Search results for: Jessica Smith

Authors: Wenli Tsou, Jessica Wu

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Courses of English for specific academic purposes (ESAP) have become popular for higher education in Taiwan; however, no standardized tests have been developed for evaluating learners’ English proficiency in individual designated fields. Assuming a learner’s proficiency in a specific academic area is built up with one’s general proficiency in English with specific knowledge and vocabulary in the content areas, an adequate ESAP proficiency test may be constructed by some selected test items related to the designated academic areas. In this study, through collaboration between a language testing institution and a university in Taiwan, three sets of ESAP tests, covering three disciplinary areas of business and the workplace, science and engineering, and health and medicine majors, were developed and administered to sophomore students (N=1704) who were enrolled in ESAP courses at a university in southern Taiwan. For this study, the courses were grouped into the above-mentioned three disciplines, and students took the specialized proficiency test based on the ESAP course they were taking. Because students were free to select which ESAP course to take, each course had both major and non-major students. Toward the end of the one-semester course, ending in January, 2015, each student took two tests, one of general English (General English Proficiency Test, or GEPT) and the other ESAP. Following each test, students filled out a survey, reporting their test taking experiences. After comparing students’ two test scores, it was found that business majors and health and medical students performed better in ESAP than the non-majors in the class, whereas science and engineering majors did about the same as their non-major counterparts. In addition, test takers with CERF B2 (upper intermediate) level or above performed well in both tests, while students who are below B2 did slightly better in ESAP. The findings suggest that students’ test performance have been enhanced by their specialist content and vocabulary knowledge. Furthermore, results of the survey show that the difficulty levels reported by students are consistent with their test performances. Based on the item analysis, the findings can be used to develop proficiency tests for specific disciplines and to identify ability indicators for college students in their designated fields.

Keywords: english for specific academic purposes (ESAP), general english proficiency test (GEPT), higher education, proficiency test

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Authors: Brid Dinnee, Jessica Taylor, Joseph Hartland, Michael Natarajan

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Background:The third stage of labour (TSL) can be complicated by Post-Partum Haemorrhage (PPH), which can have a significant impact on maternal mortality and morbidity. In Africa, 33.9% of maternal deaths are attributable to PPH1. In order to minimise this figure, current recommendations for the developing world are that all women have active management of the third stage of labour (AMTSL). The aim of this project was to examine TSL practice in a rural Ugandan Hospital, highlight any deviation from best practice and identify barriers to change in resource limited settings as part of a 4th year medical student External Student Selected Component field trip. Method: Five key elements from the current World Health Organisation (WHO) guidelines on AMTSL were used to develop an audit tool. All daytime vaginal deliveries over a two week period in July 2016 were audited. In addition to this, a retrospective comparison of PPH rates, between 2006 (when ubiquitous use of intramuscular oxytocin for management of TSL was introduced) and 2015 was performed. Results: Eight vaginal deliveries were observed; at all of which intramuscular oxytocin was administered and controlled cord traction used. Against WHO recommendation, all umbilical cords were clamped within one minute, and no infants received early skin-to-skin contact. In only one case was uterine massage performed after placental delivery. A retrospective comparison of data rates identified a 40% reduction in total number of PPHs from November 2006 to November 2015. Maternal deaths per delivery reduced from 2% to 0.5%. Discussion: Maternal mortality and PPH are still major issues in developing countries. Maternal mortality due to PPH can be reduced by good practices regarding TSL, but not all of these are used in low-resource settings. There is a notable difference in outcomes between the developed and developing world. At Kitovu Hospital, there has been a reduction in maternal mortality and number of PPHs following introduction of IM Oxytocin administration. In order to further improve these rates, staff education and further government funding is key.

Keywords: post-partum haemorrhage, PPH, third stage labour, Uganda

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Authors: Muhammad Afzal, Shahbaz Mushtaq, Duc-Anh-An-Vo, Kathryn Reardon Smith, Thanh Ma

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Climate change has become one of the most challenging environmental issues in the 21st century. Climate change-induced natural disasters, especially floods, are the major factors of livelihood vulnerability, impacting millions of individuals worldwide. Evaluating and mitigating the effects of floods requires an in-depth understanding of the relationship between vulnerability and livelihood capital assets. Using an integrated approach, sustainable livelihood framework, and system thinking approach, the study developed a conceptual model of a generalized livelihood system in District Rajanpur, Pakistan. The model visualizes the livelihood vulnerability system as a whole and identifies the key feedback loops likely to influence the livelihood vulnerability. The study suggests that such conceptual models provide effective communication and understanding tools to stakeholders and decision-makers to anticipate the problem and design appropriate policies. It can also serve as an evaluation technique for rural livelihood policy and identify key systematic interventions. The key finding of the study reveals that household income, health, and education are the major factors behind the livelihood vulnerability of the rural poor of District Rajanpur. The Pakistani government tried to reduce the livelihood vulnerability of the region through different income, health, and education programs, but still, many changes are required to make these programs more effective especially during the flood times. The government provided only cash to vulnerable and marginalized families through income support programs, but this study suggests that along with the cash, the government must provide seed storage facilities and access to crop insurance to the farmers. Similarly, the government should establish basic health units in villages and frequent visits of medical mobile vans should be arranged with advanced medical lab facilities during and after the flood.

Keywords: livelihood vulnerability, rural communities, flood, sustainable livelihood framework, system dynamics, Pakistan

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Authors: C. A. Roberts, J. G. Andrae, S. R. Smith, M. H. Poore, C. A. Young, D. W. Hancock, G. J. Pent

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To the author’s best knowledge, there are no published reports of effective methods for teaching fescue toxicosis and grass endophyte technology in the USA. To address this need, a group of university scientists, industry representatives, government agents, and livestock producers formed an organization called the Alliance for Grassland Renewal. One goal of the Alliance was to develop a teaching method that could be employed across all regions in the USA and all sectors of the agricultural community. The first step in developing this method was identification of experts who were familiar with the science and management of fescue toxicosis. The second step was curriculum development. Experts wrote a curriculum that addressed all aspects of toxicosis and management, including toxicology, animal nutrition, pasture management, economics, and mycology. The curriculum was created for presentation in lectures, laboratories, and in the field. The curriculum was in that it could be delivered across state lines, regardless of peculiar, in-state recommendations. The curriculum was also unique as it was unanimously supported by private companies otherwise in competition with each other. The final step in developing this teaching method was formulating a delivery plan. All experts, including university, industry, government, and production, volunteered to travel from any state in the USA, converge in one location, teach a 1-day workshop, then travel to the next location. The results of this teaching method indicate widespread success. Since 2012, experts across the entire USA have converged to teach Alliance workshops in Kansas, Oklahoma, Missouri, Kentucky, Georgia, South Carolina, North Carolina, and Virginia, with ongoing workshops in Arkansas and Tennessee. Data from post-workshop surveys indicate that instruction has been effective, as at least 50% of the participants stated their intention to adopt the endophyte technology presented in these workshops. The teaching method developed by the Alliance for Grassland Renewal has proved to be effective, and the Alliance continues to expand across the USA.

Keywords: endophyte, Epichloe coenophiala, ergot alkaloids, fescue toxicosis, tall fescue

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Authors: Sunny Deo, Eve Barnes, Peter Arnold-Smith

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Introduction: Healthcare technology is a rapidly expanding field in healthcare, with enthusiasts suggesting a revolution in the quality and efficiency of healthcare delivery based on the utilisation of better e-healthcare, including the move to paperless healthcare. The role and use of computers and programmes for healthcare have been increasing over the past 50 years. Despite this, there is no standardised method of assessing the quality of hardware and software utilised by frontline healthcare workers. Methods and subjects: Based on standard Patient Related Outcome Measures, a questionnaire was devised with the aim of providing quantitative and qualitative data on clinicians’ perspectives of their hospital’s Information Technology (IT). The survey was distributed via the Institution’s Intranet to all contracted doctors, and the survey's qualitative results were analysed. Qualitative opinions were grouped as positive, neutral, or negative and further sub-grouped into speed/usability, software/hardware, integration, IT staffing, clinical risk, and wellbeing. Analysis was undertaken on the basis of doctor seniority and by specialty. Results: There were 196 responses, with 51% from senior doctors (consultant grades) and the rest from junior grades, with the largest group of respondents 52% coming from medicine specialties. Differences in the proportion of principle and sub-groups were noted by seniority and specialty. Negative themes were by far the commonest stated opinion type, occurring in almost 2/3’s of responses (63%), while positive comments occurred less than 1 in 10 (8%). Conclusions: This survey confirms strongly negative attitudes to the current state of electronic documentation and IT in a large single-centre cohort of hospital-based frontline physicians after two decades of so-called progress to a paperless healthcare system. Greater use would provide further insights and potentially optimise the focus of development and delivery to improve the quality and effectiveness of IT for clinicians and their patients.

Keywords: information technology, electronic patient records, digitisation, paperless healthcare

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Authors: Jessica Chorostecki, Aashka Shah, Fen Bao, Ginny Bao, Edwin George, Navid Seraji-Bozorgzad, Veronica Gorden, Christina Caon, Elliot Frohman

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Background: Parkinson’s Disease (PD) is a neuro degenerative disorder associated with the loss of dopaminergic cells and the presence α-synuclein (AS) aggregation in of Lewy bodies. Both dopaminergic cells and AS are found in the retina. Optical coherence tomography (OCT) allows high-resolution in-vivo examination of retinal structure injury in neuro degenerative disorders including PD. Methods: We performed a cross-section OCT study in patients with definite PD and healthy controls (HC) using Spectral Domain SD-OCT platform to measure the peripapillary retinal nerve fiber layer (pRNFL) thickness and total macular volume (TMV). We performed intra-retinal segmentation with fully automated segmentation software to measure the volume of the RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), and the outer nuclear layer (ONL). Segmentation was performed blinded to the clinical status of the study participants. Results: 101 eyes from 52 PD patients (mean age 65.8 years) and 46 eyes from 24 HC subjects (mean age 64.1 years) were included in the study. The mean pRNFL thickness was not significantly different (96.95 μm vs 94.42 μm, p=0.07) but the TMV was significantly lower in PD compared to HC (8.33 mm3 vs 8.58 mm3 p=0.0002). Intra-retinal segmentation showed no significant difference in the RNFL volume between the PD and HC groups (0.95 mm3 vs 0.92 mm3 p=0.454). However, GCL, IPL, INL, and ONL volumes were significantly reduced in PD compared to HC. In contrast, the volume of OPL was significantly increased in PD compared to HC. Conclusions: Our finding of the enlarged OPL corresponds with mRNA expression studies showing localization of AS in the OPL across vertebrate species and autopsy studies demonstrating AS aggregation in the deeper layers of retina in PD. We propose that the enlargement of the OPL may represent a potential biomarker of AS aggregation in PD. Longitudinal studies in larger cohorts are warranted to confirm our observations that may have significant implications in disease monitoring and therapeutic development.

Keywords: Optical Coherence Tomography, biomarker, Parkinson's disease, alpha-synuclein, retina

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Authors: Sera Ratu, Jane Chivers, Jessica Botfield

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Objectives: The Reproductive and Family Health Association of Fiji (RFHAF) and Family Planning Australia are working together to introduce quality comprehensive sexuality education into Special Schools - which are schools for students with disability. Sexual and reproductive health information is needed by students with disability attending Special Schools. Children with special needs go through the same changes as able-bodied children. The Fiji Disability Inclusion project is a three-year project that started in 2015. One of its objectives is to increase exposure to comprehensive sexuality education for primary and secondary school students with disability. Method: A baseline survey was undertaken with 72 students with disability; it included questions about puberty, sexual health, and relationships. 34 teachers also completed a survey about their views of sexuality education and confidence in delivering it. Consent was facilitated by running information sessions with teachers and parents. The process of gaining consent and completing the surveys was designed to be accessible to students with disability. Given the sensitive nature of reproductive and sexual health, and the potential vulnerability of young people with disability, ethical considerations were important in the design and implementation of the surveys, and ethics approval was obtained. Results: Findings from the surveys suggest that students have mixed knowledge and awareness of sexual health issues. Most teachers reported a need for their students to learn about sexuality and relationships. A positive outcome of conducting the surveys was that RFHAF staff reported they have developed skills and confidence in communicating with young people with a range of disabilities. They have a greater understanding of what students want to learn, and what teachers feel is important. Conclusions: These survey findings will assist RFHAF in developing comprehensive sexuality education programs that are relevant and accessible to students in Special Schools, and to develop an appropriate professional development program for teachers. Findings may also be applicable to other Special Schools when developing sexuality education programs. The education programs developed for students as part of this project, and the professional development programs for teachers, may be relevant to other countries.

Keywords: comprehensive sexuality education, delivery, sexual and reproductive health and rights, special schools

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Authors: Nathaniel Evans, Jessica Boersma, Kenneth Kass

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With technology and STEM fields growing every day, there is a significant projected shortfall in qualified cybersecurity workers. As such, it is essential to develop a cybersecurity curriculum that builds skills and cultivates interest in cybersecurity early on. With new jobs being created every day and an already significant gap in the job market, it is vital that educators are pro-active in introducing a cybersecurity curriculum where students are able to learn new skills and engage in an age-appropriate cyber curriculum. Within this growing world of cybersecurity, students should engage in age-appropriate technology and cybersecurity curriculum, starting with elementary school (k-5), extending through high school, and ultimately into college. Such practice will provide students with the confidence, skills, and, ultimately, the opportunity to work in the burgeoning information security field. This paper examines educational methods, pedagogical practices, current cybersecurity curricula, and other educational resources and conducts analysis for false assumptions and developmental appropriateness. It also examines and identifies common mistakes with current cyber curriculum and lessons and discuss strategies for improvement. Throughout the lessons that were reviewed, many common mistakes continued to pop up. These mistakes included age appropriateness, technology resources that were available, and consistency of student’s skill levels. Many of these lessons were written for the wrong grade levels. The ones written for the elementary level all had activities that assumed that every student in the class could read at grade level and also had background knowledge of the cyber activity at hand, which is not always the case. Another major mistake was that these lessons assumed that all schools had any kind of technology resource available to them. Some schools are 1:1, and others are only allotted three computers in their classroom where the students have to share. While coming up with a cyber-curriculum, it has to be kept in mind that not all schools are the same, not every classroom is the same. There are many students who are not reading at their grade level or have not had exposure to the digital world. We need to start slow and ease children into the cyber world. Once they have a better understanding, it will be easier to move forward with these lessons and get the students engaged. With a better understanding of common mistakes that are being made, a more robust curriculum and lessons can be created that no only spark a student’s interest in this much-needed career field but encourage learning while keeping our students safe from cyber-attacks.

Keywords: assumptions, cybersecurity, k-12, teacher

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Authors: Teresa Smith, Farrah Jacquez

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Health-risk behaviors (e.g., smoking, poor diet) directly increase the risk for chronic disease and morbidity. There is substantial evidence of a negative association between socioeconomic status (SES) and engagement in health-risk behaviors. However, due to the complexity of SES, researchers have suggested looking beyond this factor to fully understand the mechanisms that underlie engagement in health-risk behaviors. Stress is one plausible mechanism through which SES impacts health-risk behaviors. Currently, it remains unclear how stress occurring across the life course might impact health behaviors and explain the association between SES and these behaviors. To address the gaps in the literature, 172 adults between the ages of 18-49 were surveyed about their lifetime stress exposure, sociodemographic variables, and health-risk behaviors via an online recruitment portal, Prolific. Five major findings emerged from the current study. First, SES was negatively associated with engagement in health-risk behaviors and lifetime stress above and beyond current stress and other relevant demographics. Second, lifetime stress was significantly associated with health-risk behaviors above and beyond current stress and relevant demographic variables. Third, lifetime stress fully mediated the association between SES and health-risk behaviors above and beyond current stress and other demographics. Fourth, the severity of stress experienced emerged as the most significant lifetime stress variable that explains the relation between SES and health-risk behaviors. Fifth and finally, lower SES and experiencing financial and legal/crime stressors increased the likelihood of engaging in health-risk behaviors. The current study results align with previous research and suggest that stress occurring over the lifespan impacts the relation between SES and health-risk behaviors, which are in turn known to impact health outcomes. However, our findings move the current literature forward by providing a more nuanced understanding of the specific aspects of stress that influence this association. Specifically, the severity of stress experienced across the entire lifespan was the most important aspect of stress when examining the association between SES and health-risk behaviors. Further, individuals most at risk for engaging in health-risk behaviors are those of the lowest SES and experience financial and legal/crime stressors. These findings have the potential to inform interventions and policies aimed at addressing health-risk behaviors by providing a more sophisticated understanding of the impact of stress.

Keywords: stress, health behaviors, socioeconomic status, health

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Authors: Emily S. M. Chow

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The word ‘utopia’ was coined by Thomas More in Utopia (1516). Its Greek roots ‘ou’ means ‘not’ and ‘topos’ means ‘place.’ In other words, it literally refers to ‘no-place.’ However, the possibility of having an alternative and better future society has always been appealing. In fact, at the core of every utopianism is the search for a future alternative state with the anticipation of a better life. Nonetheless, the practicalities of such ideas have never ceased to be questioned. At times, building a utopia presents itself as a divisive act. In addition to the violence that must be employed to sweep away the old regime in order to make space for the new, all utopias carry within them the potential for bringing catastrophic consequences to human life. After all, every utopia seeks to remodel the individual in a very particular way for the benefit of the masses. In this sense, utopian thinking has the potential both to create and destroy the future. While writing during a traumatic transitional period in Zimbabwe’s history, Dambudzo Marechera witnessed an age of upheavals in which different parties battled for power over Zimbabwe. Being aware of the fact that all institutionalized narratives, be they originated from the governance of the UK, Ian Smith’s white minority regime or Zimbabwe’s revolutionary parties, revealed themselves to be nothing more than fiction, Marechera realized the impossibility of determining reality absolutely. As such, this thesis concerns the writing of the Zimbabwean maverick, Dambudzo Marechera. It argues that Marechera writes a unique vision of utopia. In short, for Marechera utopia is not a static entity but a moment of perpetual change. He rethinks utopia in the sense that he phrases it as an event that ceaselessly contests institutionalized and naturalized narratives of a post-colonial self and its relationship to society. Marechera writes towards a vision of an alternative future of the country. Yet, it is a vision that does not constitute a fully rounded sense of utopia. Being cautious about the world and the operation of power upon the people, rather than imposing his own utopian ideals, Marechera chooses to instead peeling away the narrative constitution of the self in relation to society in order to turn towards a truly radical utopian thinking that empowers the individual.

Keywords: African literature, Marechera, post-colonial literature, utopian studies

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Authors: Jasim Uddin, Rod Smith, Malcolm Gillies

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Surface irrigation is the most popular irrigation method all over the world. However, two issues: low efficiency and huge labour involvement concern irrigators due to scarcity in recent years. To address these issues, a smart automated furrow is conceptualised that can be operated using digital devices like smartphone, iPad or computer and a preliminary evaluation was conducted in this study. The smart automated system is the integration of commercially available software and hardware. It includes real-time surface irrigation optimisation software (SISCO) and Rubicon Water’s surface irrigation automation hardware and software. The automated system consists of automatic water delivery system with 300 mm flexible pipes attached to both sides of a remotely controlled valve to operate the irrigation. A water level sensor to obtain the real-time inflow rate from the measured head in the channel, advance sensors to measure the advance time to particular points of an irrigated field, a solar-powered telemetry system including a base station to communicate all the field sensors with the main server. On the basis of field data, the software (SISCO) is optimised the ongoing irrigation and determine the optimum cut-off for particular irrigation and send this information to the control valve to stop the irrigation in a particular (cut-off) time. The preliminary evaluation shows that the automated surface irrigation worked reasonably well without manual intervention. The evaluation of farmers managed irrigation events show the potentials to save a significant amount of water and labour. A substantial amount of economic and social benefits are expected in rural industries by adopting this system. The future outcome of this work would be a fully tested commercial adaptive real-time furrow irrigation system able to compete with the pressurised alternative of centre pivot or lateral move machines on capital cost, water and labour savings but without the massive energy costs.

Keywords: furrow irrigation, smart automation, infiltration, SISCO, real-time irrigation, adoptive control

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Authors: Joshua W. Edefo, Shafiul Azam, Murray D. Smith

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Introduction: In April 2022, the Welsh Government introduced the six goals for urgent and emergency care programs. One of these goals was to provide access to clinically safe alternatives, leading to the establishment of the Same Day Emergency Care (SDEC) program. The SDEC initiative aims to offer viable options that maintain patient safety while avoiding unnecessary hospital stays. The aim of the study is to determine the duration of patient stay in SDEC and compare it with that of Emergency department (ED) stay to ascertain if one of the objectives of SDEC is achieved. Methods: Patient stays and attendance datasets were constructed from Withybush SDEC and ED patient records. These records were provided by Hywel Dda University Health Board Informatics. Some hypothetical pathways were identified, notably SDEC visits involving a single attendance and ED visits then immediately transferred to SDEC. Descriptive statistics were used to summarise the data, and hypothesis tests for mean differences used the student t-test. Propensity scoring was employed to match a set of ED patient stays to SDEC patient stays which were then used to determine the average treatment effect (ATE) to compare durations of stay in SDEC with ED. Regression methods were used to model the natural logarithm of the duration of SDEC attendance, and the level of statistical significance was set to 0.05. Results: SDEC visits involving a single attendance (170 of 384; 44.3%) is the most frequently observed pathway with patient length of stay at 256 minutes (95%CI 237.4 - 275.1). The next most frequently observed pathway of patient stay was SDEC attendance after presenting to ED (80 of 384; 20.8%) and gave the length of stay of 440 minutes (95%CI 351.6 - 529.2). Time spent in this pathway significantly increased by 184 minutes (95%CI 118.0 - 250.2, support for no difference p<0.001) compared to the most seen pathway. When SDEC data were compared with ED, the estimate for the ATE from SDEC single attendance was -272 minutes (95%CI -334.1 - -210.5; p<0.001), while that of ED then SDEC pathway was -50.6 min (95%CI -182.7-81.5; p=0.453). Conclusion: When patients are admitted to SDEC and successfully discharged, their stays are significantly shorter, approximately 4.5 hours, compared to patients who spend their entire stay in the Emergency Department. That difference vanishes when the patient stay includes a period spent previously in ED before transfer to SDEC.

Keywords: attendance, emergency-department, patient-stay, same-day-emergency-care

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Authors: Sharein El-Tourky, Sharon Smith, Gary Hitchcock

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Effective fisheries management is necessarily dependent on the accuracy of fisheries models, which can be limited if they omit critical elements. One critical element in the formulation of these models is the trophic interactions at the larval stage of fish development. At this stage, fish mortality rates are at their peak and survival is often determined by resource limitation. Thus it is crucial to identify and quantify essential prey resources and determine how they vary in abundance and availability. The main resources larval fish consume are mesozooplankton. In the Straits of Florida, little is known about temporal and spatial variability of the mesozooplankton community despite its importance as a spawning ground for fish such as the Blue Marlin. To investigate mesozooplankton distribution patterns in the Straits of Florida, a transect of 16 stations from Miami to the Bahamas was sampled once a month in 2003 and 2004 at four depths. We found marked temporal and spatial variability in mesozooplankton biomass, diversity, and depth distribution. Mesozooplankton biomass peaked on the western boundary of the SOF and decreased gradually across the straits to a minimum at eastern stations. Midcurrent stations appeared to be a region of enhanced year-round variability, but limited seasonality. Examination of dominant zooplankton groups revealed groups could be parsed into 6 clusters based on abundance. Of these zooplankton groups, copepods were the most abundant zooplankton group, with the 20 most abundant species making up 86% of the copepod community. Copepod diversity was lowest at midcurrent stations and highest in the Eastern SOF. Interestingly, one copepods species, previously identified to compose up to 90% of larval blue marlin and sailfish diets in the SOF, had a mean abundance of less than 7%. However, the unique spatial and vertical distribution patterns of this copepod coincide with peak larval fish spawning periods and larval distribution, suggesting an important relationship requiring further investigation.

Keywords: mesozooplankton biodiversity, larval fish diet, food web, Straits of Florida, vertical distribution, spatiotemporal variability, cross-current comparisons, Gulf Stream

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Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

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Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

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Authors: Bahareh Yousefian, Laurel Smith Stvan

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Linguistic structures have two facades: form and meaning. These structures could have either literal meaning or figurative meaning (although it could also depend on the context in which that structure appears). The literal meaning is understandable more easily, but for the figurative meaning, a word or concept is understood from a different word or concept. In linguistic structures with a figurative meaning, it’s more difficult to relate their forms to the meanings than structures with literal meaning. In these cases, the relationship between form and figurative meaning could be studied from different perspectives. Various linguists have been curious about what happens in someone’s mind to understand figurative meaning through the forms; they have used different perspectives and theories to explain this process. It has been studied through cognitive linguistics as well, in which mind and mental activities are really important. In this viewpoint, meaning (in other words, conceptualization) is considered a mental process. In this descriptive-analytic study, 20 Persian compound nouns with figurative meanings have been collected from the Persian-language Moeen Encyclopedic Dictionary and other sources. Examples include [“Sofreh Xaneh”] (traditional restaurant) and [“Dast Yar”] (Assistant). These were studied in a cognitive semantics framework using “Conceptual Blending Theory” which hasn’t been tested on Persian compound nouns before. It was noted that “Conceptual Blending Theory” could lead to the process of understanding the figurative meanings of Persian compound nouns. Many cognitive linguists believe that “Conceptual Blending” is not only a linguistic theory but it’s also a basic human cognitive ability that plays important roles in thought, imagination, and even everyday life as well (though unconsciously). The ability to use mental spaces and conceptual blending (which is exclusive to humankind) is such a basic but unconscious ability that we are unaware of its existence and importance. What differentiates Conceptual Blending Theory from other ways of understanding figurative meaning, are arising new semantic aspects (emergent structure) that lead to a more comprehensive and precise meaning. In this study, it was found that Conceptual Blending Theory could explain reaching the figurative meanings of Persian compound nouns from their forms, such as [talkative for compound word of “Bolbol + Zabani” (nightingale + tongue)] and [wage for compound word of “Dast + Ranj” (hand + suffering)].

Keywords: cognitive linguistics, conceptual blending, figurative meaning, Persian compound nouns

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Authors: Tasneem Chopra

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The 1968 Summer Olympics will forever be remembered for the silent protest against racism exhibited by American athletes Tommy Smith and John Carlos. Also standing on the medal podium was Australian Peter Norman, whose silent solidarity as a white sportsman completes the powerful, evocative image of that night in Mexico City. In the 50 years since Norman’s stance of solidarity with his American counterparts, Australian sports has traveled a wide arc of racism narratives, with athletes still experiencing episodes of bigotry, both on the pitch and elsewhere. Aboriginal athletes, like tennis champion Yvonne Goolagong, have endured the plaudits of appreciation for their achievements on both the national and international stage, while simultaneously being subject to both prejudice and even questions as to their right to represent their country as full, acceptable citizens. Racism in Australia is directed toward Australian athletes of colour as well as foreign sportspeople who visit the country. The complex, mutating nature of racism in Australia is also informed by the culture of silence, where fellow athletes stand mute in light of their colleagues’ experience with bigotry. This paper analyses the phenomenon of sports racism in Australia over the past fifty years, culminating in the most recent showdown between Heretier Lumumba, former Collingwood football player, and his public allegations of racism experienced by team mates over his 10 year career. It shall examine the treatment and mistreatment of athletes because of their race and will further assess how such public perceptions both shape Australian culture or are themselves a manifestation of preexisting pathologies of bigotry. Further, it will examine the efficacy of anti-racism initiatives in responding to this hate. This paper will analyse the growing influence of corporate and media entities in crafting the economics of Australian sports and assess the role of such factors in creating the narrative of racism in the nation, both as a sociological reality as well as a marker of national identity. Finally, this paper will examine the political, social and economic forces that contribute to the culture of silence in Australian society in defying racism.

Keywords: aboriginal, Australia, corporations, silence

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Authors: S. MacDonald, A. Manuel, R. Law, N. Bandruak, A. Dubrowski, V. Curran, J. Smith-Young, K. Simmons, A. Warren

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High fidelity human patient simulation has been used for many years by health sciences education programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork among nursing, medicine and pharmacy undergraduate students. This study compared the impact of high fidelity and low fidelity simulation education on teamwork among nursing, medicine and pharmacy students. For the purpose of this study, two innovative teaching scenarios were developed based on the care of an adult patient experiencing acute anaphylaxis: one high fidelity using a human patient simulator and one low fidelity using case based discussions. A within subjects, pretest-posttest, repeated measures design was used with two-treatment levels and random assignment of individual subjects to teams of two or more professions. A convenience sample of twenty-four (n=24) undergraduate students participated, including: nursing (n=11), medicine (n=9), and pharmacy (n=4). The Interprofessional Teamwork Questionnaire was used to assess for changes in students’ perception of their functionality within the team, importance of interprofessional collaboration, comprehension of roles, and confidence in communication and collaboration. Student satisfaction was also assessed. Students reported significant improvements in their understanding of the importance of interprofessional teamwork and of the roles of nursing and medicine on the team after participation in both the high fidelity and the low fidelity simulation. However, only participants in the high fidelity simulation reported a significant improvement in their ability to function effectively as a member of the team. All students reported that both simulations were a meaningful learning experience and all students would recommend both experiences to other students. These findings suggest there is merit in both high fidelity and low fidelity simulation as a teaching and learning approach to foster teamwork among undergraduate nursing, medicine and pharmacy students. However, participation in high fidelity simulation may provide a more realistic opportunity to practice and function as an effective member of the interprofessional health care team.

Keywords: acute anaphylaxis, high fidelity human patient simulation, low fidelity simulation, interprofessional education

Procedia PDF Downloads 215

Authors: Jessica Gu, Yu Chen

Abstract:

Knowledge Management (KM) is undoubtable crucial to organizational value creation, learning, and adaptation. Although the rapidly growing KM domain has been fueled with full-fledged methodologies and technologies, studies on KM evolution that bridge the organizational performance and adaptation to the organizational environment are still rarely attempted. In particular, creation (or generation) and diffusion (or share/exchange) of knowledge are of the organizational primary concerns on the problem-solving perspective, however, the optimized distribution of knowledge creation and diffusion endeavors are still unknown to knowledge workers. This research proposed an agent-based model of knowledge creation and diffusion in an organization, aiming at elucidating how the intertwining knowledge flows at microscopic level lead to optimized organizational performance at macroscopic level through evolution, and exploring what exogenous interventions by the policy maker and endogenous adjustments of the knowledge workers can better cope with different environmental conditions. With the developed model, a series of simulation experiments are conducted. Both long-term steady-state and time-dependent developmental results on organizational performance, network and structure, social interaction and learning among individuals, knowledge audit and stocktaking, and the likelihood of choosing knowledge creation and diffusion by the knowledge workers are obtained. One of the interesting findings reveals a non-monotonic phenomenon on organizational performance under turbulent environment while a monotonic phenomenon on organizational performance under a stable environment. Hence, whether the environmental condition is turbulence or stable, the most suitable exogenous KM policy and endogenous knowledge creation and diffusion choice adjustments can be identified for achieving the optimized organizational performance. Additional influential variables are further discussed and future work directions are finally elaborated. The proposed agent-based model generates evidence on how knowledge worker strategically allocates efforts on knowledge creation and diffusion, how the bottom-up interactions among individuals lead to emerged structure and optimized performance, and how environmental conditions bring in challenges to the organization system. Meanwhile, it serves as a roadmap and offers great macro and long-term insights to policy makers without interrupting the real organizational operation, sacrificing huge overhead cost, or introducing undesired panic to employees.

Keywords: knowledge creation, knowledge diffusion, agent-based modeling, organizational performance, decision making evolution

Procedia PDF Downloads 217

Authors: Mohamed Ahmed Madkour, Haitham Magdy Hamad

Abstract:

This research aims to study of the surgery science and imaging in ancient Egypt, and how to diagnose the surgical cases, whether due to injuries or disease that requires surgical intervention, Medical diagnosis and how to treat it. The ancient Egyptian physician tried to change over from magic and theological thinking to become a stand-alone experimental science, they were able to distinguish between diseases and they divide them into internal and external diseases even this division exists to date in modern medicine. There is no evidence to recognize the amount of human knowledge in the prehistoric knowledge of medicine and surgery except skeleton. It is not far from the human being in those times familiar with some means of treatment, Surgery in the Stone age was rudimentary, Flint stone was used after trimming in a certain way as a lancet to slit and open the skin. Wooden tree branches were used to make splints to treat bone fractures. Surgery developed further when copper was discovered, it led to the advancement of Egyptian civilization, then modern and advanced tools appeared in the operating theater like a knife or a scalpel. The climate and environmental conditions have preserved medical papyri and human remains that have confirmed their knowledge of surgical methods including sedation. The ancient Egyptians reached a great importance in surgery, evidenced by the scenes that depict the pathological image and the surgical process, but the image alone is not sufficient to prove the pathology, its presence in ancient Egypt and its treatment method. As there are a number of medical papyri, especially Edwin Smith and Ebris, which prove the ancient Egyptian surgeon's knowledge of the pathological condition that It requires a surgical intervention, otherwise its diagnosis and the method of treatment will not be described with such accuracy through these texts. Some surgeries are described in the department of surgery at Ebris papyrus. The level of surgery in ancient Egypt was high, and they performed surgery such as hernias and Aneurysm, however we have not received a lengthy explanation of the various surgeries and the surgeon has usually only said “treated surgically”. It is evident in the Ebris papyrus that they used sharp surgical tools and cautery in operations where bleeding is expected, such as hernias, arterial sacs and tumors.

Keywords: ancient Egypt, archaeology, Egyptian history, ancient asurgical imaging, Egyptian civilization, civilization

Procedia PDF Downloads 49

Authors: Jessica Ding

Abstract:

The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.

Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM

Procedia PDF Downloads 122

Authors: Ahmed Hefny Mohamed El-Badwy

Abstract:

This research aims to study of the surgery science and imaging in ancient Egypt, and how to diagnose the surgical cases, whether due to injuries or disease that requires surgical intervention, Medical diagnosis and how to treat it. The ancient Egyptian physician tried to change over from magic and theological thinking to become a stand-alone experimental science, they were able to distinguish between diseases, and they divide them into internal and external diseases even this division exists to date in modern medicine. There is no evidence to recognize the amount of human knowledge in the prehistoric knowledge of medicine and surgery except skeleton. It is not far from the human being in those times familiar with some means of treatment, Surgery in the Stone age was rudimentary, Flint stone was used after trimming in a certain way as a lancet to slit and open the skin. Wooden tree branches were used to make splints to treat bone fractures. Surgery developed further when copper was discovered, it led to the advancement of Egyptian civilization, then modern and advanced tools appeared in the operating theater, like a knife or a scalpel, there is evidence of surgery performed in ancient Egypt during the dynastic period (323 – 3200 BC). The climate and environmental conditions have preserved medical papyri and human remains that have confirmed their knowledge of surgical methods, including sedation. The ancient Egyptians reached a great importance in surgery, evidenced by the scenes that depict the pathological image and the surgical process, but the image alone is not sufficient to prove the pathology, its presence in ancient Egypt and its treatment method. As there are a number of medical papyri, especially Edwin Smith and Ebris, which prove the ancient Egyptian surgeon's knowledge of the pathological condition that It requires a surgical intervention, otherwise, its diagnosis and the method of treatment will not be described with such accuracy through these texts. Some surgeries are described in the department of surgery at Ebris papyrus (recipes from 863 to 877). The level of surgery in ancient Egypt was high, and they performed surgery such as hernias and Aneurysm, however, we have not received a lengthy explanation of the various surgeries, and the surgeon has usually only said “treated surgically”. It is evident in the Ebris papyrus that they used sharp surgical tools and cautery in operations where bleeding is expected, such as hernias, arterial sacs and tumors.

Keywords: ancientegypt, egypt, archaeology, the ancient egyptian

Procedia PDF Downloads 44

Authors: Rajendra Chetty

Abstract:

Decolonial aesthetics departs and delinks from colonial ideas about ‘the arts’ and the modernist/colonial work of aesthetics. Education is trapped in the western epistemic and hermeneutical vocabulary, hence it is necessary to introduce new concepts and work the entanglement between co-existing concepts. This paper will discuss the contribution of Ronnie Govender, a South African writer, to build decolonial sensibilities and delink from the grand narrative of the colonial and apartheid literary landscape in Govender’s text, At the Edge and other Cato Manor Stories. Govender uses the world of art to make a decolonial statement. Decolonial artists have to work in the entanglement of power and engage with a border epistemology. Govender’s writings depart from an embodied consciousness of the colonial wound and moves toward healing. Border thinking and doing (artistic creativity) is precisely the decolonial methodology posited by Linda T. Smith, where theory comes in the form of storytelling. Govender’s stories engage with the wounds infringed by racism and patriarchy, two pillars of eurocentric knowing, sensing, and believing that sustain a structure of knowledge. This structure is embedded in characters, institutions, languages that regulate and mange the world of the excluded. Healing is the process of delinking, or regaining pride, dignity, and humanity, not through the psychoanalytic cure, but the popular healer. The legacies of the community of Cato Manor that was pushed out of their land are built in his stories. Decoloniality then is a concept that carries the experience of liberation struggles and recognizes the strenuous conditions of marginalized people together with their strength, wisdom, and endurance. Govender’s unique performative prose reconstructs and resurrects the lives of the people of Cato Manor, their vitality and humor, pain and humiliation: a vibrant and racially integrated community destroyed by the regime’s notorious racial laws. The paper notes that Govender’s objective with his plays and stories was to open windows to both the pain and joy of life; a mission that is not didactic but to shine a torch on both mankind’s waywardness as well as its inspiring and often moving achievements against huge odds.

Keywords: Govender, decoloniality, delinking, exclusion, racism, Cato Manor

Procedia PDF Downloads 133

Authors: Haitham Nabil Zaghlol Hasan

Abstract:

This research aims to study of the surgery science and imaging in ancient Egypt and how to diagnose the surgical cases, whether due to injuries or disease that requires surgical intervention, Medical diagnosis and how to treat it. The ancient Egyptian physician tried to change over from magic and theological thinking to become a stand-alone experimental science, they were able to distinguish between diseases, and they divide them into internal and external diseases even though this division exists to date in modern medicine. There is no evidence to recognize the amount of human knowledge in the prehistoric knowledge of medicine and surgery except skeleton. It is not far from the human being in those times familiar with some means of treatment, Surgery in the Stone age was rudimentary, Flint stone was used after trimming in a certain way as a lancet to slit and open the skin. Wooden tree branches were used to make splints to treat bone fractures. Surgery developed further when copper was discovered, it led to the advancement of Egyptian civilization, then modern and advanced tools appeared in the operating theater, like a knife or a scalpel, there is evidence of surgery performed in ancient Egypt during the dynastic period (323 – 3200 BC). The climate and environmental conditions have preserved medical papyri and human remains that have confirmed their knowledge of surgical methods, including sedation. The ancient Egyptians reached great importance in surgery, evidenced by the scenes that depict the pathological image and the surgical process, but the image alone is not sufficient to prove the pathology, its presence in ancient Egypt and its treatment method. As there are a number of medical papyri, especially Edwin Smith and Ebris, which prove the ancient Egyptian surgeon's knowledge of the pathological condition that It requires surgical intervention, otherwise, its diagnosis and the method of treatment will not be described with such accuracy through these texts. Some surgeries are described in the department of surgery at Ebris papyrus (recipes from 863 to 877). The level of surgery in ancient Egypt was high, and they performed surgery such as hernias and Aneurysm, however, we have not received a lengthy explanation of the various surgeries, and the surgeon has usually only said: “treated surgically”. It is evident in the Ebris papyrus that they used sharp surgical tools and cautery in operations where bleeding is expected, such as hernias, arterial sacs and tumors.

Keywords: egypt, ancient_egypt, civilization, archaeology

Procedia PDF Downloads 44

Authors: Simona Grasso, Gabrielle Smith, Sophie Bowers, Oluseyi Moses Ajayi, Mark Swainson

Abstract:

Hybrid meat analogues are meat products whereby a proportion of meat has been partially replaced by more sustainable protein sources. These products could bridge the gap between meat and meat-free products, providing convenience, and allowing consumers to continue using meat products as they conventionally would, while lowering their overall meat intake. The study aimed to investigate the effect of introducing texturized soy protein (TSP) at different levels (15% and 30%) with and without nutritional yeast as flavour enhancer on the sensory and instrumental quality of beef meatballs, compared to a soy and yeast-free control. Proximate analysis, yield, colour, instrumental texture, and sensory quality were investigated. The addition of soy and yeast did not have significant effects on the overall protein content, but the total fat and moisture content went down with increasing soy substitution. Samples with 30% TSP had significantly higher yield than the other recipes. In terms of colour, a* redness values tended to go down and b* yellowness values tended to go up with increasing soy addition. The addition of increasing levels of soy and yeast modified the structure of meatballs resulting in a progressive decrease in hardness and chewiness compared to control. Sixty participants assessed the samples using Check-all-that-apply (CATA) questions and hedonic scales. The texture of all TSP-containing samples received significantly higher acceptability scores than control, while 15% TSP with yeast received significantly higher flavour and overall acceptability scores than control. Control samples were significantly more often associated than the other recipes to the term 'hard' and the least associated to 'soft' and 'crumbly and easy to cut'. All recipes were similarly associated to the terms 'weak meaty', 'strong meaty', 'characteristic' and 'unusual'. Correspondence analysis separated the meatballs in three distinct groups: 1) control; 2) 30%TSP with yeast; and 3) 15%TSP, 15%TSP with yeast and 30%TSP located together on the sensory map, showing similarity. Adding 15-30% TSP with or without yeast inclusion could be beneficial for the development of future meat hybrids with acceptable sensory quality. These results can provide encouragement for the use of the hybrid concept by the meat industry to promote the partial substitution of meat in flexitarians’ diets.

Keywords: CATA, hybrid meat products, texturised soy protein, yeast

Procedia PDF Downloads 137

Authors: Deborah L. Smith

Abstract:

To review our program and determine the best redesign options, department members gathered feedback and input through focus groups, analysis of data, and a review of the current research to ensure that the changes proposed were not based solely on the state’s new professional standards. In designing course assignments and assessments, we listened to a variety of constituents, including students, other institutions of higher learning, MDE webinars, host teachers, literacy clinic personnel, and other disciplinary experts. As a result, we are designing a program that is more inclusive of a variety of field experiences for growth. We have determined ways to improve our program by connecting academic disciplinary knowledge, educational psychology, and community building both inside and outside the classroom for professional learning communities. The state’s release of new professional standards led my department members to question what is working and what needs improvement in our program. One aspect of our program that continues to be supported by research and data analysis is the function of supervised field experiences with meaningful feedback. We seek to expand in this area. Other data indicate that we have strengths in modeling a variety of approaches such as cooperative learning, discussions, literacy strategies, and workshops. In the new program, field assignments will be connected to multiple courses, and efforts to scaffold student learning to guide them toward best evidence-based practices will be continuous. Despite running a program that meets multiple sets of standards, there are areas of need that we directly address in our redesign proposal. Technology is ever-changing, so it’s inevitable that improving digital skills is a focus. In addition, scaffolding procedures for English Language Learners (ELL) or other students who struggle is imperative. Diversity, equity, and inclusion (DEI) has been an integral part of our curriculum, but the research indicates that more self-reflection and a deeper understanding of culturally relevant practices would help the program improve. Connections with professional learning communities will be expanded, as will leadership components, so that teacher candidates understand their role in changing the face of education. A pilot program will run in academic year 22/23, and additional data will be collected each semester through evaluations and continued program review.

Keywords: DEI, field experiences, program redesign, teacher preparation

Procedia PDF Downloads 138

Authors: Jessica Scher Lisa, Eric Shyman

Abstract:

Autism spectrum disorder (ASD) is a neuro-developmental disorder that is characterized by persistent deficits in social communication and social interaction (i.e. deficits in social-emotional reciprocity, nonverbal communicative behaviors, and establishing/maintaining social relationships), as well as by the presence of repetitive behaviors and perseverative areas of interest (i.e. stereotyped or receptive motor movements, use of objects, or speech, rigidity, restricted interests, and hypo or hyperactivity to sensory input or unusual interest in sensory aspects of the environment). Additionally, diagnoses of ASD require the presentation of symptoms in the early developmental period, marked impairments in adaptive functioning, and a lack of explanation by general intellectual impairment or global developmental delay (although these conditions may be co-occurring). Over the past several decades, many theories have been developed in an effort to explain the root cause of ASD in terms of atypical central cognitive processes. The field of neuroscience is increasingly finding structural and functional differences between autistic and neurotypical individuals using neuro-imaging technology. One main area this research has focused upon is in visuospatial processing, with specific attention to the notion of ‘weak central coherence’ (WCC). This paper offers an analysis of findings from selected studies in order to explore research that challenges the ‘deficit’ characterization of a weak central coherence theory as opposed to a ‘superiority’ characterization of strong local coherence. The weak central coherence theory has long been both supported and refuted in the ASD literature and has most recently been increasingly challenged by advances in neuroscience. The selected studies lend evidence to the notion of amplified localized perception rather than deficient global perception. In other words, WCC may represent superiority in ‘local processing’ rather than a deficit in global processing. Additionally, the right hemisphere and the specific area of the extrastriate appear to be key in both the visual and lexicosemantic process. Overactivity in the striate region seems to suggest inaccuracy in semantic language, which lends itself to support for the link between the striate region and the atypical organization of the lexicosemantic system in ASD.

Keywords: autism spectrum disorder, neurology, visual processing, weak coherence

Procedia PDF Downloads 100

Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

Abstract:

Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

Procedia PDF Downloads 204

Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz

Abstract:

Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.

Keywords: COVID-19 pandemic, patient agitation, restraints, violence

Procedia PDF Downloads 113

Authors: Ana Paula S. A. Correa, Allan K. R. Galardo, Luana A. Lima, Talita F. Sobral, Josiane N. Muller, Jessica F. S. Barroso, Nercy V. R. Furtado, Ednaldo C. Rêgo., Jose B. P. Lima

Abstract:

Malaria is a public health problem in the Brazilian Legal Amazon. Among the integrated approaches for anopheline control, the Indoor Residual Spraying (IRS) remains one of the main tools in the basic strategy applied in the Amazonian States, where the National Malaria Control Program currently uses one of the insecticides from the pyrethroid class, the Etofenprox WP. Understanding the residual efficacy of insecticides on different surfaces is essential to determine the spray cycles, in order to maintain a rational use and to avoid product waste. The aim of this study was to evaluate the residual efficacy of Etofenprox - VECTRON ® 20 WP on surfaces of Unplastered Cement (UC) and Unpainted Wood (UW) on panels, in field, and in semi-field evaluation of Brazil’s Amapa State. The evaluation criteria used was the cone bioassay test, following the World Health Organization (WHO) recommended method, using plastic cones and female mosquitos of Anopheles sp. The tests were carried out in laboratory panels, semi-field evaluation in a “test house” built in the Macapa municipality, and in the field in 20 houses, being ten houses per surface type (UC and UW), in an endemic malaria area in Mazagão’s municipality. The residual efficacy was measured from March to September 2017, starting one day after the spraying, repeated monthly for a period of six months. The UW surface presented higher residual efficacy than the UC. In fact, the UW presented a residual efficacy of the insecticide throughout the period of this study with a mortality rate above 80% in the panels (= 95%), in the "test house" (= 86%) and in field houses ( = 87%). On the UC surface it was observed a mortality decreased in all the tests performed, with a mortality rate of 45, 47 and 29% on panels, semi-field and in field, respectively; however, the residual efficacy ≥ 80% only occurred in the first evaluation after the 24-hour spraying bioassay in the "test house". Thus, only the UW surface meets the specifications of the World Health Organization Pesticide Evaluation Scheme (WHOPES) regarding the duration of effective action (three to six months). To sum up, the insecticide residual efficacy presented variability on the different surfaces where it was sprayed. Although the IRS with Etofenprox WP was efficient on UW surfaces, and it can be used in spraying cycles at 4-month intervals, it is important to consider the diversity of houses in the Brazilian Legal Amazon, in order to implement alternatives for vector control, including the evaluation of new products or different formulations types for insecticides.

Keywords: Anopheles, vector control, insecticide, bioassay

Procedia PDF Downloads 138

Authors: Lesley Northrop, Justin DeGrazia, Jessica Greenwood

Abstract:

ASPIRA Labs now offers an en-suit and ready-to-implement technology transfer solution to enable labs and hospitals that lack the resources to build it themselves to offer in-house genetic testing. This unique platform employs a patented Molecular Inversion Probe (MIP) technology that combines the specificity of a hybrid capture protocol with the ease of an amplicon-based protocol and utilizes an advanced bioinformatics analysis pipeline based on machine learning. To demonstrate its efficacy, two independent genetic tests were validated on this technology transfer platform: expanded carrier screening (ECS) and hereditary cancer testing (HC). The analytical performance of ECS and HC was validated separately in a blinded manner for calling three different types of variants: SNVs, short indels (typically, <50 bp), and large indels/CNVs defined as multi-exonic del/dup events. The reference set was constructed using samples from Coriell Institute, an external clinical genetic testing laboratory, Maine Molecular Quality Controls Inc. (MMQCI), SeraCare and GIAB Consortium. Overall, the analytical performance showed a sensitivity and specificity of >99.4% for both ECS and HC in detecting SNVs. For indels, both tests reported specificity of 100%, and ECS demonstrated a sensitivity of 100%, whereas HC exhibited a sensitivity of 96.5%. The bioinformatics pipeline also correctly called all reference CNV events resulting in a sensitivity of 100% for both tests. No additional calls were made in the HC panel, leading to a perfect performance (specificity and F-measure of 100%). In the carrier panel, however, three additional positive calls were made outside the reference set. Two of these calls were confirmed using an orthogonal method and were re-classified as true positives leaving only one false positive. The pipeline also correctly identified all challenging carrier statuses, such as positive cases for spinal muscular atrophy and alpha-thalassemia, resulting in 100% sensitivity. After confirmation of additional positive calls via long-range PCR and MLPA, specificity for such cases was estimated at 99%. These performance metrics demonstrate that this tech-transfer solution can be confidently internalized by clinical labs and hospitals to offer mainstream ECS and HC as part of their test catalog, substantially increasing access to quality germline genetic testing for labs of all sizes and resources levels.

Keywords: clinical genetics, genetic testing, molecular genetics, technology transfer

Procedia PDF Downloads 155