Search results for: classroom intervention
789 Lactate in Critically Ill Patients an Outcome Marker with Time
Authors: Sherif Sabri, Suzy Fawzi, Sanaa Abdelshafy, Ayman Nagah
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Introduction: Static derangements in lactate homeostasis during ICU stay have become established as a clinically useful marker of increased risk of hospital and ICU mortality. Lactate indices or kinetic alteration of the anaerobic metabolism make it a potential parameter to evaluate disease severity and intervention adequacy. This is an inexpensive and simple clinical parameter that can be obtained by a minimally invasive means. Aim of work: Comparing the predictive value of dynamic indices of hyperlactatemia in the first twenty four hours of intensive care unit (ICU) admission with other static values are more commonly used. Patients and Methods: This study included 40 critically ill patients above 18 years old of both sexes with Hyperlactamia (≥ 2 m mol/L). Patients were divided into septic group (n=20) and low oxygen transport group (n=20), which include all causes of low-O2. Six lactate indices specifically relating to the first 24 hours of ICU admission were considered, three static indices and three dynamic indices. Results: There were no statistically significant differences among the two groups regarding age, most of the laboratory results including ABG and the need for mechanical ventilation. Admission lactate was significantly higher in low-oxygen transport group than the septic group [37.5±11.4 versus 30.6±7.8 P-value 0.034]. Maximum lactate was significantly higher in low-oxygen transport group than the septic group P-value (0.044). On the other hand absolute lactate (mg) was higher in septic group P-value (< 0.001). Percentage change of lactate was higher in the septic group (47.8±11.3) than the low-oxygen transport group (26.1±12.6) with highly significant P-value (< 0.001). Lastly, time weighted lactate was higher in the low-oxygen transport group (1.72±0.81) than the septic group (1.05±0.8) with significant P-value (0.012). There were statistically significant differences regarding lactate indices in survivors and non survivors, whether in septic or low-oxygen transport group. Conclusion: In critically ill patients, time weighted lactate and percent in lactate change in the first 24 hours can be an independent predictive factor in ICU mortality. Also, a rising compared to a falling blood lactate concentration over the first 24 hours can be associated with significant increase in the risk of mortality.Keywords: critically ill patients, lactate indices, mortality in intensive care, anaerobic metabolism
Procedia PDF Downloads 241788 Specific Language Impairment: Assessing Bilingual Children for Identifying Children with Specific Language Impairment (SLI)
Authors: Manish Madappa, Madhavi Gayathri Raman
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The primary vehicle of human communication is language. A breakdown occurring in any aspect of communication may lead to frustration and isolation among the learners and the teachers. Over seven percent of the population in the world currently experience limitations and those children who exhibit a deviant/deficient language acquisition curve even when being in a language rich environment as their peers may be at risk of having a language disorder or language impairment. The difficulty may be in the word level [vocabulary/word knowledge] and/or the sentence level [syntax/morphology) Children with SLI appear to be developing normally in all aspects except for their receptive and/or expressive language skills. Thus, it is utmost importance to identify children with or at risk of SLI so that an early intervention can foster language and social growth, provide the best possible learning environment with special support for language to be explicitly taught and a step in providing continuous and ongoing support. The present study looks at Kannada English bilingual children and works towards identifying children at risk of “specific language impairment”. The study was conducted through an exploratory study which systematically enquired into the narratives of young Kannada-English bilinguals and to investigate the data for story structure in their narrative formulations. Oral narrative offers a rich source of data about a child’s language use in a relatively natural context. The fundamental objective is to ensure comparability and to be more universal and thus allows for the evaluation narrative text competence. The data was collected from 10 class three students at a primary school in Mysore, Karnataka and analyzed for macrostructure component reflecting the goal directed behavior of a protagonist who is motivated to carry out some kind of action with the intention of attaining a goal. The results show that the children exhibiting a deviation of -1.25 SD are at risk of SLI. Two learners were identified to be at risk of Specific Language Impairment with a standard deviation of more the 1.25 below the mean score.Keywords: bilingual, oral narratives, SLI, macrostructure
Procedia PDF Downloads 288787 The Right of Taiwanese Individuals with Mental Illnesses to Participate in Medical Decision-Making
Authors: Ying-Lun Tseng Chiu-Ying Chen
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Taiwan's Mental Health Act was amended at the end of 2022; they added regulations regarding refusing compulsory treatment by patients with mental illnesses. In addition, not only by an examination committee, the judge must also assess the patient's need for compulsory treatment. Additionally, the maximum of compulsory hospitalization has been reduced from an unlimited period to a maximum of 60 days. They aim to promote the healthcare autonomy of individuals with mental illnesses in Taiwan and prevent their silenced voice in medical decision-making while they still possess rationality. Furthermore, they plan to use community support and social care networks to replace the current practice of compulsory treatment in Taiwan. This study uses qualitative research methodology, utilizing interview guidelines to inquire about the experiences of Taiwanese who have undergone compulsory hospitalization, compulsory community treatment, and compulsory medical care. The interviews aimed to explore their feelings when they were subjected to compulsory medical intervention, the inside of their illness, their opinions after treatments, and whether alternative medical interventions proposed by them were considered. Additionally, participants also asked about their personal life history and their support networks in their lives. We collected 12 Taiwanese who had experienced compulsory medical interventions and were interviewed 14 times. The findings indicated that participants still possessed rationality during the onset of their illness. However, when they have other treatments to replace compulsory medical, they sometimes diverge from those of the doctors and their families. Finally, doctors prefer their professional judgment and patients' families' option. Therefore, Taiwanese mental health patients' power of decision-making still needs to improve. Because this research uses qualitative research, so difficult to find participants, and the sample size rate was smaller than Taiwan's population, it may have biases in the analysis. So, Taiwan still has significant progress in enhancing the decision-making rights of participants in the study.Keywords: medical decision making, compulsory treatment, medical ethics, mental health act
Procedia PDF Downloads 80786 Outcome-Based Education as Mediator of the Effect of Blended Learning on the Student Performance in Statistics
Authors: Restituto I. Rodelas
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The higher education has adopted the outcomes-based education from K-12. In this approach, the teacher uses any teaching and learning strategies that enable the students to achieve the learning outcomes. The students may be required to exert more effort and figure things out on their own. Hence, outcomes-based students are assumed to be more responsible and more capable of applying the knowledge learned. Another approach that the higher education in the Philippines is starting to adopt from other countries is blended learning. This combination of classroom and fully online instruction and learning is expected to be more effective. Participating in the online sessions, however, is entirely up to the students. Thus, the effect of blended learning on the performance of students in Statistics may be mediated by outcomes-based education. If there is a significant positive mediating effect, then blended learning can be optimized by integrating outcomes-based education. In this study, the sample will consist of four blended learning Statistics classes at Jose Rizal University in the second semester of AY 2015–2016. Two of these classes will be assigned randomly to the experimental group that will be handled using outcomes-based education. The two classes in the control group will be handled using the traditional lecture approach. Prior to the discussion of the first topic, a pre-test will be administered. The same test will be given as posttest after the last topic is covered. In order to establish equality of the groups’ initial knowledge, single factor ANOVA of the pretest scores will be performed. Single factor ANOVA of the posttest-pretest score differences will also be conducted to compare the performance of the experimental and control groups. When a significant difference is obtained in any of these ANOVAs, post hoc analysis will be done using Tukey's honestly significant difference test (HSD). Mediating effect will be evaluated using correlation and regression analyses. The groups’ initial knowledge are equal when the result of pretest scores ANOVA is not significant. If the result of score differences ANOVA is significant and the post hoc test indicates that the classes in the experimental group have significantly different scores from those in the control group, then outcomes-based education has a positive effect. Let blended learning be the independent variable (IV), outcomes-based education be the mediating variable (MV), and score difference be the dependent variable (DV). There is mediating effect when the following requirements are satisfied: significant correlation of IV to DV, significant correlation of IV to MV, significant relationship of MV to DV when both IV and MV are predictors in a regression model, and the absolute value of the coefficient of IV as sole predictor is larger than that when both IV and MV are predictors. With a positive mediating effect of outcomes-base education on the effect of blended learning on student performance, it will be recommended to integrate outcomes-based education into blended learning. This will yield the best learning results.Keywords: outcome-based teaching, blended learning, face-to-face, student-centered
Procedia PDF Downloads 291785 Gis-Based Water Pollution Assesment of Buriganga River, Bangladesh
Authors: Nur-E-Jannat Tinu
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Water is absolutely vital not only for the survival of human beings but also for plants, animals, and all other living organisms. Water bodies, such as lakes, rivers, ponds, and estuaries, are the source of water supply in domestic, industrial, agriculture, and aquaculture purposes. The Buriganga River flows through the south and west of Dhaka city. The water quality of this river has become a matter of concern due to anthropogenic intervention of vital pollutants such as industrial effluents, urban sewage, and solid wastes in this area. Buriganga River is at risk to contamination from untreated municipal wastes, industrial discharges, runoff from organic and inorganic fertilizers, pesticides, insecticides, and oil emission around the river. The residential and commercial establishments along the river discharge wastewater either directly into the river or through drains and canals into the river. However, several regulatory measures and policies have been enforced by the Government to protect the river Buriganga from pollution, in most cases to no affect. Water quality assessment reveals that the water is also not appropriate for irrigation purposes. The physical parameters (pH, TDS, EC, Temperature, DO, COD, BOD) indicated that the water is too poor to be useable for agricultural, drinking, or other purposes. Chemical concentrations showed significant seasonal variations with high-level concentrations during the monsoon season, presumably due to extreme seasonal surface runoff. A comparative study of Electrical Conductivity (EC) and Total Dissolved Solids (TDS) indicated a considerable increase over the last five years A change in trend was observed from 2020 June-July, probably due to monsoon and post-monsoon. EC values decreased from 775 to 665 mmho/cm during this period. DO increased significantly from the mid-post-monsoon months to the early monsoon period. The pH value of river water is strongly alkaline, ranging between 6.5 and 7.79. This indicates that ecological organic compounds cause the water to become alkaline after the monsoon and monsoon seasons. As the water pollution level is very high, an effective remediation and pollution control plan should be considered.Keywords: precipitation, spatial distribution, effluent, remediation
Procedia PDF Downloads 140784 Patients' Out-Of-Pocket Expenses-Effectiveness Analysis of Presurgical Teledermatology
Authors: Felipa De Mello-Sampayo
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Background: The aim of this study is to undertake, from a patient perspective, an economic analysis of presurgical teledermatology, comparing it with a conventional referral system. Store-and-forward teledermatology allows surgical planning, saving both time and number of visits involving travel, thereby reducing patients’ out-of-pocket expenses, i.e., costs that patients incur when traveling to and from health providers for treatment, visits’ fees, and the opportunity cost of time spent in visits. Method: Patients’ out-of-pocket expenses-effectiveness of presurgical teledermatology were analyzed in the setting of a public hospital during two years. The mean delay in surgery was used to measure effectiveness. The teledermatology network covering the area served by the Hospital Garcia da Horta (HGO), Portugal, linked the primary care centers of 24 health districts with the hospital’s dermatology department. The patients’ opportunity cost of visits, travel costs, and visits’ fee of each presurgical modality (teledermatology and conventional referral), the cost ratio between the most and least expensive alternative, and the incremental cost-effectiveness ratio were calculated from initial primary care visit until surgical intervention. Two groups of patients: those with squamous cell carcinoma and those with basal cell carcinoma were distinguished in order to compare the effectiveness according to the dermatoses. Results: From a patient perspective, the conventional system was 2.15 times more expensive than presurgical teledermatology. Teledermatology had an incremental out-of-pocket expenses-effectiveness ratio of €1.22 per patient and per day of delay avoided. This saving was greater in patients with squamous cell carcinoma than in patients with basal cell carcinoma. Conclusion: From a patient economic perspective, teledermatology used for presurgical planning and preparation is the dominant strategy in terms of out-of-pocket expenses-effectiveness than the conventional referral system, especially for patients with severe dermatoses.Keywords: economic analysis, out-of-pocket expenses, opportunity cost, teledermatology, waiting time
Procedia PDF Downloads 140783 Comparison of Conjunctival Autograft versus Amniotic Membrane Transplantation for Pterygium Surgery
Authors: Luksanaporn Krungkraipetch
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Currently, surgery is the only known effective treatment for pterygium. In certain groups, the probability of recurrence after basic sclera excision is very significant. Tissue grafting is substantially more time-consuming and challenging than keeping the sclera uncovered, but it reduces the chance of recurrence. Conjunctival autograft surgery is older than amniotic membrane graft surgery. The purpose of this study was to compare pterygium surgery with conjunctival autograft against an amniotic membrane transplant. In the study, a randomized controlled trial was used. Four cases were ruled out (two for failing to meet inclusion criteria and the other for refusing to participate). Group I (n = 40) received the intervention, whereas Group II (n = 40) served as the control. Both descriptive and inferential statistical approaches were used, including data analysis and data analysis statistics. The descriptive statistics analysis covered basic pterygium surgery information as well as the risk of recurrent pterygium. As an inferential statistic, the chi-square was used. A p-value of 0.05 is statistically significant. The findings of this investigation were the majority of patients in Group I were female (70.0%), aged 41–60 years, had no underlying disease (95.0%), and had nasal pterygium (97.5%). The majority of Group II patients were female (60.0%), aged 41–60 years, had no underlying disease (97.5%) and had nasal pterygium (97.5%). Group I had no recurrence of pterygium after surgery, but Group II had a 7.5% recurrence rate. Typically, the recurrence time is twelve months. The majority of pterygium recurrences occur in females (83.3%), between the ages of 41 and 60 (66.7%), with no underlying disease. The recurrence period is typically six months (60%) and a nasal pterygium site (83.3%). Pterygium recurrence after surgery is associated with nasal location (p =.002). 16.7% of pterygium surgeries result in complications; one woman with nasal pterygium underwent autograft surgery six months later. The presence of granulation tissue at the surgical site is a mild complication. A pterygium surgery recurrence rate comparison of conjunctival autograft and amniotic membrane transplantation revealed that conjunctival autograft had a higher recurrence rate than amniotic membrane transplantation (p =.013).Keywords: pterygium, pterygium surgery, conjunctival autograft, amniotic membrane transplantation
Procedia PDF Downloads 70782 Co-Creation of Content with the Students in Entrepreneurship Education to Capture Entrepreneurship Phenomenon in an Innovative Way
Authors: Prema Basargekar
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Facilitating the subject ‘Entrepreneurship Education’ in higher education, such as management studies, can be exhilarating as well as challenging. It is a multi-disciplinary and ever-evolving subject. Capturing entrepreneurship as a phenomenon in a holistic manner is a daunting task as it requires covering various dimensions such as new ideas generation, entrepreneurial traits, business opportunities scanning, the role of policymakers, value creation, etc., to name a few. Implicit entrepreneurship theory and effectuation are two different theories that focus on engaging the participants to create content by using their own experiences, perceptions, and belief systems. It helps in understanding the phenomenon holistically. The assumption here is that all of us are part of the entrepreneurial ecosystem, and effective learning can come through active engagement and peer learning by all the participants together. The present study is an attempt to use these theories in the class assignment given to the students at the beginning of the course to build the course content and understand entrepreneurship as a phenomenon in a better way through peer learning. The assignment was given to three batches of MBA post-graduate students doing the program in one of the private business schools in India. The subject of ‘Entrepreneurship Management’ is facilitated in the third trimester of the first year. At the beginning of the course, the students were given the assignment to submit a brief write-up/ collage/picture/poem or in any other format about “What entrepreneurship means to you?” They were asked to give their candid opinions about entrepreneurship as a phenomenon as they perceive it. Nearly 156 students doing post-graduate MBA submitted the assignment. These assignments were further used to find answers to two research questions. – 1) Are students able to use divergent and innovative forms to express their opinions, such as poetry, illustrations, videos, etc.? 2) What are various dimensions of entrepreneurship which are emerging to understand the phenomenon in a better way? The study uses the Brawn and Clark framework of reflective thematic analysis for qualitative analysis. The study finds that students responded to this assignment enthusiastically and expressed their thoughts in multiple ways, such as poetry, illustration, personal narrative, videos, etc. The content analysis revealed that there could be seven dimensions to looking at entrepreneurship as a phenomenon. They are 1) entrepreneurial traits, 2) entrepreneurship as a journey, 3) value creation by entrepreneurs in terms of economic and social value, 4) entrepreneurial role models, 5) new business ideas and innovations, 6) personal entrepreneurial experiences and aspirations, and 7) entrepreneurial ecosystem. The study concludes that an implicit approach to facilitate entrepreneurship education helps in understanding it as a live phenomenon. It also encourages students to apply divergent and convergent thinking. It also helps in triggering new business ideas or stimulating the entrepreneurial aspirations of the students. The significance of the study lies in the application of implicit theories in the classroom to make higher education more engaging and effective.Keywords: co-creation of content, divergent thinking, entrepreneurship education, implicit theory
Procedia PDF Downloads 74781 Bronchoscopy and Genexpert in the Diagnosis of Pulmonary Tuberculosis in the Indian Private Health Sector: A Short Case Series
Authors: J. J. Mathew
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Pulmonary tuberculosis is highly prevalent in the Indian subcontinent. Most cases of pulmonary tuberculosis are diagnosed with sputum examinations and the vast majority of these are undertaken by the government run establishments. However, mycobacterial cultures are not routinely done, unless drug resistance is detected based on clinical response. Modern diagnostic tests like bronchoscopy and Genexpert are not routinely employed in the government institutions for the diagnosis of pulmonary tuberculosis, but have been accepted widely by good private institutions. The utility of these investigations in the private sector is not yet well recognized. This retrospective study aims to assess the usefulness of bronchoscopy and Genexpert in the diagnosis of pulmonary tuberculosis in quaternary care private hospital in India. 30 patients with respiratory symptoms raising the possibility of tuberculosis based on clinical and radiological features, but without any significant sputum production, were subject to bronchoscopy and BAL samples taken for microbiological studies, including Genexpert. 6 out of the 30 patients were found to be Genexpert positive and none of them showed Rifampicin resistance. All the 6 cases had upper zone predominant disease. One of the 6 cases of tuberculosis had another co-existent bacterial infection according to the routine culture studies. 6 other cases were proven to be due to other bacterial infections alone, 2 had a malignant diagnosis and the remaining cases were thought to be non-infective pathologies. The Genexpert results were made available within 48 hours in the 6 positive cases. All of them were commenced on standard anti-tuberculous regimen with excellent clinical response. The other infective cases were also managed successfully based on the drug susceptibilities. The study has shown the usefulness of these investigations as early intervention enabled diagnosis facilitating treatment and prevention of any clinical deterioration. The study lends support to early bronchoscopy and Genexpert testing in suspected cases of pulmonary tuberculosis without significant sputum production, in a high prevalence country which normally relies on sputum examination for the diagnosis of pulmonary tuberculosis.Keywords: pulmonary, tuberculosis, bronchoscopy, genexpert
Procedia PDF Downloads 245780 Effectiveness of Gamified Virtual Physiotherapy Patients with Shoulder Problems
Authors: A. Barratt, M. H. Granat, S. Buttress, B. Roy
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Introduction: Physiotherapy is an essential part of the treatment of patients with shoulder problems. The focus of treatment is usually centred on addressing specific physiotherapy goals, ultimately resulting in the improvement in pain and function. This study investigates if computerised physiotherapy using gamification principles are as effective as standard physiotherapy. Methods: Physiotherapy exergames were created using a combination of commercially available hardware, the Microsoft Kinect, and bespoke software. The exergames used were validated by mapping physiotherapy goals of physiotherapy which included; strength, range of movement, control, speed, and activation of the kinetic chain. A multicenter, randomised prospective controlled trial investigated the use of exergames on patients with Shoulder Impingement Syndrome who had undergone Arthroscopic Subacromial Decompression surgery. The intervention group was provided with the automated sensor-based technology, allowing them to perform exergames and track their rehabilitation progress. The control group was treated with standard physiotherapy protocols. Outcomes from different domains were used to compare the groups. An important metric was the assessment of shoulder range of movement pre- and post-operatively. The range of movement data included abduction, forward flexion and external rotation which were measured by the software, pre-operatively, 6 weeks and 12 weeks post-operatively. Results: Both groups show significant improvement from pre-operative to 12 weeks in elevation in forward flexion and abduction planes. Results for abduction showed an improvement for the interventional group (p < 0.015) as well as the test group (p < 0.003). Forward flexion improvement was interventional group (p < 0.0201) with the control group (p < 0.004). There was however no significant difference between the groups at 12 weeks for abduction (p < 0.118067) , forward flexion (p < 0.189755) or external rotation (p < 0.346967). Conclusion: Exergames may be used as an alternative to standard physiotherapy regimes; however, further analysis is required focusing on patient engagement.Keywords: shoulder, physiotherapy, exergames, gamification
Procedia PDF Downloads 194779 Research on Design Methods for Riverside Spaces of Deep-cut Rivers in Mountainous Cities: A Case Study of Qingshuixi River in Chongqing City
Authors: Luojie Tang
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Riverside space is an important public space and ecological corridor in urban areas, but mountainous urban rivers are often overlooked due to their deep valleys and poor accessibility. This article takes the Qing Shui Xi River in Chongqing as an example, and through long-term field inspections, measurements, interviews, and online surveys, summarizes the problems of poor accessibility, limited space for renovation, lack of waterfront facilities, excessive artificial intervention, low average runoff, severe river water pollution, and difficulty in integrated watershed management in riverside space. Based on the current situation and drawing on relevant experiences, this article summarizes the design methods for riverside space in deep valley rivers in mountainous urban areas. Regarding spatial design techniques, the article emphasizes the importance of integrating waterfront spaces into the urban public space system and vertical linkages. Furthermore, the article suggests different design methods and improvement strategies for the already developed areas and new development areas. Specifically, the article proposes a planning and design strategy of "protection" and "empowerment" for new development areas and an updating and transformation strategy of "improvement" and "revitalization" for already developed areas. In terms of ecological restoration methods, the article suggests three focus points: increasing the runoff of urban rivers, raising the landscape water level during dry seasons, and restoring vegetation and wetlands in the riverbank buffer zone while protecting the overall pattern of the watershed. Additionally, the article presents specific design details of the Qingshuixi River to illustrate the proposed design and restoration techniques.Keywords: deep-cut river, design method, mountainous city, Qingshuixi river in Chongqing, waterfront space design
Procedia PDF Downloads 109778 Increasing Sexual Safety Awareness and Capacity for Mental Health Professionals
Authors: Tara Hunter, Kristine Concepcion, Wendy Cheng, Brianna Pike, Jane Estoesta, Anne Stuart
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In 2015, Family Planning NSW was contracted by the NSW Ministry of Health to design and deliver Sexual Safety Policy training (SSPT) to mental health professionals across NSW. The training was based on their current guidelines and developed in consultation with an expert reference group. From October 2015 to April 2017 it was delivered to over 2,400 mental health professionals with a view to supporting implementation of consistent prevention and intervention related to sexual safety in the mental health setting. An evaluation was undertaken to determine the knowledge and confidence of participants related to sexual safety before and after the training, and whether any improvements were translated into changes in practice. Participants were invited to complete a survey prior to the training, upon completion and three to six months thereafter. Telephone interviews were conducted among service managers and mental health champions six months post-training. Prior to training, the majority of mental health professionals reported being slightly to moderately confident in identifying a sexual safety incident. When asked on their understanding of sexual safety, gender sensitive practice and trauma informed care, they reported no confidence, slight confidence and moderate confidence. Immediately after the training, 54.5% reported being very confident and 10.9% extremely confident in identifying a sexual safety incident. More than half felt very confident or extremely confident in their understanding of sexual safety principles. The impact survey (six months later) found that the majority of participants (91%) were highly confident in identifying a sexual safety incident. Telephone interviewees reported a change in workplace culture and increased awareness after the training. Mental health professionals experienced increased knowledge and confidence about sexual safety principles following the training and were able to implement positive changes and concrete actions to better address sexual safety issues in their workplace.Keywords: sexual safety, mental health professionals, trauma informed care, policy training
Procedia PDF Downloads 302777 Deep Brain Stimulation and Motor Cortex Stimulation for Post-Stroke Pain: A Systematic Review and Meta-Analysis
Authors: Siddarth Kannan
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Objectives: Deep Brain Stimulation (DBS) and Motor Cortex stimulation (MCS) are innovative interventions in order to treat various neuropathic pain disorders such as post-stroke pain. While each treatment has a varying degree of success in managing pain, comparative analysis has not yet been performed, and the success rates of these techniques using validated, objective pain scores have not been synthesised. The aim of this study was to compare the effect of pain relief offered by MCS and DBS on patients with post-stroke pain and to assess if either of these procedures offered better results. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines (PROSPEROID CRD42021277542). Three databases were searched, and articles published from 2000 to June 2023 were included (last search date 25 June 2023). Meta-analysis was performed using random effects models. We evaluated the performance of DBS or MCS by assessing studies that reported pain relief using the Visual Analogue Scale (VAS). Data analysis of descriptive statistics was performed using SPSS (Version 27; IBM; Armonk; NY; USA). R statistics (Rstudio Version 4.0.1) was used to perform meta-analysis. Results: Of the 478 articles identified, 27 were included in the analysis (232 patients- 117 DBS & 115 MCS). The pooled number of patients who improved after DBS was 0.68 (95% CI, 0.57-0.77, I2=36%). The pooled number of patients who improved after MCS was 0.72 (95% CI, 0.62-0.80, I2=59%). Further sensitivity analysis was done to include only studies with a minimum of 5 patients in order to assess if there was any impact on the overall results. Nine studies each for DBS and MCS met these criteria. There seemed to be no significant difference in results. Conclusions: The use of surgical interventions such as DBS and MCS is an upcoming field for the treatment of post-stroke pain, with limited studies exploring and comparing these two techniques. While our study shows that MCS might be a slightly better treatment option, further research would need to be done in order to determine the appropriate surgical intervention for post-stroke pain.Keywords: post-stroke pain, deep brain stimulation, motor cortex stimulation, pain relief
Procedia PDF Downloads 139776 An Assessment on Socio-Economic Impacts of Smallholder Eucalyptus Tree Plantation in the Case of Northwest Ethiopia
Authors: Mersha Tewodros Getnet, Mengistu Ketema, Bamlaku Alemu, Girma Demilew
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The availability of forest products determines the possibilities for forest-based livelihood options. Plantation forest is a widespread economic activity in highland areas of the Amhara regional state, owing primarily to degradation and limited access to natural forests. As a result, tree plantation has become one of the rural livelihood options in the area. Therefore, given the increasing importance of smallholder plantations in highland areas of Amhara Regional States, the aim of this research was to evaluate the extent of smallholder plantations and their socio-economic impact. To address the abovementioned research, a sequential embedded mixed research design was employed. This qualitative and quantitative information was gathered from both primary and secondary sources. Primary data were collected from 385 sample households, which were chosen using a three-stage, multi-stage sampling method based on the Cochran sample size formula. Both descriptive and inferential statistics were used to analyze the data. Smallholder eucalyptus plantations in the study area were discovered to be common, and they are now part of the livelihood portfolio for meeting both household wood consumption and generating cash income. According to the PSM model's ATT results, income from selling farm forest products certainly contributes more to total household income, farm expenditure per cultivated land, and education spending than non-planter households. As a result, the government must strengthen plantation practices by prioritizing specific intervention areas while implementing measures to counteract the plantation's inequality-increasing effect through a variety of means, including progressive taxation.Keywords: smallholder plantation, Eucalyptus, propensity score matching, average treatment effect and income
Procedia PDF Downloads 139775 Video Analytics on Pedagogy Using Big Data
Authors: Jamuna Loganath
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Education is the key to the development of any individual’s personality. Today’s students will be tomorrow’s citizens of the global society. The education of the student is the edifice on which his/her future will be built. Schools therefore should provide an all-round development of students so as to foster a healthy society. The behaviors and the attitude of the students in school play an essential role for the success of the education process. Frequent reports of misbehaviors such as clowning, harassing classmates, verbal insults are becoming common in schools today. If this issue is left unattended, it may develop a negative attitude and increase the delinquent behavior. So, the need of the hour is to find a solution to this problem. To solve this issue, it is important to monitor the students’ behaviors in school and give necessary feedback and mentor them to develop a positive attitude and help them to become a successful grownup. Nevertheless, measuring students’ behavior and attitude is extremely challenging. None of the present technology has proven to be effective in this measurement process because actions, reactions, interactions, response of the students are rarely used in the course of the data due to complexity. The purpose of this proposal is to recommend an effective supervising system after carrying out a feasibility study by measuring the behavior of the Students. This can be achieved by equipping schools with CCTV cameras. These CCTV cameras installed in various schools of the world capture the facial expressions and interactions of the students inside and outside their classroom. The real time raw videos captured from the CCTV can be uploaded to the cloud with the help of a network. The video feeds get scooped into various nodes in the same rack or on the different racks in the same cluster in Hadoop HDFS. The video feeds are converted into small frames and analyzed using various Pattern recognition algorithms and MapReduce algorithm. Then, the video frames are compared with the bench marking database (good behavior). When misbehavior is detected, an alert message can be sent to the counseling department which helps them in mentoring the students. This will help in improving the effectiveness of the education process. As Video feeds come from multiple geographical areas (schools from different parts of the world), BIG DATA helps in real time analysis as it analyzes computationally to reveal patterns, trends, and associations, especially relating to human behavior and interactions. It also analyzes data that can’t be analyzed by traditional software applications such as RDBMS, OODBMS. It has also proven successful in handling human reactions with ease. Therefore, BIG DATA could certainly play a vital role in handling this issue. Thus, effectiveness of the education process can be enhanced with the help of video analytics using the latest BIG DATA technology.Keywords: big data, cloud, CCTV, education process
Procedia PDF Downloads 240774 Postoperative Budesonide Nasal Irrigation vs Normal Saline Irrigation for Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis
Authors: Rakan Hassan M. Alzahrani, Ziyad Alzahrani, Bader Bashrahil, Abdulrahman Elyasi, Abdullah a Ghaddaf, Rayan Alzahrani, Mohammed Alkathlan, Nawaf Alghamdi, Dakheelallah Almutairi
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Background: Corticosteroid irrigations, which regularly involve the off-label use of budesonide mixed with normal saline in high volume Sino-nasal irrigations, have been more commonly used in the management of post-operative chronic rhinosinusitis (CRS). Objective: This article attempted to measure the efficacy of post-operative budesonide nasal irrigation compared to normal saline-alone nasal irrigation in the management of chronic rhinosinusitis (CRS) through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The databases PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched by two independent authors. Only RCTs comparing budesonide irrigation to normal saline alone irrigation for CRS with or without polyposis after functional endoscopic sinus surgery (FESS) were eligible. A random effect analysis model of the reported CRS-related quality of life (QOL) measures and the objective endoscopic assessment scales of the disease was done. Results: Only 6 RCTs met the eligibility criteria, with a total number of participants of 356. Compared to normal saline irrigation, budesonide nasal irrigation showed statically significant improvements in both the CRS-related quality of life (QOL) and the endoscopic findings (MD= -4.22 confidence interval [CI]: -5.63, -2.82 [P < 0.00001]), (SMD= -0.50 confidence interval [CI]: -0.93, -0.06 [P < 0.03]) respectively. Conclusion: Both intervention arms showed improvements in CRS-related QOL and endoscopic findings in post-FESS chronic rhinosinusitis with or without polyposis. However, budesonide irrigation seems to have a slight edge over conventional normal saline irrigation with no reported serious side effects, including hypothalamic-pituitary-adrenal (HPA) axis suppression.Keywords: Budesonide, chronic rhinosinusitis, corticosteroids, nasal irrigation, normal saline
Procedia PDF Downloads 78773 The Relation between Urbanization and Forestry Policies in Turkey
Authors: Azize Serap Tuncer
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Turkey is one of the most outstanding figures among the Mediterranean countries from the natural and historical point at view. It is relatively rich country as regards the flora and vegetation. But at the same time as a result of improper and unplanned usage of the land for centuries, its forests and fertile soils have been exposed to great damages. While rapid and uncontrolled urbanization has important effects on the environment, urban development legislations, have become very unsufficient for the protection of these areas. Some of them have been completely eradicated, and some others have lost their fertility. Besides Turkey has a high main land with a rough surface and its soils areas exposed to heavy erosion. On the other hand as a developing country, it is not willing to endanger the goals of industrialization and avoid foreign direct investment by implementing strict environmental policies. Although this kind of pressure on forestland resources threatens the stability of forest land and land use management, in recent years, there has been an obvious increase in public concern about environmental problems like over global warming, environmental pollution, deforestation and their potential effects on natural resources. To protect the ecological balance and prevention of naturel resources from the unplanned intervention of human-beıng is only possible establishing conservation areas wıth co-operation at the national and the internatıonal levels. This study was carried out to evaluate the relation between urbanization and forestry policies in Turkey. While it elaborates the normative arrangements resulting in power conflicts, it also addresses which shortages and discrepancies are responsible for the said conflicts. The present urban reconstruction and transformation practices and their aesthetic and functional aspects were studied with some examples in a country level and evaluated within the assistance of literature researches, analyses, and observations. Atatürk Forest Farm and ODTU Forest examples were negotiated as two famous cases. Obtained findings were supported by charts and photos.Keywords: deforestration, environmental policies, metropolitan, pollution, urbanization
Procedia PDF Downloads 156772 The Effect of Health Promoting Programs on Patient's Life Style after Coronary Artery Bypass Graft–Hospitalized in Shiraz Hospitals
Authors: Azizollah Arbabisarjou, Leila Safabakhsh, Mozhgan Jahantigh, Mahshid Nazemzadeh, Shahindokht Navabi
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Background: Health promotion is an essential strategy for reduction of health disparities. Health promotion includes all activities that encourage optimum physical, spiritual, and mental function. The aim of this study was to determine the impact of a Health Promotion Program (HPP) on behavior in terms of the dimensions of the Health Promoting Lifestyle Profile (HPLP) in patients after Coronary Artery Bypass Graft (CABG). Methods and Materials: In this clinical trial study, 80 patients who had undergone CABG surgery (2011-2012) were selected and randomly divided in two groups: Experimental and Control that investigated by (HPLP II). Then the experimental group was educated about diet, walking and stress management. The program process was followed up for 3months and after that all variables were investigated again. The overall score and the scores for the six dimensions of the HPLP (self-actualization, health responsibility, exercise, nutrition, interpersonal support and stress management) were measured in the pre- and post-test periods. Statistical analysis was performed using Student's t-test and paired t-test. Results: Results showed that Score of stress management (p=.036), diet (p=.002), Spiritual Growth (p=.001) and interrelationship (p=002) increase in experimental group after intervention .Average scores after 3 months in the control group had no significant changes; except responsibility for health (p < .05). Results of the study revealed that comparison the scores of the experimental group were significantly different from the control group in all lifestyle aspects except for spiritual growth. Conclusion: This study showed that Health promoting program on lifestyle and health promotion in patients who suffer from CAD could enhance patient's awareness of healthy behaviors and improves the quality of life.Keywords: coronary artery bypass graft, health promotion, lifestyle, education
Procedia PDF Downloads 461771 Portable System for the Acquisition and Processing of Electrocardiographic Signals to Obtain Different Metrics of Heart Rate Variability
Authors: Daniel F. Bohorquez, Luis M. Agudelo, Henry H. León
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Heart rate variability (HRV) is defined as the temporary variation between heartbeats or RR intervals (distance between R waves in an electrocardiographic signal). This distance is currently a recognized biomarker. With the analysis of the distance, it is possible to assess the sympathetic and parasympathetic nervous systems. These systems are responsible for the regulation of the cardiac muscle. The analysis allows health specialists and researchers to diagnose various pathologies based on this variation. For the acquisition and analysis of HRV taken from a cardiac electrical signal, electronic equipment and analysis software that work independently are currently used. This complicates and delays the process of interpretation and diagnosis. With this delay, the health condition of patients can be put at greater risk. This can lead to an untimely treatment. This document presents a single portable device capable of acquiring electrocardiographic signals and calculating a total of 19 HRV metrics. This reduces the time required, resulting in a timelier intervention. The device has an electrocardiographic signal acquisition card attached to a microcontroller capable of transmitting the cardiac signal wirelessly to a mobile device. In addition, a mobile application was designed to analyze the cardiac waveform. The device calculates the RR and different metrics. The application allows a user to visualize in real-time the cardiac signal and the 19 metrics. The information is exported to a cloud database for remote analysis. The study was performed under controlled conditions in the simulated hospital of the Universidad de la Sabana, Colombia. A total of 60 signals were acquired and analyzed. The device was compared against two reference systems. The results show a strong level of correlation (r > 0.95, p < 0.05) between the 19 metrics compared. Therefore, the use of the portable system evaluated in clinical scenarios controlled by medical specialists and researchers is recommended for the evaluation of the condition of the cardiac system.Keywords: biological signal análisis, heart rate variability (HRV), HRV metrics, mobile app, portable device.
Procedia PDF Downloads 184770 Comparative Efficacy of Gas Phase Sanitizers for Inactivating Salmonella, Escherichia coli O157:H7 and Listeria monocytogenes on Intact Lettuce Heads
Authors: Kayla Murray, Andrew Green, Gopi Paliyath, Keith Warriner
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Introduction: It is now acknowledged that control of human pathogens associated with fresh produce requires an integrated approach of several interventions as opposed to relying on post-harvest washes to remove field acquired contamination. To this end, current research is directed towards identifying such interventions that can be applied at different points in leafy green processing. Purpose: In the following the efficacy of different gas phase treatments to decontaminate whole lettuce heads during pre-processing storage were evaluated. Methods: Whole Cos lettuce heads were spot inoculated with L. monocytogenes, E. coli O157:H7 or Salmonella spp. The inoculated lettuce heads were then placed in a treatment chamber and exposed to ozone, chlorine dioxide or hydroxyl radicals at different time periods under a range of relative humidity. Survivors of the treatments were enumerated along with sensory analysis performed on the treated lettuce. Results: Ozone gas reduced L. monocytogenes by 2-log10 after ten-minutes of exposure with Salmonella and E. coli O157:H7 being decreased by 0.66 and 0.56-log cfu respectively. Chlorine dioxide gas treatment reduced L. monocytogenes and Salmonella on lettuce heads by 4 log cfu but only supported a 0.8 log cfu reduction in E. coli O157:H7 numbers. In comparison, hydroxyl radicals supported a 2.9 – 4.8 log cfu reduction of model human pathogens inoculated onto lettuce heads but required extended exposure times and relative humidity < 0.8. Significance: From the gas phase sanitizers tested, chlorine dioxide and hydroxyl radicals are the most effective. The latter process holds most promise based on the ease of delivery, worker safety and preservation of lettuce sensory characteristics. Although expose times for hydroxyl radicles was relatively long (24h) this should not be considered a limitation given the intervention is applied in store rooms or in transport containers during transit.Keywords: gas phase sanitizers, iceberg lettuce heads, leafy green processing
Procedia PDF Downloads 408769 Multi Data Management Systems in a Cluster Randomized Trial in Poor Resource Setting: The Pneumococcal Vaccine Schedules Trial
Authors: Abdoullah Nyassi, Golam Sarwar, Sarra Baldeh, Mamadou S. K. Jallow, Bai Lamin Dondeh, Isaac Osei, Grant A. Mackenzie
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A randomized controlled trial is the "gold standard" for evaluating the efficacy of an intervention. Large-scale, cluster-randomized trials are expensive and difficult to conduct, though. To guarantee the validity and generalizability of findings, high-quality, dependable, and accurate data management systems are necessary. Robust data management systems are crucial for optimizing and validating the quality, accuracy, and dependability of trial data. Regarding the difficulties of data gathering in clinical trials in low-resource areas, there is a scarcity of literature on this subject, which may raise concerns. Effective data management systems and implementation goals should be part of trial procedures. Publicizing the creative clinical data management techniques used in clinical trials should boost public confidence in the study's conclusions and encourage further replication. In the ongoing pneumococcal vaccine schedule study in rural Gambia, this report details the development and deployment of multi-data management systems and methodologies. We implemented six different data management, synchronization, and reporting systems using Microsoft Access, RedCap, SQL, Visual Basic, Ruby, and ASP.NET. Additionally, data synchronization tools were developed to integrate data from these systems into the central server for reporting systems. Clinician, lab, and field data validation systems and methodologies are the main topics of this report. Our process development efforts across all domains were driven by the complexity of research project data collected in real-time data, online reporting, data synchronization, and ways for cleaning and verifying data. Consequently, we effectively used multi-data management systems, demonstrating the value of creative approaches in enhancing the consistency, accuracy, and reporting of trial data in a poor resource setting.Keywords: data management, data collection, data cleaning, cluster-randomized trial
Procedia PDF Downloads 27768 Short Teaching Sessions for Emergency Front of Neck Access
Authors: S. M. C. Kelly, A. Hargreaves, S. Hargreaves
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Introduction: The Can’t intubate, Can’t ventilate emergency scenario is one which has been shown to be managed badly in the past. Reasons identified included gaps in knowledge of the procedure and the emergency equipment used. We aimed to show an increase in confidence amongst anesthetists and operating department practitioners in the technique following a short tea trolley style teaching intervention. Methods: We carried out the teaching on a one-to-one basis. Two Anaesthetists visited each operating theatre during normal working days. One carried out the teaching session and one took over the intra‐operative care of the patient, releasing the listed anaesthetist for a short teaching session. The teaching was delivered to mixture of students and healthcare professionals, both anaesthetists and anaesthetic practitioners. The equipment includes a trolley, an airway manikin, size 10 scalpel, bougie and size 6.0 tracheal tube. The educator discussed the equipment, performed a demonstration and observed the participants performing the procedure. We asked each person to fill out a pre and post teaching questionnaire, stating their confidence with the procedure. Results: The teaching was delivered to 63 participants in total, which included 21 consultant anaesthetists, 23 trainee doctors and 19 anaesthetic practitioners. The teaching sessions lasted on average 9 minutes (range 5– 15 minutes). All participants reported an increase in confidence in both the equipment and technique in front of neck access. Anaesthetic practitioners reported the greatest increase in confidence (53%), with trainee anaesthetists reporting 27% increase and consultant anaesthetists 22%. Overall, confidence in the performance of emergency front of neck access increased by 31% after the teaching session. Discussion: Short ‘Trolley style’ teaching improves confidence in the equipment and technique used for the emergency front of neck access. This is true for students and for consultant anaesthetists. This teaching style is quick with minimal running costs and is relevant for all anesthetic departments.Keywords: airway teaching, can't intubate can't ventilate, cricothyroidotomy, front-of-neck
Procedia PDF Downloads 150767 “The Effectiveness of Group Logo Therapy on Meaning and Quality of Life of Women in Old Age Home”
Authors: Sophia Cyril Vincent
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Background: As per the Indian Census 2011, there is nearly 104 million elderly population aged above 60 years (53 million females and 51 males), and the count is expected to be 173 million by the end of 2026. Nearly 5.5% of women and 1.5% of men are living alone.1 In India, even though it is the moral duty of the children to take care of aged parents, many elders are landing in old age homes due to the social transformation factors like mushrooming of nuclear families, migration of children, cultural echoes, differences in mindset and values. Nearly 728 old age homes are seen across the country, out of which 78 old age homes with approximately 3000 inmates are seen only in Bangalore2. The existing literature shows that elderly women residing in old age homes experience the challenges like- loneliness, health issues, rejection from children, grief, death anxiety, etc, which leads to mental and physical wellbeing in numerous and tangible ways3. Hence the best and cost-effective way to improve the meaning and quality of life among elderly females is logotherapy, a type of psychotherapeutic analysis and treatment, motivating and driving force4 within the human experience to lead a decent life. Aim: The current research is aimed at studying the effectiveness of a logotherapy intervention on meaning and quality of life among elderly women of old age homes. Samples:200 women aged < 60 years and staying in the old age home for more than 1 year were randomly allocated to the control group and experimental group. Methodology: Using the Meaning in life questionnaire (MLQ)and the World health organization quality of life (WHOQOL) questionnaire, meaning and quality of life were assessed among both groups' women. Intensive Logotherapy and meaning in life program for five days were provided for the experimental group and the control group, with no treatment. Result: Under analysis. Conclusion: It is the right of the elderly woman to lead a happy and peaceful life till her death irrespective of the residing place. Hence, continuous monitoring and effective management are necessary for elderly women.Keywords: quality of life, meaning of life, logo therapy, old age home
Procedia PDF Downloads 204766 GIS Mapping of Sheep Population and Distribution Pattern in the Derived Savannah of Nigeria
Authors: Sosina Adedayo O., Babyemi Olaniyi J.
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The location, population, and distribution pattern of sheep are severe challenges to agribusiness investment and policy formulation in the livestock industry. There is a significant disconnect between farmers' needs and the policy framework towards ameliorating the sheep production constraints. Information on the population, production, and distribution pattern of sheep remains very scanty. A multi-stage sampling technique was used to elicit information from 180 purposively selected respondents from the study area comprised of Oluyole, Ona-ara, Akinyele, Egbeda, Ido and Ibarapa East LGA. The Global Positioning Systems (GPS) of the farmers' location (distribution), and average sheep herd size (Total Livestock Unit, TLU) (population) were recorded, taking the longitude and latitude of the locations in question. The recorded GPS data of the study area were transferred into the ARC-GIS. The ARC-GIS software processed the data using the ARC-GIS model 10.0. Sheep production and distribution (TLU) ranged from 4.1 (Oluyole) to 25.0 (Ibarapa East), with Oluyole, Akinyele, Ona-ara and Egbeda having TLU of 5, 7, 8 and 20, respectively. The herd sizes were classified as less than 8 (smallholders), 9-25 (medium), 26-50 (large), and above 50 (commercial). The majority (45%) of farmers were smallholders. The FR CP (%) ranged from 5.81±0.26 (cassava leaf) to 24.91±0.91 (Amaranthus spinosus), NDF (%) ranged from 22.38±4.43 (Amaranthus spinosus) to 67.96 ± 2.58 (Althemanthe dedentata) while ME ranged from 7.88±0.24 (Althemanthe dedentata) to 10.68±0.18 (cassava leaf). The smallholders’ sheep farmers were the majority, evenly distributed across rural areas due to the availability of abundant feed resources (crop residues, tree crops, shrubs, natural pastures, and feed ingredients) coupled with a large expanse of land in the study area. Most feed resources available were below sheep protein requirement level, hence supplementation is necessary for productivity. Bio-informatics can provide relevant information for sheep production for policy framework and intervention strategies.Keywords: sheep enterprise, agribusiness investment, policy, bio-informatics, ecological zone
Procedia PDF Downloads 82765 Comparison and Effectiveness of Cranial Electrical Stimulation Treatment, Brain Training and Their Combination on Language and Verbal Fluency of Patients with Mild Cognitive Impairment: A Single Subject Design
Authors: Firoozeh Ghazanfari, Kourosh Amraei, Parisa Poorabadi
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Mild cognitive impairment is one of the neurocognitive disorders that go beyond age-related decline in cognitive functions, but in fact, it is not so severe which affects daily activities. This study aimed to investigate and compare the effectiveness of treatment with cranial electrical stimulation, brain training and their double combination on the language and verbal fluency of the elderly with mild cognitive impairment. This is a single-subject method with comparative intervention designs. Four patients with a definitive diagnosis of mild cognitive impairment by a psychiatrist were selected via purposive and convenience sampling method. Addenbrooke's Cognitive Examination Scale (2017) was used to assess language and verbal fluency. Two groups were formed with different order of cranial electrical stimulation treatment, brain training by pencil and paper method and their double combination, and two patients were randomly replaced in each group. The arrangement of the first group included cranial electrical stimulation, brain training, double combination and the second group included double combination, cranial electrical stimulation and brain training, respectively. Treatment plan included: A1, B, A2, C, A3, D, A4, where electrical stimulation treatment was given in ten 30-minutes sessions (5 mA and frequency of 0.5-500 Hz) and brain training in ten 30-minutes sessions. Each baseline lasted four weeks. Patients in first group who first received cranial electrical stimulation treatment showed a higher percentage of improvement in the language and verbal fluency subscale of Addenbrooke's Cognitive Examination in comparison to patients of the second group. Based on the results, it seems that cranial electrical stimulation with its effect on neurotransmitters and brain blood flow, especially in the brain stem, may prepare the brain at the neurochemical and molecular level for a better effectiveness of brain training at the behavioral level, and the selective treatment of electrical stimulation solitude in the first place may be more effective than combining it with paper-pencil brain training.Keywords: cranial electrical stimulation, treatment, brain training, verbal fluency, cognitive impairment
Procedia PDF Downloads 91764 A Comparative, Epidemiological Study of Acute Renal Colic Presentations to Major Academic Emergency Departments in Doha, Qatar and Melbourne, Australia
Authors: Sameer A. Pathan, Biswadev Mitra, Zain A. Bhutta, Isma Qureshi, Elle Spencer, Asmaa A. Hameed, Sana Nadeem, Ramsha Tahir, Shahzad Anjum, Peter A. Cameron
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Background: This study aimed to compare epidemiology, clinical presentations, management and outcomes of renal colic presentations in two major academic centers and discuss potential implications of these results for the applicability of current evidence in the management of renal colic. Methods: We undertook a retrospective cohort study of patients with renal colic who presented to the Hamad General Hospital Emergency Department (HGH-ED), Qatar, and The Alfred ED, Melbourne, Australia, during a period of one year from August 1, 2012, to July 3, 2013. Cases were identified using ICD-9-CM codes, and an electronic template was used to record the data on predefined clinical variables. Results: A total of 12,223 from the HGH-ED and 384 from The Alfred ED were identified as renal colic presentations during the study period. The rate of renal colic presentations at the HGH-ED was 27.9 per 1000 ED visits compared to 6.7 per 1000 ED visits at The Alfred ED. Patients presenting to the HGH-ED were significantly younger [34.9 years (29.0- 43.4) than The Alfred ED [48 years (37-60); P < 0.001]. The median stone size was larger in the HGH-ED group [6 (4-8) mm] versus The Alfred ED group [4 (3-6) mm, P < 0.001]. The intervention rate in the stone-positive population was significantly higher in the HGH-ED group as opposed to The Alfred ED group (38.7% versus 11.9%, p<0.001). At the time of discharge, The Alfred ED group received less analgesic prescriptions (55.8% versus 83.5%, P < 0.001) and more tamsulosin prescriptions (25.3% versus 11.7%, P < 0.001). Conclusions: Renal colic presentations to the HGH-ED, Qatar, were younger, with larger stone size, compared to The Alfred ED, whereas, medical expulsion therapy use was higher at the Alfred ED. Differences in epidemiology should be considered while tailoring strategies for effective management of patients with renal colic in the given setting.Keywords: kidney stones, urolithiasis, nephrolithiasis, renal colic, epidemiology
Procedia PDF Downloads 241763 Making the Invisible Visible: Exploring Immersion Teacher Perceptions of Online Content and Language Integrated Learning Professional Development Experiences
Authors: T. J. O Ceallaigh
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Subject matter driven programs such as immersion programs are increasingly popular across the world. These programs have allowed for extensive experimentation in the realm of second language teaching and learning and have been at the centre of many research agendas since their inception. Even though immersion programs are successful, especially in terms of second language development, they remain complex to implement and not always as successful as what we would hope them to be. Among all the challenges these varied programs face, research indicates that the primary issue lies in the difficulty to create well-balanced programs where both content instruction and language/literacy instruction can be targeted simultaneously. Initial teacher education and professional development experiences are key drivers of successful language immersion education globally. They are critical to the supply of teachers with the mandatory linguistic and cultural competencies as well as associated pedagogical practices required to ensure learners’ success. However, there is a significant dearth of research on professional development experiences of immersion teachers. We lack an understanding of the nature of their expertise and their needs in terms of professional development as well as their perceptions of the primary challenges they face as they attempt to formulate a coherent pedagogy of integrated language and content instruction. Such an understanding is essential if their specific needs are to be addressed appropriately and thus improve the overall quality of immersion programs. This paper reports on immersion teacher perceptions of online professional development experiences that have a positive impact on their ability to facilitate language and content connections in instruction. Twenty Irish-medium immersion teachers engaged in the instructional integration of language and content in a systematic and developmental way during a year-long online professional development program. Data were collected from a variety of sources e.g., an extensive online questionnaire, individual interviews, reflections, assignments and focus groups. This study provides compelling evidence of the potential of online professional development experiences as a pedagogical framework for understanding the complex and interconnected knowledge demands that arise in content and language integration in immersion. Findings illustrate several points of access to classroom research and pedagogy and uncover core aspects of high impact online experiences. Teachers identified aspects such as experimentation and risk-taking, authenticity and relevance, collegiality and collaboration, motivation and challenge and teacher empowerment. The potential of the online experiences to foster teacher language awareness was also identified as a contributory factor to success. The paper will conclude with implications for designing meaningful and effective online CLIL professional development experiences.Keywords: content and language integrated learning , immersion pedagogy, professional development, teacher language awareness
Procedia PDF Downloads 185762 A Psycho-Education Strategy as a Method for Reconstructing Identity in the Context of Family Violence
Authors: Charlene Petersen, Herman Grobler, Karel Botha
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Restorative intervention with adolescents from a family violence context is a much needed resource given the limited access to mental health services in South Africa. In this research article the qualitative component which formed part of a mixed methods design of an overall research study, is discussed. A qualitative case study design was used. This article explores a psycho-education strategy, using a visual creative medium as a method for reconstructing identity in the context of family violence. The aim of this psycho-education strategy was to move away from interventions based on the biomedical model, but focused more on meaning-making about violent traumatic events adolescents have experienced, and to develop more positive, adaptive views about themselves in the present, and experience hope about the future. The research question that was asked was how the meaning, that adolescents from a specific community in South Africa give to family violence, contribute to defining their identity? Twelve participants were purposively selected for the study and included both male and female adolescents with ages ranging from 15 to 18 years from three secondary schools. The strategy was applied over five sessions with the intention to bring about awareness of different selves, identifying and naming the selves, and becoming aware of the configuration of identity that could lead to a redefined identity. The data were thematically and visually analyzed. Through the process of tailoring which forms the basis for reconstruction process, participants could identify the different selves, become aware of how they configure in the field. Through the process of tailoring the different self-parts, the sense of self became more self-cohesive and allowed the individual to become aware of the role of certain. Through identifying and naming the future self and resilient self the participants were able to accomplish some order and meaning in their lives. It provided them with a sense of predictability and an optimistic and hopefulness towards the future. The research findings indicated that this strategy can be used as a method for reconstructing identity in the context of family violence.Keywords: identity, family violence, self-configuration, reconstructing identity, psycho-education strategy
Procedia PDF Downloads 367761 Learning to Transform, Transforming to Learn: An Exploration of Teacher Professional Learning in the 4Cs (Communication, Collaboration, Creativity and Critical Reflection) in the Primary (K-6) Setting
Authors: Susan E Orlovich
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Ongoing, effective teacher professional learning is acknowledged as a critical influence on teacher practice. However, it is unclear whether the elements of effective professional learning result in transformed teacher practice in the classroom. This research project is interested in 4C teacher professional learning. The professional learning practices to assist teachers in transforming their practice to integrate the 4C capabilities seldom feature in the academic literature. The 4Cs are a shorthand way of representing the concepts of communication, collaboration, creativity, and critical reflection and refer to the capabilities needed for deeper learning, personal growth, and effective participation in society. The New South Wales curriculum review (2020) acknowledges that identifying, teaching, and assessing the 4C capabilities are areas of challenge for teachers. However, it also recognises that it is essential for teachers to build the confidence and capacity to understand, teach and assess the capabilities necessary for learners to thrive in the 21st century. This qualitative research project explores the professional learning experiences of sixteen teachers in four different primaries (K-6) settings in Sydney, Australia, who are learning to integrate, teach and assess the 4Cs. The project draws on the Theory of Practice Architecture as a framework to analyse and interpret teachers' experiences in each site. The sixteen participants in the study are teachers from four primary settings and include early career, experienced, and teachers in leadership roles (including the principal). In addition, some of the participants are also teachers who are learning within a Community of Practice (CoP) as their school setting is engaged in a 4C professional learning, Community of Practice. Qualitative and arts-informed research methods are utilised to examine the cultural-discursive, social-political, and material-economic practice arrangements of the site, explore how these arrangements may have shaped the professional learning experiences of teachers, and in turn, influence the teaching practices of the 4Cs in the setting. The research is in the data analysis stage (October 2022), with preliminary findings pending. The research objective is to investigate the elements of the professional learning experiences undertaken by teachers to teach the 4Cs in the primary setting. The lens of practice architectures theory is used to identify the influence of the practice architectures on critical praxis in each site and examine how the practice arrangements enable or constrain the teaching of 4C capabilities. This research aims to offer deep insight into the practice arrangements which may enable or constrain teacher professional learning in the 4Cs. Such insight from this study may contribute to a better understanding of the practices that enable teachers to transform their practice to achieve the integration, teaching, and assessment of the 4C capabilities.Keywords: 4Cs, communication, collaboration, creativity, critical reflection, teacher professional learning
Procedia PDF Downloads 109760 A Principal’s Role in Creating and Sustaining an Inclusive Environment
Authors: Yazmin Pineda Zapata
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Leading a complete school and culture transformation can be a daunting task for any administrator. This is especially true when change agents are advocating for inclusive reform in their schools. As leaders embark on this journey, they must ascertain that an inclusive environment is not a place, a classroom, or a resource setting; it is a place of acceptance nurtured by supportive and meaningful learning opportunities where all students can thrive. A qualitative approach, phenomenology, was used to investigate principals’ actions and behaviors that supported inclusive schooling for students with disabilities. Specifically, this study sought to answer the following research question: How do leaders develop and maintain inclusive education? Fourteen K-12 principals purposefully selected from various sources (e.g., School Wide Integrated Framework for Transformation (SWIFT), The Maryland Coalition for Inclusive Education (MCIE), The Arc of Texas Inclusion Works organization, The Association for Persons with Severe Handicaps (TASH), the CAL State Summer Institute in San Marcos, and the PEAK Parent Center and/or other recognitions were interviewed individually using a semi-structured protocol. Upon completion of data collection, all interviews were transcribed and marked using A priori coding to analyze the responses and establish a correlation among Villa and Thousand’s five organizational supports to achieve inclusive educational reform: Vision, Skills, Incentives, Resources, and Action Plan. The findings of this study reveal the insights of principals who met specific criteria and whose schools had been highlighted as exemplary inclusive schools. Results show that by implementing the five organizational supports, principals were able to develop and sustain successful inclusive environments where both teachers and students were motivated, made capable, and supported through the redefinition and restructuring of systems within the school. Various key details of the five variables for change depict essential components within these systems, which include quality professional development, coaching and modeling of co-teaching strategies, collaborative co-planning, teacher leadership, and continuous stakeholder (e.g., teachers, students, support staff, and parents) involvement. The administrators in this study proved the valuable benefits of inclusive education for students with disabilities and their typically developing peers. Together, along with their teaching and school community, school leaders became capable stakeholders that promoted the vision of inclusion, planned a structured approach, and took action to make it a reality.Keywords: Inclusive education, leaders, principals, shared-decision making, shared leadership, special education, sustainable change
Procedia PDF Downloads 73