen for their economic and tourist importance, been two of them of federal and two others of private exploitation. As well as much of the road network, the analyzed stretches are coated of Hot Mix Asphalt (HMA). Thus, this present research performs a contrastive discussion between comfort conditions and safety of the roads under private exploitation in which users pay a fee to the concessionaires so they could travel on a road that meet the minimum requirements for usage, and regarding the quality of offered service on the roads under Federal Government jurisdiction. And finally, the contrast of data collected by National Department of Transport Infrastructure – DNIT, by means of a laser perfilometer, with data achieved by Roadroid, checking the applicability, the practicality and cost-effective, considering the app limitations.

Keywords: roadroid, international roughness index, Brazilian roads, pavement

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574 Effects of Bilateral Electroconvulsive Therapy on Autobiographical Memories in Asian Patients

Authors: Lai Gwen Chan, Yining Ong, Audrey Yoke Poh Wong

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Background. The efficacy of electroconvulsive therapy (ECT) as a form of treatment to a range of mental disorders is well-established. However, ECT is often associated with either temporary or persistent cognitive side-effects, resulting in the failure of wider prescription. Of which, retrograde amnesia is the most commonly reported cognitive side-effect. Most studies found a recalling deficit in autobiographical memories to be short-term, although a few have reported more persistent amnesic effects. Little is known about ECT-related amnesic effects in Asian population. Hence, this study aims to resolve conflicting findings, as well as to better elucidate the effects of ECT on cognitive functioning in a local sample. Method: 12 patients underwent bilateral ECT under the care of Psychological Medicine Department, Tan Tock Seng Hospital, Singapore. Participants’ cognition and level of functioning were assessed at four time-points: before ECT, between the third and fourth induced seizure, at the end of the whole course of ECT, and two months after the index course of ECT. Results: It was found that Global Assessment of Functioning scores increased significantly at the completion of ECT. Case-by-case analyses also revealed an overall improvement in Personal Semantic and Autobiographical memory two months after the index course of ECT. A transient dip in both personal semantic and autobiographical memory scores was observed in one participant between the third and fourth induced seizure, but subsequently resolved and showed better performance than at baseline. Conclusions: The findings of this study suggest that ECT is an effective form of treatment to alleviate the severity of symptoms of the diagnosis. ECT does not affect attention, language, executive functioning, personal semantic and autobiographical memory adversely. The findings suggest that Asian patients may respond to bilateral ECT differently from Western samples.

Keywords: electroconvulsive therapy (ECT), autobiographical memory, cognitive impairment, psychiatric disorder

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573 The Impact of Land Cover Change on Stream Discharges and Water Resources in Luvuvhu River Catchment, Vhembe District, Limpopo Province, South Africa

Authors: P. M. Kundu, L. R. Singo, J. O. Odiyo

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Luvuvhu River catchment in South Africa experiences floods resulting from heavy rainfall of intensities exceeding 15 mm per hour associated with the Inter-tropical Convergence Zone (ITCZ). The generation of runoff is triggered by the rainfall intensity and soil moisture status. In this study, remote sensing and GIS techniques were used to analyze the hydrologic response to land cover changes. Runoff was calculated as a product of the net precipitation and a curve number coefficient. It was then routed using the Muskingum-Cunge method using a diffusive wave transfer model that enabled the calculation of response functions between start and end point. Flood frequency analysis was determined using theoretical probability distributions. Spatial data on land cover was obtained from multi-temporal Landsat images while data on rainfall, soil type, runoff and stream discharges was obtained by direct measurements in the field and from the Department of Water. A digital elevation model was generated from contour maps available at http://www.ngi.gov.za. The results showed that land cover changes had impacted negatively to the hydrology of the catchment. Peak discharges in the whole catchment were noted to have increased by at least 17% over the period while flood volumes were noted to have increased by at least 11% over the same period. The flood time to peak indicated a decreasing trend, in the range of 0.5 to 1 hour within the years. The synergism between remotely sensed digital data and GIS for land surface analysis and modeling was realized, and it was therefore concluded that hydrologic modeling has potential for determining the influence of changes in land cover on the hydrologic response of the catchment.

Keywords: catchment, digital elevation model, hydrological model, routing, runoff

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572 Examination of the Relationship between Managerial Competence and Job Satisfacti̇on and Career Satisfacti̇on in Sports Managers'

Authors: Omur F. Karakullukcu, Bilal Okudan, Yusuf Can

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The aim of this study is to analyze sports managers’ managerial competence levels and job satisfaction’s correlation with career satisfaction. In the study, it has also been analyzed if there is any significant difference in sports managers’ managerial competence, job and career satisfaction in terms of gender, age, duty status, year of service and level of education. 256 sports managers, who work at department of sports service’s central and field organization at least as a chief in the manager position, have been chosen with random sampling method and they have voluntarily participated in the study. In the study, the managerial competence scale which was developed by Cetinkaya (2009), job satisfaction scale developed by Weiss at al.(1967) and Career Satisfaction Scale developed by Vatansever (2008) have been used as a data collection tool. The questionnaire form used as a data collection tool in the study includes a personal information form consisting of 5 questions; questioning gender, age, duty status, years of service and level of education. In the study, pearson correlation analysis has been used for defining the correlation of managerial competence levels, job satisfaction, and career satisfaction levels of sports managers. T-test analysis for binary grouping and anova analysis for more than binary groups have been used in the level of self-efficacy, collective and managerial competence in terms of the participants’ duty status, year of service and level of education. According to the research results, it has been found that there is a positive correlation between sports managers’ managerial competence levels, job satisfaction, and career satisfaction levels. Also, the results show that there is a significant difference in managerial competence levels, job satisfaction and career satisfaction of sports managers in terms of duty status, year of service and level of education; however, the results reveal that there is no significant difference in terms of age groups and gender.

Keywords: sports manager, managerial competence, job satisfaction, career satisfaction

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571 Exploring Gender-Base Salary Disparities and Equities Among University Presidents

Authors: Daniel Barkley, Jianyi Zhu

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This study investigates base salary differentials and gender equity among university presidents across 427 U.S. colleges and universities. While endowments typically do not directly determine university presidents' base salaries, our analysis reveals a noteworthy pattern: endowments explain more than half of the variance in female university presidents' base salaries, compared to a mere 0.69 percent for males. Moreover, female presidents' base salaries tend to rise much faster than male base salaries with increasing university endowments. This disparate impact of endowments on base salaries implies an endowment threshold for achieving gender pay equity. We develop an analytical model predicting an endowment threshold for achieving gender equality and empirically estimate this equity threshold using data from over 427 institutions. Surprisingly, the fields of science and athletics have emerged as sources of gender-neutral base pay. Both male and female university presidents with STEM backgrounds command higher base salaries than those without such qualifications. Additionally, presidents of universities affiliated with Power 5 conferences consistently receive higher base salaries regardless of gender. Consistent with the theory of human capital accumulation, the duration of the university presidency incrementally raises base salaries for both genders but at a diminishing rate. Curiously, prior administrative leadership experience as a vice president, provost, dean, or department chair does not significantly influence base salaries for either gender. By providing empirical evidence and analytical models predicting an endowment threshold for achieving gender equality in base salaries, the study offers valuable insights for policymakers, university administrators, and other stakeholders. These findings hold crucial policy implications, informing strategies to promote gender equality in executive compensation within higher education institutions.

Keywords: higher education, endowments, base salaries, university presidents

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570 Making Food Science Education and Research Activities More Attractive for University Students and Food Enterprises by Utilizing Open Innovative Space-Approach

Authors: Anna-Maria Saarela

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At the Savonia University of Applied Sciences (UAS), curriculum and studies have been improved by applying an Open Innovation Space approach (OIS). It is based on multidisciplinary action learning. The key elements of OIS-ideology are work-life orientation, and student-centric communal learning. In this approach, every participant can learn from each other and innovations will be created. In this social innovation educational approach, all practices are carried out in close collaboration with enterprises in real-life settings, not in classrooms. As an example, in this paper, Savonia UAS’s Future Food RDI hub (FF) shows how OIS practices are implemented by providing food product development and consumer research services for enterprises in close collaboration with academicians, students and consumers. In particular one example of OIS experimentation in the field is provided by a consumer research carried out utilizing verbal analysis protocol combined with audio-visual observation (VAP-WAVO). In this case, all co-learners were acting together in supermarket settings to collect the relevant data for a product development and the marketing department of a company. The company benefitted from the results obtained, students were more satisfied with their studies, educators and academicians were able to obtain good evidence for further collaboration as well as renewing curriculum contents based on the requirements of working life. In addition, society will benefit over time as young university adults find careers more easily through their OIS related food science studies. Also this knowledge interaction model re-news education practices and brings working-life closer to educational research institutes.

Keywords: collaboration, education, food science, industry, knowledge transfer, RDI, student

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569 Violence Against Nurses – Healthcare Workers with Great Sacrifice - During The COVID-19 Pandemic: A Discussion Article

Authors: Sarieh Poortaghi, Zakiyeh Jafaryparvar, Marzieh Hasanpour, Reza Negarandeh

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Aim: This article aims to discuss how violence against health care workers especially nurses affects health care systems and the quality of care of the patients. In this paper causes of violence and strategies to reduce it have been discussed. Methods: Discourse of the literature considering the violence against nurses during the COVID-19 pandemic and its reasons and outcomes. Results: The COVID-19 pandemic has led to a significant increase in violence against healthcare providers. The attacker against nurses may be among patients, companions, visitors, colleagues such as doctors and other nurses, supervisors, and managers. Many individuals who experience violence in healthcare environments refrain from reporting it. The causes of violence against nurses include spending long periods with patients, perceiving nursing as a low-status profession, gender of nurses, direct and frequent contact with patients and their companions, inadequate facilities and high workload, weak healthcare delivery systems in public hospitals and inequality in health, nature of the department and shift type of personnel, work shifts and staff shortages, forcing nurses to work in non-standard conditions during the COVID-19 pandemic, prohibition of patient visits during the pandemic, patient death and nurses' sense of incompetence, and expressing stress through aggression. Workplace violence leads to a decrease in job satisfaction and an increase in continuous psychological stress, which has a negative impact on the personal and professional lives of nurses. Potential strategies for reducing workplace violence include protecting healthcare workers through laws, improving communication with patients and their families, critically analyzing information in social media, facilitating patient access through remote medical strategies, and improving access to primary healthcare services.

Keywords: nurses, health care workers, Covid-19, nursing

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568 Developing Primary Care Datasets for a National Asthma Audit

Authors: Rachael Andrews, Viktoria McMillan, Shuaib Nasser, Christopher M. Roberts

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Background and objective: The National Review of Asthma Deaths (NRAD) found that asthma management and care was inadequate in 26% of cases reviewed. Major shortfalls identified were adherence to national guidelines and standards and, particularly, the organisation of care, including supervision and monitoring in primary care, with 70% of cases reviewed having at least one avoidable factor in this area. 5.4 million people in the UK are diagnosed with and actively treated for asthma, and approximately 60,000 are admitted to hospital with acute exacerbations each year. The majority of people with asthma receive management and treatment solely in primary care. This has therefore created concern that many people within the UK are receiving sub-optimal asthma care resulting in unnecessary morbidity and risk of adverse outcome. NRAD concluded that a national asthma audit programme should be established to measure and improve processes, organisation, and outcomes of asthma care. Objective: To develop a primary care dataset enabling extraction of information from GP practices in Wales and providing robust data by which results and lessons could be drawn and drive service development and improvement. Methods: A multidisciplinary group of experts, including general practitioners, primary care organisation representatives, and asthma patients was formed and used as a source of governance and guidance. A review of asthma literature, guidance, and standards took place and was used to identify areas of asthma care which, if improved, would lead to better patient outcomes. Modified Delphi methodology was used to gain consensus from the expert group on which of the areas identified were to be prioritised, and an asthma patient and carer focus group held to seek views and feedback on areas of asthma care that were important to them. Areas of asthma care identified by both groups were mapped to asthma guidelines and standards to inform and develop primary and secondary care datasets covering both adult and pediatric care. Dataset development consisted of expert review and a targeted consultation process in order to seek broad stakeholder views and feedback. Results: Areas of asthma care identified as requiring prioritisation by the National Asthma Audit were: (i) Prescribing, (ii) Asthma diagnosis (iii) Asthma Reviews (iv) Personalised Asthma Action Plans (PAAPs) (v) Primary care follow-up after discharge from hospital (vi) Methodologies and primary care queries were developed to cover each of the areas of poor and variable asthma care identified and the queries designed to extract information directly from electronic patients’ records. Conclusion: This paper describes the methodological approach followed to develop primary care datasets for a National Asthma Audit. It sets out the principles behind the establishment of a National Asthma Audit programme in response to a national asthma mortality review and describes the development activities undertaken. Key process elements included: (i) mapping identified areas of poor and variable asthma care to national guidelines and standards, (ii) early engagement of experts, including clinicians and patients in the process, and (iii) targeted consultation of the queries to provide further insight into measures that were collectable, reproducible and relevant.

Keywords: asthma, primary care, general practice, dataset development

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567 Revolutionizing Autonomous Trucking Logistics with Customer Relationship Management Cloud

Authors: Sharda Kumari, Saiman Shetty

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Autonomous trucking is just one of the numerous significant shifts impacting fleet management services. The Society of Automotive Engineers (SAE) has defined six levels of vehicle automation that have been adopted internationally, including by the United States Department of Transportation. On public highways in the United States, organizations are testing driverless vehicles with at least Level 4 automation which indicates that a human is present in the vehicle and can disable automation, which is usually done while the trucks are not engaged in highway driving. However, completely driverless vehicles are presently being tested in the state of California. While autonomous trucking can increase safety, decrease trucking costs, provide solutions to trucker shortages, and improve efficiencies, logistics, too, requires advancements to keep up with trucking innovations. Given that artificial intelligence, machine learning, and automated procedures enable people to do their duties in other sectors with fewer resources, CRM (Customer Relationship Management) can be applied to the autonomous trucking business to provide the same level of efficiency. In a society witnessing significant digital disruptions, fleet management is likewise being transformed by technology. Utilizing strategic alliances to enhance core services is an effective technique for capitalizing on innovations and delivering enhanced services. Utilizing analytics on CRM systems improves cost control of fuel strategy, fleet maintenance, driver behavior, route planning, road safety compliance, and capacity utilization. Integration of autonomous trucks with automated fleet management, yard/terminal management, and customer service is possible, thus having significant power to redraw the lines between the public and private spheres in autonomous trucking logistics.

Keywords: autonomous vehicles, customer relationship management, customer experience, autonomous trucking, digital transformation

Procedia PDF Downloads 110