Search results for: intensive Care

Authors: Manar Aslan, Selver Gokdemir, Chatitze Chousein

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This research was conducted to evaluate the factors affecting the working environment of nurses working in three state hospitals. A favorable working environment contributes to increased job satisfaction of nurses and improved working conditions that affects the quality of the work done in a positive way. The population of the study was composed the three largest state hospitals in the region of Thrace in Turkey and 931 nurses working in there. In this research was not used any sampling method. The sampling was composed of nurses who accepted to take part in this research from three hospitals. It was used nursing work index-the practice work environment scale (Turkish version) for data collection (Cronbach alpha: 0.94).When the total scale scores of the nurses in the research were examined, it was determined that they evaluated the working environment below the average. It was also determined that the adequacy of human and other resources, dimensions of the physician-nurse communication scores were low. As in every profession group, the working environment in nursing has an importance to provide quality health and nursing care. A favorable working environment will increase nurses' performance and satisfaction with their work. Identifying the factors affecting the working environment and carrying out the remedial work for them will increase the quality of the health service.

Keywords: work environment, work index, nursing, hospitals

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Authors: Ankita Baidya, Vanishri Ganakumar, Ranveer S. Jadon, Piyush Ranjan, Rita Sood

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Septic embolism can have varied presentations and clinical considerations. Infected central venous catheters are commonly associated with septic emboli but peripheral vascular catheters are rarely implicated. We describe a rare case of septic pulmonary emboli related to infected peripheral venous cannulation caused by an unusual etiological agent. A young male presented with complaints of fever, productive cough, sudden onset shortness of breath and cellulitis in both the upper limbs. He was recently hospitalised for dengue fever and administered intravenous fluids through peripheral venous line. The patient was febrile, tachypneic and in respiratory distress, there were multiple pus filled bullae in left hand alongwith swelling and erythema involving right forearm that started at the site of cannulation. Chest examination showed active accessory muscles of respiration, stony dull percussion at the base of right lung and decreased breath sounds at right infrascapular, infraaxillary and mammary area. Other system examination was within normal limits. Chest X-ray revealed bilateral multiple patchy heterogenous peripheral opacities and infiltrates with right-sided pleural effusion. Contrast-enhanced computed tomography (CECT) chest showed feeding vessel sign confirming the diagnosis as septic emboli. Venous Doppler and 2D-echocardiogarm were normal. Laboratory findings showed marked leucocytosis (22000/mm3). Pus aspirate, blood sample, and sputum sample were sent for microbiological testing. The patient was started empirically on ceftriaxone, vancomycin, and clindamycin. The Pus culture and sputum culture showed Klebsiella pneumoniae sensitive to cefoperazone-sulbactum, piperacillin-tazobactum, meropenem and amikacin. The antibiotics were modified accordingly to antimicrobial sensitivity profile to Cefoperazone-sulbactum. Bronchoalveolar lavage (BAL) was done and sent for microbiological investigations. BAL culture showed Klebsiella pneumoniae with same antimicrobial resistance profile. On day 6 of starting cefoperazone-sulbactum, he became afebrile. The skin lesions improved significantly. He was administered 2 weeks of cefoperazone–sulbactum and discharged on oral faropenem for 4 weeks. At the time of discharge, TLC was 11200/mm3 with marked radiological resolution of infection and healed skin lesions. He was kept in regular follow up. Chest X-ray and skin lesions showed complete resolution after 8 weeks. Till date, only couple of case reports of septic emboli through peripheral intravenous line have been reported in English literature. This case highlights that a simple procedure of peripheral intravenous cannulation can lead to catastrophic complication of septic pulmonary emboli and widespread cellulitis if not done with proper care and precautions. Also, the usual pathogens in such clinical settings are gram positive bacteria, but with the history of recent hospitalization, empirical therapy should also cover drug resistant gram negative microorganisms. It also emphasise the importance of appropriate healthcare practices to be taken care during all procedures.

Keywords: antibiotics, cannula, Klebsiella pneumoniae, septic emboli

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Authors: Nesrine Frifita

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In recent years, serious interest in underground sources has led to more intensive studies of depth, thickness, geometry and properties of aquifers. Geophysical method is the common technique used in discovering the subsurface. However, determining the exact location of groundwater in subsurface layers is one of problems that needs to be resolved. While the biggest problem is the quality of the groundwater which suffers from pollution risk especially with water shortage in arid regions under a remarkable climate change. The present study was conducted using electrical resistivity tomography at Jeffara coastal area in Southeast Tunisia to image the potential shallow aquifer and studying their physical properties. The purpose of this study is to understand the characteristics and depth of the Smar aquifer. Therefore, it can be used as a reference in groundwater drilling in order to guide the farmers and to improve the living of the inhabitants of nearby cities. The use of the Winner-Schlumberger array for data acquisition is suitable to obtain a deeper profile in areas with homogeneous layers. For that, six electrical resistivity profiles were carried out in Smar watershed using 72 electrodes with 4 and 5 m spacing. The resistivity measurements were carefully interpreted by a least-square inversion technique using the RES2DINV program. Findings show that the Smar aquifer has about 31 m thickness and it extends to 36.5 m depth in the downstream area of Oued Smar. The defined depth and geometry of Smar aquifer indicate that the sedimentary cover thins toward the coast, and the Smar shallow aquifer becomes deeper toward the West. While the resistivity values show a significant contrast even reaching < 1 Ωm in ERT1, this resistivity value can be related to the saline water that foretells a risk of pollution and bad groundwater quality. The ERT1 geoelectrical model defines an unsaturated zone, while under ERT3 site, the geoelectrical model presents a saturated zone, which reflect a low resistivity values indicate the locally surface water coming from the nearby Office of the National Sanitation Utility (ONAS) that can be a source of recharge of the studied shallow aquifer and more deteriorate the groundwater quality in this region.

Keywords: electrical resistivity tomography, groundwater, recharge, smar aquifer, southeastern tunisia

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Authors: Agbor Ekama Prisca Anne

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Current data on the prevalence and psychosocial correlates of sexual violence in the Cameroon is lacking, with the most recent sexual abuse and violence survey dating back to 2001. The current study sought to identify what proportion of University students have experienced sexual violence, if there are sex differences in exposure to different forms of sexual violence, and to what extent different forms of sexual violence are associated with adverse psychosocial outcomes. A nationally representative sample of University students (N = 1,020) completed self-report measures of history of sexual violence and mental health. Approximately one-in-three (34.4%) students experienced some form of sexual violence, including 14.8% who were sexually assaulted (raped) and 31.1% who were sexually harassed. Female students were significantly more likely than men to have experienced all forms of sexual violence (ps < .001), with the exception of sexual assault by teachers or guardian. All forms of sexual violence were associated with an increased likelihood of serious mental health problems, with sexual assault by a teacher associated with several other psychosocial outcomes in life, including education achievement, and behavior disorder. Sexual violence is a common experience in the general population and female students are disproportionately affected (1-in-2 girls versus 1-in-5 boys). Additional resources to increase mental health care among survivors of sexual violence is urgently needed.

Keywords: psychosocial, effects sexual, violence, females, students

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Authors: Estelle Ardanouy, Helene Delage, Pascal Zesiger

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Morphological awareness contributes to the acquisition of reading and spelling in typical learners as well as in children with learning disorders. Indeed, the acquisition of phoneme-grapheme correspondences is not sufficient to master spelling, especially in inconsistent orthographic systems such as English or French. Several meta-analyses show the benefit of explicit training in derivational morphology on reading and spelling in old children (who have already learned the main grapheme-phoneme correspondences), but highlight the lack of studies with younger children, particularly in French. In this study, we chose to focus on the efficiency of an intensive training in derivational morphology on spelling skills in French-speaking four-graders (9-10 years of age). The training consisted of 1) learning how to divide words into morphemes (ex: para/pente in French, paraglider in English), as well as 2) working on the meaning of affixes in relation to existing words (ex: para/pente: to protect against – para - the slope -pente). One group of pupils (N = 37, M age = 9.5) received this experimental group training in morphology while an alternative training group (N = 34, M age = 9.6) received a visuo-semantic training based on visual cues to memorize the spelling difficulties of complex words (such as the doubling of “r” in “verre” in French -or "glass" in English-which are represented by the drawing of two glasses). Both trainings lasted a total of 15 hours at a rate of four 45 minutes sessions per week, resulting in five weeks of training in the school setting. Our preliminary results show a significant improvement in the experimental group in the spelling of affixes on the trained (p < 0.001) and untrained word lists (p <0.001), but also in the root of words on the trained (p <0.001) and untrained word lists group (p <0.001). The training effect is also present on both trained and untrained morphologically composed words. By contrast, the alternative training group shows no progress on these previous measures (p >0.15). Further analyses testing the effects of both trainings on other measures such as morphological awareness and reading of morphologically compose words are in progress. These first results support the effectiveness of explicitly teaching derivational morphology to improve spelling in school-aged children. The study is currently extended to a group of children with developmental dyslexia because these children are known for their severe and persistent spelling difficulties.

Keywords: developmental dyslexia, derivational morphology, reading, school-aged children, spelling, training

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Authors: Uvais Qidwai, Amor Moursi, Mohamed Tahar, Malek Hamad, Hamad Alansi

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This paper focuses on the development and implementation of an advanced plant health monitoring system with an AI backbone and IoT sensory network. Our approach involves addressing the critical environmental factors essential for preserving a plant’s well-being, including air temperature, soil moisture, soil temperature, soil conductivity, pH, water levels, and humidity, as well as the presence of essential nutrients like nitrogen, phosphorus, and potassium. Central to our methodology is the utilization of computer vision technology, particularly a night vision camera. The captured data is then compared against a reference database containing different health statuses. This comparative analysis is implemented using an AI deep learning model, which enables us to generate accurate assessments of plant health status. By combining the AI-based decision-making approach, our system aims to provide precise and timely insights into the overall health and well-being of plants, offering a valuable tool for effective plant care and management.

Keywords: deep learning image model, IoT sensing, cloud-based analysis, remote monitoring app, computer vision, fuzzy control

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Authors: Julian Donovan, Jessica Brealey, Matthew Bowker, Marianne Feghali, Gregory Smith, Lee Thompson, Deborah Henderson

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This article details the development of the X-ray response team (XRT), a service that utilises innovative technology to safely deliver acute and elective imaging and medical assessment service in the pre-hospital and community setting. This involves a partnership between Northumbria Healthcare NHS Foundation Trust’s Radiology and Emergency Medicine departments and the North East Ambulance Service to create a multidisciplinary prehospital team. The team committed to the delivery of a two-day acute service every week, alongside elective referrals, starting in November 2020. The service was originally made available to a 15-mile radius surrounding the Northumbria Hospital. Due to demand, this was expanded to include the North Tyneside and Northumberland regions. The target population was specified as frail and vulnerable patients, as well as those deemed to benefit from staying in their own environment. Within the first two months, thirty-six percent of patients assessed were able to stay at home due to the provision of off-site imaging. In the future, this service aims to allow patient transfer directly to an appropriate ward or clinic, bypassing the emergency department to improve the patient journey and reduce emergency care pressures.

Keywords: frailty, imaging, pre-hospital, X-ray

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Authors: Adedotun Ayodele Dipeolu, Olusegun Ayotunde Oriola

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Rapid urban growth has led to the loss of contact with nature for most urban residents. While Green Infrastructure (GI) is promoted as a strategy to manage ecosystems’ functionality, the extent to which residents are aware of GI types which serve as alternatives to conventional landscapes to be conserved remains unclear. This paper examines the awareness level of GI types among residents of Lagos Metropolis, Nigeria and the association of their demographic characteristics with the level of awareness. Multi-stage sampling technique was used to select 1560 residents who completed semi-structured questionnaires. Descriptive statistics were used to explore data distributions while t-test assessed the differences in the awareness level of the male and female participants. From the 23 different types of GI facilities identified in the study area, residents reported a high level of awareness on just five of them. These include green gardens, green parks, grasses, street trees, and sports fields but a low level of awareness of the remaining 18 GI types. Awareness of GI types is presently low in the study area. Increased awareness will encourage care and protection of green infrastructure by residents which will consequently enhance availability and conservation of more biodiversity in Lagos, Nigeria, and other nations.

Keywords: awareness, biodiversity conservation, environmental sustainability, green infrastructure, urban centres

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Authors: Junie B. Billones, Maria Constancia O. Carrillo, Voltaire G. Organo, Stephani Joy Y. Macalino, Inno A. Emnacen, Jamie Bernadette A. Sy

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The drug discovery and development process is generally known to be a very lengthy and labor-intensive process. Therefore, in order to be able to deliver prompt and effective responses to cure certain diseases, there is an urgent need to reduce the time and resources needed to design, develop, and optimize potential drugs. Computer-aided drug design (CADD) is able to alleviate this issue by applying computational power in order to streamline the whole drug discovery process, starting from target identification to lead optimization. This drug design approach can be predominantly applied to diseases that cause major public health concerns, such as tuberculosis. Hitherto, there has been no concrete cure for this disease, especially with the continuing emergence of drug resistant strains. In this study, CADD is employed for tuberculosis by first identifying a key enzyme in the mycobacterium’s metabolic pathway that would make a good drug target. One such potential target is the lipoate protein ligase B enzyme (LipB), which is a key enzyme in the M. tuberculosis metabolic pathway involved in the biosynthesis of the lipoic acid cofactor. Its expression is considerably up-regulated in patients with multi-drug resistant tuberculosis (MDR-TB) and it has no known back-up mechanism that can take over its function when inhibited, making it an extremely attractive target. Using cutting-edge computational methods, compounds from AnalytiCon Discovery Natural Derivatives database were screened and docked against the LipB enzyme in order to rank them based on their binding affinities. Compounds which have better binding affinities than LipB’s known inhibitor, decanoic acid, were subjected to in silico toxicity evaluation using the ADMET and TOPKAT protocols. Out of the 31,692 compounds in the database, 112 of these showed better binding energies than decanoic acid. Furthermore, 12 out of the 112 compounds showed highly promising ADMET and TOPKAT properties. Future studies involving in vitro or in vivo bioassays may be done to further confirm the therapeutic efficacy of these 12 compounds, which eventually may then lead to a novel class of anti-tuberculosis drugs.

Keywords: pharmacophore, molecular docking, lipoate protein ligase B (LipB), ADMET, TOPKAT

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Authors: Ryan M. Monti, Bijal Mehta

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In cases of massive pulmonary embolism, defined as acute pulmonary embolism presenting with systemic hypotension or right ventricular dysfunction and impending failure, there is indication that unconventional therapies, such as phosphodiesterase inhibitors, endothelin receptor antagonists, and/or prostacyclin analogs may decrease the morbidity and mortality. Based on the premise that dilating the pulmonary artery will decrease the pulmonary vascular pressure, while simultaneously decreasing the aggregation of platelets, it can be hypothesized that increased blood flow through the pulmonary artery will decrease right heart strain and subsequent morbidity and mortality. While this theory has yet to be formally studied, the recommendations for treating massive pulmonary embolism with phosphodiesterase inhibitors, endothelin receptor antagonists, and/or prostacyclin analogs in conjunction with the current standards of care in massive pulmonary embolism should be formally studied. In particular, patients with massive PE who are unable to undergo thrombolysis/surgical intervention may be the ideal population to study the use of these treatments to determine any decrease in mortality and morbidity (short term and long term).

Keywords: acute pulmonary thromboembolism, treatment of pulmonary embolism, use of phosphodiesterase inhibitors, endothelin receptor antagonists, prostacyclin analogs in PE

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Authors: Kailin K. Zhang, Anne W. Thompson

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Electronic learning for continuing professional education (CPE) and interprofessional education (IPE) in healthcare have been shown to improve learners’ satisfaction, attitudes, and performance. Yet, their impact on behavior change in healthcare professionals through continuing interprofessional education (CIPE) is less known. A scoping review of 32 articles from 2010 to 2020 was conducted using the Arksey and O’Malley framework across all healthcare settings. It focused on evaluating the effectiveness of CIPE on behavior change of healthcare professionals, as well as identifying course features of electronic CIPE programs facilitating behavior change. Eight different types of electronic learning methods, including online programs, tele-education, and social media, were identified as interventions. More than 35,542 healthcare professionals participated in the interventions. Electronic learning for CIPE led to positive behavior outcomes in 30 out of 32 studies, especially through a change in patient care practices. The most successful programs provided interactive and authentic learning experiences tailored to learners’ needs while promoting the direct application of what was learned in their clinical settings. Future research should include monitoring of sustained behavior changes and their resultant patient outcomes.

Keywords: behavior change, continuing interprofessional education, distance learning, electronic learning

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Authors: Vanessa Cho, Janet Hsiao, Nigel King, Robert Anthonappa

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Background: The personal protective equipment (PPE) requirements for health care workers (HCWs) have changed significantly during the COVID-19 pandemic. Aim: To ascertain, using eye-tracking technology, what children notice the most when seeing HCWs in various PPE. Design: A Tobii nano pro-eye-tracking camera tracked 156 children's visual attention while they viewed photographs of HCWs in various PPEs. Eye Movement analysis with Hidden Markov Models (EMHMM) was employed to analyse 624 recordings using two approaches, namely (i) data-driven where children's fixation determined the regions of interest (ROIs), and (ii) fixed ROIs where the investigators predefined the ROIs. Results: Two significant eye movement patterns, namely distributed(85.2%) and selective(14.7%), were identified(P<0.05). Most children fixated primarily on the face regardless of the different PPEs. Children fixated equally on all PPE images in the distributed pattern, while a strong preference for unmasked faces was evident in the selective pattern (P<0.01). Conclusion: Children as young as 2.5 years used a top-down visual search behaviour and demonstrated their face processing ability. Most children did not show a strong visual preference for a specific PPE, while a minority preferred PPE with distinct facial features, namely without masks and loupes.

Keywords: COVID-19, PPE, dentistry, pediatric

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Authors: Krisztina Bohacs, Klaudia Markus

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To author’s best knowledge we are in absence of studies on cognitive program evaluation and we are certainly short of programs that prove to have high effect sizes with strong retention results. The purpose of our study was to investigate the effectiveness of a comprehensive cognitive training program, namely BrainRx. This cognitive rehabilitation program target and remediate seven core cognitive skills and related systems of sub-skills through repeated engagement in game-like mental procedures delivered one-on-one by a clinician, supplemented by digital training. A larger sample of children with learning disability were given pretest and post-test cognitive assessments. The experimental group completed a twenty-week cognitive training program in a BrainRx center. A matched control group received another twenty-week intervention with Feuerstein’s Instrumental Enrichment programs. A second matched control group did not receive training. As for pre- and post-test, we used a general intelligence test to assess IQ and a computer-based test battery for assessing cognition across the lifespan. Multiple regression analyses indicated that the experimental BrainRx treatment group had statistically significant higher outcomes in attention, working memory, processing speed, logic and reasoning, auditory processing, visual processing and long-term memory compared to the non-treatment control group with very large effect sizes. With the exception of logic and reasoning, the BrainRx treatment group realized significantly greater gains in six of the above given seven cognitive measures compared to the Feuerstein control group. Our one-year retention measures showed that all the cognitive training gains were above ninety percent with the greatest retention skills in visual processing, auditory processing, logic, and reasoning. The BrainRx program may be an effective tool to establish long-term cognitive changes in case of students with learning disabilities. Recommendations are made for treatment centers and special education institutions on the cognitive training of students with special needs. The importance of our study is that targeted, systematic, progressively loaded and intensive brain training approach may significantly change learning disabilities.

Keywords: cognitive rehabilitation training, cognitive skills, learning disability, permanent structural cognitive changes

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Authors: Martha Hough RN

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Background: New nursing graduates lack the critical thinking skills required to provide safe nursing care. Critical thinking is essential in providing safe, competent, and skillful nursing interventions. Educational institutions must provide a curriculum that improves nursing students' critical thinking abilities. In addition, the recent pandemic resulted in nursing students who previously received in-person clinical but now most clinical has been converted to remote learning, increasing the use of simulations. Unfolding medium and high-fidelity simulations and Socratic questioning are used in many simulations debriefing sessions. Methodology: Google Scholar was researched with the keywords: critical thinking of nursing students with unfolding simulation, which resulted in 22,000 articles; three were used. A second search was implemented with critical thinking of nursing students Socratic questioning, which resulted in two articles being used. Conclusion: Unfolding simulations increase nursing students' critical thinking, especially during the briefing (pre-briefing and debriefing) phases, where most learning occurs. In addition, the use of Socratic questions during the briefing phases motivates other questions, helps the student analyze and critique their thinking, and assists educators in probing students' thinking, which further increases critical thinking.

Keywords: briefing, critical thinking, Socratic thinking, unfolding simulations

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Authors: Dalia Feiziene, Virginijus Feiza, Agne Putramentaite, Jonas Volungevicius, Kristina Amaleviciute, Sarunas Antanaitis

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The investigations on soil conservation are one of the most important topics in modern agronomy. Soil management practices have great influence on soil physico-chemical quality and GHG emission. Research objective: To reveal the sensitivity and vitality of soils with different texture to long-term antropogenisation on Cambisol in Central Lithuania and to compare them with not antropogenised soil resources. Methods: Two long-term field experiments (loam on loam; sandy loam on loam) with different management intensity were estimated. Disturbed and undisturbed soil samples were collected from 5-10, 15-20 and 30-35 cm depths. Soil available P and K contents were determined by ammonium lactate extraction, total N by the dry combustion method, SOC content by Tyurin titrimetric (classical) method, texture by pipette method. In undisturbed core samples soil pore volume distribution, plant available water (PAW) content were determined. A closed chamber method was applied to quantify soil respiration (SR). Results: Long-term resources management changed soil quality. In soil with loam texture, within 0-10, 10-20 and 30-35 cm soil layers, significantly higher PAW, SOC and mesoporosity (MsP) were under no-tillage (NT) than under conventional tillage (CT). However, total porosity (TP) under NT was significantly higher only in 0-10 cm layer. MsP acted as dominant factor for N, P and K accumulation in adequate layers. P content in all soil layers was higher under NT than in CT. N and K contents were significantly higher than under CT only in 0-10 cm layer. In soil with sandy loam texture, significant increase in SOC, PAW, MsP, N, P and K under NT was only in 0-10 cm layer. TP under NT was significantly lower in all layers. PAW acted as strong dominant factor for N, P, K accumulation. The higher PAW the higher NPK contents were determined. NT did not secure chemical quality within deeper layers than CT. Long-term application of mineral fertilisers significantly increased SOC and soil NPK contents primarily in top-soil. Enlarged fertilization determined the significantly higher leaching of nutrients to deeper soil layers (CT) and increased hazards of top-soil pollution. Straw returning significantly increased SOC and NPK accumulation in top-soil. The SR on sandy loam was significantly higher than on loam. At dry weather conditions, on loam SR was higher in NT than in CT, on sandy loam SR was higher in CT than in NT. NPK fertilizers promoted significantly higher SR in both dry and wet year, but suppressed SR on sandy loam during usual year. Not antropogenised soil had similar SOC and NPK distribution within 0-35 cm layer and depended on genesis of soil profile horizons.

Keywords: fertilizers, long-term experiments, soil texture, soil tillage, straw

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Authors: Won-Gon Kim

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Introduction: The clinical value of arterial line filters is still a controversial issue. Proponents of arterial line filtration argue that filters remove particulate matter and undissolved gas from circulation, while opponents argue the absence of conclusive clinical data. We conducted scanning electron microscope (SEM) studies of arterial line filters used clinically in the CPB circuits during adult cardiac surgery and analyzed the types and characteristics of materials entrapped in the arterial line filters. Material and Methods: Twelve arterial line filters were obtained during routine hypothermic cardiopulmonary bypass in 12 adult cardiac patients. The arterial line filter was a screen type with a pore size of 40 ㎛ (Baxter Health care corporation Bentley division, Irvine, CA, U.S.A.). After opening the housing, the woven polyester strands were examined with SEM. Results and Conclusion: All segments examined(120 segments, each 2.5 X 2.5 cm in size) contained no embolic particles larger in their cross-sectional area than the pore size of the filter(40 ㎛). The origins of embolic particulates were mostly from environmental foreign bodies. This may suggest a possible need for more aggressive filtration of smaller particulates than is generally carried out at the present time.

Keywords: arterial line filter, tubing wear, scanning electron microscopy, SEM

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Authors: Oscar Maina Irungu

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Background: Men who have sex with men (MSM) in Mtwapa Town, Kilifi County are at high risk of HIV infection. Probability sample surveys to determine HIV prevalence among MSM in Mtwapa are needed to inform prevention and care services. Methods: In 2013, a cross-sectional survey was conducted among MSM aged 18-24 years old, using respondent-driven sampling (RDS) in Mtwapa. Consenting MSM were tested for HIV (fingerstick rapid test). Population-based prevalence and 95 % confidence intervals (CI) were estimated using RDS Analysis Tool (RDSAT). Results: Among 274 MSM, the median age was 20 years (IQR: 19-23 years). Fifty percent of MSM reported not selling sex, while 13.2 % reported sex work as their “main occupation”, and another 28.4 % reported selling sex in the past two months (but not as their main occupation).Overall HIV prevalence was 19.2 % (CI: 12.2-23.6%). HIV prevalence was higher among MSM who reported sex work as their main occupation (28.3%,CI: 12.1-42.3%) or selling sex in the past two months (26.6 %, CI: 17.2-35.7 %),than among MSM who did not sell sex (11.6%,CI: 7.0-18.1%). Conclusion: HIV prevalence among MSM were high than among Kilifi’s general population aged 15-64 years (8.8%; 2010 KAIS) and highest in male sex workers. Health programs need to address concerns and modify services to meet needs of diverse subgroups of MSM. We recommend continued, periodic surveillance to monitor HIV prevalence among MSM in Mtwapa, and expansion to other areas in Kenya.

Keywords: power point, Kenya, homosexuality, sex

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Authors: Tsai Su Hui

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Background: Hyperphosphatemia in patients receiving dialysis can cause hyperparathyroidism, which can lead to renal osteodystrophy, cardiovascular disease and mortality. Data showed that 26% of patients receiving dialysis had blood phosphate levels of >6.0 mg/dl at this unit from January to March 2017, higher than the Taiwan Society of Nephrology evaluation criteria of < 20%. After analysis, possible reasons included: 1. Incomprehensive education for nurse and lack of relevant training. 2. Insufficient assistive aids for nursing health education instruction. 3. Patients were unsure which foods are high or low in phosphate. 4. Patients did not have habits of taking medicine with them and how to correctly administer the medication. Purpose: To reduce the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl to less than 20% at this unit. Method: (1) Improve understanding of hyperphosphatemia and food for patients receiving dialysis and their families, (2) Acquire more nursing instruction assistive aids and improve knowledge of hyperphosphatemia for nurse. Results: After implementing the project, the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl decreased from 26.0% to 18.8% at this unit. By implementing the project, the professional skills of nurse improved, blood phosphate levels of patients receiving dialysis were reduced, and the quality of care for patients receiving dialysis at this unit was enhanced.

Keywords: hemodialysis, hyperphosphatemia, incidence, reducing

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Authors: K. Volkonitskaya, S. Lyapina

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According to the National Monitoring Centre of innovation infrastructure, scientific and technical activities and regional innovation systems by December 2014. 166 technology parks were established in Russia. Comparative analysis of technological parks performance in Russia, the USA, Israel and the European Union countries revealed significant reduction of key performance indicators in Russian innovation infrastructure institutes. The largest deviations were determined in the following indicators: new products and services launched, number of companies and jobs, amount of venture capital invested. Lower performance indicators of Russian technology parks can be partly explained by slack demand for national high-tech products and services, lack of qualified specialists in the sphere of innovation management and insufficient cooperation between different innovation infrastructure institutes. In spite of all constraints in innovation segment of Russian economy in 2010-2012 private investors for the first time proceeded to finance building of technological parks. The general purpose of the research is to answer two questions: why despite the significant investment risks private investors continue to implement such comprehensive infrastructure projects in Russia and is business model of private technological park more efficient than strategies of state innovation infrastructure institutes? The goal of the research was achieved by analyzing business models of private technological parks in Moscow, Kaliningrad, Astrakhan and Kazan. The research was conducted in two stages: the on-line survey of key performance indicators of private and state Russian technological parks and in-depth interviews with top managers and investors, who have already build private technological parks in by 2014 or are going to complete investment stage in 2014-2016. The results anticipated are intended to identify the reasons of efficient and inefficient technological parks performance. Furthermore, recommendations for improving the efficiency of state technological and industrial parks were formulated. Particularly, the recommendations affect the following issues: networking with other infrastructural institutes, services and infrastructure provided, mechanisms of public-private partnership and investment attraction. In general intensive study of private technological parks performance and development of effective mechanisms of state support can have a positive impact on the growth rates of the number of Russian technological, industrial and science parks.

Keywords: innovation development, innovation infrastructure, private technology park, public-private partnership

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Authors: F. Haddadj, S. Hamdi, A. Milla, S. Zenia, A. Smai, H. Saadi, F. Marniche, B. Doumandji-Mitiche

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The use of a biopesticide based on a microorganism scale requires particular care including safety against the useful auxiliary fauna and mammals among other human beings. Due to its persistence in soil and its apparent human and animal safety, Beauveria bassiana is a cryptogram used for controlling pests organizations, particularly in the locust where its effectiveness has been proven. This fungus is also called for greater respect for biotic communities and the environment. Indeed, biopesticides have several environmental benefits: biodegradability, their activity and selectivity decrease unintended non-target species effects, decreased resistance to some of them. It is in this sense that we contribute by presenting our work on the safety of B. bassiana against mammals. For this we conducted a toxicological study of this fungus strain on Wistar rats Rattus norvegicus, first its effect on weight gain. In a second time were performed histological target organ is the liver. After 20 days of treatment, the results of the toxicological studies have shown that B. bassiana caused no change in the physiological state of rats or weight gain, behavior and diet. On cuts in liver histology revealed no disturbance on the organ.

Keywords: B. bassiana, entomopathogenic fungus, histology, Rattus norvegicus

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Authors: LaShawnda N. Fields, Valandra

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There remains much to learn about the experiences of Black women within social work education. Higher education, in general, has a strained relationship with this demographic and while social work has espoused a code of ethics and core values, Black women report inequitable experiences similar to those in other disciplines. Research-intensive (R-1) Carnegie-designated institutions typically have lower representation of those with historically marginalized identities; this study focuses on Black women in these schools of social work. This study presents qualitative findings from 9 in-depth interviews with Black women faculty members as well as interviews with 11 Black women doctoral students at R-1 universities. Many of the poor professional outcomes for Black women in academia are a result of their experiences with imposter syndrome and feeling as though they cannot present their authentic selves. The finding of this study highlighted the many ways imposter syndrome manifests within these study participants, from an inability to be productive to overproducing in an effort to win the respect and support of colleagues. Being scrutinized and seen as unprofessional when being authentic has led to some Black women isolating themselves and struggling to remain in academia. Other Black women have decided that regardless of the backlash they may receive, they will proudly present their authentic selves and allow their work to speak for itself rather than conform to the dominant White culture. These semi-structured, in-depth interviews shined a spotlight on the ways Black women doctoral students were denied inclusion throughout their programs. These students often believed both faculty members and peers seemed to actively work to ensure discomfort in these women. In response to these negative experiences and a lack of support, many of these Black women doctoral students created their own networks of support. These networks of support often included faculty members within social work but also beyond their discipline and outside of the academy at large. The faculty members who offered support to this demographic typically shared their race and gender identities. Both Black women faculty members and doctoral students historically have been forced to prioritize surviving, not thriving as a result of toxic environments within their schools of social work. This has negatively impacted their mental health and their levels of productivity. It is necessary for these institutions to build trust with these women by respecting their diverse backgrounds, supporting their race-related research interests, and honoring the rigor in a range of methodologies if substantial, sustainable change is to be achieved.

Keywords: education, equity, inclusion, intersectionality

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Authors: Paria Koraei, Meysam Ahmadzadeh, Reza Shahriarirad, Keivan Ranjbar, Farzane Farahmand

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The rapid spread of the coronavirus disease 2019 (COVID-19) has enlisted dental offices in high-risk places. A cross-sectional survey was carried out among the general population aged 17 and above in Shiraz, Fars, Iran. The patients' demographic features were recorded and analyzed against questions regarding fear, anxiety, and attitude toward dental appointments. The Dental Anxiety Scale (DAS) questionnaire was used for the evaluation of anxiety levels. Among a total of 760 participants, the average age was 32.33±11.27 years, while 242 (31.8%) were male and 357 (47%) were single. Based on the anxiety scores, 336 (44.2%) participants had mild anxiety, 215 (28.3%) had moderate anxiety, 74 (9.7%) had high, and 135 (17.8%) had severe anxiety. The majority of participants used masks (93.8%) and disinfectants (79.9%) during dental visits, and the most emphasized policies during dental visits were using disposable face masks by the personnel (83.6%) and controlling the number of visitors in the office (81.8%). Only 226 (29.7%) reported that they hadn’t postponed their dental visits. Our findings demonstrated that anxiety in people increases toward dental treatments during the COVID-19 pandemic, resulting in decreased dental appointments. Dentally anxious people were more likely to be female and married couples. Being female and older age are possible risk factors for developing a fear of dental procedures.

Keywords: Covid-19, anxiety, fear, dentistry, dental care

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Authors: Daphne Alroy-Thiberge

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Trauma-impacted individuals present unique treatment challenges that include high reactivity, hyper-and hypo-arousal, poor adherence to therapy, as well as powerful transference and counter-transference experiences in therapy. This work provides an overview of the clinical tenets most often encountered in trauma-impacted individuals. Further, it provides readily applicable clinical techniques to optimize therapeutic rapport and facilitate accelerated positive mental health outcomes. Finally, integrated neuroscience and clinical evidence-based data are discussed to shed new light on crisis states in trauma-impacted individuals. This knowledge is utilized to provide effective and concrete interventions towards rapid and successful de-escalation of the impacted individual. A highly interactive, adult-learning-principles-based modality is utilized to provide an organic learning experience for participants. The information and techniques learned aim to increase clinical effectiveness, reduce staff injuries and burnout, and significantly enhance positive mental health outcomes and self-determination for the trauma-impacted individuals treated.

Keywords: clinical competencies, crisis interventions, psychotherapy techniques, trauma informed care

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Authors: Cristina Azocar, Ivana Markova

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A survey of 565 male undergraduates examined the effects of exposure to social networking sites and entertainment media on young men’s body image. Exposure to social and to entertainment media was found to have negative effects on men’s body satisfaction, social comparison, and thin ideal internalization. Findings indicated significant differences in those men who were more exposed to social and to entertainment media than those who were not as exposed. Consistent with past studies, gay men were found to be more dissatisfied with their bodies than straight men. Gay men compared themselves to other better-looking individuals and internalized ideal body types seen in media significantly more than their straight counterparts. Surprisingly, straight men seem to care as much about their physical attractiveness/appearance as gay men do, but only in public settings such as at the beach, at athletic events (including gyms) and social events. Although on average ethnic groups were more similar than different, small but significant differences occurred with Asian men indicating significantly higher body dissatisfaction than White/European men and Middle Eastern/Arab men their counterparts. The study increases our knowledge about SNS and entertainment use and its associated body image, and body satisfaction affects among low-income ethnic minority men.

Keywords: body dissatisfaction, body image, entertainment media, gay men, race and ethnicity, social economic status, social comparison, social media

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Authors: Chang Hsueh-Sheng, Chen Tzu-Ling

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Earthquake is an unpredictable natural disaster and intensive earthquakes have caused serious impacts on social-economic system, environmental and social resilience, and further increase vulnerability. Due to earthquakes do not kill people, buildings do. When buildings located nearby earthquake-prone areas and constructed upon poorer soil areas might result in earthquake-induced ground damage. In addition, many existing buildings built before any improved seismic provisions began to be required in building codes and inappropriate land usage with highly dense population might result in much serious earthquake disaster. Indeed, not only do earthquake disaster impact seriously on urban environment, but urban growth might increase the vulnerability. Since 1980s, ‘Cutting down risks and vulnerability’ has been brought up in both urban planning and architecture and such concept has way beyond retrofitting of seismic damages, seismic resistance, and better anti-seismic structures, and become the key action on disaster mitigation. Land use planning and zoning are two critical non-structural measures on controlling physical development while it is difficult for zoning boards and governing bodies restrict development of questionable lands to uses compatible with the hazard without credible earthquake loss projection. Therefore, identifying potential earthquake exposure, vulnerability people and places, and urban development areas might become strongly supported information for decision makers. Taiwan locates on the Pacific Ring of Fire where a seismically active zone is. Some of the active faults have been found close by densely populated and highly developed built environment in the cities. Therefore, this study attempts to base on the perspective of carrying capacity and draft out micro-zonation according to both vulnerability index and urban growth index while considering spatial variances of multi factors via geographical weighted principle components (GWPCA). The purpose in this study is to construct supported information for decision makers on revising existing zoning in high-risk areas for a more compatible use and the public on managing risks.

Keywords: earthquake disaster, vulnerability, urban growth, carrying capacity, /geographical weighted principle components (GWPCA), bivariate spatial association statistic

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Authors: Rachita Lal

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Solar energy is a clean energy source. Because it is readily available in India and has many potential decentralized uses, urban local authorities may use it in various ways to manage the energy needs in the territory under their control. Apart from these and other services for which people pay a substantial number of money, urban local councils play a crucial role in administering essential services like water supply, street lighting, and health care. ULBs may contribute considerably to the transition to solar energy, both for their benefit and simultaneously for several additional direct and indirect advantages at multiple levels. The research primarily focuses on using clean energy management to reduce urban areas' reliance on traditional (electricity) energy. A technique for estimating the rooftop solar power potential using GIS (Geographical Information System) is described. Given that the combustion of fossil fuels produces 75% of India's power, meeting the country's energy needs through renewable energy sources is a step toward sustainable development and combating climate change. The study will further help in categorization, phasing, and understanding the demand and supply and thus calculating the cumulative benefits. The main objectives are to study the consumption of conventional energy in the study area and to identify the potential areas where solar photovoltaic intervention can be installed.

Keywords: solar energy, GIS, clean energy management, sustainable development

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Authors: Xiaodong Li, Peng Gao, Chao-Jung Huang, Shiying Hao, Xuefeng B. Ling, Yongxia Han, Yaqi Zhang, Le Zheng, Chengyin Ye, Modi Liu, Minjie Xia, Changlin Fu, Bo Jin, Karl G. Sylvester, Eric Widen

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Predicting the risk of Pancreatic Adenocarcinoma (PA) in advance can benefit the quality of care and potentially reduce population mortality and morbidity. The aim of this study was to develop and prospectively validate a risk prediction model to identify patients at risk of new incident PA as early as 3 months before the onset of PA in a statewide, general population in Maine. The PA prediction model was developed using Deep Neural Networks, a deep learning algorithm, with a 2-year electronic-health-record (EHR) cohort. Prospective results showed that our model identified 54.35% of all inpatient episodes of PA, and 91.20% of all PA that required subsequent chemoradiotherapy, with a lead-time of up to 3 months and a true alert of 67.62%. The risk assessment tool has attained an improved discriminative ability. It can be immediately deployed to the health system to provide automatic early warnings to adults at risk of PA. It has potential to identify personalized risk factors to facilitate customized PA interventions.

Keywords: cancer prediction, deep learning, electronic health records, pancreatic adenocarcinoma

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Authors: Philip A. Szlosek, M. Susan Guyer, Mary G. Barnum, Elizabeth M. Mullin

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In the United States, athletic training is a healthcare profession that encompasses the prevention, examination, diagnosis, treatment, and rehabilitation of injuries and medical conditions. Athletic trainers work under the direction of or in collaboration with a physician and are recognized by the American Medical Association as allied healthcare professionals. Internationally, this profession is often known as athletic therapy. As healthcare professionals, athletic trainers must be prepared for autonomous practice immediately after graduation. However, new athletic trainers have been shown to have clinical areas of strength and weakness.To better assess professional readiness and improve the preparedness of new athletic trainers, the factors of athletic training professional readiness must be defined. Limited research exists defining the holistic aspects of professional readiness needed for athletic trainers. Confirming the factors of professional readiness in athletic training could enhance the professional preparation of athletic trainers and result in more highly prepared new professionals. The objective of this study was to further explore and confirm the factors of professional readiness in athletic training. Authors useda qualitative design based in grounded theory. Participants included athletic trainers with greater than 24 months of experience from a variety of work settings from each district of the National Athletic Trainer’s Association. Participants took the demographic questionnaire electronically using Qualtrics Survey Software (Provo UT). After completing the demographic questionnaire, 20 participants were selected to complete one-on-one interviews using GoToMeeting audiovisual web conferencing software. IBM Statistical Package for the Social Sciences (SPSS, v. 21.0) was used to calculate descriptive statistics for participant demographics. The first author transcribed all interviews verbatim and utilized a grounded theory approach during qualitative data analysis. Data were analyzed using a constant comparative analysis and open and axial coding. Trustworthiness was established using reflexivity, member checks, and peer reviews. Analysis revealed four overarching themes, including management, interpersonal relations, clinical decision-making, and confidence. Management was categorized as athletic training services not involving direct patient care and was divided into three subthemes, including administration skills, advocacy, and time management. Interpersonal Relations was categorized as the need and ability of the athletic trainer to properly interact with others. Interpersonal relations was divided into three subthemes, including personality traits, communication, and collaborative practice. Clinical decision-making was categorized as the skills and attributes required by the athletic trainer whenmaking clinical decisions related to patient care. Clinical decision-making was divided into three subthemes including clinical skills, continuing education, and reflective practice. The final theme was confidence. Participants discussed the importance of confidence regarding relationships building, clinical and administrative duties, and clinical decision-making. Overall, participants explained the value of a well-rounded athletic trainer and emphasized that athletic trainers need communication and organizational skills, the ability to collaborate, and must value self-reflection and continuing education in addition to having clinical expertise. Future research should finalize a comprehensive model of professional readiness for athletic training, develop a holistic assessment instrument for athletic training professional readiness, and explore the preparedness of new athletic trainers.

Keywords: autonomous practice, newly certified athletic trainer, preparedness for professional practice, transition to practice skills

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Authors: Jacob Nortey

Abstract:

Introduction: In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. According to the Ibero – American Study of Adverse Effects (IBEAS), about 10% of hospital patients suffer from secondary damage during the care process, and approximately 2% die from this process. Many clinical decision support systems have been developed to help mitigate some healthcare medical errors. Method: Relevant databases were searched, including ones that were peculiar to the clinical decision support system (that is, using google scholar, Pub Med and general google searches). The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of Dxplain Clinical decision support systems. Results: Inferences drawn from the articles showed high usage of Dxplain clinical decision support system for problem-based learning among students in developed countries as against little or no usage among students in Low – and Middle – income Countries. The results also indicated high usage among general practitioners. Conclusion: Despite the challenges Dxplain presents, the benefits of its usage to clinicians and students are enormous.

Keywords: dxplain, clinical decision support sytem, diagnosis, support systems

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Authors: Lizinis Cassendra Frederick Dony, Jirom Jeremy Frederick Dony, Cyril Supain Christopher

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The purpose of this paper is to improve the devotion to leadership through HR practices implementation at the PETRONAS stations. This emphasize the importance of personal grooming and Customer Care hospitality training for their front line working individuals and teams’ at PETRONAS stations in Sabah. Based on Thomas Edison, International Leadership Journal, theory, research, education and development practice and application to all organizational phenomena may affect or be affected by leadership. FINDINGS – PETRONAS in short called Petroliam Nasional Berhad is a Malaysian oil and gas company that was founded on August 17, 1974. Wholly owned by the Government of Malaysia, the corporation is vested with the entire oil and gas resources in Malaysia and is entrusted with the responsibility of developing and adding value to these resources. Fortune ranks PETRONAS as the 68th largest company in the world in 2012. It also ranks PETRONAS as the 12th most profitable company in the world and the most profitable in Asia. As of the end of March 2005, the PETRONAS Group comprised 103 wholly owned subsidiaries, 19 partly owned outfits and 57 associated companies. The group is engaged in a wide spectrum of petroleum activities, including upstream exploration and production of oil and gas to downstream oil refining, marketing and distribution of petroleum products, trading, gas processing and liquefaction, gas transmission pipeline network operations, marketing of liquefied natural gas; petrochemical manufacturing and marketing; shipping; automotive engineering and property investment. PETRONAS has growing their marketing channel in a competitive market. They have combined their resources to pursue common goals. PETRONAS provides opportunity to carry out Industrial Training Job Placement to the University students in Malaysia for 6-8 months. The effects of the Industrial Training have exposed them to the real working environment experience acting representing on behalf of General Manager for almost one year. Thus, the management education and reward incentives schemes have aspire the working teams transformed to gain their good leadership. Furthermore, knowledge and experiences are very important in the human capital development transformation. SPSS extends the accurate analysis PETRONAS achievement through 280 questionnaires and 81 questionnaires through excel calculation distributed to interview face to face with the customers, PETRONAS dealers and front desk staffs stations in the 17 stations in Kota Kinabalu, Sabah. Hence, this research study will improve its service quality innovation and business sustainability performance optimization. ORIGINALITY / VALUE – The impact of Transformational Leadership practices have influenced the working team’s behaviour as a Brand Ambassadors of PETRONAS. Finally, the findings correlation indicated that PETRONAS stations needs more HR resources practices to deploy more customer care retention resources in mitigating the business challenges in oil and gas industry. Therefore, as the business established at stiff competition globally (Cooper, 2006; Marques and Simon, 2006), it is crucial for the team management should be capable to minimize noises risk, financial risk and mitigating any other risks as a whole at the optimum level. CONCLUSION- As to conclude this research found that both transformational and transactional contingent reward leadership4 were positively correlated with ratings of platoon potency and ratings of leadership for the platoon leader and sergeant were moderately inter correlated. Due to this identification, we recommended that PETRONAS management should offers quality team management in PETRONAS stations in a broader variety of leadership training specialization in the operation efficiency at the front desk Customer Care hospitality. By having the reliability and validity of job experiences, it leverages diversity teamwork and cross collaboration. Other than leveraging factor, PETRONAS also will strengthen the interpersonal front liners effectiveness and enhance quality of interaction through effective communication. Finally, through numerous CSR correlation studies regression PETRONAS performance on Corporate Social Performance and several control variables.1 CSR model activities can be mis-specified if it is not controllable under R & D which evident in various feedbacks collected from the local communities and younger generation is inclined to higher financial expectation from PETRONAS. But, however, it created a huge impact on the nation building as part of its social adaptability overreaching their business stakeholders’ satisfaction in Sabah.

Keywords: human resources practices implementation (hrpi), source of competitive advantage in people’s development (socaipd), corporate social responsibility (csr), service quality at front desk stations (sqafd), impacts of petronas leadership (iopl)

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