Search results for: group engagement
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9171

Search results for: group engagement

7161 Knowledge and Awareness of HIV/AIDS among Male Prisoners in Kuwait

Authors: Saroj Bala Grover, Al Munther Alhasawi, Prem N. Sharma, P. S. N. Menon

Abstract:

Background: Prisoners are considered one of the high-risk populations for the transmission of human immunodeficiency virus (HIV) infection. Targeting this group is one of the strategies to reduce the incidence of acquired immune deficiency syndrome (AIDS) in the community. Subjects and Methods: A cross-sectional study was conducted among male inmates in Kuwait’s prison by administering three sets of questionnaires to assess the level of their knowledge and awareness about the mode of transmission of HIV/AIDS, their risky personal behavior that may lead to HIV infection, and the presence of any negative attitudes and stigmatization towards HIV infected individuals. Results: The study included 123 male inmates, with a mean ± SD age of 30.9 ± 8.4 years. Most participants had good general knowledge (90%) about the mode of transmission of HIV/AIDS, including sharing contaminated syringes, risky personal behaviors such as having unprotected sex and increased number of extramarital relationships (66%), and the avoidance of the regular use of condoms. The younger age group (< 35 years) had more extramarital relationships than those > 35 years (71.4% Vs. 46.4%; p=0.016). There was a perceived attitude of stigmatization among inmates towards HIV-infected persons. Conclusions: This vulnerable group of prisoners, especially young adults, need educational programs to improve knowledge about the transmission of HIV and to correct and change their risky personal behaviors to protect themselves and the community against HIV transmission.

Keywords: HIV/AIDS, Kuwait, prisoners, knowledge, awareness, personal behavior, extramarital relationships, safe sex, discrimination, stigmatization

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7160 Empowering Volunteers at Tawanchai Centre for Patients with Cleft Lip and Palate

Authors: Suteera Pradubwong, Darawan Augsornwan, Pornpen Pathumwiwathana, Benjamas Prathanee, Bowornsilp Chowchuen

Abstract:

Background: Cleft lip and palate (CLP) congenital anomalies have a high prevalence in the Northeast of Thailand. A care team’s understand of treatment plan would help to guide the family of patients with CLP to achieve the treatment. Objectives: To examine the impact of the empowering volunteer project, established in the northeast Thailand. Materials and Methods: The Empowering Volunteer project was conducted in 2008 under the Tawanchai Royal Granted project. The patients and family’s general information, treatment, the group brainstorming, and satisfaction with the project were analyzed. Results: Participants were 12 children with CLP, their families and five volunteers with CLP; the participating patients were predominantly females and the mean, age was 12.2 years. The treatment comprised of speech training, dental hygiene care, bone graft and orthodontic treatment. Four issues were addressed including: problems in taking care of breast feeding; instructions’ needs for care at birth; difficulty in access information and society impact; and needs in having a network of volunteers. Conclusions: Empowering volunteer is important for holistic care of patients with CLP which provides easy access and multiple channels for patients and their families. It should be developed as part of the self-help and family support group, the development of community based team and comprehensive CLP care program.

Keywords: self-help and family support group, community based model, volunteer, cleft lip-cleft palate

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7159 The Preventive Effect of Date Palm (Phoenixdactylifera) Seed and Fruit Hydroalcoholic Extracts on Carrageenan-Induced Inflammation in Male Rat’s Hind Paw

Authors: Siavash Azarbani

Abstract:

Background and Objective: The side effects of NSAIDS drugs have caused the increasing interest of scientists in herbal medicines as alternative treatment. In this study, the effect of anti inflammatory of seed and fruit of date palm hydroalcolic extracts, due to having antioxidants, was studied. Materials and Methods: In this study, the extraxts of date palm seed and fruit were prepared by the maceration method in 70% alcohol. Eighty male rats Wistar, divided into 10 groups of eight in each, 4 groups received different doses (100, 200, 400, and 600 mg/kg) of seed extract, and 4 other groups different doses (100, 200, 400, and 600 mg/kg) of fruits extract of the palm, and the positive control aspirin (300mg/kg) and the negative control group saline (5ml/kg) via injection intraperitoneally. Half an hour later, all animals received 100 µl of 1% carrageenan into the rats hind paw subcutaneous. The changes in rats paw edema was measured by plethysmometer every hour for five hours. Results: The effect of all of the doses of date palm seed extract on edema were less than aspirine (P<0.05). But there was no significant difference between the group that received 400 and 600 mg/kg of date palm fruit extract when compared with the aspirin group. The Dose 400 mg/kg of fruit extract showed the most anti-inflammatory effect, and it was assignded as the best dose. Conclusion: It is likely that with further studies on different model of animals and also on the human model, the palm fruit extract could be used for pain treatment.

Keywords: palm, inflamentory, date, aspirin, karageenan

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7158 Enquiry Based Approaches to Teaching Grammar and Differentiation in the Senior Japanese Classroom

Authors: Julie Devine

Abstract:

This presentation will look at the approaches to teaching grammar taken over two years with students studying Japanese in the last two years of high school. The main focus is an enquiry based approach to grammar introduction and a three tier system using videos and online support material to allow for differentiation and personalised learning in the classroom. The aim is to create space for motivated students to do some higher order activities using the target pattern to solve problems and create scenarios. Less motivated students have time to complete basic exercises and struggling students have some time with the teacher in smaller groups.

Keywords: differentiation, digital technologies, personalised learning plans, student engagement

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7157 Isolation, Identification and Measurement of Cottonseed Oil Gossypol in the Treatment of Drug-Resistant Cutaneous Leishmaniasis

Authors: Sara Taghdisi, Mehrosadat Mirmohammadi, Mostafa Mokhtarian, Mohammad Hossein Pazandeh

Abstract:

Leishmaniasis is one of the 10 most important diseases of the World Health Organization with health problems in more than 90 countries. Over one billion people are at risk of these diseases on almost every continent. The present human study was performed to evaluate the therapeutic effect of cotton plant on cutaneous leishmaniasis leision. firstly, the cotton seeds were cleaned and grinded to smaller particles. In the second step, the seeds were oiled by cold press method. In order to separate bioactive compound, after saponification of the oil, its gossypol was hydrolyzed and crystalized. finally, the therapeutic effect of Cottonseed Oil on cutaneous leishmaniasis was investigated. In the current project, Gossypol was extracted with a liquid-liquid extraction method in 120 minutes in the presence of Phosphoric acid from the cotton seed oil of Golestan beach varieties, then got crystallized in darkness using Acetic acid and isolated as Gossypol Acetic acid. The efficiency of the extracted crystal was obtained at 1.28±0.12. the cotton plant could be efficient in the treatment of Cutaneous leishmaniasis. This double-blind randomized controlled clinical trial was performed on 88 cases of leishmaniasis wounds. Patients were randomly divided into two groups of 44 cases. two groups received conventional treatment. In addition to the usual treatment (glucantime), the first group received cottonseed oil and the control group received placebo. The results of the present study showed that the surface of lesion before the intervention and in the first to fourth weeks after the intervention was not significantly different between the two groups (P-value> 0.05). But the surface of lesion in the Intervention group in the eighth and twelfth weeks was lower than the control group (P-value <0.05). This study showed that the improvement of leishmaniasis lesion using topical cotton plant mark in the eighth and twelfth weeks after the intervention was significantly more than the control group. Considering the most common chemical drugs for Cutaneous leishmaniasis treatment are sodium stibogluconate, and meglumine antimonate, which not only have relatively many side effects, but also some species of the Leishmania genus have become resistant to them. Therefore, a plant base bioactive compound such as cottonseed oil can be useful whit fewer side effects.

Keywords: cottonseed oil, crystallization, gossypol, leishmaniasis

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7156 Determinants of Youth Engagement with Health Information on Social Media Platforms in United Arab Emirates

Authors: Niyi Awofeso, Yunes Gaber, Moyosola Bamidele

Abstract:

Since most social media platforms are accessible anytime and anywhere where Internet connections and smartphones are available, the invisibility of the reader raises questions about accuracy, appropriateness and comprehensibility of social media communication. Furthermore, the identity and motives of individuals and organizations who post articles on social media sites are not always transparent. In the health sector, through socially networked platforms constitute a common source of health-related information, given their purported wealth of information. Nevertheless, fake blogs and sponsored postings for marketing 'natural cures' pervade most commonly used social media platforms, thus complicating readers’ abilities to access and understand trustworthy health-related information. This purposive sampling study of 120 participants aged 18-35 year in UAE was conducted between September and December 2017, and explored commonly used social media platforms, frequency of use of social media for accessing health related information, and approaches for assessing the trustworthiness of health information on social media platforms. Results indicate that WhatsApp (95%), Instagram (87%) and Youtube (82%) were the most commonly used social media platforms among respondents. Majority of respondents (81%) indicated that they regularly access social media to get health-associated information. More than half of respondents (55%) with non-chronic health status relied on unsolicited messages to obtain health-related information. Doctors’ health blogs (21%) and social media sites of international healthcare organizations (20%) constitute the most trusted source of health information among respondents, with UAE government health agencies’ social media accounts trusted by 15% of respondents. Cardiovascular diseases, diabetes, and hypertension were the most commonly searched topics on social media (29%), followed by nutrition (20%) and skin care (16%). Majority of respondents (41%) rely on reliability of hits on Google search engines, 22% check for health information only from 'reliable' social media sites, while 8% utilize 'logic' to ascertain reliability of health information. As social media has rapidly become an integral part of the health landscape, it is important that health care policy makers, healthcare providers and social media companies collaborate to promote the positive aspects of social media for young people, whilst mitigating the potential negatives. Utilizing popular social media platforms for posting reader-friendly health information will achieve high coverage. Improving youth digital literacy will facilitate easier access to trustworthy information on the internet.

Keywords: social media, United Arab Emirates, youth engagement, digital literacy

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7155 Community Policing: Exploring the Police and Community Participation for Crime Control in Bia West of Ghana

Authors: Bertha Korang Gyimah, Obed Asamoah, Kenross, T. Asamoah

Abstract:

In every human community, crimes or offenses cannot be eliminated, but as crimes are expected, there should be bodies that will control and prevent the crimes. There has been an increasing rate of crime, such as armed robbery, kidnapping, murder, and other forms of violence in the country. Community participation in crime control cannot be left out in Ghana. Several works have been conducted to deal with the importance of community participation in policing, but the causes of communities not fully participating in community policing have been left out. The main aim of the research was to assess the impact of community policing and why the communities are reluctant to partake in community policing to help control crime in Bia West. There have been perceptions about Police that, they expose informant after they give the police tip-off which put the whistleblower life in danger. This has made the community not to get involved in security issues in the community they live in. This situation has posed a serious threat to the Ghana Police Service and its ability to position itself strategically in order to carry out a perfect investigation to bring the perpetrators into custody and to protect their lives and property, as well as the maintenance of law and order. Due to less data on community participation in the Ghana Police Service, the research adopted an interpretative framework to assess the meaning connoted to community policing from the perspectives of the stakeholders themselves. The qualitative research method was used. There was an engagement of the police and community where focus group discussions and individual in-depth interviews were organized in the randomly selected communities in the district. Key informant interviews were used to solicit views of the people why they are reluctant to give information to the police to help them take the perpetrators to book. In the data collected, it was observed that most of the people have been under threats of offenders after they come back from the prisons, it was also observed that some of the unprofessional police personnel’s expose the whistleblowers who put their lives in danger. The data obtained were analyzed using simple Analytical tool SPSS and Excel. Based on the analysis, it was observed that a high number of people in the communities contacted had not made their mind to participate in any security issues. Based on the views of the community, there should be a high level of professionalism in the recruitment system of the Ghana police service to come out with professional police officers who can abide by the rules and regulations governing the profession.

Keywords: community, bia west, Ghana, participation, police

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7154 Effectiveness of Intraoperative Heparinization in Neonatal and Pediatric Patients with Congenital Heart Diseases: Focus in Heparin Resistance

Authors: Karakhalis N. B.

Abstract:

This study aimed to determine the prevalence of heparin resistance among cardiac surgical pediatric and neonatal patients and identify associated risk factors. Materials and Methods: The study included 306 pediatric and neonatal patients undergoing on-pump cardiac surgery. Patients whose activated clotting time (ACT) targets were achieved after the first administration of heparin formed the 1st group (n=280); the 2nd group (n=26) included patients with heparin resistance. The initial assessment of the haemostasiological profile included determining the PT, aPPT, FG, AT III activity, and INR. Intraoperative control of heparinization was carried out with a definition of ACT using a kaolin activator. A weight-associated protocol at the rate of 300 U/kg with target values of ACT >480 sec was used for intraoperative heparinization. Results: The heparin resistance was verified in 8.5% of patients included in the study. Repeated heparin administration at the maximum dose of≥600 U/kg is required in 80.77% of cases. Despite additional heparinization, 19.23% of patients had FFP infusion. There was reduced antithrombin activity in the heparin resistance group (p=0.01). Most patients with heparin resistance (57.7%) were pretreated with low molecular weight heparins during the preoperative period. Conclusion: Determining the initial level of antithrombin activity can predict the risk of developing heparin resistance. The factor analysis verified hidden risk factors for heparin resistance to the heparin pretreatment, chronic hypoxia, and chronic heart failure.

Keywords: congenital heart disease, heparin, antithrombin, activated clotting time, heparin resistance

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7153 Cultural Barriers in the Communication of Breast Cancer in Sub-Saharan Africa

Authors: Kayum Fokoue Carole

Abstract:

This paper aims at verifying the effectiveness of reaching target populations while paying attention to their cultural background when communicating new knowledge, ideas or technology in a multicultural world. Our case study is an experiment on the communication of knowledge on breast cancer in three sub-Saharan countries (Ghana, Tchad, and Cameroon health). The methodology consisted of submitting a semi-structured questionnaire to local populations in some localities in these target countries in order to determine the cultural barriers hindering the effective communication of knowledge on breast cancer. Once this done, sensitization documents on breast cancer were translated into Ewe (Ghana), Mbaye (Tchad), Ghomala’, Ewondo, and Fufulde (Cameroon). In each locality, a sensitization programme was organised for two groups. For one group, the cultural barriers discovered were taken into consideration while communicating during the programme whereas in the other group, they were not. Another questionnaire was disseminated after three months to verify the level of appropriation of those who attended the campaign based on Chumbow’s appropriation theory. This paper, therefore, discusses some spiritual beliefs, representations and practices in the target African communities hindering effective communication of issues on breast cancer in the target localities. Findings reveal that only 38% of respondents in the group of those for whom cultural barriers were not taken into account during the programme had a high level of appropriation while for the other group, 86% had a high level of appropriation. This is evidence that the communication of issues on breast cancer can be more effective by reaching different populations in a language they best master while paying attention to their culture. Therefore, international communication of new knowledge should be culturally contextualised. Suggestions at the end of the paper are directed towards the achievement of these goals. The present work promotes international partnership in addressing and resolving global health preoccupations since research findings from one community/country can be mutualized in partnership with other communities and countries.

Keywords: cultural barriers, communication, health, breast cancer

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7152 Endometrial Thickness Cut-Off for Evacuation of Retained Product of Conception

Authors: Nambiar Ritu, Ali Ban, Munawar Farida, Israell Imelda, T. Farouk Eman Rasheeda, Jangalgi Renuka, S. Boma Nellie

Abstract:

Aim: To define the ultrasonographic endometrial thickness (USG ET) cutoff for evacuation of retained pieces of conception (ERPC). Background: Studies of conservative management of 1st trimester miscarriage have questioned the need for post miscarriage curettage. Therapeutic decision making with transvaginal scan post miscarriage endometrial thickness in patients clinically thought to be incomplete miscarriage is often not clear. Method: Retrospective analysis of all 1ST trimester ERPC at Al Rahba Hospital from June 2012 to July 2013 was done. Total of 164 patients underwent ERPC. All cases were reviewed for pre-operative USG ET and post ERPC histopathological examination. TVS was done to evaluate the maximum ET of the uterine cavity along the long axis of the uterus and features of retained products was noted. All cases without preoperative USG ET measurement were excluded from the study, therefore only 62 out of 164 cases were included in the study. The patients were divided into three groups: o Group A: have retained products within endometrial cavity. o Group B: endometrial thickness equal or more than 20 mm. o Group C: endometrial thickness equal or less than 19.9 mm. o Post ERPC product was sent for HPE and the results were compared. Transvaginal sonographic findings can be used as a deciding factor in the management of patients with 1st trimester miscarriage who need ERPC. Our proposed cutoff in clinically stable patients requiring ERPC is more than 20 mm.

Keywords: ERPC, histopathological examination, long axis of the uterus, USG ET

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7151 Group Attachment Based Intervention® Reduces Toddlers' Fearfulness

Authors: Kristin Lewis, Howard Steele, Anne Murphy, Miriam Steele, Karen Bonuck, Paul Meissner

Abstract:

The present study examines data collected during the randomized control trial (RCT) of the Group Attachment-Based Intervention (GABI©), a trauma-informed, attachment-based intervention aimed at promoting healthy parent-child relationships that support child development. Families received treatment at Treatment Center and were randomly assigned to either the GABI condition or the treatment as usual condition, a parenting class called Systematic Training for Effective Parenting (STEP). Significant improvements in the parent-child relationship have been reported for families participating in GABI, but not in the STEP control group relying on Coding Interactive Behavior (CIB) as applied to 5-minute video-films of mothers and their toddlers in a free play context. This report considers five additional attachment-relevant 'clinical codes' that were also applied to the 5-minute free play sessions. Seventy-two parent-child dyads (38 in GABI and 34 in STEP) were compared to one another at intake and end-of-treatment, on these five-point dimensions: two-parent codes—the dissociation and ignoring; two child codes—simultaneous display of contradictory behavior and fear; and one parent-child code, i.e., role reversal. Overall, scores were low for these clinical codes; thus, a binary measure was computed contrasting no evidence with some evidence of each clinical code. Crosstab analyses indicate that child fear at end-of-treatment was significantly lower among children who participated in GABI (7% or 3 children) as compared to those whose mothers participated in STEP (29% or 10 children) Chi Sq= 6.57 (1), p < .01. Discussion focuses on the potential for GABI to reduce childhood fearfulness and so enhance the child's health.

Keywords: coding interactive behavior, clinical codes, group attachment based intervention, GABI, attachment, fear

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7150 Bone Mineral Density in Egyptian Children with Familial Mediterranean Fever

Authors: S. Salah, S. A. El-Masry, H. F. Sheba, R. A. El-Banna, W. Saad

Abstract:

Background: Familial Mediterranean fever (FMF) has episodic or subclinical inflammation that may lead to a decrease in bone mineral density (BMD). Objective: To assess BMD in Egyptian children with FMF on genetic basis. Subjects and Methods: A cross sectional study included 45 FMF patients and 25 control children of both sexes, with age range between 3-16 years old. The patients were reclassified into 2 groups: Group I (A) 23 cases used colchicines for 1 month or less, and Group I (B) 22 cases used colchicines for more than 6 months. For both patients and control, MEFV mutations were defined using molecular genetics technique and BMD was measured by DXA at 2 sites: proximal femur and the lumber spines. Results: four frequent gene mutations were found in the patient group: E148Q (35.6%), V726A (33.3%), M680I (28.9.0%) and M694V (2.2%). There were also 4 heterozygous gene mutations in 40% of control children. Patients received colchicines treatment for less than 1 month had highly significant lower values of BMD at femur and lumber spines than control children (p<0.05). Patients received colchicines treatment for more than 6 months had improved values of BMD at femur compared to control, but there were still significant differences between them at lumbar spine (p>0.05). There are insignificant effect of type of gene mutation on BMD and the risk of osteopenia among the patients. Conclusion: FMF had significant effect on BMD. However, regular use of colchicines treatment improves this effect mainly at femur.

Keywords: familial mediterranean fever, bone mineral density, genes, children

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7149 Utility of Range of Motion Measurements on Classification of Athletes

Authors: Dhiraj Dolai, Rupayan Bhattacharya

Abstract:

In this study, a comparison of Range Of Motion (ROM) of middle and long-distance runners and swimmers has been made. The mobility of the various joints is essential for the quick movement of any sportsman. Knowledge of a ROM helps in preventing injuries, in repeating the movement, and in generating speed and power. ROM varies among individuals, and it is influenced by factors such as gender, age, and whether the motion is performed actively or passively. ROM for running and swimming, both performed with due consideration on speed, plays an important role. The time of generation of speed and mobility of the particular joints are very important for both kinds of athletes. The difficulties that happen during running and swimming in the direction of motion is changed. In this study, data were collected for a total of 102 subjects divided into three groups: control group (22), middle and long-distance runners (40), and swimmers (40), and their ages are between 12 to 18 years. The swimmers have higher ROM in shoulder joint flexion, extension, abduction, and adduction movement. Middle and long-distance runners have significantly greater ROM from Control Group in the left shoulder joint flexion with a 5.82 mean difference. Swimmers have significantly higher ROM from the Control Group in the left shoulder joint flexion with 24.84 mean difference and swimmers have significantly higher ROM from the Middle and Long distance runners in left shoulder flexion with 19.02 mean difference. The picture will be clear after a more detailed investigation.

Keywords: range of motion, runners, swimmers, significance

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7148 The Effect of Core Training on Physical Fitness Characteristics in Male Volleyball Players

Authors: Sibel Karacaoglu, Fatma Ç. Kayapinar

Abstract:

The aim of the study is to investigate the effect of the core training program on physical fitness characteristics and body composition in male volleyball players. 26 male university volleyball team players aged between 19 to 24 years who had no health problems and injury participated in the study. Subjects were divided into training (TG) and control groups (CG) as randomly. Data from twenty-one players who completed all training sessions were used for statistical analysis (TG,n=11; CG,n=10). A core training program was applied to the training group three days a week for 10 weeks. On the other hand, the control group did not receive any training. Before and after the 10-week training program, pre- and post-testing comprised of body composition measurements (weight, BMI, bioelectrical impedance analysis) and physical fitness measurements including flexibility (sit and reach test), muscle strength (back, leg and grip strength by dynamometer), muscle endurance (sit-ups and push-ups tests), power (one-legged jump and vertical jump tests), speed (20m sprint, 30m sprint) and balance tests (one-legged standing test) were performed. Changes of pre- and post- test values of the groups were determined by using dependent t test. According to the statistical analysis of data, no significant difference was found in terms of body composition in the both groups for pre- and post- test values. In the training group, all physical fitness measurements improved significantly after core training program (p<0.05) except 30m speed and handgrip strength (p>0.05). On the hand, only 20m speed test values improved after post-test period (p<0.05), but the other physical fitness tests values did not differ (p>0.05) between pre- and post- test measurement in the control group. The results of the study suggest that the core training program has positive effect on physical fitness characteristics in male volleyball players.

Keywords: body composition, core training, physical fitness, volleyball

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7147 Effects of Mental Skill Training Programme on Direct Free Kick of Grassroot Footballers in Lagos, Nigeria

Authors: Mayowa Adeyeye, Kehinde Adeyemo

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The direct free kick is considered a great opportunity to score a goal but this is not always the case amidst Nigerian and other elite footballers. This study, therefore, examined the extent to which an 8 weeks mental skill training programme is effective for improving accuracy in direct free kick in football. Sixty (n-60) students of Pepsi Football Academy participated in the study. They were randomly distributed into two groups of positive self-talk group (intervention n-30) and control group (n-30). The instrument used in the collection of data include a standard football goal post while the research materials include a dummy soccer wall, a cord, an improvised vanishing spray, a clipboard, writing materials, a recording sheet, a self-talk log book, six standard 5 football, cones, an audiotape and a compact disc. The Weinberge and Gould (2011) mental skills training manual was used. The reliability coefficient of the apparatus following a pilot study stood at 0.72. Before the commencement of the mental skills training programme, the participants were asked to take six simulated direct free kick. At the end of each physical skills training session after the pre-test, the researcher spent at least 15 minutes with the groups exposing them to the intervention. The mental skills training programme alongside physical skills training took place in two different locations for the different groups under study, these included Agege Stadium Main bowl Football Pitch (Imagery Group), and Ogba Ijaye (Control Group). The mental skills training programme lasted for eight weeks. After the completion of the mental skills training programme, all the participants were asked to take another six simulated direct free kick attempts using the same field used for the pre-test to determine the efficacy of the treatments. The pre-test and post-test data were analysed using inferential statistics of t-test, while the alpha level was set at 0.05. The result revealed significant differences in t-test for positive self-talk and control group. Based on the findings, it is recommended that athletes should be exposed to positive self-talk alongside their normal physical skills training for quality delivery of accurate direct free kick during training and competition.

Keywords: accuracy, direct free kick, pepsi football academy, positive self-talk

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7146 Improvement of Healthcare Quality and Psychological Stress Relieve for Transition Program in Intensive Care Units

Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Shu-I Chin, Wen-Ju Yang, Wan Ming-Shang, Chien-Ying Wang

Abstract:

Background: Upon recovery from critical condition, patients are normally transferred from the intensive care units (ICUs) to the general wards. However, transferring patients to a new environment causes stressful experiences for both patients and their families. Therefore, there is a necessity to communicate with the patients and their families to reduce psychological stress and unplanned return. Methods: This study was performed in the general ICUs from January 1, 2021, to December 31, 2021, in Taipei Veteran General Hospital. The patients who were evaluated by doctors and liaison nurses transferred to the general wards were selected as the research objects and ranked by the Critical Care Transition Program (CCTP). The plan was applied to 40 patients in a study group and usual care support for a control group of 40 patients. The psychological condition of patients was evaluated by a migration stress scale and a hospital anxiety and depression scale. In addition, the rate of return to ICU was also measured. Results: A total of 63 patients out of 80 (78.8%) experienced moderate to severe degrees of anxiety, and 42 patients (52.6%) experienced moderate to severe degrees of depression before being transferred. The difference between anxiety and depression changed more after the transfer; moreover, when a transition program was applied, it was lower than without a transition program. The return to ICU rate in the study group was lower than in the usual transition group, with an adjusted odds ratio of 0.21 (95% confidence interval: 0.05-0.888, P=0.034). Conclusion: Our study found that the transfer program could reduce the anxiety and depression of patients and the associated stress on their families during the transition from ICU. Before being transferred out of ICU, the healthcare providers need to assess the needs of patients to set the goals of the care plan and perform patient-centered decision-making with multidisciplinary support.

Keywords: ICU, critical care transition program, healthcare, transition program

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7145 Empowerment Model: A Strategy for Supporting Creative Economy through Traditional Weaving in Anajiaka Village

Authors: Sita Yuliastuti Amijaya, Wiyatiningsih Wiyatiningsih, Paulus Bawole

Abstract:

Weaving skills were not originally a way to earn money for the traditional people on Sumba Island. Weaving is a leisure activity carried out between farming and caring for families. It is quite understandable if the weavers are women. At this time, weaving crafts become a unique potential inherent in an area, so that the weaver women also have the potential to drive economic activity in regional tourism sector. This study aims to measure the sustainability of traditional weaving business activities in Anajiaka Village, Umbu Ratu Nggay Barat, Central Sumba Regency, which is able to support the creative economy. The analysis was performed using qualitative descriptive methods by comparing the criteria of smart living and smart economy in the study of smart city. This study found that business sustainability will be better maintained if it is bound in a joint commitment, for example by forming a group of craftsmen. Other challenges besides the commitment of the group members are aspects of local government support and related agencies, in the form of guidance, funding, and promotion. In addition, fabric order targets, maintaining family and community balance, are recognized as obstacles for craftsmen. The modern marketing model is not yet mastered by the craftsmen group, so it needs assistance for future development.

Keywords: agriculture, craftsmen, creativepreneur, smart economy, smart living

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7144 Synthesis of 5'-Azidonucleosides as Building Blocks for the Preparation of Biologically Active Bioconjugates

Authors: Brigitta Bodnár, Lajos Kovács, Zoltán Kupihár

Abstract:

The cancer cells require higher amount of nucleoside building blocks for their proliferation, therefore they have significantly higher uptake of nucleosides by the different nucleoside transporters. Therefore, the conjugation with nucleosides may significantly increase the efficiency and selectivity of potential active pharmaceutical ingredients. On the other hand, the advantage of using a nucleoside could be either the higher activity on targeted enzymes overrepresented in cancer cells or an enhanced cellular uptake of the bioconjugates in these cells compared to the healthy ones. This fact can be used to make the nucleosides, as targeting moieties covalently bound to anti-cancer drug molecules which can selectively accumulate in cancer cells. However, in order to form the nucleoside-drug conjugates, such nucleoside building blocks are needed, which can selectively be coupled to the drug molecules containing even a high number of diverse functional groups. One of the most selective conjugation techniques is the copper-catalyzed azide-alkyne click reaction that requires the presence of an alkyl group on one of the conjugated molecules and an azide group on the other. In case of nucleosides, the development of azide group is simpler for which the replacement of the 5'-hydroxy group is the most suitable. This transformation generally involves many side reactions and result in very low yields. In addition, during our experiments, the transformation of the 2'-deoxyguanosine to the corresponding 5'-deoxy-5’-azido-2’-deoxyguanosine could not be performed with any of the methods described in the literature. Therefore, we have tried to overcome these difficulties with not only using the traditional process based on the 2 step exchange of tosyl to azide, but also using the Mitsunobu reaction which requires only one step. However, this path proved to be unsuccessful in spite of the optimizing the reaction conditions. Finally, a method has been developed whereby the azide groups were incorporated into the 5’-position resulting in significantly better yields compared to all other previous methods, and we were able to produce all the four nucleoside derivatives.

Keywords: 5'-azidonucleosides, bioconjugate, click reaction, proliferation

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7143 The Effects of Mirror Therapy on Clinical Improvement in Hemiplegic Lower Extremity Rehabilitation in Subjects with Chronic Stroke

Authors: Hassan Abo-Salem, Huang Xiaolin

Abstract:

Background and Purpose: The effectiveness of mirror therapy (MT) has been investigated in acute hemiplegia. The present study examines whether MT, given during chronic stroke, was more effective in promoting motor recovery of the lower extremity and walking speed than standard rehabilitation alone. Methods: The study enrolled 30 patients with chronic stroke. Fifteen patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received mirror therapy for 4 weeks, 5 days a week. Main measures: Passive ankle joint dorsiflexion range of motion, gait speed, Brunnstrom stages of motor recovery, plantarflexor muscle tone by Modified Ashworth Scale. Results: Results: No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation, mirror therapy improved Ankle ROM, Brunnstrom stages and waking speed (p < 0.05). However, there were no significant differences between two groups on MAS (P > 0.05). Conclusions: Mirror therapy combined with a conventional stroke rehabilitation program enhances lower-extremity motor recovery and walking speed in chronic stroke patients.

Keywords: mirror therapy, stroke, MAS, walking speed

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7142 Comparison of Gait Variability in Individuals with Trans-Tibial and Trans-Femoral Lower Limb Loss: A Pilot Study

Authors: Hilal Keklicek, Fatih Erbahceci, Elif Kirdi, Ali Yalcin, Semra Topuz, Ozlem Ulger, Gul Sener

Abstract:

Objectives and Goals: The stride-to-stride fluctuations in gait is a determinant of qualified locomotion as known as gait variability. Gait variability is an important predictive factor of fall risk and useful for monitoring the effects of therapeutic interventions and rehabilitation. Comparison of gait variability in individuals with trans-tibial lower limb loss and trans femoral lower limb loss was the aim of the study. Methods: Ten individuals with traumatic unilateral trans femoral limb loss(TF), 12 individuals with traumatic transtibial lower limb loss(TT) and 12 healthy individuals(HI) were the participants of the study. All participants were evaluated with treadmill. Gait characteristics including mean step length, step length variability, ambulation index, time on each foot of participants were evaluated with treadmill. Participants were walked at their preferred speed for six minutes. Data from 4th minutes to 6th minutes were selected for statistical analyses to eliminate learning effect. Results: There were differences between the groups in intact limb step length variation, time on each foot, ambulation index and mean age (p < .05) according to the Kruskal Wallis Test. Pairwise analyses showed that there were differences between the TT and TF in residual limb variation (p=.041), time on intact foot (p=.024), time on prosthetic foot(p=.024), ambulation index(p = .003) in favor of TT group. There were differences between the TT and HI group in intact limb variation (p = .002), time on intact foot (p<.001), time on prosthetic foot (p < .001), ambulation index result (p < .001) in favor of HI group. There were differences between the TF and HI group in intact limb variation (p = .001), time on intact foot (p=.01) ambulation index result (p < .001) in favor of HI group. There was difference between the groups in mean age result from HI group were younger (p < .05).There were similarity between the groups in step lengths (p>.05) and time of prosthesis using in individuals with lower limb loss (p > .05). Conclusions: The pilot study provided basic data about gait stability in individuals with traumatic lower limb loss. Results of the study showed that to evaluate the gait differences between in different amputation level, long-range gait analyses methods may be useful to get more valuable information. On the other hand, similarity in step length may be resulted from effective prosthetic using or effective gait rehabilitation, in conclusion, all participants with lower limb loss were already trained. The differences between the TT and HI; TF and HI may be resulted from the age related features, therefore, age matched population in HI were recommended future studies. Increasing the number of participants and comparison of age-matched groups also recommended to generalize these result.

Keywords: lower limb loss, amputee, gait variability, gait analyses

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7141 A Model for Analysing Argumentative Structures and Online Deliberation in User-Generated Comments to the Website of a South African Newspaper

Authors: Marthinus Conradie

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The conversational dynamics of democratically orientated deliberation continue to stimulate critical scholarship for its potential to bolster robust engagement between different sections of pluralist societies. Several axes of deliberation that have attracted academic attention include face-to-face vs. online interaction, and citizen-to-citizen communication vs. engagement between citizens and political elites. In all these areas, numerous researchers have explored deliberative procedures aimed at achieving instrumental goals such a securing consensus on policy issues, against procedures that prioritise expressive outcomes such as broadening the range of argumentative repertoires that discursively construct and mediate specific political issues. The study that informs this paper, works in the latter stream. Drawing its data from the reader-comments section of a South African broadsheet newspaper, the study investigates online, citizen-to-citizen deliberation by analysing the discursive practices through which competing understandings of social problems are articulated and contested. To advance this agenda, the paper deals specifically with user-generated comments posted in response to news stories on questions of race and racism in South Africa. The analysis works to discern and interpret the various sets of discourse practices that shape how citizens deliberate contentious political issues, especially racism. Since the website in question is designed to encourage the critical comparison of divergent interpretations of news events, without feeding directly into national policymaking, the study adopts an analytic framework that traces how citizens articulate arguments, rather than the instrumental effects that citizen deliberations might exert on policy. The paper starts from the argument that such expressive interactions are particularly crucial to current trends in South African politics, given that the precise nature of race and racism remain contested and uncertain. Centred on a sample of 2358 conversational moves in 814 posts to 18 news stories emanating from issues of race and racism, the analysis proceeds in a two-step fashion. The first stage conducts a qualitative content analysis that offers insights into the levels of reciprocity among commenters (do readers engage with each other or simply post isolated opinions?), as well as the structures of argumentation (do readers support opinions by citing evidence?). The second stage involves a more fine-grained discourse analysis, based on a theorisation of argumentation that delineates it into three components: opinions/conclusions, evidence/data to support opinions/conclusions and warrants that explicate precisely how evidence/data buttress opinions/conclusions. By tracing the manifestation and frequency of specific argumentative practices, this study contributes to the archive of research currently aggregating around the practices that characterise South Africans’ engagement with provocative political questions, especially racism and racial inequity. Additionally, the study also contributes to recent scholarship on the affordances of Web 2.0 software by eschewing a simplistic bifurcation between cyber-optimist vs. pessimism, in favour of a more nuanced and context-specific analysis of the patterns that structure online deliberation.

Keywords: online deliberation, discourse analysis, qualitative content analysis, racism

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7140 Increasing Student Engagement through Culturally-Responsive Classroom Management

Authors: Catherine P. Bradshaw, Elise T. Pas, Katrina J. Debnam, Jessika H. Bottiani, Michael Rosenberg

Abstract:

Worldwide, ethnically and culturally diverse students are at increased risk for school failure, discipline problems, and dropout. Despite decades of concern about this issue of disparities in education and other fields (e.g., 'school to prison pipeline'), there has been limited empirical examination of models that can actually reduce these gaps in schools. Moreover, few studies have examined the effectiveness of in-service teacher interventions and supports specifically designed to reduce discipline disparities and improve student engagement. This session provides an overview of the evidence-based Double Check model which serves as a framework for teachers to use culturally-responsive strategies to engage ethnically and culturally diverse students in the classroom and reduce discipline problems. Specifically, Double Check is a school-based prevention program which includes three core components: (a) enhancements to the school-wide Positive Behavioral Interventions and Supports (PBIS) tier-1 level of support; (b) five one-hour professional development training sessions, each of which addresses five domains of cultural competence (i.e., connection to the curriculum, authentic relationships, reflective thinking, effective communication, and sensitivity to students’ culture); and (c) coaching of classroom teachers using an adapted version of the Classroom Check-Up, which intends to increase teachers’ use of effective classroom management and culturally-responsive strategies using research-based motivational interviewing and data-informed problem-solving approaches. This paper presents findings from a randomized controlled trial (RCT) testing the impact of Double Check, on office discipline referrals (disaggregated by race) and independently observed and self-reported culturally-responsive practices and classroom behavior management. The RCT included 12 elementary and middle schools; 159 classroom teachers were randomized either to receive coaching or serve as comparisons. Specifically, multilevel analyses indicated that teacher self-reported culturally responsive behavior management improved over the course of the school year for teachers who received the coaching and professional development. However, the average annual office discipline referrals issued to black students were reduced among teachers who were randomly assigned to receive coaching relative to comparison teachers. Similarly, observations conducted by trained external raters indicated significantly more teacher proactive behavior management and anticipation of student problems, higher student compliance, less student non-compliance, and less socially disruptive behaviors in classrooms led by coached teachers than classrooms led teachers randomly assigned to the non-coached condition. These findings indicated promising effects of the Double Check model on a range of teacher and student outcomes, including disproportionality in office discipline referrals among Black students. These results also suggest that the Double Check model is one of only a few systematic approaches to promoting culturally-responsive behavior management which has been rigorously tested and shown to be associated with improvements in either student or staff outcomes indicated significant reductions in discipline problems and improvements in behavior management. Implications of these findings are considered within the broader context of globalization and demographic shifts, and their impacts on schools. These issues are particularly timely, given growing concerns about immigration policies in the U.S. and abroad.

Keywords: ethnically and culturally diverse students, student engagement, school-based prevention, academic achievement

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7139 Molecular Dynamic Simulation of CO2 Absorption into Mixed Aqueous Solutions MDEA/PZ

Authors: N. Harun, E. E. Masiren, W. H. W. Ibrahim, F. Adam

Abstract:

Amine absorption process is an approach for mitigation of CO2 from flue gas that produces from power plant. This process is the most common system used in chemical and oil industries for gas purification to remove acid gases. On the challenges of this process is high energy requirement for solvent regeneration to release CO2. In the past few years, mixed alkanolamines have received increasing attention. In most cases, the mixtures contain N-methyldiethanolamine (MDEA) as the base amine with the addition of one or two more reactive amines such as PZ. The reason for the application of such blend amine is to take advantage of high reaction rate of CO2 with the activator combined with the advantages of the low heat of regeneration of MDEA. Several experimental and simulation studies have been undertaken to understand this process using blend MDEA/PZ solvent. Despite those studies, the mechanism of CO2 absorption into the aqueous MDEA is not well understood and available knowledge within the open literature is limited. The aim of this study is to investigate the intermolecular interaction of the blend MDEA/PZ using Molecular Dynamics (MD) simulation. MD simulation was run under condition 313K and 1 atm using NVE ensemble at 200ps and NVT ensemble at 1ns. The results were interpreted in term of Radial Distribution Function (RDF) analysis through two system of interest i.e binary and tertiary. The binary system will explain the interaction between amine and water molecule while tertiary system used to determine the interaction between the amine and CO2 molecule. For the binary system, it was observed that the –OH group of MDEA is more attracted to water molecule compared to –NH group of MDEA. The –OH group of MDEA can form the hydrogen bond with water that will assist the solubility of MDEA in water. The intermolecular interaction probability of –OH and –NH group of MDEA with CO2 in blended MDEA/PZ is higher than using single MDEA. This findings show that PZ molecule act as an activator to promote the intermolecular interaction between MDEA and CO2.Thus, blend of MDEA with PZ is expecting to increase the absorption rate of CO2 and reduce the heat regeneration requirement.

Keywords: amine absorption process, blend MDEA/PZ, CO2 capture, molecular dynamic simulation, radial distribution function

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7138 Efficacy of Self-Assessment Metacognitive Strategy on Academic Performance Among Upper Basic Students in Ankpa, Kogi State, Nigeria

Authors: Daodu Joshua Rotimi

Abstract:

This study investigated the Efficacy of Self-Assessment Metacognitive Strategy on Academic performance in Energy Concepts among Upper Basic Science Students in Ankpa, Kogi State, Nigeria. The research design adopted for the study was a Quasi-experimental control group design which employed a pretest, posttest of the experimental and control groups. The population of the study consisted of one hundred and twenty-four (124) JSSII Students; sixty-five (65) for the experimental group and (59) for the control group. The instrument used for the study was the Energy Concept Performance Test (ECPT), with a reliability coefficient of 0.80. Two research questions were answered using descriptive statistics of mean and standard deviation, while two hypotheses were tested using a t-test at P≤0.05 level of significance. The findings of the study revealed that the use of the Self-Assessment Metacognitive Strategy has a positive effect on students’ performance in energy concepts among upper Basic Science Students leading to high academic performance; also, there is no significant difference in the mean Academic Performance scores between Male and Female students taught Energy Concept using Self-Assessment Metacognitive Strategy. Based on the research findings, recommendations were made, which include that Secondary school teachers should be encouraged the use Self-Assessment Metacognitive strategy so as to make the learning process attractive, interactive and enriching to the learners.

Keywords: metacognition, self-assessment, performance, efficacy

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7137 Improvements of the Difficulty in Hospital Acceptance at the Scene by the Introduction of Smartphone Application for Emergency-Medical-Service System: A Population-Based Before-And-After Observation Study in Osaka City, Japan

Authors: Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Sumito Hayashida, Taku Iwami, Takashi Kawamura, Takeshi Shimazu

Abstract:

Background: Recently, the number of ambulance dispatches has been increasing in Japan and it is, therefore, difficult to accept emergency patients to hospitals smoothly and appropriately because of the limited hospital capacity. To facilitate the request for patient transport by ambulances and hospital acceptance, the emergency information system using information technology has been built up and introduced in various communities. However, its effectiveness has not been insufficiently revealed in Japan. In 2013, we developed a smartphone application system that enables the emergency-medical-service (EMS) personnel to share information about on-scene ambulance and hospital situation. The aim of this study was to assess the introduction effect of this application for EMS system in Osaka City, Japan. Methods: This study was a retrospective study with population-based ambulance records of Osaka Municipal Fire Department. This study period was six years from January 1, 2010 to December 31, 2015. In this study, we enrolled emergency patients that on-scene EMS personnel conducted the hospital selection for them. The main endpoint was difficulty in hospital acceptance at the scene. The definition of difficulty in hospital acceptance at the scene was to make >=5 phone calls by EMS personnel at the scene to each hospital until a decision to transport was determined. The definition of the smartphone application group was emergency patients transported in the period of 2013-2015 after the introduction of this application, and we assessed the introduction effect of smartphone application with multivariable logistic regression model. Results: A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 smartphone application group (50.0%) in 2010-2012 and 300,395 non-smartphone application group (50.0%) in 2013-2015. The proportion of the difficulty in hospital acceptance was 14.2% (42,585/300,131) in the smartphone application group and 10.9% (32,819/300,395) in the non-smartphone application group, and the difficulty in hospital acceptance significantly decreased by the introduction of the smartphone application (adjusted odds ration; 0.730, 95% confidence interval; 0.718-0.741, P<0.001). Conclusions: Sharing information between ambulance and hospital by introducing smartphone application at the scene was associated with decreasing the difficulty in hospital acceptance. Our findings may be considerable useful for developing emergency medical information system with using IT in other areas of the world.

Keywords: difficulty in hospital acceptance, emergency medical service, infomation technology, smartphone application

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7136 The Effect of Trans-Cranial Direct Current Stimulation (tDCS) on Cognitive Flexibility and Social Decision-Making in Football Players

Authors: Erfan Izadpanah

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The present study was conducted to investigate the effect of the Trans-Cranial Direct Current Stimulation (tDCS) on cognitive flexibility and social decision-making in skilled, semi-skilled and novice football players. The present quasi-experimental pretest-posttest study was conducted on 60 randomly-selected subjects divided into trial and placebo groups (n=30 per group). The trial group received three 20-minute sessions of anodic stimulation at the intensity of 2 mA. The placebo group also received three sessions of sham anodic stimulation. Data were collected using the Wisconsin, Grant and Berg Card-Sorting Test (1948) and the ultimatum game and were then analyzed using the ANCOVA. The results showed significant differences between the skilled, semi-skilled and novice football players in the trial and placebo groups in terms of cognitive flexibility and social decision-making (P<0.01). TDCS appears to be able to improve cognitive flexibility and consequently social decision-making in football players and is recommended to sport psychologists and coaches as a useful intervention to increase cognitive flexibility and improve social decision-making in players.

Keywords: TDCS, cognitive flexibility, social decision-making, skilled, semi-skilled and novice football players

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7135 Improving Part-Time Instructors’ Academic Outcomes with Gamification

Authors: Jared R. Chapman

Abstract:

This study introduces a type of motivational information system called an educational engagement information system (EEIS). An EEIS draws on principles of behavioral economics, motivation theory, and learning cognition theory to design information systems that help students want to improve their performance. This study compares academic outcomes for course sections taught by part- and full-time instructors both with and without an EEIS. Without an EEIS, students in the part-time instructor's course sections demonstrated significantly higher failure rates (a 143.8% increase) and dropout rates (a 110.4% increase) with significantly fewer students scoring a B- or higher (39.8% decrease) when compared to students in the course sections taught by a full-time instructor. It is concerning that students in the part-time instructor’s course without an EEIS had significantly lower academic outcomes, suggesting less understanding of the course content. This could impact retention and continuation in a major. With an EEIS, when comparing part- and full-time instructors, there was no significant difference in failure and dropout rates or in the number of students scoring a B- or higher in the course. In fact, with an EEIS, the failure and dropout rates were statistically identical for part- and full-time instructor courses. When using an EEIS (compared with not using an EEIS), the part-time instructor showed a 62.1% decrease in failures, a 61.4% decrease in dropouts, and a 41.7% increase in the number of students scoring a B- or higher in the course. We are unaware of other interventions that yield such large improvements in academic performance. This suggests that using an EEIS such as Delphinium may compensate for part-time instructors’ limitations of expertise, time, or rewards that can have a negative impact on students’ academic outcomes. The EEIS had only a minimal impact on failure rates (7.7% decrease) and dropout rates (18.8% decrease) for the full-time instructor. This suggests there is a ceiling effect for the improvements that an EEIS can make in student performance. This may be because experienced instructors are already doing the kinds of things that an EEIS does, such as motivating students, tracking grades, and providing feedback about progress. Additionally, full-time instructors have more time to dedicate to students outside of class than part-time instructors and more rewards for doing so. Using adjunct and other types of part-time instructors will likely remain a prevalent practice in higher education management courses. Given that using part-time instructors can have a negative impact on student graduation and persistence in a field of study, it is important to identify ways we can augment part-time instructors’ performance. We demonstrated that when part-time instructors use an EEIS, it can result in significantly lower students’ failure and dropout rates and an increase in the rate of students earning a B- or above; and bring their students’ performance to parity with the performance of students taught by a full-time instructor.

Keywords: gamification, engagement, motivation, academic outcomes

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7134 The Antecedents of Facebook Check in Adoption Intention: The Perspective of Social Influence

Authors: Hsiu-Hua Cheng

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Recently, the competition between websites becomes intense. How to make users “adopt” their websites is an issue of urgent importance for online communities companies. Social procedures (such as social influence) can possibly explain how and why users’ technologies usage behaviors affect other people to use the technologies. This study proposes two types of social influences on the initial usage of Facebook Check In-friends and group members. Besides, this study indicates that Facebook friends’ previous usage of Facebook Check In and Facebook group members’ previous usage of Facebook Check In will positively influence focal actors’ Facebook Check In adoption intention. The article concludes with contributions to academic research and practice.

Keywords: social influence, adoption intention, facebook check in, previous usage behavior

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7133 Lean Implementation in a Nurse Practitioner Led Pediatric Primary Care Clinic: A Case Study

Authors: Lily Farris, Chantel E. Canessa, Rena Heathcote, Susan Shumay, Suzanna V. McRae, Alissa Collingridge, Minna K. Miller

Abstract:

Objective: To describe how the Lean approach can be applied to improve access, quality and safety of care in an ambulatory pediatric primary care setting. Background: Lean was originally developed by Toyota manufacturing in Japan, and subsequently adapted for use in the healthcare sector. Lean is a systematic approach, focused on identifying and reducing waste within organizational processes, improving patient-centered care and efficiency. Limited literature is available on the implementation of the Lean methodologies in a pediatric ambulatory care setting. Methods: A strategic continuous improvement event or Rapid Process Improvement Workshop (RPIW) was launched with the aim evaluating and structurally supporting clinic workflow, capacity building, sustainability, and ultimately improving access to care and enhancing the patient experience. The Lean process consists of five specific activities: Current state/process assessment (value stream map); development of a future state map (value stream map after waste reduction); identification, quantification and prioritization of the process improvement opportunities; implementation and evaluation of process changes; and audits to sustain the gains. Staff engagement is a critical component of the Lean process. Results: Through the implementation of the RPIW and shifting workload among the administrative team, four hours of wasted time moving between desks and doing work was eliminated from the Administrative Clerks role. To streamline clinic flow, the Nursing Assistants completed patient measurements and vitals for Nurse Practitioners, reducing patient wait times and adding value to the patients visit with the Nurse Practitioners. Additionally, through the Nurse Practitioners engagement in the Lean processes a need was recognized to articulate clinic vision, mission and the alignment of NP role and scope of practice with the agency and Ministry of Health strategic plan. Conclusions: Continuous improvement work in the Pediatric Primary Care NP Clinic has provided a unique opportunity to improve the quality of care delivered and has facilitated further alignment of the daily continuous improvement work with the strategic priorities of the Ministry of Health.

Keywords: ambulatory care, lean, pediatric primary care, system efficiency

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7132 Raw Japanese Quail Egg Produces Analgesic, Anti-Inflammatory and Gastro-Protective Effects in Rats

Authors: Sani Ismaila, Shafiu Yau, Abubakar Salisu, Buhari Salisu, Sharifat Balogun, Mustapha Abubakar, Biobaku Khalid, Agaie Bello

Abstract:

Over the years, Japanese quail egg has been in use in the management of diseases. The objective of this study was to evaluate the analgesic, anti-inflammatory and gastroprotective effects of raw Quail egg (yolk + albumin) in rats. Pain was assessed in rats by recording the latent period and writing reflex, anti-inflammatory effect was determined using both motility and compression test, while the gastro-protective effects were assessed by observing the histology of the stomach after diclofenac-induced gastric ulcers and subsequent treatment with the quail egg, Rats were randomly assigned into 4 groups; Groups I: were the control non-treated (NT), Group II were treated with Tramadol 50 mg/kg/Os (TMD) or Indomethacin (IND) 5mg/kg/Os (positive control for the writhing reflex determination), while group III and IV were treated with 3 and 6g/kg of raw quail egg respectively). Groups treated with quail egg in both doses showed a significant increase in the latent period (p <0 .05) when compared to the control NT, but lower than the group treated with tramadol at 20mins interval (p<0.05). Writing reflexes decrease in groups II, III, and IV compared to the NT group (p < 0.05). While motility increases significantly (p < 0.05) in groups II, compared to I (p<0.05). Control non-treated rats showed a quicker and extensive response to compression using the Vanier calliper on the inflamed paw compared to groups II-IV (p < 0.05). Histological studies of the stomach revealed sloughing of the epithelia, cellular infiltration with micro abscesses in the non-treated, while groups treated concurrently with quail egg showed proliferation of the glandular epithelia and goblet cells, and those treated 30 minutes before diclofenac administration showed proliferation of glands and thickening of the squamous epithelia. This study showed that quail egg has analgesic, anti-inflammatory and gastro-protective potentials and can be used as adjuvant treatment whenever COX-2 enzymes inhibitors are indicated.

Keywords: analgesia, anti-inflammatory, gastroprotective effect, japanese quail egg

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