Search results for: patient related elbow evaluation scale
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 21423

Search results for: patient related elbow evaluation scale

21183 Experiencing the Shattered: Managing Countertransference Experiences with Anorexia Patients in Psychotherapy

Authors: M. Card

Abstract:

Working with anorexia patients can be a challenging experience for mental and health care professionals. The reasons for not wanting to work with this patient population stems from the numerous concerns surrounding the patient’s health – physically and mentally. Many health care professionals reported having strong negative feelings, such as; anger, hopelessness and helplessness when working with anorexia patients. These feelings often impaired their judgement to treatment and affected how they related to the patient. This research focused on psychotherapists who preferred to work with anorexia patients; what countertransference feelings were evoked in them during sessions with patients and most importantly, how they managed the feelings. The research used interpretative phenomenological analysis (IPA) as the theoretical framework and data analysis method. Semi-structured interviews were used with ten experienced psychotherapists to obtain their countertransference experiences with anorexia patients and how they manage it. There were three main themes discovered; (1) the use of supervision, (2) their own personal therapy and finally (3) experience and evolution. The research unearthed that experienced psychotherapists also experienced strong countertransference feelings towards their patients; some positive and some negative. However, these feelings could actually be interpreted as co-transference with their anorexia patients. The psychotherapists were able to own their part in the evocative unconscious nature of a relational therapeutic space, where their personal issues may be entangled in their anorexia patient’s symptomatology.

Keywords: anorexia nervosa, countertransference, co-transference, psychotherapy, relational psychotherapy

Procedia PDF Downloads 127
21182 An ERP Study of Chinese Pseudo-Object Structures

Authors: Changyin Zhou

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Verb-argument relation is a very important aspect of syntax-semantics interaction in sentence processing. Previous ERP (event related potentials) studies in this field mainly concentrated on the relation between the verb and its core arguments. The present study aims to reveal the ERP pattern of Chinese pseudo-object structures (SOSs), in which a peripheral argument is promoted to occupy the position of the patient object, as compared with the patient object structures (POSs). The ERP data were collected when participants were asked to perform acceptability judgments about Chinese phrases. Our result shows that, similar to the previous studies of number-of-argument violations, Chinese SOSs show a bilaterally distributed N400 effect. But different from all the previous studies of verb-argument relations, Chinese SOSs demonstrate a sustained anterior positivity (SAP). This SAP, which is the first report related to complexity of argument structure operation, reflects the integration difficulty of the newly promoted arguments and the progressive nature of well-formedness checking in the processing of Chinese SOSs.

Keywords: Chinese pseudo-object structures, ERP, sustained anterior positivity, verb-argument relation

Procedia PDF Downloads 408
21181 Evaluation of Computer Usage and Related Health Hazards

Authors: B. O. Adegoke, B. O. Ola, D. T. Ademiluyi

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This paper examines the use of computer and its related health hazard among computer users in South-Western zone of Nigeria. Two hundred and eighteen (218) computer users constituted the population used to evaluate association between posture, extensive computer use and related health hazard. The instruments for the study are a questionnaire on demographics, lifestyle, body features and work ability index while mean rating, standard deviation and t test were used for data analysis. Identified health related hazard include damages to the eyesight, bad posture, arthritis, musculoskeletal disorders, headache, stress and so on. The results showed that factors such as work demand, posture, closeness to computer screen and excessive working hours on computers constitute health hazards in both old and young computer users of various gender. It is therefore recommended that total number of hours spent with computer should be monitored and controlled.

Keywords: computer-related health hazard, musculoskeletal disorders, computer usage, work ability index

Procedia PDF Downloads 458
21180 Nurses' and Patients’ Perception about Care: A Comparative Study

Authors: Evangelia Kotrotsiou, Mairy Gouva, Theodosios Paralikas, Maria Fiaka, Styliani Kotrotsiou, Maria Malliarou

Abstract:

The purpose of this research is to investigate the way nurses perceive the care provided in comparison to the way patients perceive it, taking into account existing literature. As far as the sample of research is concerned, it has come from the population of nurses working in the General Hospital of Thessaloniki, St. Paul and the patients of its surgical clinic. In the present study, the sample consists of 100 nurses and 88 patients. The questionnaire used was the Caring Nurse-Patient Interactions Scale: 23-Item Version, created by Cossette et al. (2006). In the case of both patients and nurses, a high score was observed in relational care in the case of the frequency of nursing care in daily practice, as well as the satisfaction of providing nursing care. Overall, patients rated higher clinical care in the case of the frequency of nursing care in daily practice, as well as the satisfaction of the clinical care they were given. On the other hand, nurses rated higher comfort care in the case of the frequency of nursing care in everyday practice, as well as relational care in the area of the importance of nursing care in everyday practice.

Keywords: nursing care, patient needs, patient satisfaction, care giving

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21179 A Greedy Alignment Algorithm Supporting Medication Reconciliation

Authors: David Tresner-Kirsch

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Reconciling patient medication lists from multiple sources is a critical task supporting the safe delivery of patient care. Manual reconciliation is a time-consuming and error-prone process, and recently attempts have been made to develop efficiency- and safety-oriented automated support for professionals performing the task. An important capability of any such support system is automated alignment – finding which medications from a list correspond to which medications from a different source, regardless of misspellings, naming differences (e.g. brand name vs. generic), or changes in treatment (e.g. switching a patient from one antidepressant class to another). This work describes a new algorithmic solution to this alignment task, using a greedy matching approach based on string similarity, edit distances, concept extraction and normalization, and synonym search derived from the RxNorm nomenclature. The accuracy of this algorithm was evaluated against a gold-standard corpus of 681 medication records; this evaluation found that the algorithm predicted alignments with 99% precision and 91% recall. This performance is sufficient to support decision support applications for medication reconciliation.

Keywords: clinical decision support, medication reconciliation, natural language processing, RxNorm

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21178 Students' Online Evaluation: Impact on the Polytechnic University of the Philippines Faculty's Performance

Authors: Silvia C. Ambag, Racidon P. Bernarte, Jacquelyn B. Buccahi, Jessica R. Lacaron, Charlyn L. Mangulabnan

Abstract:

This study aimed to answer the query, “What is the impact of Students Online Evaluation on PUP Faculty’s Performance?” The problem of the study was resolve through the objective of knowing the perceived impact of students’ online evaluation on PUP faculty’s performance. The objectives were carried through the application of quantitative research design and by conducting survey research method. The researchers utilized primary and secondary data. Primary data was gathered from the self-administered survey and secondary data was collected from the books, articles on both print-out and online materials and also other theses related study. Findings revealed that PUP faculty in general stated that students’ online evaluation made a highly positive impact on their performance based on their ‘Knowledge of Subject’ and ‘Teaching for Independent Learning’, giving a highest mean of 3.62 and 3.60 respectively., followed by the faculty’s performance which gained an overall means of 3.55 and 3.53 are based on their ‘Commitment’ and ‘Management of Learning’. From the findings, the researchers concluded that Students’ online evaluation made a ‘Highly Positive’ impact on PUP faculty’s performance based on all Four (4) areas. Furthermore, the study’s findings reveal that PUP faculty encountered many problems regarding the students’ online evaluation; the impact of the Students’ Online Evaluation is significant when it comes to the employment status of the faculty; and most of the PUP faculty recommends reviewing the PUP Online Survey for Faculty Evaluation for improvement. Hence, the researchers recommend the PUP Administration to revisit and revise the PUP Online Survey for Faculty Evaluation, specifically review the questions and make a set of questions that will be appropriate to the discipline or field of the faculty. Also, the administration should fully orient the students about the importance, purpose and impact of online faculty evaluation. And lastly, the researchers suggest the PUP Faculty to continue their positive performance and continue on being cooperative with the administrations’ purpose of addressing the students’ concerns and for the students, the researchers urged them to take the online faculty evaluation honestly and objectively.

Keywords: on-line Evaluation, faculty, performance, Polytechnic University of the Philippines (PUP)

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21177 Using Augmented Reality to Enhance Doctor Patient Communication

Authors: Rutusha Bhutada, Gaurav Chavan, Sarvesh Kasat, Varsha Mujumdar

Abstract:

This software system will be an Augmented Reality application designed to maximize the doctor’s productivity by providing tools to assist in automating the patient recognition and updating patient’s records using face and voice recognition features, which would otherwise have to be performed manually. By maximizing the doctor’s work efficiency and production, the application will meet the doctor’s needs while remaining easy to understand and use. More specifically, this application is designed to allow a doctor to manage his productive time in handling the patient without losing eye-contact with him and communicate with a group of other doctors for consultation, for in-place treatments through video streaming, as a video study. The system also contains a relational database containing a list of doctor, patient and display techniques.

Keywords: augmented reality, hand-held devices, head-mounted devices, marker based systems, speech recognition, face detection

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21176 Assessment of Sleep Disorders in Moroccan Women with Gynecological Cancer: Cross-Sectional Study

Authors: Amina Aquil, Abdeljalil El Got

Abstract:

Background: Sleep quality is one of the most important indicators related to the quality of life of patients suffering from cancer. Many factors could affect this quality of sleep and then be considered as associated predictors. Methods: The aim of this study was to assess the prevalence of sleep disorders and the associated factors with impaired sleep quality in Moroccan women with gynecological cancer. A cross-sectional study was carried out within the oncology department of the Ibn Rochd University Hospital, Casablanca, on Moroccan women who had undergone radical surgery for gynecological cancer (n=100). Translated and validated Arabic versions of the following international scales were used: Pittsburgh sleep quality index (PSQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's self-esteem scale (RSES), and Body image scale (BIS). Results: 78% of participants were considered poor sleepers. Most of the patients exhibited very poor subjective quality, low sleep latency, a short period of sleep, and a low rate of usual sleep efficiency. The vast majority of these patients were in poor shape during the day and did not use sleep medication. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. PSQI scores were positively correlated with anxiety, depression, body image dissatisfaction, and lower self-esteem (p < 0.001). Conclusion: Sleep quality and its predictors require a systematic evaluation and adequate management to prevent sleep disturbances and mental distress as well as to improve the quality of life of these patients.

Keywords: body image, gynecological cancer, self esteem, sleep quality

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21175 Reverse Twin Block with Expansion Screw for Treatment of Skeletal Class III Malocclusion in Growing Patient: Case Report

Authors: Alfrina Marwan, Erna Sulistyawati

Abstract:

Class III malocclusion shows both skeletal and dentoalveolar component. Sketal Class III malocclusion can have variants in different region, maxilla or mandibular. Skeletal Class III malocclusion during growth period is considered to treat to prevent its severity in adulthood. Orthopedics treatment of skeletal Class III malocclusion in growing patient can be treated by using reverse twin block with expansion screw to modify the growth pattern. The objective of this case report was to describe the functional correction of skeletal Class III maloclussion using reverse twin block with expansion screw in growing patient. A patient with concave profile came with a chief complaint of aesthetic problems. The cephalometric analysis showed that patient had skeletal Class III malocclusion (ANB -50, SNA 75º, Wits appraisal -3 mm) with anterior cross bite and deep bite (overjet -3 mm, overbite 6 mm). In this case report, the patient was treated with reverse twin block appliance with expansion screw. After three months of treatment, the skeletal problems have been corrected (ANB -1°), overjet, overbite and aesthetic were improved. Reverse twin block appliance with expansion screw can be used as orthopedics treatment for skeletal Class III malocclusion in growing patient and can improve the aesthetic with great satisfaction which was the main complaint in this patient.

Keywords: maxilla retrognatism, reverse twin block, skeletal class III malocclusion, growing patient

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21174 Evaluation of P300 and CNV Changes in Patients with Essential Tremor

Authors: Sehur Sibel Ozkaynak, Zakir Koc, Ebru Barcın

Abstract:

Essential tremor (ET) is one of the most common movement disorders and has long been considered a monosymptomatic disorder. While ET has traditionally been categorized as a pure motor disease, cross-sectional and longitudinal studies of cognition in ET have been demonstrated that these patients may have cognitive dysfunction. We investigated the neuro physiological aspects of cognition in ET, using event-related potentials (ERPs).Twenty patients with ET and 20 age-education and sex matched healthy controls underwent a neuro physiological evaluation. P300 components and Contingent Negative Variation (CNV) were recorded. The latencies and amplitudes of the P300 and CNV were evaluated. P200-N200 amplitude was significantly smaller in the ET group, while no differences emerged between patients and controls in P300 latencies. CNV amplitude was significantly smaller at Cz electrode site in the ET group. No differences were observed between in the two groups in CNV latencies. As a result, P300 and CNV parameters did not show significant differences between in the two groups, does not mean that there aren't mild cognitive changes in ET patients. In this regard, there is a need to further studies using electro physiological tests related to cognitive changes in ET patients.

Keywords: cognition, essential tremor, event related potentials

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21173 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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21172 Patients with Chronic Obstructive Pulmonary Feelings of Uncertainty

Authors: Kyngäs Helvi, Patala-Pudas, Kaakinen Pirjo

Abstract:

It has been reported that COPD -patients may experience much emotional distress, which can compromise positive health outcomes. The aim of this study was to explore disease-related uncertainty as reported by Chronic Obstructive Pulmonary Disease (COPD) patients. Uncertainty was defined as a lack of confidence; negative feelings; a sense of confidence; and awareness of the sources of uncertainty. Research design was a non-experimental cross-sectional survey. The data (n=141) was collected by validated questionnaire during COPD -patients’ visits or admissions to a tertiary hospital. The response rate was 62%. The data was analyzed by statistical methods. Around 70% of the participants were male with COPD diagnosed many years ago. Fifty-four percent were under 65 years and used an electronic respiratory aid apparatus (52%) (oxygen concentrator, ventilator or electronic inhalation device). Forty-one percent of the participants smoked. Disease-related uncertainty was widely reported. Seventy-three percent of the participants had uncertainty about their knowledge of the disease, the pulmonary medication and nutrition. One-quarter (25%) did not feel sure about managing COPD exacerbation. About forty percent (43%) reported that they did not have a written exacerbation decision aid indicating how to act in relation to COPD symptoms. Over half of the respondents were uncertain about self-management behavior related to health habits such as exercise and nutrition. Over a third of the participants (37%) felt uncertain about self-management skills related to giving up smoking. Support from the care providers was correlated significantly with the patients’ sense of confidence. COPD -patients who felt no confidence stated that they received significantly less support in care. Disease-related uncertainty should be considered more closely and broadly in the patient care context, and those strategies within patient education that enhance adherence should be strengthened and incorporated into standard practice.

Keywords: adherence, COPD, disease-management, uncertainty

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21171 Concealing Breast Cancer Status: A Qualitative Study in India

Authors: Shradha Parsekar, Suma Nair, Ajay Bailey, Binu V. S.

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Background: Concealing of cancer-related information is seen in many low-and-middle-income countries and may be associated with multiple factors. Comparatively, there is lack of information about, how breast cancers diagnosed women disclose cancer-related information to their social contacts and vice versa. To get more insights on the participant’s experience, opinions, expectations, and attitudes, a qualitative study is a suitable approach. Therefore, this study involving in-depth interviews was planned to lessen this gap. Methods: Interviews were conducted separately among breast cancer patients and their caregivers with semi-structured qualitative interview guide. Purposive and convenient sampling was being used to recruit patients and caregivers, respectively. Ethical clearance and permission from the tertiary hospital were obtained and participants were selected from the Udupi district, Karnataka, India. After obtaining a list of breast cancer diagnosed cases, participants were contacted in person and their willingness to take part in the study was taken. About 39 caregivers and 35 patients belonging to different breast cancer stages were recruited. Interviews were recorded with prior permission. Data was managed by Atlas.ti 8 software. The recordings were transcribed, translated and coded in two cycles. Most of the patients belonged to stage II and III cancer. Codes were grouped together into to whom breast cancer status was concealed to and underneath reason for the same. Main findings: followings are the codes and code families which emerged from the data. 1) Concealing the breast cancer status from social contacts other than close family members (such as extended family, neighbor and friends). Participants perceived the reasons as, a) to avoid questions which people probe (which doesn’t have answers), b) to avoid people paying courtesy visit (to inquire about the health as it is Indian culture to visit the sick person) making it inconvenient for patient and caregivers have to offer something and talk to them, c) to avoid people getting shocked (react as if cancer is different from other diseases) or getting emotional/sad, or getting fear of death d) to avoid getting negative suggestion or talking anything in front of patient as it may affect patient negatively, e) to avoid getting stigmatized, f) to avoid getting obstacle in child’s marriage. 2) Participant concealed the breast cancer status of young children as they perceived that it may a) affect studies, b) affect emotionally, c) children may get scared. 3) Concealing the breast cancer status from patients as the caregivers perceived that they have fear of a) worsening patient’s health, b) patient getting tensed, c) patient getting shocked, and d) patient getting scared. However, some participants stressed important in disclosing the cancer status to social contact/patient to make the people aware of the disease. Conclusion: The news of breast cancer spreads like electricity in the wire, therefore, patient or family avoid it for many reasons. Although, globally, due to physicians’ ethical obligations, there is an inclination towards more disclosure of cancer diagnosis and status of prognosis to the patient. However, it is an ongoing argument whether patient/social contacts should know the status especially in a country like India.

Keywords: breast cancer, concealing cancer status, India, qualitative study

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21170 Prosthesis Design for Bilateral Hip Disarticulation Management

Authors: Mauricio Plaza, Willian Aperador

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Hip disarticulation is an amputation through the hip joint capsule, removing the entire lower extremity, with a closure of the remaining musculature over the exposed acetabulum. Tumors of the distal and proximal femur were treated by total femur resection; a hip disarticulation sometimes is a performance for massive trauma with crush injuries to the lower extremity. This article discusses the design a system for rehabilitation of a patient with bilateral hip disarticulations. The prosthetics designed allowed the patient to do natural gait suspended between parallel articulate crutches with the body weight support between the crutches. The care of this patient was a challenge due to bilateral amputations at such a high level and the special needs of a patient mobility.

Keywords: amputation, prosthesis, mobility, hemipelvectomy

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21169 Review of Research on Effectiveness Evaluation of Technology Innovation Policy

Authors: Xue Wang, Li-Wei Fan

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The technology innovation has become the driving force of social and economic development and transformation. The guidance and support of public policies is an important condition to promote the realization of technology innovation goals. Policy effectiveness evaluation is instructive in policy learning and adjustment. This paper reviews existing studies and systematically evaluates the effectiveness of policy-driven technological innovation. We used 167 articles from WOS and CNKI databases as samples to clarify the measurement of technological innovation indicators and analyze the classification and application of policy evaluation methods. In general, technology innovation input and technological output are the two main aspects of technological innovation index design, among which technological patents are the focus of research, the number of patents reflects the scale of technological innovation, and the quality of patents reflects the value of innovation from multiple aspects. As for policy evaluation methods, statistical analysis methods are applied to the formulation, selection and evaluation of the after-effect of policies to analyze the effect of policy implementation qualitatively and quantitatively. The bibliometric methods are mainly based on the public policy texts, discriminating the inter-government relationship and the multi-dimensional value of the policy. Decision analysis focuses on the establishment and measurement of the comprehensive evaluation index system of public policy. The economic analysis methods focus on the performance and output of technological innovation to test the policy effect. Finally, this paper puts forward the prospect of the future research direction.

Keywords: technology innovation, index, policy effectiveness, evaluation of policy, bibliometric analysis

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21168 Impact of Preoperative Physiotherapy Care in Total Hip Arthroplasty in Slovakia and Austria

Authors: Peter Kutis, Vladimir Littva

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Nowadays, it is necessary to ensure that this reduction in costs is not at the expense of the quality of health care and future medical success. In general, physiotherapy for total hip joint arthroplasty is considered to be a routine matter that deals mainly with mobility training, increased muscular strength, and basic day-to-day activities such as bed-to-chair transition, standing, and walking. Within the KEGA project no. 003KU-4-2021, we decided to investigate preoperative physiotherapy care in Slovakia and Austria in total hip arthroplasty patients to shortened overall recovery. Research Sample and Methods: The sample comprised 498 respondents –patients who were indicated to total hip arthroplasty on the territory of Slovakia and Austria. There were 130 women in Slovakia and 135 women in Austria. The numbers of men were 120 in Slovakia and 113 men in Austria. The age of respondents was between 40 and 85 years of age. As a method of our research, we chose a non-standardized questionnaire, which consisted of three parts. The first part for the initial examination of the patient contained the identification of the patient according to the assigned number and subsequently 19 questions conditioned by the physical examination and evaluation of the patients. The second part of our questionnaire was completed after the patient's hospitalization and contained 10 questions that were conditioned by the patient's examination. The last third part for the overall assessment of the patient's state of health consisted of 12 questions conditioned by the patient's examination. This part was performed at the last meeting with the patient at the end of the treatment. All data were statistically processed by SPSS 25. Results: All data were evaluated at a significance level of p = 0.05. From the comparison of patients who underwent preoperative preparation, we can clearly state that the total duration of treatment is significantly shorter. A t-test of two mean values with uneven variance was used to verify the validity of the assumption. The total duration of treatment in patients with preoperative preparation was on average 92,635 days and without preoperative preparation was on average 135,884 days (t-Stat = 44,52784, t Critical one-tail = 1,648187415, t Critical two-tail = 1,965157). Conclusion: The results obtained during the research show the importance of adequate preoperative physiotherapeutic preparation of the patient. The results of total hip joint arthroplasty studies showed a significant reduction in a hospital stay as well as shortened total treatment time.

Keywords: THA, physiotherapy, recovery, preoperative physiotherapy care

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21167 An Appraisal of the Design, Content, Approaches and Materials of the K-12 Grade 8 English Curriculum by Language Teachers, Supervisors and Teacher-Trainers

Authors: G. Infante Dennis, S. Balinas Elvira, C. Valencia Yolanda, Cunanan

Abstract:

This paper examined the feed-backs, concerns, and insights of the teachers, supervisors, and teacher-trainers on the nature and qualities of the K-12 grade 8 design, content, approaches, and materials. Specifically, it sought to achieve the following objectives: 1) to describe the critical nature and qualities of the design, content, teaching-learning-and-evaluation approaches, and the materials to be utilized in the implementation of the grade 8 curriculum; 2) to extract the possible challenges relevant to the implementation of the design, content, teaching-learning-and-evaluation approaches, and the materials of the grade 8 curriculum in terms of the linguistic and technical competence of the teachers, readiness to implement, willingness to implement, and capability to make relevant adaptations; 3) to present essential demands on the successful and meaningful implementation of the grade 8 curriculum in terms of teacher-related factors, school-related factors, and student-related concerns.

Keywords: curriculum reforms, K-12, teacher-training, language teaching, learning

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21166 Vagal Nerve Stimulator as a Treatment Approach in CHARGE Syndrome: A Case Report

Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake

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Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.

Keywords: autism, POTs, CHARGE, VNS

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21165 Common Sports Medicine Injuries in Primary Health Care

Authors: Thuraya Ahmed Hamood Al Shidhani

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Sports Medicine injuries are very common in primary health care. It is not necessary related to direct trauma, but it could be because of repetitive stress and overuse injuries. Knowledge of Primary Health care providers about the common sports medicine injuries and when to refer to a specialist is essential. Common sports injuries are muscle strain, joint sprain, bone bruise, Patellofemoral pain syndrome, Anterior cruciate ligament injuries, meniscal injuries, ankle ligaments injuries, concussion, Rotator cuff tendinosis/impingement syndrome, lateral and medial epicondylitis and fractures. Systematic approach is very useful in evaluation of sports injuries. RICE is important in initial management. Physiotherapy is essential for rehabilitation. Definitive Management is dependent on patient’s condition and function.

Keywords: common, sports medicine injuries, primary health care, injuries

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21164 An Evaluation of Tourism Education in Nigeria’s Higher Institutions

Authors: Eldah Ephraim Buba

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This paper evaluated the quality of tourism education in Nigeria higher education. The problem of poor quality of tourism education in Nigeria’s higher institutions prompted the study. Archival research was used with evaluation reports as secondary data, twenty evaluation reports for different polytechnics from the National board for technical education (NBTE) from 1995-2012 were assessed. The evidence from the documents shows that the quality of teaching and evaluation is fair. The programmes resources are fairly good, and most of the teachers do not have a postgraduate qualification in tourism related courses. It is therefore recommended that the institutions running tourism programmes in Nigeria need to introduce self -assessment of programmes and not rely on the NBTE accreditation which comes up in three years. Also there is need for a staff development policy that will encourage Tourism educators to further their education; The Tertiary Educational Trust Fund (TETFUND) should focus on developing staff of tourism education because it is an area of study in Nigeria that lacks qualified personnel. With the way higher institution in Nigeria are finding interest in tourism programmes, having good quality programmes will not only produce better professionals but it will help in offering better services in the industry and maximizing the impacts of the business.

Keywords: education, evaluation, tourism quality, self-assessment

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21163 Best Practices to Enhance Patient Security and Confidentiality When Using E-Health in South Africa

Authors: Lethola Tshikose, Munyaradzi Katurura

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Information and Communication Technology (ICT) plays a critical role in improving daily healthcare processes. The South African healthcare organizations have adopted Information Systems to integrate their patient records. This has made it much easier for healthcare organizations because patient information can now be accessible at any time. The primary purpose of this research study was to investigate the best practices that can be applied to enhance patient security and confidentiality when using e-health systems in South Africa. Security and confidentiality are critical in healthcare organizations as they ensure safety in EHRs. The research study used an inductive research approach that included a thorough literature review; therefore, no data was collected. The research paper’s scope included patient data and possible security threats associated with healthcare systems. According to the study, South African healthcare organizations discovered various patient data security and confidentiality issues. The study also revealed that when it comes to handling patient data, health professionals sometimes make mistakes. Some may not be computer literate, which posed issues and caused data to be tempered with. The research paper recommends that healthcare organizations ensure that security measures are adequately supported and promoted by their IT department. This will ensure that adequate resources are distributed to keep patient data secure and confidential. Healthcare organizations must correctly use standards set up by IT specialists to solve patient data security and confidentiality issues. Healthcare organizations must make sure that their organizational structures are adaptable to improve security and confidentiality.

Keywords: E-health, EHR, security, confidentiality, healthcare

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21162 Students' Perspectives on Quality of Course Evaluation Practices and Feedbacks in Eritrea

Authors: Ermias Melake Tesfay

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The importance of evaluation practice and feedback to student advancement and retention has gained importance in the literature over the past ten years. So many issues and cases have been raised about the quality and types of evaluation carried out in higher education and the quality and quantity of student feedback. The aim of this study was to explore the students’ perspectives on the quality of course evaluation practice and feedback in College of Education and College of Science. The study used both quantitative and qualitative methods to collect data. Data were collected from third-year and fourth-year students of 13 departments in the College of Education and College of Science in Eritrea. A modified Service Performance (SERVPERF) questionnaire and focus group discussions were used to collect the data. The sample population comprised of 135 third-year and fourth-year students’ from both Colleges. A questionnaire using a 5 point Likert-scale was administered to all respondents whilst two focus group discussions were conducted. Findings from survey data and focus group discussions showed that the majority of students hold a positive perception of the quality of course evaluation practice but had a negative perception of methods of awarding grades and administrators’ role in listening to the students complain about the course. Furthermore, the analysis from the questionnaire showed that there is no statistically significant difference between third-year and fourth-year students, College of Education and College of Science and male and female students on the quality of course evaluation practice and feedback. The study recommends that colleges improve the quality of fairness and feedback during course assessment.

Keywords: evaluation, feedback, quality, students' perception

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21161 Evaluation of a Higher Diploma in Mental Health Nursing Using Qualitative and Quantitative Methods: Effects on Student Behavior, Attitude and Perception

Authors: T. Frawley, G. O'Kelly

Abstract:

The UCD School of Nursing, Midwifery and Health Systems Higher Diploma in Mental Health (HDMH) nursing programme commenced in January 2017. Forty students successfully completed the programme. Programme evaluation was conducted from the outset. Research ethics approval was granted by the UCD Human Research Ethics Committee – Sciences in November 2016 (LS-E-16-163). Plan for Sustainability: Each iteration of the programme continues to be evaluated and adjusted accordingly. Aims: The ultimate purpose of the HDMH programme is to prepare registered nurses (registered children’s nurse (RCN), registered nurse in intellectual disability (RNID) and registered general nurse (RGN)) to function as effective registered psychiatric nurses in all settings which provide care and treatment for people experiencing mental health difficulties. Curriculum evaluation is essential to ensure that the programme achieves its purpose, that aims and expected outcomes are met and that required changes are highlighted for the programme’s continuing positive development. Methods: Both quantitative and qualitative methods were used in the evaluation. A series of questionnaires were used (the majority pre and post programme) to determine student perceptions of the programme, behaviour and attitudinal change from commencement to completion. These included the student assessment of learning gains (SALG); mental health knowledge schedule (MAKS); mental health clinician attitudes scale (MICA); reported and intended behaviour scale (RIBS); and community attitudes towards the mentally ill (CAMI). In addition, student and staff focus groups were conducted. Evaluation methods also incorporated module feedback. Outcome/Results: The evaluation highlighted a very positive response in relation to the achievement of programme outcomes and preparation for future work as registered psychiatric nursing. Some areas were highlighted for further development, which have been taken cognisance of in the 2019 iteration of the programme.

Keywords: learning gains, mental health, nursing, stigma

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21160 Pilot Scale Sub-Surface Constructed Wetland: Evaluation of Performance of Bed Vegetated with Water Hyacinth in the Treatment of Domestic Sewage

Authors: Abdul-Hakeem Olatunji Abiola, A. E. Adeniran, A. O. Ajimo, A. B. Lamilisa

Abstract:

Introduction: Conventional wastewater treatment technology has been found to fail in developing countries because they are expensive to construct, operate and maintain. Constructed wetlands are nowadays considered as a low-cost alternative for effective wastewater treatment, especially where suitable land can be available. This study aims to evaluate the performance of the constructed wetland vegetated with water hyacinth (Eichhornia crassipes) plant for the treatment of wastewater. Methodology: The sub-surface flow wetland used for this study was an experimental scale constructed wetland consisting of four beds A, B, C, and D. Beds A, B, and D were vegetated while bed C which was used as a control was non-vegetated. This present study presents the results from bed B vegetated with water hyacinth (Eichhornia crassipes) and control bed C which was non-vegetated. The influent of the experimental scale wetland has been pre-treated with sedimentation, screening and anaerobic chamber before feeding into the experimental scale wetland. Results: pH and conductivity level were more reduced, colour of effluent was more improved, nitrate, iron, phosphate, and chromium were more removed, and dissolved oxygen was more improved in the water hyacinth bed than the control bed. While manganese, nickel, cyanuric acid, and copper were more removed from the control bed than the water hyacinth bed. Conclusion: The performance of the experimental scale constructed wetland bed planted with water hyacinth (Eichhornia crassipes) is better than that of the control bed. It is therefore recommended that plain bed without any plant should not be encouraged.

Keywords: constructed experimental scale wetland, domestic sewage, treatment, water hyacinth

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21159 Evaluation of Food Services by the Personnel in Hospitals of Athens, Greece

Authors: I. Mentziou, C. Delezos, D. Krikidis, A. Nestoridou, G. Boskou

Abstract:

Introduction: The systems of production and distribution of meals can have a significant impact on the food intake of hospital patients who are likely to develop malnutrition. In hospitals, the consequences of food borne infections can range from annoying to life-threatening for a patient, since they can lead up to death in vulnerable groups Aim: The aim of the present study was the evaluation of food safety management systems implementation, as well as the general evaluation of the total quality management systems in Greek hospitals. Methods: This is a multifocal study on the implementation and evaluation of the food safety management systems in the Greek hospitals of Attica region. Eleven hospitals from the city of Athens were chosen for this purpose. The sample was derived from the high rank personnel of the nutritional department (dietician, head-chef, food technologist, public health inspector). Tailor made questionnaires on hygiene regulations were used as tools for the interviews. Results: Overall, 30 employees in the field of hospital nutrition participated. Most of the replies implied that almost always the hygiene regulations are implemented. Nevertheless, only 30% stated that there is a Hazard Analysis Critical Control Points HACCP system (HACCP) in the hospital. In a small number of questionnaires there were proposals for changes by the staff. Conclusion: Measurement of the opinion of the personnel about the provided food services within a hospital can further lead to continuous improvement of the hospital nutrition.

Keywords: evaluation, food service, HACCP, hospital, personnel

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21158 Controller Design and Experimental Evaluation of a Motorized Assistance for a Patient Transfer Floor Lift

Authors: Donatien Callon, Ian Lalonde, Mathieu Nadeau, Alexandre Girard

Abstract:

Patient transfer is a challenging, critical task because it exposes caregivers to injury risks. Available transfer devices, like floor lifts, lead to improvements but are far from perfect. They do not eliminate the caregivers’ risk of musculoskeletal disorders, and they can be burdensome to use due to their poor maneuverability. This paper presents a new motorized floor lift with a single central motorized wheel connected to an instrumented handle. Admittance controllers are designed to 1) improve the device maneuverability, 2) reduce the required caregiver effort, and 3) ensure the security and comfort of patients. Two controller designs, one with a linear admittance law and a non-linear admittance law with variable damping, were developed and implemented on a prototype. Tests were performed on seven participants to evaluate the performance of the assistance system and the controllers. The experimental results show that 1) the motorized assistance with the variable damping controller improves maneuverability by 28%, 2) reduces the amount of effort required to push the lift by 66%, and 3) provides the same level of patient comfort compared to a standard unassisted floor lift.

Keywords: floor lift, human robot interaction, admittance controller, variable admittance

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21157 Language Development in Rare Diseases: Angelman Syndrome vs Prader-Willi Syndrome

Authors: Sara Canas Pedrosa, Esther Moraleda SepuLveda

Abstract:

Angelman Syndrome (AS) and Prader-Willi Syndrome (PWS) are considered rare genetic disorders that share the same chromosomal region: 15q11.2-q13. This is why both share some common characteristics, such as, delay in language development. However, there is still little research that specifically focuses on the linguistic profile in these populations. Therefore, the objective of this study was to know the characteristics of oral and written language that Angelman Syndrome and Prader-Willi Syndrome present from the point of view of parents. The sample consisted of 36 families (with children between 6 and 17 years old), of which 23 had children with AS and 13 had children with PWS. All of them answered the Language Assessment Scale of the standardized test CELF-4, Spanish Clinical Evaluation of Language Fundamentals-4 (Wiig, Secord & Semel, 2006). The scale is made up of 40 items that assesses the perception of parents in areas such as: difficulty of listening, speaking, reading and writing. The results indicate that the majority of parents manifest problems in almost all the sub-areas related to oral language and written language, taking into account that many do not achieve a literacy level, with similar results in comparison with both syndromes. These data support the importance of working on oral language delay and its relationship with the subsequent learning of literacy throughout its development.

Keywords: Angelman Syndrome , development, language, Prader-Willi Syndrome

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21156 The Experience of Applying Multi-Sensory Stimulation ICU for Arousing a Patient with Traumatic Brain Injury in Intensive Care

Authors: Hsiao-Wen Tsai

Abstract:

Motor vehicle accident is the first cause of head injury in the world; severe head injury cases may cause conscious disturbance and death. This is a report about a case of a young adult patient suffering from motor vehicle accident leading to severe head injury who passed through three time surgical procedures, and his mother (who is the informal caregiver). This case was followed from 28th January to 15th February 2011 by using Gordon’s 11 functional health patterns. Patient’s cognitive-perceptual and self-perception-self-concept patterns were altered. Anxiety was also noted on his informal caregiver due to patients’ condition. During the intensive care period, maintaining patient’s vital signs and cerebral perfusion pressure were essential to avoid secondary neuronal injury. Multi-sensory stimulation, caring accompanying, supporting, listening and encouraging patient’s family involved in patient care were very important to reduce informal caregiver anxiety. Finally, the patient consciousness improved from GCS 4 to GCS 11 before discharging from ICU. Patient’s primary informal caregiver, his mother, also showed anxiety improvement. This is was successful case with traumatic brain injury recovered from coma.

Keywords: anxiety, multi-sensory stimulation, reduce intracranial adaptive capacity, traumatic brain injury

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21155 Peripheral Neuropathy after Locoregional Anesthesia

Authors: Dalila Chaid, Bennameur Fedilli, Mohammed Amine Bellelou

Abstract:

The study focuses on the experience of lower-limb amputees, who face both physical and psychological challenges due to their disability. Chronic neuropathic pain and various types of limb pain are common in these patients. They often require orthopaedic interventions for issues such as dressings, infection, ulceration, and bone-related problems. Research Aim: The aim of this study is to determine the most suitable anaesthetic technique for lower-limb amputees, which can provide them with the greatest comfort and prolonged analgesia. The study also aims to demonstrate the effectiveness and cost-effectiveness of ultrasound-guided local regional anaesthesia (LRA) in this patient population. Methodology: The study is an observational analytical study conducted over a period of eight years, from 2010 to 2018. It includes a total of 955 cases of revisions performed on lower limb stumps. The parameters analyzed in this study include the effectiveness of the block and the use of sedation, the duration of the block, the post-operative visual analog scale (VAS) scores, and patient comfort. Findings: The study findings highlight the benefits of ultrasound-guided LRA in providing comfort by optimizing post-operative analgesia, which can contribute to psychological and bodily repair in lower-limb amputees. Additionally, the study emphasizes the use of alpha2 agonist adjuvants with sedative and analgesic properties, long-acting local anaesthetics, and larger volumes for better outcomes. Theoretical Importance: This study contributes to the existing knowledge by emphasizing the importance of choosing an appropriate anaesthetic technique for lower-limb amputees. It highlights the potential of ultrasound-guided LRA and the use of specific adjuvants and local anaesthetics in improving post-operative analgesia and overall patient outcomes. Data Collection and Analysis Procedures: Data for this study were collected through the analysis of medical records and relevant documentation related to the 955 cases included in the study. The effectiveness of the anaesthetic technique, duration of the block, post-operative pain scores, and patient comfort were analyzed using statistical methods. Question Addressed: The study addresses the question of which anaesthetic technique would be most suitable for lower-limb amputees to provide them with optimal comfort and prolonged analgesia. Conclusion: The study concludes that ultrasound-guided LRA, along with the use of alpha2 agonist adjuvants, long-acting local anaesthetics, and larger volumes, can be an effective approach in providing comfort and improving post-operative analgesia for lower-limb amputees. This technique can potentially contribute to the psychological and bodily repair of these patients. The findings of this study have implications for clinical practice in the management of lower-limb amputees, highlighting the importance of personalized anaesthetic approaches for better outcomes.

Keywords: neuropathic pain, ultrasound-guided peripheral nerve block, DN4 quiz, EMG

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21154 Preventing the Septic Shock in an Oncological Patient with Febrile Neutropenia Submitted to Chemotherapy: The Nurse's Responsibility

Authors: Hugo Reis, Isabel Rabiais

Abstract:

The main purpose of the present study is to understand the nurse’s responsibility in preventing the septic shock in an oncological patient with febrile neutropenia submitted to chemotherapy. In order to do it, an integrative review of literature has been conducted. In the research done in many databases, it was concluded that only 7 out of 5202 articles compiled the entire inclusion standard present in the strict protocol of research, being this made up by all different methodologies. On the research done in the 7 articles it has resulted 8 text macro-units associated to different nursing interventions: ‘Health Education’; ‘Prophylactic Therapy Administration’; ‘Scales Utilization’; ‘Patient Evaluation’; ‘Environment Control’; ‘Performance of Diagnostic Auxiliary Exams’; ‘Protocol Enforcement/Procedure Guidelines’; ‘Antibiotic Therapy Administration’. Concerning the prevalence/result’s division there can be identified many conclusions: the macro-units ‘Patient Evaluation’, ‘Performance of Diagnostic Auxiliary Exams’, and ‘Antibiotic Therapy Administration’ present themselves to be the most prevalent in the research – 6 in 7 occurrences (approximately 85.7%). Next, the macro-unit ‘Protocol Enforcement/Procedure Guidelines’ presents itself as an important expression unit – being part of 5 out of the 7 analyzed studies (approximately 71.4%). The macro-unit ‘Health Education’, seems to be in the same way, an important expression unit – 4 out of the 7 (or approximately 57%). The macro-unit ‘Scales Utilization’, represents a minor part in the research done – it’s in only 2 out of the 7 cases (approximately 28.6%). On the other hand, the macro-units ‘Prophylactic Therapy Administration’ and ‘Environment Control’ are the two categories with fewer results in the research - 1 out of the 7 cases, the same as approximately 14.3% of the research results. Every research done to the macro-unit ‘Antibiotic Therapy Administration’ agreed to refer that the intervention should be strictly done, in a period of time less than one hour after diagnosing the fever, with the purpose of controlling the quick spread of infection – minimizing its seriousness. Identifying these interventions contributes, concluding that, to adopt strategies in order to prevent the phenomenon that represents a daily scenario responsible for the cost´s increase in health institutions, being at the same time responsible for the high morbidity rates and mortality increase associated with this specific group of patients.

Keywords: febrile neutropenia, oncology nursing, patient, septic shock

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