Search results for: clinical document retrieval

Authors: Suraj Gururaj, Sumantha Udupa U.

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Browsing the Web has emerged as the de facto activity performed on the Internet. Although browsing gets tracked, the manageability aspect of Web browsing history is very poor. In this paper, we have a workable solution implemented by using machine learning and natural language processing techniques for efficient manageability of user’s browsing history. The significance of adding such a capability to a Web browser is that it ensures efficient and quick information retrieval from browsing history, which currently is very challenging. Our solution guarantees that any important websites visited in the past can be easily accessible because of the intelligent and automatic classification. In a nutshell, our solution-based paper provides an implementation as a browser extension by intelligently classifying the browsing history into most relevant category automatically without any user’s intervention. This guarantees no information is lost and increases productivity by saving time spent revisiting websites that were of much importance.

Keywords: adhoc retrieval, Chrome extension, supervised learning, tile, Web personalization

Procedia PDF Downloads 350

Authors: Eric Tardif, Nicolas Meylan

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Recent studies suggest that the consolidation of episodic memory is better achieved through repeated retrieval than with the use of concept mapping or repeated study. Although such laboratory results highly appeal to educationalists, it remains to be shown whether they can be directly used in a classroom setting. Forty-five college students (42 girls; mean age 16.1 y/o) were asked to remember pairs of biology-related words (e.g. mitochondria-energy) in two configurations. The first configuration consisted of a three-minute study of pairs of words followed by a final one-minute test in which the first word of a pair was shown and the subject asked to write down the second associated word. This procedure was repeated three times. The second configuration consisted of a one-minute study of a list of pairs of words, which was immediately followed by a one-minute test. This procedure was repeated 6 times. Subjects filled out a small questionnaire assessing their general mood, level of fatigue, stress and motivation to do the exercise. One week later, subjects were given a final test using the same words. A total of 8 lists of words were studied and tested during the semester. Results showed that subjects recalled more correct words when using the second configuration, both within the study period and one week later, confirming laboratory findings. However, the general performance (mean items recalled) as well as the motivation to do the exercise gradually decreased during the semester. Motivation was positively correlated with performance (r=0.77, p<0.05). The results suggest that laboratory findings may provide some applications in education but other variables inherent to the classroom setting must also be considered.

Keywords: long-term, episodic memory, consolidation, retrieval, school setting

Procedia PDF Downloads 319

Authors: Ramy Shaaban

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The purpose of this study was to examine the difference in clinical reasoning skills of students when using virtual audiology cases with and without collaborative assistance from major learning approaches important to clinical reasoning skills and computer-based learning models: Situated Learning Theory, Social Development Theory, Scaffolding, and Collaborative Learning. A quasi-experimental design was conducted at two United States universities to examine whether there is a significant difference in clinical reasoning skills between three treatment groups using IUP Audiosim software. Two computer-based audiology case simulations were developed, and participants were randomly placed into the three groups: no collaboration, virtual collaboration, and live collaboration. The clinical reasoning data were analyzed using One-Way ANOVA and Tukey posthoc analyses. The results show that there was a significant difference in clinical reasoning skills between the three treatment groups. The score obtained by the no collaboration group was significantly less than the scores obtained by the virtual and live collaboration groups. Collaboration, whether virtual or in person, has a positive effect on students’ clinical reasoning. These results with audiology students indicate that combining collaboration models with scaffolding and embedding situated learning and social development theories into the design of future virtual patients has the potential to improve students’ clinical reasoning skills.

Keywords: clinical reasoning, virtual patients, collaborative learning, scaffolding

Procedia PDF Downloads 188

Authors: Sheeraz Memon, Namunu C. Maddage, Margaret Lech, Nicholas Allen

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The effect of a clinical environment on the accuracy of the speaker verification was tested. The speaker verification tests were performed within homogeneous environments containing clinically depressed speakers only, and non-depresses speakers only, as well as within mixed environments containing different mixtures of both climatically depressed and non-depressed speakers. The speaker verification framework included the MFCCs features and the GMM modeling and classification method. The speaker verification experiments within homogeneous environments showed 5.1% increase of the EER within the clinically depressed environment when compared to the non-depressed environment. It indicated that the clinical depression increases the intra-speaker variability and makes the speaker verification task more challenging. Experiments with mixed environments indicated that the increase of the percentage of the depressed individuals within a mixed environment increases the speaker verification equal error rates.

Keywords: speaker verification, GMM, EM, clinical environment, clinical depression

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Authors: Shatadru Das, Natarajan Vijayarangan

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In this paper, a system and method for generating and recovering an authorization code has been designed and analyzed. The system creates an authorization code by accepting a base-sentence from a user. Based on the characters present in this base-sentence, the system computes a base-sentence matrix. The system also generates a plurality of patterns. The user can either select the pattern from the multiple patterns suggested by the system or can create his/her own pattern. The system then performs multiplications between the base-sentence matrix and the selected pattern matrix at different stages in the path forward, for obtaining a strong authorization code. In case the user forgets the base sentence, the system has a provision to manage and retrieve 'forgotten authorization code'. This is done by fragmenting the base sentence into different matrices and storing the fragmented matrices into a repository after computing matrix multiplication with a security question-answer approach and with a secret key provided by the user.

Keywords: easy authentication, key retrieval, memorable passwords, strong password generation

Procedia PDF Downloads 374

Authors: Boris M. Fedorov, Liudmila P. Goncharenko, Sergey A. Sybachin, Natalia A. Mamedova, Ekaterina V. Makarenkova, Saule Rakhimova

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In modern economic conditions, the question of the possibility of correct recognition of a signature on digital documents in order to verify the expression of will or confirm a certain operation is relevant. The additional complexity of processing lies in the dynamic variability of the signature for each individual, as well as in the way information is processed because the signature refers to biometric data. The article discusses the issues of using artificial intelligence models in order to improve the quality of signature confirmation in document recognition. The analysis of several possible options for using the model is carried out. The results of the study are given, in which it is possible to correctly determine the authenticity of the signature on small samples.

Keywords: signature recognition, biometric data, artificial intelligence, neural networks

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Authors: Luca Martignoni

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The increasing usage of clinical decision support systems in healthcare and the demand for software that enables doctors to take informed decisions is changing everyday clinical practice. However, as technology advances not only are the benefits of technology growing, but so are the potential risks. A growing danger is the doctors’ over-reliance on the proposed decision of the clinical decision support system, leading towards deskilling and rash decisions by doctors. In that regard, identifying doctors' requirements for software and developing approaches to prevent technological over-reliance is of utmost importance. In this paper, we report the results of a design science research study, focusing on the requirements and design principles of ultrasound software. We conducted a total of 15 interviews with experts about poten-tial ultrasound software functions. Subsequently, we developed meta-requirements and design principles to design future clinical decision support systems efficiently and as free from the occur-rence of technological over-reliance as possible.

Keywords: clinical decision support systems, technological over-reliance, design principles, design science research

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Authors: Mamdouh Milad Adly Morkos

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Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theoryclinical simulation, education, pharmacology, simulation, virtual learning low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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Authors: R. Babi Saraswathi, K. Divya, A. Habeebur Rahman, D. B. Hari Prakash, S. Jayanth, T. Kumar, N. Vijayarangan

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Document automation is the design of systems and workflows, assembling repetitive documents to meet the specific business needs. In any organization or institution, documenting employee’s information is very important for both employees as well as management. It shows an individual’s progress to the management. Many documents of the employee are in the form of papers, so it is very difficult to arrange and for future reference we need to spend more time in getting the exact document. Also, it is very tedious to generate reports according to our needs. The process gets even more difficult on getting approvals and hence lacks its security aspects. This project overcomes the above-stated issues. By storing the details in the database and maintaining the e-documents, the automation system reduces the manual work to a large extent. Then the approval process of some important documents can be done in a much-secured manner by using Digital Signature and encryption techniques. Details are maintained in the database and e-documents are stored in specific folders and generation of various kinds of reports is possible. Moreover, an efficient search method is implemented is used in the database. Automation supporting document maintenance in many aspects is useful for minimize data entry, reduce the time spent on proof-reading, avoids duplication, and reduce the risks associated with the manual error, etc.

Keywords: e-documents, automation, digital signature, encryption

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Authors: Sarra Senhadji, Imene Benzeguimi, Zohra Yagoub

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Big Data represents the recent technology of manipulating voluminous and unstructured data sets over multiple sources. Therefore, NOSQL appears to handle the problem of unstructured data. Association rules mining is one of the popular techniques of data mining to extract hidden relationship from transactional databases. The algorithm for finding association dependencies is well-solved with Map Reduce. The goal of our work is to reduce the time of generating of frequent itemsets by using Map Reduce and NOSQL database oriented document. A comparative study is given to evaluate the performances of our algorithm with the classical algorithm Apriori.

Keywords: Apriori, Association rules mining, Big Data, Data Mining, Hadoop, MapReduce, MongoDB, NoSQL

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Authors: Tuong Thi Van Thuy, Dao Van Toan, Nguyen Duc Phuc

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Mesenchymal stem cells (MSCs) were discovered in the 1970s with their unique properties of differentiation, immunomodulation, multiple secreting, and homing factors to injured organs. MSC-based therapies have emerged as a promising strategy for various diseases such as cancer, tissue regeneration, or immunologic/inflammatory-related diseases. This study evaluated the clinical application of MSCs for cancer therapy in trials registered on Clinical Trial as of July 2022. The results showed 40 clinical trials used MSCs in various cancer conditions. 62% of trials used MSCs for therapeutic purposes to minimize the side effects of cancer treatment. Besides, 38% of trials were focused on using MSCs as a therapeutic agent to treat cancer directly. Most trials (38/40) are ongoing phase I/II, and 2 are entering phase III. 84% of trials used allogeneic MSCs compared with 13% using autologous sources and 3% using both. 25/40 trials showed participants received a single dose of MSCs, while the most times were 12 times in a pancreatic cancer treatment trial. Conclusion: MSC-based therapy for cancer in clinical trials should be applied to (1) minimize the side effects of oncological treatments and (2) directly affect the tumor via selectively delivering anti-cancer payloads to tumor cells. Allogeneic MSCs are a priority selected in clinical cancer therapy.

Keywords: mesenchymal stem cells, MSC-based therapy, cancer condition, cancer treatment, clinical trials

Procedia PDF Downloads 67

Authors: Y. Bablu Singh, B. S. Purkayashtha, Chungkham Yashawanta Singh

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Morphological analysis forms the basic foundation in NLP applications including syntax parsing Machine Translation (MT), Information Retrieval (IR) and automatic indexing in all languages. It is the field of the linguistics; it can provide valuable information for computer based linguistics task such as lemmatization and studies of internal structure of the words. Computational Morphology is the application of morphological rules in the field of computational linguistics, and it is the emerging area in AI, which studies the structure of words, which are formed by combining smaller units of linguistics information, called morphemes: the building blocks of words. Morphological analysis provides about semantic and syntactic role in a sentence. It analyzes the Manipuri word forms and produces several grammatical information associated with the words. The Morphological Analyzer for Manipuri has been tested on 3500 Manipuri words in Shakti Standard format (SSF) using Meitei Mayek as source; thereby an accuracy of 80% has been obtained on a manual check.

Keywords: morphological analysis, machine translation, computational morphology, information retrieval, SSF

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Authors: Supattra Pranee

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The objectives of this research were to study the product development process to obtain a community standard product certificate and to set a guideline for the product development process to obtain the community product certificate. Focus group discussion was conducted with many experts in the field, local government officials, and representatives from local producers in Bangkontee district. The findings revealed that there were eight important processes to obtain the community product certificate: 1) prepare document, 2) submit the document, 3) set up an appointment for onsite inspection, 4) onsite inspection and sample collections, 5) evaluate samples, 6) obtain test result, and 7) obtain certificate.

Keywords: perceived values, tourist destination, visiting, product development

Procedia PDF Downloads 423

Authors: Sohil I. Alqazlan

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Introduction and Objectives: The individual educational plans (IEPs) is the cornerstone in education for students with special education need (SEN). The Saudi government supported the students’ right to have an IEP, and their education is one of the primary goals for the Ministry of Education (MoE). However, this support does not reflect the huge government investment. For example, some SEN students do not have an IEP, and poor communication was found between IEP teams and student's families. As a result, this study investigated perspectives and understandings of the IEP from the views of SEN teachers in the Saudi context. Methods: This study design utilised a qualitative approach, where in-depth semi-structured interviews were used with 8 SEN teachers in Riyadh (the capital city of Saudi Arabia) schools. In terms of analysing the interviews’ findings, the researcher used the thematic analyses approach. Results and Conclusion: The legality and the consideration of the legal document in Saudi Arabia are the main areas wherein study participants were questioned. It was observed that the IEP is not considered a legal document in the region of Saudi Arabia. As interpreted from the response of the SEN teachers, the IEP lacks the required legality with respect to its implementation in Saudi Arabia. All teachers were in agreement that the IEP is not considered to be a legal document in the Kingdom of Saudi Arabia. As a result, they did not use it for all their students with SEN. Such findings might have affected the teaching quality, and school outcomes as all SEN students must be supported individually depending on their needs.

Keywords: individual education plan, special education, IEP, teachers

Procedia PDF Downloads 148

Authors: Anmol Patel

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Cardiopulmonary resuscitation is medical intervention which should be considered for all inpatients; with a patient centred approach, open communication and accurate documentation of clinical decisions. National enquiries have shown that in a significant number of cases CPR was attempted when it was considered inappropriate. In these circumstances attempting to prevent a natural death and subjecting a patient to trauma at the end of life would deprive them of a dignified death. Anticipatory “do not attempt CPR (DNACPR)” decisions aim to prevent this for those considered appropriate. As a legal document, these forms are required to be completed accurately and thoroughly. The aim of this study was to evaluate the difference in quality of DNACPR forms completed using electronic versus paper formats. A retrospective review of DNACPR forms and related documentation was completed in two District General Hospitals in South-East England, one of which uses electronic forms, while the other uses paper red forms. 50 completed forms from each hospital were analysed to assess for legibility, and quality of completion of all subsections of the form, including communications with family, relatives and the Multidisciplinary team. The hospital using paper forms showed a 40-44% rate of completion of sections relating to communication with patients and family, compared to 70% with the hospital using electronic forms. Similar trends were observed with other sections of the form. Conclusion: This study suggests that the implementation of electronic DNACPR forms significantly improves clinical practice and promotes better open communication with patients, family and the MDT.

Keywords: DNACPR, resuscitation, DNAR, patient communication

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Authors: Xuanyu Bai

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“The Communist Manifesto”, written by Karl Marx and Friedrich Engels, is one of the most significant documents throughout the whole history which covers across different fields including Economic, Politic, Sociology and Philosophy. Instead of discussing the Communist ideas presented in the Communist Manifesto, the essay focuses on exploring the reasons that contributed to the popularization of the document and its influence on political revolutions in 19^th century Europe by concentrating on the document itself along with other primary and secondary sources and temporal artwork. Combining the details from the Communist Manifesto and other documents, Marx’s writing style and word choice, his convincible notions about a new society dominated by proletariats, and the revolutionary idea of class destruction has led to the popularization of the Communist Manifesto and influenced the latter political revolutions.

Keywords: communist manifesto, Marx, Engels, capitalism

Procedia PDF Downloads 111

Authors: Abiola Falilat Ibraheem, Akinyimika Sowunmi, Valerie Otti

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Background: Introduction of innovative cancer clinical trials to Nigeria is a critical step in addressing global inequities of cancer burden. Low health and clinical trial literacy among Nigerian patients have been sighted as a significant barrier to ensuring that patients enrolled in clinical trials are truly informed. Video intervention has been shown to be the most proactive method to improving patient’s clinical trial knowledge. In the US, video interventions have been successful at improving education about cancer clinical trials among minority patients. Thus, this study aimed to apply and adapt video interventions addressing attitudinal barriers peculiar to Nigerian patients. Methods: A hospital-based representative mixed-method study was conducted at the Lagos State University Teaching Hospital (LASUTH) from July to December 2020, comprising of cancer patients aged 18 and above. Patients were randomly selected during every clinic day, of which 63 patients volunteered to participate in this study. We first administered a cancer literacy survey to determine patients’ knowledge about clinical trials. For patients who had prior knowledge, a pre-intervention test was administered, after which a 15-minute video (attitudes and intention to enroll in therapeutic clinical trials (AIET)) to improve patients’ knowledge, perception, and attitudes towards clinical trials was played, and then ended by administering a post-intervention test to the patients. For patients who had no prior knowledge, the AIET video was played for them, followed by the post-intervention test. Results: Out of 63 patients sampled, 43 (68.3%) had breast cancer. On average, patients agreed to understand their cancer diagnosis and treatment very well. 84.1% of patients had never heard about cancer clinical trials, and 85.7% did not know what cancer clinical trials were. There was a strong positive relationship (r=0.916) between the pretest and posttest, which means that the intervention improved patients’ knowledge, perception, and attitudes about cancer clinical trials. In the focus groups, patients recommended adapting the video in Nigerian settings and representing all religions in order to address trust in local clinical trialists. Conclusion: Due to the small size of patients, change in clinical trial knowledge was not statistically significant. However, there is a trend suggesting that culturally adapted video interventions can be used to improve knowledge and perception about cancer clinical trials.

Keywords: clinical trials, culturally targeted intervention, patient education, video intervention

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Authors: Ibrahim Ercan, Mustafa Arikan

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In recent years, alternative dispute resolution methods have attracted the attention of many country’s legislators. Instead of solving the disputes by litigation, putting the end to a dispute by parties themselves is more important for the preservation of social peace. Therefore, alternative dispute resolution methods (ADR) have been discussed more intensively in Turkey as well as the whole world. After these discussions, Mediation Act was adopted on 07.06.2012 and entered into force on 21.06.2013. According to the Mediation Act, it is only possible to mediate issues arising from the private law. Also, it is not compulsory to go to mediation in Turkish law, it is optional. Therefore, the parties are completely free to choose mediation method in dispute resolution. Mediators need to be a lawyer with experience in five years. Therefore, it is not possible to be a mediator who is not lawyers. Beyond five years of experience, getting education and success in exams about especially body language and psychology is also very important to be a mediator. If the parties compromise as a result of mediation, a document is issued. This document will also have the ability to exercising availability under certain circumstances. Thus, the parties will not need to apply to the court again. On the contrary, they will find the opportunity to execute this document, so they can regain their debts. However, the Mediation Act has entered into force in a period of nearly two years of history; it is possible to say that the interest in mediation is not at the expected level. Therefore, making mediation mandatory for some disputes has been discussed recently. At this point, once the mediation becomes mandatory and good results follows it, this institution will be able to find a serious interest in Turkey. Otherwise, if the results will not be satisfying, the mediation method will be removed.

Keywords: alternative dispute resolution methods, mediation act, mediation, mediator, mediation in Turkey

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Authors: Oleg A. Romanovskii, Vladimir D. Burlakov, Sergey I. Dolgii, Olga V. Kharchenko, Alexey A. Nevzorov, Alexey V. Nevzorov

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The paper presents the results of DIAL measurements of the vertical ozone distribution. The ozone lidar operate as part of the measurement complex at Siberian Lidar Station (SLS) of V.E. Zuev Institute of Atmospheric Optics SB RAS, Tomsk (56.5ºN; 85.0ºE) and designed for study of the vertical ozone distribution in the upper troposphere–lower stratosphere. Most suitable wavelengths for measurements of ozone profiles are selected. We present an algorithm for retrieval of vertical distribution of ozone with temperature and aerosol correction during DIAL lidar sounding of the atmosphere. The temperature correction of ozone absorption coefficients is introduced in the software to reduce the retrieval errors. Results of lidar measurement at wavelengths of 299 and 341 nm agree with model estimates, which point to acceptable accuracy of ozone sounding in the 6–18 km altitude range.

Keywords: lidar, ozone distribution, atmosphere, DIAL

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Authors: Ghanem Al-Ghamdi

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African Horse Sickness causes significant challenges to horse practitioners and owners in Africa and possibly in certain locations in the Arab Pensila. The aim of this work was to observe a hot spot of epidemic in Al-Baha, Southwestern of Saudi Arabia that could be AHS. A five year-old horse farm that had eight horses with no history of clinical problems was visited in late October 2014. In August 2014, horses showed clinical signs of severe pain, congestion of mucus membranes, foam oozing of the nose, recumbency, difficult breath and ultimately death. The course of the disease averaged 2 days. The farm had no previous history of this episode. Other animals including camel, sheep reside the same farm sharing feeding and water sources however no obvious similar clinical problems were noticed among the two species. Five horses showed the clinical disease and all horses were lost. Veterinary help was not available for diagnosis or treatment. A follow up visit to the farm after one year indicated that the three remaining horses were healthy but were relocated to a different facility out the Al-Baha Region. The most likely cause of such clinical problem is African Horse Sickness, however clinical exam and sampling of other horses in the region is absolute must as well as examining arthropods.

Keywords: African horse sickness, horses, Al-Baha, Saudi Arabia

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Authors: Piedad Garrido, Fernando Repulles, Andy Bloor, Julio A. Sanguesa, Jesus Gallardo, Vicente Torres, Jesus Tramullas

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With the emergence and development of Information and Communications Technologies (ICTs), Higher Education is experiencing rapid changes, not only in its teaching strategies but also in student’s learning skills. However, we have noticed that students often have difficulty when seeking innovative, useful, and interesting learning resources for their work. This is due to the lack of supervision in the selection of good query tools. This paper presents AINA, an Information Retrieval (IR) computer system aimed at providing motivating and stimulating content to both students and teachers working on different areas and at different educational levels. In particular, our proposal consists of an open virtual resource environment oriented to the vast universe of Disney comics and cartoons. Our test suite includes Disney’s long and shorts films, and we have performed some activities based on the Just In Time Teaching (JiTT) methodology. More specifically, it has been tested by groups of university and secondary school students.

Keywords: information retrieval, animation, educational resources, JiTT

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Authors: Paul Holmes, Mike N. G.

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Foundation-year doctors face increased stress, pressure and uncertainty when starting new rotations throughout their first years of work. This research questionnaire resulted in an induction cheat sheet and induction video that enhanced the Junior doctor's understanding of how to work effectively within the plastic surgery department at NHS Tayside. The objectives and goals were to improve the transition between cohorts of junior doctors in ward 26 at Ninewells Hospital. Before this quality improvement project, the induction pack was 74 pages long and over eight years old. With the support of consultant Mike Ng a new up-to-date induction was created. This involved a questionnaire and cheat sheet being developed. The questionnaire covered clerking, venipuncture, ward pharmacy, theatres, admissions, specialties on the ward, the cardiac arrest trolley, clinical emergencies, discharges and escalation. This audit has three completed cycles between August 2022 and August 2023. The cheat sheet developed a concise two-page A4 document designed for doctors to be able to reference easily and understand the essentials. The document format is a table containing ward layout; specialty; location; physician associate, shift patterns; ward rounds; handover location and time; hours coverage; senior escalation; nights; daytime duties, meetings/MDTs/board meetings, important bleeps and codes; department guidelines; boarders; referrals and patient stream; pharmacy; absences; rota coordinator; annual leave; top tips. The induction video is a 10-minute in-depth explanation of all aspects of the ward. The video explores in more depth the contents of the cheat sheet. This alternative visual format familiarizes the junior doctor with all aspects of the ward. These were provided to all foundation year 1 and 2 doctors on ward 26 at Ninewells Hospital at NHS Tayside Scotland. This work has since been adopted by the General Surgery Department, which extends to six further wards and has improved the effective handing over of the junior doctor’s role between cohorts. There is potential to further expand the cheat sheet to other departments as the concise document takes around 30 minutes to complete by a doctor who is currently on that ward. The time spent filling out the form provides vital information to the incoming junior doctors, which has a significant possibility to improve patient care.

Keywords: induction, junior doctor, handover, plastic surgery

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Authors: Valerie A. Conrade

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Introduction: A large body of literature suggests patients who complete fecal immunochemical testing (FIT) kits are likely to identify colorectal cancer sooner than those who do not complete FIT kits. Background: Patients who do not participate in preventative measures such as the FIT kit are at a higher risk of colorectal cancer growing unnoticed. The objective was to see if the method the principal investigator (PI) uses to educate clinical staff on the importance of FIT kit administration provides an increased amount of FIT kit dissemination to patients post clinical education. Methodologies: Data collection via manual tallies took place before and after the clinical staff was educated on the importance of FIT kits. Results: The results showed an increase in FIT kit dissemination post clinical staff education. Through enhanced instruction to the clinical staff regarding the importance of FIT kits, expanding their knowledge on preventative measures to detect colorectal cancer positively impacted nurses and, in turn, their patients.

Keywords: colon cancer, education, fecal immunochemical testing, nursing

Procedia PDF Downloads 114

Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Afolabi O.J, Simon-Oke I.A., Oniya M.O., Okaka C.E.

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River blindness is a skin, and an eye disease caused by Onchocerca volvulus and vectored by a female hematophagous blackfly. The study aims to evaluate the distribution of the clinical signs of river blindness and the efficacy of ivermectin in the treatment of river blindness in Idogun. Observational studies in epidemiology that involve the use of a structured questionnaire to obtain useful epidemiological information from the respondents, physical assessment via palpation from head to ankle was used to assess clinical signs from the respondents and skin snip test was used to evaluate the prevalence of the disease. The efficacy of the drug was evaluated and expressed in percentages. One hundred and ninety-two (192) out of the 384 respondents examined, showed various signs of river blindness. However, it was only 108 (28.1%) respondents with the clinical signs that demonstrated Onchocerca volvulus microfilariae in their skin snips. The clinical signs observed among the respondents include skin depigmentation such as dermatitis, leopard skin, papules, pruritus and self-inflicted injury, while ocular symptoms include cataract, ocular lesion and partial blindness. Among these clinical signs, papules, and pruritus were the most dominant in the community. The prevalence of the clinical signs was observed to vary significantly among the age groups and gender (P<0.05). The efficacy of the drug after 6 and 12 months of treatments shows that the drug is more effective at age groups 10-50 years than the age groups 51-90 years. Ivermectin is observed to be efficacious in the treatment of the disease. However, to achieve eradication of the disease, the drug may be administered at 0.15mg/kg twice a year.

Keywords: riverblindness, clinical signs, ivermectin, Idogun

Procedia PDF Downloads 131

Authors: Abeer Alhazmi

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Introduction: Clinical education is considered a significant part of the learning process for nurses and nursing students. However, recruiting high- caliber individuals to train them to be tomorrow’s educators/teachers has been a recurrent challenge. One of the troubling challenges in this field is the absent of proper training programmes to train educators to be future education professionals and leaders. Aim: To explore the impact of a stage 1 and stage 2 clinical instructor courses on developing leadership skills for nurses as educators.Theoretical Framework: Informed by a symbolic interactionist framework, this research explored the Impact of stage 1 and stage 2 clinical instructor courses on nurses' knowledge, attitudes, and leadership skills. Method: Using Glaserian grounded theory method the data were derived from 3 focus groups and 15 in-depth interviews with nurse educators/clinical instructors and nurses who attended stage 1 and stage 2 clinical instructor courses at King Abdu-Aziz University Hospital (KAUH). Findings: The findings of the research are represented in the core category exploring new identity as educator and its two constituent categories Accepting change, and constructing educator identity. The core and sub- categories were generated through a theoretical exploration of the development of educator’s identity throughout stage 1 and stage 2 clinical instructor courses. Conclusion: The social identity of the nurse educators was developed and changed during and after attending stage 1 and stage 2 clinical instructor courses. In light of an increased understanding of the development process of educators identity and role, the research presents implications and recommendations that may contribute to the development of nursing educators in general and in Saudi Arabia in specific.

Keywords: clinical instructor course, educators, identity work, clinical nursing

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Authors: Dries Dulsster

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This research we want to discuss the implications of the concept of ‘lalangue’ and illustrate its importance for lacanian psychoanalysis and its clinical practice. We will look at this concept through an in depth reading of Lacan’s later seminars, his lectures at the North-American universities and his study on James Joyce. We will illustrate the importance of this concept with a case study from a clinical practice. We will argue that the introduction of ‘lalangue’ has several theoretical and clinical implications that will radically change Lacans teachings. We will illustrate the distinction between language and lalangue. Language serves communication, but this is not the case with lalangue. We will claim that there is jouissance in language and will approach this by introducing the concept of ‘lalangue’. We will ask ourselves what the effect will be of this distinction and how we can use this in clinical practice. The concept of ‘lalangue’ will introduce a new way of thinking about the unconscious. It will force us to no longer view the unconscious as Symbolic, but as Imaginary or Real. Another implication will be the approach on the symptom, no longer approaching it as a formation of the unconscious. It will be renamed as ‘sinthome’, as function of the real. Last of all it will force us to rethink the lacanian interpretation and how we direct the treatment. The implications on a clinical level will be how we think about the lacanian interpretation and the direction of the treatment. We will no longer focus on language and meaning, but focus on jouissance and the ways in which the subject deals with this. We will illustrate this importance with a clinical case study. To summarize, the concept of lalangue forces us to radically rethink lacanian psychoanalysis, with major implications on a theoretical and clinical level. It introduces new concepts such as the real unconscious and the sinthome. It will also make us rethink the way we work as lacanian psychoanalysts.

Keywords: Lacan's later teaching, language, Lalangue, the unconscious

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Authors: Susan Ka Yee Chow

Abstract:

Effective clinical preceptorship is affecting students’ competence and fostering their growth in applying theoretical knowledge and skills in clinical settings. Any difference between the expected and actual learning experience will reduce nursing students’ interest in clinical practices and having a negative consequence with their clinical performance. This cross-sectional study is an attempt to compare the differences between preferred and actual preceptorship experience of final year nursing students, and to examine the relationship between the actual preceptorship experience and perceived clinical competence of the students in a tertiary institution. Participants of the study were final year bachelor nursing students of a self-financing tertiary institution in Hong Kong. The instruments used to measure the effectiveness of clinical preceptorship was developed by the participating institution. The scale consisted of five items in a 5-point likert scale. The questions including goals development, critical thinking, learning objectives, asking questions and providing feedback to students. The “Clinical Competence Questionnaire” by Liou & Cheng (2014) was used to examine students’ perceived clinical competences. The scale consisted of 47 items categorized into four domains, namely nursing professional behaviours; skill competence: general performance; skill competence: core nursing skills and skill competence: advanced nursing skills. There were 193 questionnaires returned with a response rate of 89%. The paired t-test was used to compare the differences between preferred and actual preceptorship experiences of students. The results showed significant differences (p<0.001) for the five questions. The mean for the preferred scores is higher than the actual scores resulting statistically significance. The maximum mean difference was accepted goal and the highest mean different was giving feedback. The Pearson Correlation Coefficient was used to examine the relationship. The results showed moderate correlations between nursing professional behaviours with asking questions and providing feedback. Providing useful feedback to students is having moderate correlations with all domains of the Clinical Competence Questionnaire (r=0.269 – 0.345). It is concluded that nursing students do not have a positive perception of the clinical preceptorship. Their perceptions are significantly different from their expected preceptorship. If students were given more opportunities to ask questions in a pedagogical atmosphere, their perceived clinical competence and learning outcomes could be improved as a result.

Keywords: clinical preceptor, clinical competence, clinical practicum, nursing students

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Authors: Phang Moon Leng

Abstract:

Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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Authors: Zohra Benfodda, Valentin Duvauchelle, Chaimae Majdi, David Bénimélis, Catherine Dunyach-Remy, Patrick Meffre

Abstract:

New antibiotics are necessary to treat microbial pathogens, especially ESKAPE pathogens that are becoming increasingly resistant to available treatment. Despite the medical need, the number of newly approved drugs continues to decline. The majority of antibiotics under clinical development are natural products or derivatives thereof. 43 juglone/naphthazarin derivatives were synthesized using Minisci-type direct C–H alkylation and evaluated for their antibacterial properties against various clinical and reference Gram-positive MSSA, clinical Gram-positive MRSA. Different compounds of the synthesized series showed promising activity against clinical and reference MSSA (MIC: 1–8 μg/ml) and good efficacy against clinical MRSA (MIC: 2–8 μg/ml) strains. The synergistic effects of active compounds were evaluated with reference antibiotics (vancomycin and cloxacillin), and it was found that the antibiotic combination with those active compounds efficiently enhanced the antimicrobial activity and consequently the MIC values of reference antibiotics were lowered up to 1/16th of the original MIC. These synthesized compounds did not present hemolytic activity on sheep red blood cells. In addition to the in silico prediction of ADME profile parameter which is promising and encouraging for further development.

Keywords: juglone, naphthazarin, antibacterial, clinical MRSA, synergistic studies, MIC determination

Procedia PDF Downloads 98