Search results for: Kenyatta National Hospital
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6379

Search results for: Kenyatta National Hospital

6199 Covid-19: Preparedness, Response, and Use of Video Technology in Managing Infection Rate at Lagos University Teaching Hospital, Lagos-Nigeria

Authors: Afolakemi Helen Olaleye, Ogunjobi A. O

Abstract:

Since coronavirus disease 2019 (COVID-19) was first reported in Nigeria, the virus has spread to virtually all sub-Saharan Africa (SSA) countries. In Nigeria, government agencies came together to create a goal-driven taskforce in improving our response against the virus. As COVID-19 international spread has been curtailed, community spread became rampant locally, leading to many health authorities raising concerns over the scarcity of medical consumables and supplies. Here at Lagos university teaching Hospital (LUTH), we present data analysis of COVID-19 infections offered at our Hospital (LUTH) and the surrounding communities. In addition, the adopted innovative solution to control the spread of infection, methods used in filling shortages of consumables, personal protective equipment (PPE), and use of mobile video technology in patient’s consultation. The management style and strategy adopted has led to a decline in infection rates in our community and among our front line staff. The current COVID -19 crisis has created an opportunity to test and demonstrate our pandemic response and control of infectious disease along with the revealed unknown potential in our community.

Keywords: COVID-19, preparedness, response, Lagos university teaching hospital

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6198 Nationalist Approach to the Music Culture in Early Republic Period in Turkey

Authors: Hilmi Yazici

Abstract:

Just after Ottoman period, new more homogenic republic was struggling to form a national identity and dealing with the cultural and historical background of the nation. This new republic had an aim of modernization and westernization which started in the late ottoman period. In this process, the culture was an important basis to form a new nation and it clearly put forward that the new citizens of the new national republic are to have a modern and national culture. The result of this aimed change was to find the Turkish culture suppressed among the common people of the Anatolia and to take the western modernization and breed this with national culture. So in this context, we can say that this approach separated the people from ottoman culture and its roots to empower the national identity. Repeatedly, it may be said that Turkish folkloric music was an important basis for the new revolution, on the other hand classical Turkish music was alienated with the idea that it didn’t belong to Turkish culture. So the aim of this study is to determine how these efforts to nationalize a new identity and culture was successful and conscious intervention to folkloric Turkish music became efficient.

Keywords: opera, nationalism in music, Turkish music

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6197 Stress and Personality as Predictors of Aggressive Behaviour among Nurses of Private Hospitals in Imo State, Nigeria

Authors: Ngozi N. Sydney-Agbor, Chioma N. Ihegboro

Abstract:

Stress and personality as factors influencing nurses’ aggressive behaviour were investigated. The participants comprised of one hundred and fifty nurses selected through convenience sampling technique from four (4) private hospitals in Imo State, Nigeria; namely: Eastern Summit Specialist Clinics and Maternity, St. David Hospital, New Cross Hospital, and Christian Teaching Hospital. The nurses were all females with ages between 20–35 and a mean age of 25.10 years and a standard deviation of 4.15. The participants were administered with Job Related Tension Scale, Type A Behaviour Scale and Buss- Perry Aggressive Behaviour Scale. Two hypotheses were postulated and tested. Cross- sectional survey and Regression Analysis were adopted as design and statistics respectively. Results showed that as stress increased, nurses aggression also increased. Personality also predicted nurses aggressive behaviour with Type As’ exhibiting higher aggression than Type Bs’.The study recommended that hospital management board should improve the welfare of the nurses and their morale should be boosted by involving them in policy-making concerning their welfare and care of their patients, this will help minimise situations capable of increasing aggressive behaviour. There should also be sensitization on the negative impact of aggressive behaviour to patients especially amongst the personality Type A’s who are more susceptible to aggression.

Keywords: aggressive behaviour, nurses, personality, stress

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6196 The Analysis of the Role of Handicrafts in Consolidating Iran National Identity

Authors: Nadia Pourabbas Tahvildari

Abstract:

National identity is formed in the process of time and in the community while influenced by the historical events. The country which has a more coherent national and historical identity would be successful as well as strengthening solidarity and social cohesion. Among the international community where the various likes challenge the subject of identity, taking into consideration the components which using identity seems to be very critical. Handicrafts as reflecting the historical and cultural characteristics of the product location can be used as an important component in order to introduce the culture and identity to be evaluated. As one of the most durable crafts for man, handicrafts have played a continuous role in sustaining human culture. Today without the presence of handicrafts, restoration of culture and national identity and religious beliefs of the past clans and people, is not only difficult but is even impossible also. Due to its brilliant historical experience and having rich culture and civilization, Iran has accomplished to the high competence in the field of traditional arts and handicrafts. This article is a scientific approach which by using descriptive – analytic method based on library studies tried to address the issue of handicrafts looking to examine the position of the industry to consolidate the national identity. Studies indicate that Iran as one of the original human habitats in the field of handicrafts has adequate enrichment and in case there will be an appropriate planning and investment away from oil-based industry, it would be beneficent. Furthermore, the quality and variety of handicrafts can be used as an essential yardstick for the consolidation of Iran national identity in the age of globalization.

Keywords: handicrafts, Iran national identity, globalization, cultural heritage

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6195 Heat Waves and Hospital Admissions for Mental Disorders in Hanoi Vietnam

Authors: Phan Minh Trang, Joacim Rocklöv, Kim Bao Giang, Gunnar Kullgren, Maria Nilsson

Abstract:

There are recent studies from high income countries reporting an association between heat waves and hospital admissions for mental health disorders. It is not previously studied if such relations exist in sub-tropical and tropical low- and middle-income countries. In this study from Vietnam, the assumption was that hospital admissions for mental disorders may be triggered, or exacerbated, by heat exposure and heat waves. A database from Hanoi Mental Hospital with mental disorders diagnosed by the International Classification of Diseases 10, spanning over five years, was used to estimate the heatwave-related impacts on admissions for mental disorders. The relationship was analysed by a Negative Binomial regression model accounting for year, month, and days of week. The focus of the study was heat-wave events with periods of three or seven consecutive days above the threshold of 35oC daily maximum temperature. The preliminary study results indicated that heat-waves increased the risks for hospital admission for mental disorders (F00-79) from heat-waves of three and seven days with relative risks (RRs) of 1.16 (1.01–1.33) and 1.42 (1.02–1.99) respectively, when compared with non-heat-wave periods. Heatwave-related admissions for mental disorders increased statistically significantly among men, among residents in rural communities and in elderly. Moreover, cases for organic mental disorders including symptomatic illnesses (F0-9) and mental retardation (F70-79) raised in high risks during heat waves. The findings are novel studying a sub-tropical middle-income city, facing rapid urbanisation and epidemiological and demographic transitions.

Keywords: mental disorders, admissions for F0-9 or F70-79, maximum temperature, heat waves

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6194 The Use of Emergency Coronary Angiography in Patients Following Out-Of-Hospital Cardiac Arrest and Subsequent Cardio-Pulmonary Resuscitation

Authors: Scott Ashby, Emily Granger, Mark Connellan

Abstract:

Objectives: 1) To identify if emergency coronary angiography improves outcomes in studies examining OHCA from assumed cardiac aetiology? 2) If so, is it indicated in all patients resuscitated following OHCA, and if not, who is it indicated for? 3) How effective are investigations for screening for the appropriate patients? Background: Out-of-hospital cardiac arrest is one of the leading mechanisms of death, and the most common causative pathology is coronary artery disease. In-hospital treatment following resuscitation greatly affects outcomes, yet there is debate over the most effective protocol. Methods: A literature search was conducted over multiple databases to identify all relevant articles published from 2005. An inclusion criterion was applied to all publications retrieved, which were then sorted by type. Results: A total of 3 existing reviews and 29 clinical studies were analysed in this review. There were conflicting conclusions, however increased use of angiography has shown to improve outcomes in the majority of studies, which cover a variety of settings and cohorts. Recommendations: Currently, emergency coronary angiography appears to improve outcomes in all/most cases of OHCA of assumed cardiac aetiology, regardless of ECG findings. Until a better tool for screening is available to reduce unnecessary procedures, the benefits appear to outweigh the costs/risks.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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6193 Leveraging Li-Fi to Enhance Security and Performance of Medical Devices

Authors: Trevor Kroeger, Hayden Williams, Edward Holzinger, David Coleman, Brian Haberman

Abstract:

The network connectivity of medical devices is increasing at a rapid rate. Many medical devices, such as vital sign monitors, share information via wireless or wired connections. However, these connectivity options suffer from a variety of well-known limitations. Wireless connectivity, especially in the unlicensed radio frequency bands, can be disrupted. Such disruption could be due to benign reasons, such as a crowded spectrum, or to malicious intent. While wired connections are less susceptible to interference, they inhibit the mobility of the medical devices, which could be critical in a variety of scenarios. This work explores the application of Light Fidelity (Li-Fi) communication to enhance the security, performance, and mobility of medical devices in connected healthcare scenarios. A simple bridge for connected devices serves as an avenue to connect traditional medical devices to the Li-Fi network. This bridge was utilized to conduct bandwidth tests on a small Li-Fi network installed into a Mock-ICU setting with a backend enterprise network similar to that of a hospital. Mobile and stationary tests were conducted to replicate various different situations that might occur within a hospital setting. Results show that in room Li-Fi connectivity provides reasonable bandwidth and latency within a hospital like setting.

Keywords: hospital, light fidelity, Li-Fi, medical devices, security

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6192 Patient Safety Culture in Brazilian Hospitals from Nurse's Team Perspective

Authors: Carmen Silvia Gabriel, Dsniele Bernardi da Costa, Andrea Bernardes, Sabrina Elias Mikael, Daniele da Silva Ramos

Abstract:

The goal of this quantitative study is to investigate patient safety culture from the perspective of professional from the hospital nursing team.It was conducted in two Brazilian hospitals,.The sample included 282 nurses Data collection occurred in 2013, through the questionnaire Hospital Survey on Patient Safety Culture.Based on the assessment of the dimensions is stressed that, in the dimension teamwork across hospital units, 69.4% of professionals agree that when a lot of work needs to be done quickly, they work together as a team; about the dimension supervisor/ manager expectations and actions promoting safety, 70.2% agree that their supervisor overlooks patient safety problems.Related to organizational learning and continuous improvement, 56.5% agree that there is evaluation of the effectiveness of the changes after its implementation.On hospital management support for patient safety, 52.8% refer that the actions of hospital management show that patient safety is a top priority.On the overall perception of patient safety, 57.2% disagree that patient safety is never compromised due to higher amount of work to be completed.In what refers to feedback and communication about error, 57.7% refer that always and usually receive such information. Relative to communication openness, 42.9% said they never or rarely feel free to question the decisions / actions of their superiors.On frequency of event reporting, 64.7% said often and always notify events with no damages to patients..About teamwork across hospital units is noted similarity between the percentages of agreement and disagreement, as on the item there is a good cooperation among hospital units that need to work together, that indicates 41.4% and 40.5% respectively.Related to adequacy of professionals, 77.8 % disagree on the existence of sufficient amount of employees to do the job, 52.4% agree that shift changes are problematic for patients. On nonpunitive response to errors, 71.7% indicate that when an event is reported it seems that the focus is on the person.On the patient safety grade of the institution, 41.6 % classified it as very good. it is concluded that there are positive points in the safety culture, and some weaknesses as a punitive culture and impaired patient safety due to work overload .

Keywords: quality of health care, health services evaluation, safety culture, patient safety, nursing team

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6191 Multilingualism and the Question of National Language in Nigeria

Authors: Salome Labeh

Abstract:

Diverse Languages that exist in Nigeria, gave rise to the need to choose among these languages, which one or ones to be used as the National Language(s) in Nigeria. The Multilingual Nature of Nigeria has been examined, in relation to the provisional result of 1991 census conducted in Nigeria and the status of language policy in the country, which eventually led to the discovery of the fact that Hausa, Igbo, Yoruba languages have the highest speaker in terms of population, and are already made co-official languages in Nigeria, alongside with English language. Then, these languages should be considered as the National Languages, if eventually a language policy emerges in Nigeria.

Keywords: multilingual, languages, culture, Nigeria

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6190 Revisiting Hospital Ward Design Basics for Sustainable Family Integration

Authors: Ibrahim Abubakar Alkali, Abubakar Sarkile Kawuwa, Ibrahim Sani Khalil

Abstract:

The concept of space and function forms the bedrock for spatial configuration in architectural design. Thus, the effectiveness and functionality of an architectural product depends their cordial relationship. This applies to all buildings especially to a hospital ward setting designed to accommodate various complex and diverse functions. Health care facilities design, especially an inpatient setting, is governed by many regulations and technical requirements. It is also affected by many less defined needs, particularly, response to culture and the need to provide for patient families’ presence and participation. The spatial configuration of the hospital ward setting in developing countries has no consideration for the patient’s families despite the significant role they play in promoting recovery. Attempts to integrate facilities for patients’ families have always been challenging, especially in developing countries like Nigeria, where accommodation for inpatients is predominantly in an open ward system. In addition, the situation is compounded by culture, which significantly dictates healthcare practices in Africa. Therefore, achieving such a hospital ward setting that is patient and family-centered requires careful assessment of family care actions and transaction spaces so as to arrive at an evidence based solution. Therefore, the aim of this study is to identify how hospital ward spaces can be reconfigured to provide for sustainable family integration. In achieving this aim, a qualitative approach using the principles of behavioral mapping was employed in male and female medical wards of the Federal Teaching Hospital (FTH) Gombe, Nigeria. The data obtained was analysed using classical and comparative content analysis. Patients’ families have been found to be a critical component of hospital ward design that cannot be undermined. Accordingly, bedsides, open yards, corridors and foyers have been identified as patient families’ transaction spaces that require design attention. Arriving at sustainable family integration can be achieved by revisiting the design requirements of the family transaction spaces based on the findings in order to avoid the rowdiness of the wards and uncoordinated sprawl.

Keywords: caregiving, design basics, family integration, hospital ward, sustainability

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6189 Examining the Influences of Exchange Programmes on Youths' National Identity: A Hong Kong Case Study

Authors: Annie Y. N. Cheng

Abstract:

Since the handover of Hong Kong to China, 'National Identity' has become a vital focus promoted by the HKSAR government. According to the poll by the University of Hong Kong’s Public Opinion Programme (2010 – 2015), young people aged between 18 and 29 have the least and decreasing recognition, an average 5.5%, of their Chinese identity. Past research has shown that student participation in exchange programmes and study tours provides the possibility of new formulations of national identity. Since the Policy Address 2008, the HKSAR government has been actively expanding and exploring the feasibility of Mainland exchange programmes to enhance our youths’ understanding of Chineseness and to strengthen their national identity. Schools have been sponsored or subsidized with the costs of Mainland exchange activities through various grants and channels. Considering the significantly increasing number of Hong Kong youths who have participated in these Mainland exchange programmes and study tours, however, the effectiveness of these activities is understudied. At present, there is the lack of systematic research on the impacts of these activities and the ways in which they influence our students’ perceptions of national identity. Using case study approach, this study aims to examine students’ perceptions of their national identity; and evaluate whether the Mainland exchange programmes or study tours have influences on students’ perceptions of national identity. Results show that the influences on national identity varied which were dependent on the objectives and destinations of the programmes. The findings of this study can provide significant feedback for schools to organize meaningful Mainland exchange activities or study tours and inform policy makers how to formulate effective strategies for promoting such exchange activities.

Keywords: Hong Kong youth, mainland exchange programme, national identity, study tours

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6188 Asthma Nurse Specialist Improves the Management of Acute Asthma in a University Teaching Hospital: A Quality Improvement Project

Authors: T. Suleiman, C. Mchugh, H. Ranu

Abstract:

Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

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6187 Poisoning Admission in Pediatrics Benghazi Hospital in Libya: Three Years Review of Medical Record

Authors: Mudafara Bengleil

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Estimation of the magnitude and causes of poisoning was the objective of the current study. A retrospective study of medical records of all poisoning children admitted to Benghazi Children Hospital in Libya from January 2008 up to December 2010. Number of children admitted was 244; the age ranged from less than one to 13 years old. Most of cases were admitted with mild symptom and the majority of them were boys. Only few cases admitted to intensive care unit and there was no mortality recorded through the period of study. Age group 1 to 3 years (50.8%) had the highest frequency of admission and the peak of admission was during summer. The most common cause of admission was due to ingestion of medication (53.69%), House hold product exposure (26.64%) was the second causes of admission while, 19.67% of admissions were due to Food poisoning. Almost all admitted cases were accidental and medicines were the most consumed substances in addition, improper storage of toxic agents were the first risk factor of poisoning. Present results indicated that, children poisoning seems to be a common pediatric care problem which need to control and prevent.

Keywords: poisoning, children, hospital, medical

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6186 Framework for the Assessment of National Systems of Innovation in Biotechnology

Authors: Andrea Schiffauerova, Amnah Alzeyoudi

Abstract:

This paper studies patterns of innovation within national constitutional context. Its objective is to examine national systems of innovation in biotechnology in six leading innovative countries: the US, Japan, Germany, the UK, France and Canada. The framework proposed for this purpose consists of specific factors considered critical for the development of national systems of innovation, which are industry size, innovative activities, area of specialization, industry structure, national policy, the level of government intervention, the stock of knowledge in universities and industries, knowledge transfer from universities to industry and country-specific conditions for start-ups. The paper then uses the framework to provide detailed cross-country comparisons while highlighting particular features of national institutional context which affect the creation and diffusion of scientific knowledge within the system. The study is primarily based on the extensive survey of literature and it is complemented by the quantitative analysis of the patent data extracted from the United States Patent and Trademark Office (USPTO). The empirical analysis provides numerous insights and greatly complements the data gained from the literature and other sources. The final cross-country comparative analysis identifies three patterns followed by the national innovation systems in the six countries. The proposed cross-country relative positioning analysis may help in drawing policy implications and strategies leading to the enhancement of national competitive advantage and innovation capabilities of nations.

Keywords: comparative analysis, framework, national systems of innovation, patent analysis, United States Patent and Trademark Office (USPTO)

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6185 Analyses of the Constitutional Identity in Hungary: A Case Study on the Concept of Constitutionalism and Legal Continuity in New Fundamental Law of Hungary

Authors: Zsuzsanna Fejes

Abstract:

The aim of this paper is to provide an overview of the legal history of constitutionalism in Hungary, in focus of the democratic transitions in 1989-1990, describing the historical and political background of the changes and presenting the main and most important features of the new democracy, and institutional and legal orders. In Hungary the evolved political, economic and moral crisis prior to the constitutional years 2010-11 had been such a constitutional moment, which led to an opportune and unavoidable change at the same time. The Hungarian constitutional power intended to adopt a new constitution, which was competent to create a common constitutional identity and to express a national unity. The Hungarian Parliament on 18th April 2011 passed the New Fundamental Law. The new Fundamental Law rich in national values meant a new challenge for the academics, lawyers, and political scientists. Not only the classical political science, but also the constitutional law and theory have to struggle with the interpretation of the new declarations about national constitutional values in the Fundamental Law. The main features and structure of the new Fundamental Law will be analysed, and given a detailed interpretation of the Preamble as a declaration of constitutional values. During the examination of the Preamble shall be cleared up the components of Hungarian statehood and national unity, individual and common human rights, the practical and theoretical demand on national sovereignty, and the content and possibilities for the interpretation of the achievements of the historical Constitution. These scopes of problems will be presented during the examination of the text of National Avowal, as a preamble of the Fundamental Law. It is examined whether the Fundamental Law itself could be suitable and sufficient means to citizens of Hungary to express the ideas therein as their own, it will be analysed how could the national and European common traditions, values and principles stated in the Fundamental Law mean maintenance in Hungary’s participation in the European integration.

Keywords: common constitutional values, constitutionalism, national identity, national sovereignty, national unity, statehood

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6184 Ethno-Religious Conflicts In Nigeria; Implications for National Security

Authors: Samuel Onyekachi Chidi

Abstract:

Nigeria today faces more internal threats stemming from ethnic and religious conflicts than external sources. This article seeks to examine the ethno-religious conflicts in Nigeria from 2015 to 2021 and their impact on national security. The research was guided by six objectives. The theoretical framework adopted for this study is Structural Conflict Theory, which provides an adequate explanation, a predictive rationale for the frequent occurrence of ethno-religious conflicts and a tendency to provide the necessary insight for their resolution. The results of the study revealed that there is a strong relationship between ethnicity, religion, conflict and national security and that the ethno-religious conflicts experienced in Nigeria have gross implications for national security. The study recommends that the secularity of the Nigerian state be restored and preserved and that the state of origin be removed and replaced by the state of residence in all our national documents, as this will reduce ethnic identity, which is in opposition to nationalism. Religious leaders, traditional rulers, the media and other stakeholders should support the government in its fight to reduce ethno-religious conflict by sensitizing its youth, preaching unity and peaceful coexistence, and discouraging the use of violence as a means of settling disputes between groups and individuals.

Keywords: ethnicity, religion, conflict, national security

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6183 Introduction of Acute Paediatric Services in Primary Care: Evaluating the Impact on GP Education

Authors: Salman Imran, Chris Healey

Abstract:

Traditionally, medical care of children in England and Wales starts from primary care with a referral to secondary care paediatricians who may not investigate further. Many primary care doctors do not undergo a paediatric rotation/exposure in training. As a result, there are many who have not acquired the necessary skills to manage children hence increasing hospital referral. With the current demand on hospitals in the National Health Service managing more problems in the community is needed. One way of handling this is to set up clinics, meetings and huddles in GP surgeries where professionals involved (general practitioner, paediatrician, health visitor, community nurse, dietician, school nurse) come together and share information which can help improve communication and care. The increased awareness and education that paediatricians can impart in this way will help boost confidence for primary care professionals to be able to be more self-sufficient. This has been tried successfully in other regions e.g., St. Mary’s Hospital in London but is crucial for a more rural setting like ours. The primary aim of this project would be to educate specifically GP’s and generally all other health professionals involved. Additional benefits would be providing care nearer home, increasing patient’s confidence in their local surgery, improving communication and reducing unnecessary patient flow to already stretched hospital resources. Methods: This was done as a plan do study act cycle (PDSA). Three clinics were delivered in different practices over six months where feedback from staff and patients was collected. Designated time for teaching/discussion was used which involved some cases from the actual clinics. Both new and follow up patients were included. Two clinics were conducted by a paediatrician and nurse whilst the 3rd involved paediatrician and local doctor. The distance from hospital to clinics varied from two miles to 22 miles approximately. All equipment used was provided by primary care. Results: A total of 30 patients were seen. All patients found the location convenient as it was nearer than the hospital. 70-90% clearly understood the reason for a change in venue. 95% agreed to the importance of their local doctor being involved in their care. 20% needed to be seen in the hospital for further investigations. Patients felt this to be a more personalised, in-depth, friendly and polite experience. Local physicians felt this to be a more relaxed, familiar and local experience for their patients and they managed to get immediate feedback regarding their own clinical management. 90% felt they gained important learning from the discussion time and the paediatrician also learned about their understanding and gaps in knowledge/focus areas. 80% felt this time was valuable for targeted learning. Equipment, information technology, and office space could be improved for the smooth running of any future clinics. Conclusion: The acute paediatric outpatient clinic can be successfully established in primary care facilities. Careful patient selection and adequate facilities are important. We have demonstrated a further step in the reduction of patient flow to hospitals and upskilling primary care health professionals. This service is expected to become more efficient with experience.

Keywords: clinics, education, paediatricians, primary care

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6182 Environmental Health Risk Assessment of Hospital Wastewater in Enugu Urban, Nigeria

Authors: C. T. Eze, I. N. E. Onwurah

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An important hydrogeologic problem in areas of high faults formations is high environmental health hazard occasioned by microbial and heavy metals contamination of ground waters. Consequently, we examined the microbial load and heavy metals concentration of hospital wastewater discharged into the environment at Park Lane General Hospital Enugu Urban, Nigeria. The microbial counts, characteristics and frequency of occurrences of the isolated microorganisms were determined by cultural, morphological and biochemical characteristics using established procedure while the varying concentrations of the identified heavy metals were determined using the spectrophotometric method. The microbiological analyses showed a mean total aerobic bacteria counts from 13.7 ± 0.65 × 107 to 22.8 ± 1.14 ×1010 CFU/ml, mean total anaerobic bacteria counts from 6.0 ± 1.6 × 103 to 1.7 ± 0.41 ×104 CFU/ml and mean total fungal counts from 0 ± 0 to 2.3 ± 0.16 × 105 CFU/ml. The isolated micro-organisms which included both pathogenic and non-pathogenic organisms were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Salmonella typhi, Bacillus subtilis, Proteus vulgaris, Klesbsiella pneumonia and bacteriodes sp. The only fungal isolate was Candida albican. The heavy metals identified in the leachate were Arsenic, Cadmium, Lead, Mercury and Chromium and their concentrations ranged from 0.003 ± 0.00082 to 0.14 ± 0.0082 mg/l. These values were above WHO permissible limits while others fall within the limits. Therefore, hospital waste water can pose the environmental health risk when not properly treated before discharge, especially in geologic formations with high fault formations.

Keywords: bacterial isolates, fungal isolates, heavy metals, hospital wastewater, microbial counts

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6181 Principles and Practice of Therapeutic Architecture

Authors: Umedov Mekhroz, Griaznova Svetlana

Abstract:

The quality of life and well-being of patients, staff and visitors are central to the delivery of health care. Architecture and design are becoming an integral part of the healing and recovery approach. The most significant point that can be implemented in hospital buildings is the therapeutic value of the artificial environment, the design and integration of plants to bring the natural world into the healthcare environment. The hospital environment should feel like home comfort. The techniques that therapeutic architecture uses are very cheap, but provide real benefit to patients, staff and visitors, demonstrating that the difference is not in cost but in design quality. The best environment is not necessarily more expensive - it is about special use of light and color, rational use of materials and flexibility of premises. All this forms innovative concepts in modern hospital architecture, in new construction, renovation or expansion projects. The aim of the study is to identify the methods and principles of therapeutic architecture. The research methodology consists in studying and summarizing international experience in scientific research, literature, standards, methodological manuals and project materials on the research topic. The result of the research is the development of graphic-analytical tables based on the system analysis of the processed information; 3d visualization of hospital interiors based on processed information.

Keywords: therapeutic architecture, healthcare interiors, sustainable design, materials, color scheme, lighting, environment.

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6180 Anterior Uveitis Caused by Infection with Cytomegalovirus and Herpes Simplex Virus Type I at Cicendo Eye Hospital Bandung

Authors: Shinta Stri Ayuda Nur Setyaningsih

Abstract:

Anterior uveitis is often triggered by viral infections such as herpes simplex virus (HSV) and cytomegalovirus (CMV). This study aims to provide an overview of the demographic and clinical characteristics of patients with anterior uveitis caused by CMV and HSV infection at PMN Cicendo Eye Hospital Bandung. This study used a retrospective observational method. Data were collected from the medical records of patients who visited the PMN Infection and Immunology Polyclinic at Cicendo Eye Hospital between February and July 2023. The results showed that anterior uveitis associated with HSV and CMV viruses often occurs in the elderly and more in women. The most common clinical symptoms are red eyes and decreased visual acuity, with a gradual onset of symptoms. Complications that often arise are cataracts and glaucoma. This study provides a deeper understanding of anterior uveitis caused by infection with HSV and CMV viruses.

Keywords: uveitis anterior, cytomegavirus, herpes simplex virus type I ELISA

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6179 Strategies for Achieving Application of Science in National Development

Authors: Orisakwe Chimuanya Favour Israel

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In a world filled with the products of scientific inquiry, scientific literacy has become a necessity for everyone because it is indispensable to achieving technological development of any nation. Everyone needs to use scientific information to make choices that arise every day. Everyone needs to be able to engage intelligently in public discourse and debate about important issues that involves science and technology. And everyone deserves to share in the excitement and personal fulfillment that can come from -understanding and learning about the natural world. No doubt that industrialized countries have, through their control of science and technology education, developed the potential to increase production, and to improve the standard of living of their people. The main thrust of this paper therefore, is to present an overview of science education, strategies for achieving application of science in national development, such as teaching science with the right spirit of inquiry. Also, the paper discussed three research models that can help in national development and suggests the best out of the three which is more realistic for a developing country like ours (Nigeria) to follow for a sustainable national development and finally suggests some key ways of solving problems of development.

Keywords: scientific inquiry, scientific literacy, strategies, sustainable national development

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6178 Revisiting Ecotourism Development Strategy of Cuc Phuong National Park in Vietnam: Considering Residents’ Perception and Attitudes

Authors: Bui Duc Sinh

Abstract:

Ecotourism in national parks seemed to be one of the options in the conservation of the natural resources and to improve the living condition of local communities. However, ecotourism development will be useless if it lacks the perception and support of local communities and appropriate ecotourism strategies. The aims of this study were to measure residents’ perception and satisfaction towards ecotourism impacts and their attitudes for ecotourism development in Cuc Phuong National Park; to assess the current ecotourism strategies based on ecotourism criteria and then to provide recommendations on ecotourism development strategies. The primary data were collected through personal observations, in-depth interviews with residents and national park staffs, and from surveys on households in all of the five communes in the Cuc Phuong National Park. The results depicted that local communities were aware of ecotourism impacts and had positive attitudes toward ecotourism development, and were satisfied of ecotourism development. However, higher perception rate was found on specific groups such as the young, the high income and educated, and those with jobs related to ecotourism. The study revealed the issues of concerns about the current ecotourism development strategies in Cuc Phuong National Park. The major hindrances for ecotourism development were lack of local participation and unattractive ecotourism services. It was also suggested that Cuc Phuong National Park should use ecotourism criteria to implement ecotourism activities sustainably and to harmonize the sharing of benefits amongst the stakeholders. The approaches proposed were to: create local employment through reengineering, improve the ecotourism quality, appropriate tourism benefits to the stakeholders, and carry out education and training programs. Furthermore, the results of the study helped tour operators and tourism promoters aware the real concerns, issues on current ecotourism activities in Cuc Phuong National Park.

Keywords: ecotourism, ecotourism impact, local community, national park

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6177 Factors Affecting of Musculoskeletal Disorders in Nurses from a Taiwan Hospital

Authors: Hsien Hua Kuo, Wen Chun Lin, Chia Chi Hsu, Hsien Wen Kuo

Abstract:

Objective: Despite the high prevalence of musculoskeletal disorders (MSDs) among nurses, which has been consistently observed in the studies of Western countries, very little information regarding intensity of workload and work-related quality of life (WRQOL) related to MSDs among nurses is available in Taiwan. The objective of this study is to investigate the factors affecting musculoskeletal disorders in nurses from a hospital. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire which contained the demographic information, workplace condition and musculoskeletal disorders. Results: Response rate of nurses were 92.5% from a teaching hospital. Based on medical diagnosis by physician, neck of musculoskeletal disorders had the highest percentage in nine body portions. The higher percentage of musculoskeletal disorders in nurses found from wards of internal and surgery. Severity and symptoms of musculoskeletal disorders diagnosed by self-reported questionnaire significantly correlated with WRQOL, job satisfaction and intensity of workload among nurses based on the logistic regression model. Conclusion: The severity and symptoms of musculoskeletal disorders among nurses showed a dose-dependent with WRQOL and workload. When work characteristics in hospital were modified, the severity of musculoskeletal disorders among nurses will be decreased and alleviated. Comment: Multifaceted ergonomic intervention programme to reduce the prevalence of MSDs among nurses was by encouraging nurses to do more physical activity which will make them more flexible and increase their strength. Therefore, the head nurse should encourage nurses to regularly physical activity and to modify unfitting ergonomic environment in order to reduce the prevalence of MSDs.

Keywords: musculoskeletal disorders, nurse, WRQOL, job satisfaction

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6176 Audit Management of Constipation According to National Institute for Health and Care Excellence Guideline

Authors: Areej Makeineldein Mustafa

Abstract:

The study evaluates the management processes and healthcare provider compliance with the National Institute for Health and Care Excellence recommendations for constipation management. We aimed to evaluate the adherence to National Institute for Health and Care Excellence guidelines in the management of constipation during the period from February to June 2023. We collected data from a random sample ( 51 patients) over 4 months with inclusion criteria for patients above 60 who were just admitted to the care of the elderly department during this period. Patient age, sex, medical records for constipation, acute or chronic constipation, or opioid-induced constipation, and treatment options were used to identify constipation and the type of treatment given. Our findings indicate that there is a gap between practice and National Institute for Health and Care Excellence guideline steps; only 3 patient was given medications according to National Institute for Health and Care Excellence guidelines in order of combination or steps of escalation. Addressing these gaps could potentially lead to enhanced patient outcomes and an overall improvement in the quality of care provided to individuals suffering from constipation.

Keywords: constipation, elderly, management, patient

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6175 Preliminary Study of Medicinal Plants in Phu Langka National Park, Nakhon Phanom Province, Thailand

Authors: W. Chatan, W. Promprom

Abstract:

Phu Langka National Park is located in Nakhon Phanom Province, the Northeast of Thailand. It contains about 50 km2 of one mountain and three types of forest including deciduous dipterocarp, mixed deciduous and dry evergreen forests. It was interesting area because of that there were some local ethnic groups living around the national park and most people use plants in this area for their life. The objective of this research is to preliminary survey of the use of medicinal plants from this area by local ethnic groups living around the national park. Colour photographs of each species were prepared. In addition, ecology, distribution in the study area, utilization and vernacular names were provided. The result showed that sixteen species of medicinal plant species were found and most plants were used for digestive system and wound. The voucher specimens were deposited in the Forest Herbarium, Department of National Parks, Wildlife and Plant Conservation (BKF), Thailand.

Keywords: diversity, ethnobotany, ethnophamacology, taxonomy, utilization

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6174 Overview of Pre-Analytical Lab Errors in a Tertiary Care Hospital at Rawalpindi, Pakistan

Authors: S. Saeed, T. Butt, M. Rehan, S. Khaliq

Abstract:

Objective: To determine the frequency of pre-analytical errors in samples taken from patients for various lab tests at Fauji Foundation Hospital, Rawalpindi. Material and Methods: All the lab specimens for diagnostic purposes received at the lab from Fauji Foundation hospital, Rawalpindi indoor and outdoor patients were included. Total number of samples received in the lab is recorded in the computerized program made for the hospital. All the errors observed for pre-analytical process including patient identification, sampling techniques, test collection procedures, specimen transport/processing and storage were recorded in the log book kept for the purpose. Results: A total of 476616 specimens were received in the lab during the period of study including 237931 and 238685 from outdoor and indoor patients respectively. Forty-one percent of the samples (n=197976) revealed pre-analytical discrepancies. The discrepancies included Hemolyzed samples (34.8%), Clotted blood (27.8%), Incorrect samples (17.4%), Unlabeled samples (8.9%), Insufficient specimens (3.9%), Request forms without authorized signature (2.9%), Empty containers (3.9%) and tube breakage during centrifugation (0.8%). Most of these pre-analytical discrepancies were observed in samples received from the wards revealing that inappropriate sample collection by the medical staff of the ward, as most of the outdoor samples are collected by the lab staff who are properly trained for sample collection. Conclusion: It is mandatory to educate phlebotomists and paramedical staff particularly performing duties in the wards regarding timing and techniques of sampling/appropriate container to use/early delivery of the samples to the lab to reduce pre-analytical errors.

Keywords: pre analytical lab errors, tertiary care hospital, hemolyzed, paramedical staff

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6173 Analyses of Adverse Drug Reactions Reported of Hospital in Taiwan

Authors: Yu-Hong Lin

Abstract:

Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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6172 Ensuring a Sustainable National Development Through Entrepreneurship Education in Nigerian Tertiary Institutions

Authors: Adeyemi Oluremi Olubusuyi

Abstract:

In most of the developed countries, entrepreneurship education has been and will continue to be, a great economic stimulator. Entrepreneurship advantages cannot be overemphasized in any society that desires sustainable national development because it creates new technologies, production and services; which in turn encourage improved productivity and rapid economic growth. Economic growth will invariably have positive influences on the health, thereby leading to sound body systems, increase in the lifespan, improvement in social status and standard condition of living. Promoting an effective application of entrepreneurship education principle will, in no small measure, propel Nigeria to the much desired enviable national development level which the country is currently yearning for. The focus of this paper is to discuss entrepreneurship education with reference to its concept, nature, objectives and development approaches.

Keywords: entreprenuership, entrepreneurship education, national development, tertiary institutions

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6171 Consultation Liasion Psychiatry in a Tertiary Care Hospital

Authors: K. Pankaj, R. K. Chaudhary, B. P. Mishra, S. Kochar

Abstract:

Introduction: Consultation-Liaison psychiatry is a branch of psychiatry that includes clinical service, teaching and research. A consultation-liaison psychiatrist plays a role in having an expert opinion and linking the patients to other medical professionals and the patient’s bio-psycho-social aspects that may be leading to his/her symptoms. Consultation-Liaison psychiatry has been recognised as 'The guardian of the holistic approach to the patient', underlining its pre-eminent role in the management of patients who are admitted in a tertiary care hospital. Aims/ Objectives: The aim of the study was to analyse the utilization of psychiatric services and reasons for referrals in a tertiary care hospital. Materials and Methods: The study was done in a tertiary care hospital. The study included all the cases referred from different Inpatient wards to the psychiatry department for consultation. The study was conducted on 300 patients over a 3 month period. International classification of diseases 10 was used to diagnose the referred cases. Results: The majority of the referral was from the Medical Intensive care unit (22%) followed by general medical wards (18.66%). Majority of the referral was taken for altered sensorium (24.66%), followed by low mood or unexplained medical symptoms (21%). Majority of the referrals had a diagnosis of alcohol withdrawal syndrome (21%) as per International classification of diseases criteria, followed by unipolar Depression and Anxiety disorder (~ 14%), followed by Schizophrenia (5%) and Polysubstance abuse (2.6%). Conclusions: Our study concludes the importance of utilization of consultation-liaison psychiatric services. Also, the study signifies the need for sensitization of our colleagues regarding psychiatric sign and symptoms from time to time and seek psychiatric consult timely to decrease morbidity.

Keywords: consultation-liaison, psychiatry, referral, tertiary care hospital

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6170 Effectiveness of Acceptance and Commitment Therapy on Reducing Corona Disease Anxiety in the Staff Working in Shahid Beheshti Hospital of Shiraz

Authors: Gholam Reza Mirzaei

Abstract:

This research aimed to investigate the effectiveness of acceptance and commitment therapy (ACT) in reducing corona disease anxiety in the staff working at Shahid Beheshti Hospital of Shiraz. The current research was a quasi-experimental study having pre-test and post-test with two experimental and control groups. The statistical population of the research included all the staff of Shahid Beheshti Hospital of Shiraz in 2021. From among the statistical population, 30 participants (N =15 in the experimental group and N =15 in the control group) were selected by available sampling. The materials used in the study comprised the Cognitive Emotion Regulation Questionnaire (CERQ) and Corona Disease Anxiety Scale (CDAS). Following data collection, the participants’ scores were analyzed using SPSS 20 at both descriptive (mean and standard deviation) and inferential (analysis of covariance) levels. The results of the analysis of covariance (ANCOVA) showed that acceptance and commitment therapy (ACT) is effective in reducing Corona disease anxiety (mental and physical symptoms) in the staff working at Shahid Beheshti Hospital of Shiraz. The effectiveness of acceptance and commitment therapy (ACT) on reducing mental symptoms was 25.5% and on physical symptoms was 13.8%. The mean scores of the experimental group in the sub-scales of Corona disease anxiety (mental and physical symptoms) in the post-test were lower than the mean scores of the control group.

Keywords: acceptance and commitment therapy, corona disease anxiety, hospital staff, Shiraz

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