Search results for: clinical chemistry
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4056

Search results for: clinical chemistry

3996 Fecal Immunochemical Testing to Deter Colon Cancer

Authors: Valerie A. Conrade

Abstract:

Introduction: A large body of literature suggests patients who complete fecal immunochemical testing (FIT) kits are likely to identify colorectal cancer sooner than those who do not complete FIT kits. Background: Patients who do not participate in preventative measures such as the FIT kit are at a higher risk of colorectal cancer growing unnoticed. The objective was to see if the method the principal investigator (PI) uses to educate clinical staff on the importance of FIT kit administration provides an increased amount of FIT kit dissemination to patients post clinical education. Methodologies: Data collection via manual tallies took place before and after the clinical staff was educated on the importance of FIT kits. Results: The results showed an increase in FIT kit dissemination post clinical staff education. Through enhanced instruction to the clinical staff regarding the importance of FIT kits, expanding their knowledge on preventative measures to detect colorectal cancer positively impacted nurses and, in turn, their patients.

Keywords: colon cancer, education, fecal immunochemical testing, nursing

Procedia PDF Downloads 108
3995 Podcasting: A Tool for an Enhanced Learning Experience of Introductory Courses to Science and Engineering Students

Authors: Yaser E. Greish, Emad F. Hindawy, Maryam S. Al Nehayan

Abstract:

Introductory courses such as General Chemistry I, General Physics I and General Biology need special attention as students taking these courses are usually at their first year of the university. In addition to the language barrier for most of them, they also face other difficulties if these elementary courses are taught in the traditional way. Changing the routine method of teaching of these courses is therefore mandated. In this regard, podcasting of chemistry lectures was used as an add-on to the traditional and non-traditional methods of teaching chemistry to science and non-science students. Podcasts refer to video files that are distributed in a digital format through the Internet using personal computers or mobile devices. Pedagogical strategy is another way of identifying podcasts. Three distinct teaching approaches are evident in the current literature and include receptive viewing, problem-solving, and created video podcasts. The digital format and dispensing of video podcasts have stabilized over the past eight years, the type of podcasts vary considerably according to their purpose, degree of segmentation, pedagogical strategy, and academic focus. In this regard, the whole syllabus of 'General Chemistry I' course was developed as podcasts and were delivered to students throughout the semester. Students used the podcasted files extensively during their studies, especially as part of their preparations for exams. Feedback of students strongly supported the idea of using podcasting as it reflected its effect on the overall understanding of the subject, and a consequent improvement of their grades.

Keywords: podcasting, introductory course, interactivity, flipped classroom

Procedia PDF Downloads 241
3994 Nano-Zinc Oxide: A Powerful and Recyclable Catalyst for Chemospecific Synthesis of Dicoumarols Based on Aryl Glyoxals

Authors: F. Jafari, S. GharehzadehShirazi, S. Khodabakhshi

Abstract:

An efficient, simple, and environmentally benign procedure for the one-pot synthesis of dicoumarols was reported. The reaction entails the condensation of aryl glyoxals and 4-hydroxyxoumarin in the presence of catalytic amount of zinc oxide nanoparticles (ZnO NPs) as recyclable catalyst in aqueous media. High product yields and use of clean conditions are important factors of green chemistry.Part of our continued interest to achieve high atom economic reactions by the use safe catalysts. The reaction mixture was refluxed with catalytic amount (3 mol%) of zinc oxide nanoparticles.Reducing the amount of toxic waste and byproducts arising from chemical reactions is an important issue in the context of green chemistry. In comparison with commonly organic solvents, the aqueous media is cheaper and more environmentally friendly. Avoiding the use of organic solvents is an important way to prevent waste in chemical processes. In the context of green and sustainable chemistry, one ofthe most promising approaches is the use of water as the reaction media. In recent years, there has been increasing recognition that water is an attractive media for manyorganic reactions. Using water continues to attract wide attention among synthetic chemists in the design of new synthetic methods.

Keywords: zinc oxide, dicoumarol, aryl glyoxal, green chemistry, catalyst

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3993 The Extension of Monomeric Computational Results to Polymeric Measurable Properties: An Introductory Computational Chemistry Experiment

Authors: Jing Zhao, Yongqing Bai, Qiaofang Shi, Huaihao Zhang

Abstract:

Advances in software technology enable computational chemistry to be commonly applied in various research fields, especially in pedagogy. Thus, in order to expand and improve experimental instructions of computational chemistry for undergraduates, we designed an introductory experiment—research on acrylamide molecular structure and physicochemical properties. Initially, students construct molecular models of acrylamide and polyacrylamide in Gaussian and Materials Studio software respectively. Then, the infrared spectral data, atomic charge and molecular orbitals of acrylamide as well as solvation effect of polyacrylamide are calculated to predict their physicochemical performance. At last, rheological experiments are used to validate these predictions. Through the combination of molecular simulation (performed on Gaussian, Materials Studio) with experimental verification (rheology experiment), learners have deeply comprehended the chemical nature of acrylamide and polyacrylamide, achieving good learning outcomes.

Keywords: upper-division undergraduate, computer-based learning, laboratory instruction, molecular modeling

Procedia PDF Downloads 110
3992 Recovery from Detrimental pH Troughs in a Moorland River Using Monitored Calcium Carbonate Introductions

Authors: Lauren Dawson, Sean Comber, Richard Sandford, Alan Tappin, Bruce Stockley

Abstract:

The West Dart River is underperforming for Salmon (Salmo salar) survival rates due to acidified pH troughs under the European Water Framework Directive (2000/60/EC). These troughs have been identified as being caused by historic acid rain pollution which is being held in situ by peat bog presence at site and released during flushing events. Natural recovery has been deemed unlikely by the year 2020 using steady state water chemistry models and therefore a program of monitored calcium carbonate (CaCO3) introductions are being conducted to eliminate these troughs, which can drop to pH 2.93 (salmon survival – pH 5.5). The river should be naturally acidic (pH 5.5-6) due to the granite geology of Dartmoor and therefore the CaCO3 introductions are under new methodology (the encasing of the CaCO3 in permeable sacks) to ensure removal should the water pH rise above neutral levels. The water chemistry and ecology are undergoing comprehensive monitoring, including pH and turbidity levels, dissolved organic carbon and aluminum concentration and speciation, while the aquatic biota is being used to assess the potential water chemistry changes. While this project is ongoing, results from the preliminary field trial show only a temporary, localized increase in pH following CaCO3 introductions into the water column. However, changes to the water chemistry have only been identified in the West Dart after methodology adjustments to account for flow rates and spate-dissolution, though no long-term changes have so far been found in the ecology of the river. However, this is not necessarily a negative factor, as the aim of the study is to protect the current ecological communities and the natural pH of the river while remediating only the detrimental pH troughs.

Keywords: anthropogenic acidification recovery, calcium carbonate introductions, ecology monitoring, water chemistry monitoring

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3991 Clinical Advice Services: Using Lean Chassis to Optimize Nurse-Driven Telephonic Triage of After-Hour Calls from Patients

Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

Abstract:

It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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3990 Variability of Physico-Chemical and Carbonate Chemistry of Seawater in Selected Portions of the Central Atlantic Coastline of Ghana

Authors: Robert Kwame Kpaliba, Dennis Kpakpor Adotey, Yaw Serfor-Armah

Abstract:

Increase in the oceanic carbon dioxide absorbance from the atmosphere due to climate change has led to appreciable change in the chemistry of the oceans. The change in oceanic pH referred to as ocean acidification poses multiple threats and stresses on marine species, biodiversity, goods and services, and livelihoods. Marine ecosystems are continuously threatened by plethora of natural and anthropogenic stressors including carbon dioxide (CO₂) emissions causing a lot of changes which has not been experienced for approximately 60 years. Little has been done in Africa as a whole and Ghana in particular to improve the understanding of the variations of the carbonate chemistry of seawater and the biophysical impacts of ocean acidification on security of seafood, nutrition, climate and environmental change. There is, therefore, the need for regular monitoring of carbonate chemistry of seawater along Ghana’s coastline to generate reliable data to aid marine policy formulation. Samples of seawater were collected thrice every month for a one-year period from five study sites for the various parameters to be analyzed. Analysis of the measured physico-chemical and the carbonate chemistry parameters was done using simple statistics. Correlation test and ANOVA were run on both of the physico-chemical and carbonate chemistry parameters. The carbonate chemistry parameters were measured using computer software programme (CO₂cal v4.0.9) except total alkalinity and pH. The study assessed the variability of seawater carbonate chemistry in selected portions of the Central Atlantic Coastline of Ghana (Tsokomey/Bortianor, Kokrobitey, Gomoa Nyanyanor, Gomoa Fetteh, and Senya Breku landing beaches) over a 1-year period (June 2016–May 2017). For physico-chemical parameters, there was insignificant variation in nitrate (NO₃⁻) (1.62 - 2.3 mg/L), ammonia (NH₃) (1.52 - 2.05 mg/L), and salinity (sal) (34.50 - 34.74 ppt). Carbonate chemistry parameters for all the five study sites showed significant variation: partial pressure of carbon dioxide (pCO₂) (414.08-715.5 µmol/kg), carbonate ion (CO₃²⁻) (115-157.92 µmol/kg), pH (7.9-8.12), total alkalinity (TA) (1711.8-1986 µmol/kg), total carbon dioxide (TCO₂) (1512.1 - 1792 µmol/kg), dissolved carbon dioxide (CO₂aq) (10.97-18.92 µmol/kg), Revelle Factor (RF) (9.62-11.84), aragonite (ΩAr) (0.75-1.48) and calcite (ΩCa) (1.08-2.14). The study revealed that the partial pressure of carbon dioxide and temperature did not have a significant effect on each other (r² = 0.31) (p-value = 0.0717). There was an appreciable effect of pH on dissolved carbon dioxide (r² = 0.921) (p-value = 0.0000). The variation between total alkalinity and dissolved carbon dioxide was appreciable (r² = 0.731) (p-value = 0.0008). There was a significant correlation between total carbon dioxide and dissolved carbon dioxide (r² = 0.852) (p-value = 0.0000). Revelle factor correlated strongly with dissolved carbon dioxide (r² = 0.982) (p-value = 0.0000). Partial pressure of carbon dioxide corresponds strongly with atmospheric carbon dioxide (r² = 0.9999) (p-value = 0.00000).

Keywords: carbonate chemistry, seawater, central atlantic coastline, Ghana, ocean acidification

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3989 Clinical Signs of River Blindness and the Efficacy of Ivermectin Therapy in Idogun, Ondo State-Nigeria

Authors: Afolabi O.J, Simon-Oke I.A., Oniya M.O., Okaka C.E.

Abstract:

River blindness is a skin, and an eye disease caused by Onchocerca volvulus and vectored by a female hematophagous blackfly. The study aims to evaluate the distribution of the clinical signs of river blindness and the efficacy of ivermectin in the treatment of river blindness in Idogun. Observational studies in epidemiology that involve the use of a structured questionnaire to obtain useful epidemiological information from the respondents, physical assessment via palpation from head to ankle was used to assess clinical signs from the respondents and skin snip test was used to evaluate the prevalence of the disease. The efficacy of the drug was evaluated and expressed in percentages. One hundred and ninety-two (192) out of the 384 respondents examined, showed various signs of river blindness. However, it was only 108 (28.1%) respondents with the clinical signs that demonstrated Onchocerca volvulus microfilariae in their skin snips. The clinical signs observed among the respondents include skin depigmentation such as dermatitis, leopard skin, papules, pruritus and self-inflicted injury, while ocular symptoms include cataract, ocular lesion and partial blindness. Among these clinical signs, papules, and pruritus were the most dominant in the community. The prevalence of the clinical signs was observed to vary significantly among the age groups and gender (P<0.05). The efficacy of the drug after 6 and 12 months of treatments shows that the drug is more effective at age groups 10-50 years than the age groups 51-90 years. Ivermectin is observed to be efficacious in the treatment of the disease. However, to achieve eradication of the disease, the drug may be administered at 0.15mg/kg twice a year.

Keywords: riverblindness, clinical signs, ivermectin, Idogun

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3988 Leadership Development for Nurses as Educators

Authors: Abeer Alhazmi

Abstract:

Introduction: Clinical education is considered a significant part of the learning process for nurses and nursing students. However, recruiting high- caliber individuals to train them to be tomorrow’s educators/teachers has been a recurrent challenge. One of the troubling challenges in this field is the absent of proper training programmes to train educators to be future education professionals and leaders. Aim: To explore the impact of a stage 1 and stage 2 clinical instructor courses on developing leadership skills for nurses as educators.Theoretical Framework: Informed by a symbolic interactionist framework, this research explored the Impact of stage 1 and stage 2 clinical instructor courses on nurses' knowledge, attitudes, and leadership skills. Method: Using Glaserian grounded theory method the data were derived from 3 focus groups and 15 in-depth interviews with nurse educators/clinical instructors and nurses who attended stage 1 and stage 2 clinical instructor courses at King Abdu-Aziz University Hospital (KAUH). Findings: The findings of the research are represented in the core category exploring new identity as educator and its two constituent categories Accepting change, and constructing educator identity. The core and sub- categories were generated through a theoretical exploration of the development of educator’s identity throughout stage 1 and stage 2 clinical instructor courses. Conclusion: The social identity of the nurse educators was developed and changed during and after attending stage 1 and stage 2 clinical instructor courses. In light of an increased understanding of the development process of educators identity and role, the research presents implications and recommendations that may contribute to the development of nursing educators in general and in Saudi Arabia in specific.

Keywords: clinical instructor course, educators, identity work, clinical nursing

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3987 The Implications of the Lacanian Concept of 'Lalangue' for Lacanian Theory and Clinical Practice

Authors: Dries Dulsster

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This research we want to discuss the implications of the concept of ‘lalangue’ and illustrate its importance for lacanian psychoanalysis and its clinical practice. We will look at this concept through an in depth reading of Lacan’s later seminars, his lectures at the North-American universities and his study on James Joyce. We will illustrate the importance of this concept with a case study from a clinical practice. We will argue that the introduction of ‘lalangue’ has several theoretical and clinical implications that will radically change Lacans teachings. We will illustrate the distinction between language and lalangue. Language serves communication, but this is not the case with lalangue. We will claim that there is jouissance in language and will approach this by introducing the concept of ‘lalangue’. We will ask ourselves what the effect will be of this distinction and how we can use this in clinical practice. The concept of ‘lalangue’ will introduce a new way of thinking about the unconscious. It will force us to no longer view the unconscious as Symbolic, but as Imaginary or Real. Another implication will be the approach on the symptom, no longer approaching it as a formation of the unconscious. It will be renamed as ‘sinthome’, as function of the real. Last of all it will force us to rethink the lacanian interpretation and how we direct the treatment. The implications on a clinical level will be how we think about the lacanian interpretation and the direction of the treatment. We will no longer focus on language and meaning, but focus on jouissance and the ways in which the subject deals with this. We will illustrate this importance with a clinical case study. To summarize, the concept of lalangue forces us to radically rethink lacanian psychoanalysis, with major implications on a theoretical and clinical level. It introduces new concepts such as the real unconscious and the sinthome. It will also make us rethink the way we work as lacanian psychoanalysts.

Keywords: Lacan's later teaching, language, Lalangue, the unconscious

Procedia PDF Downloads 200
3986 Thermochemical Study of the Degradation of the Panels of Wings in a Space Shuttle by Utilization of HSC Chemistry Software and Its Database

Authors: Ahmed Ait Hou

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The wing leading edge and nose cone of the space shuttle are fabricated from a reinforced carbon/carbon material. This material attains its durability from a diffusion coating of silicon carbide (SiC) and a glass sealant. During re-entry into the atmosphere, this material is subject to an oxidizing high-temperature environment. The use of thermochemical calculations resulting at the HSC CHEMISTRY software and its database allows us to interpret the phenomena of oxidation and chloridation observed on the wing leading edge and nose cone of the space shuttle during its mission in space. First study is the monitoring of the oxidation reaction of SiC. It has been demonstrated that thermal oxidation of the SiC gives the two compounds SiO₂(s) and CO(g). In the extreme conditions of very low oxygen partial pressures and high temperatures, there is a reaction between SiC and SiO₂, leading to SiO(g) and CO(g). We had represented the phase stability diagram of Si-C-O system calculated by the use of the HSC Chemistry at 1300°C. The principal characteristic of this diagram of predominance is the line of SiC + SiO₂ coexistence. Second study is the monitoring of the chloridation reaction of SiC. The other problem encountered in addition to oxidation is the phenomenon of chloridation due to the presence of NaCl. Indeed, after many missions, the leading edge wing surfaces have exhibited small pinholes. We have used the HSC Chemistry database to analyze these various reactions. Our calculations concorde with the phenomena we announced in research work resulting in NASA LEWIS Research center.

Keywords: thermochchemicals calculations, HSC software, oxidation and chloridation, wings in space

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3985 The Preceptorship Experience and Clinical Competence of Final Year Nursing Students

Authors: Susan Ka Yee Chow

Abstract:

Effective clinical preceptorship is affecting students’ competence and fostering their growth in applying theoretical knowledge and skills in clinical settings. Any difference between the expected and actual learning experience will reduce nursing students’ interest in clinical practices and having a negative consequence with their clinical performance. This cross-sectional study is an attempt to compare the differences between preferred and actual preceptorship experience of final year nursing students, and to examine the relationship between the actual preceptorship experience and perceived clinical competence of the students in a tertiary institution. Participants of the study were final year bachelor nursing students of a self-financing tertiary institution in Hong Kong. The instruments used to measure the effectiveness of clinical preceptorship was developed by the participating institution. The scale consisted of five items in a 5-point likert scale. The questions including goals development, critical thinking, learning objectives, asking questions and providing feedback to students. The “Clinical Competence Questionnaire” by Liou & Cheng (2014) was used to examine students’ perceived clinical competences. The scale consisted of 47 items categorized into four domains, namely nursing professional behaviours; skill competence: general performance; skill competence: core nursing skills and skill competence: advanced nursing skills. There were 193 questionnaires returned with a response rate of 89%. The paired t-test was used to compare the differences between preferred and actual preceptorship experiences of students. The results showed significant differences (p<0.001) for the five questions. The mean for the preferred scores is higher than the actual scores resulting statistically significance. The maximum mean difference was accepted goal and the highest mean different was giving feedback. The Pearson Correlation Coefficient was used to examine the relationship. The results showed moderate correlations between nursing professional behaviours with asking questions and providing feedback. Providing useful feedback to students is having moderate correlations with all domains of the Clinical Competence Questionnaire (r=0.269 – 0.345). It is concluded that nursing students do not have a positive perception of the clinical preceptorship. Their perceptions are significantly different from their expected preceptorship. If students were given more opportunities to ask questions in a pedagogical atmosphere, their perceived clinical competence and learning outcomes could be improved as a result.

Keywords: clinical preceptor, clinical competence, clinical practicum, nursing students

Procedia PDF Downloads 98
3984 Characteristics and Item Parameters Fitness on Chemistry Teacher-Made Test Instrument

Authors: Rizki Nor Amelia, Farida A. Setiawati

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This study aimed to: (1) describe the characteristics of teacher-made test instrument used to measure the ability of students’chemistry, and (2) identify the presence of the compability difficulty level set by teachers to difficulty level by empirical results. Based on these objectives, this study was a descriptive research. The analysis in this study used the Rasch model and Chi-square statistics. Analysis using Rasch Model was based on the response patterns of high school students to the teacher-made test instrument on chemistry subject Academic Year 2015/2016 in the Yogyakarta. The sample of this research were 358 students taken by cluster random sampling technique. The analysis showed that: (1) a teacher-made tests instrument has a medium on the mean difficulty level. This instrument is capable to measure the ability on the interval of -0,259 ≤ θ ≤ 0,659 logit. Maximum Test Information Function obtained at 18.187 on the ability +0,2 logit; (2) 100% items categorized either as easy or difficult by rasch model is match with the teachers’ judgment; while 37 items are categorized according to rasch model which 8.10% and 10.81% categorized as easy and difficult items respectively according to the teachers, the others are medium categorized. Overall, the distribution of the level of difficulty formulated by the teachers has the distinction (not match) to the level of difficulty based on the empirical results.

Keywords: chemistry, items parameter fitness, Rasch model, teacher-made test

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3983 Contribution of Automated Early Warning Score Usage to Patient Safety

Authors: Phang Moon Leng

Abstract:

Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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3982 Induced Chemistry for Dissociative Electron Attachment to Focused Electron Beam Induced Deposition Precursors Based on Ti, Si and Fe Metal Elements

Authors: Maria Pintea, Nigel Mason

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Induced chemistry is one of the newest pathways in the nanotechnology field with applications in the focused electron beam induced processes for deposition of nm scale structures. Si(OPr)₄ and Ti(OEt)₄ are two of the precursors that have not been so extensively researched, though highly sought for semiconductor and medical applications fields, the two compounds make good candidates for FEBIP and are the subject of velocity slice map imaging analysis for deposition purposes, offering information on kinetic energies, fragmentation channels, and angular distributions. The velocity slice map imaging technique is a method used for the characterization of molecular dynamics of the molecule and the fragmentation channels as a result of induced chemistry. To support the gas-phase analysis, Meso-Bio-Nano simulations of irradiation dynamics studies are employed with final results on Fe(CO)₅ deposited on various substrates. The software is capable of running large scale simulations for complex biomolecular, nano- and mesoscopic systems with applications to thermos-mechanical DNA damage, complex materials, gases, nanoparticles for cancer research and deposition applications for nanotechnology, using a large library of classical potentials, many-body force fields, molecular force fields involved in the classical molecular dynamics.

Keywords: focused electron beam induced deposition, FEBID, induced chemistry, molecular dynamics, velocity map slice imaging

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3981 Synthesis, Antibacterial Activities, and Synergistic Effects of Novel Juglone and Naphthazarin Derivatives Against Clinical Methicillin-Resistant Staphylococcus aureus Strains

Authors: Zohra Benfodda, Valentin Duvauchelle, Chaimae Majdi, David Bénimélis, Catherine Dunyach-Remy, Patrick Meffre

Abstract:

New antibiotics are necessary to treat microbial pathogens, especially ESKAPE pathogens that are becoming increasingly resistant to available treatment. Despite the medical need, the number of newly approved drugs continues to decline. The majority of antibiotics under clinical development are natural products or derivatives thereof. 43 juglone/naphthazarin derivatives were synthesized using Minisci-type direct C–H alkylation and evaluated for their antibacterial properties against various clinical and reference Gram-positive MSSA, clinical Gram-positive MRSA. Different compounds of the synthesized series showed promising activity against clinical and reference MSSA (MIC: 1–8 μg/ml) and good efficacy against clinical MRSA (MIC: 2–8 μg/ml) strains. The synergistic effects of active compounds were evaluated with reference antibiotics (vancomycin and cloxacillin), and it was found that the antibiotic combination with those active compounds efficiently enhanced the antimicrobial activity and consequently the MIC values of reference antibiotics were lowered up to 1/16th of the original MIC. These synthesized compounds did not present hemolytic activity on sheep red blood cells. In addition to the in silico prediction of ADME profile parameter which is promising and encouraging for further development.

Keywords: juglone, naphthazarin, antibacterial, clinical MRSA, synergistic studies, MIC determination

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3980 The Effectiveness of a Courseware in 7th Grade Chemistry Lesson

Authors: Oguz Ak

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In this study a courseware for the learning unit of `Properties of matters` in chemistry course is developed. The courseware is applied to 15 7th grade (about age 14) students in real settings. As a result of the study it is found that the students` grade in the learning unit significantly increased when they study the courseware themselves. In addition, the score improvements of the students who found the courseware is usable is not significantly higher than the score improvements of the students who did not found it usable.

Keywords: computer based instruction, effect of courseware and usability of courseware, 7th grade

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3979 A Script for Presentation to the Management of a Teaching Hospital on DXplain Clinical Decision Support System

Authors: Jacob Nortey

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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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3978 Exploring Students’ Visual Conception of Matter and Its Implications to Teaching and Learning Chemistry

Authors: Allen A. Espinosa, Arlyne C. Marasigan, Janir T. Datukan

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The study explored how students visualize the states and classifications of matter using scientific models. It also identified misconceptions of students in using scientific models. In general, high percentage of students was able to use scientific models correctly and only a little misconception was identified. From the result of the study, a teaching framework was formulated wherein scientific models should be employed in classroom instruction to visualize abstract concepts in chemistry and for better conceptual understanding.

Keywords: visual conception, scientific models, mental models, states of matter, classification of matter

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3977 Assessment of Barriers to the Clinical Adoption of Cell-Based Therapeutics

Authors: David Pettitt, Benjamin Davies, Georg Holländer, David Brindley

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Cellular based therapies, whose origins can be traced from the intertwined concepts of tissue engineering and regenerative medicine, have the potential to transform the current medical landscape and offer an approach to managing what were once considered untreatable diseases. However, despite a large increase in basic science activity in the cell therapy arena alongside a growing portfolio of cell therapy trials, the number of industry products available for widespread clinical use correlates poorly with such a magnitude of activity, with the number of cell-based therapeutics in mainstream use remaining comparatively low. This research serves to quantitatively assess the barriers to the clinical adoption of cell-based therapeutics through identification of unique barriers, specific challenges and opportunities facing the development and adoption of such therapies.

Keywords: cell therapy, clinical adoption, commercialization, translation

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3976 On-Site Coaching on Freshly-Graduated Nurses to Improves Quality of Clinical Handover and to Avoid Clinical Error

Authors: Sau Kam Adeline Chan

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World Health Organization had listed ‘Communication during Patient Care Handovers’ as one of its highest 5 patient safety initiatives. Clinical handover means transfer of accountability and responsibility of clinical information from one health professional to another. The main goal of clinical handover is to convey patient’s current condition and treatment plan accurately. Ineffective communication at point of care is globally regarded as the main cause of the sentinel event. Situation, Background, Assessment and Recommendation (SBAR), a communication tool, is extensively regarded as an effective communication tool in healthcare setting. Nonetheless, just by scenario-based program in nursing school or attending workshops on SBAR would not be enough for freshly graduated nurses to apply it competently in a complex clinical practice. To what extend and in-depth of information should be conveyed during handover process is not easy to learn. As such, on-site coaching is essential to upgrade their expertise on the usage of SBAR and ultimately to avoid any clinical error. On-site coaching for all freshly graduated nurses on the usage of SBAR in clinical handover was commenced in August 2014. During the preceptorship period, freshly graduated nurses were coached by the preceptor. After that, they were gradually assigned to take care of a group of patients independently. Nurse leaders would join in their shift handover process at patient’s bedside. Feedback and support were given to them accordingly. Discrepancies on their clinical handover process were shared with them and documented for further improvement work. Owing to the constraint of manpower in nurse leader, about coaching for 30 times were provided to a nurse in a year. Staff satisfaction survey was conducted to gauge their feelings about the coaching and look into areas for further improvement. Number of clinical error avoided was documented as well. The nurses reported that there was a significant improvement particularly in their confidence and knowledge in clinical handover process. In addition, the sense of empowerment was developed when liaising with senior and experienced nurses. Their proficiency in applying SBAR was enhanced and they become more alert to the critical criteria of an effective clinical handover. Most importantly, accuracy of transferring patient’s condition was improved and repetition of information was avoided. Clinical errors were prevented and quality patient care was ensured. Using SBAR as a communication tool looks simple. The tool only provides a framework to guide the handover process. Nevertheless, without on-site training, loophole on clinical handover still exists, patient’s safety will be affected and clinical error still happens.

Keywords: freshly graduated nurse, competency of clinical handover, quality, clinical error

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3975 Clinical Signs of Neonatal Calves in Experimental Colisepticemia

Authors: Samad Lotfollahzadeh

Abstract:

Escherichia coli (E.coli) is the most isolated bacteria from blood circulation of septicemic calves. Given the prevalence of septicemia in animals and its economic importance in veterinary practice, better understanding of changes in clinical signs following disease, may contribute to early detection of the disorder. The present study has been carried out to detect changes of clinical signs in induced sepsis in calves with E.coli. Colisepticemia has been induced in 10 twenty-day old healthy Holstein- Frisian calves with intravenous injection of 1.5 X 109 colony forming units (cfu) of O111: H8 strain of E.coli. Clinical signs including rectal temperature, heart rate, respiratory rate, shock, appetite, sucking reflex, feces consistency, general behavior, dehydration and standing ability were recorded in experimental calves during 24 hours after induction of colisepticemia. Blood culture was also carried out from calves four times during the experiment. ANOVA with repeated measure is used to see changes of calves’ clinical signs to experimental colisepticemia, and values of P≤ 0.05 was considered statistically significant. Mean values of rectal temperature and heart rate as well as median values of respiratory rate, appetite, suckling reflex, standing ability and feces consistency of experimental calves increased significantly during the study (P<0.05). In the present study, median value of shock score was not significantly increased in experimental calves (P> 0.05). The results of present study showed that total score of clinical signs in calves with experimental colisepticemia increased significantly, although the score of some clinical signs such as shock did not change significantly.

Keywords: calves, clinical signs scoring, E. coli O111:H8, experimental colisepticemia

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3974 Evaluating the Learning Outcomes of Physical Therapy Clinical Fieldwork Course

Authors: Hui-Yi Wang, Shu-Mei Chen, Mei-Fang Liu

Abstract:

Background and purpose: Providing clinical experience in medical education is an important discipline method where students can gradually apply their academic knowledge to clinical situations. The purpose of this study was to establish self-assessment questionnaires for students to assess their learning outcomes for two fields of physical therapy, orthopedic physical therapy, and pediatric physical therapy, in a clinical fieldwork course. Methods: The questionnaires were developed based on the core competence dimensions of the course. The content validity of the questionnaires was evaluated and established by expert meetings. Among the third-year undergraduate students who took the clinical fieldwork course, there were 49 students participated in this study. Teachers arranged for the students to study two professional fields, and each professional field conducted a three-week clinical lesson. The students filled out the self-assessment questionnaires before and after each three-week lesson. Results: The self-assessment questionnaires were established by expert meetings that there were six core competency dimensions in each of the two fields, with 20 and 21 item-questions, respectively. After each three-week clinical fieldwork, the self-rating scores in each core competency dimension were higher when compared to those before the course, indicating having better clinical abilities after the lessons. The best self-rating scores were the dimension of attitude and humanistic literacy, and the two lower scores were the dimensions of professional knowledge and skills and problem-solving critical thinking. Conclusions: This study developed questionnaires for clinical fieldwork courses to reflect students' learning outcomes, including the performance of professional knowledge, practice skills, and professional attitudes. The use of self-assessment of learning performance can help students build up their reflective competencies. Teachers can guide students to pay attention to the performance of abilities in each core dimension to enhance the effectiveness of learning through self-reflection and improvement.

Keywords: physical therapy, clinical fieldwork course, learning outcomes assessment, medical education, self-reflection ability

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3973 Comparing the ‘Urgent Community Care Team’ Clinical Referrals in the Community with Suggestions from the Clinical Decision Support Software Dem DX

Authors: R. Tariq, R. Lee

Abstract:

Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

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3972 Superamolecular Chemistry and Packing of FAMEs in the Liquid Phase for Optimization of Combustion and Emission

Authors: Zeev Wiesman, Paula Berman, Nitzan Meiri, Charles Linder

Abstract:

Supramolecular chemistry refers to the domain of chemistry beyond that of molecules and focuses on the chemical systems made up of a discrete number of assembled molecular sub units or components. Biodiesel components self arrangements is closely related/affect their physical properties in combustion systems and emission. Due to technological difficulties, knowledge regarding the molecular packing of FAMEs (biodiesel) in the liquid phase is limited. Spectral tools such as X-ray and NMR are known to provide evidences related to molecular structure organization. Recently, it was reported by our research group that using 1H Time Domain NMR methodology based on relaxation time and self diffusion coefficients, FAMEs clusters with different motilities can be accurately studied in the liquid phase. Head to head dimarization with quasi-smectic clusters organization, based on molecular motion analysis, was clearly demonstrated. These findings about the assembly/packing of the FAME components are directly associated with fluidity/viscosity of the biodiesel. Furthermore, these findings may provide information of micro/nano-particles that are formed in the delivery and injection system of various combustion systems (affected by thermodynamic conditions). Various relevant parameters to combustion such as: distillation/Liquid Gas phase transition, cetane number/ignition delay, shoot, oxidation/NOX emission maybe predicted. These data may open the window for further optimization of FAME/diesel mixture in terms of combustion and emission.

Keywords: supermolecular chemistry, FAMEs, liquid phase, fluidity, LF-NMR

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3971 Intersections and Consequences of the Epistemology and Methodology used in Equity-Related Chemistry Education Research

Authors: Vanessa R. Ralph, Kathryn N. Hosbein, Megan Y. Deshaye, Paulette Vincent-Ruz

Abstract:

The language of the statement “persistent achievement gaps between demographic groups” communicates much about the philosophies inherent to the author. In this synthesis of two flagship journals of Chemistry Education Research: Chemistry Education Research and Practice and the Journal of Chemical Education, the use and investigation of equity was examined by the language, epistemology, and methodologies of the researchers. Findings include a considerable increase in the use and investigation of equity in these journals following the years 2012 and 2020. While an increase in consciousness of equity was apparent, epistemologies were stagnated. The majority reflects a deficit-oriented perspective wherein deficits are attributed to students as a “lack of achievement” inherent to specific “demographic groups” and minimized as “gaps” rather than systemic inequities. The lack of epistemological progress may be the result of reading and citing literature within discipline-based education research, failing to acknowledge the efforts propagated for decades by equity theory advancement in disciplines of sociology and psychology. To envision liberated educational systems across the globe, one must first contend with the biases within.

Keywords: liberating education research, philosophy of research, synthesis, review

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3970 [Keynote Talk]: From Clinical Practice to Academic Setup, 'Quality Circles' for Quality Outputs in Both

Authors: Vandita Mishra

Abstract:

From the management of patients, reception, record, and assistants in a clinical practice; to the management of ongoing research, clinical cases and department profile in an academic setup, the healthcare provider has to deal with all of it. The victory lies in smooth running of the show in both the above situations with an apt solution of problems encountered and smooth management of crisis faced. Thus this paper amalgamates dental science with health administration by means of introduction of a concept for practice management and problem-solving called 'Quality Circles'. This concept uses various tools for problem solving given by experts from different fields. QC tools can be applied in both clinical and academic settings in dentistry for better productivity and for scientifically approaching the process of continuous improvement in both the categories. When approached through QC, our organization showed better patient outcomes and more patient satisfaction. Introduced in 1962 by Kaoru Ishikawa, this tool has been extensively applied in certain fields outside dentistry and healthcare. By exemplification of some clinical cases and virtual scenarios, the tools of Quality circles will be elaborated and discussed upon.

Keywords: academics, dentistry, healthcare, quality

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3969 Synthesis of 5-Substituted 1H-Tetrazoles in Deep Eutectic Solvent

Authors: Swapnil A. Padvi, Dipak S. Dalal

Abstract:

The chemistry of tetrazoles has been grown tremendously in the past few years because tetrazoles are important and useful class of heterocyclic compounds which have a widespread application such as anticancer, antimicrobial, analgesics, antibacterial, antifungal, antihypertensive, and anti-allergic drugs in medicinal chemistry. Furthermore, tetrazoles have application in material sciences as explosives, rocket propellants, and in information recording systems. In addition to this, they have a wide range of application in coordination chemistry as a ligand. Deep eutectic solvents (DES) have emerged over the current decade as a novel class of green reaction media and applied in various fields of sciences because of their unique physical and chemical properties similar to the ionic liquids such as low vapor pressure, non-volatility, high thermal stability and recyclability. In addition, the reactants of DES are cheaply available, low-toxic, and biodegradable, which makes them predominantly required for large-scale applications effectively in industrial production. Herein we report the [2+3] cycloaddition reaction of organic nitriles with sodium azide affords the corresponding 5-substituted 1H-tetrazoles in six different types of choline chloride based deep eutectic solvents under mild reaction condition. Choline chloride: ZnCl2 (1:2) showed the best results for the synthesis of 5-substituted 1 H-tetrazoles. This method reduces the disadvantages such as: the use of toxic metals and expensive reagents, drastic reaction conditions and the presence of dangerous hydrazoic acid. The approach provides environment-friendly, short reaction times, good to excellent yields; safe process and simple workup make this method an attractive and useful contribution to present green organic synthesis of 5-substituted-1H-tetrazoles. All synthesized compounds were characterized by IR, 1H NMR, 13C NMR and Mass spectroscopy. DES can be recovered and reused three times with very little loss in activity.

Keywords: click chemistry, choline chloride, green chemistry, deep eutectic solvent, tetrazoles

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3968 Preparation of MgO Nanoparticles by Green Methods

Authors: Maryam Sabbaghan, Pegah Sofalgar

Abstract:

Over the past few decades, a significant amount of research activities in the chemical community has been directed towards green synthesis. This area of chemistry has received extensive attention because of environmentally benign processes as well as economically viable. In this article, the MgO nanoparticles were prepared by different methods in the present of ionic liquids. A wide range of Magnesium oxide particle sizes within the nanometer scale is obtained by these methods. The structure of these MgO particles was studied by using X-ray diffraction (XRD), Infrared spectroscopy (IR), and scanning electron microscopy (SEM). It was found that the formation of nanoparticle could involve the role of performed 'nucleus' and used template to control the growth rate of nucleuses. The crystallite size of the MgO products was in a range from 31 to 77 nm.

Keywords: MgO, ionic liquid, nanoparticles, green chemistry

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3967 A Cross-Sectional Study on Clinical Self-Efficacy of Final Year School of Nursing Students among Universities of Tigray Region, Northern Ethiopia

Authors: Awole Seid, Yosef Zenebe, Hadgu Gerensea, Kebede Haile Misgina

Abstract:

Background: Clinical competence is one of the ultimate goals of nursing education. Clinical skills are more than successfully performing tasks; it incorporates client assessment, identification of deficits and the ability to critically think to provide solutions. Assessment of clinical competence, particularly identifying gaps that need improvement and determining the educational needs of nursing students have great importance in nursing education. Thus this study aims determining clinical self-efficacy of final year school of nursing students in three universities of Tigray Region. Methods: A cross-sectional study was conducted on 224 final year school of nursing students from department of nursing, psychiatric nursing, and midwifery on three universities of Tigray region. Anonymous self-administered questionnaire was administered to generate data collected on June, 2017. The data were analyzed using SPSS version 20. The result is described using tables and charts as required. Logistic regression was employed to test associations. Result: The mean age of students was 22.94 + 1.44. Generally, 21% of students have been graduated in the department in which they are not interested. The study demonstrated 28.6% had poor and 71.4% had good perceived clinical self-efficacy. Beside this, 43.8% of psychiatric nursing and 32.6% of comprehensive nursing students have poor clinical self-efficacy. Among the four domains, 39.3% and 37.9% have poor clinical self- efficacy with regard to ‘Professional development’ and ‘Management of care’. Place of the institution [AOR=3.480 (1.333 - 9.088), p=0.011], interest during department selection [AOR=2.202 (1.045 - 4.642), p=.038], and theory-practice gap [AOR=0.224 (0.110 - 0.457), p=0.000] were significantly associated with perceived clinical self-efficacy. Conclusion: The magnitude of students with poor clinically self efficacy was high. Place of institution, theory-practice gap, students interest to the discipline were the significant predictors of clinical self-efficacy. Students from youngest universities have good clinical self-efficacy. During department selection, student’s interest should be respected. The universities and other stakeholders should improve the capacity of surrounding affiliate teaching hospitals to set and improve care standards in order to narrow the theory-practice gap. School faculties should provide trainings to hospital staffs and monitor standards of clinical procedures.

Keywords: clinical self-efficacy, nursing students, Tigray, northern Ethiopia

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