Search results for: patient perspectives

Authors: Kin Yan Ho

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Negative brand news (such as Volkswagen’s faulty carbon emission reports, China’s Luckin Coffee scandal, and bribery in reputable US universities) influence how people perceive a company. Germany’s citizens claimed Volkswagen’s scandal as a national embarrassment and cannot recover their psychological damages through monetary and non-monetary compensation. The main research question is to examine how consumers evaluate and respond to embarrassing brand publicity. The cognitive appraisal theory is used as a theoretical foundation. This study describes the use of scenario-based experiment. The findings suggest that consumers with different levels of embarrassment evaluate brand remedial offers from emotion-focused and task-focused restorative justice perspectives (newly derived from the well-established scales of perceived justice). When consumers face both negative and positive brand information (i.e., negative publicity news and a remedial offer), they change their appraisal criterion. The social situation in the cognitive reappraisal process influences the quality of the customer-brand relationship and the customer’s recovery from brand embarrassment. The results also depict that the components of recovery compensation cause differences in emotion recovery, relationship quality, and repurchase intentions. This study extends embarrassment literature in an embarrassing brand publicity context. The emotional components of brand remedial tactics provide insights to brand managers on how to handle different consumers’ emotions, consumer satisfaction, and foster positive future behavior.

Keywords: brand relationship quality, cognitive appraisal, crisis communications, emotion, justice, social presence

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Authors: Maryam Borjali

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Introduction. Mortality due to noncommunicable diseases has increased in the world today with the advent of demographic shifts, growing age, and lifestyle patterns in the world, which have been affected by economic and social crises. Congenital heart defects are one of the forms of diseases that have raised infant mortality worldwide. e objective of present study was to identify nonmedical determinants related to this abnormality from the mother’s perspectives. Methods. is research was a qualitative study and the data collection method was a semistructured interview with mothers who had children with congenital heart diseases referring to the Shahid Rajaei Heart Hospital in Tehran, Iran. A thematic analysis approach was employed to analyze transcribed documents assisted by MAXQDA Plus version 12. Results. Four general themes and ten subthemes including social contexts (social harms, social interactions, and social necessities), psychological contexts (mood disorders and mental well-being), cultural contexts (unhealthy lifestyle, family culture, and poor parental health behaviors), and environmental contexts (living area and polluted air) were extracted from interviews with mothers of children with congenital heart diseases. Conclusions. Results suggest that factors such as childhood poverty, lack of parental awareness of congenital diseases, lack of proper nutrition and health facilities, education, and lack of medical supervision during pregnancy were most related with the birth of children with congenital heart disease from mothers’ prospective. In this regard, targeted and intersectorial collaborations are proposed to address nonmedical determinants related to the incidence of congenital heart diseases.

Keywords: congenital_cou, cultural, social, platform

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Authors: Mara Gabrielli, Jordi Pamies Rovira

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From a theoretical and interdisciplinary approach to visual ethnography and visual anthropology, this small scale, in-depth study explores the potential of photography as a participatory ethnographic method for a deep-understanding of the socio-educational integration of young refugees and asylum-seekers in the host society as regards their daily experiences, their needs, desires, expectations, and future goals. Qualitative data is collected by the author by observing 12 young participants in the age group 12-24 years per week for 12 months. The data consists of field notes, participatory observation, in-depth interviews with professionals, and the use of visual participatory ethnographic methods. Therefore, the young participants build their stories through the implementation of two participatory photographic methods - the 'photo-diary' and the 'photo-elicitation' - that permit them to analyse and narrate their social and educational experiences from their perspectives, thus collaborating in the construction of knowledge during the different stages of the research. Preliminary findings show the high resilience and social adaptability of young refugees and asylum-seekers to achieve their goals and overcome structural and socio-cultural barriers. However, the uncertainty of their administrative situation during the asylum submission and the lack of specific resources might impact negatively on their educational pathways and the transition to the labour market. Finally, this study also highlights the benefits of participatory photographic methods in ethnographic research, which impacts positively the well-being of these young people, helps them to develop critical thinking, and it also allows them to access information more respectfully when narrating painful experiences.

Keywords: photo-diary, photo-elicitation, resilience, strategies, visual methodologies, young refugees and asylum seekers

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Authors: Tahsien Okasha

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Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page.". The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: organ transplant, clinical pathway, postoperative care, same page

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Authors: Lowai Abed

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The differences in languages play a big role in cross-cultural communication. If meanings are not translated accurately, the risk can be crucial not only on an interpersonal level, but also on the international and political levels. The use of metaphorical language by politicians can cause great confusion, often leading to statements being misconstrued. In these situations, it is the translators who struggle to put forward the intended meaning with clarity and this makes translation an important field to study and analyze when it comes to cross-cultural communication. Owing to the growing importance of language and the power of translation in politics, this research analyzes part of President Bush’s speech in 2001 in which he used the word “Crusade” which caused his statement to be misconstrued. The research uses a discourse analysis of cross-cultural communication literature which provides answers supported by historical, linguistic, and communicative perspectives. The first finding indicates that the word ‘crusade’ carries different meaning and significance in the narratives of the Western world when compared to the Middle East. The second one is that, linguistically, maintaining cultural meanings through translation is quite difficult and challenging. Third, when it comes to the cross-cultural communication perspective, the common and frequent usage of literal translation is a sign of poor strategies being followed in translation training. Based on the example of Bush’s speech, this paper hopes to highlight the weak practices in translation in cross-cultural communication which are still commonly used across the world. Translation studies have to take issues such as this seriously and attempt to find a solution. In every language, there are words and phrases that have cultural, historical and social meanings that are woven into the language. Literal translation is not the solution for this problem because that strategy is unable to convey these meanings in the target language.

Keywords: crusade, metaphor, mistranslation, war in terror

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Authors: Sheng-Bo Zhang, Huan-Hao Zhang, Zhi-Hua Chen, Chun Zheng

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In this paper, the Richtmyer-Meshkov instability has been studied numerically by using the high-resolution Roe scheme based on the two-dimensional unsteady Euler equation, which was caused by the interaction between shock wave and the helium circular light gas cylinder with different component distributions. The numerical results further discuss the deformation process of the gas cylinder, the wave structure of the flow field and quantitatively analyze the characteristic dimensions (length, height, and central axial width) of the gas cylinder, the volume compression ratio of the cylinder over time. In addition, the flow mechanism of shock-driven interface gas mixing is analyzed from multiple perspectives by combining it with the flow field pressure, velocity, circulation, and gas mixing rate. Then the effects of different initial component distribution conditions on interface instability are investigated. The results show when the diffusion interface transit to the sharp interface, the reflection coefficient gradually increases on both sides of the interface. When the incident shock wave interacts with the cylinder, the transmission of the shock wave will transit from conventional transmission to unconventional transmission. At the same time, the reflected shock wave is gradually strengthened, and the transmitted shock wave is gradually weakened, which leads to an increase in the Richtmyer-Meshkov instability. Moreover, the Atwood number on both sides of the interface also increases as the diffusion interface transit to the sharp interface, which leads to an increase in the Rayleigh-Taylor instability and the Kelvin-Helmholtz instability. Therefore, the increase in instability will lead to an increase the circulation, resulting in an increase in the growth rate of gas mixing rate.

Keywords: shock wave, He light cylinder, Richtmyer-Meshkov instability, Gaussian distribution

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Authors: Ashlesha Khanapure, Harsh Kashyap, Abhinav Anand, Sanjana Habib, Anupama Bidargaddi

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Technologies that are developing quickly are being developed daily in a variety of disciplines, particularly the medical field. For the purpose of detecting bone fractures in X-ray pictures of different body segments, our work compares the ResNet-50 and MobileNetV3 architectures. It evaluates accuracy and computing efficiency with X-rays of the elbow, hand, and shoulder from the MURA dataset. Through training and validation, the models are evaluated on normal and fractured images. While ResNet-50 showcases superior accuracy in fracture identification, MobileNetV3 showcases superior speed and resource optimization. Despite ResNet-50’s accuracy, MobileNetV3’s swifter inference makes it a viable choice for real-time clinical applications, emphasizing the importance of balancing computational efficiency and accuracy in medical imaging. We created a graphical user interface (GUI) for MobileNet V3 model bone fracture detection. This research underscores MobileNetV3’s potential to streamline bone fracture diagnoses, potentially revolutionizing orthopedic medical procedures and enhancing patient care.

Keywords: CNN, MobileNet V3, ResNet-50, healthcare, MURA, X-ray, fracture detection

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Authors: Nika GorgoShadze, Anri Shainidze, Bachuki Katamadze

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In parallel to the development of the digital economy in the world, electronic commerce is also widely developing. Internet and ICT (information and communication technology) have created new business models as well as promoted to market consolidation, sustainability of the business environment, creation of digital economy, facilitation of business and trade, business dynamism, higher competitiveness, etc. Electronic commerce involves internet technology which is sold via the internet. Nowadays electronic commerce is a field of business which is used by leading world brands very effectively. After the research of internet market in Georgia, it was found out that quality of internet is high in Tbilisi and is low in the regions. The internet market of Tbilisi can be evaluated as high-speed internet service, competitive and cost effective internet market. Development of electronic commerce in Georgia is connected with organizational and methodological as well as legal problems. First of all, a legal framework should be developed which will regulate responsibilities of organizations. The Ministry of Economy and Sustainable Development will play a crucial role in creating legal framework. Ministry of Justice will also be involved in this process as well as agency for data exchange. Measures should be taken in order to make electronic commerce in Georgia easier. Business companies may be offered some model to get low-cost and complex service. A service centre should be created which will provide all kinds of online-shopping. This will be a rather interesting innovation which will facilitate online-shopping in Georgia. Development of electronic business in Georgia requires modernized infrastructure of telecommunications (especially in the regions) as well as solution of institutional and socio-economic problems. Issues concerning internet availability and computer skills are also important.

Keywords: electronic commerce, internet market, electronic business, information technology, information society, electronic systems

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Authors: Aofan Liu, Qianqian Tan, Burra Venkata Durga Kumar

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Data security is of the utmost importance in the healthcare area, as sensitive patient information is constantly sent around and analyzed by many different parties. The use of federated learning, which enables data to be evaluated locally on devices rather than being transferred to a central server, has emerged as a potential solution for protecting the privacy of user information. To protect against data breaches and unauthorized access, federated learning alone might not be adequate. In this context, the application of blockchain technology could provide the system extra protection. This study proposes a distributed federated learning system that is built on blockchain technology in order to enhance security in healthcare. This makes it possible for a wide variety of healthcare providers to work together on data analysis without raising concerns about the confidentiality of the data. The technical aspects of the system, including as the design and implementation of distributed learning algorithms, consensus mechanisms, and smart contracts, are also investigated as part of this process. The technique that was offered is a workable alternative that addresses concerns about the safety of healthcare while also fostering collaborative research and the interchange of data.

Keywords: data privacy, distributed system, federated learning, machine learning

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Authors: Lamia Bouzgarrou, Amira Omrane, Naima Bouatay, Chaima Harrathi, Samia Machroughl, Ahmed Mhalla

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Background and Aims: Professionals of health care sector are exposed to psychosocial constraints like stress, harassment, violence, which can lead to many mental health problems such as, depression, addictive behavior, and burn-out. Moreover, it’s well established that caregivers affected to intensive care units are more likely to experience such constraints and mental health problems. For these caregivers, the mental health state may affect care quality and patient’s safety. This study aims either to identify occupational psychosocial constraints and their mental health consequences among paramedical and medical caregivers affected to intensive units in Tunisian public hospital. Methods: An exhaustive three months cross-sectional study conducted among medical and paramedical staffs of intensive care units in three Tunisian university hospitals. After informed consent collection, we evaluated work-related stress, workplace harassment, depression, anxious troubles, addictive behavior, and self-esteems through an anonymous self-completed inquiry form. Five validated questionnaires and scales were included in this form: Karasek's Job Content Questionnaire, Negative Acts Questionnaire, Rosenberg, Beck depression inventory and Hamilton Anxiety scale. Results: We included 129 intensive unit caregivers; with a mean age of 36.1 ± 1.1 years and a sex ratio of 0.58. Among these caregivers, 30% were specialist or under-specialization doctors. The average seniority in the intensive care was 6.1 ± 1.2 (extremes=1 to 40 years). Atypical working schedules were noted among 36.7% of the subjects with an imposed choice in 52.4% of cases. During the last 12 months preceding the survey, 51.7% of care workers were absent from work because of a health problem with stops exceeding 15 days in 11.7%. Job strain was objective among 15% of caregivers and 38.33% of them were victims of moral harassment. A low or very low self-esteem was noted among 40% of respondents. Moreover, active smoking was reported by 20% subjects, alcohol consumption by 13.3% and psychotropic substance use by 1.7% of them. According to Beck inventory and Hamilton Anxiety scale, we concluded that 61.7% of intensive care providers were depressed, with 'severe' depression in 13.3% of cases and 49.9% of them present anxious disorders. Multivariate analysis objective that, job strain was correlated with young age (p=0.005) and shorter work seniority (p=0.001). Workplace and moral harassment was more prevalent among females (p=0.009), under-specialization doctor (p=0.021), those affected to atypical schedules (p=0.008). Concerning depression, it was more prevalent among staff in job strain situation (p = 0.004), among smokers caregivers (p = 0.048), and those with no leisure activity (p < 0.001). Anxious disorders were positively correlated to chronic diseases history (p = 0.001) and work-bullying exposure (p = 0.004). Conclusions: Our findings reflected a high frequency of caregivers who are under stress at work and those who are victims of moral harassment. These health professionals were at increased risk for developing psychiatric illness such depressive and anxious disorders and addictive behavior. Our results suggest the necessity of preventive strategies of occupational psychosocial constraints in order to preserve professional’s mental health and maximize patient safety and quality of care.

Keywords: health care sector, intensive care units, mental health, psychosocial constraints

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Authors: Aysegul Evren Yapicioglu

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The social roles and responsibilities expected from citizens are increasing due to changing global living conditions. Science education is expected to prepare conscious and sensitive students. Because today’s students are the adults of future. Precondition of this task is Teacher Education. In the past decade, one of the most important research field is socioscientific issues. This study deals with advantages and disadvantages of socioscientific issue based instruction in science classroom according to pre-service science teachers’ views. A case study approach that is one of the qualitative research design was used to explore their views. Fourteen pre-service science teachers participated to instruction process. Dolphinariums, Kyoto Protocol, genetically modified organisms, recyclable black bags’ benefits and damages, genetic tests, alternative energy sources and organ donation are examples of socioscientific issues, which were taught through activities in a special teaching course. Diaries and focus group interview were used as data collection tools. As a result of the study, the advantages of socioscientific issue based instruction in science classroom comprise of six sub-categories which are multi-skilling, social awareness development of thinking, meaningful learning, character and professional development, contribution of scientific literacy whereas disadvantages of this instruction process are challenges teachers and students, limitations of teaching and learning process in pre-service science teachers’ perspectives. Finally, this study contributes to science teachers and researchers to overcome disadvantages and benefit from the advantage of socioscientific issue based instruction in science classroom.

Keywords: science education, socioscientific issues, socioscientific issue based instruction, pre-service science teacher

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Authors: Haira Rizka, Imas Istiani

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The way women and men use language is an interesting topic to discuss. Nowadays, Instagram shows many videos which illustrate the difference of women’s and men’s language. Furthermore, the videos show how different genders behave in daily communication. This research aims to (1) investigate conversational characteristics of women represented in Indonesian Instagram videos, and (2) investigate how different genders behave in daily communication. To analyze the two research problems, this research employs Tannen’s theory of language and gender (1996). This is a descriptive qualitative research which describes phenomena of language and gender shown in Indonesian Instagram videos. The data were collected through observation. The collected data were then analyzed by employing ethnography and textual analysis. The research results show that in Indonesian Instagram videos, women dominate the conversation than men. Women’s are portrayed as a figure who are talkative, never wrong, and sensitive. Women’s dominating men proves that women always want to be understood, produce more words than men, and are more creative in producing verbal communication. Meanwhile, men are portrayed as calm, gentle, and patient creature who listen to women’s talk. Furthermore, men are portrayed to prefer being silent for avoiding conflict.

Keywords: gender, Instagram videos, language variety, women's language

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Authors: Marilei Amadeu Sabino

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Idiomatic expressions are linguistic phraseologisms present in natural languages. Known to be metaphorical linguistic combinations, a good majority of them provide elements that reveal important cultural aspects of their linguistic community through their metaphors. With the advent of Cognitive Linguistics (more specifically of Cognitive Semantics), the metaphor ceased to be related to poetic language and rhetorical embellishment and came to be seen as part of simple everyday language, reflecting the way human beings think, act and conceive reality, i. e., a fundamental mechanism of human conceptualizations of the world. In this sense, it came to be conceived as an inevitable mechanism for representing the nature of thought and language. The speakers, in conceptualizing reality, often use metaphorically parts of the body in expressions known as somatic. Several conceptual metaphors appear to be potentially universal or near-universal, because people across the world share certain bodily experiences. In these terms, many linguistic metaphors may be identical or very similar in several languages. These similarities, according to the Theory of Conceptual Metaphor, derive from universal aspects of the human body. Thus, this research aims to investigate the nature of some metaphors underlying somatic idiomatic expressions of Portuguese, Italian and English languages, establishing a pattern of similarities and differences among them from a trilingual perspective. The analysis shows that much of the studied expressions are really structurally, semantically and metaphorically identical or similar in the three languages. These findings incite relevant discussions concerning mother and foreign language learning and aim to contribute to the teaching of phraseological Lexicon as well as to materials development in mono and multilingual perspectives.

Keywords: idiomatic expressions, materials development, metaphors, phraseological lexicon, teaching and learning

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Authors: Delly C. Lestari, Linosefa, Ardiana Kusumaningrum, Andi Yasmon, Anis Karuniawati

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The objective of this study is to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mecA genes from screening isolates among intensive care unit (ICU) patients. All MRSA screening isolates from ICU’s patients of Cipto Mangunkusumo Hospital during 2011 and 2014 were included in this study. Identification and susceptibility test was performed using Vitek2 system (Biomereux®). PCR was conducted to characterize the SCCmec of S. aureus harboring the mecA gene on each isolate. Patient’s history of illness was traced through medical record. 24 isolates from 327 screening isolates were MRSA positive (7.3%). From PCR, we found 17 (70.8%) isolates carrying SCCmec type I, 3 (12.5%) isolates carrying SCCmec type III, and 2 (8.3%) isolates carrying SCCmec type IV. In conclusion, SCCmec type I is the most prevalent MRSA colonization among ICU patients in Cipto Mangunkusumo Hospital.

Keywords: MRSA, mecA genes, ICU, colonization

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Authors: Maryum Nawaz

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Purpose: To determine the frequency of refractive errors in squinting eyes of children from 4 to 16 years presenting at tertiary care hospital. Study Design: A descriptive cross-sectional study was done. Place and Duration: The study was conducted in Pediatric Ophthalmology, Hayatabad Medical Complex, Peshawar. Materials and Methods: The sample size was 146 keeping 41.45%5 proportion of refractive errors in children with squinting eyes, 95% confidence interval and 8% margin of error under WHO sample size calculations. Non-probability consecutive sampling was done. Result: Mean age was 8.57±2.66 years. Male were 89 (61.0%) and female were 57 (39.0%). Refractive error was present in 56 (38.4%) and was not present in 90 (61.6%) of patients. There was no association of gender, age, parent refractive errors, or early usage of electric equipment with the refractive errors. Conclusion: There is a high prevalence of refractive errors in a patient with strabismus. There is no association of age, gender, parent refractive errors, or early usage of electric equipment in the occurrence of refractive errors. Further studies are recommended for confirmation of these.

Keywords: strabismus, refractive error, myopia, hypermetropia, astigmatism

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Authors: Allmin Susaiyah, Aki Härmä, Milan Petković

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Automatic generation of insights from data using insight mining systems (IMS) is useful in many applications, such as personal health tracking, patient monitoring, and business process management. Existing IMS face challenges in controlling insight extraction, scaling to large databases, and generalising to unseen domains. In this work, we propose a hybrid approach consisting of rule-based and neural components for generating insights from data while overcoming the aforementioned challenges. Firstly, a rule-based data 2CNL component is used to extract statistically significant insights from data and represent them in a controlled natural language (CNL). Secondly, a BERTSum-based CNL2NL component is used to convert these CNLs into natural language texts. We improve the model using task-specific and domain-specific fine-tuning. Our approach has been evaluated using statistical techniques and standard evaluation metrics. We overcame the aforementioned challenges and observed significant improvement with domain-specific fine-tuning.

Keywords: data mining, insight mining, natural language generation, pre-trained language models

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Authors: Joshua Abraham, Craig Wales

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Abstract—SIGN Guideline 122 recommends that all patients who are admitted to hospital are assessed for venous thromboembolism risk within 24 hours of admission. NHS Greater Glasgow and Clyde provide guidance on this in the form of a proforma. Patients are then subsequently prescribed either thrombo-embolic-deterrent stockings (TEDS)/low molecular weight heparin (LMWH) for the prevention of VTE based on their score. A retrospective casenote audit of a random sample of fifty oncology and trauma inpatients at the QEUH in December 2019 was performed. 90% of patients had a risk assessment conducted as evidenced by a completed proforma. In 78% of these patients, the proforma fully completed. Overall 94% of patients had some for of thromboprophylaxis prescribed in the form of TEDS or LMWH. A lack of 100% compliance against the given standards highlighted potential implications for patient safety, but also medico-legal ramifications for staff. Clinical judgement can only be relied upon if there is written documentation as evidence. Further staff education and the suggestion of a written prompt to the clerk-in documentation will hopefully improve compliance, whilst a repeat audit should demonstrate any improvement.

Keywords: Maxillofacial , Thromboembolism, Thromboprophylaxis , Prescription

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Authors: Patricia Kopetz

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Too often our youngest children with disabilities receive diagnostic labels and accompanying treatment plans based upon perceptions that the children are of limited aptitude and/or ambition. However, children of varied-ability levels who are diagnosed with ‘multiple disabilities,’ can participate and excel in school-based instruction that aligns with their desires, interests, and fortitude – criteria components not foretold by scores on standardized assessments. The paper represents theoretical work in Special Education Innovative Instruction, and includes presenting research materials, some developed by the author herself. The majority of students with disabilities are now served in general education settings in the United States, embracing inclusive practices in our schools. ‘There is now a stronger call for special education to step up and improve efficiency, implement evidence-based practices, and provide greater accountability on key performance indicators that support successful academic and post-school outcomes for students with disabilities.’ For example, in the United States, the Office of Special Education Programs (OSEP) is focusing on results-driven indicators to improve outcomes for students with disabilities. School personnel are appreciating the implications of research-driven approaches for students diagnosed with multiple disabilities, and aim to align their practices toward such focus. The paper presented will provide updates on current theoretical principles and perspectives, and explore advancements in latest, evidence-based and results-driven instructional practices that can motivate children with multiple disabilities to advance their skills and engage in learning activities that as nonconventional, innovative, and proven successful.

Keywords: childhood special education, educational technology , innovative instruction, multiple disabilities

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Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh

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Introduction: Chemical peeling is a popular, relatively inexpensive day procedure and generally safe method for treatment of pigmentary skin disorders and for skin rejuvenation. Chemical peels are classified by the depth of action into superficial, medium, and deep peels.Various facial pigmentary conditions have significant impact on quality of life causing psychological stress, necessitating its safe and effective treatment.Aim & Objectives:To compare the efficacy of Salicylic acid, Trichloroaceticacid & Glycolic Acid in facial melanosis(melasma,photomelanosis& post acne pigmentation).To study the side effects of above mentioned peeling agents. Method and Materials:It was a randomized parallel control single blind study consisting of total of 36 cases, 12 cases each of melasma, photo melanosis and post acne pigmentation within age group 20-50 years having fitzpatrick’s skin type4. Woods lamp examination was done to confirm the type of melasma.Patients with keloidal tendency, active herpes infection or past history of hypersensitivity to salicylic acid, trichloroaceticand glycolic acid as well aspatients on systemic isotretinoin were excluded.Clinical photographs at the beginning of therapy and then serially, were taken to assess the clinical response. Prior to application a written informed consent was obtained. A post auricular test peel was performed. Patients were divided into 3 groups, containing 12 patients each of melasma, photomelanosis and post acnepigmentation.All the three peels SA peel 20% (done once in 2 weeks), GA peel 50% (done once in 3 weeks) and TCA 15% (done once in 3 weeks) were used with total six settings for each patient. Before application of peel patients were counseled to wash the face with soap and water. Then face was dried and cleaned with spirit and acetone to remove all cutaneous oils. GA, TCA, SA were applied with cotton buds/gauze withmild strokes. After a contact period off 5-10mins neutralization was done with cold water. Post peel topical sunscreen application was mandatory. MASI was used pre and post treatment to assess melasma. Investigator’s global improvement scale- overall hyperpigmentation (4-significant, 3-moderate, 2-mild, 1-minimal, 0-no change ) and Patient’s satisfaction grading scale (>70%- excellent response, 50-70%- good response, <50%- average response) was used to assess improvement in all the three facial melanosis.Results:In our study of 12 patients of melasma, 4 (33.33%)patients showed excellent results;3 (25%) with GAand 1(8.33%) of TCA.Good response was seen in 4 (33.33%) patients;1(8.33%) each for GA & SA and 2(16.66%) for TCA.Poor response was seen in 4(33.33%) patients;1(8.33%) for TCA and 3 (25%) for SA.Of 12 patients of photomelanosis, excellent resultswas seen in 3(25%)patients of TCA. Good response was seen in 4 (33.33%) patients, 1(8.33%) each of TCA &SA and 2(16.66%) of GA.Poor responsewas seen in 5(41.66%) patients;3 (25%) for SA and 2(16.66%) of GA.Of 12 patients of post acne pigmentation, excellent responsein 3 (25%) patients;2(16.66%) of SA and 1(8.33%) of TCA.Good responsewas seen in 5(41.66%) patients;2(16.66%) of SA and GA and1(8.33%) of TCA.Poor response was seen in 4 (33.33%) patients; 2 (16.66%) for SA and TCA both. No major side effects in the form of scarring or persistant pigmentation was seen. Transient blackening of skin with burning sensation was seen in cases treated with TCA and SA. Post procedural itching and redness was noted with GA peel. Conclusion- In our study GA(50%),TCA(15%) & SA(20%) peels showed excellent response in melasma, photomelanosis and post-acne pigmentation respectively.All the 3 peeling agents were well tolerated without any significant side-effects in the above specified concentrations.

Keywords: facial melanosis, gycolic acid, salicylic acid, trichloroacetic acid

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Authors: Maria Granados

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Information technology (IT) facilitates the management of knowledge in organisations through the effective leverage of collective experience and knowledge of employees. This supports information processing needs, as well as enables and facilitates sense-making activities of knowledge workers. The study of IT support for knowledge management (KM) has been carried out mainly in larger organisations where resources and competitive conditions can trigger the use of KM. However, there is still a lack of understanding on how IT can support the management of knowledge under different organisational settings influenced by: constant tensions between social and economic objectives, more focus on sustainability than competiveness, limited resources, and high levels of democratic participation and intrinsic motivations among employees. All these conditions are presented in Social Enterprises (SEs), which are normally micro and small businesses that trade to tackle social problems, improve communities, people’s life chances, and the environment. Thus, their importance to society and economies is increasing. However, there is still a need for more understanding of how these organisations operate, perform, innovate and scale-up. This knowledge is crucial to design and provide accurate strategies to enhance the sector and increase its impact and coverage. To obtain a conceptual and empirical understanding of how IT can facilitate KM in the particular organisational conditions of SEs, a quantitative study was conducted with 432 owners and senior members of SEs in UK, underpinned by 21 interviews. The findings demonstrated how IT was supporting more the recovery and storage of necessary information in SEs, and less the collaborative work and communication among enterprise members. However, it was established that SEs were using cloud solutions, web 2.0 tools, Skype and centralised shared servers to manage informally their knowledge. The possible impediments for SEs to support themselves more on IT solutions can be linked mainly to economic and human constraints. These findings elucidate new perspectives that can contribute not only to SEs and SE supporters, but also to other businesses.

Keywords: social enterprises, knowledge management, information technology, collaboration, small firms

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Authors: Wan Shan Chiang, Charn Ting Wang, Wei-Chih Kan, Hui-Chen Huang

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Dialysis patients have risk in Zoster virus because of low immune. Valacyclovir (product name: Valtex) 500mg/tab, an anti-zoster virus medicine, is digested in kidney and it has side-effect of nervous system in patients with malfunction kidneys. Although the clinical basis of the proposed administration, we found that patients still have side effects. So we want to explore the appropriate dose of peritoneal dialysis patients. We read small samples of case reports and analyze 8 cases in our hospital, some patients’ Kt/v, match the standard of dialysis, and still go to the toilet, they still have side effect seriously with 500mg portion. The solution to this includes stopping medicine, reduction of medicine, increase of liquid change and timely hemodialysis and all of them speed up the recovery. The safety of medication needs extra attention of medical care employee. If they can tell the doctor if the patient has urine or not in his or her Kt/v, the doctor can prescribe the medicine accordingly. About the limitation, due to the lack of cases and related pharmacokinetics numbers. Therefore, for peritoneal patients, we think 500mg/48hoursis the saves. We also want to remind pharmaceuticals to revise the portion taken by patients, so that the doctor may judge the use.

Keywords: herpes zoster, Valacyclovir, peritoneal dialysis, health education

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Authors: Georges F. Hatoum, Thomas H. Temple, Silvio Garcia, Xiaodong Wu

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Soft Tissue Sarcomas (STS) represent a diverse group of malignancies with heterogeneous clinical and pathological features. The treatment of extremity STS aims to achieve optimal local tumor control, improved survival, and preservation of limb function. The National Comprehensive Cancer Network guidelines, based on the cumulated clinical data, recommend radiation therapy (RT) in conjunction with limb-sparing surgery for large, high-grade STS measuring greater than 5 cm in size. Such treatment strategy can offer a cure for patients. However, when recurrence occurs (in nearly half of patients), the prognosis is poor, with a median survival of 12 to 15 months and with only palliative treatment options available. The spatially-fractionated-radiotherapy (SFRT), with a long history of treating bulky tumors as a non-mainstream technique, has gained new attention in recent years due to its unconventional therapeutic effects, such as bystander/abscopal effects. Combining single fraction of GRID, the original form of SFRT, with conventional RT was shown to have marginally increased the rate of pathological necrosis, which has been recognized to have a positive correlation to overall survival. In an effort to consistently increase the pathological necrosis rate over 90%, multiple fractions of Lattice RT (LRT), a newer form of 3D SFRT, interdigitated with the standard RT as neoadjuvant therapy was conducted in a preliminary clinical setting. With favorable results of over 95% of necrosis rate in a small cohort of patients, a Phase I/II clinical study was proposed to exam the safety and feasibility of this new strategy. Herein the design of the clinical study is presented. In this single-arm, two-stage phase I/II clinical trial, the primary objectives are >80% of the patients achieving >90% tumor necrosis and to evaluation the toxicity; the secondary objectives are to evaluate the local control, disease free survival and overall survival (OS), as well as the correlation between clinical response and the relevant biomarkers. The study plans to accrue patients over a span of two years. All patient will be treated with the new neoadjuvant RT regimen, in which one of every five fractions of conventional RT is replaced by a LRT fraction with vertices receiving dose ≥10Gy while keeping the tumor periphery at or close to 2 Gy per fraction. Surgical removal of the tumor is planned to occur 6 to 8 weeks following the completion of radiation therapy. The study will employ a Pocock-style early stopping boundary to ensure patient safety. The patients will be followed and monitored for a period of five years. Despite much effort, the rarity of the disease has resulted in limited novel therapeutic breakthroughs. Although a higher rate of treatment-induced tumor necrosis has been associated with improved OS, with the current techniques, only 20% of patients with large, high-grade tumors achieve a tumor necrosis rate exceeding 50%. If this new neoadjuvant strategy is proven effective, an appreciable improvement in clinical outcome without added toxicity can be anticipated. Due to the rarity of the disease, it is hoped that such study could be orchestrated in a multi-institutional setting.

Keywords: lattice RT, necrosis, SFRT, soft tissue sarcoma

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Authors: E.A. Kuchma

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Photodynamic therapy (PDT) is considered an alternative and minimally invasive cancer treatment modality compared to chemotherapy and radiation therapy. PDT includes three main components: a photosensitizer (PS), oxygen, and a light source. PS is injected into the patient's body and then selectively accumulates in the tumor. However, the light used in PDT (spectral range 400–700 nm) is limited to superficial lesions, and the light penetration depth does not exceed a few cm. The problem of PDT (poor visible light transmission) can be solved by using X-rays. The penetration depth of X-rays is ten times greater than that of visible light. Therefore, X-ray radiation easily penetrates through the tissues of the body. The aim of this work is to develop universal nanocomposites for X-ray photodynamic therapy of deep and superficial tumors using scintillation nanoparticles of gadolinium fluoride (GdF3), doped with Tb3+, coated with a biocompatible coating (PEG) and photosensitizer RB (Rose Bengal). PEG@GdF3:Tb3+(15%) – RB could be used as an effective X-ray, UV, and photoluminescent mediator to excite a photosensitizer for generating reactive oxygen species (ROS) to kill tumor cells via photodynamic therapy. GdF3 nanoparticles can also be used as contrast agents for computed tomography (CT) and magnetic resonance imaging (MRI).

Keywords: X-ray induced photodynamic therapy, scintillating nanoparticle, radiosensitizer, photosensitizer

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Authors: Amina Bayazid, Habiba Fetati, Houari Toumi

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Introduction: The clinical value of vitamin K antagonists (VKA) has been widely demonstrated in numerous indications. Unfortunately, VKA are not devoid of drawbacks and risk of serious bleeding. The iatrogenic induced by these drugs is a major public health problem. Patients & Methods: We conducted a retrospective study period extending from February 2012 to August 2013 in the pharmacovigilance service of EHUO (clinical pharmacology unit). The prescription of painkillers was analyzed in patients on VKA followed at our level. The influence of these analgesics on the evolution of the INR is an important component in our work. Results: We counted a total of 195 patients, of whom 32 (or 16.41% of the total population) had received analgesic treatment. The frequencies of different categories of analgesics administered were: • Analgesics opioids: 0% • Analgesics weak opioids: Tramadol: 21.87% • The non-opioid analgesics: -AINS: 71.87% (indomethacin: 68.75% ibuprofen: 3.12%) - Paracetamol: 6.25% -Salicyles (Acetylsalicylic acid): 0%. Conclusion: The management of pain in patients under vitamin K antagonists has special features, given their many drug interactions with analgesics and their influence on the evolution of the INR which can have dramatic consequences. As such, special attention must be paid to the use of analgesics in this type of patient.

Keywords: vitamin K antagonists, pain killers, interactions, INR

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Authors: Yun-Ching Tu, Yu-Chun Chih

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People with aphasia (PWA) may have communicative difficulties in their daily lives, but research on functional communication in aphasia is still limited in Taiwan. The aim of the study was to investigate the impact of aphasia-related factors on functional communication assessment. This study adopted a convenience sampling method. Thirty aphasic participants participated in the study. During the test, the examiner would ask questions that are encountered in daily life and record the participant‘s responses. Some questions would provide pictures to simulate situations in daily life. The results showed that the non-fluent aphasia group performed significantly worse than the fluent aphasia group. In addition, patients with severe aphasia performed significantly lower scores than patients with moderate aphasia and mild aphasia. However, group differences in the chronic stage and acute stage were not significant. In sum, since communication in daily life is diverse and language is still needed in the communication process, patients with aphasia who have better language ability may have relatively better functional communication. In contrast, the more severely impaired the language ability of a patient with aphasia is, the more functional communication will be affected, resulting in poor communication performance in daily life.

Keywords: adult, aphasia, assessment, functional communication

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Authors: Aparna Bandyopadhyay

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The proposed paper will examine how prostitution produced a vast corpus of literature in colonial Bengal. This corpus included autobiographical accounts by prostitutes themselves. While the authenticity of some of these has, at times, been doubted by contemporary observers, the sheer magnitude of such narrative prose demands critical attention. Many of these autobiographical narratives focused on the prostitute’s early life within respectable society and then proceeded to delineate the transgressions and the inescapable chain of circumstances that eventually rendered her a prostitute. Significantly, these serve to corroborate the findings of official investigations regarding the circumstances that led upper-caste Hindu women in Bengal to embrace prostitution in this period. The literary corpus that dwelt on prostitution also included a vast volume of fiction penned by celebrated writers. These foregrounded a prostitute as the central protagonist, telling the life-stories of prostitutes and the circumstances that made them what they were. Novels and short stories often represented the prostitute as an affective being – an individual capable of deep emotions despite her profession. She was seldom a person who had voluntarily embraced prostitution. She was always a figure of helplessness and suffering, a woman whose desire to love and be loved transcended the carnality of her livelihood. She was an outcast, but she experienced the entire repertoire of emotions experienced by her respectable counterparts. The proposed paper will examine the trends and characteristics of the available repertoire of prostitute-oriented literature in late colonial Bengal. It will begin by focusing on the existing perspectives on the origins of prostitution in late colonial Bengal. It will proceed to discuss the literary corpus supposedly penned by prostitutes themselves and then focus on the manner in which some of the stalwarts of high literature represented the prostitute in their literary creations.

Keywords: emotions, literature, prostitution, transgression

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Authors: John Chau, Tzvi Aviv

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Cardiometabolic conditions (hypertension, diabetes, and hyperlipidemia) are major public health concerns. Analysis of all prescription records from about 10 million patients at the largest network of pharmacies in Canada reveals small year-over-year increases in the treatment prevalence of cardiometabolic diseases prior to the COVID-19 pandemic. Cardiometabolic treatment rates increase with age and are higher in males than females. Hypertension treatment rates were 24% in males and 19% in females in 2021. Diabetes treatment rates were 10% in males and 7% in females in 2021. Geospatial analysis using patient addresses reveals interesting differences among provinces and neighborhoods in Canada. Using digital surveys distributed among 8,504 Canadian adults, an increase in hypertension awareness with age and female gender was observed. However, 7% of seniors and 6% of middle-aged Canadians reported uncontrolled blood pressure (>140/90 mmHg). In addition, elevated blood pressure (130-139/80-89 mmHg) was reported by 20% of seniors and 14% of middle-aged Canadians.

Keywords: cardiometabolic conditions, diabetes, hypertension, precision public health

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Authors: Javkhlan Nyamjav, Simona Fischer, Lauren Garner, Veronica McCracken

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Current whole building life cycle assessments (LCA) primarily focus on structural and major architectural elements to measure building embodied carbon. Most of the interior finishes and fixtures are available on digital tools (such as Tally); however, furniture is still left unaccounted for. Due to its repeated refreshments and its complexity, furniture embodied carbon can accumulate over time, becoming comparable to structure and envelope numbers. This paper presents a method to calculate the Global Warming Potential (GWP) of furniture elements in commercial buildings. The calculator uses the quantity takeoff method with GWP averages gathered from environmental product declarations (EPD). The data was collected from EPD databases and furniture manufacturers from North America to Europe. A total of 48 GWP numbers were collected, with 16 GWP coming from alternative EPD. The finalized calculator shows the average GWP of typical commercial furniture and helps the decision-making process to reduce embodied carbon. The calculator was tested on MSR Design projects and showed furniture can account for more than half of the interior embodied carbon. The calculator highlights the importance of adding furniture to the overall conversation. However, the data collection process showed a) acquiring furniture EPD is not straightforward as other building materials; b) there are very limited furniture EPD, which can be explained from many perspectives, including the EPD price; c) the EPD themselves vary in terms of units, LCA scopes, and timeframes, which makes it hard to compare the products. Even though there are current limitations, the emerging focus on interior embodied carbon will create more demand for furniture EPD. It will allow manufacturers to represent all their efforts on reducing embodied carbon. In addition, the study concludes with recommendations on how designers can reduce furniture-embodied carbon through reuse and closed-loop systems.

Keywords: furniture, embodied carbon, calculator, tenant improvement, interior design

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Authors: Ram Sharan Mehta

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The number of new cancer cases annually is estimated to rise from 10.9 million in 2002 to more than 16 million by 2020, if current trends continue. Much of this increase in absolute numbers derives from the ageing of populations worldwide. The objectives of this study were to find out the demographic characteristics of the admitted cancer patients in BPKIHS. It was hospital based descriptive cross-sectional study conducted reviewing all the records of admitted diagnosed cancer patients in BPKIHS from 15th October 2004 to 14th October 2012. Using total enumerative sampling technique all 1379 diagnosed cancer patients record were reviewed after obtaining the permission from concerned authorities. Using SPSS-15 software package data was analyzed. It was found that majority (71%) of cancer patients were of age more than 40 years and equal of both sexes. Most of the clients were form Sunsari (31.1%), Morang (16.6%) and Jhapa (17%) districts. The mean hospitalization day is 8.32 and very few patients (5.2%) were only cured. The numbers of cancer patients are markedly increases in BPKIHS, especially in advanced stage. It is mandatory to start the cancer information and education programme in eastern region of Nepal and proper management of cancer patients using chemotherapy, radiotherapy and surgery at BPKIHS for quality patient care.

Keywords: lung, cancer, patients, Nepal

Procedia PDF Downloads 365

Authors: Sultan Samah A Almjlad

Abstract:

The translation industry in Saudi Arabia is experiencing significant shifts driven by Vision 2030, which aims to diversify the economy and enhance international engagement. This change highlights the need for translators who are skilled in various languages and cultures, playing a crucial role in the nation's global integration efforts. However, there's a notable gap between the skills taught in academic institutions and what the job market demands. Many translation programs in Saudi universities don't align well with industry needs, resulting in graduates who may not meet employer expectations. To tackle this challenge, it's essential to thoroughly analyze the market to identify the key skills required, especially in sectors like legal, medical, technical, and audiovisual translation. At the same time, existing translation programs need to be evaluated to see if they cover necessary topics and provide practical training. Involving stakeholders such as translation agencies, professionals, and students is crucial to gather diverse perspectives. Identifying discrepancies between academic offerings and market demands will guide the development of targeted strategies. These strategies may include enriching curricula with industry-specific content, integrating emerging technologies like machine translation and CAT tools, and establishing partnerships with industry players to offer practical training opportunities and internships. Industry-led workshops and seminars can provide students with valuable insights, and certification programs can validate their skills. By aligning academic programs with industry needs, Saudi Arabia can build a skilled workforce of translators, supporting its economic diversification goals under Vision 2030. This alignment benefits both students and the industry, contributing to the growth of the translation sector and the overall development of the country.

Keywords: translation industry, briging gap, labor market, requirements

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