Search results for: critical care transition program

Authors: Katie Temple

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This paper investigates how corporate actors forge commensurability between Buddhist-based mindfulness techniques and day-to-day organizational life. In-depth interviews were conducted with mindfulness instructors certified through Google’s Search Inside Yourself Leadership Institute (SIYLI), an organization that designs corporate mindfulness program curricula based on their experiences guiding courses in Fortune 500 companies. Drawing from anti-essentialist sociology and interpretive data analysis, this paper describes instructors’ use of their standardized teacher guidebooks, a regulatory script all SIYLI-certified instructors must adhere to, and instructors’ reinterpretations of teaching protocols at the local level. Instructors mediate standardized rules through their embodied knowledge, perceived receptivity and effect of a given audience, and their political values. Instructors also resist standardizing practices by developing creative, under-the-radar tactics to deviate from the guidebook and assert their own spiritual autonomy. This research contributes to growing debates challenging critical and neoliberal accounts of capitalist abstraction.

Keywords: anti-essentialism, corporate culture, interpretive methods, mindfulness and meditation, relational sociology

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Authors: S. Karthikeyan, Naveen Bindra

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Introduction: To update ourselves and understand the concept of latest electronic formats available for Health care providers and how it could be used and developed as per standards. The idea is to correlate between the patients Manual Medical Records keeping and maintaining patients Electronic Information in a Health care setup in this world. Furthermore this stands with adapting to the right technology depending upon the organization and improve our quality and quantity of Healthcare providing skills. Objective: The concept and theory is to explain the terms of Electronic Medical Record (EMR), Electronic Health Record (EHR) and Personal Health Record (PHR) and selecting the best technical among the available Electronic sources and software before implementing. It is to guide and make sure the technology used by the end users without any doubts and difficulties. The idea is to evaluate is to admire the uses and barriers of EMR-EHR-PHR. Aim and Scope: The target is to achieve the health care providers like Physicians, Nurses, Therapists, Medical Bill reimbursements, Insurances and Government to assess the patient’s information on easy and systematic manner without diluting the confidentiality of patient’s information. Method: Health Information Technology can be implemented with the help of Organisations providing with legal guidelines and help to stand by the health care provider. The main objective is to select the correct embedded and affordable database management software and generating large-scale data. The parallel need is to know how the latest software available in the market. Conclusion: The question lies here is implementing the Electronic information system with healthcare providers and organisation. The clinicians are the main users of the technology and manage us to ‘go paperless’. The fact is that day today changing technologically is very sound and up to date. Basically the idea is to tell how to store the data electronically safe and secure. All three exemplifies the fact that an electronic format has its own benefit as well as barriers.

Keywords: medical records, digital records, health information, electronic record system

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Authors: Ade O. Oyewole, Sunday O. Okoh, Ruth O. Ishola, Adenike D. Odusote, Chima C. Igwe, Gloria N. Elemo, Anthony I. Okoh

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Azadirachta indica (Neem tree) also referred to as an all-purpose tree is used in a wide range of medical preparations in tropical and subtropical countries for prevention and management of various livestock, crops products and human diseases. In Nigeria however, the potentials of this plant have not been fully exploited thus it causes an environmental nuisance during the fruiting season. With a rise in the demand for herbal personal care products globally extracts from different parts of the neem plant were used as the bio-active ingredients in the formulation of personal care products. In this study, formulated neem soap, body cream, lotion, toothpaste and shampoo are analyzed to determine their antibacterial, antifungal, and toxicity properties. The efficacies of these products for management of infectious diseases, both oral and dermal, were also investigated in vitro. Oil from the neem seeds obtained using a mechanical press and acetone extracts of both the neem bark and leaves obtained by the maceration method were used in the formulation and production of the neem personal care products. The antimicrobial and toxicity properties of these products were investigated by agar diffusion, and haemolytic methods respectively. The five neem products (NPs) exhibited strong antibacterial activities against four multi–drug resistant pathogenic and three none pathogenic bacterial strains (Escherichia coli (180), Listeria ivanovii, Staphylococcus aureus, Enterobacter cloacae, Vibro spp., Streptococcus uberis, Mycobacterium smegmatis), except the neem lotion with insignificant activity against E. coli and S. aureus. The minimum inhibitory concentration (MIC) range was between 0.20-0.40 mg/ mL. The 5 NPs demonstrated moderate activity against three clinical dermatophytes isolates (Tinea corporis, Tinea capitis, and Tinea cruiz) as well as one fungal strain (Candida albican) with the MIC ranging between 0.30 - 0.50 mg/ mL and 0.550 mg/mL respectively. The soap and shampoo were the most active against test bacteria and fungi. The haemolytic analysis results on the 5 NPs indicated none toxicity at 0.50 mg/ mL in sheep red blood cells (SRBC).

Keywords: antimicrobial, Azadirachta indica, multi–drug resistant pathogenic bacteria, personal care products

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Authors: B. Sudhakara Reddy

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In modern economy, energy is fundamental to virtually every product and service in use. It has been developed on the dependence of abundant and easy-to-transform polluting fossil fuels. On one hand, increase in population and income levels combined with increased per capita energy consumption requires energy production to keep pace with economic growth, and on the other, the impact of fossil fuel use on environmental degradation is enormous. The conflicting policy objectives of protecting the environment while increasing economic growth and employment has resulted in this paradox. Hence, it is important to decouple economic growth from environmental degeneration. Hence, the search for green energy involving affordable, low-carbon, and renewable energies has become global priority. This paper explores a transition to a sustainable energy system using the socio-economic-technical scenario method. This approach takes into account the multifaceted nature of transitions which not only require the development and use of new technologies, but also of changes in user behaviour, policy and regulation. The scenarios that are developed are: baseline business as usual (BAU) as well as green energy (GE). The baseline scenario assumes that the current trends (energy use, efficiency levels, etc.) will continue in future. India’s population is projected to grow by 23% during 2010 –2030, reaching 1.47 billion. The real GDP, as per the model, is projected to grow by 6.5% per year on average between 2010 and 2030 reaching US$5.1 trillion or $3,586 per capita (base year 2010). Due to increase in population and GDP, the primary energy demand will double in two decades reaching 1,397 MTOE in 2030 with the share of fossil fuels remaining around 80%. The increase in energy use corresponds to an increase in energy intensity (TOE/US $ of GDP) from 0.019 to 0.036. The carbon emissions are projected to increase by 2.5 times from 2010 reaching 3,440 million tonnes with per capita emissions of 2.2 tons/annum. However, the carbon intensity (tons per US$ of GDP) decreases from 0.96 to 0.67. As per GE scenario, energy use will reach 1079 MTOE by 2030, a saving of about 30% over BAU. The penetration rate of renewable energy resources will reduce the total primary energy demand by 23% under GE. The reduction in fossil fuel demand and focus on clean energy will reduce the energy intensity to 0.21 (TOE/US$ of GDP) and carbon intensity to 0.42 (ton/US$ of GDP) under the GE scenario. The study develops new ‘pathways out of poverty’ by creating more than 10 million jobs and thus raise the standard of living of low-income people. Our scenarios are, to a great extent, based on the existing technologies. The challenges to this path lie in socio-economic-political domains. However, to attain a green economy the appropriate policy package should be in place which will be critical in determining the kind of investments that will be needed and the incidence of costs and benefits. These results provide a basis for policy discussions on investments, policies and incentives to be put in place by national and local governments.

Keywords: energy, renewables, green technology, scenario

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Authors: Julie Lucille H. Del Valle

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To improve its public school education, the Philippines took a radical curriculum reform in 2012, by launching the K-to-12 program which not only added two years to its basic education but also mandated for a replacement of traditional teaching with learner-centered pedagogy, an instruction whose western underpinnings suggest improving student achievement, thus, making pedagogies in the country more or less similar with those in Europe and USA. This policy, however, placed learner-centered pedagogy in a binary opposition against teacher-centered instruction, creating a simplistic dichotomy between good and bad teaching. It is in this dichotomy that this study seeks to explore, using Critical Pedagogy of the Place as the lens, in understanding what constitutes good teaching across a range of learner-centered and teacher-centered pedagogies in the context of public schools in disadvantaged communities. Furthermore, this paper examines how pedagogical homogeneity, arguably influenced by dominant global imperatives with economic agenda – often referred as economisation of education – not only thins out local identities as structures of global schooling become increasingly similar but also limits the concept of good teaching to student outcomes and corporate employability. This paper draws from qualitative research on students, thus addressing the gap created by studies on good teaching which looked mainly into the perceptions of teachers and administrators, while overlooking those of students whose voices must be considered in the formulation of inclusive policies that advocate for true education reform. Using ethnographic methods including student focus groups, classroom observations, and teacher interviews, responses from students of disadvantaged schools reveal that good teaching includes both learner-centered and teacher-centered practices that incorporate ‘academic caring’ which sustains their motivation to achieve in school despite the challenging learning environments. The combination of these two pedagogies equips students with life-long skills necessary to gain equal access to sustainable economic opportunities in their local communities.

Keywords: critical pedagogy of the place, good teaching, learner-centered pedagogy, placed-based instruction

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Authors: Karolin Bauer, Anna Brinkmann

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Vulnerabilities in critical infrastructure can cause significant difficulties for the affected population during crises. Securing the food supply as part of the critical infrastructure in crisis situations is an essential part of public services and a ground stone for a successful concept of civil protection. In most industrialized countries, there are currently no comparative studies regarding the food supply of the population during crisis and disaster events. In order to mitigate the potential impact in case of major disasters in Germany, it is absolutely necessary to investigate how the food supply can be secured. The research project aims to provide in-depth research on the experiences gathered during past large-scale disasters in the 34 OECD member countries in order to discover alternatives for an updated civil protection system in Germany. The basic research question is: "Which international approaches and structures of civil protection have been proven and would be useful to modernize the German civil protection with regards to the critical infrastructure and food supply?" Research findings should be extracted from an extensive literature review covering the entire research period as well as from personal and online-based interviews with experts and responsible persons from involved institutions. The capability of the research project insists on the deliberate choice to investigate previous large-scale disasters to formulate important and practical approaches to modernize civil protection in Germany.

Keywords: food supply, vulnerabilty, critical infratstructure, large-scale disaster

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Authors: Veronique Jubera, Guillaume Salek, Manuel Gaudon, Alain Garcia, Alain Demourgues

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Luminescence of transition metal and rare earth elements cover ultraviolet to far infrared wavelengths. Applications of phosphors are numerous. One can cite lighting, sensing, laser, energy, medical or military applications. But regarding each domain, specific criteria are required and they can be achieved with a strong control of the chemical composition. Emission of doped materials can be tailored with modifications of the local environment of the cations. For instance, the increase of the crystal field effect shifts the divalent manganese radiative transitions from the green to the red color. External factor as heat-treatment can induce changes of the doping element location or modify the unit cell crystalline symmetry. By controlling carefully the synthesis route, it is possible to initiate emission shift and to establish the thermal history of a compound. We propose to demonstrate through the luminescence of divalent manganese and trivalent rare earth doped oxide, that it is possible to follow the thermal history of a material. After optimization of the synthesis route, structural and optical properties are discussed. Finally, thermal calibration graphs are successfully established on these doped compounds. This makes these materials promising probe for thermal sensing.

Keywords: emission, thermal sensing, transition metal, rare eath element

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Authors: Guan-Ying Chen, Han-Tsung Liou, Shou-Ren Hu

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To address traffic congestion problems and encourage the use of public transportation systems in the Taipei metropolitan area, the Taipei City Government and the New Taipei City Government implemented a monthly ticket policy on April 16, 2018. This policy offers unlimited rides on the Taipei MRT, Taipei City Bus, New Taipei City Bus, Danhai Light Rail, and Public Bike (YouBike) on a monthly basis. Additionally, both city governments replaced the smart card discount policy with a new frequent flyer discount program (referred to as the loyal customer program) on February 1, 2020, introducing a differential pricing policy. Specifically, the more frequently the Taipei MRT system is used, the greater the discounts users receive. To analyze the impact of the Taipei public transport monthly ticket policy and the frequent user discount program on the passenger volume of the Taipei MRT system and the transferring behaviors of MRT users, this study conducts a trip-chain analysis using transaction data from Taipei MRT smart cards between September 2017 and December 2020. To achieve these objectives, the study employs four indicators: 1) number of passengers, 2) average number of rides, 3) average trip distance, and 4) instances of multiple consecutive rides. The study applies the t-test and Mann-Kendall trend test to investigate whether the proposed indicators have changed over time due to the implementation of the discount policy. Furthermore, the study examines the travel behaviors of passengers who use monthly tickets. The empirical results of the study indicate that the implementation of the Taipei public transport monthly ticket policy has led to an increase in the average number of passengers and a reduction in the average trip distance. Moreover, there has been a significant increase in instances of multiple consecutive rides, attributable to the unlimited rides offered by the monthly tickets. The impact of the frequent user discount program on changes in MRT passengers is not as pronounced as that of the Taipei public transportation monthly ticket policy. This is partly due to the fact that the frequent user discount program is only applicable to the Taipei MRT system, and the passenger volume was greatly affected by the COVID-19 pandemic. The findings of this research can serve as a reference for Taipei MRT Corporation in formulating its fare strategy and can also provide guidance for the Taipei and New Taipei City Governments in evaluating differential pricing policies for public transportation systems.

Keywords: frequent user discount program, mass rapid transit, monthly ticket, smart card

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Authors: Shuai Liu

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In corporate social responsibility (CSR) reporting, companies are expected to present both the positive and negative parts of the social and environmental impacts of their performance. This study investigates how the companies that listed in fortune 500 respond to this challenge by analyzing the representations of negative part especially the safety performance. It has found that in the level of genre analysis, it presented 3 major moves and 11 steps in terms of the interdiscursivity analysis. It was made up of three dominant discourse.. The study calls for greater focus on the internal and external analysis of the negative aspect of aspects of companies’ self-disclosure.

Keywords: CSR reports, negative parts, critical genre analysis, interdiscursivity

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Authors: Hiranmoyee Das

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Aim. Due to late presentation and delayed diagnosis mortality rate of retinoblastoma is more than 50% in developing counties. So to facilitate the diagnosis, to decrease the disease and treatment burden and to increase the disease survival rate, an attempt was made for early diagnosis of Retinoblastoma by including fundus examination in routine immunization programs. Methods- A unique immunization card is followed in a tertiary health care center where examination of pupillary reflex is made mandatory in each visit of the child for routine immunization. In case of any abnormality, the child is referred to the ophthalmology department. Conclusion- Early detection is the key in the management of retinoblastoma. Every child is brought to the health care system at least five times before the age of 2 years for routine immunization. We should not miss this golden opportunity for early detection of retinoblastoma.

Keywords: retinoblastoma, immunization, unique, early

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Authors: Jonathan Marks, Lauren Katz

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Family firms are a vital component of a country’s stability, prosperity and development. Their sustainability, longevity and continuity are critical. Given the premise that family firms wish to continue the business for the benefit of the family, the family founder / owner is faced with an emotionally charged transition option; either to transfer the family business to a family member or to transfer the firm to a non-family member. The rationale employed by family founders to select non-family members as successors/ executives of choice and the concomitant rationale employed by non-family members to select family firms as employers of choice, has been under-researched in the literature of family business succession planning. This qualitative study used semi-structured interviews to gain access to family firm founders/ owners, non-family successors/ executives and industry experts on family business. The findings indicated that the rationale for family members to select non-family successors/ executives was underpinned by the objective to grow the family firm for the benefit of the family. If non-family members were the most suitable candidates to ensure this outcome, family members were comfortable to employ non-family members. Non- family members, despite the knowledge that benefit lay primarily with family members, chose to work for family firms for personal benefits in terms of wealth, security and close connections. A commonly shared value system was a pre-requisite for all respondents. The research study provides insights from family founders/ owners, non-family successors/ executives, and industry experts on the subject of succession planning outside the family structure.

Keywords: agency theory, family business, institutional logics, non-family successors, Stewardship Theory

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Authors: Rosanna M. Rooney, Sharinaz Hassan, Maryanne McDevitt, Jacob D. Peckover, Robert T. Kane

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Anxiety and depression are the most common mental health problems experienced by Australian children and adolescents. Research into youth mental health points to the importance of considering emotional competence, parental influence on the child’s emotional development, and the fact that cognitions are still developing in childhood when designing and implementing positive psychology interventions. Additionally, research into such interventions has suggested the inclusion of a coaching component aimed at supporting those implementing the intervention enhances the effects of the intervention itself. In light of these findings and given the burden of anxiety and depression in the longer term, it is necessary to enhance the Aussie Optimism Positive Thinking Skills program and evaluate its efficacy in terms of children’s mental health outcomes. It was expected that the enhancement of the emotional and cognitive aspects of the Aussie Optimism Positive Thinking Skills program, the addition of coaching, and the inclusion of a parent manual would lead to significant prevention effects in internalizing problems at post-test, 6- and 18-months after the completion of the intervention. 502 students (9-11 years old) were randomly assigned to the intervention group (n = 347) or control group (n = 155). At each time point (baseline, post-test, 6-month follow-up, and 18-month follow-up), students completed a battery of self-report measures. The ten intervention sessions making up the enhanced Aussie Optimism Positive Thinking Skills program were run weekly. At post-test and 6-month follow-up, the intervention group reported significantly lower depression than the control group, with no group differences at the 18-month follow-up. The intervention group reported significantly lower anxiety than the control group only at the 6-month follow-up, with no group differences in the post-test or at the 18-month follow-up. Results suggest that the enhanced Aussie Optimism Positive Thinking Skills program can reduce depressive and anxious symptoms in the short term and highlight the importance of universally implemented positive psychology interventions.

Keywords: positive psychology, emotional competence, internalizing symptoms, universal implementation

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Authors: Mary-Ellen Hooper, Anthony Paul O'Brien, Graeme Browne

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Background: It has been proposed that negative experiences in mental health nursing increase the risk of attrition for newly graduated nurses. The risk of nurse attrition is of particular concern with current nurse shortages worldwide continuing to rise. The purpose of this study was to identify and explore the qualitative experiences of new graduate nurses as they enter mental health services in their first year of clinical practice. Method: An ethnographic research design was utilized in order to explore the sub-cultural experiences of new graduate nurses. Which included 31 separate episodes of field observation (62 hours) and (n=24) semi-structured interviews. A total number of 26 new graduates and recently graduated nurses participated in this study – 14 new graduate nurses and 12 recently graduate nurses. Data collection was conducted across 6 separate Australian, NSW, mental health units from April until September 2017. Results: A major theme emerging from the research is the new graduate nurses experience of communication in their nursing role, particularly within the context of the multidisciplinary team, and the barriers to sharing information related to care. This presentation describes the thematic structure of the major theme 'communication' in the context of the everyday experience of the New Graduate mental health nurse's participation in their chosen nursing discipline. The participants described diminished communication as a negative experience affecting their envisioned notion of holistic care, which they had associated with the role of the mental health nurse. Conclusion: The relationship between nurses and members of the multidisciplinary team plays a key role in the communication of patient care, patient-centeredness and inter-professional collaboration, potentially affecting the role of the mental health nurse, satisfaction of new graduate nurses, and patient care.

Keywords: culture, mental health nursing, multidisciplinary team, new graduate nurse

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Authors: Wincharles Coker

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This study troubles the role the state as the chief sponsor of higher education plays in shaping communication training in Ghana. Using a public university as a case study, it explores how the government of Ghana, through its regimes of control, exercises its authority over the means of production in the academy. Based on Wenger’s community of practice theory and critical theory, the research analyzes the political economy within which higher education in the country operates, focusing on the mandates of two of its bodies: the National Council for Tertiary Education (NCTE) and the National Accreditation Board (NAB). Results show that communication training in Ghana is shaped by three basic strategies of control: developmentalism, bureaucratization, and corporatization. This governmentality, the research reveals nonetheless, largely constrains the agency and practices of the community of communication faculty and administrators, and thus presents a major challenge to the exercise of intellectual freedom, and the self-critical nature of the academy. The study bears implications for further research in the political economy of communication studies, the administration of higher education, and critical/cultural studies in education.

Keywords: communication, developmentalism, educattion, governmentality

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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: Mohamed M. Diab, Fahmy E. Mohamed, Alaa Balbaa

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Background: Myofascial pain syndrome a common type of non-articular musculoskeletal pain, is a condition associated with regional pain and muscle tenderness characterized by the presence of hypersensitive nodules. Objectives: the purpose of this study is to compare between the effects of manual progressive ischemic pressure versus the effect of post isometric facilitation in the treatment of Rhomboid latent myofascial trigger points. Methods: six patients had participated in this study. Patients divided into two groups. Group A treated by manual progressive ischemic pressure and traditional physical therapy program. Group B treated by post isometric facilitation and traditional physical therapy program. Treatment program was for 6 sessions over two week’s period. Result: Statistical analysis revealed that there is no significant difference in post treatment from pretreatment in pain severity (VAS) in myofascial trigger points with Rhomboid muscles) and Pain pressure threshold (PPT) for tenderness at both groups (A,B). Conclusion: ischemic pressure technique appear to be no more effective than post isometric facilitation in treatment of rhomboids latent myofacial trigger point.

Keywords: Rhmoiboid trigger point, myofacila trigger point, ischemic pressure, post isometric facilitation

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Authors: Young-Hun Lee, Tae-Gwan Kim, Jong-Kyu Kim, Young-Chul Park

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In this study, Spring safety valve Heat - structure coupled analysis was carried out. Full analysis procedure and performing thermal analysis at a maximum temperature, them to the results obtained through to give an additional load and the pressure on the valve interior, and Disc holder Heat-Coupled structure Analysis was carried out. Modeled using a 3D design program Solidworks, For the modeling of the safety valve was used 3D finite element analysis program ANSYS. The final result to be obtained through the Analysis examined the stability of the maximum displacement and the maximum stress to the valve internal components occurring in the high-pressure conditions.

Keywords: finite element method, spring safety valve, gap, stress, strain, deformation

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Authors: Poonsuck Thatchaopas, Nik Kamariah Nik Mat, Nattakarn Eakuru

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“One College One Product” OCOP business model is launched by the Vocational Education Commission to encourage college students to choose at least one product for business venture. However, the number of successful OCOP projects is still minimal. The objective of this paper is to identify the critical success factors needed to be a successful OCOP business entrepreneur. This study uses qualitative method by interviewing business partners of an OCOP business called Crispy Roti Krua Acheeva Brand (CRKAB). This project was initiated by three female alumni students of the CRKAB. The finding shows that the main critical success factors are self-confidence, creativity or innovativeness, knowledge, skills and perseverance. Additionally, they reiterated that the keys to business success are product quality, perceived price, promotion, branding, new packaging to increase sales and continuous developments. The results implies for a business SME to be successful, the company should have credible partners and effective marketing plan.

Keywords: new entrepreneurship student model, business incubator, food industry, Pattani Province, Thailand

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Authors: Salima Kerai, Muhammad Islam, Uzma Khan, Nargis Asad, Junaid Razzak, Omrana Pasha

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Background: Pre-hospital care providers are exposed to various kinds of stressors. Their daily exposure to diverse critical and traumatic incidents can lead to stress reactions like Post-Traumatic Stress Disorder (PTSD). Consequences of PTSD in terms of work loss can be catastrophic because of its compound effect on families, which affect them economically, socially and emotionally. Therefore, it is critical to assess the association between PTSD and Work performance in Emergency Medical Service (EMS) if exist any. Methods: This prospective observational study was carried out at AMAN EMS in Karachi, Pakistan. EMS personnel were screened for potential PTSD using impact of event scale-revised (IES-R). Work performance was assessed on basis of five variables; number of late arrivals to work, number of days absent, number of days sick, adherence to protocol and patient satisfaction survey over the period of 3 months. In order to model outcomes like number of late arrivals to work, days absent and days late; negative binomial regression was used whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. Results: Out of 536 EMS personnel, 525 were found to be eligible, of them 518 consented. However data on 507 were included because 7 left the job during study period. The mean score of PTSD was found to be 24.0 ± 12.2. However, weak and insignificant association was found between PTSD and work performance measures: number of late arrivals (RRadj 0.99; 95% CI 0.98-1.00), days absent (RRadj 0.98; 95% CI 0.96-0.99), days sick (Rradj 0.99; 95% CI 0.98 to 1.00), adherence to protocol (ORadj 1.01: 95% CI 0.99 to 1.04) and patient satisfaction (0.001% score; 95% CI -0.03% to 0.03%). Conclusion: No association was found between PTSD and Work performance in the selected EMS population in Karachi Pakistan. Further studies are needed to explore the phenomenon of resiliency in these populations. Moreover, qualitative work is required to explore perceptions and feelings like willingness to go to work, readiness to carry out job responsibilities.

Keywords: trauma, emergency medical service, stress, pakistan

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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: 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: 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: 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: 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: 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: 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: 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: 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: 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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