Search results for: medical specialties
3315 Making Waves: Preparing the Next Generation of Bilingual Medical Doctors
Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan
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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.Keywords: bilingual, English, medicine, doctor
Procedia PDF Downloads 1393314 Anonymity and Irreplaceability: Gross Anatomical Practices in Japanese Medical Education
Authors: Ayami Umemura
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Without exception, all the bodies dissected in the gross anatomical practices are bodies that have lived irreplaceable lives, laughing and talking with family and friends. While medical education aims to cultivate medical knowledge that is universally applicable to all human bodies, it relies on a unique, irreplaceable, and singular entity. In this presentation, we will explore the ``irreplaceable relationship'' that is cultivated between medical students and anonymous cadavers during gross anatomical practices, drawing on Emmanuel Levinas's ``ethics of the face'' and Martin Buber's discussion of “I-Thou.'' Through this, we aim to present ``a different ethic'' that emerges only in the context of face-to-face relationships, which differs from the generalized, institutionalized, mass-produced ethics like seen in so-called ``ethics codes.'' Since the 1990s, there has been a movement around the world to use gross anatomical practices as an "educational tool" for medical professionalism and medical ethics, and some educational institutions have started disclosing the actual names, occupations, and places of birth of corpses to medical students. These efforts have also been criticized because they lack medical calmness. In any case, the issue here is that this information is all about the past that medical students never know directly. The critical fact that medical students are building relationships from scratch and spending precious time together without any information about the corpses before death is overlooked. Amid gross anatomical practices, a medical student is exposed to anonymous cadavers with faces and touching and feeling them. In this presentation, we will examine a collection of essays written by medical students on gross anatomical practices collected by the Japanese Association for Volunteer Body Donation from medical students across the country since 1978. There, we see the students calling out to the corpse, being called out to, being encouraged, superimposing the carcasses on their own immediate family, regretting parting, and shedding tears. Then, medical students can be seen addressing the dead body in the second person singular, “you.” These behaviors reveal an irreplaceable relationship between the anonymous cadavers and the medical students. The moment they become involved in an irreplaceable relationship between “I and you,” an accidental and anonymous encounter becomes inevitable. When medical students notice being the inevitable takers of voluntary and addressless gifts, they pledge to become “Good Doctors” owing the anonymous persons. This presentation aims to present “a different ethic” based on uniqueness and irreplaceability that comes from the faces of the others embedded in each context, which is different from “routine” and “institutionalized” ethics. That can only be realized ``because of anonymity''.Keywords: anonymity, irreplaceability, uniqueness, singularlity, emanuel levinas, martin buber, alain badiou, medical education
Procedia PDF Downloads 623313 Modelling and Simulation of Single Mode Optical Fiber Directional Coupler for Medical Application
Authors: Shilpa Kulkarni, Sujata Patrikar
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A single-mode fiber directional coupler is modeled and simulated for its application in medical field. Various fiber devices based on evanescent field absorption, interferometry, couplers, resonators, tip coated fibers, etc, have been developed so far, suitable for medical application. This work focuses on the possibility of sensing by single mode fiber directional coupler. In the preset work, a fiber directional coupler is modeled to detect the changes taking place in the surrounding medium optoelectronically. In this work, waveguiding characteristics of the fiber are studied in depth. The sensor is modeled and simulated by finding photocurrent, sensitivity and detection limit by varying various parameters of the directional coupler. The device is optimized for the best possible output. It is found that the directional coupler shows measurable photocurrents and good sensitivity with coupling length in micrometers. It is thus a miniature device, hence, suitable for medical applications.Keywords: single mode fiber directional coupler, modeling and simulation of fiber directional coupler sensor, biomolecular sensing, medical sensor device
Procedia PDF Downloads 2733312 The Impact of Regulatory Changes on the Development of Mobile Medical Apps
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Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.Keywords: agile, applications, FDA, medical, mobile, regulations, software engineering, standards
Procedia PDF Downloads 3593311 Objective Evaluation on Medical Image Compression Using Wavelet Transformation
Authors: Amhimmid Mohammed Saffour, Mustafa Mohamed Abdullah
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The use of computers for handling image data in the healthcare is growing. However, the amount of data produced by modern image generating techniques is vast. This data might be a problem from a storage point of view or when the data is sent over a network. This paper using wavelet transform technique for medical images compression. MATLAB program, are designed to evaluate medical images storage and transmission time problem at Sebha Medical Center Libya. In this paper, three different Computed Tomography images which are abdomen, brain and chest have been selected and compressed using wavelet transform. Objective evaluation has been performed to measure the quality of the compressed images. For this evaluation, the results show that the Peak Signal to Noise Ratio (PSNR) which indicates the quality of the compressed image is ranging from (25.89db to 34.35db for abdomen images, 23.26db to 33.3db for brain images and 25.5db to 36.11db for chest images. These values shows that the compression ratio is nearly to 30:1 is acceptable.Keywords: medical image, Matlab, image compression, wavelet's, objective evaluation
Procedia PDF Downloads 2853310 Identifying, Reporting and Preventing Medical Errors Among Nurses Working in Critical Care Units At Kenyatta National Hospital, Kenya: Closing the Gap Between Attitude and Practice
Authors: Jared Abuga, Wesley Too
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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023Keywords: errors, medical, kenya, nurses, safety
Procedia PDF Downloads 2463309 Performance Analysis with the Combination of Visualization and Classification Technique for Medical Chatbot
Authors: Shajida M., Sakthiyadharshini N. P., Kamalesh S., Aswitha B.
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Natural Language Processing (NLP) continues to play a strategic part in complaint discovery and medicine discovery during the current epidemic. This abstract provides an overview of performance analysis with a combination of visualization and classification techniques of NLP for a medical chatbot. Sentiment analysis is an important aspect of NLP that is used to determine the emotional tone behind a piece of text. This technique has been applied to various domains, including medical chatbots. In this, we have compared the combination of the decision tree with heatmap and Naïve Bayes with Word Cloud. The performance of the chatbot was evaluated using accuracy, and the results indicate that the combination of visualization and classification techniques significantly improves the chatbot's performance.Keywords: sentimental analysis, NLP, medical chatbot, decision tree, heatmap, naïve bayes, word cloud
Procedia PDF Downloads 723308 Scaling Siamese Neural Network for Cross-Domain Few Shot Learning in Medical Imaging
Authors: Jinan Fiaidhi, Sabah Mohammed
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Cross-domain learning in the medical field is a research challenge as many conditions, like in oncology imaging, use different imaging modalities. Moreover, in most of the medical learning applications, the sample training size is relatively small. Although few-shot learning (FSL) through the use of a Siamese neural network was able to be trained on a small sample with remarkable accuracy, FSL fails to be effective for use in multiple domains as their convolution weights are set for task-specific applications. In this paper, we are addressing this problem by enabling FSL to possess the ability to shift across domains by designing a two-layer FSL network that can learn individually from each domain and produce a shared features map with extra modulation to be used at the second layer that can recognize important targets from mix domains. Our initial experimentations based on mixed medical datasets like the Medical-MNIST reveal promising results. We aim to continue this research to perform full-scale analytics for testing our cross-domain FSL learning.Keywords: Siamese neural network, few-shot learning, meta-learning, metric-based learning, thick data transformation and analytics
Procedia PDF Downloads 563307 Formal Stress Management Teaching Incorporated into the First Year of a Doctor's Practice: A Career Transition Study of British Foundation Year 1 Doctors
Authors: Edward Ridyard, Vinary Varadarajan
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Background and Aims: The first year as a doctor in any country represents a major career transition in any physician's life. During this period, many physicians concentrate on obtaining clinical skills but may not obtain the important skills necessary to cope with stress. In this study we elucidate stress levels amongst FY1 doctors regarding the transitioning into specialty career choices, working in the NHS and anxiety about future career success. Methods: A prospective single blinded analysis of Foundation Year one (FY1) trainees using a non-mandatory online questionnaire was distributed. No exclusion criteria were applied. The only inclusion criteria was the doctor was in a full-time FY1 post and this was their first job in the UK. A total of n= 22 doctors were included in the study. After data collection, statistical analysis using chi-squared testing was applied. Results: The large majority of FY1 doctors (72.7%) already knew what specialty they wished to pursue (p=0.0001). With regards to their future careers 45.5% of FY1 doctors stated "above average" stress levels. The majority of FY1 doctors (64.3%) stated their stress levels working in the NHS were either "above average" or "high". Finally, 81.8% of respondents know colleagues who have been put off from pursuing specialties due to the stress of competition. Conclusions: A large majority of FY1 doctors already know at this early stage what area they would like to specialise in. With this in mind, a large proportion have above "average" levels of stress with regards to securing this future career path. The most worrying finding is that 64.3% of FY1s stated they had "above average" or "high" stress levels working in the NHS. We therefore recommend formal stress management education to be incorporated into the foundation programme curriculum.Keywords: stress, anxiety, junior doctor, education
Procedia PDF Downloads 3703306 Multi-Scaled Non-Local Means Filter for Medical Images Denoising: Empirical Mode Decomposition vs. Wavelet Transform
Authors: Hana Rabbouch
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In recent years, there has been considerable growth of denoising techniques mainly devoted to medical imaging. This important evolution is not only due to the progress of computing techniques, but also to the emergence of multi-resolution analysis (MRA) on both mathematical and algorithmic bases. In this paper, a comparative study is conducted between the two best-known MRA-based decomposition techniques: the Empirical Mode Decomposition (EMD) and the Discrete Wavelet Transform (DWT). The comparison is carried out in a framework of multi-scale denoising, where a Non-Local Means (NLM) filter is performed scale-by-scale to a sample of benchmark medical images. The results prove the effectiveness of the multiscaled denoising, especially when the NLM filtering is coupled with the EMD.Keywords: medical imaging, non local means, denoising, multiscaled analysis, empirical mode decomposition, wavelets
Procedia PDF Downloads 1413305 A Comparison between Different Segmentation Techniques Used in Medical Imaging
Authors: Ibtihal D. Mustafa, Mawia A. Hassan
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Tumor segmentation from MRI image is important part of medical images experts. This is particularly a challenging task because of the high assorting appearance of tumor tissue among different patients. MRI images are advance of medical imaging because it is give richer information about human soft tissue. There are different segmentation techniques to detect MRI brain tumor. In this paper, different procedure segmentation methods are used to segment brain tumors and compare the result of segmentations by using correlation and structural similarity index (SSIM) to analysis and see the best technique that could be applied to MRI image.Keywords: MRI, segmentation, correlation, structural similarity
Procedia PDF Downloads 4103304 The Perspectives of Preparing Psychology Practitioners in Armenian Universities
Authors: L. Petrosyan
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The problem of psychologist training remains a key priority in Armenia. During the Soviet period, the notion of a psychologist was obscure not only in Armenia but also in other Soviet republics. The breakup of the Soviet Union triggered a gradual change in this area activating the cooperation with specialists from other countries. The need for recovery from the psychological trauma caused by the 1988 earthquake pushed forward the development of practical psychology in Armenia. This phenomenon led to positive changes in perception of and interest to a psychologist profession.Armenian universities started designing special programs for psychologists’ preparation. Armenian psychologists combined their efforts in the field of training relevant specialists. During the recent years, the Bologna educational system was introduced in Armenia which led to implementation of education quality improvement programs. Nevertheless, even today the issue of psychologists’ training is not yet settled in Armenian universities. So far graduate psychologists haven’t got a clear idea of personal and professional qualities of a psychologist. Recently, as a result of educational reforms, the psychology curricula underwent changes, but so far they have not led to a desired outcome. Almost all curricula in certain specialties are aimed to form professional competencies and strengthen practical skills. A survey conducted in Armenia aimed to identify what are the ideas of young psychology specialists on the image of a psychologist. The survey respondents were 45 specialists holding bachelor’s degree as well as 30 master degree graduates, who have not been working yet. The research reveals that we need to change the approach of preparing psychology practitioners in the universities of Armenia. Such an approach to psychologist training will make it possible to train qualified specialists for enhancement of modern psychology theory and practice.Keywords: practitioners, psychology degree, study, professional competencies
Procedia PDF Downloads 4523303 A Medical Resource Forecasting Model for Emergency Room Patients with Acute Hepatitis
Authors: R. J. Kuo, W. C. Cheng, W. C. Lien, T. J. Yang
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Taiwan is a hyper endemic area for the Hepatitis B virus (HBV). The estimated total number of HBsAg carriers in the general population who are more than 20 years old is more than 3 million. Therefore, a case record review is conducted from January 2003 to June 2007 for all patients with a diagnosis of acute hepatitis who were admitted to the Emergency Department (ED) of a well-known teaching hospital. The cost for the use of medical resources is defined as the total medical fee. In this study, principal component analysis (PCA) is firstly employed to reduce the number of dimensions. Support vector regression (SVR) and artificial neural network (ANN) are then used to develop the forecasting model. A total of 117 patients meet the inclusion criteria. 61% patients involved in this study are hepatitis B related. The computational result shows that the proposed PCA-SVR model has superior performance than other compared algorithms. In conclusion, the Child-Pugh score and echogram can both be used to predict the cost of medical resources for patients with acute hepatitis in the ED.Keywords: acute hepatitis, medical resource cost, artificial neural network, support vector regression
Procedia PDF Downloads 4223302 Mediation in Turkish Health Law for Healthcare Disputes
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In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.Keywords: malpractice mediation, medical disputes, reconciliation, health litigation, Turkish health law
Procedia PDF Downloads 3123301 Performance Comparison of Tablet Devices and Medical Diagnostic Display Devices Using Digital Object Patterns in PACS Environment
Authors: Yan-Lin Liu, Cheng-Ting Shih, Jay Wu
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Tablet devices have been introduced into the medical environment in recent years. The performance of display can be varied based on the use of different hardware specifications and types of display technologies. Therefore, the differences between tablet devices and medical diagnostic LCDs have to be verified to ensure that image quality is not jeopardized for clinical diagnosis in a picture archiving and communication system (PACS). In this study, a set of randomized object test patterns (ROTPs) were developed, which included randomly located spheres in abdominal CT images. Five radiologists were asked to independently review the CT images on different generations of iPads and a diagnostic monochrome medical LCD monitor. Receiver operating characteristic (ROC) analysis was performed by using a five-point rating scale, and the average area under curve (AUC) and average reading time (ART) were calculated. The AUC values for the second generation iPad, iPad mini, iPad Air, and monochrome medical monitor were 0.712, 0.717, 0.725, and 0.740, respectively. The differences between iPads were not significant. The ARTs were 177 min and 127 min for iPad mini and medical LCD monitor, respectively. A significant difference appeared (p = 0.04). The results show that the iPads were slightly inferior to the monochrome medical LCD monitor. However, tablet devices possess advantages in portability and versatility, which can improve the convenience of rapid diagnosis and teleradiology. With advances in display technology, the applicability of tablet devices and mobile devices may be more diversified in PACS.Keywords: tablet devices, PACS, receiver operating characteristic, LCD monitor
Procedia PDF Downloads 4803300 Diversion of Airplanes for Medical Emergencies at Taoyuan International Airport
Authors: Chin-Hsiang Lo, Wey Chia, Shih-Tien Hsu
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Introduction: Since 2016, the annual number of passengers on commercial flights at Taoyuan International Airport (TIA) has been ~40 million. Due to the outbreak and spread of COVID-19, the number of international flights sharply diminished in recent years. However, TIA is located at an East-Asian flight transportation junction; thus, many commercial and cargo flights continue service. When severe medical events happen on a commercial airliner, the decision to divert or not is based on consideration of both medical and operational issues. This study discusses the events related to the diversion of airplanes or reentry after taxiing for medical emergencies at Taoyuan International Airport. Background: We analyzed emergency medical records from the medical clinic of TIA from January 1, 2017, to December 31, 2022, for patients who needed emergency medical services but were unable to reach the airport clinic by themselves. We also collected data for patients treated after diversion from other airports or reentry after taxiing due to medical emergencies. Information such as when and where the event occurred, chief signs and symptoms, the tentative diagnosis (using the ICD-9-CM), management, and the sociodemographic features of the passengers were extracted from the medical records. Summary of Cases: TIA handled approximately 152 million passengers and 1,093,762 flights during the study period; a total of 2,804 emergencies occurred during this time period. Thirty-three medical emergencies warranted diversion (21 cases) or reentry (12 cases); 13 cases were diverted from Asia-Pacific flights and five from Asia-North America flights. The age of the passengers with diversion emergencies ranged from 2–85 years (mean, 46±20-years-old). Twenty-seven patients were transported to an emergency department, and four patients died. For all cases of diversion or reentry, the most common diagnoses were neurogenic problems (42.4%), Out-of-hospital cardiac arrest (OHCA) (15.2%), and cardiovascular problems (12.1%). Discussion: Most aircraft diversions were related to syncope, seizure, and OHCA. The decision to divert depends on medical and operational considerations. Emergency conditions are often serious; thus, improvement of the effectiveness of cooperation between airlines and medical teams remains a challenge.Keywords: diversion, syncope, seizure, OHCA
Procedia PDF Downloads 813299 Addressing Primary Care Clinician Burnout in a Value Based Care Setting During the COVID-19 Pandemic
Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar
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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement
Procedia PDF Downloads 823298 A Quantitative Model for Replacement of Medical Equipment Based on Technical and Environmental Factors
Authors: Ghadeer Mohammad Said El-Sheikh, Samer Mohamad Shalhoob
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Medical equipment operation state is a valid reflection of health care organizations' performance, where such equipment highly contributes to the quality of healthcare services on several levels in which quality improvement has become an intrinsic part of the discourse and activities of health care services. In healthcare organizations, clinical and biomedical engineering departments play an essential role in maintaining the safety and efficiency of such equipment. One of the most challenging topics when it comes to such sophisticated equipment is the lifespan of medical equipment, where many factors will impact such characteristics of medical equipment through its life cycle. So far, many attempts have been made in order to address this issue where most of the approaches are kind of arbitrary approaches and one of the criticisms of existing approaches trying to estimate and understand the lifetime of a medical equipment lies under the inquiry of what are the environmental factors that can play into such a critical characteristic of a medical equipment. In an attempt to address this shortcoming, the purpose of our study rises where in addition to the standard technical factors taken into consideration through the decision-making process by a clinical engineer in case of medical equipment failure, the dimension of environmental factors shall be added. The investigations, researches and studies applied for the purpose of supporting the decision making process by a clinical engineers and assessing the lifespan of healthcare equipment’s in the Lebanese society was highly dependent on the identification of technical criteria’s that impacts the lifespan of a medical equipment where the affecting environmental factors didn’t receive the proper attention. The objective of our study is based on the need for introducing a new well-designed plan for evaluating medical equipment depending on two dimensions. According to this approach, the equipment that should be replaced or repaired will be classified based on a systematic method taking into account two essential criteria; the standard identified technical criteria and the added environmental criteria.Keywords: technical, environmental, healthcare, characteristic of medical equipment
Procedia PDF Downloads 1553297 Toward Automatic Chest CT Image Segmentation
Authors: Angely Sim Jia Wun, Sasa Arsovski
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Numerous studies have been conducted on the segmentation of medical images. Segmenting the lungs is one of the common research topics in those studies. Our research stemmed from the lack of solutions for automatic bone, airway, and vessel segmentation, despite the existence of multiple lung segmentation techniques. Consequently, currently, available software tools used for medical image segmentation do not provide automatic lung, bone, airway, and vessel segmentation. This paper presents segmentation techniques along with an interactive software tool architecture for segmenting bone, lung, airway, and vessel tissues. Additionally, we propose a method for creating binary masks from automatically generated segments. The key contribution of our approach is the technique for automatic image thresholding using adjustable Hounsfield values and binary mask extraction. Generated binary masks can be successfully used as a training dataset for deep-learning solutions in medical image segmentation. In this paper, we also examine the current software tools used for medical image segmentation, discuss our approach, and identify its advantages.Keywords: lung segmentation, binary masks, U-Net, medical software tools
Procedia PDF Downloads 983296 Determinants of Quality of Life and Mental Health in Medical Students During Two Years Observation
Authors: Szymon Szemik, Małgorzata Kowalska
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Objective: Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status. POLLEK (POLski LEKarz, eng. Polish Physician) study aims to identify and evaluate the quality of life, mental health status, and ever-recognized chronic diseases by simultaneously assessing their determinants in Polish medical students during long-term observation. Material and Methods: The POLLEK is the follow-up cohort study conducted among medical students at the Medical University of Silesia in Katowice. Students were followed during two observation periods: in their first year of studies, the academic year 2021/2022 (T1), and in their second year, the academic year 2022/2023 (T2). Results: The total number of participants in the first year of observation (T1) was 427 while in the second year (T2) was 335. Obtained results confirmed that the QoL score significantly decreased in their second year of studies mainly in the somatic and psychological domains. Moreover, we observed a significant increase in self-declared scoring of somatic symptoms year by year (from M=4.75 at T1 to M=8.06 at T2, p<0.001) in the GHQ-28 questionnaire survey. The determinants of QoL domains common to T1 and T2 remained self-declared health status, frequency of physical activity, and current financial situation. In the first year of evaluation, 56 students (13.10%) were overweight or obese, and 52 (15.8%) in the second. Regardless of the academic year, the increased risk of being overweight or obese was significantly associated with dissatisfaction with personal health, financial deficiencies, and a diet abundant in meat consumption. Conclusions: The QoL in medical students and selected determinants of their health status deteriorated during the observation period. Our findings suggest that medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study.Keywords: quality of life, mental health, medical students, follow-up study
Procedia PDF Downloads 403295 Injection Practices among Private Medical Practitioners of Karachi Pakistan
Authors: Mohammad Tahir Yousafzai, Nighat Nisar, Rehana Khalil
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The aim of this study is to assess the practices of sharp injuries and factors leading to it among medical practitioners in slum areas of Karachi, Pakistan. A cross sectional study was conducted in slum areas of Landhi Town Karachi. All medical practitioners (317) running the private clinics in the areas were asked to participate in the study. Data was collected on self administered pre-tested structured questionnaires. The frequency with percentage and 95% confidence interval was calculated for at least one sharp injury (SI) in the last one year. The factors leading to sharp injuries were assessed using multiple logistic regressions. About 80% of private medical practitioners consented to participate. Among these 87% were males and 13% were female. The mean age was 38±11 years and mean work experience was 12±9 years. The frequency of at least one sharp injury in the last one year was 27%(95% CI: 22.2-32). Almost 47% of Sharp Injuries were caused by needle recapping, less work experience, less than 14 years of schooling, more than 20 patients per day, administering more than 30 injections per day, reuse of syringes and needle recapping after use were significantly associated with sharp injuries. Injection practices were found inadequate among private medical practitioners in slum areas of Karachi, and the frequency of Sharp Injuries was found high in these areas. There is a risk of occupational transmission of blood borne infections among medical practitioners warranting an urgent need for launching awareness and training on standard precautions for private medical practitioners in the slum areas of Karachi.Keywords: injection practices, private practitioners, sharp injuries, blood borne infections
Procedia PDF Downloads 4203294 Polymorphisms of the UM Genotype of CYP2C19*17 in Thais Taking Medical Cannabis
Authors: Athicha Cherdpunt, Patompong Satapornpong
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The medical cannabis is made up of components also known as cannabinoids, which consists of two ingredients which are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). Interestingly, the Cannabinoid can be used for many treatments such as chemotherapy, including nausea and vomiting, cachexia, anorexia nervosa, spinal cord injury and disease, epilepsy, pain, and many others. However, the adverse drug reactions (ADRs) of THC can cause sedation, anxiety, dizziness, appetite stimulation and impairments in driving and cognitive function. Furthermore, genetic polymorphisms of CYP2C9, CYP2C19 and CYP3A4 influenced the THC metabolism and might be a cause of ADRs. Particularly, CYP2C19*17 allele increases gene transcription and therefore results in ultra-rapid metabolizer phenotype (UM). The aim of this study, is to investigate the frequency of CYP2C19*17 alleles in Thai patients who have been treated with medical cannabis. We prospectively enrolled 60 Thai patients who were treated with medical cannabis and clinical data from College of Pharmacy, Rangsit University. DNA of each patient was isolated from EDTA blood, using the Genomic DNA Mini Kit. CYP2C19*17 genotyping was conducted using the real time-PCR ViiA7 (ABI, Foster City, CA, USA). 30 patients with medical cannabis-induced ADRs group, 20 (67%) were female, and 10 (33%) were male, with an age range of 30-69 years. On the other hand, 30 patients without medical cannabis-induced ADRs (control group) consist of 17 (57%) female and 13 (43%) male. The most ADRs for medical cannabis treatment in the case group were dry mouth and dry throat (77%), tachycardia (70%), nausea (30%) and arrhythmia(10%). Accordingly, the case group carried CYP2C19*1/*1 (normal metabolizer) approximately 93%, while 7% patients carrying CYP2C19*1/*17 (ultra rapid metabolizers) exhibited in this group. Meanwhile, we found 90% of CYP2C19*1/*1 and 10% of CYP2C19*1/*17 in control group. In this study, we identified the frequency of CYP2C19*17 allele in Thai population which will support the pharmacogenetics biomarkers for screening and avoid ADRs of medical cannabis treatment.Keywords: CYP2C19, allele frequency, ultra rapid metabolizer, medical cannabis
Procedia PDF Downloads 1093293 The Impact of the Core Competencies in Business Management to the Existence and Progress of Traditional Foods Business with the Case of Study: Gudeg Sagan Yogyakarta
Authors: Lutfi AuliaRahman, Hari Rizki Ananda
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The traditional food is a typical food of a certain region that has a taste of its own unique and typically consumed by a society in certain areas, one of which is Gudeg, a regional specialties traditional food of Yogyakarta and Central Java which is made of young jackfruit cooked in coconut milk, edible with rice and served with thick coconut milk (areh), chicken, eggs, tofu and sambal goreng krecek. However, lately, the image of traditional food has declined among people, so with gudeg, which today's society, especially among young people, tend to prefer modern types of food such as fast food and some other foods that are popular. Moreover, traditional food usually only preferred by consumers of local communities and lack of demand by consumers from different areas for different tastes. Thus, the traditional food producers increasingly marginalized and their consumers are on the wane. This study aimed to evaluate the management used by producers of traditional food with a case study of Gudeg Sagan which located in the city of Yogyakarta, with the ability of their management in creating core competencies, which includes the competence of cost, competence of flexibility, competence of quality, competence of time, and value-based competence. And then, in addition to surviving and continuing to exist with the existing external environment, Gudeg Sagan can increase the number of consumers and also reach a broader segment of teenagers and adults as well as consumers from different areas. And finally, in this paper will be found positive impact on the creation of the core competencies of the existence and progress of the traditional food business based on case study of Gudeg Sagan.Keywords: Gudeg Sagan, traditional food, core competencies, existence
Procedia PDF Downloads 2513292 Assessing the Incapacity of Indonesian Aviators Medical Conditions in 2016 – 2017
Authors: Ferdi Afian, Inne Yuliawati
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Background: The change in causes of death from infectious diseases to non-communicable diseases also occurs in the aviation community in Indonesia. Non-communicable diseases are influenced by several internal risk factors, such as age, lifestyle changes and the presence of other diseases. These risk factors will increase the incidence of heart diseases resulting in the incapacity of Indonesian aviators which will disrupt flight safety. Method: The study was conducted by collecting secondary data. The retrieval of primary data was obtained from medical records at the Indonesian Aviation Health Center in 2016-2017. The subjects in this study were all cases of incapacity in Indonesian aviators medical conditions. Results: In this study, there were 15 cases of aviators in Indonesia who experienced incapacity of medical conditions related to heart and lung diseases in 2016-2017. Based on the secondary data contained in the flight medical records at the Aviation Health Center Aviation, it was found that several factors related to aviators incapacity causing its inability to carried out flight duties. Conclusion: Incapacity of Indonesian aviators medical conditions are most affected by the high value of Body Mass Index (86%) and less affected by high of Uric Acid in the blood (26%) and Hyperglycemia (26%).Keywords: incapacity, aviators, flight, Indonesia
Procedia PDF Downloads 1313291 Impacts of Online Behaviors on Empathy in Medical Students
Authors: Ling-Lang Huang, Yih-Jer Wu
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Empathy is crucial for a patient-physician relationship and medical professionalism. Internet activity, gaming, or even addiction, have been more and more common among medical students. However, there’s been no report showing whether internet behavior has a substantial impact on empathy in medical students to our best knowledge. All year-2 medical students taking the optional course 'Narrative, Comprehension, and Communication' were enrolled. Internet behaviors are divided into two groups, 'internet users without online gaming (IU)' and 'internet users with online gaming (IG)', each group was further divided into 3 groups according to their average online retention time each day (< 2, 2 - 6, > 6 hours). Empathy was evaluated by the scores of the reports and humanities reflection after watching indicated movies, and by self-measured empathy questionnaire. All students taking the year-2 optional course 'Narrative, Comprehension, and Communication' were enrolled. As compared with students in the IU group, those in the IG group had significantly lower scores for the reports (81.3 ± 3.7 vs. 86.4 ± 5.1, P = 0.014). If further dividing the students into 5 groups (IU < 2, IU 2-6, IG < 2, IG 2 - 6, and IG > 6 hours), the scores were significantly and negatively correlated to online gaming with longer hours (r = -0.556, P = 0.006). However, there was no significant difference between IU and IG groups (33.0 ± 5.4 vs. 34.8 ± 3.2, P = n.s.), in terms of scores in the self-measured empathy questionnaire, neither was there any significant trend of scores along with longer online hours across the 5 groups (r = -0.164, P = n.s.). To date, there has been no evidence showing whether different internet behaviors (with or without online gaming) have distinct impacts on empathy. Although all of the medical students had a similarly good self-perception for empathy, our data suggested that online gaming did have a negative impact on their actual expression of empathy. Our observation has brought up an important issue for pondering: May IT- or gaming-assisted medical learning actually harm students’ empathy? In conclusion, this data suggests that long hours of online gaming harms expression of empathy, though all medics think themselves a person of high empathy.Keywords: empathy. Internet, medical students, online gaming
Procedia PDF Downloads 1323290 Evaluation of the Sterilization Practice in Liberal Dental Surgeons at Sidi Bel Abbes- Algeria
Authors: A. Chenafa, S. Boulenouar, M. Zitouni, M. Boukouria
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The sterilization of medical devices constitutes for all the medical professions, an inescapable obligation. It has for objective to prevent the infectious risk, both for the patient and for the medical team. The Dental surgeon as every healthcare professional has to master perfectly this subject and to train his staff to the various techniques of sterilization. It is the only way to assure the patients all the security for which they are entitled to wait when they undergo a dental care. It’s for it, that we undertook to lead an investigation aiming at estimating the sterilization practice at the dental surgeon of Sidi bel Abbes. The survey result showed a youth marked with the profession with a majority use of autoclave with cycle B and an almost total absence of the sterilization controls (test of Bowie and Dick). However, the majority of the dentists control and validate their sterilizers. Finally, our survey allowed us to describe some practices which must be improved regarding control, regarding qualification and regarding staff training. And suggestions were made in this sense.Keywords: dental surgeon, medical devices, sterilization, survey
Procedia PDF Downloads 4003289 A Study of Emotional Intelligence and Perceived Stress among First and Second Year Medical Students in South India
Authors: Nitin Joseph
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Objectives: This study was done to assess emotional intelligence levels and to find out its association with socio demographic variables and perceived stress among medical students. Material and Methods: This study was done among first and second year medical students. Data was collected using a self-administered questionnaire. Results: Emotional intelligence scores was found to significantly increase with age of the participants (F=2.377, P < 0.05). Perceived stress was found to be significantly more among first year (t=1.997, P=0.05). Perceived stress was found to significantly decrease with increasing emotional intelligence scores (r = – 0.226, P < 0.001). Conclusion: First year students were found to be more vulnerable to stress than their seniors probably due to lesser emotional intelligence. As both these parameters are related, ample measures to improve emotional intelligence needs to be supported in the training curriculum of beginners so as to make them more stress free during early student life.Keywords: emotional intelligence, medical students, perceived stress, socio demographic variables
Procedia PDF Downloads 4513288 The Effect of a Multidisciplinary Spine Clinic on Treatment Rates and Lead Times to Care
Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky
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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive
Procedia PDF Downloads 1403287 Mandatory Wellness Assessments for Medical Students at the University of Ottawa
Authors: Haykal. Kay-Anne
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The health and well-being of students is a priority for the Faculty of Medicine at the University of Ottawa. The demands of medical studies are extreme, and many studies confirm that the prevalence of psychological distress is very high among medical students and that it is higher than that of the general population of the same age. The main goal is to identify risk factors for mental health among medical students at the University of Ottawa. The secondary objectives are to determine the variation of these risk factors according to demographic variables, as well as to determine if there is a change in the mental health of students during the 1st and 3rd years of their study. Medical students have a mandatory first and third-year wellness check meeting. This assessment includes a questionnaire on demographic information, mental health, and risk factors such as physical health, sleep, social support, financial stress, education and career, stress and drug use and/or alcohol. Student responses were converted to numerical values and analyzed statistically. The results show that 61% of the variation in the mean of the mental health score is explained by the following risk factors (R2 = 0.61, F (9.396) = 67.197, p < 0.01): lack of sleep and fatigue (β = 0.281, p < 0.001), lack of social support (β = 0.217, p <0.001), poor study or career development (β = 0.195, p < 0.001) and an increase stress and drug and alcohol use (β = -0.239, p < 0.001). No demographic variable has a significant effect on the presence of risk factors. In addition, fixed-effects regression demonstrated significantly lower mental health (p < 0.1) among first-year students (M = 0.587, SD = 0.072) than among third-year students (M = 0.719, SD = 0.071). This preliminary study indicates the need to continue data collection and analysis to increase the significance of the study results. As risk factors are present at the beginning of medical studies, it is important to offer resources to students very early in their medical studies and to have close monitoring and supervision.Keywords: assessment of mental health, medical students, risk factors for mental health, wellness assessment
Procedia PDF Downloads 1233286 The Prevalence and Impact of Anxiety Among Medical Students in the MENA Region: A Systematic Review, Meta-Analysis, and Meta-Regression
Authors: Kawthar F. Albasri, Abdullah M. AlHudaithi, Dana B. AlTurairi, Abdullaziz S. AlQuraini, Adoub Y. AlDerazi, Reem A. Hubail, Haitham A. Jahrami
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Several studies have found that medical students have a significant prevalence of anxiety. The purpose of this review paper is to carefully evaluate the current research on anxiety among medical students in the MENA region and, as a result, estimate the prevalence of these disturbances. Multiple databases, including the CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Library, Embase, MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed, PsycINFO (Psychological Information Database), Scopus, Web of Science, UpToDate, ClinicalTrials.gov, WHO Global Health Library, EbscoHost, ProQuest, JAMA Network, and ScienceDirect, were searched. The retrieved article reference lists were rigorously searched and rated for quality. A random effects meta-analysis was performed to compute estimates. The current meta-analysis revealed an alarming estimated pooled prevalence of anxiety (K = 46, N = 27023) of 52.5% [95%CI: 43.3%–61.6%]. A total of 62.0% [95% CI 42.9%; 78.0%] of the students (K = 18, N = 16466) suffered from anxiety during the COVID-19 pandemic, while 52.5% [95% CI 43.3%; 61.6%] had anxiety before COVID-19. Based on the GAD-7 measure, a total of 55.7% [95%CI 30.5%; 78.3%] of the students (K = 10, N = 5830) had anxiety, and a total of 54.7% of the students (K = 18, N = 12154) [95%CI 42.8%; 66.0%] had anxiety using the DASS-21 or 42 measure. Anxiety is a common issue among medical students, making it a genuine problem. Further research should be conducted post-COVD 19, with a focus on anxiety prevention and intervention initiatives for medical students.Keywords: anxiety, medical students, MENA, meta-analysis, prevalence
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