Search results for: international patient safety goals

Authors: Fatma Refaat Ahmed, Sally Mohamed Farghaly

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Context: Intensive care unit (ICU) nurses often face pressure and constraints in their work, leading to the rationing of care when demands exceed available time and resources. Observations suggest that ICU nurses are frequently distracted from their core nursing roles by non-core tasks. This study aims to provide evidence on ICU nurses' multitasking activities and explore the association between nurses' personal and clinical characteristics and their time allocation. Research Aim: The aim of this study is to quantify the time spent by ICU nurses on multitasking activities and investigate the relationship between their personal and clinical characteristics and time allocation. Methodology: A self-observation form utilizing the "Diary" recording method was used to record the number of tasks performed by ICU nurses and the time allocated to each task category. Nurses also reported on the distractions encountered during their nursing activities. A convenience sample of 60 ICU nurses participated in the study, with each nurse observed for one nursing shift (6 hours), amounting to a total of 360 hours. The study was conducted in two ICUs within a university teaching hospital in Alexandria, Egypt. Findings: The results showed that ICU nurses completed 2,730 direct patient-related tasks and 1,037 indirect tasks during the 360-hour observation period. Nurses spent an average of 33.65 minutes on ventilator care-related tasks, 14.88 minutes on tube care-related tasks, and 10.77 minutes on inpatient care-related tasks. Additionally, nurses spent an average of 17.70 minutes on indirect care tasks per hour. The study identified correlations between nursing time and nurses' personal and clinical characteristics. Theoretical Importance: This study contributes to the existing research on ICU nurses' multitasking activities and their relationship with personal and clinical characteristics. The findings shed light on the significant time spent by ICU nurses on direct care for mechanically ventilated patients and the distractions that require attention from ICU managers. Data Collection: Data were collected using self-observation forms completed by participating ICU nurses. The forms recorded the number of tasks performed, the time allocated to each task category, and any distractions encountered during nursing activities. Analysis Procedures: The collected data were analyzed to quantify the time spent on different tasks by ICU nurses. Correlations were also examined between nursing time and nurses' personal and clinical characteristics. Question Addressed: This study addressed the question of how ICU nurses allocate their time across multitasking activities and whether there is an association between nurses' personal and clinical characteristics and time allocation. Conclusion: The findings of this study emphasize the need for a lean evaluation of ICU nurses' activities to identify and address potential gaps in patient care and distractions. Implementing lean techniques can improve efficiency, safety, clinical outcomes, and satisfaction for both patients and nurses, ultimately enhancing the quality of care and organizational performance in the ICU setting.

Keywords: motion study, ICU nurse, lean, nursing time, multitasking activities

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Authors: Nina Dziatzko, Christopher Stehr, Franziska Struve

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Intercultural competence as an explicit required skill nearly never appears in job advertisements in international or even global contexts. But especially those who have to deal with different nationalities and cultures in their everyday business need to have several intercultural competencies and further a global mind-set. This way the question arises how potential future global managers can be trained to learn these competencies. In this regard, it might be helpful to see if different types of intercultural trainings have different effects on those skills. This paper outlines lessons learned based on the evaluation of two different intercultural trainings for management students. The main differences between the observed intercultural trainings are the amount of theoretical input in relation to hands-on experiences, the number of trainers as well as the used methods to teach implicit cultural rules. Both groups contain management students with the willingness and perspective to work abroad or to work in international context. The research is carried out with a pre-training-survey and a post-training-survey which consists of questions referring the international context of the students and a self-estimation of 19 identified intercultural and global mind-set skills, such as: cosmopolitanism, empathy, differentiation and adaptability. Whereas there is no clear result which training gets overall a significant higher increase of skills, there is a clear difference between the focus of competencies trained by each of the intercultural trainings. This way this research provides a guideline for both academicals institutions as well as companies for the decision between different types of intercultural trainings, if the to be trained required skills are defined. Therefore the efficiency and the accuracy of fit of the education of future global managers get optimized.

Keywords: global mind-set, intercultural competencies, intercultural training, learning experiences

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Authors: Z. Tasir, S. N. Kew, D. West, Z. Abdullah, D. Toohey

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Research on Learning Analytics is progressively developing in the higher education field by concentrating on the process of students' learning. Therefore, a research project between Malaysian and Australian Universities was initiated in 2015 to look at the use of Learning Analytics to support the development of teaching practice. The focal point of this article is to discuss and share the experiences of Malaysian and Australian universities in the process of developing the collaborative research on Learning Analytics. Three aspects of this will be discussed: 1) Establishing an international research project and team members, 2) cross-cultural understandings, and 3) ways of working in relation to the practicalities of the project. This article is intended to benefit other researchers by highlighting the challenges as well as the strategies used in this project to ensure such collaborative research succeeds.

Keywords: academic research project, collaborative research, cross-cultural understanding, international research project

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Authors: Rose Virginy S. Bautista, Ida Marie Tabangay-Lim, Helen Bongalon-Amo, Jose Modesto B. Abellera

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Chordomas, particularly those of the spine and the head and neck region, represent a rare and locally aggressive group of malignancies. The complexity of these tumors -given the rarity, location, and involvement of neurovascular structures- imposes a challenge in the diagnosis and management. We herein report a case of spinal cord compression due to a prevertebral cervical chordoma. The patient presented with a gradually enlarging lateral neck mass, with progressive bilateral extremity weakness and urinary incontinence; preoperative biopsy showed chordoma. A multidisciplinary approach for the management of this case was made, involving neurosurgery, head and neck surgery, and radiation oncology services. Surgical collaboration between the two cutting services was done to have a radical excision of the tumor and spinal cord decompression. The patient was then referred for adjuvant radiation therapy. With this collaborative treatment strategy, more comprehensive and quality care could be provided to our patients.

Keywords: chordoma, surgical collaboration, spinal cord compression, neurosurgery, head and neck surgery

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Authors: Fabien Candau, Florian Lafferrere

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This article analyses how an emission policy for vessels (named California’s Ocean-Going Vessel Fuel Rule) was implemented in 2009 in California impacts trade and marine biodiversity. By studying the decrease in emission levels anticipated by the policy, we measure not only the consequences for port activities but also for one of the most important marine ecosystems of the California Coast: the Kelp forests. Using the Difference in Difference (DiD) approach at the Californian ports level, we find that this policy has led to a significant decrease in trade volume during this period. Therefore, we find a positive and significant effect of shipping policy on kelp canopy and biomass growth by controlling the specific climatic and environmental characteristics of California coastal areas.

Keywords: international trade, shipping, marine biodiversity, emission control area

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Authors: Nditsheni Ramakuela, Sonto Maputle, Base Khoza, Augustine Tugli

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Inadequate health literacy can cause difficulties in understanding and compliance to treatment plan. With diabetic condition, self-care activities include behaviours of following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care. Patients with poor health literacy have difficulty interpreting medication warning labels, following directions on a prescription label and identifying their medications. Difficulties in understanding and performing self-care and health-related activities may ultimately lead to poor health outcomes. The study explored and described factors affecting health literacy and self-care to diabetic regimen by female patients at selected hospital in Limpopo Province of South Africa. Qualitative and explorative research design was used. Female patients who were admitted and diagnosed with diabetes in female medical ward constituted the study population. Non-probability, purposive sampling was used to select 20 female patients diagnosed with diabetes, who were above 18 years and admitted during April–November 2014. An in-depth face-to-face, unstructured interview was used to collect data. Data were analysed using open coding method. Measures to ensure trustworthiness and ethical considerations were adhered to. Findings revealed factors affecting health literacy for diabetic self-care activities amongst patients were; patient, family, disease and facility related. Proposed recommendations were; to strengthen diabetes education and patient-provider partnership. This is important and must be transferred to strengthen self-care activities to fully benefit the patient.

Keywords: compliance, diabetes mellitus, diabetic regimen, health literacy, self activities

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Authors: M. S. Riyazulla

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Since the dawn of the 21st century, there has been a perceptible decline in Islamic supremacy in world affairs, apart from the gradual waning of the amiable relations and relevance of Islamic countries in the International political arena. For a long, Islamic countries have been marginalised by the superpowers in the global conflicting issues. This was evident in the context of their recent invasions and interference in Afghanistan, Syria, Iraq, and Libya. The leading International Islamic organizations like the Arab League, Organization of Islamic Cooperation, Gulf Cooperation Council, and Muslim World League did not play any prominent role there in resolving the crisis that ensued due to the exogenous and endogenous causes. Hence, there is a need for Islamic countries to create a credible International Islamic organization that could dictate its terms and shape a new Islamic world order. The prominent Islamic countries are divided on ideological and religious fault lines. Their concord is indispensable to enhance their image and placate the relations with other countries and communities. The massive boon of oil and gas could be synergistically utilised to exhibit their omnipotence and eminence through constructive ways. The prevailing menace of Islamophobia could be abated through syncretic messages, discussions, and deliberations by the sagacious Islamic scholars with the other community leaders. Presently, as Muslims are at a crossroads, a dynamic leadership could navigate the agitated Muslim community on the constructive path and herald political stability around the world. The present political disorder, chaos, and economic challenges necessities a paradigm shift in approach to worldly affairs. This could also be accomplished through the advancement in science and technology, particularly space exploration, for peaceful purposes. The Islamic world, in order to regain its lost preeminence, should rise to the occasion in promoting peace and tranquility in the world and should evolve a rational and human-centric solution to global disputes and concerns. As a splendid contribution to humanity and for amicable international relations, they should devote all their resources and scientific intellect towards space exploration and should safely transport man from the Earth to the nearest and most accessible cosmic body, the Moon, within one hundred years as the mankind is facing the existential threat on the planet.

Keywords: carboniferous period, Earth, extinction, fossil fuels, global leaders, Islamic glory, international order, life, marginalization, Moon, natural catastrophes

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Authors: Diafat Abdelouahab, Ekhalfi A Hammoudia, Meribai Abdelmalek A, Bahloul Ahmedb

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The present study aimed to characterize 30 honey samples from the Bordj Bou Arreridj region (Algeria) regarding their floral origins, physicochemical parameters, mineral composition and microbial safety. Mean values obtained for physicochemical parameters were: pH 4.11, 17.17% moisture, 0.0061% ash, 370.57μS cm−1 electrical conductivity, 21.98 meq/kg free acidity, and 9.703 mg/kg HMF. The mineral content was determined by atomic absorption spectrometry. The mean values obtained were (mg/kg): Fe, 7.5714; Mg, 37.68; Na, 186,63; Zn, 3,86; Pb, 0,4869 × 10-3 ; Cd, 267 × 10-3. Aerobic mesophiles, fecal coliforms and sulphite-reducing clostridia were the microbial contaminants of interest studied. Microbiologically, the honey quality was considered good and all samples showed to be negative in respect to safety parameters. The results obtained for physicochemical characteristics of Bordj Bou Arreridj honey indicate a good quality level, adequate processing, good maturity and freshness.

Keywords: pollen analysis, physicochemical analysis, mineral content, microbial contaminants

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Authors: Wan Wang, Xing Li

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With the international river playing an increasingly important role in international relations, the border river between China and Russia has attracted more attention. During the history of Sino-Russian relations, Heilong-Amur River used to be a disputed border. The Sino-Russian transboundary water cooperation regarding the Heilong-Amur River started in 1950s and has obtained rapid improvement. In the 21st century, this cooperation has made substantial progress, which is worthy of a further study. However, this cooperation is facing with obstacles in aspects of economy, policy, implementation and mutual understandings. Under this circumstance, from the perspective of China, it is of necessity to realize these problems and take appropriate measures to promote the cooperation. The current Sino-Russian relations is conducive to transboundary water resources cooperation regarding the Heilong-Amur River and some measures adopted by China are already ongoing.

Keywords: China, cooperation, Heilong-Amur River, Russia

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Authors: Sarieh Poortaghi, Zakiyeh Jafaryparvar, Marzieh Hasanpour, Reza Negarandeh

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Aim: This article aims to discuss how violence against health care workers especially nurses affects health care systems and the quality of care of the patients. In this paper causes of violence and strategies to reduce it have been discussed. Methods: Discourse of the literature considering the violence against nurses during the COVID-19 pandemic and its reasons and outcomes. Results: The COVID-19 pandemic has led to a significant increase in violence against healthcare providers. The attacker against nurses may be among patients, companions, visitors, colleagues such as doctors and other nurses, supervisors, and managers. Many individuals who experience violence in healthcare environments refrain from reporting it. The causes of violence against nurses include spending long periods with patients, perceiving nursing as a low-status profession, gender of nurses, direct and frequent contact with patients and their companions, inadequate facilities and high workload, weak healthcare delivery systems in public hospitals and inequality in health, nature of the department and shift type of personnel, work shifts and staff shortages, forcing nurses to work in non-standard conditions during the COVID-19 pandemic, prohibition of patient visits during the pandemic, patient death and nurses' sense of incompetence, and expressing stress through aggression. Workplace violence leads to a decrease in job satisfaction and an increase in continuous psychological stress, which has a negative impact on the personal and professional lives of nurses. Potential strategies for reducing workplace violence include protecting healthcare workers through laws, improving communication with patients and their families, critically analyzing information in social media, facilitating patient access through remote medical strategies, and improving access to primary healthcare services.

Keywords: nurses, health care workers, Covid-19, nursing

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Authors: Aya Tanaka, Mariko Era, Manami Masuda, Yui Okuno, Takayoshi Kawahara, Takahide Kanyama, Hiroshi Morita

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Objectives— Fungi and bacteria are present in a wide range of natural environments. They are breed in the foods such as vegetables and fruit, causing corruption and deterioration of these foods in some cases. Furthermore, some species of fungi and bacteria are known to cause food intoxication or allergic reactions in some individuals. To prevent fungal and bacterial contamination, various fungicides and bactericidal have been developed that inhibit fungal and bacterial growth. Fungicides and bactericides must show high antifungal and antibacterial activity, sustainable activity, and a high degree of safety. Therefore, we focused on the fatty acid salt which is the main component of soap. We focused on especially C10K and C12K. This study aimed to find the effectiveness of the fatty acid salt as antimicrobial agents for food safety. Materials and Methods— Cladosporium cladosporioides NBRC 30314, Penicillium pinophilum NBRC 6345, Aspergillus oryzae (Akita Konno store), Rhizopus oryzae NBRC 4716, Fusarium oxysporum NBRC 31631, Escherichia coli NBRC 3972, Bacillus subtilis NBRC 3335, Staphylococcus aureus NBRC 12732, Pseudomonas aenuginosa NBRC 13275 and Serratia marcescens NBRC 102204 were chosen as tested fungi and bacteria. Hartmannella vermiformis NBRC 50599 and Acanthamoeba castellanii NBRC 30010 were chosen as tested amoeba. Nine fatty acid salts including potassium caprate (C10K) and laurate (C12K) at 350 mM and pH 10.5 were used as antifungal activity. The spore suspension of each fungus (3.0×10⁴ spores/mL) or the bacterial suspension (3.0×10⁵ or 3.0×10⁶ or 3.0×10⁷ CFU/mL) was mixed with each of the fatty acid salts (final concentration of 175 mM). Samples were counted at 0, 10, 60, and 180 min by plating (100 µL) on potato dextrose agar or nutrient agar. Fungal and bacterial colonies were counted after incubation for 1 or 2 days at 30 °C. Results— C10K was antifungal activity of 4 log-unit incubated time for 10 min against fungi other than A. oryzae. C12K was antifungal activity of 4 log-unit incubated time for 10 min against fungi other than P. pinophilum and A. oryzae. C10K and C12K did not show high anti-yeast activity. C10K was antibacterial activity of 6 or 7 log-unit incubated time for 10 min against bacteria other than B. subtilis. C12K was antibacterial activity of 5 to 7 log-unit incubated time for 10 min against bacteria other than S. marcescens. C12K was anti-amoeba activity of 4 log-unit incubated time for 10 min against H. vermiformis. These results suggest C10K and C12K have potential in the field of food safety.

Keywords: food safety, microbes, antimicrobial, fatty acid salts

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Authors: Aline Giardin, Ana Fontoura, Thomas Anderson

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Transsexuality is a condition that requires the work of professionals from various fields for diagnosis and treatment. The correct diagnosis is very important because the surgery is irreversible. Diagnostic elements are essentially clinical and an observation period of two years prior to surgery is recommended. In this review article, we discuss the importance of psychiatric nursing for the care of transgender patients, as well as their mental health. Transsexuality is a phenomenon that contrasts our common understandings of sexuality, but it is not a sexual issue. Also called gender dysphoria is a mismatch between the anatomical sex of an individual and their gender identity. In relation to mental health, among transsexuals, we find variations ranging from psychoses to total normality. As the etiology is still controversial, there is no biological marker and only the clinical criteria can be used. Portaria nº 2803, of November 19, 2013, Brazil, regulates the surgical reassignment of sex by the SUS and the nurse started to work also in operational groups (transsexuals who wish to perform surgery and other procedures of reassignment of sex). Health and education, establishes links and guides the care that female and male transsexual patients will have to have before and after surgery. It is also important to say that the work of health education is not only concerned with aspects related to the sexual reassignment surgery, but also with the mental health of its patients and with the family. One of the main complaints of patients is the impression that professionals seem to find them strange and feel extremely uncomfortable when they talk about their desire to undergo sex-change surgery: Investigate the role of nursing in the process of change sexual. Our methodology was a review of articles produced between 1994 and 2015. It was concluded that nursing should specialize for this new demand, which is growing more and more in our health services. We believe that nursing is specializing to enter this context and the expectations are good for the professionals and for the reception of the transsexual patient.

Keywords: transex, nursing, importance, patient

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Authors: Shierwin Agagen Cabunilas

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Countless Filipinos are reeling in dire economic inequality while many others are victims of human trafficking. Where there is extreme economic inequality, majority of the Filipinos are deprived of basic needs to have a good life, i.e., decent shelter, safe environment, food, quality education, social security, etc. The problem on human trafficking poses a scandal and threat in respect to human rights and dignity of a person on matters of sex, gender, ethnicity and race among others. The economic inequality and trafficking in persons are social pathologies that needed considerable amount of attention and visible solution both in the national and international level. However, the Philippine government seems falls short in terms of goals to lessen, if not altogether eradicate, the dire fate of many Filipinos. The lack of solidarity among Filipinos seems to further aggravate injustice and create hindrances to economic equity and protection of Filipinos from syndicated crimes, i.e., human trafficking. Indifference towards the welfare and well-being of the Filipino people trashes them into an unending cycle of marginalization and neglect. A transnational solidaristic action in response to these concerns is imperative. The subsequent sections will first discuss the notion of solidarity and the motivating factors for collective action. While solidarity has been previously thought of as stemming from and for one’s own community and people, it can be argued as a value that defies borders. Solidarity bridges peoples of diverse societies and cultures. Although there are limits to international interventions on another’s sovereignty, such as, internal political autonomy, transnational solidarity may not be an opposition to solidarity with people suffering injustices. Governments, nations and institutions can work together in securing justice. Solidarity thus is a positive political action that can best respond to issues of economic, class, racial and gender injustices. This is followed by a critical analysis of some data on Philippine economic inequality and human trafficking and link the place of transnational solidaristic arrangements. Here, the present work is interested on the normative aspect of the problem. It begins with the section on economic inequality and subsequently, human trafficking. It is argued that a transnational solidarity is vital in assisting the Philippine governing bodies and authorities to seriously execute innovative economic policies and developmental programs that are justice and egalitarian oriented. Transnational solidarity impacts a corrective measure in the economic practices, and activities of the Philippine government. Moreover, it is suggested that in order to mitigate Philippine economic inequality and human trafficking concerns it involves a (a) historical analysis of systems that brought about economic anomalies, (b) renewed and innovated economic policies, (c) mutual trust and relatively high transparency, and (d) grass-root and context-based approach. In conclusion, the findings are briefly sketched and integrated in an optimistic view that transnational solidarity is capable of influencing Philippine governing bodies towards socio-economic transformation and development of the lives of Filipinos.

Keywords: Philippines, Filipino, economic inequality, human trafficking, transnational solidarity

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Authors: Ika Wulansari, Yati Afiyanti, Indang Trihandini

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Sleeping disorder experienced by patients with breast cancer can affect the physical, mental, health, and well-being. This study examines the effect of progressive muscle relaxation training and sleep hygiene education to change sleep quality scores of the patient with breast cancer. The study design using quasi-experiment with pre-post test within the control group, involving 62 breast cancer patients using consecutive sampling method in Jakarta. Statistical test results with independent t-test showed a significant difference in score of sleep quality between in intervention group and the control group (6,66±3,815; 9,30±3,334, p-value = 0,005). Progressive muscle relaxation exercise and sleep hygiene education proven to be affective to change the patients sleeping quality, so that it can be an alternative therapeutic option to overcome sleeping disorders.

Keywords: sleeping disorders, breast cancer, progressive muscle relaxation, sleep hygiene education

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Authors: Khaja Moiduddin, Sherif Mohammed Elseufy, Hisham Alkhalefah

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Recent advances in three-dimensional (3D) printing, medical imaging, and implant design may alter how craniomaxillofacial surgeons construct individualized treatments using patient data. By utilizing medical image data, medical professionals can obtain detailed information about a patient's injuries, enabling them to conduct a thorough preoperative assessment while ensuring the implant's accuracy. However, selecting the right implant material requires careful consideration of various mechanical properties. This study aims to compare the two commonly used implant material for cranial reconstruction which includes titanium (Ti6Al4V) and Polyetheretherketone (PEEK). Biomechanical analysis was performed to study the implant behavior, by keeping the implant design and fixation constant in both cases. A finite element model was created and analyzed under loading conditions. The finite element analysis proves that although Ti6Al4V is stronger than PEEK but, its mechanical strength is adequate to bear the loads of the adjacent bone tissue.

Keywords: cranial reconstruction, titanium implants, PEEK, finite element model

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Authors: Anjali Kanagali, Astha Sinha

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Climate change is the greatest threat being faced by mankind in the 21st century. It no longer is merely an environmental, scientific or economic issue but is a humanitarian issue as well. Paris Agreement put great pressure on the businesses to reduce carbon emissions and mitigate the impact of climate change. However, the already increased climate variability and extreme weather are aggravating emergency humanitarian needs. According to the Intergovernmental Panel on Climate Change (IPCC), if efficient policy changes are not made in time to combat the climate change issues, the situation will deteriorate with an estimated global temperature rise of 4 degrees. The existing international network of Humanitarian system is not adequately structured to handle the projected natural disasters and climate change crisis. The 2030 Agenda which embraces the 17 Sustainable Development Goals (SGDs) discussed the relationship between the climate change and humanitarian assistance. The Humanitarian law aims to protect, amongst other things, ‘internally displaced persons’ which includes people displaced due to natural hazard related disasters engulfing the hazards of climate change. ‘Legal protection’ of displaced people to protect their rights is becoming a pressing need in such times. In this paper, attempts will be made to analyze the causes of the displacement, identify areas where the effect of the climate change is most likely to occur and to examine the character of forced displacement triggering population movement. We shall discuss the pressure on the Humanitarian system and assistance due to climate change issues and the need for vesting powers to the local communities or local government players to deal with the climate changes. We shall also discuss the possibility of setting up a new framework where non-state actors could be set up for climate change impact and its governance.

Keywords: humanitarian assistance to climate change, humanitarian crisis, internally displaced person, legal framework for climate migrants, non-state actors

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Authors: Susan Amirsalari, Azime Khosrinejad, Elham Rahimian

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Objective: Epilepsy is a common brain disorder characterized by a persistent tendency to develop in neurological, cognitive, and psychological contents. Magnetic Resonance Imaging (MRI) is a neuroimaging test facilitating the detection of structural epileptogenic lesions. This study aimed to compare the MRI findings between patients with intractable and drug-responsive epilepsy. Material & methods: This case-control study was conducted from 2007 to 2019. The research population encompassed all 1-16- year-old patients with intractable epilepsy referred to the Shafa Neuroscience Center (n=72) (a case group) and drug-responsive patients referred to the pediatric neurology clinic of Baqiyatallah Hospital (a control group). Results: There were 72 (23.5%) patients in the intractable epilepsy group and 200 (76.5%) patients in the drug-responsive group. The participants' mean age was 6.70 ±4.13 years, and there were 126 males and 106 females in this study Normal brain MRI was noticed in 21 (29.16%) patients in the case group and 184 (92.46%) patients in the control group. Neuronal migration disorder (NMD)was also exhibited in 7 (9.72%) patients in the case group and no patient in the control group. There were hippocampal abnormalities and focal lesions (mass, dysplasia, etc.) in 10 (13.88%) patients in the case group and only 1 (0.05%) patient in the control group. Gliosis and porencephalic cysts were presented in 3 (4.16%) patients in the case group and no patient in the control group. Cerebral and cerebellar atrophy was revealed in 8 (11.11%) patients in the case group and 4 (2.01%) patients in the control group. Corpus callosum agenesis, hydrocephalus, brain malacia, and developmental cyst were more frequent in the case group; however, the difference between the groups was not significant. Conclusion: The MRI findings such as hippocampal abnormalities, focal lesions (mass, dysplasia), NMD, porencephalic cysts, gliosis, and atrophy are significantly more frequent in children with intractable epilepsy than in those with drug-responsive epilepsy.

Keywords: magnetic resonance imaging, intractable epilepsy, drug responsive epilepsy, neuronal migrational disorder

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Authors: Fatima M. Jadu, Asmaa A. Alzahrani, Maha A. Almutairi, Salma O. Al-Amoudi, Mawya A. Khafaji

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Introduction: Estimating the potential radiation risk for a widely used imaging technique such as cone beam CT (CBCT) is crucial. The aim of this study was to examine the effect of varying two CBCT technical factors, the voxel size (VOX) and the Field-of-View (FOV) centralization, on the radiation dose. Methodology: The head and neck slices of a RANDO® man phantom (Alderson Research Laboratories) were used with nanoDot™ OSLD dosimeters to measure the absorbed radiation dose at 25 predetermined sites. Imaging was done using the i-CAT® (Imaging Science International, Hatfield, PA, USA) CBCT unit. The VOX was changed for every three cycles of exposures from 0.2mm to 0.3mm and then 0.4mm. Then the FOV was centered on the maxilla and mandible alternatively while holding all other factors constant. Finally, the effective radiation dose was calculated for each view and voxel setting. Results: The effective radiation dose was greatest when the smallest VOX was chosen. When the FOV was centered on the maxilla, the highest radiation doses were recorded in the eyes and parotid glands. While on the mandible, the highest radiation doses were recorded in the sublingual and submandibular glands. Conclusion: Minor variations in the CBCT exposure factors significantly affect the effective radiation dose and thus the radiation risk to the patient. Therefore, extreme care must be taken when choosing these parameters especially for vulnerable patients such as children.

Keywords: CBCT, cone beam CT, effective dose, field of view, mandible, maxilla, resolution, voxel

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Authors: David Maman, David E. Rothem, Merav Ben Natan, Yaron Berkovich

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Introduction: Hip fractures are a major health concern due to their impact on disability, independence, and mortality. Timely rehabilitation is crucial for improving patient outcomes and reducing healthcare costs, yet delays in rehabilitation, often due to challenges in discharge processes, can lead to adverse events and increased healthcare burdens. Aim: The study aimed to investigate two primary aspects related to hip fracture older adults patients: firstly, identifying subgroups more prone to delayed discharge for further rehabilitation; and secondly, exploring the consequences of this delay on short-term outcomes and the incidence of adverse events. Methods: Conducting a retrospective analysis, we examined the medical records of 474 patients aged 65 and older, hospitalized for hip fractures between 2018 and 2022 in a major hospital in the north-central region of Israel. All patients were eligible for further rehabilitation, including options for in-patient or home-based care. Results: Of the studied patients, 61.4% experienced delayed discharge, with an average waiting period of 3.5 days. Factors such as older age, prolonged hospital stay, and the need for in-patient rehabilitation were associated with a higher likelihood of delayed discharge. Those promptly discharged demonstrated lower rates of infections, falls, and mortality. Furthermore, delayed discharge to further rehabilitation correlated with elevated hospitalization costs. Notably, no significant differences were observed in re-hospitalization or repeat surgery rates. Conclusion: This study underscores the pressing need for efficient strategies to ensure timely rehabilitation, particularly for older adults. Implementing such strategies can optimize outcomes, mitigate adverse events, and contribute to a reduction in healthcare costs.

Keywords: hip fracture rehabilitation, delayed discharge, older adults, healthcare coordination, adverse events

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Authors: Sarinra Thongmee, Krittaporn Prakobsaeng, Adithep Mingsuan, Chanyapak Polkhet, Supattra Wongsuk

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The purposes of this research and developmentwasto develop and evaluation of the clinical nursingpractice guideline (CNPG) for the prevention infection during intubation in patient with suspected or confirmedCOVID-19 patient. This study was developed by using the evidencebased practice model of Soukup (2000) asa conceptual framework. The study consisted of 4 steps: 1) situational analysis of intubation service in patientswith confirmed COVID-19; 2) development of the CNPG; 3) apply the NPG to trial; and 4) evaluation of the CNPG. The sample consisted of 52 nurse anesthetists and 25 infected or suspected COVID-19 patients. The research instrument consisted of 1) the CNPG, which was developed by the researchers; 2) the nurses anesthetist opinion questionnaire to the guideline; 3) the evaluation practice form; and 4) the nurse anesthetist knowledge test on nursing care of patients infected with COVID-19. Data were analyzed by using descriptive statistics, and Wilcoxon matched-pairs signed rank test. The results revealed this developed CNPG consists of 4 sections: 1)the CNPG for airborne precautions2) the preparation of anesthetic and intubation equipments3) the roles and duties of the intubation team, 4) the guidelines for intubation in suspected or confirmed COVID-19 patients. The results of CNPG use found that 1)the provider: using NPG in providers revealed that nurse anesthetist had a higher mean of knowledge scores than before using CNPG statistically significant at the 0.05 level (p<0.01) and able to follow the NPG 100% inall activities. The anesthetic team was not infected with COVID-19 from intubation outside the operating room. 2)the client: the patient was safe, with no complications from intubation. Summary CNPG to prevent infection during reintubation of suspected or confirmedCOVID-19patient was appropriate and applicable to practice.

Keywords: clinical nursing practice guideline, prevention of infection, endotracheal intubation, COVID-19

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Authors: S. Khalifa, R. Chkoundali

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The specific role of banks in economic development varies, depending on scope. Firstly, the participation of banks in economic development focus around providing credit and services to generate revenues, which are then invested back into a local, national or international community. The specific roles banks play in the economic development of a small community differ from the role banks play in national or international economic development. Although the role can vary, factors such as access to credit and bank investment policies or practices remain constant, no matter the scope of economic development. This paper provides an overview of the economic situation of Africa and its short-term outlook. He referred to the progress made in the implementation of the Medium-Term Strategy (2008-2012) and some major achievements of the Bank, as the speed and flexibility with which she responded to the oil crisis, food and financial.

Keywords: economic growth, bank, Africa, economic development

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Authors: Brar Prabhdip

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Art and fashion are coupled by a common bridge which is ‘Creativity’. For centuries art has influenced fashion and has been inspirational for modern-day national as well as international designers. Italian artists during the Renaissance period were highly influenced by art. 20th and 21st-century artists have often found themselves the muses of major fashion houses. Many times artists and designers like Andy Warhol, Damien Hirst, and Dior, Prada, respectively, have collaborated and successfully created prints, textiles, and silhouettes that have dazzled the art and fashion world. This paper nudges deeper and discourses the statement pieces of remarkable designers that have been influenced by art and adorned by international celebrities. Indian designer Manish Arora has been able to design a remarkable position for himself in the international fashion world. His clothes are avant-garde and favoured choice of celebrities like Lady Gaga and Katy Perry. The Manish Arora collaboration with Berlin-based artist Amrie Hoffstater has carved its space for a new segment. The latest collaboration, despite being in the pandemic, is between Sabyasachi (India) and Bergdorfs Goodman (New York). It boasts of the traditional Colonial Indian sensibility juxtaposed with the eclectic Western American mix for the new-age wearer. A qualitative and exploratory research design is steered towards both art and fashion as they reflect social, economic, and political changes. Social issues are highlighted through these platforms. Secondary data has been used for this paper to explain how designers have bridged the way for how one could wear fashion as a piece of art in and of itself. Conclusively we reach the perfect camaraderie between art and fashion.

Keywords: art, artist, collaboration, designer, fashion, relationship commas

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Authors: Md. Omar Bin Harun Khan

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The collapse of the infamous Rana Plaza, a multi-storeyed commercial building in Savar, near Dhaka, Bangladesh has brought with it a plethora of positive and negative consequences. Bangladesh being a key player in the export of clothing, found itself amidst a wave of economic upheaval following this tragic incident that resulted in numerous Bangladeshis, most of whom were factory workers. This paper compares the consequences that the country’s Ready Made Garments (RMG) sector is facing now, two years into the incident. The paper presents a comparison of statistical data from study reports and brings forward perspectives from all dimensions of Labour, Employment and Industrial Relations in Bangladesh following the event. The paper brings across the viewpoint of donor organizations and donor countries, the impacts of several initiatives taken by foreign organizations like the International Labour Organization, and local entities like the Bangladesh Garment Manufacturers and Exporters Association (BGMEA) in order to reinforce compliance and stabilize the shaky foundation that the RMG sector had found itself following the collapse. Focus of the paper remains on the stance taken by the suppliers in Bangladesh, with inputs from buying houses and factories, and also on the reaction of foreign brands. The paper also focuses on the horrific physical, mental and financial implications sustained by the victims and their families, and the consequent uproar from workers in general regarding compliance with work safety and workers’ welfare conditions. The purpose is to get across both sides of the scenario: the economic impact that suppliers / factories/ sellers/ buying houses/exporters have faced in Bangladesh as a result of complete loss of reliability on them regarding working standards; and also to cover the aftershock felt on the other end of the spectrum by the importers/ buyers, particularly the foreign entities, in terms of the sudden accountability of being affiliated with non- compliant factories. The collapse of Rana Plaza has received vast international attention and strong criticism. Nevertheless, the almost immediate strengthening of labourrights and the wholesale reform undertaken on all sides of the supply chain, evidence a move of all local and foreign stakeholders towards greater compliance and taking of precautionary steps for prevention of further disasters. The tragedy that Rana Plaza embodies served as a much-needed epiphany for the soaring RMG Sector of Bangladesh. Prompt co-operation on the part of all stakeholders and regulatory bodies now show a move towards sustainable development, which further ensures safeguarding against any future irregularities and pave the way for steady economic growth.

Keywords: economy, employment standards, Rana Plaza, RMG

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Authors: R. Tariq, R. Lee

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Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.

Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation

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Authors: Shan-Yu Hsu, Hsin-Shu Huang

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The main purpose of this teaching research is to design an interdisciplinary team-assisted teaching method for trainees and interns and review the effectiveness of this teaching method on trainees' understanding of peritoneal dialysis. The teaching research object is the fifth and sixth-grade trainees in a medical center's medical school. The teaching methods include media teaching, demonstration of technical operation, face-to-face communication with patients, special case discussions, and field visits to the peritoneal dialysis room. Evaluate learning effectiveness before, after, and verbally. Statistical analysis was performed using the SPSS paired-sample t-test to analyze whether there is a difference in peritoneal dialysis professional cognition before and after teaching intervention. Descriptive statistics show that the average score of the previous test is 74.44, the standard deviation is 9.34, the average score of the post-test is 95.56, and the standard deviation is 5.06. The results of the t-test of the paired samples are shown as p-value = 0.006, showing the peritoneal dialysis professional cognitive test. Significant differences were observed before and after. The interdisciplinary team-assisted teaching method helps trainees and interns to improve their professional awareness of peritoneal dialysis. At the same time, trainee physicians have positive feedback on the inter-professional team-assisted teaching method. This teaching research finds that the clinical ability development education of trainees and interns can provide cross-professional team-assisted teaching methods to assist clinical teaching guidance.

Keywords: monitor quality, patient safety, health promotion objective, cross-professional team-assisted teaching methods

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Authors: Changyin Zhou

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Verb-argument relation is a very important aspect of syntax-semantics interaction in sentence processing. Previous ERP (event related potentials) studies in this field mainly concentrated on the relation between the verb and its core arguments. The present study aims to reveal the ERP pattern of Chinese pseudo-object structures (SOSs), in which a peripheral argument is promoted to occupy the position of the patient object, as compared with the patient object structures (POSs). The ERP data were collected when participants were asked to perform acceptability judgments about Chinese phrases. Our result shows that, similar to the previous studies of number-of-argument violations, Chinese SOSs show a bilaterally distributed N400 effect. But different from all the previous studies of verb-argument relations, Chinese SOSs demonstrate a sustained anterior positivity (SAP). This SAP, which is the first report related to complexity of argument structure operation, reflects the integration difficulty of the newly promoted arguments and the progressive nature of well-formedness checking in the processing of Chinese SOSs.

Keywords: Chinese pseudo-object structures, ERP, sustained anterior positivity, verb-argument relation

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Authors: Abraham J. Rizkalla, Joanne F. Irons, Christopher Q. Cao

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Purpose: Lobectomy was considered the standard of care for early-stage non-small lung cancer (NSCLC) after the Lung Cancer Study Group trial demonstrated increased locoregional recurrence for sublobar resections. However, there has been heightened interest in segmentectomies for selected patients with peripheral lesions ≤2cm, as investigated by the JCOG0802 and CALGB140503 trials. Minimally invasive robotic surgery facilitates segmentectomies with improved maneuverability and visualization of intersegmental planes using indocyanine green. We hereby present a patient who underwent robotic lingulectomy for an undiagnosed ground-glass opacity. Methodology: This video demonstrates a robotic portal lingulectomy using three 8mm ports and a 12mm port. Stereoscopic direct vision facilitated the identification of the lingula artery and vein, and intra-operative bronchoscopy was performed to confirm the lingula bronchus. The intersegmental plane was identified by indocyanine green and a near-infrared camera. Thorough lymph node sampling was performed in accordance with international standards. Results: The 18mm lesion was successfully excised with clear margins to achieve R0 resection with no evidence of malignancy in the 8 lymph nodes sampled. Histopathological examination revealed lepidic predominant adenocarcinoma, pathological stage IA. Conclusion: This video presentation exemplifies the standard approach for robotic portal lingulectomy in appropriately selected patients.

Keywords: lung cancer, robotic segmentectomy, indocyanine green, lingulectomy

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Authors: Djalal Hamed

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The aim of this paper is to perform an analytic solution of steady state natural convection in a narrow rectangular channel between two vertical parallel MTR-type fuel plates, imposed under a cosine shape heat flux to determine the margin of the nuclear core power at which the natural convection cooling mode can ensure a safe core cooling, where the cladding temperature should not be reach the specific safety limits (90 °C). For this purpose, a simple computer program is developed to determine the principal parameter related to the nuclear core safety such as the temperature distribution in the fuel plate and in the coolant (light water) as a function of the reactor power. Our results are validated throughout a comparison against the results of another published work, which is considered like a reference of this study.

Keywords: buoyancy force, friction force, natural convection, thermal hydraulic analysis, vertical heated rectangular channel

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Authors: Laxmi R. Kasaraneni

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The Internet connects all the networks, including the nation’s critical infrastructure that are used extensively by not only a nation’s government and military to protect sensitive information and execute missions, but also the primary infrastructure that provides services that enable modern conveniences such as education, potable water, electricity, natural gas, and financial transactions. It has become the central nervous system for the government, the citizens, and the industries. When it is attacked, the effects can ripple far and wide impacts not only to citizens’ well-being but nation’s economy, civil infrastructure, and national security. As such, these critical services may be targeted by malicious hackers during cyber warfare, it is imperative to not only protect them and mitigate any immediate or potential threats, but to also understand the current or potential impacts beyond the IT networks or the organization. The Nation’s IT infrastructure which is now vital for communication, commerce, and control of our physical infrastructure, is highly vulnerable to attack. While existing technologies can address some vulnerabilities, fundamentally new architectures and technologies are needed to address the larger structural insecurities of an infrastructure developed in a more trusting time when mass cyber attacks were not foreseen. This research is intended to improve the core functions of the Internet and critical-sector information systems by providing a clear path to create a safe, secure, and resilient cyber environment that help stakeholders at all levels of government, and the private sector work together to develop the cybersecurity capabilities that are key to our economy, national security, and public health and safety. This research paper also emphasizes the present and future cyber security threats, the capabilities and goals of cyber attackers, a strategic concept and steps to implement cybersecurity for maximum effectiveness, enabling technologies, some strategic assumptions and critical challenges, and the future of cyberspace.

Keywords: critical challenges, critical infrastructure, cyber security, enabling technologies, national security

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Authors: Iman Shabanzadeh

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The economic growth and the special model of development in China have caused sensitivity in the public opinion of the world regarding the nature of this growth and development. In this regard, the Chinese have tried to put an end to such alarming procedures by using all the tools at their disposal and seek to present a peaceful and cooperative image of themselves. In this way, one of the most important diplomatic tools that Beijing has used to reduce the concerns caused by the Threat Theory has been the use of soft power resources and its tools in its development policies. This article begins by analyzing the concept of soft power and examining its foundations in international relations, and continues to examine the components of soft power in its Chinese version. The main purpose of the article is to figure out about the position of West Asia in China's soft power strategy and resources China use to achieve its goals in this region. In response to the main question, the paper's hypothesis is that soft power in its Chinese version had significant differences from Joseph Nye's original idea. In fact, the Chinese have imported the American version of soft power and adjusted, strengthened and, in other words, internalized it with their abilities, capacities and political philosophy. Based on this, China's software presence in West Asia can be traced in three areas. The first source of China's soft power in this region of West Asia is cultural in nature and is realized through strategies such as "use of educational tools and methods", "media methods" and "tourism industry". The second source is related to political soft power, which is applied through the policy of "balance of influence" and the policy of "mediation" and relying on the "ideological foundations of Confucianism". The third source also refers to China's economic soft power and is realized through three tools: "energy exchanges", "foreign investments" and "Belt-Road initiative". The research method of this article is descriptive-analytical.

Keywords: soft power, cooperative power, china, west asia

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