Search results for: university hospital

Authors: Nasiruddin Khan

Abstract:

The increased use of caffeinated beverages and energy drink is posing threat to all ages and gender especially, younger adults. There is a lack of scientific evidence in Oman regarding caffeine and energy drink consumption. Our study aims to demonstrate the prevalence, pattern, knowledge and awareness, and side effects of caffeine intake among university students. This cross-sectional study including (N=365) apparently healthy male and female Omani university students aged 18-30 years, was carried out from February 2018-June 2018. A self-administered questionnaire with various sections was used to obtain information. The prevalence of caffeinated beverage consumption was commonly high among participants (97%). The males preferred Nescafe, coffee (both p < 0.001), espresso (p < 0.022), and soda (p < 0.008) while females consumed more tea (p < 0.029). The awareness about negative health impact of caffeine intake was significantly higher in females rather than males (p < 0.002). The overall prevalence of energy drink consumption was 42.1% (n=149), and higher in males (75%, p < 0.001). More males consumed 3-5 and > 5 cans/day while females used 1-2 cans/day. The starting age of energy drink use was higher in females (16-20 years (51.1%)) as compared to males (11-15 years (33.3%)). Females were more aware of caffeine as energy drink ingredient (p < 0.036) than males. The major source of information about enery drink was family and friends (58.3%). Red Bull was the commonly used brand (55.5%) among participants. Common reasons for high energy drink consumption were energy boost (68.4 %), taste (62.9%), reduce fatigue (52.1%), and better performance (47.3%). Females reported breathing problem, and abnormal heart beat (p < 0.004, 0.054, respectively), while more males reported irritability than females (p < 0.052). The prevalence of caffeinated beverage and energy drink consumption is high among participants. The awareness, and knowledge among university student is not satisfactory and needs immediate action to avoid excess use of such consumption.

Keywords: energy drink, caffeinated beverages, awareness, Oman

Procedia PDF Downloads 129

Authors: Widad Kouachi, Nacera Benmouhoub

Abstract:

Background: Erector spinae plane block (ESP) and thoracic paravertebral block (PVB) are two widely used regional anesthesia techniques in breast cancer surgery. Both techniques aim to improve postoperative pain management and reduce opioid consumption. However, comparative data on their efficacy in oncologic breast surgery remains limited. Objectives: This study aims to compare the efficacy of ESP and PVB in postoperative pain control, patient satisfaction, and opioid consumption in breast cancer surgery. Methods: A randomized, double-blind trial was conducted involving 100 patients undergoing oncologic breast surgery. Patients were randomly assigned to two groups: 50 received ESP, and 50 received PVB. Postoperative pain scores (at rest and during movement), opioid consumption, patient satisfaction, and hospital length of stay were recorded and analyzed. Results: Both ESP and PVB provided effective postoperative analgesia. No significant difference in pain scores was observed between the two groups within the first 24 hours. However, ESP showed a notable advantage in managing chronic postoperative pain at the 6-month follow-up. Opioid consumption was lower in both groups compared to patients without a block. No significant differences in complication rates or hospital stay were noted between the groups. Conclusion: ESP and PVB offer comparable efficacy for immediate postoperative pain control in breast cancer surgery. Nevertheless, ESP may have a superior role in managing long-term pain. Further research is needed to explore the mechanisms behind the observed differences in chronic pain outcomes.

Keywords: pain assessment, brest surgery, bpv block, ESP block

Procedia PDF Downloads 30

Authors: Autumn Tooms Cypres

Abstract:

Throughout the 2016 presidential campaign, Republican nominee Donald Trump, capitalizing on his reputation for blunt and brash comments, created a political brand based on unedited statements and sweeping promises. While he vowed to 'Make America Great Again,' for many, the candidate’s discourse invoked legacies of marginalization and exclusion. As a result, this discussion focuses on Trump’s anti-immigration discourse (one of the primary foci of his campaign platform) and its influence across educational settings. The purpose of this effort is to demonstrate the power of political discourses relative to educational settings and to discuss the resulting everyday leadership challenges and opportunities. Discourse analysis frameworks are used to unpack the socio-political implications of the presidential campaign. In particular, they examine a serious of emails that a university administrator received post-election. The discussion concludes that leaders in education have a critical role to maintaining democratic institutions and ensuring inclusivity and belonging for all educational stakeholders.

Keywords: educational managment, politics, immigration, discourse

Procedia PDF Downloads 289

Authors: Sepideh Nikounejad, Mostafa Ghaderi, Nematollah Azizi, Per-Olof Thang, Mohamad Reza Neyestani

Abstract:

From an educational perspective, an effective and efficient relationship between university and industry can be considered as an important means by which not only both sides are improved but also it brings many advantages and benefits for both parties. It means more specifically, mutual collaboration between universities and industry can not only reduce youth unemployment, but it can improve the quality of teaching and learning in higher education settings while providing more qualified people to industrial enterprises. Indeed the lack of effective interaction between Iranian universities and industry has confronted the country and created many challenges include in increasing number of unskillful and unemployed graduates. However, in order to suggest appropriate practical strategies, it is very important to see how this issue has been tackled by Swedish universities, which have had a good background in this collaboration and how they are connected to the industry in particular and labour market in general. The research aims to study and compare the mechanisms, processes, and policies of the current model in the relationships between university and industry in Iran and Sweden. As a qualitative study, grounded theory was applied. Data were collected via semi-structured interviews. Participants were selected purposefully and by the snowball sampling method. The findings indicate that despite reported needs from both sides for close collaborations between universities and industries in Iran, current policies and practices, including internship, laboratory, and financial support, need to be revised critically. However, in light of our findings on the Swedish policies and practices for linking universities and industries, some practical strategies will be suggested for the Iranian higher education context. In conclusion, cooperation models between universities and industries in Iran and Sweden will be described.

Keywords: cooperation, higher education, industry, comparative

Procedia PDF Downloads 133

Authors: Recep Kesli, Onur Turkyilmaz, Cengiz Demir

Abstract:

Objective: Autoimmune collagen diseases occur with the immune reactions against the body’s own cell or tissues which cause inflammation and damage the tissues and organs. In this study, it was aimed to compare seropositivity rates and patterns of the anti-nuclear antibodies (ANA) in the diagnosis of four different autoimmune collagen tissue diseases (Rheumatoid Arthritis-RA, Systemic Lupus Erythematous-SLE, Scleroderma-SSc and Sjogren Syndrome-SS) with each other. Methods: One hundred eighty-eight patients applied to different clinics in Afyon Kocatepe University ANS Practice and Research Hospital between 11.07.2014 and 14.07.2015 that thought the different collagen disease such as RA, SLE, SSc and SS have participated in the study retrospectively. All the data obtained from the patients participated in the study were evaluated according to the included criteria. The historical archives belonging to the patients have been screened, assessed in terms of ANA positivity. The obtained data was analysed by using the descriptive statistics; chi-squared, Fischer's exact test. The evaluations were performed by SPSS 20.0 version and p < 0.05 level was considered as significant. Results: Distribution rates of the totally one hundred eighty-eight patients according to the diagnosis were found as follows: 82 (43.6%) were RA, 38 (20.2%) were SLE, 22 (11.7%) were SSc, and 46 (24.5%) were SS. Distribution of ANA positivity rates according to the collagen tissue diseases were found as follows; for RA were 54 (65,9 %), for SLE were 36 (94,7 %), for SSc were 18 (81,8 %), and for SS were 43 (93,5 %). Rheumatoid arthritis should be evaluated and classified as a different class among all the other investigated three autoimmune illnesses. ANA positivity rates were found as differently higher (91.5 %) in the SLE, SSc, and SS, from the RA (65.9 %). Differences at ANA positivity rates for RA and the other three diseases were found as statistically significant (p=0.015). Conclusions: Systemic autoimmune illnesses show broad spectrum. ANA positivity was found as an important predictor marker in the diagnosis of the rheumatologic illnesses. ANA positivity should be evaluated as more valuable and sensitive a predictor diagnostic marker in the laboratory findings of the SLE, SSc, and SS according to RA.

Keywords: antinuclear antibody (ANA), rheumatoid arthritis, scleroderma, Sjogren syndrome, systemic lupus Erythemotosus

Procedia PDF Downloads 243

Authors: Hamzeh Dodeen

Abstract:

This study aims at examining the effects of item wording effects on the factor structure of the University of California, Los Angeles (UCLA) Loneliness Scale: gender, age, and marital status differences. A total of 2374 persons from the UAE participated, representing six different populations (teenagers/elderly, males/females, and married/unmarried). The results of the exploratory factor analysis using principal axis factoring with (oblique) rotation revealed that two factors were extracted from the 20 items of the scale. The nine positively worded items were highly loaded on the first factor, while 10 out of the 11 negatively worded items were highly loaded on the second factor. The two-factor solution was confirmed on the six different populations based on age, gender, and marital status. It has been concluded that the rating of the UCLA scale is affected by a response style related to the item wording.

Keywords: UCLA Loneliness Scale, loneliness, positively worded items, factor structure, negatively worded items

Procedia PDF Downloads 353

Authors: Li Yuqing

Abstract:

Fostering the development of intercultural (communicative) competence (IC) is one way to equip our students with the linguistic and cultural skills to communicate effectively with people from diverse backgrounds, particularly English majors who are most likely to encounter multicultural work environments in the future. The purpose of this study is to compare the English majors' intercultural competence in terms of cognitive, affective, and behavioral aspects before and after a ten-week telecollaboration program between 23 English majors at a Chinese university and 23 American students enrolled in a Chinese class at an American university, and analyze their development during the program. The results indicate that subjects' cognitive, affective, and behavioral perceptions of IC improved significantly over time. In addition, the program had significant effects on the participants' “Interaction Confidence,” “Interaction Engagement,” and “Interaction Enjoyment” - three components of intercultural sensitivity - as well as their overall intercultural effectiveness (except for “Message Skills”). With the widespread use of the internet, this type of online cultural exchange has a promising future, as suggested by the findings of the current study.

Keywords: intercultural competence, English majors, computer-mediated communication, telecollaboration

Procedia PDF Downloads 74

Authors: Naila Naseer

Abstract:

Emotional Intelligence (EI) concept is not new yet unique and interesting. EI is a person’s ability to be aware of his/her own emotions and to manage, handle and communicate emotions with others effectively. The present study was conducted to assess the relationship between emotional intelligence and age of graduate level students at Allama Iqbal Open University (AIOU). Population consisted of Allama Iqbal Open University students (B.Ed 3rd Semester, Autumn 2007) from Rawalpindi and Islamabad regions. Total number of sample consisted of 469 participants was randomly drawn out by using table of random numbers. Bar-On EQ-i was administered on the participants through personal contact. The instrument was also validated through pilot study on a random sample of 50 participants (B.Ed students Spring 2006), who had completed their B.Ed degree successfully. Data was analyzed and tabulated in percentages, frequencies, mean, standard deviation, correlation, and scatter gram in SPSS (version 16.0 for windows). The results revealed that students with higher age group had scored low on the scale (Bar-On EQ-i). Moreover, the students in low age groups exhibited higher levels of EI as compared with old age students.

Keywords: emotional intelligence, age level, learning, emotion-related feelings

Procedia PDF Downloads 331

Authors: Ratna Farida Soenarto, Anas Alatas, Made Ryan Kharmayani

Abstract:

Background: Conventional ultrafiltration (CUF) system was shown to be helpful in reducing anti-inflammatory mediators for patients who underwent open heart surgery. Additionally, modified ultrafiltration (MUF) has been shown to reduce anti-inflammatory mediators further while reducing interstitial fluid volume at the same time. However, there has been minimal data concerning the efficacy of combining both ultrafiltration methods. This study aims to compare inflammation marker, vascular resistance, and cardiac index on CUF+MUF patients with CUF only patients undergoing open heart surgery. Method: This is a single blind randomized controlled trial on patients undergoing open heart surgery between June 2021 - October 2021 in CiptoMangunkusumo National Referral Hospital and Jakarta Heart Hospital. Patients wererandomized using block randomization into modified ultrafiltration following conventional ultrafiltration (CUF+MUF) and conventional ultrafiltration (CUF) only. Outcome assessed in this study were 24-hoursinterleukin-6 levels, systemic vascular resistance (SVR), pulmonary vascular resistance (PVR), and cardiac index. Results: A total of 38patients were included (19 CUF+MUF and 19 CUF subjects). There was no difference in postoperative IL-6 level between groups (p > 0.05).No difference in PVR was observed between groups.Higher difference in SVR was observed in CUF+MUF group (-646 vs. -261dyn/s/cm-5, p < 0.05). Higher cardiac index was observed on CUF+MUF group (0.93 vs. 0.48, p < 0.05). Conclusion: Patients undergoing open heart surgery with modified ultrafiltration following conventional ultrafiltration had similar systemic inflammatory response and better cardiac response than those having conventional ultrafiltration.

Keywords: open-heart, CUF, MUF, SVR, PVR, IL-6

Procedia PDF Downloads 153

Authors: O. O. Onafowokan, K. Anderson, M. R. Norton, R. G. Middleton

Abstract:

Revision total hip arthroplasty (THA) is known to be a challenging procedure with potential for poor outcomes. Due to its lack of metaphyseal encroachment, hip resurfacing arthroplasty (HRA) is classified as a bone conserving procedure. Although the literature postulates that this is an advantage at time of revision surgery, there is no evidence to either support or refute this claim. We identified 129 hips that had undergone HRA and 129 controls undergoing first revision THA. We recorded the clinical assessment and survivorship of implants in a multi-surgeon, single centre, retrospective case control series for both arms. These were matched for age and sex. Data collected included demographics, indications for surgery, Oxford Hip Score (OHS), length of surgery, length of hospital stay, blood transfusion, implant complexity and further surgical procedures. Significance was taken as p < 0.05. Mean follow up was 7.5 years (1 to 15). There was a significant 6 point difference in postoperative OHS in favour of the revision resurfacing group (p=0.0001). The revision HRA group recorded 48 minutes less length of surgery (p<0.0001), 2 days less in length of hospital stay (p=0.018), a reduced need for blood transfusion (p=0.0001), a need for less complexity in revision implants (p=0.001) and a reduced probability of further surgery being required (P=0.003). Whilst we acknowledge the limitations of this study our results suggest that, in contrast to THA, the bone conservation element of HRA may make for a less traumatic revision procedure with better functional outcomes. Use of HRA has seen a dramatic decline as a result of concerns regarding metallosis. However, this information remains of relevance when counselling young active patients about their arthroplasty options and may become pertinent in the future if the promise of ceramic hip resurfacing is ever realized.

Keywords: hip resurfacing, metallosis, revision surgery, total hip arthroplasty

Procedia PDF Downloads 88

Authors: Mustafa Al-Refai

Abstract:

This paper presents the optimal design and simulation of a grid-connected Photovoltaic (PV) system to supply electric power to meet the energy demand by Electrical Department in University of Tripoli Libya. Solar radiation is the key factor determining electricity produced by photovoltaic (PV) systems. This paper is designed to develop a novel method to calculate the solar photovoltaic generation capacity on the basis of Mean Global Solar Radiation data available for Tripoli Libya and finally develop a system design of possible plant capacity for the available roof area. MatLab/Simulink Programming tools and monthly average solar radiation data are used for this design and simulation. The specifications of equipments are provided based on the availability of the components in the market. Simulation results and analyses are presented to validate the proposed system configuration.

Keywords: photovoltaic (PV), grid, Simulink, solar energy, power plant, solar irradiation

Procedia PDF Downloads 301

Authors: Lee Kok Yueh, Fatin Hamadah Rahman, David Hassell, Au Thien Wan

Abstract:

This work reports on a genre based study of lectures at a University in Brunei, Universiti Teknologi Brunei to explore the communicative functions and to gain insight into the discourse. It explores these in three different domains; Social Science, Engineering and Computing. Audio recordings from four lecturers comprising 20 lectures were transcribed and analysed, with the duration of each lecture varying between 20 to 90 minutes. This qualitative study found similar patterns and functions of lectures as those found in existing research amongst which include greetings, housekeeping, or recapping of previous lectures in the lecture introductions. In the lecture content, comprehension check and use of examples or analogies are very prevalent. However, the use of examples largely depend on the lecture content; and the more technical the content, the harder it was for lecturers to provide examples or analogies. Three functional moves are identified in the lecture conclusions; announcement, summary and future plan, all of which are optional. Despite the relatively small sample size, the present study shows that lectures are interactive and there are some consistencies with the delivery of lecture in relation to the communicative functions and genre of lecture.

Keywords: communicative functions, genre analysis, higher education, lectures

Procedia PDF Downloads 191

Authors: Vitaliy Petrov, Natalia Shusharina, Vitaliy Kasymov, Maksim Patrushev, Evgeny Bogdanov

Abstract:

The leading worldwide death reasons are ischemic heart disease and other cardiovascular illnesses. Generally, the common symptom is high blood pressure. Long-time blood pressure control is very important for the prophylaxis, correct diagnosis and timely therapy. Non-invasive methods which are based on Korotkoff sounds are impossible to apply often and for a long time. Implantable devices can combine longtime monitoring with high accuracy of measurements. The main purpose of this work is to create a real-time monitoring system for decreasing the death rate from cardiovascular diseases. These days implantable electronic devices began to play an important role in medicine. Usually implantable devices consist of a transmitter, powering which could be wireless with a special made battery and measurement circuit. Common problems in making implantable devices are short lifetime of the battery, big size and biocompatibility. In these work, blood pressure measure will be the focus because it’s one of the main symptoms of cardiovascular diseases. Our device will consist of three parts: the implantable pressure sensor, external transmitter and automated workstation in a hospital. The Implantable part of pressure sensors could be based on piezoresistive or capacitive technologies. Both sensors have some advantages and some limitations. The Developed circuit is based on a small capacitive sensor which is made of the technology of microelectromechanical systems (MEMS). The Capacitive sensor can provide high sensitivity, low power consumption and minimum hysteresis compared to the piezoresistive sensor. For this device, it was selected the oscillator-based circuit where frequency depends from the capacitance of sensor hence from capacitance one can calculate pressure. The external device (transmitter) used for wireless charging and signal transmission. Some implant devices for these applications are passive, the external device sends radio wave signal on internal LC circuit device. The external device gets reflected the signal from the implant and from a change of frequency is possible to calculate changing of capacitance and then blood pressure. However, this method has some disadvantages, such as the patient position dependence and static using. Developed implantable device doesn’t have these disadvantages and sends blood pressure data to the external part in real-time. The external device continuously sends information about blood pressure to hospital cloud service for analysis by a physician. Doctor’s automated workstation at the hospital also acts as a dashboard, which displays actual medical data of patients (which require attention) and stores it in cloud service. Usually, critical heart conditions occur few hours before heart attack but the device is able to send an alarm signal to the hospital for an early action of medical service. The system was tested with wireless charging and data transmission. These results can be used for ASIC design for MEMS pressure sensor.

Keywords: MEMS sensor, RF power, wireless data, oscillator-based circuit

Procedia PDF Downloads 589

Authors: Ugochukwu D. Abasilim, Aize I. Obayan, Adedayo J. Odukoya, Godwyns Agube, Power A. I. Wogu, Nchekwube Excellence-Oluye

Abstract:

This paper examines the effect of transformational leadership style on organizational commitment among Private University employees in Nigeria. A quantitative methodology was adopted for this study. A structured Multi-factor Leadership Questionnaire (MLQ) developed by Bass and Avolio (1997) and Organizational Commitment Questionnaire (OCQ) developed by Meyer and Allen (1997) were the major instruments used for data collection. Simple linear regression was used for testing the hypothesis. The results indicated that there was no significant positive effect of transformational leadership style on organizational commitment among employees of the Nigerian private university studied. Though the respondents rated their leaders high on transformational leadership style, their organizational commitment rating was average for majority, which implies that employees’ level of commitment could be accounted for by transformational leadership style existing in the institution. This finding is antithetical to the common submission in literature that transformational leadership style has a significant effect on organizational commitment. It was therefore recommended that further studies may want to further explore the reasons for this variance.

Keywords: leadership style, Nigeria, organizational, commitment, transformational leadership

Procedia PDF Downloads 424

Authors: Fatimah Alhomaid

Abstract:

The present study was planned to investigate the role of molecular changes and immunohistochemical in early detection of colon cancer in Saudi patients. Our results were carried out on 48 patients colon cancer. We obtained our data from laboratory in King Khalid university hospital. The specimens were taken (48) patients with colon cancer 34 male and 14 female and 2 control. The average age of varied from 37-85 years. The tumor was diagnosed as I in tow patients (male and female) and grade 2 in 42 patients (29 male and 13 female) while the grade 3 in 4 patients (all males). The specimens were processed for haematoxylin and eosin staining , immunohistochemical technique and flow cytometry analysis. Our study noted that most patients had adenocarcinoma which characterized by presence of signet-ring cells were very clear in advanced patients of adenocarcinoma. Our sections in adenocarcinoma in grade 2 and stage 3 had an increase in signet ring cells,an increase in the acini of glands and an increase in number of lymphocytes which spread to the muscularis layer. With advancing the disease, there were haemorge in blood and increase in lymphocytes and increase number of nuclei in the tubular glands. Our study was carried on 48 patients, immunohistochemical diagnosis (CK20,PCNA,P53) and the analysis of DNA content by flow cytometry technique. Our study indicated that the presence of correlation between the immunohistochemical analysis for P53 and the grades. The reaction of P53 appeared as strong in nucleus in grades &stage 3 and appeared in other sections as dark brown pigment. Our study indicated that the absence of correlation between the immunohistochemical analysis for pcan and the grades. In our sections, there were strong reactions in the more 80% of nuclei in grade 1& stage 2. Our study indicated that the presence of correlation between the immunohistochemical analysis for CK20 and the grades. Our results indicated the presence of positive reaction in cytoplasm varied from weak to moderate in grade 3 & stage 4. Concerning the Flow cytometry technique our results indicated that the presence of correlation between the DNA and different stages of colon cancer.

Keywords: DNA-CK20, PCNA, P53, colon cancer

Procedia PDF Downloads 356

Authors: Somdech Rungsrisawat

Abstract:

The objective of this research was to investigate how to develop an appropriate management and administration model for the College of Film, Television, Multimedia and Performing Arts at Suan Sunandha Rajabhat University. A combination of qualitative and quantitative data collection and analysis methods was employed. The data collection was from the 8 experts who were the academic staff and entrepreneurs in films, television, multimedia and performing arts, and from 471 students studying in the communication arts field. The findings of this research paper presented the appropriate management and administration model for the College of Film, Television, Multimedia and Performing Arts, which depended on 3 factors: [i] the marketing management and the supporting facilities such as buildings, equipments and accessibility for students to the college; [ii] the competency of academic staff or lecturers and supporting staff; and [iii] career opportunities after graduation.

Keywords: educational institution management, educational management, learning resources, non-formal education, Thai qualifications framework for higher education

Procedia PDF Downloads 330

Authors: R. Roznowski

Abstract:

This paper is an examination of a recent Michigan State University production of the classic musical, Peter Pan. In this production, approved by the licensor, the action was moved to Colonial India transforming the musical’s message to include themes of cultural identity, racism, classism and ultimately inclusion. Major character changes and casting decisions expanded the scope of the musical while still retaining the original book and score. Major changes included reframing the Darlings as British Colonials stationed in India. The Lost Boy’s as mixed race children of British officials and their Indian nannies, the Pirates were a female 'fishing fleet' a group of women sent from England to keep the British soldiers from mixing with the locals and the Michigan State University Bhangra Dance Team played the Indians in the production. Traditional Indian theatrical techniques were also employed in the storytelling. The presentation will cover the key changes to the musical, the rehearsal process, historical accuracy and audience reaction. A final analysis of cultural appropriation versus historical reframing will be examined.

Keywords: directing, history, musical theatre, producing

Procedia PDF Downloads 251

Authors: Anish Desai, Reshmi Pillai, Nilesh Mahajan, Hitesh Chopra, Vishal Mahajan, Ajay Grover, Ashish Kohli

Abstract:

Surgical Site Infection (SSI) is hospital acquired infection of growing concern. This study presents the efficacy and cost-effectiveness of triclosan-coated suture, in reducing the burden of SSI in India. Methodology: A systematic literature search was conducted for economic burden (1998-2018) of SSI and efficacy of triclosan-coated sutures (TCS) vs. non-coated sutures (NCS) (2000-2018). PubMed Medline and EMBASE indexed articles were searched using Mesh terms or Emtree. Decision tree analysis was used to calculate, the cost difference between TCS and NCS at private and public hospitals, respectively for 7 surgical procedures. Results: The SSI range from low to high for Caesarean section (C-section), Laparoscopic hysterectomy (L-hysterectomy), Open Hernia (O-Hernia), Laparoscopic Cholecystectomy (L-Cholecystectomy), Coronary artery bypass graft (CABG), Total knee replacement (TKR), and Mastectomy were (3.77 to 24.2%), (2.28 to 11.7%), (1.75 to 60%), (1.71 to 25.58%), (1.6 to 18.86%), (1.74 to 12.5%), and (5.56 to 25%), respectively. The incremental cost (%) of TCS ranged 0.1%-0.01% in private and from 0.9%-0.09% at public hospitals across all surgical procedures. Cost savings at median efficacy & SSI risk was 6.52%, 5.07 %, 11.39%, 9.63%, 3.62%, 2.71%, 9.41% for C-section, L-hysterectomy, O-Hernia, L-Cholecystectomy, CABG, TKR, and Mastectomy in private and 8.79%, 4.99%, 12.67%, 10.58%, 3.32%, 2.35%, 11.83% in public hospital, respectively. Efficacy of TCS and SSI incidence in a particular surgical procedure were important determinants of cost savings using one-way sensitivity analysis. Conclusion: TCS suture led to cost savings across all 7 surgeries in both private and public hospitals in India.

Keywords: cost Savings, non-coated sutures, surgical site infection, triclosan-coated sutures

Procedia PDF Downloads 398

Authors: Emily Moore, Andrew Gaukroger, Matthew Solan, Lucy Bailey, Alexandra Boxall, Andrew Carne, Chintu Gadamsetty, Charlotte Morley, Katy Western, Iwona Kolodziejczyk

Abstract:

Introduction: Rupture of the Achilles tendon is common and has a long recovery period. Most cases are managed non-operatively. Foot and Ankle Surgeons advise an ultrasound scan to check the gap between the torn ends. A large gap (with the ankle in equinus) is a relative indication for surgery. The definitive decision regarding surgical versus non-operative management can only be made once an ultrasound scan is undertaken and the patient is subsequently reviewed by a Foot and Ankle surgeon. To get to this point, the patient journey involves several hospital departments. In nearby trusts, patients reattend for a scan and go to the plaster room both before and after the ultrasound for removal and re-application of the cast. At a third visit to the hospital, the surgeon and patient discuss options for definitive treatment. It may take 2-3 weeks from the initial Emergency Department visit before the final treatment decision is made. This “wasted time” is ultimately added to the recovery period for the patient. In this hospital, Achilles rupture patients are seen in a weekly multidisciplinary OneStop Heel Pain clinic. This pathway was already efficient but subject to occasional frustrating delays if a key staff member was absent. A new pathway was introduced with the goal to reduce delays to a definitive treatment plan. Method: A retrospective series of Achilles tendon ruptures managed according to the 2019 protocol was identified. Time taken from the Emergency Department to have both an ultrasound scan and specialist Foot and Ankle surgical review were calculated. 30 consecutive patients were treated with our new pathway and prospectively followed. The time taken for a scan and for specialist review were compared to the 30 consecutive cases from the 2019 (pre-COVID) cohort. The new pathway includes 1. A new contoured splint applied to the front of the injured limb held with a bandage. This can be removed and replaced (unlike a plaster cast) in the ultrasound department, removing the need for plaster room visits. 2. Urgent triage to a Foot and Ankle specialist. 3. Ultrasound scan for assessment of rupture gap and deep vein thrombosis check. 4. Early decision regarding surgery. Transfer to weight bearing in a prosthetic boot in equinuswithout waiting for the once-a-week clinic. 5. Extended oral VTE prophylaxis. Results: The time taken for a patient to have both an ultrasound scan and specialist review fell > 50%. All patients in the new pathway reached a definitive treatment decision within one week. There were no significant differences in patient demographics or rates of surgical vs non-operative treatment. The mean time from Emergency Department visit to specialist review and ultrasound scan fell from 8.7 days (old protocol) to 2.9 days (new pathway). The maximum time for this fell from 23 days (old protocol) to 6 days (new pathway). Conclusion: Teamwork and innovation have improved the experience for patients with an Achilles tendon rupture. The new pathway brings many advantages - reduced time in the Emergency Department, fewer hospital visits, less time using crutches and reduced overall recovery time.

Keywords: orthopaedics, achilles rupture, ultrasound, innovation

Procedia PDF Downloads 123

Authors: Tayyab Ahmad, Gerard Healey

Abstract:

Sustainability in built environment sector is subject to many development constraints. Building projects are developed under different requirements of deliverables which makes each project unique. For an owner organization, i.e., a higher-education institution, involved in a significant building stock, it is important to prioritize some of the sustainability initiatives over the others in order to align the sustainable building development with organizational goals. The point-based green building rating tools i.e. Green Star, LEED, BREEAM are becoming increasingly popular and are well-acknowledged worldwide for verifying a sustainable development. It is imperative to synthesize a multi-criteria decision-making tool that can capitalize on the point-based methodology of rating systems while customizing the sustainable development of building projects according to the individual requirements and constraints of the client organization. A multi-criteria decision-making tool for the University of Melbourne is developed that builds on the action-learning and experience of implementing Green Buildings at the University of Melbourne. The tool evaluates the different sustainable building initiatives based on the framework of Green Star rating tool of Green Building Council of Australia. For each different sustainability initiative the decision-making tool makes an assessment based on at least five performance criteria including the ease with which a sustainability initiative can be achieved and the potential of a sustainability initiative to enhance project objectives, reduce life-cycle costs, enhance University’s reputation, and increase the confidence in quality construction. The use of a weighted aggregation mathematical model in the proposed tool can have a considerable role in the decision-making process of a Green Building project by indexing the Green Building initiatives in terms of organizational priorities. The index value of each initiative will be based on its alignment with some of the key performance criteria. The usefulness of the decision-making tool is validated by conducting structured interviews with some of the key stakeholders involved in the development of sustainable building projects at the University of Melbourne. The proposed tool is realized to help a client organization in deciding that within limited resources which sustainability initiatives and practices are more important to be pursued than others.

Keywords: higher education institution, multi-criteria decision-making tool, organizational values, prioritizing sustainability initiatives, weighted aggregation model

Procedia PDF Downloads 234

Authors: Camarena Rodriguez C. S., Portocarrero Bonifaz A., Palma Esparza R., Romero Carlos N. A.

Abstract:

Adobe is a construction material that fulfills the same function as a conventional brick. Widely used since ancient times, it is present in an appreciable percentage of buildings in Latin America. Adobe is a mixture of clay and sand. The interest in the study of the properties of this material arises due to its presence in the infrastructure of hospital´s radiological services, located in places with low economic resources, for the attenuation of radiation. Some materials such as lead and concrete are the most used for shielding and are widely studied in the literature. The present study will determine the mass attenuation coefficient of Adobe. The minimum required thicknesses for the primary and secondary barriers will be estimated for the shielding of radiological facilities where conventional and dental X-rays are performed. For the experimental procedure, an X-ray source emitted direct radiation towards different thicknesses of an Adobe barrier, and a detector was placed on the other side. For this purpose, an UNFORS Xi solid state detector was used, which collected information on the difference of radiation intensity. The initial parameters of the exposure started at 45 kV; and then the tube tension was varied in increments of 5 kV, reaching a maximum of 125 kV. The X-Ray tube was positioned at a distance of 0.5 m from the surface of the Adobe bricks, and the collimation of the radiation beam was set for an area of 0.15 m x 0.15 m. Finally, mathematical methods were applied to determine the mass attenuation coefficient for different energy ranges. In conclusion, the mass attenuation coefficient for Adobe was determined and the approximate thicknesses of the most common Adobe barriers in the hospital buildings were calculated for their later application in the radiological protection.

Keywords: Adobe, attenuation coefficient, radiological protection, shielding, x-rays

Procedia PDF Downloads 157

Authors: Laila Seada, Ashraf Ibrahim, Amjad Al Shammari

Abstract:

Background and Objectives: Breast carcinoma is the most common cancer of females in Hail region, accounting for 31% of all diagnosed cancer cases followed by thyroid carcinoma (25%) and colorectal carcinoma (13%). Methods: In the present retrospective study, all cases of breast lesions received at the histopathology department in King Khalid Hospital, Hail, during the period from May 2011 to April 2016 have been retrieved from department files. For all cases, a trucut biopsy, lumpectomy, or modified radical mastectomy was available for histopathologic diagnosis, while 105/140 (75%) had, as well, preoperative fine needle aspirates (FNA). Results: 49 cases out of 140 (35%) breast lesions were carcinomas: 44/49 (89.75%) was invasive ductal, 2/49(4.1%) invasive lobular carcinomas, 1/49(2.05%) intracystic low grade papillary carcinoma and 2/49 (4.1%) ductal carcinoma in situ (DCIS). Mean age for malignant cases was 45.06 (+/-10.58): 32.6% were below the age of 40 and 30.6 below 50 years, 18.3% below 60 and 16.3% below 70 years. For the benign group, mean age was 32.52 (+/10.5) years. Benign lesions were in order of frequency: 34 fibroadenomas, 14 fibrocystic disease, 12 chronic mastitis, five granulomatous mastitis, three intraductal papillomas, and three benign phyllodes tumor. Tubular adenoma, lipoma, skin nevus, pilomatrixoma, and breast reduction specimens constituted the remaining specimens. Conclusion: Breast lesions are common in our series and invasive carcinoma accounts for more than 1/3^rd of the lumps, with 63.2% incidence in pre-menopausal ladies, below the age of 50 years. FNA as a non-invasive procedure, proved to be an effective tool in diagnosing both benign and malignant/suspicious breast lumps and should continue to be used as a first assessment line of palpable breast masses.

Keywords: age incidence, breast carcinoma, fine needle aspiration, hail region

Procedia PDF Downloads 279

Authors: Rizwan Iqbal

Abstract:

Introduction: Re-TURBT has been recommended by international guidelines for patients with non-muscle invasive bladder cancer (NMIBC) who are deemed high-risk. Indications for re-TURBTs remain controversial and studies show mixed outcomes. It should be performed when the initial TURBT specimen lacks detrusor muscle, has tumor stage pT1 or G3/high-grade, or where resection is deemed incomplete. This ensures complete resection of tumors that have a high risk of recurrence as well as accurately identifying any tumors which have been upstaged. The aim of this audit was to evaluate the quality of re-TURBTs in a district general hospital. Method: Data were retrospectively collected from 31 patients who had re-TURBTs between April 2021 and September 2022. Data included baseline demographics, time from initial to re-TURBT, quality of operation note, presence of residual tumor, complications, and administration of chemotherapy within 24 hours of the initial TURBT. Data collection remains ongoing at the time of writing. Results: The mean age was 76 years old and 71.0% of patients were male. 32.3% of patients had their re-TURBT within six weeks and 32.3% had intravesical chemotherapy administered within 24 hours of the initial TURBT. 74.2% of initial TURBTs had detrusor muscle present in the specimen. 48.4% of patients had residual disease following re-TURBT. Just one patient had their pathology upstaged at re-TURBT. The use of the TURBT proforma on the operation note was variable, with 51.6% and 38.7% of surgeons using the proforma after the initial and re-TURBT. Conclusion: Re-TURBT improves bladder cancer staging and is necessary in patients who are deemed high-risk in order to identify any upstaging or recurrence of the disease.

Keywords: urology, bladder cancer, turbt, cancer

Procedia PDF Downloads 62

Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

Abstract:

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: anaemia, haemoglobinopathies, pregnancy, sickle cell disease

Procedia PDF Downloads 258

Authors: Abdul Matin, Muazzama Akhtar, Shahid Nisar, Saddaf Mazzar, Umer Rashid

Abstract:

Antibiotic resistance is an increasing concern worldwide now a day. Neisseria gonorrhea and Staphylococcus aureus are known to cause major human sexually transmitted and respiratory diseases respectively. Nanotechnology is an emerging discipline and its application in various fields especially in medical sciences is gigantic. In the present study, we synthesized multi-walled carbon nanotubes (MWNTs) using acid oxidation method and solubilized MWNTs were with length predominantly >500 nm and diameters ranging from 40 to 50 nm. The locally synthesized MWNTs were used against gram positive and negative bacteria to determine their impact on bacterial growth. Clinical isolates of Neisseria gonorrhea (isolate: 4C-11) and Staphylococcus aureus (isolate: 38541) were obtained from local hospital and normally cultured in LB broth at 37°C. Both clinical strains can be obtained on request from University of Gujarat. Spectophometric assay was performed to determine the impact of MWNTs on bacterial growth in vitro. To determine the effect of MWTNs on test organisms, various concentration of MWNTs were used and recorded observation on various time intervals to understand the growth inhibition pattern. Our results demonstrated that MWNTs exhibited toxic effects to Staphylococcus aureus while showed very limited growth inhibition to Neisseria gonorrhea, which suggests the resistant potential of Neisseria against nanoparticles. Our results clearly demonstrate the gradual decrease in bacterial numbers with passage of time when compared with control. Maximum bacterial inhibition was observed at maximum concentration (50 µg/ml). Our future work will include further characterization and mode of action of our locally synthesized MWNTs. In conclusion, we investigated and reported for the first time the inhibitory potential of locally synthesized MWNTs on local clinical isolates of Staphylococcus aureus and Neisseria gonorrhea.

Keywords: antibacterial activity, multi walled carbon nanotubes, Neisseria gonorrhea, spectrophotometer assay, Staphylococcus aureus

Procedia PDF Downloads 314

Authors: Maria Lucia G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

Isosporiasis is an affliction caused by coccidial protozoa belonging to genera Isospora spp. or Cystoisospora spp., which may parasitize the small and large intestines of dogs, of which neonates and young animals present higher risk of infection. This study aims at reporting a case of isosporiasis in neonate Pitbull dogs, as well as the diagnosis and treatment. Seven Pitbull puppies were admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil, with history of yellowish diarrhea without mucus or blood for the past two days. The animals were five days old. The history of the mother, a primiparous two-year-old, revealed that she was properly vaccinated, not de-wormed and did not present diarrhea. The clinical examination revealed that the neonates weighted between 308 and 360 grams, and presented normal reflexes, moderate dehydration, body temperatures between 36.8 and 37.2 ºC, blood sugar between 103 and 124 mg/dL and normal appetite. A full blood count and a parasitology assay were performed to aid in the diagnosis. The full blood count detected eosinophilia, without any other relevant alterations. The parasitology assay (Willis-Molly & Faust) revealed the presence of Cystoisospora spp. The treatment was instituted with heated fluid therapy with Ringer’s Lactate (4 mL/100 g, subcutaneous) and antibiotic therapy with sulfamethoxazole-trimethoprim (15 mg/kg, orally) every 12 hours for ten days. The mother and other dogs that came in contact with the newborns were also treated. The environment was disinfected for 10 minutes with 1.6% quaternary ammonium. After 10 days, the newborns presented normal clinical signs and no alterations in the full blood count. Isosporiasis is an affliction with high mortality rates in litters that should be diagnosed and treated as soon as possible to increase the survival rates in these patients.

Keywords: Cystoisospora spp., neonatal infection, puppies, diarrhea,

Procedia PDF Downloads 129

Authors: Wojciech Kulesza

Abstract:

The north-western part of the Poland, specifically West Pomerania and Lubuskie provinces, from several years are the subject of research of the Department of Archaeology of Early Middle Ages of Institute of Archaeology of Nicolaus Copernicus University in Toruń. This area has a dense network of rivers and numerous lakes, where many of them are connected to the southern part of the Baltic Sea. During the many years of research in this area, archaeologists discovered the remains of the early Middle Ages settlement located on several islands and in most cases were encountered relics of early Middle Ages bridges linking those islands with the mainland. During the excavation, work was carried out both under water and on land for the accurate identification of islands and adjacent to them underwater areas. The result of this work is a graphic documentation, made in a three-dimensional technique, not only for the underwater trenches but also relics of bridges and objects discovered during exploration, which as the main theme will be presented in the full presentation.

Keywords: Poland, underwater archaeology, Nicolaus Copernicus University, early middle ages

Procedia PDF Downloads 245

Authors: Abdul-Ganiyu Fuseini, Bernice Redley, Helen Rawson, Lenore Lay, Debra Kerr

Abstract:

Aim: The study aimed to develop and validate a culturally appropriate patient-reported outcome measure for measuring dignity for older adults during acute hospital admissions. Design: A three-phased mixed-method sequential exploratory design was used. Methods: Concept elicitation and generation of items for the scale was informed by older adults’ perspectives about dignity during acute hospitalization and a literature review. Content validity evaluation and pre-testing were undertaken using standard instrument development techniques. A cross-sectional survey design was conducted involving 270 hospitalized older adults for evaluation of construct and convergent validity, internal consistency reliability, and test–retest reliability of the scale. Analysis was performed using Statistical Package for the Social Sciences, version 25. Reporting of the study was guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: We established the 15-item Hospitalized Older Adults’ Dignity Scale that has a 5-factor structure: Shared Decision-Making (3 items); Healthcare Professional-Patient Communication (3 items); Patient Autonomy (4 items); Patient Privacy (2 items); and Respectful Care (3 items). Excellent content validity, adequate construct and convergent validity, acceptable internal consistency reliability, and good test-retest reliability were demonstrated. Conclusion: We established the Hospitalized Older Adults Dignity Scale as a valid and reliable scale to measure dignity for older adults during acute hospital admissions. Future studies using confirmatory factor analysis are needed to corroborate the dimensionality of the factor structure and external validity of the scale. Routine use of the scale may provide information that informs the development of strategies to improve dignity-related care in the future. Impact: The development and validation of the Hospitalized Older Adults Dignity Scale will provide healthcare professionals with a feasible and reliable scale for measuring older adults’ dignity during acute hospitalization. Routine use of the scale may enable the capturing and incorporation of older patients’ perspectives about their healthcare experience and provide information that informs the development of strategies to improve dignity-related care in the future.

Keywords: dignity, older adults, hospitalisation, scale, patients, dignified care, acute care

Procedia PDF Downloads 90

Authors: Silas Webb, Joseph Hartland

Abstract:

Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

Procedia PDF Downloads 186

Authors: Fatemeh Keivanifard

Abstract:

E-learning is becoming increasingly prominent in higher education, with universities increasing provision and more students signing up. This paper examines factors that predict students' attitudes to adapt e-learning at the Khuzestan province Iran. Understanding the nature of these factors may assist these universities in promoting the use of information and communication technology in teaching and learning. The main focus of the paper is on the university students, whose decision supports effective implementation of e-learning. Data was collected through a survey of 300 post graduate students at the University of dezful, shooshtar and chamran in Khuzestan. The technology adoption model put forward by Davis is utilized in this study. Two more independent variables are added to the original model, namely, the pressure to act and resources availability. The results show that there are five factors that can be used in modeling students' attitudes to adapt e-learning. These factors are intention toward e-learning, perceived usefulness of e-learning, perceived ease of e-learning use, pressure to use e-learning, and the availability of resources needed to use e-learning.

Keywords: e-learning, intention, ease of use, pressure to use, usefulness

Procedia PDF Downloads 368