Search results for: presentation workshops
97 Opportunities and Challenges: Tracing the Evolution of India's First State-led Curriculum-based Media Literacy Intervention
Authors: Ayush Aditya
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In today's digitised world, the extent of an individual’s social involvement is largely determined by their interaction over the internet. The Internet has emerged as a primary source of information consumption and a reliable medium for receiving updates on everyday activities. Owing to this change in the information consumption pattern, the internet has also emerged as a hotbed of misinformation. Experts are of the view that media literacy has emerged as one of the most effective strategies for addressing the issue of misinformation. This paper aims to study the evolution of the Kerala government's media literacy policy, its implementation strategy, challenges and opportunities. The objective of this paper is to create a conceptual framework containing details of the implementation strategy based on the Kerala model. Extensive secondary research of literature, newspaper articles, and other online sources was carried out to locate the timeline of this policy. This was followed by semi-structured interview discussions with government officials from Kerala to trace the origin and evolution of this policy. Preliminary findings based on the collected data suggest that this policy is a case of policy by chance, as the officer who headed this policy during the state level implementation was the one who has already piloted a media literacy program in a district called Kannur as the district collector. Through this paper, an attempt is made to trace the history of the media literacy policy starting from the Kannur intervention in 2018, which was started to address the issue of vaccine hesitancy around measles rubella(MR) vaccination. If not for the vaccine hesitancy, this program would not have been rolled out in Kannur. Interviews with government officials suggest that when authorities decided to take up this initiative in 2020, a huge amount of misinformation emerging during the COVID-19 pandemic was the trigger. There was misinformation regarding government orders, healthcare facilities, vaccination, and lockdown regulations, which affected everyone, unlike the case of Kannur, where it was only a certain age group of kids. As a solution to this problem, the state government decided to create a media literacy curriculum to be taught in all government schools of the state starting from standard 8 till graduation. This was a tricky task, as a new course had to be immediately introduced in the school curriculum amid all the disruptions in the education system caused by the pandemic. It was revealed during the interview that in the case of the state-wide implementation, every step involved multiple checks and balances, unlike the earlier program where stakeholders were roped-in as and when the need emerged. On the pedagogy, while the training during the pilot could be managed through PowerPoint presentation, designing a state-wide curriculum involved multiple iterations and expert approvals. The reason for this is COVID-19 related misinformation has lost its significance. In the next phase of the research, an attempt will be made to compare other aspects of the pilot implementation with the state-wide implementation.Keywords: media literacy, digital media literacy, curriculum based media literacy intervention, misinformation
Procedia PDF Downloads 9396 Creating Moments and Memories: An Evaluation of the Starlight 'Moments' Program for Palliative Children, Adolescents and Their Families
Authors: C. Treadgold, S. Sivaraman
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The Starlight Children's Foundation (Starlight) is an Australian non-profit organisation that delivers programs, in partnership with health professionals, to support children, adolescents, and their families who are living with a serious illness. While supporting children and adolescents with life-limiting conditions has always been a feature of Starlight's work, providing a dedicated program, specifically targeting and meeting the needs of the paediatric palliative population, is a recent area of focus. Recognising the challenges in providing children’s palliative services, Starlight initiated a research and development project to better understand and meet the needs of this group. The aim was to create a program which enhances the wellbeing of children, adolescents, and their families receiving paediatric palliative care in their community through the provision of on-going, tailored, positive experiences or 'moments'. This paper will present the results of the formative evaluation of this unique program, highlighting the development processes and outcomes of the pilot. The pilot was designed using an innovation methodology, which included a number of research components. There was a strong belief that it needed to be delivered in partnership with a dedicated palliative care team, helping to ensure the best interests of the family were always represented. This resulted in Starlight collaborating with both the Victorian Paediatric Palliative Care Program (VPPCP) at the Royal Children's Hospital, Melbourne, and the Sydney Children's Hospital Network (SCHN) to pilot the 'Moments' program. As experts in 'positive disruption', with a long history of collaborating with health professionals, Starlight was well placed to deliver a program which helps children, adolescents, and their families to experience moments of joy, connection and achieve their own sense of accomplishment. Building on Starlight’s evidence-based approach and experience in creative service delivery, the program aims to use the power of 'positive disruption' to brighten the lives of this group and create important memories. The clinical and Starlight team members collaborate to ensure that the child and family are at the centre of the program. The design of each experience is specific to their needs and ensures the creation of positive memories and family connection. It aims for each moment to enhance quality of life. The partnership with the VPPCP and SCHN has allowed the program to reach families across metropolitan and regional locations. In late 2019 a formative evaluation of the pilot was conducted utilising both quantitative and qualitative methodologies to document both the delivery and outcomes of the program. Central to the evaluation was the interviews conducted with both clinical teams and families in order to gain a comprehensive understanding of the impact of and satisfaction with the program. The findings, which will be shared in this presentation, provide practical insight into the delivery of the program, the key elements for its success with families, and areas which could benefit from additional research and focus. It will use stories and case studies from the pilot to highlight the impact of the program and discuss what opportunities, challenges, and learnings emerged.Keywords: children, families, memory making, pediatric palliative care, support
Procedia PDF Downloads 9995 Systemic Family therapy in the Queensland Foster Care System: The implementation of Integrative Practice as a Purposeful Intervention Implemented with Complex ‘Family’ Systems
Authors: Rachel Jones
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Systemic Family therapy in the Queensland Foster Care System is the implementation of Integrative Practice as a purposeful intervention implemented with complex ‘family’ systems (by expanding the traditional concept of family to include all relevant stakeholders for a child) and is shown to improve the overall wellbeing of children (with developmental delays and trauma) in Queensland out of home care contexts. The importance of purposeful integrative practice in the field of systemic family therapy has been highlighted in achieving change in complex family systems. Essentially, it is the purposeful use of multiple interventions designed to meet the myriad of competing needs apparent for a child (with developmental delays resulting from early traumatic experiences - both in utero and in their early years) and their family. In the out-of-home care context, integrative practice is particularly useful to promote positive change for the child and what is an extended concept of whom constitutes their family. Traditionally, a child’s family may have included biological and foster care family members, but when this concept is extended to include all their relevant stakeholders (including biological family, foster carers, residential care workers, child safety, school representatives, Health and Allied Health staff, police and youth justice staff), the use of integrative family therapy can produce positive change for the child in their overall wellbeing, development, risk profile, social and emotional functioning, mental health symptoms and relationships across domains. By tailoring therapeutic interventions that draw on systemic family therapies from the first and second-order schools of family therapy, neurobiology, solution focussed, trauma-informed, play and art therapy, and narrative interventions, disability/behavioural interventions, clinicians can promote change by mixing therapeutic modalities with the individual and their stakeholders. This presentation will unpack the implementation of systemic family therapy using this integrative approach to formulation and treatment for a child in out-of-home care in Queensland (experiencing developmental delays resulting from trauma). It considers the need for intervention for the individual and in the context of the environment and relationships. By reviewing a case example, this study aims to highlight the simultaneous and successful use of pharmacological interventions, psychoeducational programs for carers and school staff, parenting programs, cognitive-behavioural and trauma-informed interventions, traditional disability approaches, play therapy, mapping genograms and meaning-making, and using family and dyadic sessions for the system associated with the foster child. These elements of integrative systemic family practice have seen success in the reduction of symptoms and improved overall well-being of foster children and their stakeholders. Accordingly, a model for best practice using this integrative systemic approach is presented for this population group and preliminary findings for this approach over four years of local data have been reviewed.Keywords: systemic family therapy, treating families of children with delays, trauma and attachment in families systems, improving practice and functioning of children and families
Procedia PDF Downloads 1394 The Design and Development of Online Infertility Prevention Education in the Frame of Mayer's Multimedia Learning Theory
Authors: B. Baran, S. N. Kaptanoglu, M. Ocal, Y. Kagnici, E. Esen, E. Siyez, D. M. Siyez
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Infertility is the fact that couples cannot have children despite 1 year of unprotected sexual life. Infertility can be considered as an important problem affecting not only sexual life but also social and psychological conditions of couples. Learning about information about preventable factors related to infertility during university years plays an important role in preventing a possible infertility case in older ages. The possibility to facilitate access to information with the internet has provided the opportunity to reach a broad audience in the diverse learning environments and educational environment. Moreover, the internet has become a basic resource for the 21st-century learners. Providing information about infertility over the internet will enable more people to reach in a short time. When studies conducted abroad about infertility are examined, interactive websites and online education programs come to the fore. In Turkey, while there is no comprehensive online education program for university students, it seems that existing studies are aimed to make more advertisements for doctors or hospitals. In this study, it was aimed to design and develop online infertility prevention education for university students. Mayer’s Multimedia Learning Theory made up the framework for the online learning environment in this study. The results of the needs analysis collected from the university students in Turkey who were selected with sampling to represent the audience for online learning contributed to the design phase. In this study, an infertility prevention online education environment designed as a 4-week education was developed by explaining the theoretical basis and needs analysis results. As a result; in the development of the online environment, different kind of visual aids that will increase teaching were used in the environment of online education according to Mayer’s principles of extraneous processing (coherence, signaling, spatial contiguity, temporal contiguity, redundancy, expectation principles), essential processing (segmenting, pre-training, modality principles) and generative processing (multimedia, personalization, voice principles). For example, the important points in reproductive systems’ expression were emphasized by visuals in order to draw learners’ attention, and the presentation of the information was also supported by the human voice. In addition, because of the limited knowledge of university students in the subject, the issue of female reproductive and male reproductive systems was taught before preventable factors related to infertility. Furthermore, 3D video and augmented reality application were developed in order to embody female and male reproductive systems. In conclusion, this study aims to develop an interactive Online Infertility Prevention Education in which university students can easily access reliable information and evaluate their own level of knowledge about the subject. It is believed that the study will also guide the researchers who want to develop online education in this area as it contains design-stage decisions of interactive online infertility prevention education for university students.Keywords: infertility, multimedia learning theory, online education, reproductive health
Procedia PDF Downloads 17093 The Cadence of Proximity: Indigenous Resilience as Caring for Country-in-the-City
Authors: Jo Anne Rey
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Caring for Country (Ngurrain Dharug language) is core to Aboriginal identity, Law/Lore, practice, and resilience within the continent called ‘Australia’. It is the basis of thousands of years of sustainability. However, when Ngurra is a city known as Sydney, due to 235 years of colonial impact, caring for the Country is limited, being controlled by the State and private ownership of the land title. Recent research indicates that localised Indigenous activism is most successful when community members are geographically proximate to the presences and places of connection, caring, and belonging. This article frames these findings through the cadence that proximity provides. This presentation is centred on the proximate agency that is being exercised by Dharug community through three significant sites within the Sydney basin. Those sites include, firstly, Shaw’s Creek Aboriginal Place, at the foot of the Blue Mountains in far western Sydney. Second inclusion is the site of Blacktown Native Institution, that was the part of the authoritarian colonial governance of British Governor Lachlan Macquarie (after who Macquarie University is named), which saw the beginnings of the removal of children from their families and culture to ‘civilize’ them. The third site is that of the so-called Brown’s Waterhole in the State government administered Lane Cove National Park. Each of these sites is being activated through Dharug and, more broadly, Aboriginalways of knowing, doing, and being. These ways involvethe land, water, wind, and star-based ecologies interwoven with traditional transgenerational storying of the presences (Ancestral and spiritual) creating them. Activations include, but are not limited to, the return of cultural fire for reviving plants, soils, animals, and birds. These fire practices have traditionally been at the basis of sustainable, regenerative biodiversity. These practices involve the literacy of reading Ngurra and the seasonal interactions across the ecologies. Together, they both care for the Country and support humanity, and have done so across thousands of years. However, when the cost of real-estate and rental accommodation prevents community members from being able to live on Dharug Ngurra when bureaucratic governance restricts and/or excludes traditional custodial relationships, and when private treaty land title destroys the presences and places while disconnecting people from their Ancestral practices, it becomes clear that caring for Country is only possible when the community can afford to live nearby. Recognising the cadence of proximityas the agency that underpinscaring for Country-in-the-city, sustainable change opportunities don’t have to only focus on regional and remote areas. Urban-based Aboriginal relationality offers an alternative to the unsustainable practices that underpin human-centric disconnection. Weaving Indigenous cadence offers opportunities for sustainable futures even when facing the extremes of climate changing catastrophes.Keywords: australian aboriginal, biocultural knowledges, climate change, dharug ngurra, sustainability, resilience
Procedia PDF Downloads 8992 Geotechnical Evaluation and Sizing of the Reinforcement Layer on Soft Soil in the Construction of the North Triage Road Clover, in Brasilia Federal District, Brazil
Authors: Rideci Farias, Haroldo Paranhos, Joyce Silva, Elson Almeida, Hellen Silva, Lucas Silva
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The constant growth of the fleet of vehicles in the big cities, makes that the Engineering is dynamic, with respect to the new solutions for traffic flow in general. In the Federal District (DF), Brazil, it is no different. The city of Brasilia, Capital of Brazil, and Cultural Heritage of Humanity by UNESCO, is projected to 500 thousand inhabitants, and today circulates more than 3 million people in the city, and with a fleet of more than one vehicle for every two inhabitants. The growth of the city to the North region, made that the urban planning presented solutions for the fleet in constant growth. In this context, a complex of viaducts, road accesses, creation of new rolling roads and duplication of the Bragueto bridge over Paranoa lake in the northern part of the city was designed, giving access to the BR-020 highway, denominated Clover of North Triage (TTN). In the geopedological context, the region is composed of hydromorphic soils, with the presence of the water level at some times of the year. From the geotechnical point of view, are soils with SPT < 4 and Resistance not drained, Su < 50 kPa. According to urban planning in Brasília, special art works can not rise in the urban landscape, contrasting with the urban characteristics of the architects Lúcio Costa and Oscar Niemeyer. Architects hired to design the new Capital of Brazil. The urban criterion then created the technical impasse, resulting in the technical need to ‘bury’ the works of art and in turn the access greenhouses at different levels, in regions of low support soil and water level Outcrossing, generally inducing the need for this study and design. For the adoption of the appropriate solution, Standard Penetration Test (SPT), Vane Test, Diagnostic peritoneal lavage (DPL) and auger boring campaigns were carried out. With the comparison of the results of these tests, the profiles of resistance of the soils and water levels were created in the studied sections. Geometric factors such as existing sidewalks and lack of elevation for the discharge of deep drainage water have inhibited traditional techniques for total removal of soft soils, thus avoiding the use of temporary drawdown and shoring of excavations. Thus, a structural layer was designed to reinforce the subgrade by means of the ‘needling’ of the soft soil, without the need for longitudinal drains. In this context, the article presents the geological and geotechnical studies carried out, but also the dimensioning of the reinforcement layer on the soft soil with a view to the main objective of this solution that is to allow the execution of the civil works without the interference in the roads in use, Execution of services in rainy periods, presentation of solution compatible with drainage characteristics and soft soil reinforcement.Keywords: layer, reinforcement, soft soil, clover of north triage
Procedia PDF Downloads 22691 Sustainable Agricultural and Soil Water Management Practices in Relation to Climate Change and Disaster: A Himalayan Country Experience
Authors: Krishna Raj Regmi
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A “Climate change adaptation and disaster risk management for sustainable agriculture” project was implemented in Nepal, a Himalayan country during 2008 to 2013 sponsored jointly by Food and Agriculture Organization (FAO) and United Nations Development Programme (UNDP), Nepal. The paper is based on the results and findings of this joint pilot project. The climate change events such as increased intensity of erratic rains in short spells, trend of prolonged drought, gradual rise in temperature in the higher elevations and occurrence of cold and hot waves in Terai (lower plains) has led to flash floods, massive erosion in the hills particularly in Churia range and drying of water sources. These recurring natural and climate-induced disasters are causing heavy damages through sedimentation and inundation of agricultural lands, crops, livestock, infrastructures and rural settlements in the downstream plains and thus reducing agriculture productivity and food security in the country. About 65% of the cultivated land in Nepal is rainfed with drought-prone characteristics and stabilization of agricultural production and productivity in these tracts will be possible through adoption of rainfed and drought-tolerant technologies as well as efficient soil-water management by the local communities. The adaptation and mitigation technologies and options identified by the project for soil erosion, flash floods and landslide control are on-farm watershed management, sloping land agriculture technologies (SALT), agro-forestry practices, agri-silvi-pastoral management, hedge-row contour planting, bio-engineering along slopes and river banks, plantation of multi-purpose trees and management of degraded waste land including sandy river-bed flood plains. The stress tolerant technologies with respect to drought, floods and temperature stress for efficient utilization of nutrient, soil, water and other resources for increased productivity are adoption of stress tolerant crop varieties and breeds of animals, indigenous proven technologies, mixed and inter-cropping systems, system of rice/wheat intensification (SRI), direct rice seeding, double transplanting of rice, off-season vegetable production and regular management of nurseries, orchards and animal sheds. The alternate energy use options and resource conservation practices for use by local communities are installation of bio-gas plants and clean stoves (Chulla range) for mitigation of green house gas (GHG) emissions, use of organic manures and bio-pesticides, jatropha cultivation, green manuring in rice fields and minimum/zero tillage practices for marshy lands. The efficient water management practices for increasing productivity of crops and livestock are use of micro-irrigation practices, construction of water conservation and water harvesting ponds, use of overhead water tanks and Thai jars for rain water harvesting and rehabilitation of on-farm irrigation systems. Initiation of some works on community-based early warning system, strengthening of met stations and disaster database management has made genuine efforts in providing disaster-tailored early warning, meteorological and insurance services to the local communities. Contingent planning is recommended to develop coping strategies and capacities of local communities to adopt necessary changes in the cropping patterns and practices in relation to adverse climatic and disaster risk conditions. At the end, adoption of awareness raising and capacity development activities (technical and institutional) and networking on climate-induced disaster and risks through training, visits and knowledge sharing workshops, dissemination of technical know-how and technologies, conduct of farmers' field schools, development of extension materials and their displays are being promoted. However, there is still need of strong coordination and linkage between agriculture, environment, forestry, meteorology, irrigation, climate-induced pro-active disaster preparedness and research at the ministry, department and district level for up-scaling, implementation and institutionalization of climate change and disaster risk management activities and adaptation mitigation options in agriculture for sustainable livelihoods of the communities.Keywords: climate change adaptation, disaster risk management, soil-water management practices, sustainable agriculture
Procedia PDF Downloads 51090 Moral Decision-Making in the Criminal Justice System: The Influence of Gruesome Descriptions
Authors: Michel Patiño-Sáenz, Martín Haissiner, Jorge Martínez-Cotrina, Daniel Pastor, Hernando Santamaría-García, Maria-Alejandra Tangarife, Agustin Ibáñez, Sandra Baez
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It has been shown that gruesome descriptions of harm can increase the punishment given to a transgressor. This biasing effect is mediated by negative emotions, which are elicited upon the presentation of gruesome descriptions. However, there is a lack of studies inquiring the influence of such descriptions on moral decision-making in people involved in the criminal justice system. Such populations are of special interest since they have experience dealing with gruesome evidence, but also formal education on how to assess evidence and gauge the appropriate punishment according to the law. Likewise, they are expected to be objective and rational when performing their duty, because their decisions can impact profoundly people`s lives. Considering these antecedents, the objective of this study was to explore the influence gruesome written descriptions on moral decision-making in this group of people. To that end, we recruited attorneys, judges and public prosecutors (Criminal justice group, CJ, n=30) whose field of specialty is criminal law. In addition, we included a control group of people who did not have a formal education in law (n=30), but who were paired in age and years of education with the CJ group. All participants completed an online, Spanish-adapted version of a moral decision-making task, which was previously reported in the literature and also standardized and validated in the Latin-American context. A series of text-based stories describing two characters, one inflicting harm on the other, were presented to participants. Transgressor's intentionality (accidental vs. intentional harm) and language (gruesome vs. plain) used to describe harm were manipulated employing a within-subjects and a between-subjects design, respectively. After reading each story, participants were asked to rate (a) the harmful action's moral adequacy, (b) the amount of punishment deserving the transgressor and (c) how damaging was his behavior. Results showed main effects of group, intentionality and type of language on all dependent measures. In both groups, intentional harmful actions were rated as significantly less morally adequate, were punished more severely and were deemed as more damaging. Moreover, control subjects deemed more damaging and punished more severely any type of action than the CJ group. In addition, there was an interaction between intentionality and group. People in the control group rated harmful actions as less morally adequate than the CJ group, but only when the action was accidental. Also, there was an interaction between intentionality and language on punishment ratings. Controls punished more when harm was described using gruesome language. However, that was not the case of people in the CJ group, who assigned the same amount of punishment in both conditions. In conclusion, participants with job experience in the criminal justice system or criminal law differ in the way they make moral decisions. Particularly, it seems that they are less sensitive to the biasing effect of gruesome evidence, which is probably explained by their formal education or their experience in dealing with such evidence. Nonetheless, more studies are needed to determine the impact this phenomenon has on the fulfillment of their duty.Keywords: criminal justice system, emotions, gruesome descriptions, intentionality, moral decision-making
Procedia PDF Downloads 18889 Designing Short-Term Study Abroad Programs for Graduate Students: The Case of Morocco
Authors: Elaine Crable, Amit Sen
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Short-term study abroad programs have become a mainstay of MBA programs. The benefits of international business experiences, along with its exposure to global cultures, are well documented. However, developing a rewarding study, abroad program at the graduate level can be challenging for Faculty, especially when devising such a program for a group of part-time MBA students who come with a wide range of experiences and demographic characteristics. Each student has individual expectations for the study abroad experience. This study provides suggestions and considerations for Faculty that are planning to design a short-term study abroad program, especially for part-time MBA students. Insights are based on a recent experience leading a group of twenty-one students on a ten-day program to Morocco. The trip was designed and facilitated by two faculty members and a local Moroccan facilitator. This experience led to a number of insights and recommendations. First, the choice of location is critical. The choice of Morocco was very deliberate, owing to its multi-faceted cultural landscape and international business interest. It is an Islamic State with close ties to Europe both culturally and geographically and Morocco is a multi-lingual country with some combination of three languages spoken by most – English, Arabic, and French. Second, collaboration with a local ‘academic’ partner allowed the level of instruction to be both rigorous and significantly more engaging. Third, allowing students to participate in the planning of the trip enabled the trip participants to collaborate, negotiate, and share their own experiences and strengths. The pre-trip engagement was structured by creating four sub-groups, each responsible for an assigned city. Each student sub-group had to provide a historical background of the assigned city, plan the itinerary including sites to visit, cuisine to experience, industries to explore, markets to visit, plus provide a budget for that city’s expenses. The pre-planning segment of the course was critical for the success of the program as students were able to contribute to the design of the program through collaboration and negotiation with their peers. Fourth, each student sub-group was assigned industry to study within Morocco. The student sub-group prepared a presentation and a group paper with their analysis of the chosen industries. The pre-planning activities created strong bonds among the trip participants, which was evident when faced with on-ground challenges, especially when it was necessary to quickly evacuate due to a surprise USA COVID evacuation notice. The entire group supported each other when quickly making their way back to the United States. Unfortunately, the trip was cut short by two days due to this emergency exit, but the feedback regarding the program was very positive all around. While the program design put pressure on the Faculty leads regarding planning and coordination upfront, the outcome in terms of student engagement, student learning, collaboration and negotiation were all favorable and worth the effort. Finally, an added value, the cost of the program for the student was significantly lower compared to running a program with a professional provider.Keywords: business education, experiential learning, international education, study abroad
Procedia PDF Downloads 16888 Management of Femoral Neck Stress Fractures at a Specialist Centre and Predictive Factors to Return to Activity Time: An Audit
Authors: Charlotte K. Lee, Henrique R. N. Aguiar, Ralph Smith, James Baldock, Sam Botchey
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Background: Femoral neck stress fractures (FNSF) are uncommon, making up 1 to 7.2% of stress fractures in healthy subjects. FNSFs are prevalent in young women, military recruits, endurance athletes, and individuals with energy deficiency syndrome or female athlete triad. Presentation is often non-specific and is often misdiagnosed following the initial examination. There is limited research addressing the return–to–activity time after FNSF. Previous studies have demonstrated prognostic time predictions based on various imaging techniques. Here, (1) OxSport clinic FNSF practice standards are retrospectively reviewed, (2) FNSF cohort demographics are examined, (3) Regression models were used to predict return–to–activity prognosis and consequently determine bone stress risk factors. Methods: Patients with a diagnosis of FNSF attending Oxsport clinic between 01/06/2020 and 01/01/2020 were selected from the Rheumatology Assessment Database Innovation in Oxford (RhADiOn) and OxSport Stress Fracture Database (n = 14). (1) Clinical practice was audited against five criteria based on local and National Institute for Health Care Excellence guidance, with a 100% standard. (2) Demographics of the FNSF cohort were examined with Student’s T-Test. (3) Lastly, linear regression and Random Forest regression models were used on this patient cohort to predict return–to–activity time. Consequently, an analysis of feature importance was conducted after fitting each model. Results: OxSport clinical practice met standard (100%) in 3/5 criteria. The criteria not met were patient waiting times and documentation of all bone stress risk factors. Importantly, analysis of patient demographics showed that of the population with complete bone stress risk factor assessments, 53% were positive for modifiable bone stress risk factors. Lastly, linear regression analysis was utilized to identify demographic factors that predicted return–to–activity time [R2 = 79.172%; average error 0.226]. This analysis identified four key variables that predicted return-to-activity time: vitamin D level, total hip DEXA T value, femoral neck DEXA T value, and history of an eating disorder/disordered eating. Furthermore, random forest regression models were employed for this task [R2 = 97.805%; average error 0.024]. Analysis of the importance of each feature again identified a set of 4 variables, 3 of which matched with the linear regression analysis (vitamin D level, total hip DEXA T value, and femoral neck DEXA T value) and the fourth: age. Conclusion: OxSport clinical practice could be improved by more comprehensively evaluating bone stress risk factors. The importance of this evaluation is demonstrated by the population found positive for these risk factors. Using this cohort, potential bone stress risk factors that significantly impacted return-to-activity prognosis were predicted using regression models.Keywords: eating disorder, bone stress risk factor, femoral neck stress fracture, vitamin D
Procedia PDF Downloads 18387 A Designing 3D Model: Castle of the Mall-Dern
Authors: Nanadcha Sinjindawong
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This article discusses the design process of a community mall called Castle of The Mall-dern. The concept behind this mall is to combine elements of a medieval castle with modern architecture. The author aims to create a building that fits into the surroundings while also providing users with the vibes of the ancient era. The total area used for the mall is 4,000 square meters, with three floors. The first floor is 1,500 square meters, the second floor is 1,750 square meters, and the third floor is 750 square meters. Research Aim: The aim of this research is to design a community mall that sells ancient clothes and accessories, and to combine sustainable architectural design with the ideas of ancient architecture in an urban area with convenient transportation. Methodology: The research utilizes qualitative research methods in architectural design. The process begins with calculating the given area and dividing it into different zones. The author then sketches and draws the plan of each floor, adding the necessary rooms based on the floor areas mentioned earlier. The program "SketchUp" is used to create an online 3D model of the community mall, and a physical model is built for presentation purposes on A1 paper, explaining all the details. Findings: The result of this research is a community mall with various amenities. The first floor includes retail shops, clothing stores, a food center, and a service zone. Additionally, there is an indoor garden with a fountain and a tree for relaxation. The second and third floors feature a void in the middle, with a few stores, cafes, restaurants, and studios on the second floor. The third floor is home to the administration and security control room, as well as a community gathering area designed as a public library with a café inside. Theoretical Importance: This research contributes to the field of sustainable architectural design by combining ancient architectural ideas with modern elements. It showcases the potential for creating buildings that blend historical aesthetics with contemporary functionality. Data Collection and Analysis Procedures: The data for this research is collected through a combination of area calculation, sketching, and building a 3D model. The analysis involves evaluating the design based on the allocated area, zoning, and functional requirements for a community mall. Question Addressed: The research addresses the question of how to design a community mall with a theme of ancient Medieval and Victorian eras. It explores how to combine sustainable architectural design principles with historical aesthetics to create a functional and visually appealing space. Conclusion: In conclusion, this research successfully designs a community mall called “Castle of The Mall-dern” that incorporates elements of Medieval and Victorian architecture. The building encompasses various zones, including retail shops, restaurants, community gathering areas, and service zones. It also features an interior garden and a public library within the mall. The research contributes to the field of sustainable architectural design by showcasing the potential for combining ancient architectural ideas with modern elements in an urban setting.Keywords: 3D model, community mall, modern architecture, medieval architecture
Procedia PDF Downloads 10786 Developing Telehealth-Focused Advanced Practice Nurse Educational Partnerships
Authors: Shelley Y. Hawkins
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Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth
Procedia PDF Downloads 24285 Reducing Diagnostic Error in Australian Emergency Departments Using a Behavioural Approach
Authors: Breanna Wright, Peter Bragge
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Diagnostic error rates in healthcare are approximately 10% of cases. Diagnostic errors can cause patient harm due to inappropriate, inadequate or delayed treatment, and such errors contribute heavily to medical liability claims globally. Therefore, addressing diagnostic error is a high priority. In most cases, diagnostic errors are the result of faulty information synthesis rather than lack of knowledge. Specifically, the majority of diagnostic errors involve cognitive factors, and in particular, cognitive biases. Emergency Departments are an environment with heightened risk of diagnostic error due to time and resource pressures, a frequently chaotic environment, and patients arriving undifferentiated and with minimal context. This project aimed to develop a behavioural, evidence-informed intervention to reduce diagnostic error in Emergency Departments through co-design with emergency physicians, insurers, researchers, hospital managers, citizens and consumer representatives. The Forum Process was utilised to address this aim. This involves convening a small (4 – 6 member) expert panel to guide a focused literature and practice review; convening of a 10 – 12 person citizens panel to gather perspectives of laypeople, including those affected by misdiagnoses; and a 18 – 22 person structured stakeholder dialogue bringing together representatives of the aforementioned stakeholder groups. The process not only provides in-depth analysis of the problem and associated behaviours, but brings together expertise and insight to facilitate identification of a behaviour change intervention. Informed by the literature and practice review, the Citizens Panel focused on eliciting the values and concerns of those affected or potentially affected by diagnostic error. Citizens were comfortable with diagnostic uncertainty if doctors were honest with them. They also emphasised the importance of open communication between doctors and patients and their families. Citizens expect more consistent standards across the state and better access for both patients and their doctors to patient health information to avoid time-consuming re-taking of long patient histories and medication regimes when re-presenting at Emergency Departments and to reduce the risk of unintentional omissions. The structured Stakeholder Dialogue focused on identifying a feasible behavioural intervention to review diagnoses in Emergency Departments. This needed to consider the role of cognitive bias in medical decision-making; contextual factors (in Victoria, there is a legislated 4-hour maximum time between ED triage and discharge / hospital admission); resource availability; and the need to ensure the intervention could work in large metropolitan as well as small rural and regional ED settings across Victoria. The identified behavioural intervention will be piloted in approximately ten hospital EDs across Victoria, Australia. This presentation will detail the findings of all review and consultation activities, describe the behavioural intervention developed and present results of the pilot trial.Keywords: behavioural intervention, cognitive bias, decision-making, diagnostic error
Procedia PDF Downloads 12984 The Relevance of (Re)Designing Professional Paths with Unemployed Working-Age Adults
Authors: Ana Rodrigues, Maria Cadilhe, Filipa Ferreira, Claudia Pereira, Marta Santos
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Professional paths must be understood in the multiplicity of their possible configurations. While some actors tend to represent their path as a harmonious succession of positions in the life cycle, most recognize the existence of unforeseen and uncontrollable bifurcations, caused, for example, by a work accident or by going through a period of unemployment. Considering the intensified challenges posed by the ongoing societal changes (e.g., technological and demographic), and looking at the Portuguese context, where the unemployment rate continues to be more evident in certain age groups, like in individuals aged 45 years or over, it is essential to support those adults by providing strategies capable of supporting them during professional transitions, being this a joint responsibility of governments, employers, workers, educational institutions, among others. Concerned about those issues, Porto City Council launched the challenge of designing and implementing a Lifelong Career Guidance program, which was answered with the presentation of a customized conceptual and operational model: groWing|Lifelong Career Guidance. A pilot project targeting working-age adults (35 or older) who were unemployed was carried out, aiming to support them to reconstruct their professional paths, through the recovery of their past experiences and through a reflection about dimensions such as skills, interests, constraints, and labor market. A research action approach was used to assess the proposed model, namely the perceived relevance of the theme and of the project, by adults themselves (N=44), employment professionals (N=15) and local companies (N=15), in an integrated manner. A set of activities were carried out: a train the trainer course and a monitoring session with employment professionals; collective and individual sessions with adults, including a monitoring session as well; and a workshop with local companies. Support materials for individual/collective reflection about professional paths were created and adjusted for each involved agent. An evaluation model was co-build by different stakeholders. Assessment was carried through a form created for the purpose, completed at the end of the different activities, which allowed us to collect quantitative and qualitative data. Statistical analysis was carried through SPSS software. Results showed that the participants, as well as the employment professionals and the companies involved, considered both the topic and the project as extremely relevant. Also, adults saw the project as an opportunity to reflect on their paths and become aware of the opportunities and the necessary conditions to achieve their goals; the professionals highlighted the support given by an integrated methodology and the existence of tools to assist the process; companies valued the opportunity to think about the topic and the possible initiatives they could implement within the company to diversify their recruitment pool. The results allow us to conclude that, in the local context under study, there is an alignment between different agents regarding the pertinence of supporting adults with work experience in professional transitions, seeing the project as a relevant strategy to address this issue, which justifies that it can be extended in time and to other working-age adults in the future.Keywords: professional paths, research action, turning points, lifelong career guidance, relevance
Procedia PDF Downloads 8783 Endometrial Biopsy Curettage vs Endometrial Aspiration: Better Modality in Female Genital Tuberculosis
Authors: Rupali Bhatia, Deepthi Nair, Geetika Khanna, Seema Singhal
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Introduction: Genital tract tuberculosis is a chronic disease (caused by reactivation of organisms from systemic distribution of Mycobacterium tuberculosis) that often presents with low grade symptoms and non-specific complaints. Patients with genital tuberculosis are usually young women seeking workup and treatment for infertility. Infertility is the commonest presentation due to involvement of the fallopian tubes, endometrium and ovarian damage with poor ovarian volume and reserve. The diagnosis of genital tuberculosis is difficult because of the fact that it is a silent invader of genital tract. Since tissue cannot be obtained from fallopian tubes, the diagnosis is made by isolation of bacilli from endometrial tissue obtained by endometrial biopsy curettage and/or aspiration. Problems are associated with sampling technique as well as diagnostic modality due to lack of adequate sample volumes and the segregation of the sample for various diagnostic tests resulting in non-uniform distribution of microorganisms. Moreover, lack of an efficient sampling technique universally applicable for all specific diagnostic tests contributes to the diagnostic challenges. Endometrial sampling plays a key role in accurate diagnosis of female genital tuberculosis. It may be done by 2 methods viz. endometrial curettage and endometrial aspiration. Both endometrial curettage and aspirate have their own limitations as curettage picks up strip of the endometrium from one of the walls of the uterine cavity including tubal osteal areas whereas aspirate obtains total tissue with exfoliated cells present in the secretory fluid of the endometrial cavity. Further, sparse and uneven distribution of the bacilli remains a major factor contributing to the limitations of the techniques. The sample that is obtained by either technique is subjected to histopathological examination, AFB staining, culture and PCR. Aim: Comparison of the sampling techniques viz. endometrial biopsy curettage and endometrial aspiration using different laboratory methods of histopathology, cytology, microbiology and molecular biology. Method: In a hospital based observational study, 75 Indian females suspected of genital tuberculosis were selected on the basis of inclusion criteria. The women underwent endometrial tissue sampling using Novaks biopsy curette and Karmans cannula. One part of the specimen obtained was sent in formalin solution for histopathological testing and another part was sent in normal saline for acid fast bacilli smear, culture and polymerase chain reaction. The results so obtained were correlated using coefficient of correlation and chi square test. Result: Concordance of results showed moderate agreement between both the sampling techniques. Among HPE, AFB and PCR, maximum sensitivity was observed for PCR, though the specificity was not as high as other techniques. Conclusion: Statistically no significant difference was observed between the results obtained by the two sampling techniques. Therefore, one may use either EA or EB to obtain endometrial samples and avoid multiple sampling as both the techniques are equally efficient in diagnosing genital tuberculosis by HPE, AFB, culture or PCR.Keywords: acid fast bacilli (AFB), histopatholgy examination (HPE), polymerase chain reaction (PCR), endometrial biopsy curettage
Procedia PDF Downloads 32682 Tracing Graduates of Vocational Schools with Transnational Mobility Experience: Conclusions and Recommendations from Poland
Authors: Michal Pachocki
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This study investigates the effects of mobility in the context of a different environment and work culture through analysing the learners perception of their international work experience. Since this kind of professional training abroad is becoming more popular in Europe, mainly due to the EU funding opportunities, it is of paramount importance to assess its long-term impact on educational and career paths of former students. Moreover, the tracer study aimed at defining what professional, social and intercultural competencies were gained or developed by the interns and to which extent those competences proved to be useful meeting the labor market requirements. Being a populous EU member state which actively modernizes its vocational education system (also with European funds), Poland can serve as an illustrative case study to investigate the above described research problems. However, the examined processes are most certainly universal, wherever mobility is included in the learning process. The target group of this research was the former mobility participants and the study was conducted using quantitative and qualitative methods, such as the online survey with over 2 600 questionnaires completed by the former mobility participants; -individual in-depth interviews (IDIs) with 20 Polish graduates already present in the labour market; - 5 focus group interviews (FGIs) with 60 current students of the Polish vocational schools, who have recently returned from the training abroad. As the adopted methodology included a data triangulation, the collected findings have also been supplemented with data obtained by the desk research (mainly contextual information and statistical summary of mobility implementation). The results of this research – to be presented in full scope within the conference presentation – include the participants’ perception of their work mobility. The vast majority of graduates agrees that such an experience has had a significant impact on their professional careers and claims that they would recommend training abroad to persons who are about to enter the labor market. Moreover, in their view, such form of practical training going beyond formal education provided them with an opportunity to try their hand in the world of work. This allowed them – as they accounted for them – to get acquainted with a work system and context different from the ones experienced in Poland. Although the work mobility becomes an important element of the learning process in the growing number of Polish schools, this study reveals that many sending institutions suffer from a lack of the coherent strategy for planning domestic and foreign training programmes. Nevertheless, the significant number of graduates claims that such a synergy improves the quality of provided training. Despite that, the research proved that the transnational mobilities exert an impact on their future careers and personal development. However, such impact is, in their opinion, dependant on other factors, such as length of the training period, the nature and extent of work, recruitment criteria and the quality of organizational arrangement and mentoring provided to learners. This may indicate the salience of the sending and receiving institutions organizational capacity to deal with mobility.Keywords: learning mobility, transnational training, vocational education and training graduates, tracer study
Procedia PDF Downloads 9681 Exploring a Cross-Sectional Analysis Defining Social Work Leadership Competencies in Social Work Education and Practice
Authors: Trevor Stephen, Joshua D. Aceves, David Guyer, Jona Jacobson
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As a profession, social work has much to offer individuals, groups, and organizations. A multidisciplinary approach to understanding and solving complex challenges and a commitment to developing and training ethical practitioners outlines characteristics of a profession embedded with leadership skills. This presentation will take an overview of the historical context of social work leadership, examine social work as a unique leadership model composed of its qualities and theories that inform effective leadership capability as it relates to our code of ethics. Reflect critically on leadership theories and their foundational comparison. Finally, a look at recommendations and implementation to social work education and practice. Similar to defining leadership, there is no universally accepted definition of social work leadership. However, some distinct traits and characteristics are essential. Recent studies help set the stage for this research proposal because they measure views on effective social work leadership among social work and non-social leaders and followers. However, this research is interested in working backward from that approach and examining social workers' leadership preparedness perspectives based solely on social work training, competencies, values, and ethics. Social workers understand how to change complex structures and challenge resistance to change to improve the well-being of organizations and those they serve. Furthermore, previous studies align with the idea of practitioners assessing their skill and capacity to engage in leadership but not to lead. In addition, this research is significant because it explores aspiring social work leaders' competence to translate social work practice into direct leadership skills. The research question seeks to answer whether social work training and competencies are sufficient to determine whether social workers believe they possess the capacity and skill to engage in leadership practice. Aim 1: Assess whether social workers have the capacity and skills to assume leadership roles. Aim 2: Evaluate how the development of social workers is sufficient in defining leadership. This research intends to reframe the misconception that social workers do not possess the capacity and skills to be effective leaders. On the contrary, social work encompasses a framework dedicated to lifelong development and growth. Social workers must be skilled, competent, ethical, supportive, and empathic. These are all qualities and traits of effective leadership, whereas leaders are in relation with others and embody partnership and collaboration with followers and stakeholders. The proposed study is a cross-sectional quasi-experimental survey design that will include the distribution of a multi-level social work leadership model and assessment tool. The assessment tool aims to help define leadership in social work using a Likert scale model. A cross-sectional research design is appropriate for answering the research questions because the measurement survey will help gather data using a structured tool. Other than the proposed social work leadership measurement tool, there is no other mechanism based on social work theory and designed to measure the capacity and skill of social work leadership.Keywords: leadership competencies, leadership education, multi-level social work leadership model, social work core values, social work leadership, social work leadership education, social work leadership measurement tool
Procedia PDF Downloads 17280 Increasing Adherence to Preventative Care Bundles for Healthcare-Associated Infections: The Impact of Nurse Education
Authors: Lauren G. Coggins
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Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.Keywords: education, healthcare-associated infections, infection, nursing, prevention
Procedia PDF Downloads 11679 Cross-cultural Training in International Cooperation Efforts
Authors: Shawn Baker-Garcia, Janna O. Schaeffer
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As the global and national communities and governments strive to address ongoing and evolving threats to humanity and pervasive or emerging “shared” global priorities on environmental, economic, political, and security, it is more urgent than ever before to understand each other, communicate effectively with one another, identify models of cooperation that yield improved, mutually reinforcing outcomes across and within cultures. It is within the backdrop of this reality that the presentation examines whether cultural training as we have approached it in recent decades is sufficiently meeting our current needs and what changes may be applied to foster better and more productive and sustainable intercultural interactions. Domestic and global relations face multiple challenges to peaceable cooperation. The last two years, in particular, have been defined by a travel-restricted COVID-19 pandemic yielding increased intercultural interactions over virtual platforms, polarized politics dividing nations and regions, and the commensurate rise in weaponized social and traditional media communication. These societal and cultural fissures are noticeably challenging our collective and individual abilities to constructively interact both at home and abroad. It is within this pressure cooker environment that the authors believe it is time to reexamine existing and broadly accepted inter- and cross- cultural training approaches and concepts to determine their level of effectiveness in setting conditions for optimal human understanding and relationships both in the national and international context. In order to better understand the amount and the type of intercultural training practitioners professionally engaging in international partnership building have received throughout their careers and its perceived effectiveness, a survey was designed and distributed to US and international professionals presently engaged in the fields of diplomacy, military, academia, and international business. The survey questions were deigned to address the two primary research questions investigators posed in this exploratory study. Research questions aimed to examine practitioners’ view of the role and effectiveness of current and traditional cultural training and education as a means to fostering improved communication, interactions, understanding, and cooperation among inter, cross, or multi-cultural communities or efforts.Responses were then collected and analyzed for themes present in the participants’ reflections. In their responses, the practitioners identified the areas of improvement and desired outcomes in regards to intercultural training and awareness raising curricular approaches. They also raised issues directly and indirectly pertaining to the role of foreign language proficiency in intercultural interactions and a need for a solid grasp on cultural and regional issues (regional expertise) to facilitate such an interaction. Respondents indicated knowledge, skills, abilities, and capabilities that the participants were not trained on but learned through ad hoc personal and professional intercultural interactions, which they found most valuable and wished they had acquired prior to the intercultural experience.Keywords: cultural training, improved communication, intercultural competence, international cooperation
Procedia PDF Downloads 13278 Transgressing Boundaries for Encouraging Critical Thinking: Reflections on the Integration of Active Pedagogy and Transnational Exchange into Social Work Education
Authors: Rosemary R. Carlton, Roxane Caron
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Almost three decades ago, bell hooks (1994) identified the classroom as “the most radical space of possibility in the academy”. A feminist scholar, educator, and activist, hooks urged educators to transgress the boundaries of what might be customary or considered acceptable in teaching, thus encouraging the pursuit of new ways of knowing and different strategies for sharing knowledge. This paper reflects upon a particular response to hooks’ still relevant call for transgression in teaching. Specifically, this paper reports on the design, implementation, and preliminary analysis of a social work course integrating active pedagogy and transnational exchange to encourage students’ critical thinking and autonomous learning in their development as social workers in a global context. The bachelor’s level course, Pratiques spécifiques: Projet international, was developed collaboratively across three francophone institutions of higher learning in Belgium, Canada, and France: the Haute École de Namur-Liège-Luxembourg (Hénallux); the Université de Montréal; and, the Institut d’enseignement supérieur et professionnel, l’IRTS Paris Île-de-France. The driving aims of the course are to promote autonomous learning and critical thinking through a lens of transnational understandings of social problems -competencies indispensable to students’ development as social workers. The course is offered to two paired cohorts, one addressing the subject of “migrations” (Canada/France) and the other the subject of “sexual exploitation” (Canada/Belgium). Through the adaptation of a critical pedagogy of problem-based learning, students are called upon to actively engage in acquiring and applying knowledge to respond to “real life” social issues relating to migration or sexual exploitation. At the conclusion of the course, each cohort of students is brought together for a week-long intensive period of transnational exchange either at the Université de Montréal in Canada or at Hénallux in Belgium. Extending the bounds of the classroom across international borders allows students novel opportunities to deepen and expand their understandings of issues relating to predefined social issues and to critically examine associated social work practices. The paper opens with a presentation of the social work course. Specifically, the authors will outline their adaptation of a pedagogy of problem-based learning integrating transnational exchange in the design and implementation of the course. Returning to hooks’ notion of transgression in teaching, the paper offers a preliminary analysis of how and with what effect the course provides opportunities to transgress hierarchical student-teacher relationships; transgress conventional modes of learning to explore diverse sources of knowledge and transgress the walls of the university to engage with and learn from local and global partners. The paper concludes with a consideration of the potential influence of such transgressions in teaching for students’ development of critical thinking in their practice of social work in global context.Keywords: active learning, critical pedagogy, social work intervention, transnational learning
Procedia PDF Downloads 16577 The Evaluation of Child Maltreatment Severity and the Decision-Making Processes in the Child Protection System
Authors: Maria M. Calheiros, Carla Silva, Eunice Magalhães
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Professionals working in child protection services (CPS) need to have common and clear criteria to identify cases of maltreatment and to differentiate levels of severity in order to determine when CPS intervention is required, its nature and urgency, and, in most countries, the service that will be in charge of the case (community or specialized CPS). Actually, decision-making process is complex in CPS, and, for that reason, such criteria are particularly important for who significantly contribute to that decision-making in child maltreatment cases. The main objective of this presentation is to describe the Maltreatment Severity Assessment Questionnaire (MSQ), specifically designed to be used by professionals in the CPS, which adopts a multidimensional approach and uses a scale of severity within subtypes. Specifically, we aim to provide evidence of validity and reliability of this tool, in order to improve the quality and validity of assessment processes and, consequently, the decision making in CPS. The total sample was composed of 1000 children and/or adolescents (51.1% boys), aged between 0 and 18 years old (M = 9.47; DP = 4.51). All the participants were referred to official institutions of the children and youth protective system. Children and adolescents maltreatment (abuse, neglect experiences and sexual abuse) were assessed with 21 items of the Maltreatment Severity Questionnaire (MSQ), by professionals of CPS. Each item (sub-type) was composed of four descriptors of increasing severity. Professionals rated the level of severity, using a 4-point scale (1= minimally severe; 2= moderately severe; 3= highly severe; 4= extremely severe). The construct validity of the Maltreatment Severity Questionnaire was assessed with a holdout method, performing an Exploratory Factor Analysis (EFA) followed by a Confirmatory Factor Analysis (CFA). The final solution comprised 18 items organized in three factors 47.3% of variance explained. ‘Physical neglect’ (eight items) was defined by parental omissions concerning the insurance and monitoring of the child’s physical well-being and health, namely in terms of clothing, hygiene, housing conditions and contextual environmental security. ‘Physical and Psychological Abuse’ (four items) described abusive physical and psychological actions, namely, coercive/punitive disciplinary methods, physically violent methods or verbal interactions that offend and denigrate the child, with the potential to disrupt psychological attributes (e.g., self-esteem). ‘Psychological neglect’ (six items) involved omissions related to children emotional development, mental health monitoring, school attendance, development needs, as well as inappropriate relationship patterns with attachment figures. Results indicated a good reliability of all the factors. The assessment of child maltreatment cases with MSQ could have a set of practical and research implications: a) It is a valid and reliable multidimensional instrument to measure child maltreatment, b) It is an instrument integrating the co-occurrence of various types of maltreatment and a within-subtypes scale of severity; c) Specifically designed for professionals, it may assist them in decision-making processes; d) More than using case file reports to evaluate maltreatment experiences, researchers could guide more appropriately their research about determinants and consequences of maltreatment.Keywords: assessment, maltreatment, children and youth, decision-making
Procedia PDF Downloads 29076 When Ideological Intervention Backfires: The Case of the Iranian Clerical System’s Intervention in the Pandemic-Era Elementary Education
Authors: Hasti Ebrahimi
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This study sheds light on the challenges and difficulties caused by the Iranian clerical system’s intervention in the country’s school education during the COVID-19 pandemic, when schools remained closed for almost two years. The pandemic brought Iranian elementary school education to a standstill for almost 6 months before the country developed a nationwide learning platform – a customized television network. While the initiative seemed to have been welcomed by the majority of Iranian parents, it resented some of the more traditional strata of the society, including the influential Friday Prayer Leaders who found the televised version of the elementary education ‘less spiritual’ and ‘more ‘material’ or science-based. That prompted the Iranian Channel of Education, the specialized television network that had been chosen to serve as a nationally televised school during the pandemic, to try to redefine much of its online elementary school educational content within the religious ideology of the Islamic Republic of Iran. As a result, young clergies appeared on the television screen as preachers of Islamic morality, religious themes and even sociology, history, and arts. The present research delves into the consequences of such an intervention, how it might have impacted the infrastructure of Iranian elementary education and whether or not the new ideology-infused curricula would withstand the opposition of students and mainstream teachers. The main methodology used in this study is Critical Discourse Analysis with a cognitive approach. It systematically finds and analyzes the alternative ideological structures of discourse in the Iranian Channel of Education from September 2021 to July 2022, when the clergy ‘teachers’ replaced ‘regular’ history and arts teachers on the television screen for the first time. It has aimed to assess how the various uses of the alternative ideological discourse in elementary school content have influenced the processes of learning: the acquisition of knowledge, beliefs, opinions, attitudes, abilities, and other cognitive and emotional changes, which are the goals of institutional education. This study has been an effort aimed at understanding and perhaps clarifying the relationships between the traditional textual structures and processing on the one hand and socio-cultural contexts created by the clergy teachers on the other. This analysis shows how the clerical portion of elementary education on the Channel of Education that seemed to have dominated the entire televised teaching and learning process faded away as the pandemic was contained and mainstream classes were restored. It nevertheless reflects the deep ideological rifts between the clerical approach to school education and the mainstream teaching process in Iranian schools. The semantic macrostructures of social content in the current Iranian elementary school education, this study suggests, have remained intact despite the temporary ideological intervention of the ruling clerical elite in their formulation and presentation. Finally, using thematic and schematic frameworks, the essay suggests that the ‘clerical’ social content taught on the Channel of Education during the pandemic cannot have been accepted cognitively by the channel’s target audience, including students and mainstream teachers.Keywords: televised elementary school learning, Covid 19, critical discourse analysis, Iranian clerical ideology
Procedia PDF Downloads 5475 Evaluation of Biological and Confinement Properties of a Bone Substitute to in Situ Preparation Based on Demineralized Bone Matrix for Bone Tissue Regeneration
Authors: Aura Maria Lopera Echavarria, Angela Maria Lema Perez, Daniela Medrano David, Pedronel Araque Marin, Marta Elena Londoño Lopez
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Bone regeneration is the process by which the formation of new bone is stimulated. Bone fractures can originate at any time due to trauma, infections, tumors, congenital malformations or skeletal diseases. Currently there are different strategies to treat bone defects that in some cases, regeneration does not occur on its own. That is why they are treated with bone substitutes, which provide a necessary environment for the cells to synthesize new bone. The Demineralized Bone Matrix (DBM) is widely used as a bone implant due to its good properties, such as osteoinduction and bioactivity. However, the use of DBM is limited, because its presentation is powder, which is difficult to implant with precision and is susceptible to migrating to other sites through blood flow. That is why the DBM is commonly incorporated into a variety of vehicles or carriers. The objective of this project is to evaluate the bioactive and confinement properties of a bone substitute based on demineralized bone matrix (DBM). Also, structural and morphological properties were evaluated. Bone substitute was obtained from EIA Biomaterials Laboratory of EIA University and the DBM was facilitated by Tissue Bank Foundation. Morphological and structural properties were evaluated by scanning electron microscopy (SEM), X-ray diffraction (DRX) and Fourier transform infrared spectroscopy with total attenuated reflection (FTIR-ATR). Water absorption capacity and degradation were also evaluated during three months. The cytotoxicity was evaluated by the MTT test. The bioactivity of the bone substitute was evaluated through immersion of the samples in simulated body fluid during four weeks. Confinement tests were performed on tibial fragments of a human donor with bone defects of determined size, to ensure that the substitute remains in the defect despite the continuous flow of fluid. According of the knowledge of the authors, the methodology for evaluating samples in a confined environment has not been evaluated before in real human bones. The morphology of the samples showed irregular surface and presented some porosity. DRX confirmed a semi-crystalline structure. The FTIR-ATR determined the organic and inorganic phase of the sample. The degradation and absorption measurements stablished a loss of 3% and 150% in one month respectively. The MTT showed that the system is not cytotoxic. Apatite clusters formed from the first week were visualized by SEM and confirmed by EDS. These calcium phosphates are necessary to stimulate bone regeneration and thanks to the porosity of the developed material, osteinduction and osteoconduction are possible. The results of the in vitro evaluation of the confinement of the material showed that the migration of the bone filling to other sites is negligible, although the samples were subjected to the passage of simulated body fluid. The bone substitute, putty type, showed stability, is bioactive, non-cytotoxic and has handling properties for specialists at the time of implantation. The obtained system allows to maintain the osteoinductive properties of DBM and it can fill completely fractures in any way; however, it does not provide a structural support, that is, it should only be used to treat fractures without requiring a mechanical load.Keywords: bone regeneration, cytotoxicity, demineralized bone matrix, hydrogel
Procedia PDF Downloads 12174 Evaluation: Developing An Appropriate Survey Instrument For E-Learning
Authors: Brenda Ravenscroft, Ulemu Luhanga, Bev King
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A comprehensive evaluation of online learning needs to include a blend of educational design, technology use, and online instructional practices that integrate technology appropriately for developing and delivering quality online courses. Research shows that classroom-based evaluation tools do not adequately capture the dynamic relationships between content, pedagogy, and technology in online courses. Furthermore, studies suggest that using classroom evaluations for online courses yields lower than normal scores for instructors, and may affect faculty negatively in terms of administrative decisions. In 2014, the Faculty of Arts and Science at Queen’s University responded to this evidence by seeking an alternative to the university-mandated evaluation tool, which is designed for classroom learning. The Faculty is deeply engaged in e-learning, offering large variety of online courses and programs in the sciences, social sciences, humanities and arts. This paper describes the process by which a new student survey instrument for online courses was developed and piloted, the methods used to analyze the data, and the ways in which the instrument was subsequently adapted based on the results. It concludes with a critical reflection on the challenges of evaluating e-learning. The Student Evaluation of Online Teaching Effectiveness (SEOTE), developed by Arthur W. Bangert in 2004 to assess constructivist-compatible online teaching practices, provided the starting point. Modifications were made in order to allow the instrument to serve the two functions required by the university: student survey results provide the instructor with feedback to enhance their teaching, and also provide the institution with evidence of teaching quality in personnel processes. Changes were therefore made to the SEOTE to distinguish more clearly between evaluation of the instructor’s teaching and evaluation of the course design, since, in the online environment, the instructor is not necessarily the course designer. After the first pilot phase, involving 35 courses, the results were analyzed using Stobart's validity framework as a guide. This process included statistical analyses of the data to test for reliability and validity, student and instructor focus groups to ascertain the tool’s usefulness in terms of the feedback it provided, and an assessment of the utility of the results by the Faculty’s e-learning unit responsible for supporting online course design. A set of recommendations led to further modifications to the survey instrument prior to a second pilot phase involving 19 courses. Following the second pilot, statistical analyses were repeated, and more focus groups were used, this time involving deans and other decision makers to determine the usefulness of the survey results in personnel processes. As a result of this inclusive process and robust analysis, the modified SEOTE instrument is currently being considered for adoption as the standard evaluation tool for all online courses at the university. Audience members at this presentation will be stimulated to consider factors that differentiate effective evaluation of online courses from classroom-based teaching. They will gain insight into strategies for introducing a new evaluation tool in a unionized institutional environment, and methodologies for evaluating the tool itself.Keywords: evaluation, online courses, student survey, teaching effectiveness
Procedia PDF Downloads 26673 From Indigeneity to Urbanity: A Performative Study of Indian Saang (Folk Play) Tradition
Authors: Shiv Kumar
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In the shifting scenario of postmodern age that foregrounds the multiplicity of meanings and discourses, the present research article seeks to investigate various paradigm shift of contemporary performances concerning Haryanvi Saangs, so-called folk plays, which are being performed widely in the regional territory of Haryana, a northern state of India. Folk arts cannot be studied efficiently by using the tools of literary criticism because it differs from the literature in many aspects. One of the most essential differences is that literary works invariably have an author. Folk works, on the contrary, never have an author. The situation is quite clear: either we acknowledge the presence of folk art as a phenomenon in the social and cultural history of people, or we do not acknowledge it and argue it is a poetical or art of fiction. This paper is an effort to understand the performative tradition of Saang which is traditionally known as Saang, Swang or Svang became a popular source for instruction and entertainment in the region and neighbouring states. Scholars and critics have long been debating about the origin of the word swang/svang/saang and their relationship to the Sanskrit word –Sangit, which means singing and music. But in the cultural context of Haryana, the word Saang means ‘to impersonate’ or ‘to imitate’ or ‘to copy someone or something’. The stories they portray are derived for the most part from the same myths, tales, epics and from the lives of Indian religious and folk heroes. Literally, the use of poetic sense, the implication of prose style and elaborate figurative technique are worthwhile to compile the productivity of a performance. All use music and song as an integral part of the performance so that it is also appropriate to call them folk opera. These folk plays are performed strictly by aboriginal people in the state. These people, sometimes denominated as Saangi, possess a culture distinct from the rest of Indian folk performances. The concerned form is also known with various other names like Manch, Khayal, Opera, Nautanki. The group of such folk plays can be seen as a dynamic activity and performed in the open space of the theatre. Nowadays, producers contributed greatly in order to create a rapidly growing musical outlet for budding new style of folk presentation and give rise to the electronic focus genre utilizing many musicians and performers who had to become precursors of the folk tradition in the region. Moreover, the paper proposes to examine available sources relative to this article, and it is believed to draw some different conclusions. For instance, to be a spectator of ongoing performances will contribute to providing enough guidance to move forward on this root. In this connection, the paper focuses critically upon the major performative aspects of Haryanvi Saang in relation to several inquiries such as the study of these plays in the context of Indian literary scenario, gender visualization and their dramatic representation, a song-music tradition in folk creativity and development of Haryanvi dramatic art in the contemporary socio-political background.Keywords: folk play, indigenous, performance, Saang, tradition
Procedia PDF Downloads 15772 Tuberculous Osteomyelitis Mimicking Tumours and Tumour-Like Lesions of Bone: Clinico-Radiologic Study of 22 Patients
Authors: Parveen Kundu, Zile Singh, Kunika Kundu, Swaran Kaur
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Context: Tuberculous osteomyelitis is a relatively uncommon condition that can present with various clinical and radiological features, often mimicking bone tumors or tumor-like lesions. In endemic countries like India, tuberculosis should be considered as a potential differential diagnosis for lytic bone lesions. This study aimed to highlight the different presentations of tuberculosis that can mimic tumors or tumor-like lesions in bone and emphasize the successful outcome of antitubercular therapy (ATT) in treating these cases. Research Aim: The main objective of this research was to explore the varied presentations of tuberculosis that mimic bone tumors or tumor-like lesions both clinically and radiologically, focusing on different bones. The study aimed to raise awareness among clinicians about this possibility and highlight the importance of histopathological confirmation before initiating treatment for lytic bone lesions. Methodology: This study utilized a retrospective review of 22 patients with suspected lytic bone lesions, who were subsequently diagnosed with tuberculous osteomyelitis through histopathological examination. The cases were collected over a period of ten years. Eleven cases required curettage for extensive lesions with sequestrations, while all 22 patients received 12 months of antitubercular therapy. Findings: The study included 14 male and 8 female patients, ranging in age from 3 to 61 years, with an average age of 22.05. The clinical and radiological presentations varied, with examples including bone cysts in the metaphyseal area of long bones, lesions resembling chondroblastomas, giant cell tumors, and osteoid osteoma, as well as multifocal lytic lesions resembling metastasis or multiple myeloma. One patient had lesions in both the clavicle and hand. Lesions mimicking chondromas were also observed in the phalanges of the hand and foot metatarsal. All patients showed resolution of the lesions and no residual disability following ATT. Theoretical Importance: This study highlights the importance of considering tuberculosis as a potential differential diagnosis for lytic bone lesions, particularly in endemic regions. It emphasizes the need for histopathological confirmation to accurately diagnose tuberculous osteomyelitis, as this is considered the gold standard. Data Collection and Analysis Procedures: Data for this study were collected retrospectively from medical records and radiological images of the 22 patients. The cases were analyzed based on clinical presentation, radiological findings, and histopathological confirmation. The outcomes of antitubercular therapy were also assessed. The data were summarized and presented descriptively. Question Addressed: This study aimed to address the question of how tuberculosis can mimic different bone tumors and tumor-like lesions clinically and radiologically. It also aimed to assess the successful outcome of antitubercular therapy in treating these cases. Conclusion: Tuberculous osteomyelitis can present with varied clinical and radiological features, often mimicking bone tumors or tumor-like lesions. Clinicians should consider tuberculosis as a potential diagnosis for lytic bone lesions, especially in endemic areas. Histopathological confirmation is essential for accurate diagnosis. Antitubercular therapy is an effective treatment for tuberculous osteomyelitis, leading to the resolution of the lesions with no residual disability.Keywords: tuberculosis, tumor, curettage, bone
Procedia PDF Downloads 9171 Cystic Ganglionosis in Child: Rare Entity
Authors: Jatinder Pal Singh, Harpreet Singh, Gagandeep Singh Digra, Mandeep Kaur Sidhu, Pawan Kumar
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Introduction: Ganglion cyst is a benign condition in which there is a cystic lesion in relation to a joint or a tendon sheath arising from myxoid degeneration of fibrous connective tissue. These can be unilocular or multilocular. In rare cases, there may be multiple ganglion cysts, known as cystic ganglionosis. They can occur at any age but are commonly seen in adults. Clinically they may be asymptomatic or present as swelling or mass effect in adjacent structures. These are common in extremities such as hands and feet. Case Presentation: 11-year-old female child presented with slowly progressive painless swelling of her right hand since the age of 4. Antenatal and perinatal history was unremarkable. Her family history was negative. She denies fever, malaise, morning stiffness, weight loss, fatigue, restriction of joint movements, or any sensory and motor deficit. Lab parameters were negative for inflammatory or infectious etiology. No other joint or extremity involvement was present. On physical examination, the swelling was present on the dorsum and palmer aspect of the right hand and wrist. They were non-tender on palpation without any motor or sensory deficit. MRI hand revealed multiple well-defined fluid signal intensity cystic appearing lesions in periarticular/intraarticular locations in relation to distal radio-ulnar, radio-carpal, intercarpal, carpometacarpal, metacarpophalangeal and interphalangeal joints as well as peritendinous location around flexor tendons more so in the region of wrist, palm, 1st and 5th digit and along extensor tendons in the region of wrist, largest one noted along flexor pollicis longus tendon in thenar region and along 1st digit measuring approx. 4.6 x 1.2 x 1.2 centimeter. Pressure erosions and bone remodelling were noted in the bases of the 2nd to 5th metacarpals, capitate, trapezoid, the distal shaft of 1st metacarpal, and proximal phalanx of 1st digit. Marrow edema was noted in the base and proximal shaft of the 4th metacarpal and proximal shaft of the 3rd metacarpal – likely stress or pressure related. The patient was advised of aspiration, but the family refused the procedure. Therefore the patient was kept on conservative treatment. Conclusion: Cystic ganglionosis is a rare condition with very few cases reported in the medical literature. Its prevalence and association are not known because of the rarity of this condition. It should be considered as an important differential in patients presenting with soft tissue swelling in extremities. Treatment option includes conservative management, aspiration, and surgery. Aspiration has a high recurrence rate. Although surgery has a low recurrence rate, it carries a high rate of complications. Imaging with MRI is essential for confirmation of the cystic nature of lesions and their relation with the joint capsules or tendons. This helps in differentiating from other soft tissue lesions and presurgical planning.Keywords: radiology, rare, cystic ganglionosis, child
Procedia PDF Downloads 7770 Advertising Campaigns for a Sustainable Future: The Fight against Plastic Pollution in the Ocean
Authors: Mokhlisur Rahman
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Ocean inhibits one of the most complex ecosystems on the planet that regulates the earth's climate and weather by providing us with compatible weather to live. Ocean provides food by extending various ways of lifestyles that are dependent on it, transportation by accommodating the world's biggest carriers, recreation by offering its beauty in many moods, and home to countless species. At the essence of receiving various forms of entertainment, consumers choose to be close to the ocean while performing many fun activities. Which, at some point, upsets the stomach of the ocean by threatening marine life and the environment. Consumers throw the waste into the ocean after using it. Most of them are plastics that float over the ocean and turn into thousands of micro pieces that are hard to observe with the naked eye but easily eaten by the sea species. Eventually, that conflicts with the natural consumption process of any living species, making them sick. This information is not known by most consumers who go to the sea or seashores occasionally to spend time, nor is it widely discussed, which creates an information gap among consumers. However, advertising is a powerful tool to educate people about ocean pollution. This abstract analyzes three major ocean-saving advertisement campaigns that use innovative and advanced technology to get maximum exposure. The study collects data from the selected campaigns' websites and retrieves all available content related to messages, videos, and images. First, the SeaLegacy campaign uses stunning images to create awareness among the people; they use social media content, videos, and other educational content. They create content and strategies to build an emotional connection among the consumers that encourage them to move on an action. All the messages in their campaign empower consumers by using powerful words. Second, Ocean Conservancy Campaign uses social media marketing, events, and educational content to protect the ocean from various pollutants, including plastics, climate change, and overfishing. They use powerful images and videos of marine life. Their mission is to create evidence-based solutions toward a healthy ocean. Their message includes the message regarding the local communities along with the sea species. Third, ocean clean-up is a campaign that applies strategies using innovative technologies to remove plastic waste from the ocean. They use social media, digital, and email marketing to reach people and raise awareness. They also use images and videos to evoke an emotional response to take action. These tree advertisements use realistic images, powerful words, and the presence of living species in the imagery presentation, which are eye-catching and can grow emotional connection among the consumers. Identifying the effectiveness of the messages these advertisements carry and their strategies highlights the knowledge gap of mass people between real pollution and its consequences, making the message more accessible to the mass of people. This study aims to provide insights into the effectiveness of ocean-saving advertisement campaigns and their impact on the public's awareness of ocean conservation. The findings from this study help shape future campaigns.Keywords: advertising-campaign, content-creation, images ocean-saving technology, videos
Procedia PDF Downloads 7869 Case Report on Anaesthesia for Ruptured Ectopic with Severe Pulmonary Hypertension in a Mute Patient
Authors: Pamela Chia, Tay Yoong Chuan
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Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing.Keywords: pulmonary hypertension, case report, warfarin reversal, emergency surgery
Procedia PDF Downloads 22068 Identification of the Target Genes to Increase the Immunotherapy Response in Bladder Cancer Patients using Computational and Experimental Approach
Authors: Sahar Nasr, Lin Li, Edwin Wang
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Bladder cancer (BLCA) is known as the 13th cause of death among cancer patients worldwide, and ~575,000 new BLCA cases are diagnosed each year. Urothelial carcinoma (UC) is the most prevalent subtype among BLCA patients, which can be categorized into muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC). Currently, various therapeutic options are available for UC patients, including (1) transurethral resection followed by intravesical instillation of chemotherapeutics or Bacillus Calmette-Guérin for NMIBC patients, (2) neoadjuvant platinum-based chemotherapy (NAC) plus radical cystectomy is the standard of care for localized MIBC patients, and (3) systematic chemotherapy for metastatic UC. However, conventional treatments may lead to several challenges for treating patients. As an illustration, some patients may suffer from recurrence of the disease after the first line of treatment. Recently, immune checkpoint therapy (ICT) has been introduced as an alternative treatment strategy for the first or second line of treatment in advanced or metastatic BLCA patients. Although ICT showed lucrative results for a fraction of BLCA patients, ~80% of patients were not responsive to it. Therefore, novel treatment methods are required to augment the ICI response rate within BLCA patients. It has been shown that the infiltration of T-cells into the tumor microenvironment (TME) is positively correlated with the response to ICT within cancerous patients. Therefore, the goal of this study is to enhance the infiltration of cytotoxic T-cells into TME through the identification of target genes within the tumor that are responsible for the non-T-cell inflamed TME and their inhibition. BLCA bulk RNA-sequencing data from The Cancer Genome Atlas (TCGA) and immune score for TCGA samples were used to determine the Pearson correlation score between the expression of different genes and immune score for each sample. The genes with strong negative correlations were selected (r < -0.2). Thereafter, the correlation between the expression of each gene and survival in BLCA patients was calculated using the TCGA data and Cox regression method. The genes that are common in both selected gene lists were chosen for further analysis. Afterward, BLCA bulk and single-cell RNA-sequencing data were ranked based on the expression of each selected gene and the top and bottom 25% samples were used for pathway enrichment analysis. If the pathways related to the T-cell infiltration (e.g., antigen presentation, interferon, or chemokine pathways) were enriched within the low-expression group, the gene was included for downstream analysis. Finally, the selected genes will be used to calculate the correlation between their expression and the infiltration rate of the activated CD+8 T-cells, natural killer cells and the activated dendric cells. A list of potential target genes has been identified and ranked based on the above-mentioned analysis and criteria. SUN-1 got the highest score within the gene list and other identified genes in the literature as benchmarks. In conclusion, inhibition of SUN1 may increase the tumor-infiltrating lymphocytes and the efficacy of ICI in BLCA patients. BLCA tumor cells with and without SUN-1 CRISPR/Cas9 knockout will be injected into the syngeneic mouse model to validate the predicted SUN-1 effect on increasing tumor-infiltrating lymphocytes.Keywords: data analysis, gene expression analysis, gene identification, immunoinformatic, functional genomics, transcriptomics
Procedia PDF Downloads 156