Search results for: teaching hospital

Authors: Mohammad H. Yarmohammadian, Mehdi Nasr Isfahani, Elham Anbari

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Introduction: The awareness of using chemical, biological, and nuclear agents in everyday industrial and non-industrial incidents has increased recently; release of these materials can be accidental or intentional. Since hospitals are the forefronts of confronting Chemical, Biological, Radiological and Nuclear( CBRN) incidents, the goal of the present research was to provide a generic protocol for CBRN incidents through a comparative review of CBRN protocols and guidelines of different countries and reviewing various books, handbooks and papers. Method: The integrative approach or research synthesis was adopted in this study. First a simple narrative review of programs, books, handbooks, and papers about response to CBRN incidents in different countries was carried out. Then the most important and functional information was discussed in the form of a generic protocol in focus group sessions and subsequently confirmed. Results: Findings indicated that most of the countries had various protocols, guidelines, and handbooks for hazardous materials or CBRN incidents. The final outcome of the research synthesis was a 50 page generic protocol whose main topics included introduction, definition and classification of CBRN agents, four major phases of incident and disaster management cycle, hospital response management plan, equipment, and recommended supplies and antidotes for decontamination (radiological/nuclear, chemical, biological); each of these also had subtopics. Conclusion: In the majority of international protocols, guidelines, handbooks and also international and Iranian books and papers, there is an emphasis on the importance of incident command system, determining the safety degree of decontamination zones, maps of decontamination zones, decontamination process, triage classifications, personal protective equipment, and supplies and antidotes for decontamination; these are the least requirements for such incidents and also consistent with the provided generic protocol.

Keywords: hospital, CBRN, decontamination, generic protocol, CBRN Incidents

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Authors: Tsebe Wilfred Molotja, Mahlapahlapane Themane, Kgetja Maruma

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It is globally accepted that reading in the primary schools serves as a foundational basis for good reading skills. This is evident in the students’ academic success throughout their studying life. However, the PIRLS (2016) report on Literacy performance found that primary school learners are not able to read as fluently as expected. The results from ANA (2012) also indicated that South African learners achieved the lowest as compared to other global ones. The purpose of this study is to investigate the approaches employed by educators in developing learners’ reading and writing skills and to workshop them on the best reading and writing approaches to be implemented. The study adopted an explorative qualitative design where 27 educators from primary schools around the University of Limpopo were purposefully sampled to participate in this study. Data was collected through interviews and classroom observation during class visits facilitated by research assistants. The study found that teachers are aware of different approaches to developing learners’ reading and writing skills even thou these are not aligned with the curriculum. However, the problem is with implementation, as the conditions in the classrooms are not conducive for such. The study recommends that more workshops on capacitating teachers with the pedagogical approaches to teaching reading be held. The appeal is also made to the Department of Basic Education that it makes the classrooms to be conducive for teaching and learning to take place.

Keywords: academic success, reading and writing, community based, approaches

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Authors: Rodchares Hanrinth, Theerapong Srisil, Peeraya Sriphong, Pawich Paktipat

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The trigger tool is the low-cost, low-tech method to detect adverse events through clues called triggers. The Institute for Healthcare Improvement (IHI) has developed the Global Trigger Tool for measuring and preventing adverse events. However, this tool is not specific for detecting adverse drug events. The pharmacy-based trigger tool is needed to detect adverse drug events (ADEs). Group concept mapping is an effective method for conceptualizing various ideas from diverse stakeholders. This technique was used to identify a pharmacy-based trigger to detect adverse drug events (ADEs). The aim of this study was to involve the pharmacists in conceptualizing, developing, and prioritizing a feasible trigger tool to detect adverse drug events in a provincial hospital, the northeastern part of Thailand. The study was conducted during the 6-month period between April 1 and September 30, 2017. Study participants involved 20 pharmacists (17 hospital pharmacists and 3 pharmacy lecturers) engaging in three concept mapping workshops. In this meeting, the concept mapping technique created by Trochim, a highly constructed qualitative group technic for idea generating and sharing, was used to produce and construct participants' views on what triggers were potential to detect ADEs. During the workshops, participants (n = 20) were asked to individually rate the feasibility and potentiality of each trigger and to group them into relevant categories to enable multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the trigger list, cluster list, point map, point rating map, cluster map, and cluster rating map. The three workshops together resulted in 21 different triggers that were structured in a framework forming 5 clusters: drug allergy, drugs induced diseases, dosage adjustment in renal diseases, potassium concerning, and drug overdose. The first cluster is drug allergy such as the doctor’s orders for dexamethasone injection combined with chlorpheniramine injection. Later, the diagnosis of drug-induced hepatitis in a patient taking anti-tuberculosis drugs is one trigger in the ‘drugs induced diseases’ cluster. Then, for the third cluster, the doctor’s orders for enalapril combined with ibuprofen in a patient with chronic kidney disease is the example of a trigger. The doctor’s orders for digoxin in a patient with hypokalemia is a trigger in a cluster. Finally, the doctor’s orders for naloxone with narcotic overdose was classified as a trigger in a cluster. This study generated triggers that are similar to some of IHI Global trigger tool, especially in the medication module such as drug allergy and drug overdose. However, there are some specific aspects of this tool, including drug-induced diseases, dosage adjustment in renal diseases, and potassium concerning which do not contain in any trigger tools. The pharmacy-based trigger tool is suitable for pharmacists in hospitals to detect potential adverse drug events using clues of triggers.

Keywords: adverse drug events, concept mapping, hospital, pharmacy-based trigger tool

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Authors: Nurul Yusnita

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Many studies have been developed to help the students to get good achievement in English learning. They can be from the teaching method or psychological ones. One of the psychological studies in educational research is learning style. In some ways, learning style can affect the achievement of the students. This study aimed to examine 4 (four) learning styles and their relations to English achievement among the students learning English in Language Training Center of Universitas Muhammadiyah Yogyakarta (LTC UMY). The method of this study was descriptive analytical. The sample consisted of 39 Accounting students in LTC UMY. The data was collected through questionnaires with Likert-scale. The achievement was obtained from the grade of the students. To analyze the questionnaires and to see the relation between the learning styles and the student achievement, SPSS statistical software of correlational analysis was used. The result showed that both visual and auditory had the same percentage of 35.9% (14 students). 3 students (7.7%) had kinaesthetic learning style and 8 students (20.5%) had visual and auditory ones. Meanwhile, there were 5 students (12.8%) who had visual learning style could increase their grades. Only 1 student (2.5%) who had visual and auditory could improve his grade. Besides grade increase, there were also grade decrease. Students with visual, auditory, visual and auditory, and kinaesthetic learning styles were 3 students (7.7%), 5 students (12%), 4 students (10.2%) and 1 student (2.5%) respectively. In conclusion, there was no significant relationship between learning style and English achievement. Most of the good achievers were the students with visual and auditory learning styles and most of them preferred visual method. The implication is the teachers and material designers could improve their method through visual things to achieve effective English teaching learning.

Keywords: accounting students, English achievement, language training centre, learning styles

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Authors: Yahya Toyin Muritala, Nonglaksana Kama, Ahmad Yani

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The aim of the paper is to investigate various linguistic techniques in enhancing and facilitating the acquisition of the practical knowledge of Arabic grammatical structuring among non-Arab learners of the standard classical Arabic language in non-Arabic speaking academic settings in the course of the current growth of the internationalism and cultural integration in some higher institutions. As the nature of the project requires standard investigations into the unique principal features of Arabic structurings and implications, the findings of the research work suggest some principles to follow in solving the problems faced by learners while acquiring grammatical aspects of Arabic language. The work also concentrates on the the structural features of the language in terms of inflection/parsing, structural arrangement order, functional particles, morphological formation and conformity etc. Therefore, grammatical aspect of Arabic which has gone through major stages in its early evolution of the classical stages up to the era of stagnation, development and modern stage of revitalization is a main subject matter of the paper as it is globally connected with communication and religion of Islam practiced by millions of Arabs and non-Arabs nowadays. The conclusion of the work shows new findings, through the descriptive and analytical methods, in terms of teaching language for the purpose of effective global communication with focus on methods of second language acquisitions by application.

Keywords: language structure, Arabic grammar, classical Arabic, intercultural communication, non-Arabic speaking environment and prospects

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Authors: Gina L. Solano

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This project endeavors to enhance learning experiences for undergraduate pre-service teachers and graduate K-12 educators by leveraging artificial intelligence (AI). Firstly, the initiative delves into integrating AI within undergraduate education courses, fostering traditional literacy skills essential for academic success and extending their applicability beyond the classroom. Education students will explore AI tools to design literacy-focused activities aligned with their curriculum. Secondly, the project investigates the utilization of AI to craft instructional materials employing gamification strategies (e.g., digital and classic games, badges, quests) to amplify student engagement and motivation in mastering course content. Lastly, it aims to create a professional repertoire that can be applied by pre-service and current teachers in P-12 classrooms, promoting seamless integration for those already in teaching positions. The project's impact extends to benefiting college students, including pre-service and graduate teachers, as they enhance literacy and digital skills through AI. It also benefits current P-12 educators who can integrate AI into their classrooms, fostering innovative teaching practices. Moreover, the project contributes to faculty development, allowing them to cultivate low-risk and engaging classroom environments, ultimately enriching the learning journey. The insights gained from this project can be shared within and beyond the discipline to advance the broader field of study.

Keywords: artificial intelligence, gamification, learning experiences, literacy skills, engagement

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Authors: Petcharat Lovichakorntikul, John Walsh

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Meditation is in the process of becoming a globalized practice and its benefits have been widely acknowledged. The first wave of internationalized meditation techniques and practices was represented by Chan and Zen Buddhism and a new wave of practice has arisen in Thailand as part of the Phra Dhammakaya temple movement. This form of meditation is intended to be simple and straightforward so that it can easily be taught to people unfamiliar with the basic procedures and philosophy. This has made Phra Dhammakaya an important means of outreach to the international community. One notable aspect is to encourage adults to become like children to perform it – that is, to return to a naïve state prior to the adoption of ideology as a means of understanding the world. It is said that the Lord Buddha achieved the point of awakening at the age of seven and Phra Dhammakaya has a program to teach meditation to both children and adults. This brings about the research question of how practitioners respond to the practice of meditation and how should they be taught? If a careful understanding of how children behave can be achieved, then it will help in teaching adults how to become like children (albeit idealized children) in their approach to meditation. This paper reports on action research in this regard. Personal interviews and focus groups are held with a view to understanding self-learning methods with respect to Buddhist meditation and understanding and appreciation of the practices involved. The findings are considered in the context of existing knowledge about different learning techniques among people of different ages. The implications for pedagogical practice are discussed and learning methods are outlined.

Keywords: Buddhist meditation, Dhammakaya, meditation technique, pedagogy, self-learning

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Authors: M. G. N. A. S. Fernando

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This study uses a researchable framework to improve the quality of ICT education and the Teaching Learning Assessment/ Evaluation (TLA/TLE) process. It utilizes existing resources while improving the methodologies along with pedagogical techniques and e-Learning approaches used in the secondary schools of Sri Lanka. The study was carried out in two phases. Phase I focused on investigating the factors which affect the quality of ICT education. Based on the key factors of phase I, the Phase II focused on the design of an Experimental Application Model with 6 activity levels. Each Level in the Activity Model covers one or more levels in the Revised Bloom’s Taxonomy. Towards further enhancement of activity levels, other pedagogical techniques (activity based learning, e-learning techniques, problem solving activities and peer discussions etc.) were incorporated to each level in the activity model as appropriate. The application model was validated by a panel of teachers including a domain expert and was tested in the school environment too. The validity of performance was proved using 6 hypotheses testing and other methodologies. The analysis shows that student performance with problem solving activities increased by 19.5% due to the different treatment levels used. Compared to existing process it was also proved that the embedded techniques (mixture of traditional and modern pedagogical methods and their applications) are more effective with skills development of teachers and students.

Keywords: activity models, Bloom’s taxonomy, ICT education, pedagogies

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Authors: Lu-Chiu Huang, Pei-Pei Chen, Li-Chin Yu, Chiao-Wen Kuo, Tsui-Tao Liu, Rung-Chuang Feng

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Purpose: People put increasing emphasis on demands of medical quality and protecting their interests. Patients' or family's dissatisfaction with medical care may easily lead to medical dispute. Physician-family communication plays an essential role in medical care. A sound communication cannot only strengthen patients' belief in the medical team but make patient have definite insight into treatment course of the disease. A family meeting provides an effective platform for communication between clinical staff, patients and family. Decisions and consensuses formed in family meetings can promote patients' or family's satisfaction with medical care. Clinical staff's attitudes toward family meeting may determine behavioral intentions to hold family meeting. This study aims to explore clinical staff's difficulties in holding family meeting and evaluate how their attitudes and behavior influence the effect of family meetings. Methods: This was a cross-sectional study. It was conducted at a regional teaching hospital in Taipei city. The research team developed its own structural questionnaires, whose expert validity was checked by the nursing experts. Participants filled in the questionnaires online. Data were collected by convenience sampling. A total of 568 participants were invited. They included doctors, nurses, social workers, and so on. Results: 1) The average score of ‘clinical staff’s attitudes to family meetings’ was 5.15 (SD=0.898). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It indicated that clinical staff had positive attitudes toward family meetings, 2) The average score of ‘clinical staff’s behavior to family meetings’ was 5.61 (SD=0.937). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It meant clinical staff tended to have positive behavior at the family meeting, and 3) The average score of ‘Difficulty in conducting family meetings’ was 5.15 (SD=0.897). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. The higher the score was, the less difficulty the clinical staff felt. It demonstrated clinical staff felt less difficulty in conducting family meetings. Clinical staff's identification with family meetings brought favored effects. Persistent and active promotion for family meetings can bring patients and family more benefits. Implications for practice: Understanding clinical staff's difficulty in participating family meeting and exploring their attitudes or behavior toward physician-family communication are helpful to develop modes of interaction. Consequently, quality and satisfaction of physician-family communication can be increased.

Keywords: clinical staff, communication, family meeting, physician-family

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Authors: Tadesse Melaku Abegaz

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Background: there was paucity of data on the self-reported adverse drug reactions (ADRs), level of adherence and clinical outcomes with antidepressants among major depressive disorder (MDD) patients in Ethiopia. Hence, the present study sought to determine the level of adherence for and clinical outcome with antidepressants and the magnitude of ADRs. Methods: A prospective cross-sectional study was employed on MDD patients from September 2016 to January 2017 at Gondar university hospital psychiatry clinic. All patients who were available during the study period were included under the study population. The Naranjo adverse drug reaction probability scale was employed to assess the adverse drug reaction. The rate of medication adherence was determined using morisky medication adherence measurement scale eight. Clinical Outcome of patients was measured by using patient health questionnaire. Multivariable logistic carried out to determine factors for adherence and patient outcome. Results: two hundred seventy patients were participated in the study. More than half of the respondents were males 122(56.2%). The mean age of the participants was 30.94 ± 8.853. More than one-half of the subjects had low adherence to their medications 124(57.1%). About 186(85.7%) of patients encountered ADR. The most common ADR was weight gain 29(13.2). Around 198(92.2%) ADRs were probable and 19(8.8%) were possible. Patients with long standing MDD had high risk of non-adherence COR: 2.458[4.413-4.227], AOR: 2.424[1.185-4.961]. More than one-half 125(57.6) of respondents showed improved outcome. Optimal level of medication adherence was found to be associated with reduced risk of progression of the diseases COR: 0.37[0.110-5.379] and AOR: 0.432[0.201-0.909]. Conclusion: Patient reported adverse drug reactions were more prevalent in major depressive disorder patients. Adherence to medications was very poor in the setup. However, the clinical outcome was relatively higher. Long standing depression was associated with non-adherence. In addition, clinical outcome of patients were affected by non-adherence. Therefore, adherence enhancing interventions should be provided to improve medication adherence and patient outcome.

Keywords: adverse drug reactions, clinical outcomes, Ethiopia, prospective study, medication adherence

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Authors: N. Al Khashan, H. Al Shammari, W. Al Bahli

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Patients who are eligible to receive treatment at the National Guard Health Affairs (NGHA), Saudi Arabia will typically have four medical record numbers (MRN), one in each of the geographical areas. More hospitals and primary healthcare facilities in other geographical areas will launch soon which means more MRNs. When patients own four MRNs, this will cause major drawbacks in patients’ quality of care such as creating new medical files in different regions for relocated patients and using referral system among regions. Consequently, the access to a patient’s medical record from other regions and the interoperability of health information between the four hospitals’ information system would be challenging. Thus, there is a need to unify medical records among these five facilities. As part of the effort to increase the quality of care, a new Hospital Information Systems (HIS) was implemented in all NGHA facilities by the end of 2016. NGHA’s plan is put to be aligned with the Saudi Arabian national transformation program 2020; whereby 70% citizens and residents of Saudi Arabia would have a unified medical record number that enables transactions between multiple Electronic Medical Records (EMRs) vendors. The aim of the study is to explore the plan, the challenges and barriers of unifying the 4 MRNs into one Enterprise Patient Identifier (EPI) in NGHA hospitals by December 2018. A descriptive study methodology was used. A journey map and a project plan are created to be followed by the project team to ensure a smooth implementation of the EPI. It includes the following: 1) Approved project charter, 2) Project management plan, 3) Change management plan, 4) Project milestone dates. Currently, the HIS is using the regional MRN. Therefore, the HIS and all integrated health care systems in all regions will need modification to move from MRN to EPI without interfering with patient care. For now, the NGHA have successfully implemented an EPI connected with the 4 MRNs that work in the back end in the systems’ database.

Keywords: consumer health, health informatics, hospital information system, universal medical record number

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Authors: Khachen Kongpakwattana, Charungthai Dejthevaporn, Orapitchaya Krairit, Piyameth Dilokthornsakul, Devi Mohan, Nathorn Chaiyakunapruk

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Background: Although an increase in the burden of Alzheimer’s disease (AD) is evident worldwide, knowledge of costs and health-related quality of life (HR-QoL) associated with AD in Low- and Middle-Income Countries (LMICs) is still lacking. We, therefore, aimed to collect real-world cost and HR-QoL data, and investigate their associations with multiple disease-severity indicators among AD patients in Thailand. Methods: We recruited AD patients aged ≥ 60 years accompanied by their caregivers at a university-affiliated tertiary hospital. A one-time structured interview was conducted to collect disease-severity indicators, HR-QoL and caregiving information using standardized tools. The hospital’s database was used to retrieve healthcare resource utilization occurred over 6 months preceding the interview date. Costs were annualized and stratified based on cognitive status. Generalized linear models were employed to evaluate determinants of costs and HR-QoL. Results: Among 148 community-dwelling patients, average annual total societal costs of AD care were 8,014 US$ [95% Confidence Interval (95% CI): 7,295 US$ - 8,844 US$] per patient. Total costs of patients with severe stage (9,860 US$; 95% CI: 8,785 US$ - 11,328 US$) were almost twice as high as those of mild stage (5,524 US$; 95% CI: 4,649 US$ - 6,593 US$). The major cost driver was direct medical costs, particularly those incurred by AD prescriptions. Functional status was the strongest determinant for both total costs and patient’s HR-QoL (p-value < 0.001). Conclusions: Our real-world findings suggest the distinct major cost driver which results from expensive AD treatment, emphasizing the demand for country-specific cost evidence. Increases in cognitive and functional status are significantly associated with decreases in total costs of AD care and improvement on patient’s HR-QoL.

Keywords: Alzheimer's disease, associations, costs, disease-severity indicators, health-related quality of life

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Authors: Mahmood Dehqan, Peyman Peyvasteh

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In recent years there has been a growing interest in issues concerning the impact of sociocultural theory (SCT) of learning on different aspects of second/foreign language learning. This study aimed to find the possible effects of sociocultural teaching techniques on reading strategy of EFL learners. Indeed, the present research compared the impact of peer and teacher scaffolding on EFL learners’ reading strategy use across two proficiency levels. To this end, a pre-test post-test quasi-experimental research design was used and two instruments were utilized to collect the data: Nelson English language test and reading strategy questionnaire. Ninety five university students participated in this study were divided into two groups of teacher and peer scaffolding. Teacher scaffolding group received scaffolded help from the teacher based on three mechanisms of effective help within ZPD: graduated, contingent, dialogic. In contrast, learners of peer scaffolding group were unleashed from the teacher-fronted classroom as they were asked to carry out the reading comprehension tasks with the feedback they provided for each other. Results obtained from ANOVA revealed that teacher scaffolding group outperformed the peer scaffolding group in terms of reading strategy use. It means teacher’s scaffolded help provided within the learners’ ZPD led to better reading strategy improvement compared with the peer scaffolded help. However, the interaction effect between proficiency factor and teaching technique was non-significant, leading to the conclusion that strategy use of the learners was not affected by their proficiency level in either teacher or peer scaffolding groups.

Keywords: peer scaffolding, proficiency level, reading strategy, sociocultural theory, teacher scaffolding

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Authors: Eru Ihie Joel

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This study was carried out to investigate the influence of information technology on financial management practice in secondary schools for transformation. In Zone C Senatorial District of Benue state. The study answered four research questions and tested four hypotheses. Related literature was reviewed to show the gap to be filled in the study. The population was 196 respondents made up of principals and finance clerks of secondary schools. The descriptive survey was adopted for the study. A structured 20 item questionnaire (IITFMPSQ) was constructed and used to collect date for the study. Data obtained were analyzed using descriptive and inferential statistic. Mean and standard deviation were used to analyze the research question while the chi- square (x2) test of goodness of fit was used to test the hypothesis. The major findings revealed that the use of computer system significantly influences budgeting in secondary schools in zone senatorial district of Benue State for transformation. It was also established that the use of internet facilities influences the funding of secondary schools for transformation in the zone. Based on the findings of the study, it was recommended among other things that administrators and teachers in schools should be trained to make effective use of the computer in budgeting so as to facilitate delegations, control, evaluation, accountability for transformation. It was further suggested that the study be replicated on the effective use of information communication teaching (ITC) in teaching and learning in secondary school for transformation.

Keywords: influence, finance, management, technology

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Authors: Rahaf Mandura

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Background: Idiopathic intracranial hypertension (IIH) is a disorder with elevated intracranial pressure (ICP) more than 250 mm H₂O, without evidence of meningeal inflammation, space-occupying lesion, or venous thrombosis. The aim of this research is to study the clinical profile, evaluation, management, and visual outcome in a hospital-based population of IIH cases in Jeddah. Methodology: This is a retrospective observational study that included the medical records of all patients referred to neuro-ophthalmology service for evaluation of papilledema. The medical records have been reviewed from October 2018 to February 2020 at Jeddah Eye Hospital (JEH), Saudi Arabia. A total of fifty-one patients presented with papilledema in the studied period. Forty-seven patients met our inclusion criteria and were included in the study. Results: Most of the patients were females (43, 91.5%) with a mean age of presentation of 30.83±11.40 years. The most common presenting symptom was headache (40 patients, 85.1%), followed by transient visual obscuration (20 patients, 42.6%), and reduced visual acuity (15 patients, 31.9%). All 47 patients were started on medical treatment with oral acetazolamide with four patients (8.5%) shifted to topiramate because of the lack of response or intolerance to acetazolamide while four patients (8.5%) underwent lumbar-peritoneal shunt because of inadequate control of the disease despite the treatment with medical therapy. For both eyes, the change in visual acuity across all assessment points was statistically significant. Nevertheless, there were no significant changes in the visual field findings among all of the compared assessment points. Conclusion: The present study has shown that IIH-related papilledema is common in young female patients with headaches, transient visual obscurations and reduced visual acuity. Those are the commonest symptoms in our IIH population. Medical treatment of IIH is significantly efficacious and should be considered in order to enhance the prognosis of IIH-related complications. Therefore, the visual status should be frequently monitored for these patients.

Keywords: idiopathic intracranial hypertension, intracranial hypertension, papilledema, headache

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Authors: Angelina A. Tzacheva, Jaishree Ranganathan

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Interest in (STEM) Science Technology Engineering Mathematics education especially Computer Science education has seen a drastic increase across the country. This fuels effort towards recruiting and admitting a diverse population of students. Thus the changing conditions in terms of the student population, diversity and the expected teaching and learning outcomes give the platform for use of Innovative Teaching models and technologies. It is necessary that these methods adapted should also concentrate on raising quality of such innovations and have positive impact on student learning. Light-Weight Team is an Active Learning Pedagogy, which is considered to be low-stake activity and has very little or no direct impact on student grades. Emotion plays a major role in student’s motivation to learning. In this work we use the student feedback data with emotion classification using surveys at a public research institution in the United States. We use Actionable Pattern Discovery method for this purpose. Actionable patterns are patterns that provide suggestions in the form of rules to help the user achieve better outcomes. The proposed method provides meaningful insight in terms of changes that can be incorporated in the Light-Weight team activities, resources utilized in the course. The results suggest how to enhance student emotions to a more positive state, in particular focuses on the emotions ‘Trust’ and ‘Joy’.

Keywords: actionable pattern discovery, education, emotion, data mining

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Authors: L. Cruz-Lopes, M. Sell, P. Escudeiro, B. Esteves

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It might be difficult for deaf people to communicate since spoken and written languages are different from sign language. When it comes to getting information, going to places of cultural heritage, or using services and infrastructure, there is a clear lack of inclusiveness. By creating assistive technology that enables deaf individuals to get around communication hurdles and encourage inclusive tourism, the ICHT- Inclusive Cultural Heritage Tourism initiative hopes to increase knowledge of sign language. The purpose of the Inclusive Cultural Heritage Tourism (ICHT) project is to develop online and on-site sign language tools and material for usage at popular tourist destinations in the northern region of Portugal, including Torre dos Clérigos, the Lello bookstore, Maia Zoo, Porto wine cellars, and São Pedro do Sul (Viseu) thermae. The ICHT system consists of an application using holography, a mobile game, an online platform for collaboration with deaf and hearing users, and a collection of International Sign training courses. The project also offers a prospect for a more inclusive society by introducing a method of teaching sign languages to tourism industry professionals. As a result, the teaching and learning of sign language along with the assistive technology tools created by the project sets up an inclusive environment for the deaf community, producing results in the area of automatic sign language translation and aiding in the global recognition of the Portuguese tourism industry.

Keywords: inclusive tourism, games, international sign training, deaf community

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Authors: Jelena Slugan, Ivica Ružić

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We are witnessing the rapid development of technologies that change the world around us. However, curriculums and teaching processes are often slow to adapt to the change; it takes time, money and expertise to implement technology in the classroom. Therefore, the University of Split, Croatia, partnered with local school Marko Marulić High School and created the project "Modern competence in modern high schools" as part of which five different curriculums for STEM areas were developed. One of the curriculums involves combining information technology with physics. The main idea was to teach students how to use different circuits and microcomputers to explore nature and physical phenomena. As a result, using electrical circuits, students are able to recreate in the classroom the phenomena that they observe every day in their environment. So far, high school students had very little opportunity to perform experiments independently, and especially, those physics experiment did not involve ICT. Therefore, this project has a great importance, because the students will finally get a chance to develop themselves in accordance to modern technologies. This paper presents some new methods of teaching physics that will help students to develop experimental skills through the study of deterministic nature of physical laws. Students will learn how to formulate hypotheses, model physical problems using the electronic circuits and evaluate their results. While doing that, they will also acquire useful problem solving skills.

Keywords: ICT in physics, curriculum, laboratory activities, STEM (science, technology, engineering, mathematics)

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Authors: Anne Crescini

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The number of loanwords borrowed into the Japanese language is increasing rapidly in recent years, and many linguists argue that loanwords make up more than 10% of the Japanese lexicon. While these loanwords come from various Western languages, 80%-90% are borrowed from English. Also, there is a separate group of words and phrases categorized as ‘Japanese English’. These made-in-Japan linguistic creations may look and sound like English, but in fact are not used by native speakers and are often incomprehensible to them. Linguistically, the important thing to remember is that these terms are not English ones, but in fact, 100% Japanese words. A problem arises in language teaching, however, when Japanese English learners are unable to distinguish authentic loans from Japanese English terms. This confusion could greatly impede language acquisition and communication. The goal of this paper is to determine to what degree this potential misunderstanding may interfere with communication. Native English speakers living in the United States were interviewed and shown a list of romanized Japanese English terms, which are both commonly used and often mistaken for authentic loans. Then, the words were put into the context of a sentence in order to ascertain if context in any way aided comprehension. The results showed that while some terms are understood on their own, and others are understood better in context, a large number of the terms are entirely incomprehensible to native English speakers. If that is the case, and a Japanese learner mistakes a Japanese English term for an authentic loan, a communication breakdown may occur during interaction in English. With the ever-increasing presence of both groups of terms in the Japanese language, it is more important than ever that teaching professionals address this topic in the language classroom.

Keywords: Japanese, Japanese English, language acquisition, loanwords

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Authors: Alba Prats-Bisbe, Jaume López-Carballo, David Leno-Colorado, Alberto García Molina, Alicia Romero Marquez, Elena Hernández Pena, Eloy Opisso Salleras, Raimon Jané Campos

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Neurological disorders are a leading cause of disability and premature mortality worldwide. Neurorehabilitation (NRHB) is a clinical process aimed at reducing functional impairment, promoting societal participation, and improving the quality of life for affected individuals. Virtual reality (VR) technology is emerging as a promising NRHB support tool. Its immersive nature fosters a strong sense of agency and embodiment, motivating patients to engage in meaningful tasks and increasing adherence to therapy. However, the clinical benefits of VR interventions are challenging to determine due to the high heterogeneity among health applications. This study explores a stepwise development approach for creating VR-based tools to assist individuals with neurological disorders in medical practice, aiming to enhance reproducibility, facilitate comparison, and promote the generalization of findings. Building on previous research, the step-by-step methodology encompasses: Needs Identification– conducting cross-disciplinary meetings to brainstorm problems, solutions, and address barriers. Intervention Definition– target population, set goals, and conceptualize the VR system (equipment and environments). Material Selection and Placement– choose appropriate hardware and software, place the device within the hospital setting, and test equipment. Co-design– collaboratively create VR environments, user interfaces, and data management strategies. Prototyping– develop VR prototypes, conduct user testing, and make iterative redesigns. Usability and Feasibility Assessment– design protocols and conduct trials with stakeholders in the hospital setting. Efficacy Assessment– conduct clinical trials to evaluate outcomes and long-term effects. Cost-Effectiveness Validation– assess reproducibility, sustainability, and balance between costs and benefits. NRHB is complex due to the multifaceted needs of patients and the interdisciplinary healthcare architecture. VR has the potential to support various applications, such as motor skill training, cognitive tasks, pain management, unilateral spatial neglect (diagnosis and treatment), mirror therapy, and ecologically valid activities of daily living. Following this methodology was crucial for launching a VR-based system in a real hospital environment. Collaboration with neuropsychologists lead to develop A) a VR-based tool for cognitive rehabilitation in patients with acquired brain injury (ABI). The system comprises a head-mounted display (HTC Vive Pro Eye) and 7 tasks targeting attention, memory, and executive functions. A desktop application facilitates session configuration, while database records in-game variables. The VR tool's usability and feasibility were demonstrated in proof-of-concept trials with 20 patients, and effectiveness is being tested through a clinical protocol with 12 patients completing 24-session treatment. Another case involved collaboration with nurses and paediatric physiatrists to create B) a VR-based distraction tool during invasive techniques. The goal is to alleviate pain and anxiety associated with botulinum toxin (BTX) injections, blood tests, or intravenous placements. An all-in-one headset (HTC Vive Focus 3) deploys 360º videos to improve the experience for paediatric patients and their families. This study presents a framework for developing clinically relevant and technologically feasible VR-based support tools for hospital settings. Despite differences in patient type, intervention purpose, and VR system, the methodology demonstrates usability, viability, reproducibility and preliminary clinical benefits. It highlights the importance approach centred on clinician and patient needs for any aspect of NRHB within a real hospital setting.

Keywords: neurological disorders, neurorehabilitation, stepwise development approach, virtual reality

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Authors: Seval Kula-Kartal

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Developing students’ reading comprehension skills is an aim that is difficult to accomplish and requires to follow long-term and systematic teaching and assessment processes. In these processes, teachers need tools to provide guidance to them on what reading comprehension is and which comprehension skills they should develop. Due to a lack of clear and evidence-based frameworks defining reading comprehension skills, especially in Turkiye, teachers and students mostly follow various processes in the classrooms without having an idea about what their comprehension goals are and what those goals mean. Since teachers and students do not have a clear view of comprehension targets, strengths, and weaknesses in students’ comprehension skills, the formative feedback processes cannot be managed in an effective way. It is believed that detecting and defining influential comprehension skills may provide guidance both to teachers and students during the feedback process. Therefore, in the current study, some of the reading comprehension frameworks that define comprehension skills operationally were examined. The aim of the study is to develop a simple and clear framework that can be used by teachers and students during their teaching, learning, assessment, and feedback processes. The current study is qualitative research in which documents related to reading comprehension skills were analyzed. Therefore, the study group consisted of recourses and frameworks which made big contributions to theoretical and operational definitions of reading comprehension. A content analysis was conducted on the resources included in the study group. To determine the validity of the themes and sub-categories revealed as the result of content analysis, three educational assessment experts were asked to examine the content analysis results. The Fleiss’ Cappa coefficient revealed that there is consistency among themes and categories defined by three different experts. The content analysis of the reading comprehension frameworks revealed that comprehension skills could be examined under four different themes. The first and second themes focus on understanding information given explicitly or implicitly within a text. The third theme includes skills used by the readers to make connections between their personal knowledge and the information given in the text. Lastly, the fourth theme focus on skills used by readers to examine the text with a critical view. The results suggested that fundamental reading comprehension skills can be examined under four themes. Teachers are recommended to use these themes in their reading comprehension teaching and assessment processes. Acknowledgment: This research is supported by Pamukkale University Scientific Research Unit within the project, whose title is Developing A Reading Comprehension Rubric.

Keywords: reading comprehension, assessing reading comprehension, comprehension taxonomies, educational assessment

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Authors: Maaly Jarrah

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In a study abroad context, students have the advantage of immersing themselves in the environment of the target language and being exposed to it. However, in and a stay home context, where English is not the mother tongue, students’ exposure to the second language is often times restricted to the classroom. Although language teachers are keen to develop inside class room activities and practices that increase the suitability of students to acquire a second language (Cook & Singleton, 2014), many would agree that class time is too limited to enhance students’ oral fluency skills. Consequently, creating opportunities outside the classroom for students to speak English is an effective strategy in compensating for students’ limited use of the L2. In an argument by Ortega (2012) external classroom activities have equal significance in enabling students learn English as a second language. The author further asserts that the activities provide a non-educational environment from which a student may feel free and comfortable to acquire new language skills. This study investigates the significance of outside classroom activities in promoting students’ oral proficiency. In addition, it reports on students’ perceptions of such activities. 15 participants from the American University of Kuwait took part in this study. Open-ended interviews were done to find out what the participants thought of these activities, and what they gained from them. Interview results show that students found outside classroom activities very effective in improving not only their oral fluency skills, but their confidence and critical thinking skills as well. The implications of this research study are for language practitioners and language programs in the EFL context to be aware of the benefits of incorporating outside classroom activities in language teaching.

Keywords: language teaching, oral fluency, outside classroom activities

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Authors: Mary Ann Cristine R. Olgado

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Diversity in the classroom might make it difficult to promote individualized learning, but differentiated instruction that caters to students' various learning preferences may prove to be beneficial. Hence, this study examined the effectiveness of Hybrid-Differentiated Mathematics Instruction (HDMI) in improving the students’ academic performance in Mathematics. It employed the quasi-experimental research design by using a comparative analysis of the two variables: the experimental and control groups. The learning styles of the students were identified using the Grasha-Riechmann Student Learning Style Scale (GRSLSS), which served as the basis for designing differentiated action plans in Mathematics. In addition, adapted survey questionnaires, pre-tests, and post-tests were used to gather information and were analyzed using descriptive and correlational statistics to find the relationship between variables. The experimental group received differentiated instruction for a month, while the control group received traditional teaching instruction. The study found that Hybrid-Differentiated Mathematics Instruction (HDMI) improved the academic performance of Grade 11-TVL students, with the experimental group performing better than the control group. This program has effectively tailored the teaching methods to meet the diverse learning needs of the students, fostering and enhancing a deeper understanding of mathematical concepts in Statistics & Probability, both within and beyond the classroom.

Keywords: differentiated instruction, hybrid, learning styles, academic performance

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Authors: Pia Kastl

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Potentials of blended learning are the flexibility of learning and the possibility to get in touch with lecturers and fellow students on site. By combining face-to-face sessions with digital self-learning units, the learning process can be optimized, and learning success increased. To examine wether blended learning outperforms online and face-to-face teaching, a theory-based questionnaire survey was conducted. The results show that the interaction and cooperation among students is poorly provided in blended learning, and face-to-face teaching performs better in this respect. The aim of this article is to identify concrete suggestions students have for improving cooperation and interaction in blended learning courses. For this purpose, interviews were conducted with students from various academic disciplines in face-to-face, online, or blended learning courses (N= 60). The questions referred to opinions and suggestions for improvement regarding the course design of the respective learning environment. The analysis was carried out by qualitative content analysis. The results show that students perceive the interaction as beneficial to their learning. They verbalize their knowledge and are exposed to different perspectives. In addition, emotional support is particularly important in exam phases. Interaction and cooperation were primarily enabled in the face-to-face component of the courses studied, while there was very limited contact with fellow students in the asynchronous component. Forums offered were hardly used or not used at all because the barrier to asking a question publicly is too high, and students prefer private channels for communication. This is accompanied by the disadvantage that the interaction occurs only among people who already know each other. Creating contacts is not fostered in the blended learning courses. Students consider optimization possibilities as a task of the lecturers in the face-to-face sessions: Here, interaction and cooperation should be encouraged through get-to-know-you rounds or group work. It is important here to group the participants randomly to establish contact with new people. In addition, sufficient time for interaction is desired in the lecture, e.g., in the context of discussions or partner work. In the digital component, students prefer synchronous exchange at a fixed time, for example, in breakout rooms or an MS Teams channel. The results provide an overview of how interaction and cooperation can be implemented in blended learning courses. Positive design possibilities are partly dependent on subject area and course. Future studies could tie in here with a course-specific analysis.

Keywords: blended learning, higher education, hybrid teaching, qualitative research, student learning

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Authors: Gabriel Michel

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The aim of our research is to find solutions for adapting university teaching to today's students and companies. To achieve this, we have tried to change the posture and behavior of those involved in the learning situation by promoting other skills. There is a gap between the expectations and functioning of students and university teaching. At the same time, the business world needs employees who are obviously competent and proficient in technology, but who are also imaginative, flexible, able to communicate, learn on their own and work in groups. These skills are rarely developed as a goal at university. The flipped classroom has been one solution. Thanks to digital tools such as Moodle, for example, but the model behind them is still centered on teachers and classic learning scenarios: it makes course materials available without really involving them and encouraging them to cooperate. It's against this backdrop that we've conducted action research to explore the possibility of changing the way we learn (rather than teach) by changing the posture of both the classic student and the teacher. We hypothesized that a tool we developed would encourage autonomy, the possibility of progressing at one's own pace, collaboration and learning using all available resources(other students, course materials, those on the web and the teacher/facilitator). Experimentation with this tool was carried out with around thirty German and French first-year students at the Université de Lorraine in Metz (France). The projected changesin the groups' learning situations were as follows: - use the flipped classroom approach but with a few traditional presentations by the teacher (materials having been put on a server) and lots of collective case solving, - engage students in their learning by inviting them to set themselves a primary objective from the outset, e.g. “Assimilating 90% of the course”, and secondary objectives (like a to-do list) such as “create a new case study for Tuesday”, - encourage students to take control of their learning (knowing at all times where they stand and how far they still have to go), - develop cooperation: the tool should encourage group work, the search for common solutions and the exchange of the best solutions with other groups. Those who have advanced much faster than the others, or who already have expertise in a subject, can become tutors for the others. A student can also present a case study he or she has developed, for example, or share materials found on the web or produced by the group, as well as evaluating the productions of others, - etc… A questionnaire and analysis of assessment results showed that the test group made considerable progress compared with a similar control group. These results confirmed our hypotheses. Obviously, this tool is only effective if the organization of teaching is adapted and if teachers are willing to change the way they work.

Keywords: pedagogy, cooperation, university, learning environment

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Authors: Asma Qudrat, Abid Ullah, Rafi Ullah, Ali Raza, Shah Zeb, Syed Ali Shan Ul-Haq, Shahkar Ahmed Shah, Attiya Hameed Khan, Saad Zaheer, Umama Qasim, Kiran Jamal, Zahoor khan

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Objectives: Coronary artery disease (CAD) is the major public health issue associated with high mortality and morbidity rate worldwide. Young patients with ACS have unique characteristics with different demographic profiles and risk factors. The precise diagnosis and early risk stratification is important in guiding treatment and predicting the prognosis of young patients with ACS. To evaluate the associated demographics, risk factors, and outcomes profile of ACS in young age patients. Methods: The research follow a retrospective design, the single centre study of patients diagnosis with the first event of ACS in young age (>18 and <40) were included. Data collection included demographic profiles, risk factors, and in-hospital outcomes of young ACS patients. The patient’s data was retrieved through Electronic Medical Records (EMR) of Peshawar Institute of Cardiology (PIC), and all characteristic were assessed. Results: In this study, 77% were male, and 23% were female patients. The risk factors were assessed with CAD and shown significant results (P < 0.01). The most common presentation was STEMI, with (45%) most in ACS young patients. The angiographic pattern showed single vessel disease (SVD) in 49%, double vessel disease (DVD) in 17% and triple vessel disease (TVD) was found in 10%, and Left Artery Disease (LAD) (54%) was present to be the most common involved artery. Conclusion: It is concluded that the male sex was predominant in ACS young age patients. SVD was the common coronary angiographic finding. Risk factors showed significant results towards CAD and common presentations.

Keywords: coronary artery disease, Non-ST elevation myocardial infarction, ST elevation myocardial infarction, unstable angina, acute coronary syndrome

Procedia PDF Downloads 166

Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee

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In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.

Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing

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Authors: Michael Amankwaa Adu

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This study investigates the speech acts employed by a Career Technology teacher during classroom interactions in a junior high school. While much research exists on speech acts in language teaching, little attention has been given to technical subjects. This has created a gap in understanding how teachers of non-language subjects utilize speech acts in classroom communication. This study aims to analyze the types and frequencies of speech acts used by a Career Technology teacher during three key classroom encounters: lesson introduction, content delivery, and classroom management. Using a mixed-methods approach, the study examines 113 utterances from the teacher's lesson, categorizing them into four primary speech act types: directives, assertives, expressives, and commissives. Directives emerged as the most dominant form, accounting for 59.3% of the utterances, followed by assertives (20.4%), expressives (14.2%), and commissives (6.2%). No declarations were observed. The study demonstrates how the teacher uses directives to manage student behavior and assertives to reinforce information. Expressives are used sparingly but play a role in motivating or disciplining students, while commissives help establish classroom rules and set expectations. The findings contribute to understanding classroom interaction strategies in non-language subjects, offering insights that could inform teacher training and curriculum development. The study underscores the importance of effective communication in technical subjects and suggests ways in which language teaching techniques might be integrated into other subject areas.

Keywords: classroom management, directives, speech acts, technical subjects., assertives

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Authors: Dawit Assefa, Kassaye Tekie, Gebrie Alebachew, Degefu Beyene, Bikila Alemu, Naji Mohammed, Asnakech Agegnehu, Seble Tsehay, Geremew Tasew

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Background: Implementation of a Laboratory Quality Management System (LQMS) is critical to ensure accurate, reliable, and efficient laboratory testing of antimicrobial resistance (AMR). However, limited LQMS implementation and progress toward accreditation in the AMR surveillance laboratory testing setting exist in Ethiopia. By addressing non-conformances (NCs) and working towards accreditation, microbiology laboratories can improve the quality of their services, increase staff competence, and contribute to mitigate the spread of AMR. Methods: Using standard ISO 15189 horizontal and vertical assessment checklists, certified assessors identified NCs at Hawassa and Jimma Hospital microbiology laboratories. The Ethiopian Public Health Institute AMR mentors and IDDS staff prioritized closing the NCs through the implementation of an intensified mentorship program that included ISO 15189 orientation training, resource allocation, and action plan development. Results: For the two facilities to clear their NCs, an intensified mentorship approach was adopted by providing ISO 15189 orientation training, provision of buffer reagents, controls, standards, and axillary equipment, and facilitating equipment maintenance and calibration. Method verification and competency assessment were also conducted along with the implementation of standard operating procedures and recommended corrective actions. This approach enhanced the laboratory's readiness for accreditation. After addressing their NCs, the two laboratories applied to Ethiopian Accreditation Services for ISO 15189 accreditation. Conclusions: Clearing NCs through the implementation of intensified mentorship was crucial in preparing the two laboratories for accreditation and improving quality laboratory test results. This approach can guide other microbiology laboratories’ accreditation attainment efforts.

Keywords: non-conformance clearance, intensified mentorship, accreditation, ISO 15189

Procedia PDF Downloads 92

Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

Procedia PDF Downloads 130