Search results for: patient communication

Authors: Rebecca Keyte, Helen Egan, Michail Mantzios

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It is well acknowledged that ongoing adherence is a major concern within CF. However recently literature has indicated that non-adherence should not be viewed just in terms of medical regimens. There are other damaging behaviours that some chronically ill patients engage in which can be viewed as a form of non-adherence, such as risky behaviours. Risky behaviours are a major concern within CF, as they can have adverse health effects on patients regardless of patients adherence to medical regimens. The risky behaviours this research is predominantly focusing on are smoking, excessive alcohol consumption, illicit drug use and risky sexual behaviour. This research investigates patient’s beliefs about their CF and the impact their CF has upon their life, exploring rationales for why some patients engage in risky behaviours. This research utilises qualitative semi-structured interviews taking an interpretive perspective. Twenty-four adult participants have been recruited (16 male, age range 19–66 yrs) from two UK regional CF centres, with a median FEV1 61.77% predicted. Participants were recruited via clinician guidance, with 13 participants identified by clinicians as partaking in risky behaviours. However, during the interviews 17 participants were identified as partaking in risky behaviours, illustrating that not all patients offer full disclosure of engagement in such behaviours to their clinicians. Preliminary findings illustrate a variety of reasons as to why some CF patients engage in risky behaviours, with many participants stating that one challenge in terms of living with CF is accepting their illness. Disclosure of illness was also an issue, the desire to be seen as ‘normal’ was important to many. It is often possible for CF patients to hide their illness as they do not always appear to be unwell. However, literature indicates a desire for normalcy can be accompanied with the engagement of normalised risky behaviours, enabling patients to retaliate against their illness identity. There was also evidence of a life-orientated perspective amongst participants, with some reporting that their desire for fun and enjoyment was the reason for why they were engaging in risky behaviours. Some participants did not acknowledge the impact their risky behaviours could have upon their CF, and others rationalised their continuation with the behaviours by suggesting that they were in fact beneficial to their health. There was an apparent lack of knowledge around the implications of risky behaviours, with participants indicating that they had not been informed of such potential consequences by their clinicians. Given the adverse health effects of risky behaviours within CF, more effective health promotion measures are needed to both reduce and more importantly prevent these behaviours. Due to the initiation of risky behaviours within the CF population commonly occurring during adolescence, the researcher now proposes to conduct semi-structured interviews with paediatric patients to investigate their awareness and beliefs towards risky behaviours. Overall, this research will highlight reasons why some CF patients engage in risky behaviours, in order to inform interventions aimed to prevent the initiation in risky behaviours by increasing patient awareness.

Keywords: cystic fibrosis, health beliefs, preliminary findings, risky health behaviours

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Authors: Mohamed Saeed Ahmed Salman

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The aim of this Current Study is to reveals the impact of Transformational Leadership on Organizational Innovation in Mobile Jordanian Communication Companies, (Zain; Orange; Umniah and Xpress). The study depends on descriptive and analytical mothodize using the practical manner, study sample consists of Head of section and Experts from all Specializations in Mobile Jordanian Communication Companies amounted (120). A major study finding all Transformational Leadership Behaviors was median extent. The innovation adoption and innovation abilities availability was high extent. Besides there is a significant statistical impact of Transformational Leadership Behaviors, (Idealized Influence; Intellectual Stimulation; Individualized Consideration and Empowerment), on Organizational Innovation (innovation adoption & innovation abilities availability). It can be said that organizational creativity is the adoption of new ideas and behaviors that are applied in the organization, whether this is in creating new products or services, or new technology that is used at work. Transformational leadership is a process that occurs when one or more people engage with others in a way that enables leaders and followers to raise each other to higher levels of morals, motivations, and behaviors (desires, needs, ambitions, and followers' core values). An effective leader under transformational leadership is one who has a high ability to communicate, motivate, delegate, and listen to others, and is characterized by great flexibility in solving problems and dealing greatly with variables. The difference between creativity and innovation, in conclusion, innovation, invention, and creativity are three important elements for any institution or organization, and there is a fine line that separates them, which is that creativity works to generate new ideas, while invention makes them tangible, and innovation makes them valuable.

Keywords: leadership, organizational, transformational, creativity

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Authors: Justyna Mroczkowska

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Social worker's ability to provide culturally sensitive assistance in child protection is taken for granted; given limited training opportunities and lack of clear guidance, practitioners report working with migrant families more demanding in comparison to working with native families. In this study, the author developed and factor analyzed the Norwegian Cultural Self-Efficacy Scale to describe the level of cultural capability among Norwegian child protection professionals. The study aimed to determine the main influencing factors to cultural efficacy and examine the relationship between self-efficacy and perceived difficulty in working with migrant families. The scale was administered to child protection workers in Norway (N=251), and the reliability of the scale measured by Cronbach's alpha coefficient was .904. The confirmatory factor analysis of social work cultural self-efficacy found support for four separate but correlated subscales: Assessment, Communication, Support Request, and Teamwork. Regression analyses found the experience in working with migrant families, training and support from external agencies, and colleague support to be significant predictors of cultural self-efficacy. Self-efficacy in assessment skills and self-efficacy in communication skills were moderately related to the perceived difficulty to work with migrant families. The findings conclude with previous research and highlight the need for both professional development programs and institutional resources to be provided to support the practitioner's preparation for multicultural practice in child protection.

Keywords: child protection, cultural self-efficacy, cultural competency, migration, resources

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Authors: Venkata Buddharaju, Irene Mccarron, Hazel Alba

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Introduction: Male external catheters (MECs) are commonly used to collect and drain urine. MECs are increasingly used in acute care, long-term acute care hospitals, and nursing facilities, and in other patients as an alternative to invasive urinary catheters to reduce catheter-associated urinary tract infections (CAUTI).MECs are also used to avoid the need for incontinence pads and diapers. Most of the Male External Catheters are held in place by skin adhesive, with the exception of a few, which uses a foam strap clamp around the penile shaft. The adhesive condom catheters typically stay for 24 hours or less. It is also a common practice that extra skin adhesive tape is wrapped around the condom catheter for additional security of the device. The fixed nature of the adhesive will not allow the normal skin expansion of penile size over time. The adhesive can cause skin irritation, redness, erosion, and skin damage. Acanthus condom catheter (ACC) is a patented, specially designed, stretchable silicone catheter without adhesive, adapts to the size and contour of the penis. It is held in place with a single elastic strap that wraps around the lower back and tied to the opposite catheter ring holescriss cross. It can be reused for up to 5 days on the same patient after daily cleaning and washingpotentially reducing cost. Methods: The study was conducted from September 17th to October 8th, 2020. The nursing staff was educated and trained on how to use and reuse the catheter. After identifying five (5) appropriate patients, the catheter was placed and maintained by nursing staff. The data on the ease of use, leak, and skin damage were collected and reported by nurses to the nursing education department of the hospital for analysis. Setting: RML Chicago, long-term acute care hospital, an affiliate of Loyola University Medical Center, Chicago, IL USA. Results: The data showed that the catheter was easy to apply, remove, wash and reuse, without skin problems or urine infections. One patient had used for 16 days after wash, reuse, and replacement without any urine leak or skin issues. A minimal leak was observed on two patients. Conclusion: Acanthus condom catheter was easy to use, functioned well with minimal or no leak during use and reuse. The skin was intact in all patients studied. There were no urinary tract infections in any of the studied patients.

Keywords: CAUTI, male external catheter, reusable, skin adhesive

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Authors: Sang Ho Lee, Yountaik Leem

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This paper reviews Korean cases of smart cities through the analysis framework of strategic foci, characteristics and effects. Firstly, national strategies including c(cyber), e(electronic), u(ubiquitous) and s(smart) Korea strategies were considered from strategic angles. Secondly, the characteristics of smart cities in Korea were looked through the smart cities examples such as Seoul, Busan, Songdo and Sejong cities etc. from the views on the by STIM (Service, Technology, Infrastructure and Management) analysis. Finally, the effects of smart cities on socio-economies were investigated from industrial perspective using the input-output model and structural path analysis. Korean smart city strategies revealed that there were different kinds of strategic foci. c-Korea strategy focused on information and communications network building and user IT literacy. e-Korea strategy encouraged e-government and e-business through utilizing high-speed information and communications network. u-Korea strategy made ubiquitous service as well as integrated information and communication operations center. s-Korea strategy is propelling 4th industrial platform. Smart cities in Korea showed their own features and trends such as eco-intelligence, high efficiency and low cost oriented IoT, citizen sensored city, big data city. Smart city progress made new production chains fostering ICTs (Information Communication Technologies) and knowledge intermediate inputs to industries.

Keywords: Korean smart cities, Korean smart city strategies, STIM, smart service, infrastructure, technologies, management, effect of smart city

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Authors: Ellie Abdi

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This paper is a review of a recently published book (April 2018) by Dr. Ellie Abdi. The book divides into two sections of 1) leadership in school organization and 2) pragmatic research in physical education professional development. The first part of the book explores school organizational development in terms of 1) communication development, 2) community development, and 3) decision making development. It concludes to acknowledge that decision making is the heart of educational management. This is while communication and community are essential to the development of the school organization. The role of a leader in a professional learning community (PLC) is acknowledged with the organizational development plan and moves onto 5 overall objectives of a professional development plan. It clarifies that professional learning community (PLC) benefits both students and professionals in education. Furthermore, professional development needs to be involved in opportunities to value diversity and foundations of learning, in addition to search for veteran teachers who offer a rich combination of experience and perspective. School educational platform in terms of teacher training in physical education is discussed in the second part. The book reviews that well-designed programs are powerful and constructive ways to identify the strength and weaknesses of teachers. Post-positivism, constructivism, advocacy/participatory, and pragmatism in teacher education are also disclosed. The book specifically unfolds pragmatic research in professional development of physical education. It provides researchers, doctoral, and masters level students with defined examples. In summary, the book shows how appropriate it is when many different traditions are displayed in a pragmatic way, following the stages of research from development to dissemination.

Keywords: leadership, physical education, pragmatic, professional development

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Authors: Lavanya Ratnabala, Robinroy Peter, E. Y. A. Charles

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This research paper addresses the challenges of exploration and navigation in unknown environments from an evolutionary swarm robotics perspective. Path formation plays a crucial role in enabling cooperative swarm robots to accomplish these tasks. The paper presents a method called the sub-goal-based path formation, which establishes a path between two different locations by exploiting visually connected sub-goals. Simulation experiments conducted in the Argos simulator demonstrate the successful formation of paths in the majority of trials. Furthermore, the paper tackles the problem of inter-collision (traffic) among a large number of robots engaged in path formation, which negatively impacts the performance of the sub-goal-based method. To mitigate this issue, a task allocation strategy is proposed, leveraging local communication protocols and light signal-based communication. The strategy evaluates the distance between points and determines the required number of robots for the path formation task, reducing unwanted exploration and traffic congestion. The performance of the sub-goal-based path formation and task allocation strategy is evaluated by comparing path length, time, and resource reduction against the A* algorithm. The simulation experiments demonstrate promising results, showcasing the scalability, robustness, and fault tolerance characteristics of the proposed approach.

Keywords: swarm, path formation, task allocation, Argos, exploration, navigation, sub-goal

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Authors: Joao Garretto, R. J. Yarwood, Vamsi Borra, Frank Li

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Bluetooth Low Energy (BLE) has emerged as one of the main wireless communication technologies used in low-power electronics, such as wearables, beacons, and Internet of Things (IoT) devices. BLE’s energy efficiency characteristic, smart mobiles interoperability, and Over the Air (OTA) capabilities are essential features for ultralow-power devices, which are usually designed with size and cost constraints. Most current research regarding the power analysis of BLE devices focuses on the theoretical aspects of the advertising and scanning cycles, with most results being presented in the form of mathematical models and computer software simulations. Such computer modeling and simulations are important for the comprehension of the technology, but hardware measurement is essential for the understanding of how BLE devices behave in real operation. In addition, recent literature focuses mostly on the BLE technology, leaving possible applications and its analysis out of scope. In this paper, a coin cell battery-powered BLE Data Acquisition Device, with a 4-in-1 sensor and one accelerometer, is proposed and evaluated with respect to its Power Consumption. First, evaluations of the device in advertising mode with the sensors turned off completely, followed by the power analysis when each of the sensors is individually turned on and data is being transmitted, and concluding with the power consumption evaluation when both sensors are on and respectively broadcasting the data to a mobile phone. The results presented in this paper are real-time measurements of the electrical current consumption of the BLE device, where the energy levels that are demonstrated are matched to the BLE behavior and sensor activity.

Keywords: bluetooth low energy, power analysis, BLE advertising cycle, wireless sensor node

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Authors: Naima Jannat, Ariful Islam, Sharafat Hossain

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Due to the involvement of the large target volume, Craniospinal Irradiation makes it challenging to achieve a uniform dose, and it requires different isocenters. This isocentric junction needs to shift after every five fractions to overcome the possibility of hot and cold spots. This study aims to evaluate the Planning Target Volume coverage & sparing Organ at Risk between two techniques and shows that the Field Alignment Technique does not need replanning and resetting. Planning method for Craniospinal Irradiation by Eclipse treatment planning system Field Alignment and Extended Source to Surface Distance technique was developed where 36 Gy in 20 Fraction at the rate of 1.8 Gy was prescribed. The patient was immobilized in the prone position. In the Field Alignment technique, the plan consists of half beam blocked parallel opposed cranium and a single posterior cervicospine field was developed by sharing the same isocenter, which obviates divergence matching. Further, a single field was created to treat the remaining lumbosacral spine. Matching between the inferior diverging edge of the cervicospine field and the superior diverging edge of a lumbosacral field, the field alignment option was used, which automatically matches the field edge divergence as per the field alignment rule in Eclipse Treatment Planning System where the couch was set to 2700. In the Extended Source to Surface Distance technique, two parallel opposed fields were created for the cranium, and a single posterior cervicospine field was created where the Source to Surface Distance was from 120-140 cm. Dose Volume Histograms were obtained for each organ contoured and for each technique used. In all, the patient’s maximum dose to Planning Target Volume is higher for the Extended Source to Surface Distance technique to Field Alignment technique. The dose to all surrounding structures was increased with the use of a single Extended Source to Surface Distance when compared to the Field Alignment technique. The average mean dose to Eye, Brain Steam, Kidney, Oesophagus, Heart, Liver, Lung, and Ovaries were respectively (58% & 60 %), (103% & 98%), (13% & 15%), (10% & 63%), (12% & 16%), (33% & 30%), (14% & 18%), (69% & 61%) for Field Alignment and Extended Source to Surface Distance technique. However, the clinical target volume at the spine junction site received a less homogeneous dose with the Field Alignment technique as compared to Extended Source to Surface Distance. We conclude that, although the use of a single field Extended Source to Surface Distance delivered a more homogenous, but its maximum dose is higher than the Field Alignment technique. Also, a huge advantage of the Field Alignment technique for Craniospinal Irradiation is that it doesn’t need replanning and resetting up of patients after every five fractions and 95% prescribed dose was received by more than 95% of the Planning Target Volume in all the plane with the acceptable hot spot.

Keywords: craniospinalirradiation, cranium, cervicospine, immobilize, lumbosacral spine

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Authors: Rajesh Bansal, Amit Raj Sharma, Vakil Singh

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The success and predictability of titanium implants for long durations are well established and there has been a tremendous increase in the popularity of implants among patients as well as clinicians over the last four decades. However, sometimes complications arise, which lead to the loss of the implant as well as the prosthesis. Fracture of dental implants is rare; however, at times, implants or abutment screws fracture and lead to many problems for the clinician and the patient. Possible causes of implant fracture include improper design, overload, fatigue and corrosion. Six retrieved fractured dental implants, with varying diameters and designs, were collected from time to time to examine by scanning electron microscope (SEM) to characterize fracture behavior and assess the mechanism of fracture. In this investigation, it was observed that fracture of the five dental implants occurred due to fatigue crack initiation and propagation from the thread roots.

Keywords: titanium, dental, implant, fracture, failure

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Authors: Abimbola Olaotan Akinsete

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Government all over the world has intensified efforts in making internet and resource centres readily available in public institutions and centres for the advancement of humanity and working processes. Information and communication resource centre will not only help in the reduction of task that are presumed to be herculean. This centres influenced the working rate and productivity of both staffs and students and its benefit. The utilization of the internet and information resource centre will not only speed up service delivery, working time and efficiency of the system. Information and Communication Technology plays significant roles in presenting equalization strategy for developing university community and improving educational service delivery. This equalization will not only advance, accelerate and ensure results are accessed electronically, ensuring the transfer and confirmation of students’ academic records and their results in the world without physically available to request for these services. This study seeks to make Critical Appraisal of Adekunle Ajasin University Policy on Internet Resource Centre in Service Delivery Adekunle Ajasin University, Akungba-Akoko, Ondo State. The study employ descriptive survey design method in identifying hindrances of the non-utilization of technology in the service delivery in the university. Findings revealed that the adoption of internet and resource centre in the Exams and Records unit of the University shall help in delivering more in students’ records/results processing.

Keywords: internet, resource, centre, policy and service delivery

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Authors: Yogesh Mahor, Subhash Nigam, Abhai Khare

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Road safety education is a composite subject which should be viewed holistically if taken into accoubehavior change communication, safe road infrastructure and low enforcement. Specific and customized road safety education is crucial for each type of road user and learners in the formal and informal teaching and various kind of training programs directly sponsored by state and center government, as they are active contributors to shaping a community and responsible citizens. The aim of this discussion article is to explore a strategy to integrate road safety education into the formal curriculum of schools, higher education institutions, driving schools, skill development centers, various government funded urban and rural development training institutions and their work plans as standing agenda. By applying the desktop research method, the article conceptualizes what the possible focus of road safety education and training should be. The article then explores international common practices in road safety education and training, and considers the necessary synergy between education, road engineering and low enforcement. The article uses secondary data collected from documents which are then analysed in a sectoral way. A well-designed road safety strategy for mainstreaming education and government-sponsored training is urgently needed, facilitating partnerships in various sectors to implement such education in the students and learners in multidisciplinary ways.

Keywords: road safety education, curriculum-based road safety education, behavior change communication, low enforcement, road engineering, safe system approach, infrastructure development consultants

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Authors: Lizhi Ma, Dan Liu

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Pipeline parallelism has been widely used to accelerate distributed deep learning to alleviate GPU memory bottlenecks and to ensure that models can be trained and deployed smoothly under limited graphics memory conditions. However, in highly heterogeneous distributed clusters, traditional model partitioning methods are not able to achieve load balancing. The overlap of communication and computation is also a big challenge. In this paper, HePipe is proposed, an efficient pipeline parallel training method for highly heterogeneous clusters. According to the characteristics of the neural network model pipeline training task, oriented to the 2-level heterogeneous cluster computing topology, a training method based on the 2-level stage division of neural network modeling and partitioning is designed to improve the parallelism. Additionally, a multi-forward 1F1B scheduling strategy is designed to accelerate the training time of each stage by executing the computation units in advance to maximize the overlap between the forward propagation communication and backward propagation computation. Finally, a dynamic recomputation strategy based on task memory requirement prediction is proposed to improve the fitness ratio of task and memory, which improves the throughput of the cluster and solves the memory shortfall problem caused by memory differences in heterogeneous clusters. The empirical results show that HePipe improves the training speed by 1.6×−2.2× over the existing asynchronous pipeline baselines.

Keywords: pipeline parallelism, heterogeneous cluster, model training, 2-level stage partitioning

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Authors: Innocent Uzougbo Onwuegbuzie, Siene Elizabeth Eke

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This study investigates cybersecurity challenges and solutions in managing Information and Communication Technology (ICT) at the Federal Polytechnic, Ado-Ekiti, South-West Nigeria. The rapid evolution of ICT has revolutionized organizational operations and impacted various sectors, including education, healthcare, and finance. While ICT advancements facilitate seamless communication, complex data analytics, and strategic decision-making, they also introduce significant cybersecurity risks such as data breaches, ransomware, and other malicious attacks. These threats jeopardize the confidentiality, integrity, and availability of information systems, necessitating robust cybersecurity measures. The primary aim of this research is to identify prevalent cybersecurity challenges in ICT management, evaluate their impact on the institution's operations, and assess the effectiveness of current cybersecurity solutions. Adopting a quantitative research approach, data was collected through surveys and structured questionnaires from students, staff, and IT professionals at the Federal Polytechnic, Ado-Ekiti. The findings underscore the critical need for continuous investment in cybersecurity technologies, employee and student training, and regulatory compliance to mitigate evolving cyber threats. This research contributes to bridging the knowledge gap in cybersecurity management and provides valuable insights into effective strategies and technologies for safeguarding ICT systems in educational institutions. The study's objectives are to enhance the security posture of the Federal Polytechnic, Ado-Ekiti, in an increasingly digital world by identifying and addressing the cybersecurity challenges faced by its ICT management.

Keywords: cybersecurity challenges, cyber threat mitigation, federal polytechnic Ado-Ekiti, ICT management

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Authors: Prakash Karrun, M. Manoj Deepak, Mathivanan, K. Venkatachalam

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Our study aims to evaluate the rates of healing and the efficacy of the arthroscopic repair of the rotator cuff tears. 40 patients who had rotator cuff tears were taken up for the study and arthroscopic repair was done with double row technique.They were evaluated and followed up for a minimum of 2 years minimum.The functional status,range of motion and healing rates were compared post operatively. All the patients were followed up with serial questionnaires and MRI at the end of 2 years. There was significant improvement in the functional status of the patient. The MRI showed better rates of healing in these patients.Thus our study effectively proves the efficacy of our operating technique.

Keywords: rotator cuff tear, arthroscopic repair, double stich, healing

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Authors: Faten Khanfir, Mohamed Tlili, Ali Medeb Hamrouni, Raki Selmi, M. S. Khalfi, Faten Ben Amor

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Introduction: dental implant failure is a major concern for the clinician and the patient. Objectives: The aim of our study is to investigate the way in which 100 Tunisian dentists carried implant treatment for their patients from the early phase of planning and selection of patients to the placement of the implant in order to look for the implant failure factors. Results: significant correlations were found between failure rates > 5 and their corresponding factors as the number of implants placed (p = 0.001<0, 05), smoking (0.046 <0.05), unbalanced diabetes (0.03<0.05), aseptic protocol (= 0.004< 0.05) and the drilling speed (0,002<0.05) Conclusion: It seems that the number of implant placed, smoking, diabetes, aseptic protocol, and the drilling speed may contribute to dental implant failure.

Keywords: failure, implants, survey, risk, osseointegration

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Authors: P. T. Collett, M. Kershaw

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Introduction: The discussion regarding which method of anesthesia provides better results for lower limb arthroplasty is a continuing debate. Multiple meta-analysis has been performed with no clear consensus. The current recommendation is to use neuraxial anesthesia for lower limb arthroplasty; however, the evidence to support this decision is weak. The Enhanced Recovery After Surgery (ERAS) society has recommended, either technique can be used as part of a multimodal anesthetic regimen. A local study was performed to see if the current anesthetic practice correlates with the current recommendations and to evaluate the efficacy of the different techniques utilized. Method: 90 patients who underwent total hip or total knee replacements at Nevill Hall Hospital between February 2019 to July 2019 were reviewed. Data collected included the anesthetic technique, day one opiate use, pain score, and length of stay. The data was collected from anesthetic charts, and the pain team follows up forms. Analysis: The average of patients undergoing lower limb arthroplasty was 70. Of those 83% (n=75) received a spinal anaesthetic and 17% (n=15) received a general anaesthetic. For patients undergoing knee replacement under general anesthetic the average day, one pain score was 2.29 and 1.94 if a spinal anesthetic was performed. For hip replacements, the scores were 1.87 and 1.8, respectively. There was no statistical significance between these scores. Day 1 opiate usage was significantly higher in knee replacement patients who were given a general anesthetic (45.7mg IV morphine equivalent) vs. those who were operated on under spinal anesthetic (19.7mg). This difference was not noticeable in hip replacement patients. There was no significant difference in length of stay between the two anesthetic techniques. Discussion: There was no significant difference in the day one pain score between the patients who received a general or spinal anesthetic for either knee or hip replacements. The higher pain scores in the knee replacement group overall are consistent with this being a more painful procedure. This is a small patient population, which means any difference between the two groups is unlikely to be representative of a larger population. The pain scale has 4 points, which means it is difficult to identify a significant difference between pain scores. Conclusion: There is currently little standardization between the different anesthetic approaches utilized in Nevill Hall Hospital. This is likely due to the lack of adherence to a standardized anesthetic regimen. In accordance with ERAS recommends a standard anesthetic protocol is a core component. The results of this study and the guidance from the ERAS society will support the implementation of a new health board wide ERAS protocol.

Keywords: anaesthesia, orthopaedics, intensive care, patient centered decision making, treatment escalation

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Authors: Junior Akunzi

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In the matter of patient treatment planning quality assurance in 3D conformational therapy (3D-CRT) and volumetric arc therapy (VMAT or RapidArc), the independent monitor unit verification calculation (MUVC) is an indispensable part of the process. Concerning 3D-CRT treatment planning, the MUVC can be performed manually applying the standard ESTRO formalism. However, due to the complex shape and the amount of beams in advanced treatment planning technic such as RapidArc, the manual independent MUVC is inadequate. Therefore, commercially available software such as RadCalc can be used to perform the MUVC in complex treatment planning been. Indeed, RadCalc (version 6.3 LifeLine Inc.) uses a simplified Clarkson algorithm to compute the dose contribution for individual RapidArc fields to the isocenter. The purpose of this project is the validation of RadCalc in 3D-CRT and RapidArc for treatment planning dosimetry quality assurance at Antoine Lacassagne center (Nice, France). Firstly, the interfaces between RadCalc and our treatment planning systems (TPS) Isogray (version 4.2) and Eclipse (version13.6) were checked for data transfer accuracy. Secondly, we created test plans in both Isogray and Eclipse featuring open fields, wedges fields, and irregular MLC fields. These test plans were transferred from TPSs according to the radiotherapy protocol of DICOM RT to RadCalc and the linac via Mosaiq (version 2.5). Measurements were performed in water phantom using a PTW cylindrical semiflex ionisation chamber (0.3 cm³, 31010) and compared with the TPSs and RadCalc calculation. Finally, 30 3D-CRT plans and 40 RapidArc plans created with patients CT scan were recalculated using the CT scan of a solid PMMA water equivalent phantom for 3D-CRT and the Octavius II phantom (PTW) CT scan for RapidArc. Next, we measure the doses delivered into these phantoms for each plan with a 0.3 cm³ PTW 31010 cylindrical semiflex ionisation chamber (3D-CRT) and 0.015 cm³ PTW PinPoint ionisation chamber (Rapidarc). For our test plans, good agreements were found between calculation (RadCalc and TPSs) and measurement (mean: 1.3%; standard deviation: ± 0.8%). Regarding the patient plans, the measured doses were compared to the calculation in RadCalc and in our TPSs. Moreover, RadCalc calculations were compared to Isogray and Eclispse ones. Agreements better than (2.8%; ± 1.2%) were found between RadCalc and TPSs. As for the comparison between calculation and measurement the agreement for all of our plans was better than (2.3%; ± 1.1%). The independent MU verification calculation software RadCal has been validated for clinical use and for both 3D-CRT and RapidArc techniques. The perspective of this project includes the validation of RadCal for the Tomotherapy machine installed at centre Antoine Lacassagne.

Keywords: 3D conformational radiotherapy, intensity modulated radiotherapy, monitor unit calculation, dosimetry quality assurance

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Authors: Tesfaye Basha

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The purpose of this study was to examine the sign language and academic achievement of deaf students in special and inclusive primary schools of Southern Ethiopia. The study used a mixed-method to collect varied data. The study contained Signed Amharic and English skill tasks, questionnaire, 8th-grade Primary School Leaving Certificate Examination results, classroom observation, and interviews. For quantitative (n=70) deaf students and for qualitative data collection, 16 participants were involved. The finding revealed that the limitation of sign language is a problem in signing and academic achievements. This displays that schools are not linguistically rich to enable sign language achievement for deaf students. Moreover, the finding revealed that the contribution of Total Communication in the growth of natural sign language for deaf students was unsatisfactory. The results also indicated that special schools of deaf students performed better sign language skills and academic achievement than inclusive schools. In addition, the findings revealed that high signed skill group showed higher academic achievement than the low skill group. This displayed that sign language skill is highly associated with academic achievement. In addition, to qualify deaf students in sign language and academics, teacher institutions must produce competent teachers on how to teach deaf students with sign language and literacy skills.

Keywords: academic achievement, inclusive school, sign language, signed Amharic, signed English, special school, total communication

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Authors: Temesgen Geremew

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Functionalized nanoparticles have emerged as a revolutionary platform for drug delivery, offering significant advantages over traditional methods. By strategically modifying their surface properties, these nanoparticles can be designed to target specific tissues and cells, significantly reducing off-target effects and enhancing therapeutic efficacy. This targeted approach allows for lower drug doses, minimizing systemic exposure and potential side effects. Additionally, functionalization enables controlled release of the encapsulated drug, improving drug stability and reducing the frequency of administration, leading to improved patient compliance. This work explores the immense potential of functionalized nanoparticles in revolutionizing drug delivery, addressing limitations associated with conventional therapies and paving the way for personalized medicine with precise and targeted treatment strategies.

Keywords: nanoparticles, drug, nanomaterials, applications

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Authors: Diaa Ahmed Mohamed Ahmedien

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Nowadays, it cannot be denied that the most important interactive arts trends have appeared as a result of significant scientific mutations in the modern sciences, and holographic art is not an exception, where it is considered as a one of the most important major contemporary interactive arts trends in visual arts. Holographic technique had been evoked through the modern physics application in late 1940s, for the improvement of the quality of electron microscope images by Denis Gabor, until it had arrived to Margaret Benyon’s art exhibitions, and then it passed through a lot of procedures to enhance its quality and artistic applications technically and visually more over 70 years in visual arts. As a modest extension to these great efforts, this research aimed to invoke extraordinary attempt to enroll sample of normal people in Egyptian community in holographic recording program to record their appreciated objects or antiques, therefore examine their abilities to interact with modern techniques in visual communication arts. So this research tried to answer to main three questions: 'can we use the analog holographic techniques to unleash new theoretical and practical knowledge in interactive arts for public in Egyptian community?', 'to what extent holographic art can be familiar with public and make them able to produce interactive artistic samples?', 'are there possibilities to build holographic interactive program for normal people which lead them to enhance their understanding to visual communication in public and, be aware of interactive arts trends?' This research was depending in its first part on experimental methods, where it conducted in Laser lab at Cairo University, using Nd: Yag Laser 532 nm, and holographic optical layout, with selected samples of Egyptian people that they have been asked to record their appreciated object, after they had already learned recording methods, and in its second part on a lot of discussion panel had conducted to discuss the result and how participants felt towards their holographic artistic products through survey, questionnaires, take notes and critiquing holographic artworks. Our practical experiments and final discussions have already lead us to say that this experimental research was able to make most of participants pass through paradigm shift in their visual and conceptual experiences towards more interaction with contemporary visual arts trends, as an attempt to emphasize to the role of mature relationship between the art, science and technology, to spread interactive arts out in our community through the latest scientific and artistic mutations around the world and the role of this relationship in our societies particularly with those who have never been enrolled in practical arts programs before.

Keywords: Egyptian community, holographic art, laser art, visual art

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Authors: Shailja Thakur

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In this paper it is shown that how farmers are suffering from all sides including vagaries of weather then price fluctuations, demand supply constraints, poor soil health etc. Also the ICT can prove to be of great help if incorporated rightly into Indian agriculture. Some innovative ways to reward farmers and distribution of subsidies to them can improve the current scenario.

Keywords: cost of farming, information and communication technology, innovative steps, roof gardening, vermicomposting

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Authors: Ji Su Kim, Bo Ram Choi, Ju Yeon Cho, Hyukjin Lee

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Epidermal growth factor receptor (EGFR) 19 deletion mutation gene is over-expressed in carcinoma patient. EGFR 19 deletion mutation is known as typical biomarker of non-small cell lung cancer (NSCLC), which one section in the coding exon 19 of EGFR is deleted. Therefore, there have been many attempts over the years to detect EGFR 19 deletion mutation for replacing conventional diagnostic method such as PCR and tissue biopsy. We developed a simple and facile detection platform based on Rolling Circle Amplification (RCA), which provides highly amplified products in isothermal amplification of the ligated DNA template. Limit of detection (~50 nM) and a faster detection time (~30 min) could be achieved by introducing RCA.

Keywords: EGFR19, cancer, diagnosis, rolling circle amplification (RCA), hydrogel

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: Judith Partouche-Sebban, Saeedeh Rezaee Vessal

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Because of the rising number of new cases of cancer, especially among women, it is more than essential to better understand how women experience cancer in order to bring them adapted to support and care and enhance their well-being and patient experience. Cancer stands for a traumatic experience in which the diagnosis, its medical treatments, and the related side effects lead to deep physical and psychological changes that may arouse considerable stress and anxiety. In order to reduce these negative emotions, women tend to use various defense mechanisms, among which denial has been defined as the most frequent mechanism used by breast cancer patients. This study aims to better understand the consequences of the experience of cancer and their link with the adoption of a denial strategy. The empirical research was done among female cancer survivors in France. Since the topic of this study is relatively unexplored, a qualitative methodology and open-ended interviews were employed. In total, 25 semi-directive interviews were conducted with a female with different cancers, different stages of treatment, and different ages. A systematic inductive method was performed to analyze data. The content analysis enabled to highlight three different denial-related behaviors among women with cancer, which serve a self-protective function. First, women who expressed high levels of anxiety confessed they tended to completely deny the existence of their cancer immediately after the diagnosis of their illness. These women mainly exhibit many fears and a deep distrust toward the medical context and professionals. This coping mechanism is defined by the patient as being unconscious. Second, other women deliberately decided to deny partial information about their cancer, whether this information is related to the stages of the illness, the emotional consequences, or the behavioral consequences of the illness. These women use this strategy as a way to avoid the reality of the illness and its impact on the different aspects of their life as if cancer does not exist. Third, some women tend to reinterpret and give meaning to their cancer as a way to reduce its impact on their life. To this end, they may use magical thinking or positive reframing, or reinterpretation. Because denial may lead to delays in medical treatments, this topic deserves a deep investigation, especially in the context of oncology. As denial is defined as a specific defense mechanism, this study contributes to the existing literature in service marketing which focuses on emotions and emotional regulation in healthcare services which is a crucial issue. Moreover, this study has several managerial implications for healthcare professionals who interact with patients in order to implement better care and support for the patients.

Keywords: cancer, coping mechanisms, denial, healthcare services

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Authors: Krzysztof Buczak, Sonia Lachowska, Pawel Kucharski, Agnieszka Antonczyk

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Tiletamine - zolazepam combination is increasingly used in veterinary anaesthesiology in wild animals, including snakes. The available literature shows a lack of information about anesthesia in this mixture in ovoviviparous snakes. The studies show the possibility of using the combination at a dose of 20 mg/kg or more for snake immobilization. This paper presents an anesthetic protocol with the use of a combination of tiletamine - zolazepam at the dose of 10 mg/kg intramuscularly and maintenance with inhalant anesthesia with isoflurane in pure oxygen. The objective of this study was to evaluate the usefulness of the anesthetic protocol to proceed with coeliotomy in Amazon Tree Boa. The patient was a five years old bicolor female Amazon Tree Boa (Corallus hortulanus) with dystocia. The clinical examination reveals significant emaciation (bodyweight 520g), high degree of dehydration, heart rate (HR = 60 / min), pale mucous membranes and poor reactivity. Meloxicam (1 mg/kg) and tramadol (10 mg/kg) were administered subcutaneously and the patient was placed in an incubator with access to fresh oxygen. Four hours later, the combination of tiletamine - zolazepam (10 mg/kg) was administered intramuscularly for induction of anesthesia. The snake was intubated and connected to inhalant anesthesia equipment. For maintenance, the anesthesia isoflurane in pure oxygen was used due to apnea, which occurs 30 minutes after the induction semi-closed system was attached and the ventilator was turned on (PCV system, four breaths per minute, 8 cm of H2O). Cardiopulmonary parameters (HR, RR, SPO2, ETCO2, ETISO) were assessed throughout the procedure. During the entire procedure, the operating room was heated to a temperature of 26 degrees Celsius. Additionally, the hose was placed on a heating mat, which maintained a temperature of 30 degrees Celsius. For 15 minutes after induction, the loss of muscle tone was observed from the head to the tail. Induction of general anesthesia was scored as good because of the possibility of intubation. During the whole procedure, the heart rate was at the rate of 58 beats per minute (bpm). Ventilation parameters were stable throughout the procedure. The recovery period lasts for about 4 hours after the end of general anesthesia. The muscle tension returned from tail to head. The snake started to breathe spontaneously within 1,5 hours after the end of general anesthesia. The protocol of general anesthesia with the combination of tiletamine- zolazepam with a dose of 10 mg/kg is useful for proceeding with the emergency coeliotomy in maintenance with isoflurane in oxygen. Further study about the impact of the combination of tiletamine- zolazepam for the recovery period is needed.

Keywords: anesthesia, corallus hortulanus, ovoviparous, snake, tiletamine, zolazepam

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Authors: Nancy Wilson

Abstract:

In utero, fetal drug exposure is prevalent amongst birthing facilities. Assessment tools for neonatal abstinence syndrome (NAS) are often cumbersome and ill-fitting, harboring immense subjectivity. This paradox often leads the clinical assessor to be hypervigilant when assessing the newborn for subtle symptoms of NAS, often mistaken for normal newborn behaviors. As a quality improvement initiative, this project led to a more adaptable NAS tool termed eat, sleep, console (ESC). This function-based NAS assessment scores the infant based on the ability to accomplish three basic newborn necessities- to sleep, to eat, and to be consoled. Literature supports that ESC methodology improves patient and family outcomes while providing more cost-effective care.

Keywords: neonatal abstinence syndrome, neonatal opioid withdrawal, maternal substance abuse, pregnancy, and addiction, Finnegan neonatal abstinence syndrome tool, eat, sleep, console

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Authors: Alia Al Rayssi, Mahra Al Marar, Alyazia Alkhaili, Reem Al Dhaheri, Shayma Alkobaisi, Hoda Amer

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We present in this paper a web-based system called “HelpMeBreathe” for managing asthma. The proposed system provides analytical tools, which allow better understanding of environmental triggers of asthma, hence better support of data-driven decision making. The developed system provides warning messages to a specific asthma patient if the weather in his/her area might cause any difficulty in breathing or could trigger an asthma attack. HelpMeBreathe collects, stores, and analyzes individuals’ moving trajectories and health conditions as well as environmental data. It then processes and displays the patients’ data through an analytical tool that leads to an effective decision making by physicians and other decision makers.

Keywords: asthma, environmental triggers, map interface, web-based systems

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Authors: Christi Jackson, Chuka Onaga

Abstract:

Introduction: We report a case of delayed diagnosis of extra-pulmonary INH-mono-resistant Tuberculosis (TB) in a South African patient with drug-resistant HIV. Case Presentation: A 36-year old male was initiated on 1st line (NNRTI-based) anti-retroviral therapy (ART) in September 2009 and switched to 2nd line (PI-based) ART in 2011, according to local guidelines. He was following up at the outpatient wellness unit of a public hospital, where he was diagnosed with Protease Inhibitor resistant HIV in March 2016. He had an HIV viral load (HIVVL) of 737000 copies/mL, CD4-count of 10 cells/µL and presented with complaints of productive cough, weight loss, chronic diarrhoea and a septic buttock wound. Several investigations were done on sputum, stool and pus samples but all were negative for TB. The patient was treated with antibiotics and the cough and the buttock wound improved. He was subsequently started on a 3rd-line ART regimen of Darunavir, Ritonavir, Etravirine, Raltegravir, Tenofovir and Emtricitabine in May 2016. He continued losing weight, became too weak to stand unsupported and started complaining of abdominal pain. Further investigations were done in September 2016, including a urine specimen for Line Probe Assay (LPA), which showed M. tuberculosis sensitive to Rifampicin but resistant to INH. A lymph node biopsy also showed histological confirmation of TB. Management and outcome: He was started on Rifabutin, Pyrazinamide and Ethambutol in September 2016, and Etravirine was discontinued. After 6 months on ART and 2 months on TB treatment, his HIVVL had dropped to 286 copies/mL, CD4 improved to 179 cells/µL and he showed clinical improvement. Pharmacy supply of his individualised drugs was unreliable and presented some challenges to continuity of treatment. He successfully completed his treatment in June 2017 while still maintaining virological suppression. Discussion: Several laboratory-related factors delayed the diagnosis of TB, including the unavailability of urine-lipoarabinomannan (LAM) and urine-GeneXpert (GXP) tests at this facility. Once the diagnosis was made, it presented a treatment dilemma due to the expected drug-drug interactions between his 3rd-line ART regimen and his INH-resistant TB regimen, and specialist input was required. Conclusion: TB is more difficult to diagnose in patients with severe immunosuppression, therefore additional tests like urine-LAM and urine-GXP can be helpful in expediting the diagnosis in these cases. Patients with non-standard drug regimens should always be discussed with a specialist in order to avoid potentially harmful drug-drug interactions.

Keywords: drug-resistance, HIV, line probe assay, tuberculosis

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Authors: Mary Rose Eunice S. Gundayao, Manolo M. Fernandez

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Metachromatic leukodystrophy (MLD) is a rare lysosomal storage disorder with an autosomal recessive inheritance pattern. Lysosomal storage disorders are often severe, follow a progressively neurodegenerative path, and may result in multi-organ failure, potentially leading to death within 5 to 6 years in cases of early-onset forms. There are limited data regarding cases of MLD in Filipino children. This is the case of a 2-year-old Filipino girl who presented with progressive neurological deterioration and was diagnosed with metachromatic leukodystrophy by molecular genetic testing. This case report aims to present this patient’s clinical history, neurological findings, diagnosis and novel genetic mutations causing MLD. A concise review of updated literature on MLD will be discussed.

Keywords: metachromatic leukodystrophy, ARSA gene, peripheral neuropathy, case report, demyelinating disease

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