Search results for: patient communication

Authors: Fatemeh Rasooli, Behzad Simiari, Pooya Payandemehr, Amir Nejati, Maryam Bahreini, Atefeh Abdollahi

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Introduction: Pain is a complex physiological reaction to tissue injury. In the course of painful procedures such as nerve block, ice has been shown to be a feasible and inexpensive material to control pain. It delays nerve conduction, actives other senses and reduces inflammatory and painful responses. This study assessed the effect of ice in reducing pain caused by needling and infiltration during digital block. Patient satisfaction recorded as a secondary outcome. Methods: This study was designed as a non-blinded randomized clinical trial approved by Tehran University of Medical Sciences Ethical Committee. Informed consent was taken from all the participants who were then randomly divided into two groups. Digital block performed by standard approach in selected patients. Tubes of ice were prepared in gloves and were fragmented at a time of application for circling around the finger. Tubes were applied for 6 minutes before digital nerve block in the site of needling in the case group. Patients in the control group underwent digital nerve block with the conventional method without ice administration. Numeric Rating Scale (NRS) used for grading pain. 0 used for no pain and 10 for the worst pain that patient had experienced until now. Scores were analyzed by Wilcoxon Rank Sum test and compared in case and control groups. Results: 100 patients aged 16-50 years were enrolled. Mean NRS scores with and without ice were 1.5 mm (S.D ± 1.44) and 6.8 mm (S.D ± 1.40) for needling pain and for infiltration pain were 2.7mm ( S.D ±1.65) and 8.5mm ( S.D ± 1.47), respectively (p<0.001). Besides, patients’ satisfactions were significantly higher in the ice group (p<0.001). Conclusion: Application of ice for 6 minutes significantly reduced pain of needling and infiltration in digital nerve block; thus, it seems to be a feasible and inexpensive material which acts effectively to decrease pain and stress before the procedure.

Keywords: digital block, ice, needle, pain

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Authors: J. S. M. Yang, G. E. T. Chua

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Diploma in Optometry (OPT) course is a three-year program offered by Ngee Ann Polytechnic (NP) to train students to provide primary eye care. Students are equipped with foundational conceptual knowledge and practical skills in the first three semesters before clinical modules in fourth to six semesters. In the clinical modules, students typically have difficulties in integrating the acquired knowledge and skills from the past semesters to perform general eye examinations on public patients at NP Optometry Centre (NPOC). To help the students overcome the challenge, a web-based game Virtual Optometrist (VO) was developed to help students apply their skills and knowledge through scenario-based learning. It consisted of two interfaces, Optical Practice Counter (OPC) and Optometric Consultation Room (OCR), to provide two simulated settings for authentic learning experiences. In OPC, students would recommend and provide appropriate frame and lens selection based on virtual patient’s case history. In OCR, students would diagnose and manage virtual patients with common ocular conditions. Simulated scenarios provided real-world clinical situations that required contextual application of integrated knowledge from relevant modules. The stages in OPC and OCR are of increasing complexity to align to expected students’ clinical competency as they progress to more senior semesters. This prevented gameplay fatigue as VO was used over the semesters to achieve different learning outcomes. Numerous feedback opportunities were provided to students based on their decisions to allow individualized learning to take place. The game-based learning element in VO was achieved through the scoreboard and leader board to enhance students' motivation to perform. Scores were based on the speed and accuracy of students’ responses to the questions posed in the simulated scenarios, preparing the students to perform accurately and effectively under time pressure in a realistic optometric environment. Learning analytics was generated in VO’s backend office based on students’ responses, offering real-time data on distinctive and observable learners’ behavior to monitor students’ engagement and learning progress. The backend office allowed versatility to add, edit, and delete scenarios for different intended learning outcomes. Likert Scale was used to measure students’ learning experience with VO for OPT Year 2 and 3 students. The survey results highlighted the learning benefits of implementing VO in the different modules, such as enhancing recall and reinforcement of clinical knowledge for contextual application to develop higher-order thinking skills, increasing efficiency in clinical decision-making, facilitating learning through immediate feedback and second attempts, providing exposure to common and significant ocular conditions, and training effective communication skills. The results showed that VO has been useful in reinforcing optometry students’ learning and supporting the development of higher-order thinking, increasing efficiency in clinical decision-making, and allowing students to learn from their mistakes with immediate feedback and second attempts. VO also exposed the students to diverse ocular conditions through simulated real-world clinical scenarios, which may otherwise not be encountered in NPOC, and promoted effective communication skills.

Keywords: authentic learning, game-based learning, scenario-based learning, simulated clinical scenarios

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Authors: Isari Pairoa, Proud Arunrangsiwed

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Brand mascots are the cartoon characters, which are mainly designed for advertising or other related marketing purposes. Many brand mascots are extremely popular, since they were presented in commercial advertisements and Line Stickers. Brand Line Stickers could lead the users to identify with the brand and brand mascots, where might influence users to become loyal customers, and share the identity with the brand. The objective of the current study is to examine the effect of brand mascots on consumers’ decision and consumers’ intention to purchase the product. This study involved 400 participants, using cluster sampling from 50 districts in Bangkok metropolitan area. The descriptive analysis shows that using brand mascot causes consumers' positive attitude toward the products, and also heightens the possibility to purchasing the products. The current study suggests the new type of marketing strategy, which is brand fandom. This study has also contributed the knowledge to the area of integrated marketing communication and identification theory.

Keywords: brand mascot, consumers’ behavior, marketing communication, purchasing

Procedia PDF Downloads 256

Authors: Hande Yesil, Seda Aycan Altan, M. Vehbi Bal, Alper Uyar, O. Cumhur Sipahi

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Purpose: Fixed partial dentures (FPDs) must fulfill functional requirements such as phonetics, chewing efficiency and esthetics especially in the anterior region. A convex type tissue surface is usually recommended for pontics of FPDs. That pontic design also provides suitable oral hygiene and ease of cleaning. However, high esthetic requirements and correct emergence profile are not always achievable because of the convex shape of adjacent soft tissues. Therefore, the ovate type pontic which fulfills the high esthetic demands of the patients may be a good alternative to the modified ridge lap pontic design. Clinical Report: A female patient referred with the complaint of anterior upper edentulousness. In the oral examination it was determined that teeth 11, 12, 21, 22 were deficient. A thick and convex gingival tissue that may cause aesthetic problems was also observed.. Periodontal augmentation surgery was performed to ensure proper papillary configuration and gingival contour. An interim removable partial denture (IRPD) which applied pressure to operated gingival tissues was fabricated postoperatively. The IRPD was used for 4 weeks and after completion of tissue sculpting, the permanent FPD with an ovate pontic was fabricated and cemented. After a follow-up period of 6 months, not any esthetical and hygienic problem was detected and the patient was satisfied with her prosthesis. Conclusion: It was concluded that shaping of gingival contours with IRPD and use of a FPD with ovate pontic fulfills all esthetic and hygienic requirements.

Keywords: interim appliance, ovate pontic, tissue sculpturing, fixed partial denture

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Authors: Katarzyna Kamińska

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When thinking about custodial arrangements after divorce or separation, there has been a shift from sole custody, particularly maternal preference, to joint physical custody. In many Western countries, an increasing of children with separated parents have joint physical custody, which is believed to be in the best interests of the child, as children can maintain personal relations and direct contact with both parents on a regular basis. The aim of the article is to examine joint physical custody, both from the perspective of the binding legal instruments that are relevant to joint physical custody, the Principles of European Family Law drafted by the CEFL, as well as the international research on this matter. The thesis underlying this paper is that joint physical custody is in itself neither good nor bad, and it depends on how the arrangements are managed by the parents. The paper includes a reflection on joint physical custody in the face of the COVID-19 crisis. The results indicate that in normal circumstances, joint physical custody demands broad communication, and now it times of crisis, we need over-communication about children and plans. Only a very tight and coordinated co-parenting plan make the whole family safer.

Keywords: joint physical custody, co-parenting, child welfare, COVID-19

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Authors: Venuste Kayinamura, V. Iyamuremye, A. Ngirabakunzi

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Anti-retroviral therapy (ART) for HIV patient can cause a deficiency in glucose metabolism by promoting insulin resistance, glucose intolerance, and diabetes, diabetes mellitus keep increasing among HIV-infected patients worldwide but there is limited data on levels of blood glucose and its relationship with antiretroviral drugs (ARVs) and HIV-infection worldwide, particularly in Rwanda. A convenient sampling strategy was used in this study and it involved 323 HIV patients (n=323). Patients who are HIV positive under ARVs were involved in this study. The patient’s blood glucose was analyzed using an automated machine or glucometer (COBAS C 311). Data were analyzed using Microsoft Excel and SPSS V. 20.0 and presented in percentages. The highest diabetes mellitus prevalence was 93.33 % in people aged >40 years while the lowest diabetes mellitus prevalence was 6.67% in people aged between 21-and 40 years. The P-value was (0.021). Thus, there is a significant association between age and diabetes occurrence. The highest diabetes mellitus prevalence was 28.2% in patients under ART treatment for more than 10 years, 16.7% were <5years while 20% of patients were on ART treatment between 5-10 years. The P-value here is (0.03), thus the incidence of diabetes is associated with long-term ART use in HIV-infected patients. This study assessed the prevalence of diabetes among HIV-infected patients under ARVs attending the University Teaching Hospital of Butare (CHUB), it shows that the prevalence of diabetes is high in HIV-infected patients under ARTs. This study found no significant relationship between gender and diabetes mellitus growth. Therefore, regular assessment of diabetes mellitus especially among HIV-infected patients under ARVs is highly recommended to control other health issues caused by diabetes mellitus.

Keywords: anti-retroviral, diabetes mellitus, antiretroviral therapy, human immune deficiency virus

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Authors: Masud Karim, Md. Solaiman Mia, Saifuddin Md. Tareeq, Md. Hasanuzzaman

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Autism Spectrum Disorder (ASD) is a neurodevelopment disorder. Such disorder is found in childhood life. Children with ASD have less capabilities in communication and social skills. Therapies are used to develop communication and social skills. Recently researchers have been trying to use robots in such therapies. In this paper, we have presented social skill learning test cases for children with ASD. Autism conditions are measured in 30 children in a special school. Among them, twelve children are selected who have equal ASD conditions. Then six children participated in training with humans, and another six children participated in training with robots. The learning session continued for one week and three hours each day. We have taken an assessment test before the learning sessions. After completing the learning sessions, we have taken another assessment test. We have found better performances from children who have participated in robotic sessions rather than the children who have participated in human sessions.

Keywords: children with ASD, NAO robot, human-robot interaction, social skills

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Authors: Oumayma Hilal

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The devastating earthquake in Marrakech-El Haouz in September 2023 underscores the critical need for sustainable tourism practices. This study proposes innovative approaches to territory tourism, prioritizing resilient and sustainable development to aid recovery and empower local communities. Using a mixed-methods approach, the research evaluates post-earthquake tourism impacts, gathers local perspectives, and benchmarks global models for disaster recovery through tourism. The paper aims to offer practical, community-centric tourism initiatives, integrated with strategic communication strategies, to enhance socio-economic welfare and ensure long-term resilience. The findings are expected to contribute significantly to sustainable tourism literature in post-disaster contexts and provide actionable strategies for the revitalization of the Marrakech-El Haouz region.

Keywords: sustainable tourism, community development, Marrakech El Haouz, communication strategies, territory tourism, sustainable tourism, community development

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Authors: Khayriniso Bakhtiyarovna Ganiyeva

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The article explores the significance of punctuation in achieving communicative competence. It underscores that effective communication goes beyond simply using punctuation correctly. In the successful completion of a communicative activity, it is important not that the writer correctly uses punctuation marks but that he was able to achieve a goal aimed at expressing a certain meaning. The unanimity of the writer and the reader in the mutual understanding of the text is of primary importance. It should also be taken into account that situational communication provides special informative content and expressiveness of speech. Also, the norms of the situation are determined by the nature of the information in the text, and the punctuation marks expressed in accordance with the norm perform logical-semantic, highlighting expressive-emotional and signaling functions. It is a mistake to classify the signs subject to the norm of the situation as created by the author because they functionally reflect the general stylistic features of different texts. Such signs are among the common signs that are codified only by the semantics and structure of the created text.

Keywords: communicative-pragmatic approach, expressiveness of speech, stylistic features, comparative analysis

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Authors: Emily Moore, Dora Amos, Tracy Ellimah, Natasha Parrott

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Postoperative haematoma is a well-recognised complication of thyroid surgery with an incidence of 1-5%. Haematoma formation causes progressive airway obstruction, necessitating emergency bedside haematoma evacuation in up to ¼ of patients. ENT UK, BAETS and DAS have developed consensus guidelines to improve perioperative care, recommending that all healthcare staff interacting with patients undergoing thyroid surgery should be trained in managing post-thyroidectomy haematoma. The aim was to assess the effectiveness of a hybrid simulation model in improving clinician’s confidence in dealing with this surgical emergency. A hybrid simulation was designed, consisting of a standardised patient wearing a part-task trainer to mimic a post-thyroidectomy haematoma in a real patient. The part-task trainer was an adapted C-spine collar with layers of silicone representing the skin and strap muscles and thickened jelly representing the haematoma. Both the skin and strap muscle layers had to be opened in order to evacuate the haematoma. Boxes have been implemented into the appropriate post operative areas (recovery and surgical wards), which contain a printed algorithm designed to assist in remembering a sequence of steps for haematoma evacuation using the ‘SCOOP’ method (skin exposure, cut sutures, open skin, open muscles, pack wound) along with all the necessary equipment to open the front of the neck. Small-group teaching sessions were delivered by ENT and anaesthetic trainees to members of the multidisciplinary team normally involved in perioperative patient care, which included ENT surgeons, anaesthetists, recovery nurses, HCAs and ODPs. The DESATS acronym of signs and symptoms to recognise (difficulty swallowing, EWS score, swelling, anxiety, tachycardia, stridor) was highlighted. Then participants took part in the hybrid simulation in order to practice this ‘SCOOP’ method of haematoma evacuation. Participants were surveyed using a Likert scale to assess their level of confidence pre- and post teaching session. 30 clinicians took part. Confidence (agreed/strongly agreed) in recognition of post thyroidectomy haematoma improved from 58.6% to 96.5%. Confidence in management improved from 27.5% to 89.7%. All participants successfully decompressed the haematoma. All participants agreed/strongly agreed, that the sessions were useful for their learning. Multidisciplinary team simulation teaching is effective at significantly improving confidence in both the recognition and management of postoperative haematoma. Hybrid simulation sessions are useful and should be incorporated into training for clinicians.

Keywords: thyroid surgery, haematoma, teaching, hybrid simulation

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Authors: Tony Wilson

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This paper sets out a practices perspective or practices theory, which has become pervasive from business to sociological studies. In doing so, it locates the perspective historically (in the work of the philosopher Heidegger) and provides a contemporary illustration of its application to communication, consumer and cultural studies as central to this conference theme. The structured account of practices (as articulated in eight ‘axioms’) presented towards the conclusion of this paper is an initial statement - planned to encourage further detailed qualitative and systematic research in areas of interest to the conference. Practice theories of equipped and situated construction of participatory meaning (as in media and marketing consuming) are frequently characterized as lacking common ground, or core principles. This paper explores whether by retracing a journey to earlier philosophical underwriting, a shared territory promoting new research can be located as current philosophical hermeneutics. Moreover, through returning to hermeneutic first principles, the paper shows that a series of spatio-temporal metaphors become available - appropriate to analyzing communication as a process across disciplines in which it is considered. Thus one can argue, for instance, that media users engage (enter) digital text from their diverse ‘horizons of expectation’, in a productive enlarging ‘fusion’ of horizons of understanding, thereby ‘projecting’ a new narrative, integrated in a ‘hermeneutic circle’ of meaning. A politics of communication studies may contest a horizon of understanding - so engaging in critical ‘distancing’. Marketing’s consumers can occupy particular places on a horizon of understanding. Media users pass over borders of changing, revised perspectives. Practices research can now not only be discerned in multiple disciplines but equally crosses disciplines. The ubiquitous practice of media use by managers and visitors in a shopping mall - the mediatization of malls - responds to investigating not just with media study expertise, but from an interpretive marketing perspective. How have mediated identities of person or place been changed? Emphasizing understanding of entities in a material environment as ‘equipment’, practices theory enables the quantitative correlation of use and demographic variable as ‘Zeug Score’. Human behavior is fundamentally habitual - shaped by its tacit assumptions - occasionally interrupted by reflection. Practices theory acknowledges such action to be minimally monitored yet nonetheless considers it as constructing narrative. Thus presented in research, ‘storied’ behavior can then be seen to be (in)formed and shaped from a shifting hierarchy of ‘horizons’ or of perspectives - from habituated to reflective - rather than a single seamless narrative. Taking a communication practices perspective here avoids conflating tacit, transformative and theoretical understanding in research. In short, a historically grounded and unifying statement of contemporary practices theory will enhance its potential as a tool in communication, consumer and cultural research, landscaping interpretative horizons of human behaviour through exploring widely the culturally (in)formed narratives equipping and incorporated (reflectively, unreflectively) in people’s everyday lives.

Keywords: communication, consumer, cultural practices, hermeneutics

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Authors: Chih-Ping Chen

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In recent years, some scholars established the reflection of cultural values in advertisements. However, despite the Internet’s rapid development, few studies have focused on observing cross-cultural differences of values reflected in online advertisements. As mirrors of culture, advertisements are believed to reflect values relevant to consumers. Therefore, this research aims to examine the cultural values reflected on online skincare advertisements between countries with different cultural influences. We argue that culture affects the values presented in the slogans, endorsers, brand prominence, and product prominence of online advertisements; a concept that challenges the standardized manner of communication utilized by most multinational brands. Results highlight that the Philippines and Taiwan are neither located on extreme low-context nor extreme high-context cultures. Moreover, although advertisements reflect culture, it may be affected by potential value shifting caused by globalization, standardized communication, and the advertisers’ marketing priorities.

Keywords: cross-culture, cultural values, online advertising, prominence, beauty

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Authors: Hiesik Kim, YongBeum Kim

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Internet of Things (IoT) applications are widely serviced and spread worldwide. Local wireless data transmission technique must be developed to speed up with some technique. Bluetooth wireless data communication is wireless technique is technique made by Special Inter Group(SIG) using the frequency range 2.4 GHz, and it is exploiting Frequency Hopping to avoid collision with different device. To implement experiment, equipment for experiment transmitting measured data is made by using Arduino as Open source hardware, Gas sensor, and Bluetooth Module and algorithm controlling transmission speed is demonstrated. Experiment controlling transmission speed also is progressed by developing Android Application receiving measured data, and controlling this speed is available at the experiment result. it is important that in the future, improvement for communication algorithm be needed because few error occurs when data is transferred or received.

Keywords: Arduino, Bluetooth, gas sensor, internet of things, transmission Speed

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Authors: Syed Mahbubuz Zaman, A. B. M. Abrar Haque, Mehedi Hassan Nayeem, Misbah Uddin Sagor

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Everyday e-mails are being used by millions of people as an effective form of communication over the Internet. Although e-mails allow high-speed communication, there is a constant threat known as spam. Spam e-mail is often called junk e-mails which are unsolicited and sent in bulk. These unsolicited emails cause security concerns among internet users because they are being exposed to inappropriate content. There is no guaranteed way to stop spammers who use static filters as they are bypassed very easily. In this paper, a smart system is proposed that will be using neural networks to approach spam in a different way, and meanwhile, this will also detect the most relevant features that will help to design the spam filter. Also, a comparison of different parameters for different neural network models has been shown to determine which model works best within suitable parameters.

Keywords: long short-term memory, bidirectional long short-term memory, gated recurrent unit, natural language processing, natural language processing

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Authors: Itee Chowdhury, Shikha Modi

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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.

Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption

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Authors: Ali Alshahrani, Adel Almaai, Saad Garni

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Aim of the study: To explore duration and determinants of consultation time at a family medicine center. Methodology: This study was conducted at the Family Medicine Center in Ahad Rafidah City, at the southwestern part of Saudi Arabia. It was conducted on the working days of March 2013. Trained nurses helped in filling in the checklist. A total of 459 patients were included. A checklist was designed and used in this study. It included patient’s age, sex, diagnosis, type of visit, referral and its type, psychological problems and additional work-up. In addition, number of daily bookings, physician`s experience and consultation time. Results: More than half of patients (58.39%) had less than 10 minutes’ consultation (Mean+SD: 12.73+9.22 minutes). Patients treated by physicians with shortest experience (i.e., ≤5 years) had the longest consultation time while those who were treated with physicians with the longest experience (i.e., > 10 years) had the shortest consultation time (13.94±10.99 versus 10.79±7.28, p=0.011). Regarding patients’ diagnosis, those with chronic diseases had the longest consultation time (p<0.001). Patients who did not need referral had significantly shorter consultation time compared with those who had routine or urgent referral (11.91±8.42,14.60±9.03 and 22.42±14.81 minutes, respectively, p<0.001). Patients with associated psychological problems needed significantly longer consultation time than those without associated psychological problems (20.06±13.32 versus 12.45±8.93, p<0.001). Conclusions: The average length of consultation time at Ahad Rafidah Family Medicine Center is approximately 13 minutes. Less-experienced physicians tend to spend longer consultation times with patients. Referred patients, those with psychological problems, those with chronic diseases tend to have longer consultation time. Recommendations: Family physicians should be encouraged to keep their optimal consultation time. Booking an adequate number of patients per shift would allow the family physician to provide enough consultation time for each patient.

Keywords: consultation, quality, medicine, clinics

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Authors: Nannapus Saramad, Rewwadee Petsirasan, Jom Suwanno

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Background: This retrospective study design was to describe average blood pressure, blood pressure level, target blood pressure control rate post-stroke BP control in the year following discharge from Sichon hospital, Sichon District, Nakhon Si Thammarat province. The secondary data analysis was employed from the patient’s health records with patient or caregiver interview. A total of 232 eligible post-acute ischemic strokes in the year following discharge (2017-2018) were recruited. Methods: Data analyses were applied to identify the relationship values of single variables were determined through univariate analyses: The Chi-square test, Fisher exact test, the variables found to have a p-value < 0.2 were analyzed by the binary logistic regression Results: Most of the patients in this study were men 61.6%, an average age of 65.4 ± 14.8 years. Systolic blood pressure levels were in the grade 1-2 hypertension and diastolic pressure at optimal and normal at all times during the initial treatment through the present. The results revealed 25% among the groups under the age of 60 achieved BP control; 36.3% for older than 60 years group; and 27.9% for diabetic group. The multivariate analysis revealed the final relationship of four significant variables: 1) receiving calcium-channel blocker (p =.027); 2) medication adherence of antihypertensive (p = .024) 3) medication adherence of antiplatelet ( p = .020); and 4) medication behavior ( p = . 010) . Conclusion: The medical nurse and health care provider should promote their adherence to behavior to improve their blood pressure control.

Keywords: acute ischemic stroke, target blood pressure control, medication adherence, recurrence stroke

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Authors: Galih Imaduddin

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Knowledge has been viewed as one of the most important resources in organizations, including those that operate in the healthcare sector. On that basis, Knowledge Management (KM) is crucial for healthcare organizations to improve their productivity and ensure effective utilization of their resources. Despite the growing interests to understand how KM might work for healthcare organizations, there is only a modest amount of empirical inquiries which have specifically focused on the tools and initiatives to share knowledge. Hence, the main purpose of this paper is to investigate the way healthcare organizations, particularly public sector ones, utilize knowledge sharing tools and initiatives for the benefit of patient-care. Employing a qualitative method, 13 (thirteen) Community Health Centers (CHCs) from a high-performing district health setting in Indonesia were observed. Data collection and analysis involved a repetition of document retrievals and interviews (n=41) with multidisciplinary health professionals who work in these CHCs. A single case study was cultivated reflecting on the means that were used to share knowledge, along with the factors that inhibited the exchange of knowledge among those health professionals. The study discovers that all of the thirteen CHCs exhibited and applied knowledge sharing means which included knowledge documents, virtual communication channels (i.e. emails and chatting applications), and social learning forums such as staff meetings, morning briefings, and communities of practices. However, the intensity of utilization was different among these CHCs, in which organizational culture, leadership, professional boundaries, and employees’ technological aptitude were presumed to be the factors that inhibit knowledge sharing processes. Making a distance with the KM literature of other sectors, this study denounces the primacy of technology-based tools, suggesting that socially-based initiatives could be more reliable for sharing knowledge. This suggestion is largely due to the nature of healthcare work which is still predominantly based on the tacit form of knowledge.

Keywords: knowledge management, knowledge sharing, knowledge sharing tools and initiatives, knowledge sharing inhibitors, primary health care organizations

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Authors: Kuei-Chun Liu, Yu-Yu Lai, Ching-Hong Wu, Hsiao-Han Huang

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The number of Android applications (Apps) has increased rapidly in recent years. In order to get better programmatic control over Apps, we designed a record-and-replay mechanism to record Android input events and accessibility service events then make shortcuts. The shortcut is useful for complicated routine works and to Android beginners. We also generated graphical user interface (GUI) API by these shortcuts. GUI API helps developers make integrated Apps which can control other third-party Apps even if the official API is not offered by their providers. We demonstrated the usage of GUI API with two integrated Apps: Universal Bank App and Universal Communication App. Universal Bank App integrates three accounts from different banks and Universal Communication App integrates Line with WhatsApp. Both of them show the advantage of extendable GUI API. Furthermore, using our mechanism, shortcuts could replay almost all of the Top-100 Apps on Google Play correctly. In sum, the approach we present can help both Android developers and general users.

Keywords: graphical user interface, GUI API, record-and-replay, third-party apps

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Authors: Ibrahim Isa Ali (Pantami), Abdu Jaafaru Bambale, Abimbola Alale, Danjuma Ibrahim Ndihgihdah, Muhammad Alkali, Adamu Idris Umar, Moshood Kareem, Samson Olufunmilayo Abodunrin, Muhammad Dokko Zubairu

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The National Digital Economy Policy and Strategy, NDEPS document developed by Nigeria’s Federal Ministry of Communications & Digital Economy (FMoCDE) is anchored on 8 pillars for the acceleration of the National Digital Economy for a Digital Nigeria. NIGCOMSAT-1R and the planned HTS communication Satellite are critical assets for supporting the pillars in the drive for sustainable growth and development. This paper discusses on the gains and contribution of the strategy as a solid infrastructure. The paper also highlights these assets’ contribution as platform for Indigenous Content Development & Adoption, Digital Literacy & Skills, and Digital Services Development & Promotion.

Keywords: FMoCDE, HTS, NDEPS, nigcomsat!R, pillars

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Authors: Abdullah Al Mamun, Talal Alkharobi

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As data size is growing up, people are became more familiar to store big amount of secret information into cloud storage. Companies are always required to need transfer massive business files from one end to another. We are going to lose privacy if we transmit it as it is and continuing same scenario repeatedly without securing the communication mechanism means proper encryption. Although asymmetric key encryption solves the main problem of symmetric key encryption but it can only encrypt limited size of data which is inapplicable for large data encryption. In this paper we propose a probable approach of pretty good privacy for encrypt big data using both symmetric and asymmetric keys. Our goal is to achieve encrypt huge collection information and transmit it through a secure communication channel for committing the business and personal privacy. To justify our method an experimental dataset from three different platform is provided. We would like to show that our approach is working for massive size of various data efficiently and reliably.

Keywords: big data, cloud computing, cryptography, hadoop, public key

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Authors: Abhijit Trailokya

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Background: Cardiovascular diseases (CVD’s) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy. In Indian patients, comprehensive data on dyslipidemia management and its treatment outcomes are inadequate. There is lack of information on existing treatment patterns, the patient’s profile being treated, and factors that determine treatment success or failure in achieving desired goals. Purpose: The present study was planned to determine the lipid control status in high-risk dyslipidemic patients treated with lipid-lowering therapy in India. Methods: This cross-sectional, non-interventional, single visit program was conducted across 483 sites in India where male and female patients with high-risk dyslipidemia aged 18 to 65 years who had visited for a routine health check-up to their respective physician at hospital or a healthcare center. Percentage of high-risk dyslipidemic patients achieving adequate LDL-C level (< 70 mg/dL) on lipid-lowering therapy and the association of lipid parameters with patient characteristics, comorbid conditions, and lipid lowering drugs were analysed. Results: 3089 patients were enrolled in the study; of which 64% were males. LDL-C data was available for 95.2% of the patients; only 7.7% of these patients achieved LDL-C levels < 70 mg/dL on lipid-lowering therapy, which may be due to inability to follow therapeutic plans, poor compliance, or inadequate counselling by physician. The physician’s lack of awareness about recent treatment guidelines also might contribute to patients’ poor adherence, not explaining adequately the benefit and risks of a medication, not giving consideration to the patient’s life style and the cost of medication. Statin was the most commonly used anti-dyslipidemic drug across population. The higher proportion of patients had the comorbid condition of CVD and diabetes mellitus across all dyslipidemic patients. Conclusion: As per the European Society of Cardiology guidelines the ideal LDL-C levels in high risk dyslipidemic patients should be less than 70%. In the present study, 7.7% of the patients achieved LDL-C levels < 70 mg/dL on lipid lowering therapy which is very less. Most of high risk dyslipidemic patients in India are on suboptimal dosage of statin. So more aggressive and high dosage statin therapy may be required to achieve target LDLC levels in high risk Indian dyslipidemic patients.

Keywords: cardiovascular disease, diabetes mellitus, dyslipidemia, LDL-C, lipid lowering drug, statins

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Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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Authors: Humraaz Kaja, Kofi Mensah, Frasia Oosthuizen

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Background and Aim: Vilazodone was approved in 2011 as an antidepressant to treat the major depressive disorder. As a relatively new drug, it is not clear if all adverse effects have been identified. The aim of this study was to review the adverse effects reported to the WHO Programme for International Drug Monitoring (PIDM) in order to add to the knowledge about the safety profile and adverse effects caused by vilazodone. Method: Data on adverse effects reported for vilazodone was obtained from the database VigiAccess managed by PIDM. Data was extracted from VigiAccess using Excel® and analyzed using descriptive statistics. The data collected was compared to the patient information leaflet (PIL) of Viibryd® and the FDA documents to determine adverse drug reactions reported post-marketing. Results: A total of 9708 adverse events had been recorded on VigiAccess, of which 6054 were not recorded on the PIL and the FDA approval document. Most of the reports were received from the Americas and were for adult women aged 45-64 years (24%, n=1059). The highest number of adverse events reported were for psychiatric events (19%; n=1889), followed by gastro-intestinal effects (18%; n=1839). Specific psychiatric disorders recorded included anxiety (316), depression (208), hallucination (168) and agitation (142). The systematic review confirmed several psychiatric adverse effects associated with the use of vilazodone. The findings of this study suggested that these common psychiatric adverse effects associated with the use of vilazodone were not known during the time of FDA approval of the drug and is not currently recorded in the patient information leaflet (PIL). Conclusions: In summary, this study found several adverse drug reactions not recorded in documents emanating from clinical trials pre-marketing. This highlights the importance of continued post-marketing surveillance of a drug, as well as the need for further studies on the psychiatric adverse events associated with vilazodone in order to improve the safety profile.

Keywords: adverse drug reactions, pharmacovigilance, post-marketing surveillance, vilazodone

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Authors: Ku Aina Afiqah Ku Adzman, Manmeet Mahinderjit Singh, Zarul Fitri Zaaba

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NFC operates on low-range 13.56 MHz frequency within a distance from 4cm to 10cm, and the applications can be categorized as touch and go, touch and confirm, touch and connect, and touch and explore. NFC applications are vulnerable to various security and privacy attacks such due to its physical nature; unprotected data stored in NFC tag and insecure communication between its applications. This paper aims to determine the likelihood of security risks happening in an NFC technology and application. We present an NFC technology taxonomy covering NFC standards, types of application and various security and privacy attack. Based on observations and the survey presented to evaluate the risk assessment within the touch and go application demonstrates two security attacks that are high risks namely data corruption and DOS attacks. After the risks are determined, risk countermeasures by using AHP is adopted. The guideline and solutions to these two high risks, attacks are later applied to a secure NFC-enabled Smartphone Attendance System.

Keywords: Near Field Communication (NFC), risk assessment, multi-criteria decision making, Analytical Hierarchy Process (AHP)

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Authors: Adhimoolam Saravana Kumar, K. N. Govindarajan, B. Devanand, R. Rajakumar

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The quality of Computed Tomography (CT) procedures has improved in recent years due to technological developments and increased diagnostic ability of CT scanners. Due to the fact that CT doses are the peak among diagnostic radiology practices, it is of great significance to be aware of patient’s CT radiation dose whenever a CT examination is preferred. CT radiation dose delivered to patients in the form of volume CT dose index (CTDIvol) values, is displayed on scanner monitors at the end of each examination and it is an important fact to assure that this information is accurate. The objective of this study was to estimate the CTDIvol values for great number of patients during the most frequent CT examinations, to study the comparison between CT dose monitor values and measured ones, as well as to highlight the fluctuation of CTDIvol values for the same CT examination at different centres and scanner models. The output CT dose indices measurements were carried out on single and multislice scanners for available kV, 5 mm slice thickness, 100 mA and FOV combination used. The 100 CT scanners were involved in this study. Data with regard to 15,000 examinations in patients, who underwent routine head, chest and abdomen CT were collected using a questionnaire sent to a large number of hospitals. Out of the 15,000 examinations, 5000 were head CT examinations, 5000 were chest CT examinations and 5000 were abdominal CT examinations. Comprehensive quality assurance (QA) was performed for all the machines involved in this work. Followed by QA, CT phantom dose measurements were carried out in South India using actual scanning parameters used clinically by the hospitals. From this study, we have measured the mean divergence between the measured and displayed CTDIvol values were 5.2, 8.4, and -5.7 for selected head, chest and abdomen procedures for protocols as mentioned above, respectively. Thus, this investigation revealed an observable change in CT practices, with a much wider range of studies being performed currently in South India. This reflects the improved capacity of CT scanners to scan longer scan lengths and at finer resolutions as permitted by helical and multislice technology. Also, some of the CT scanners have used smaller slice thickness for routine CT procedures to achieve better resolution and image quality. It leads to an increase in the patient radiation dose as well as the measured CTDIv, so it is suggested that such CT scanners should select appropriate slice thickness and scanning parameters in order to reduce the patient dose. If these routine scan parameters for head, chest and abdomen procedures are optimized than the dose indices would be optimal and lead to the lowering of the CT doses. In South Indian region all the CT machines were routinely tested for QA once in a year as per AERB requirements.

Keywords: CT dose index, weighted CTDI, volumetric CTDI, radiation dose

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Authors: Piyarat Parklug, Busaba Supawattanaobodee, Penpat Pinyowattanasilp

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The radioactive iodine thyroid uptake (RAIU) has been widely used to differentiate the cause of thyrotoxicosis and treatment. Twenty-four hours RAIU is routinely used to calculate the dose of radioactive iodine (RAI) therapy; however, 2 days protocol is required. This study aims to evaluate the modification of Penpat Pinyowattanasilp equation application by the exclusion of outlier data, 3 hours RAIU less than 20% and more than 80%, to improve prediction of 24-hour uptake. The equation is predicted 24 hours RAIU (P24RAIU) = 32.5+0.702 (3 hours RAIU). Then calculating separation first and second therapeutic doses in Graves’ disease patients. Methods; This study was a retrospective study at Faculty of Medicine Vajira Hospital in Bangkok, Thailand. Inclusion were Graves’ disease patients who visited RAI clinic between January 2014-March 2019. We divided subjects into 2 groups according to first and second therapeutic doses. Results; Our study had a total of 151 patients. The study was done in 115 patients with first RAI dose and 36 patients with second RAI dose. The P24RAIU are highly correlated with actual 24-hour RAIU in first and second therapeutic doses (r = 0.913, 95% CI = 0.876 to 0.939 and r = 0.806, 95% CI = 0.649 to 0.897). Bland-Altman plot shows that mean differences between predictive and actual 24 hours RAI in the first dose and second dose were 2.14% (95%CI 0.83-3.46) and 1.37% (95%CI -1.41-4.14). The mean first actual and predictive therapeutic doses are 8.33 ± 4.93 and 7.38 ± 3.43 milliCuries (mCi) respectively. The mean second actual and predictive therapeutic doses are 6.51 ± 3.96 and 6.01 ± 3.11 mCi respectively. The predictive therapeutic doses are highly correlated with the actual dose in first and second therapeutic doses (r = 0.907, 95% CI = 0.868 to 0.935 and r = 0.953, 95% CI = 0.909 to 0.976). Bland-Altman plot shows that mean difference between predictive and actual P24RAIU in the first dose and second dose were less than 1 mCi (-0.94 and -0.5 mCi). This modification equation application is simply used in clinical practice especially patient with 3 hours RAIU in range of 20-80% in a Thai population. Before use, this equation for other population should be tested for the correlation.

Keywords: equation, Graves’disease, prediction, 24-hour uptake

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Authors: Aniqa Jabeen

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The aim of this study was to evaluate the effectiveness of Tc-99m MIBI (Technetium 99-methoxy-iso-butyl-isonitrile) scintigraphy to differentiate malignancies from benign lesions, which were detected on planar bone scans. Materials and Methods: 59 patients with bone lesions were enrolled in the study. The scintigraphic findings were compared with the clinical, radiological and the histological findings. Each patient initially underwent a three-phase bone scan with Tc-99m MDP (Methylene Diphosphonate) and if evidence of lesion found, the patient then underwent a dynamic and static MIBI scintigraphy after three to four days. The MDP and MIBI scans were evaluated visually and quantitatively. For quantitative analysis count ratios of lesions and contralateral normal side (L/C) were taken by region of interests drawn on scans. The Student T test was applied to assess the significant difference between benign and malignant lesions p-value < 0.05 was considered significant. Result: The MDP scans showed the increase tracer uptake, but there was no significant difference between benign and malignant uptake of the radiotracer. However significant difference (p-value 0.015), in uptake was seen in malignant (L/C = 3.51 ± 1.02) and benign lesion (L/C = 2.50±0.42) on MIBI scan. Three of thirty benign lesions did not show significant MIBI uptake. Seven malignant appeared as false negatives. Specificity of the scan was 86.66%, and its Negative Predictive Value (NPV) was 81.25% whereas the sensitivity of scan was 79.31%. In excluding the axial metastasis from the lesions, the sensitivity of MIBI scan increased to 91.66% and the NPV also increased to 92.85%. Conclusion: MIBI scintigraphy provides its usefulness by distinguishing malignant from benign lesions. MIBI also correctly identifies metastatic lesions. The negative predictive value of the scan points towards its ability to accurately diagnose the normal (benign) cases. However, biopsy remains the gold standard and a definitive diagnostic modality in musculoskeletal tumors. MIBI scan provides useful information in preoperative assessment and in distinguishing between malignant and benign lesions.

Keywords: benign, malignancies, MDP bone scan, MIBI scintigraphy

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Authors: Laleh Golamrej Eliasi, Mahsa Tahzibi, Mohammad Torkashvand Moradabadi

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TheIranian Ear, Throat, Nose, Head, and Neck Research Center has estimated that three to five percent of Iran’s population has moderate to profound hearing disorders. The prevalence of hearing loss in provincial centers is equal to 4.7 per thousand live births (362 cases). The deaf community has limited access to information and health services due to language and communication barriers. Communication and language limitations isolate and limit deaf people from social media, health services, and communication with caregivers and health providers.Limitedcommunicationwith the deaf has led to a lack of knowledge and information about domestic violence against the deaf (DVAD) in this target group in Iran. To fill this knowledge gap, deaf living in Iranwere selected as the target group to assess their views on DVAD. This study is implemented in the socio-ecological approach framework to assess the impacts of individual characteristics, interpersonal relationships, community, and society components on DVAD. Semi-structured interviews with the Iranian deaf and Content analysis are used to find the participants’ point of view on DVAD, its risk factors, and the reduction approach to DVAD. The main purpose is to obtain information about participants' views on the subject. The findings can be used to improve culturally safe social work knowledge and practices with a bottom-up approach to reduce DV and increase their well-being. Therefore, this research can have important effects on the sustainable development of services and supports the welfare and inclusion of the deaf.

Keywords: domestic violence, Iranian deaf, social work, content analysis

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Authors: Tang Mui Joo, Chan Eang Teng

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The use of social media has become more defined. It has been widely used for the purpose of business. More marketers are now using social media as tools to enhance their businesses. Whereas on the other hand, there are more and more people spending their time through mobile apps to be engaged in the social media sites like YouTube, Facebook, Twitter and others. Social media has even become common in Public Relations (PR). It has become number one platform for creating and sharing content. In view to this, social media has changed the rules in PR where it brings new challenges and opportunities to the profession. Although corporate websites, chat-rooms, email customer response facilities and electronic news release distribution are now viewed as standard aspects of PR practice, many PR practitioners are still struggling with the impact of new media though the implementation of social media is potentially reducing the cost of communication. It is to the point that PR practitioners are not fully embracing new media, they are ill-equipped to do so and they have a fear of the technology. Somehow that social media has become a new style of communication that is characterized by conversation and community. It has become a platform that allows individuals to interact with one another and build relationship among each other. Therefore, in the use of business world, consumers are able to interact with those companies that have joined any social media. Based on their experiences with social networking site interactions, they are also exposed to personal interaction while communicating. This paper is to study the impact of social media to PR. This paper discovers the potential changes of PR practices in a developing country like Malaysia. Eventually the study reflects on how PR practitioners are actually using social media in the country. This paper is based on two theories in its development of this research foundation. Media Ecology Theory is to support the impact and changes to PR. Social Penetration Theory is to reflect on how the use of social media is among PRs. This research is using survey with PR practitioners in its data collection. The results have shown that PR professionals value social media more than they actually use it and the way of organizations communicate had been changed due to the transformation of social media.

Keywords: new media, social media, PR, change of trend, communication, digital culture

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