Search results for: critical care transition program

Authors: N. W. Paul, S. Michl

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In our globalized world we need to appreciate the fact that questions of health and justice need to be addressed on a global scale, too. The way in which diverse governmental and non-governmental initiatives are trying to answer the need for humanitarian medical aid has long since been a visible result of globalized responsibility. While the intention of humanitarian medical aids seems to be evident, the allocation of resources has become more and more an ethical and societal challenge. With a rising number and growing dimension of humanitarian catastrophes around the globe the search for ethically justifiable ways to decide who might benefit from limited resources has become a pressing question. Rooted in theories of justice (Rawls) and concepts of social welfare (Sen) we developed and implemented a model for an ethically sound distribution of a limited annual budget for humanitarian care in one of the largest medical universities of Germany. Based on our long lasting experience with civil casualties of war (Afghanistan) and civil war (Libya) as well as with under- and uninsured and/or stateless patients we are now facing the on-going refugee crisis as our most recent challenge in terms of global health and justice. Against this background, the paper strives to a) explain key issues of humanitarian medical aid in the 21st century, b) explore the problem of rationing from an ethical point of view, c) suggest a tool for the rational allocation of scarce resources in humanitarian medical aid, d) present actual cases of humanitarian care that have been managed with our toolbox, and e) discuss the international applicability of our model beyond local contexts.

Keywords: humanitarian care, medical ethics, allocation, rationing

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Authors: David Tresner-Kirsch

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Reconciling patient medication lists from multiple sources is a critical task supporting the safe delivery of patient care. Manual reconciliation is a time-consuming and error-prone process, and recently attempts have been made to develop efficiency- and safety-oriented automated support for professionals performing the task. An important capability of any such support system is automated alignment – finding which medications from a list correspond to which medications from a different source, regardless of misspellings, naming differences (e.g. brand name vs. generic), or changes in treatment (e.g. switching a patient from one antidepressant class to another). This work describes a new algorithmic solution to this alignment task, using a greedy matching approach based on string similarity, edit distances, concept extraction and normalization, and synonym search derived from the RxNorm nomenclature. The accuracy of this algorithm was evaluated against a gold-standard corpus of 681 medication records; this evaluation found that the algorithm predicted alignments with 99% precision and 91% recall. This performance is sufficient to support decision support applications for medication reconciliation.

Keywords: clinical decision support, medication reconciliation, natural language processing, RxNorm

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Authors: Ying-Jung Hsieh, Angela S. Huang, Chu-Ming Chiu, Yu-Min Chou, Chin-Hui Yang

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Background and Objectives: Hepatitis A is primarily acquired by the fecal-oral route through person-to-person contact or ingestion of contaminated food or water. During 2010 to 2014, an average of 83 cases of locally-acquired disease was reported to Taiwan’s notifiable disease system. Taiwan Centers for Disease Control (TCDC) identified an outbreak of acute hepatitis A which began in June 2015. Of the 126 cases reported in 2015, 103 (82%) cases were reported during June–December and 95 cases (92%) of them were male. The average age of all male cases was 31 years (median, 29 years; range, 15–76 years). Among the 95 male cases, 49 (52%) were also infected with HIV, and all reported to have had sex with other men. To control this outbreak, TCDC launched a free hepatitis A vaccination program in January 2016 for close contacts of confirmed hepatitis A cases, including family members, sexual partners, and household contacts. Effect of the vaccination program was evaluated. Methods: All cases of hepatitis A reported to the National Notifiable Disease Surveillance System were included. A case of hepatitis A was defined as a locally-acquired disease in a person who had acute clinical symptoms include fever, malaise, loss of appetite, nausea or abdominal discomfort compatible with hepatitis, and tested positive for anti-HAV IgM during June 2015 to June 2016 in Taiwan. The rate of case accumulation was calculated using a simple regression model. Results: During January–June 2016, there were 466 cases of hepatitis A reported; of the 243 (52%) who were also infected with HIV, 232 (95%) had a history of having sex with men. Of the 346 cases that were followed up, 259 (75%) provided information on contacts but only 14 (5%) of them provided the name of their sexual partners. Among the 602 contacts reported, 349 (58%) were family members, 14 (2%) were sexual partners, and 239 (40%) were other household contacts. Among the 602 contacts eligible for free hepatitis A vaccination, 440 (73%) received the vaccine. There were 87 (25%) cases that refused to disclose their close contacts. The average case accumulation rate during January–June 2016 was 21.7 cases per month, which was 6.8 times compared to the average case accumulation rate during June–December 2015 of 3.2 cases per month. Conclusions: Despite vaccination program aimed to provide free hepatitis A vaccine to close contacts of hepatitis A patients, the outbreak continued and even gained momentum in transmission. Refusal by hepatitis A patients to provide names of their close contacts and rejection of contacts to take the hepatitis A vaccine may have contributed to the poor effect of the program. Targeted vaccination efforts of all MSM may be needed to control the outbreak among this population in the short term. In the long term, universal vaccination program is needed to prevent the infection of hepatitis A.

Keywords: hepatitis A, HIV, men who have sex with men, vaccination

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Authors: Nuttapimon Bhirommuang, Kulapong Jayanama

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Background: Prevalence of malnutrition in hospitalized patient is higher than general population. As a result of the unawareness of consequence and the more concerning in the other aspects of care, many patients with high risk of malnutrition are unrecognized. Even if malnutrition has been identified as affecting in many patient outcomes, the impact may differ in each population and group of patients. Objectives: The aims of this study were to examine the association between the nutritional status and the length of stay and hospital costs in hospitalized patients, to investigate the factors related these outcomes and to determine the frequency of malnutrition in hospitals. Method: This retrospective cohort study enrolled all patients aged 15 years old or older and admitted in SDMC, Ramathibodi Hospital between 1st January 2016 and 30th September 2016. The nutritional status assessment by Nutrition Alert Form (NAF) was performed by well-trained nurses in all patients at admission. Baseline characteristics were recorded. Length of stay and hospital costs were collected during their hospitalization. Univariate analysis, nonparametric rank test, Kruskal-Wallis test were used to compare means in the case of nonnormally and noncontinuously distributed data. Chi-square used to analyze categorical variables, the nutritional status and the length of stay and hospital costs and identify possible confounding factors (data were analyzed using SPSS version 18.0). Result: Of the 2,906 patients, 3.9% were severe malnutrition (NAF-C score > 10) and 11.4% were moderate malnutrition (NAF-B score 6 - 10). Both length of stay and hospital costs were found significantly higher in more severe malnutrition group (p < 0.001), NAF = A: 3.21 days, 95% CI 3.06-3.35 and 111,544.25 THB, 95% CI 106,994.41 – 116,094.1; NAF = B: 7.54 days, 95% CI 6.32 – 8.76 and 162,302.4 THB, 95% CI 129,557.88 – 195,046.92; NAF =C: 14.77 days, 95% CI 11.34 – 18.2 and 323,572.11 THB, 95% CI 226,958.1 – 420,096.13 (1 THB = 0.03019 USD). Age of each nutritional status group had also significant increase from NAF A to NAF C (p < 0.001): 55.07, 67.03 and 73.88 years old, respectively. Conclusion: The prevalence of malnutrition in Ramathibodi hospital is voluminous. Severe malnutrition screening by NAF is significantly correlated with worse clinical outcome, especially higher length of stay and hospital costs. Elderly is also a significant factor which correlates with malnutrition. The results of this study could change the awareness of health personnel and the practice protocol. Moreover, the further study concerning nutritional support in high-risk group of malnutrition is ongoing to confirm this hypothesis.

Keywords: malnutrition, NAF, length of stay, hospital costs

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Authors: Nareenad Panbun

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The objective is to study the knowledge utilization from the participants of the announcer training program by National Broadcasting and Telecommunications Commission (NBTC). This study is a quantitative research based on surveys and self-answering questionnaires. The population of this study is 100 participants randomly chosen by non-probability sampling method. The results have shown that most of the participants were satisfied with the topics of general knowledge about the broadcasting and television business for 37 people representing 37%, followed by the topics of broadcasting techniques. The legal issues, consumer rights, television business ethics, and credibility of the media are, in addition to the media's role and responsibilities in society, the use of language for successful communication. Therefore, the communication language skills are the most important for all of the trainees and will also build up the image of the broadcasting center.

Keywords: announcer training program, participant, requirements announced, theory of utilization

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Authors: Christine Ivy A. Nogot

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Under the colony of Spain for more than three centuries, the Philippines has a deep-rooted structure of Western ideologies and colonialism. The late 19th century, the period of Enlightenment, created a significant impact on our history when a group of middle-class Filipino men were sent to Europe to study. They were called Ilustrados, a Spanish word for erudite. They were the enlightened; the well-educated, intellectual scholars. Their writings provide intellectual grounds for the awakening of national consciousness that eventually prompted national movements and revolutions. They helped to establish a postcolonial society. In the modern era, Miguel Syjuco, a Filipino expatriate, wrote a novel and titled it Ilustrado. It is a representation of the liberal mind of the diasporic author in contemporary discourse. It provides a critical examination of the ilustrado in transition through the character of Miguel, who is also an expatriate writer. Using Syjuco’s award-winning novel as the primary text and anchored on Said’s concept of Orientalism, this paper examines how the depiction of features of the Eastern world is presented in the literary discourse. This paper looks into Said’s concept of orientalism as a hegemonic discursive structure and shows how Western superiority influences the Eastern culture in literary discourse. It explores Gramsci’s theory of cultural hegemony to explore Said’s argument that Western powers conquer the orient through culture and ideology. This paper presents how dominant ideologies and the social context redefine the ilustrado in the contemporary era.

Keywords: cultural hegemony, ilustrado, orientalism, postcolonial

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Authors: Majedah Fawzy Abu Alrub

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The purpose of this study was to assess the benefits of full-day vs. half-day kindergarten. Research suggests that there is a common trend among full-day kindergarten programs. Academic, social, and emotional benefits are evident, as well as preferential trends among the parents and teachers. The review began by identifying 20 references of literature on full-day kindergarten published in the last two decades (1997-2017). Of these, 20 passed an initial screening designed to identify research reports that examined academic, social, and emotional outcomes of full-day kindergarten programs as compared with half-day programs. Studies indicated that children who attend full-day kindergarten are positively related to high performance through their schools. There is much evidence to support a full-day program for children. Results indicated that full-day programs have obvious benefits for children; however, they may not be the best program for all children.

Keywords: preschool, full-day kindergarten, academic benefits, social and emotional benefits

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Authors: Salma Ainine, Colin Ritchie, Tracey McFee

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Background: The societal impact of antibiotic resistance is a major public health concern. The increase in the incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently cross-checked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014–September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification, and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, an introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: antibiotic resistance, antibiotic stewardship, dental infection, hygiene standards

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Authors: Najah Kalifah Almazmomi

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In the time of artificial intelligence (AI), there is a need to know the determinants of success in business management, which are taking on a new dimension. This research purports to scrutinize the Critical Success Factors (CSFs) that drive and ignite the fire of success to help uncover the subtle and profound dynamics that might be operative in organizations. By means of a systematic literature review and a number of empirical methods, the paper is aimed at determining and assessing the key aspects of CSFs, putting emphasis on their role and meaning in the context of AI technology adoption. Some central features such as leadership ways, innovation models, strategic thinking methodologies, organizational culture transformations, and human resource management approaches are compared and contrasted with the AI-driven revolution. Additionally, this research will explore the interactive effects of these factors and their joint impact on the success, survival, and flexibility of a business in the current environment, which is changing due to AI development. Through the use of different qualitative and quantitative methodologies, the research concludes that the findings are significant in understanding the relative roles of individual CSFs and in studying the interactions between them in such an AI-enabled business environment.

Keywords: critical success factors, business and management, artificial intelligence, leadership strategies

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Authors: Long-Shan Wu, Ming-Chen Ko, Chien-Chang Ho, Po-Fu Lee, Li-Yun Chen, Ching-Yu Tseng

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The purpose of this study was to determine whether progressive aerobic exercise intensity effects the changes in insulin resistance indicators among obese college students in Taiwan. Forty-eight obese subjects [body mass index (BMI) ≧ 27 kg/m2, aged 18-26 years old] were randomized into four equal groups (n = 12): light-intensity training group (LITG): 40-50% of their heart rate reserve (HRR); middle-intensity training group (MITG): 50-70% of their HRR; high-intensity training group (HITG): 70-80% of their HRR, and control group (CG). The aerobic exercise training program was performed 60 minutes per day on a treadmill three days/week in a training period of 12 weeks. All subjects’ anthropometric data, blood biochemical parameters, and health-related physical fitness components were measured at baseline and after 12 weeks. At baseline, all insulin resistance indicators did not differ significantly among the four groups (p > 0.05). After 12-week exercise intervention, the HITG had significantly more changes in insulin level than the MITG, LITG, and CG. Our findings suggested that a short-term aerobic exercise program can play an important role in improving insulin resistance indicators; either middle-intensity training significantly increases the insulin level, but the high-intensity exercise training program effectively improves obese college students’ insulin resistance.

Keywords: aerobic training, exercise intensity, insulin resistance, obesity

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Authors: Buket Boz, Alvaro Diez

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Waste heat recovery by means of Organic Rankine Cycle is a promising technology for the recovery of engine exhaust heat. However, it is complex to find out the optimum cycle conditions with appropriate working fluids to match exhaust gas waste heat due to its high temperature. Hence, this paper focuses on comparing sub-critical and supercritical ORC conditions with eight working fluids on a combined diesel engine-ORC system. The model employs two ORC designs, Regenerative-ORC and Pre-Heating-Regenerative-ORC respectively. The thermodynamic calculations rely on the first and second law of thermodynamics, thermal efficiency and exergy destruction factors are the fundamental parameters evaluated. Additionally, in this study, environmental and safety, GWP (Global Warming Potential) and ODP (Ozone Depletion Potential), characteristic of the refrigerants are taken into consideration as evaluation criteria to define the optimal ORC configuration and conditions. Consequently, the studys outcomes reveal that supercritical ORCs with alkane and siloxane are more suitable for high temperature exhaust waste heat recovery in contrast to sub-critical conditions.

Keywords: internal combustion engine, organic Rankine cycle, waste heat recovery, working fluids

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Authors: M. Cangi, T. Dolar, C. Ersoy, Y. E. Aydogdu, A. I. Aydeniz, A. Mugan

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The drum is one of the critical parts in a washing machine in which the clothes are washed and spin by the rotational movement. It is activated by the drum shaft which is attached to an electric motor and subjected to dynamic loading. Being one of the critical components, failures of the drum require costly repairs of dynamic components. In this study, tolerance bands between the drum shaft and its two bearings were examined to develop a relationship between the fatigue life of the shaft and the interaction tolerances. Optimization of tolerance bands was completed in consideration of the fatigue life of the shaft as the cost function. The following methodology is followed: multibody dynamic model of a washing machine was constructed and used to calculate dynamic loading on the components. Then, these forces were used in finite element analyses to calculate the stress field in critical components which was used for fatigue life predictions. The factors affecting the fatigue life were examined to find optimum tolerance grade for a given test condition. Numerical results were verified by experimental observations.

Keywords: fatigue life, finite element analysis, tolerance analysis, optimization

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Authors: Yu-Chieh Chen, Kuei-Feng Shen, Chia-Ling Chao

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The purpose of this report was to present the nursing experience and case of an unexpected cerebellar hemorrhagic stroke with acute hydrocephalus patient after lumbar spine surgery. The patient had been suffering from an emergent external ventricular drainage and stayed in the Surgical Intensive Care Unit from July 8, 2016, to July 22, 2016. During the period of the case, the data were collected for attendance, evaluation, observation, interview, searching medical record, etc. An integral evaluation of the patient's physiological 'psychological' social and spiritual states was also noted. The author noticed the following major nursing problems including ineffective cerebral perfusion 'physical activity dysfunction' family resource preparation for disability. The author provided nursing care to maintain normal intracranial pressure, along with a well-therapeutic relationship and applied interdisciplinary medical/nursing team to draft an individualized and appropriate nursing plan for them to face the psychosocial impact of the patient disabilities. We also actively participated in the rehabilitation treatments to improve daily activity and confidence. This was deemed necessary to empower them to a more positive attitude in the future.

Keywords: family resourace preparation inability, hemorrhagic sroke, ineffective tissue cerebral perfusion, lumbar spine surgery

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Authors: Mehwish Sarfaraz Ahmad

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Background: There is a prevailing perception in Pakistan that private hospitals offer better services than government hospitals. Unfortunately, Pakistan faces challenges in providing efficient healthcare due to limited resources and management capabilities, resulting in demotivation among healthcare workers. Aim: The purpose of this study was to conduct a comprehensive assessment of the occupational health and well-being of healthcare workers in both public and private sector tertiary care hospitals in Lahore, Pakistan, to compare the well-being of healthcare professionals in these two sectors and investigate the influence of workplace culture and experiences on their overall health. Methods: A cross-sectional study was conducted using a validated International Questionnaire, and data from 440 participants was collected using a stratified random sampling technique from a diverse group of healthcare professionals from the public and private tertiary care hospitals in Lahore, Pakistan. The researcher conducted a comparative analysis using appropriate statistical tests, such as Anova, t-tests, chi-square tests, and regression analysis, to explore potential relationships between various factors. Results: The majority of respondents (70.2%) reported their health as "Good" or "Very good, a small percentage (8.2%) rated their health as "Poor," while 24.1% considered their health as "Fair". 39.6% reported being satisfied with their workplace culture, while a majority of 60.4% indicated being unsatisfied with their workplace culture. Results showed that workplace culture has a positive correlation with the overall health and well-being of healthcare professionals. The study found significant differences in health ratings, prevalence of chronic health conditions, workplace culture, and safety perceptions between healthcare professionals in public and private sector tertiary care hospitals. Conclusion: The study's findings emphasize the significance of promoting a positive workplace culture, ensuring workplace safety, and addressing chronic health conditions among healthcare workers.

Keywords: occupational health and well-being, workplace culture, frequency of fatigue, availabity of benefits

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Authors: Brian Connett, Bryan O'Halloran

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Systems assets within critical infrastructures were seemingly safe from the exploitation or attack by nefarious cyberspace actors. Now, critical infrastructure is a target and the resources to exploit the cyber physical systems exist. These resources are characterized in terms of patience, stealth, replication-ability and extraordinary robustness. System owners are obligated to maintain a high level of protection measures. The difficulty lies in knowing when to fortify a critical infrastructure against an impending attack. Models currently exist that demonstrate the value of knowing the attacker’s capabilities in the cyber realm and the strength of the target. The shortcomings of these models are that they are not designed to respond to the inherent fast timing of an attack, an impetus that can be derived based on open-source reporting, common knowledge of exploits of and the physical architecture of the infrastructure. A useful model will inform systems owners how to align infrastructure architecture in a manner that is responsive to the capability, willingness and timing of the attacker. This research group has used an existing theoretical model for estimating parameters, and through analysis, to develop a decision tool for would-be target owners. The continuation of the research develops further this model by estimating the variable parameters. Understanding these parameter estimations will uniquely position the decision maker to posture having revealed the vulnerabilities of an attacker’s, persistence and stealth. This research explores different approaches to improve on current attacker-defender models that focus on cyber threats. An existing foundational model takes the point of view of an attacker who must decide what cyber resource to use and when to use it to exploit a system vulnerability. It is valuable for estimating parameters for the model, and through analysis, develop a decision tool for would-be target owners.

Keywords: critical infrastructure, cyber physical systems, modeling, exploitation

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Authors: Chalermsri Sorasit, Siriporn Mongkhonthawornchai, Darawan Augsornwan, Sudthanom Kamollirt

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Background: Although knowledge of pain and pain management is improving, they are still inadequate to patients. The Nursing Division of Srinagarind Hospital is responsible for setting the pain management system, including work instruction development and pain management indicators. We have developed an information technology program for monitoring pain quality indicators, which was implemented to all nursing departments in April 2013. Objective: To study outcomes of acute pain management in process and outcome indicators. Method: This is a retrospective descriptive study. The sample population was patients who had acute pain 24-48 hours after receiving a procedure, while admitted to Srinagarind Hospital in 2014. Data were collected from the information technology program. 2709 patients with acute pain from 10 Nursing Departments were recruited in the study. The research tools in this study were 1) the demographic questionnaire 2) the pain management questionnaire for process indicators, and 3) the pain management questionnaire for outcome indicators. Data were analyzed and presented by percentages and means. Results: The process indicators show that nurses used pain assessment tool and recorded 99.19%. The pain reassessment after the intervention was 96.09%. The 80.15% of the patients received opioid for pain medication and the most frequency of non-pharmacological intervention used was positioning (76.72%). For the outcome indicators, nearly half of them (49.90%) had moderate–severe pain, mean scores of worst pain was 6.48 and overall pain was 4.08. Patient satisfaction level with pain management was good (49.17%) and very good (46.62%). Conclusion: Nurses used pain assessment tools and pain documents which met the goal of the pain management process. Patient satisfaction with pain management was at high level. However the patients had still moderate to severe pain. Nurses should adhere more strictly to the guidelines of pain management, by using acute pain guidelines especially when pain intensity is particularly moderate-high. Nurses should also develop and practice a non-pharmacological pain management program to continually improve the quality of pain management. The information technology program should have more details about non-pharmacological pain techniques.

Keywords: outcome, pain management, acute pain, Srinagarind Hospital

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Authors: Abbul B. Khan, Neeraj Dohare, Rajan Patel

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The mixed micellization of adiphenine hydrochloride (ADP) with 1-decyl-3-methylimidazolium chloride (C10mim.Cl), was investigated at different mole fractions and temperatures by surface tension measurements. The synergistic behavior (i.e., non-ideal behavior) for binary mixtures was explained by the deviation of critical micelle concentration (cmc) from ideal critical micelle concentration (cmc*), micellar mole fraction (Xim) from ideal micellar mole fraction (Xiideal), the values of interaction parameter (β) and activity coefficients (fi) (for both mixed micelles and mixed monolayer). The excess free energy (∆Gex) for the ADP- C10mim.Cl binary mixtures explain the stability of mixed micelles in comparison to micelles of pure ADP and C10mim.Cl. Interfacial parameters, i.e., Gibbs surface excess (Гmax), minimum head group area at air/ water interface (Amin), and free energy of micellization (ΔG0m) were also evaluated for the systems.

Keywords: adiphenine hydrochloride, critical micelle concentration, interaction parameter, activity coefficient

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Authors: Ahasanul Haque, Noor Hazilah Abd Manaf, Zohurul Anis, Tarekol Islam

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Sustainable community health (SCH) is an example of a new healthcare concept formed from applying the Maqasid al-Shariah principle to hospital management and delivery services. Because the idea is novel, it needs comprehensive and ongoing investigation to be improved. However, there is a lack of research on the necessity of developing sustainable community health (SCH), particularly its organizational structure. Furthermore, there is a misconception about the order of components in Maqasid al-Shariah, particularly in a hospital setting. Furthermore, the use of medicines and treatment by conventional recommendations to carry out the treatment by the Maqasid al Shariah. As such, this study focuses on the essential prerequisite for establishing a sustainable community health system based on Maqasid al-Shariah. This study discusses the use of Maqasid al-Shariah in administration and treatment. In this qualitative research approach, a literature search and interviews with specialists are conducted. The gathered data is examined using content analysis, emphasizing inductive and deductive reasoning. The research reveals that the Shariah Advisory Council and Shariah Critical Point are necessary for sustainable community health. In conclusion, by discussing the causes for each instance, this research adds to the creation of methods for determining the level of Maasid al-Shariah in-hospital care.

Keywords: empowering, sustainability, community health, maqasid al shariah, hospital and malaysia

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Authors: Jatuphum Ketchatturat

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The objective of this research was to study the learning and innovation skills of undergraduate students after Research-Based Learning had been applied. Eighty research participants were selected from undergraduate students enrolled in Educational Research Program using the Purposive Sampling Method. Research Methodology was Descriptive Research, the research took one semester to complete. The research instruments consisted of (1) Research Skill Assessment Form, (2) Research Quality Assessment Form, (3) Scale of learning and innovation skills 25 items. The quantitative data were analysed using descriptive statistics including, frequency, percentage, average and standard deviation. The qualitative data were analyzed using content analysis. The research results were (1) The students were able to conduct research that focused on educational research, which has a fair to the excellent level of standards of a research learning outcome, research skills, and research quality. The student’s learning and innovation skills have relating to research skills and research quality. (2) The findings found that the students have been developed to be learning and innovation skills such as systematic thinking, analytical thinking, critical thinking, creative problem solving, collaborative, research-creation, communication, and knowledge and experience sharing to friends, community and society.

Keywords: learning and innovation skills, research based learning, research skills, undergraduate students

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Authors: Pampita Chakraborty, Sukumar Mukherjee

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This study was done to determine the prevalence of nosocomial infections in the ICU and to identify the common microorganisms causing these infections and their antimicrobial sensitivity pattern. Nosocomial infection or hospital-acquired infection is a localized or a systemic condition resulting from an adverse reaction to the presence of infectious agents. Nosocomial infections are not present or incubating when the patient is admitted to hospital or other health care facility. They are caused by pathogens that easily spread through the body. Many hospitalized patients have compromised immune systems, so they are less able to fight off infections. These infections occur worldwide, both in the developed and developing the world. They are a significant burden to patients and public health. They are a major cause of death and increased morbidity in hospitalized patients, which is a matter of serious concern today. This study was done during the period of one year (2012-2013) in the ICU of the tertiary care hospital in eastern India. Prevalence of nosocomial infection was determined; site of infection and the pattern of microorganisms were identified along with the assessment of antibiotic susceptibility profile. Patients who developed an infection after 48 hours of admission to the ICU were included in the study. A total of 324 ICU patients were analyzed, of these 79 patients were found to have developed a nosocomial infection (24.3% prevalence). Urinary tract infection was found to be more predominant followed by respiratory tract infection and soft tissue infection. The most frequently isolated microorganism was E. coli, Pseudomonas aeruginosa, Klebsiella pneumoniae followed by other organisms respectively. Antibiotic susceptibility test of these isolates was done against commonly used antibiotics. Patients admitted to the ICU are especially susceptible to nosocomial infections. Despite adequate antimicrobial treatment, nosocomial ICU infections can significantly affect ICU stay and can cause an increase in patient’s morbidity and mortality. Adherence to infection protocol, proper monitoring and the judicious use of antibiotics are important in preventing such infections on a regular basis.

Keywords: antibiotic susceptibility, intensive care unit, nosocomial infection, nosocomial pathogen

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Authors: Jonathan H. Westover, Jacque P. Westover, Maureen S. Andrade

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Though learning theories vary in complexity and usefulness, a thorough understanding of foundational learning theories is a necessity in today’s educational environment. Additionally, learning theories lead to approaches in instruction that can affect student motivation and learning. The combination of a learning theory and elements to enhance student motivation can create a learning context where the student can thrive in their educational pursuits. This paper will provide an overview of three main learning theories: (1) Behavioral Theory, (2) Cognitive Theory, and (3) Constructivist Theory and explore their connection to elements of student learning motivation. Finally, we apply these learning theories and elements of student motivation to the following two context: (1) The FastStart Program at the Community College of Denver, and (2) An Online Academic English Language Course. We discussed potential of the program and course to have success in increasing student success outcomes.

Keywords: learning theory, student motivation, inclusive pedagogy, developmental education

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Authors: Vassilis Argyropoulos, Magda Nikolaraizi, Maria Papazafiri

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A growing number of students with disabilities attend institutions of higher education, and according to evidenced-based data, it seems that they face many obstacles regarding their academic access and inclusion. The fact that more and more students decide to actively participate in higher education, on the one hand, empowers and strengthens inclusiveness in tertiary education, but on the other hand, it brings new challenges to their access to scientific content as well as to their interactions with other students and faculty members. For this, accessibility centres have come to the fore in many higher education institutions, in order to respond to the needs of students with disabilities. In this paper, we present a study regarding the peer tutoring program, which is a service delivered by the Accessibility Centre at the University of Thessaly in Greece. Specifically, the current paper aims to describe the experiences of tutees and tutors regarding their relationships developed throughout the peer tutoring program. Twelve tutors and eight tutees with disabilities participated in the study, whose experiences were explored through interviews and were analyzed in a qualitative way. In our study, all tutees and most of the tutors described their relationship as friendly, while a few tutors preferred a more formal relationship. Also, both tutors and tutees described some of the challenges, such as setting limits or arranging an appointment. Finally, peer tutoring programs seem very promising, but in order to be effective, there is a need for training and supporting students regarding their role as well as monitoring the progress of the peer tutoring program, ensuring its smooth operation and success for both tutors and tutees.

Keywords: disability, higher education institutions, interviews, peer tutoring, inclusiveness

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Authors: Mike Wei, Mario Cedillo, Jiahui Lin, Carol Lorraine Storey-Johnson, Carla Boutin-Foster

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Purpose: The extent to which health insurance enrollment succeeds under the Affordable Care Act (ACA) rests heavily on the ability to reach the uninsured and motivate them to enroll. We sought to identify perceptions about the ACA among uninsured patients at a free clinic in New York City. Background: The ACA holds tremendous promise for reducing the number of uninsured Americans. As of April 2014, nearly 8 million people had signed up for health insurance through the Health Insurance Marketplace. Despite this early success, future and continued enrollment rests heavily on the degree of public awareness. Reaching eligible individuals and increasing their awareness and understanding remains a fundamental challenge to realizing the full potential of the ACA. Reaching out to uninsured patients who are seeking care through safety net facilities such as free clinics may provide important avenues for reaching potential enrollees. This project focuses on the experience at the free clinic at Weill Cornell Medical College, the Weill Cornell Community Clinic (WCCC), and seeks to understand perceptions about the ACA among its patient population. Methods: This was a cross-sectional study of all patients who visited the free clinic at Weill Cornell Medical College, the Weill Cornell Community Clinic, from July 2013 to May 2014. Patients who provided informed consent at their visit and completed a semi-structured questionnaire were included (N=62). The questionnaire comprised of questions about demographic characteristics and open-ended questions about their knowledge and perception of the impact of the ACA. Descriptive statistics were used to characterize the population demographics. Qualitative coding techniques were used for open-ended items. Results: Approximately one third of patients surveyed never had health insurance. Of the remaining 65%, 20% lost their insurance within the past year. Only 55% had heard about the ACA, and only 10% knew about the Health Benefits Exchange. Of those who had heard about the ACA, sentiments were tinged with optimistic misperceptions, such as “it will be free health care for all.” While optimistic, most of the responses focused on the economic implications of the ACA. Conclusions: These findings reveal the immense amount of misconception and lack of understanding with regards to the ACA. As such, the study highlights the need to educate and address the concerns of those who remain skeptical or uncertain about the implications of the ACA.

Keywords: Affordable Care Act, demographics, free clinics, underserved.

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Authors: Neda Valizadeh, Mani Mofidi, Sama Haghighi, Ali Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: There are many systems and parameters to evaluate trauma patients in the emergency department. Most of these evaluations are to distinguish patients with worse conditions so that the care systems have a better prediction of condition for a better care-giving. The purpose of this study is to determine the relationship between axillary body temperature and mortality in patients hospitalized in the intensive care unit (ICU) with multiple traumas and with other clinical and para-clinical factors. Methods: All patients between 16 and 75 years old with multiple traumas who were admitted into Emergency Department then hospitalized in the ICU were included in our study. An axillary temperature in the first and the second day of admission, Glasgow cola scale (GCS), systolic blood pressure, Serum glucose levels, and white blood cell counts of all patients at the admission day were recorded and their relationship with mortality were analyzed by SPSS software with suitable statistical tests. Results: Axillary body temperatures in the first and second day were statistically lower in expired traumatic patients (p=0.001 and p<0,001 respectively). Patients with lower GCS had a significantly lower first-day temperature and a significantly higher mortality. (p=0.006 and p=0.006 respectively). Furthermore, the first-day axillary temperature was significantly lower in patients with a lower first-day systolic blood pressure (p=0.014). Conclusion: Our results showed that lower axillary body temperature in the first day is associated with higher mortality, lower GCS, and lower systolic blood pressure. Thus, this could be used as a predictor of mortality in evaluation of traumatic patients in emergency settings.

Keywords: fever, trauma, mortality, emergency

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Authors: Lucia Mavudzi

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Socioeconomic and demographic factors influence male attendance of antenatal care (ANC) activities which are beneficial in improving maternal health and birth outcome. When a male, as the head of the family is expected to solely make decisions of how finances are managed, when and where health services are sought, it impacts on the woman’s health seeking behavior. Using the data from the Zimbabwe Demographic and Health Survey 2010-2011 this paper seeks to assess the prevalence of male ANC attendance in Zimbabwe and factors that influence male ANC attendance. We hypothesized that socioeconomic and demographic factors do not influence male ANC attendance. To achieve the objectives of this paper, descriptive analysis was used to describe the characteristics of men and the Binomial logistic modelling was used to assess the relationship between male ANC attendance and selected socioeconomic and demographic factors. Male ANC attendance was used as the dependent variable, and the independent variables are age, marital status, place of residence, wealth, education, religion and employment. A high percentage of males did not attend ANC with their pregnant partners. Religion, education, and place of residence were found to be significantly associated with male ANC attendance. There was no evidence to show that there was a difference in male ANC attendance by employment, marital status, and age. Findings from this paper are relevant to public health. They will be used to develop strategies and intervention programs to improve pregnant women’s attendance of ANC attendance by involving men in maternal health.

Keywords: antenatal care, male participation, maternal health, socio-economic and demographic factors

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Authors: D. Srinivasacharya, Nidhi Humnekar

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The goal of this research is to numerically investigate the convection of nanofluid flow in an inclined porous channel. Brownian motion and thermophoresis effects are accounted for by nanofluid. In addition, the flow in the porous region governs Brinkman’s equation. The perturbed state of the generalized eigenvalue problem is obtained using normal mode analysis, and Chebyshev spectral collocation was used to solve this problem. For various values of the governing parameters, the critical wavenumber and critical Rayleigh number are calculated, and preferred modes are identified.

Keywords: Brinkman model, inclined channel, nanofluid, linear stability, porous media

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Authors: Janaina Pereira, Barbara Gonzalez, Valentina Chitas, Teresa Molina

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Intro: The positive impact of opioid maintenance programs on the health of heroin addicts, and on public health in general, has been widely recognized, namely on the prevalence reduction of infectious diseases as HIV, and on the social reintegration of this population. Nevertheless, a part of patients in these programs cannot remain heroin abstinent, or has relapses, during the treatment. Method: Thus, this cross-sectional research aims at analyzing the relation between a set of psychological and psychosocial variables, which have been associated with the onset of heroin use, and assess if they are also associated with absence of abstinence in participants in an opioid maintenance program. A total of 62 patients, aged between 26 and 58 years old (M= 40.87, DP= 7.39) with a time in opioid maintenance program between 1 and 10 years (M= 5.42, DP= 3.05), 77.4% male and 22.6% female, participated in this research. To assess the criterion variable (heroin use) we used the mean value of positive results in urine tests during the participation in the program, weighted according to the number of months in program. The predictor variables were the coping strategies, the dispositional sensation seeking, and the existence of Posttraumatic stress disorder (PTSD). Results: The results showed that only 33.87% of the patients were totally abstinent of heroin use since the beginning of the program, and the absence of abstinence, as the number of positive heroin tests, was primarily predicted by less proactive coping, and secondarily by a higher level of sensation seeking. 16.13% of the sample fulfilled diagnosis criteria for PTSD, and 67.74 % had at least one traumatic experience throughout their lives. The total of PTSD symptoms had a positive correlation with the number of physical health problems, and with the lack of professional occupation. These results have several implications for the clinical practice in this field, and we suggest the promotion of proactive coping strategies should integrate these opioid maintenance programs, as they represent the tendency to face future events as challenges and opportunities, being positively related to positive results on several fields. The early identification of PTSD in the participants, before entering the opioid maintenance programs, would be important as it is related to negative features that hinder social reintegration, Finally, to identify individuals with a sensation seeking profile would be relevant, not only because they face a higher risk of relapse, but also because the therapeutical approaches should not ignore this dispositional feature in the alternatives they propose to the patients.

Keywords: opioid maintenance programs, proactive coping, PTSD, sensation seeking

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Authors: Glenn Koonce

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There is a need to address the improvement of university educational leadership preparation programs through the processes of accreditation and continuous improvement. The program faculty in a university in the eastern part of the United States has incorporated an employer satisfaction focus group to address their national accreditation standard so that employers are satisfied with completers' preparation for the position of principal or assistant principal. Using the Council for the Accreditation of Educator Preparation (CAEP) required proficiencies, the following research questions are investigated: 1) what proficiencies do completers perform the strongest? 2) what proficiencies need to be strengthened? 3) what other strengths beyond the required proficiencies do completers demonstrate? 4) what other areas of responsibility beyond the required proficiencies do completers demonstrate? and 5) how can the program improve in preparing candidates for their positions? This study focuses on employers of one public school district that has a large number of educational leadership completers employed as principals and assistant principals. Central office directors who evaluate principals and principals who evaluate assistant principals are focus group participants. Construction of the focus group questions is a result of recommendations from an accreditation regulatory specialist, reviewed by an expert panel, and piloted by an experienced focus group leader. The focus group session was audio recorded, transcribed, and analyzed using the NVivo Version 14 software. After constructing folders in NVivo, the focus group transcript was loaded and skimmed by diagnosing significant statements and assessing core ideas for developing primary themes. These themes were aligned to address the research questions. From the transcript, codes were assigned to the themes and NVivo provided a coding hierarchy chart or graphical illustration for framing the coding. A final report of the coding process was designed using the primary themes and pertinent codes that were supported in excerpts from the transcript. The outcome of this study is to identify themes that can provide evidence that the educational leadership program is meeting its mission to improve PreK-12 student achievement through well-prepared completers who have achieved the position of principal or assistant principal. The considerations will be used to derive a composite profile of employers' satisfaction with program completers with the capacity to serve, influence, and thrive as educational leaders. Analysis of the idealized themes will result in identifying issues that may challenge university educational leadership programs to improve. Results, conclusions, and recommendations are used for continuous improvement, which is another national accreditation standard required for the program.

Keywords: educational leadership preparation, CAEP accreditation, principal & assistant principal evaluations, continuous improvement

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Authors: A. Latif Karimi

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Since 2001, construction works, especially the construction of new homes and residential buildings, witnessed a dramatic boom across Afghanistan. More so, the construction industry and house builders are relied upon as important players in the country’s job market, economy and infrastructural development schemes. However, a lack of innovation, quality assurance mechanism, substandard construction and market dominance by traditional methods push all the parties in house building sector to shift for more advanced construction techniques and mass production technologies to meet the rising demands for proper accommodation. Meanwhile, rapid population growth and urbanization are widening the gap between the demand and supply of new and modern houses in urban areas like Kabul, Herat, etc. This paper investigates about current condition of construction practices in house building projects, the associated challenges, and the outcomes of transition to more reasonable and sustainable building methods. It is obvious, the introduction and use of Modern Methods of Construction (MMC) can help construction industry and house builders in Afghanistan to tackle the challenges and meet the desired standards for modern houses. This paper focuses on prefabrication, a popular MMC that is becoming more common, improving in quality and available in a variety of budgets. It is revealed that this method is the way forward to improving house building practices as it has been proven to reduce construction time, minimize waste and improve environmental performance of construction developments.

Keywords: modern houses, traditional construction, modern methods of construction, prefabrication, sustainable building

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Authors: Anil K. Giri, Dipak Subedi, Kathleen Kassel, Ashok Mishra

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The United States Department of Agriculture’s programs has been accused of being discriminatory in the past based on the race of the farmer, especially African-American producers. This study examines if there was racial discrimination in payments from the most recent new USDA programs, including those made in response to the pandemic. This study uses the Analysis of Variance (ANOVA) to examine the payments after normalizing them relative to cash receipts to test if discrimination in the number of payments received exists. Three programs investigated in this study are: i) the Coronavirus Food Assistance Program (CFAP), ii) the Market Facilitation Program (MFP), and (iii) the Paycheck Protection Program (PPP). The PPP program was administered by the Small Business Administration, whereas the other two were designed and implemented by the USDA. The PPP made forgivable loans to small businesses and, initially, was heavily criticized for not reaching minority businesses (in general). The Small Business Administration then initiated a second draw of PPP loans, prioritizing minority-owned businesses. This study compares attributes of PPP loans made to African-American farming businesses and other farming businesses in the two draws of the PPP. We find that the number of African-American farming businesses participating in the second draw of PPP loans decreased significantly from the first draw. However, the average amount of PPP loans to African-American farming businesses increased in the second draw. In the first draw, the average cost of jobs reported per loan was higher for African-American farming businesses than for other producers. In the second draw, the average cost of jobs reported per loan was significantly higher for other farming businesses than for African-American businesses. The share of PPP loans forgiven for African-American farming businesses is significantly below the national rate of 89 percent. The rate of forgiveness for PPP loans made to African-American producers is unlikely to increase significantly without policy changes. This can increase financial burdens in the future to farm operations operated by African- Americans. Finally, we conclude that the initial goal of increasing minority participation in PPP loans in the second draw, at least among African-Americans in the agricultural sector, did not meet. CFAP made almost $600 million in direct payments to minority producers, including Black producers. Black or African American producers received more than $52 million in CFAP payments. CFAP payments were proportional to the value of agricultural commodities sold for most minority producers. The 2017 Census of Agriculture showed that the majority of minority producers, including African American producers but excluding Asian producers, raised livestock. CFAP made the highest payments to livestock minority producers.

Keywords: United States department of agriculture (USDA), coronavirus food assistance program (CFAP), paycheck protection program (PPP), African-American producers, minority American producers

Procedia PDF Downloads 88