Search results for: practical screening

Authors: Siyathorn Khunon, Thanawit Buafai

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This paper aims to investigate management of beach safety with a focus on tourist drownings in Samui. The data collected in this investigation will then lead to the proposal of a practical management model suitable for use in Samui. Qualitative research was conducted in the following manner: nine stakeholders from local government organizations and tourism businesses were interviewed in-depth. Additionally, a best practice case study from Phuket was applied to analyze beach safety. Twelve foreign tourists were also interviewed. Then, a focus group comprised of 32 people was used to determine practical solutions for enhancing tourists’ safety on the beach in Samui. A steering committee to coordinate between public and private organizations was proposed to manage and enhance tourists’ safety. A practical model is proposed to increase the safety level of tourists in Samui

Keywords: beach safety, drowning, tourist, Samui

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Authors: Samson Munn, Virginia H. Kim, Huija Chen, Sean Maldonado, Michelle Kim, Paul Koscheski, Babak N. Kalantari, Gregory Eckel, Albert Lee

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In terms of screening mammography quality, neither the portion of reports that advise call-back imaging that should be bilateral versus unilateral nor how much the unilateral call-backs may appropriately diverge from 50–50 (left versus right) is known. Many factors may affect detection laterality: display arrangement, reflections preferentially striking one display location, hanging protocols, seating positions with respect to others and displays, visual field cuts, health, etc. The call-back bilateral fraction may reflect radiologist experience (not in our data) or confidence level. Thus, laterality and bilaterality of call-backs advised in screening mammography reports could be worthy quality metrics. Here, laterality data did not reveal a concern until drilling down to individuals. Bilateral screening mammogram report recommendations by five breast imaging, attending radiologists at Harbor-UCLA Medical Center (Torrance, California) 9/1/15--8/31/16 and 9/1/16--8/31/17 were retrospectively reviewed. Recommended call-backs for bilateral versus unilateral, and for left versus right, findings were counted. Chi-square (χ²) statistic was applied. Year 1: of 2,665 bilateral screening mammograms, reports of 556 (20.9%) recommended call-back, of which 99 (17.8% of the 556) were for bilateral findings. Of the 457 unilateral recommendations, 222 (48.6%) regarded the left breast. Year 2: of 2,106 bilateral screening mammograms, reports of 439 (20.8%) recommended call-back, of which 65 (14.8% of the 439) were for bilateral findings. Of the 374 unilateral recommendations, 182 (48.7%) regarded the left breast. Individual ranges of call-backs that were bilateral were 13.2–23.3%, 10.2–22.5%, and 13.6–17.9%, by year(s) 1, 2, and 1+2, respectively; these ranges were unrelated to experience level; the two-year mean was 15.8% (SD=1.9%). The lowest χ² p value of the group's sidedness disparities years 1, 2, and 1+2 was > 0.4. Regarding four individual radiologists, the lowest p value was 0.42. However, the fifth radiologist disfavored the left, with p values of 0.21, 0.19, and 0.07, respectively; that radiologist had the greatest number of years of experience. There was a concerning, 93% likelihood that bias against left breast findings evidenced by one of our radiologists was not random. Notably, very soon after the period under review, he retired, presented with leukemia, and died. We call for research to be done, particularly by large departments with many radiologists, of two possible, new, quality metrics in screening mammography: laterality and bilaterality. (Images, patient outcomes, report validity, and radiologist psychological confidence levels were not assessed. No intervention nor subsequent data collection was conducted. This uncomplicated collection of data and simple appraisal were not designed, nor had there been any intention to develop or contribute, to generalizable knowledge (per U.S. DHHS 45 CFR, part 46)).

Keywords: mammography, screening mammography, quality, quality metrics, laterality

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Authors: Mary Kiviiri Nakawuka, Mary Namugalu, Andrew Otiti

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BACKGROUND Cervical cancer is the fourth most common cancer in women and seventh overall among all cancers worldwide. It accounts for about 7.5% of all female-cancer deaths with 85% occurring in low and middle-income countries and the first most common female cancer in women aged 15 to 44 years in Uganda with an annual number of new cases at 3,915 and 2,275 annual number of cervical cancer deaths in 2012 (ICO INFORMATION CENTRE ON HPV AND CANCER, 2017).Despite the available free cervical cancer screening services whose uptake has been documented to improve the chances of successful treatment of pre-cancers and cancers among women of reproductive age, there is a low uptake of these services thus we sought to examine the uptake of cervical cancer services and associated factors among women of reproductive age (25-49) attending the ART clinic of KISWA HCII in Kampala, Uganda METHODS The research was carried out in the ART clinic of KISWA HCII among 385 participants. An analytical, cross-sectional study with quantitative methods of data collection was used. The study adopted a non-probability convenience sampling method to select participants. Quantitative data was collected through structured questionnaires. RESULTS 72.2% of the participants were found to have been screened for cervical cancer. 36 % of the screened women had a positive HPV or VIA result ,59.2% of the screened women had a negative HPV or VIA result and 4.8% had an invalid HPV test result. Only 39.5% of the participants had adequate overall knowledge about cervical cancer, more than a third of the participants (50%) had moderate or low knowledge and minority of them (10.5%) had no knowledge. There was no significant association between the uptake of cervical cancer screening services among participants and their socio-demographic characteristics. CONCLUSIONS Although majority of the women surveyed had been screened for cervical cancer, a comparatively large number of participants had inadequate knowledge about cervical cancer and therefore there is still need to continue teaching about cervical cancer and this may include education campaigns, improvements to the accessibility and convenience of the screening services.

Keywords: cervical cancer uptake, cervical cancer screening, women of reproductive age., cervical cancer knowledge

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Authors: Adnan Ahmad, Yusri Kamin, Asnol Dahar Minghat, Mohd. Khir Nordin, Dayana Farzeha, Ahmad Nabil

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The purpose of this study is to identify the teaching method practices of the practical work subject in Vocational Secondary School. This study examined the practice of Vocational Teaching Method in Automotive Practical Work. The quantitative method used the sets of the questionnaire. 283 students and 63 teachers involved from ten VSS involved in this research. Research finding showed in conducting the introduction session teachers prefer used the demonstration method and questioning technique. While in deliver the content of practical task, teachers applied group monitoring and problem-solving approach. To conclude the task of automotive practical work, teachers choose re-explain and report writing to make sure students really understand all the process of teaching. VTM-APW also involved the competency-based concept to embed in the model. Derived from factors investigated, research produced the combination of elements in teaching skills and vocational skills which could be used as the best teaching method in automotive practical work for school level. As conclusion this study has concluded that the VTM-APW model is able to apply in teaching to make an improvement with current practices in Vocational Secondary School. Hence, teachers are suggested to use this method to enhance student's knowledge in Automotive and teachers will deliver skills to the current and future workforce relevant with the required competency skilled in workplace.

Keywords: vocational teaching method, practical task, teacher preferences, student preferences

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Authors: V. Shapaval, N. K. Afseth, D. Tzimorotas, A. Kohler

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Globally there is a dramatic increase in the demand for food, energy, materials and clean water since natural resources are limited. As a result, industries are looking for ways to reduce rest materials and to improve resource efficiency. Microorganisms have a high potential to be used as bio factories for the production of primary and secondary metabolites that represent high-value bio-products (enzymes, polyunsaturated fatty acids, bio-plastics, glucans, etc.). In order to find good microbial producers, to design suitable substrates from food rest materials and to optimize fermentation conditions, rapid analytical techniques for quantifying target bio products in microbial cells are needed. In the EU project FUST (R4SME, Fp7), we have developed a fully automated high-throughput FUST system based on micro-cultivation and FTIR spectroscopy that facilitates the screening of microorganisms, substrates and fermentation conditions for the optimization of the production of different high-value metabolites (single cell oils, bio plastics). The automated system allows the preparation of 100 samples per hour. Currently, The FUST system is in use for screening of filamentous fungi in order to find oleaginous strains with the ability to produce polyunsaturated fatty acids, and the optimization of cheap substrates, derived from food rest materials, and the optimization of fermentation conditions for the high yield of single cell oil.

Keywords: FTIR spectroscopy, FUST system, screening, biotechnology

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Authors: Shu-Min Tsao, Chung-Ming Lo, Shao-Chun Chen

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Most diabetes patients tend to suffer from its complication of retina diseases. Therefore, early detection and early treatment are important. In clinical examinations, using color fundus image was the most convenient and available examination method. According to the exudates appeared in the retinal image, the status of retina can be confirmed. However, the routine screening of diabetic retinopathy by color fundus images would bring time-consuming tasks to physicians. This study thus proposed a computer-aided exudate diagnosis for the screening of diabetic retinopathy. After removing vessels and optic disc in the retinal image, six quantitative features including region number, region area, and gray-scale values etc… were extracted from the remaining regions for classification. As results, all six features were evaluated to be statistically significant (p-value < 0.001). The accuracy of classifying the retinal images into normal and diabetic retinopathy achieved 82%. Based on this system, the clinical workload could be reduced. The examination procedure may also be improved to be more efficient.

Keywords: computer-aided diagnosis, diabetic retinopathy, exudate, image processing

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Authors: Wafa Al Jabri

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Background: In Middle Eastern Islamic Countries (MEICs), there is a high prevalence of genetic blood disorders (GBDs), particularly sickle cell disease and thalassemia. The GBDs are considered a major public health concern, especially with the increase in affected populations along with the associated psychological, social, and financial cost of management. Despite the availability of premarital screening services (PSS) that aim to identify the asymptomatic carriers of GBDs and provide genetic counseling to couples in order toreduce the prevalence of these diseases; yet, the success rate of PSS is very low due to religious and socio-cultural concerns. Purpose: This paper aims to highlight the factors that affect the success of PSS in MEICs. Methods: A literature review of articles located in CINAHL, PubMed, SCOPUS, and MedLinewas carried out using the following terms: “premarital screening,” “success,” “effectiveness,” and “ genetic blood disorders.” Second, a hand search of the reference lists and Google searches were conducted to find studies that did not exist in the primary database searches. Only studies which are conducted in MEICs countries and published in the last five years were included. Studies that were not published in English were excluded. Results: Fourteen articles were included in the review. The results showed that PSS in most of the MEICs was successful in achieving its objective of identifying high-risk marriages; however, the service failed to meetitsultimate goal of reducing the prevalence of GBDs. Various factors seem to hinder the success of PSS, including poor public awareness, late timing of the screening, culture and social stigma, religious beliefs, availability of prenatal diagnosis and therapeutic abortion, emotional factors, and availability of genetic counseling services. However, poor public awareness, late timing of the screening, and unavailability of adequate counseling services were the most common barriers identified. Conclusion: Overcoming the identified barriers by providing effective health education programs, offering the screening test to young adults at an earlier stage, and tailoring the genetic counseling would be crucial steps to provide a framework for an effective PSS in MEICs.

Keywords: premarital screening, success, effectiveness, and genetic blood disorders

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Authors: Soumeya Krimat, Tahar Dob, Mohamed Toumi, Aicha Kesouri, Hafidha Metidji, Chelghoum Chabane

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Lavandula antineae Maire is an endemic medicinal plant of Algeria which is traditionally used for the treatment of chills, bruises, oedema and rheumatism. The present study was designed to investigate the phytochemical screening, total phenolic and antioxidant activity of Lavandula antineae Maire for the first time. Phytochemical screening revealed the presence of different kind of chemical groups (anthraquinones, terpenes, saponins, flavonoids, tannins, O-heterosides, C-heterosides, phenolic acids). The amounts of total phenolics in the extracts (hydromethanolic and ethyl acetate extract) were determined spectrometrically. From the analyses, ethyl acetate extract had the highest total phenolic content (262.35 mg GA/g extract) and antioxidant activity (IC50=7.10 µg/ml) using DPPH method. The ethyl acetate extract was also more potent on reducing power compared to hydromethanolic extract. The results suggested that L. antineae could be considered as a new potential source of natural antioxidant for pharmaceuticals and food preservation.

Keywords: Lavandula antineae, antioxidant activity, phytochemical screening, total phenolics

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Authors: Salwa Hagag Abdelaziz, Naglaa Fathy Youssef, Nadia Abdellatif Hassan, Rasha Wesam Abdelrahman

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Breast cancer is considered as a substantial health concern and practicing mammography screening [MS] is important in minimizing its related morbidity. So it is essential to have a better understanding of breast cancer screening behaviors of women and factors that influence utilization of them. The aim of this study is to identify the factors that are linked to MS behaviors among the Egyptian women. A cross-sectional descriptive design was carried out to provide a snapshot of the factors that are linked to MS behaviors. A convenience sample of 311 women was utilized and all eligible participants admitted to the Women Imaging Unit who are 40 years of age or above, coming for mammography assessment, not pregnant or breast feeding and who accepted to participate in the study were included. A structured questionnaire was developed by the researchers and contains three parts; Socio-demographic data; Motivating factors associated with MS; and association between MS and model of behavior change. The analyzed data indicated that most of the participated women (66.6 %) belonged to the age group of 40-49.A high proportion of participants (58.1%) of group having previous MS influenced by their neighbors to practice MS, whereas 32.7 % in group not having previous MS were influenced by family members which indicated significant differences (P <0.05). Doctors and media are shown to be the least influence of others to practice MS. Women with intention to have a future mammogram had higher OR (1.404) for practicing MS compared with women with no intention. Further studies are needed to examine the relation between Trans-theoretical Model [TTM] and practicing MS.

Keywords: breast cancer, mammography, screening behaviors, morbidity

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Authors: Basant Singh Sikarwar, Mukesh Roy, Ayush Goyal, Priya Ranjan

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This work combines two bodies of knowledge which includes biomedical basis of blood stain formation and fluid communities’ wisdom that such formation of blood stain depends heavily on physical properties. Moreover biomedical research tells that different patterns in stains of blood are robust indicator of blood donor’s health or lack thereof. Based on these valuable insights an innovative screening tool is proposed which can act as an aide in the diagnosis of diseases such Anemia, Hyperlipidaemia, Tuberculosis, Blood cancer, Leukemia, Malaria etc., with enhanced confidence in the proposed analysis. To realize this powerful technique, simple, robust and low-cost micro-fluidic devices, a micro-capillary viscometer and a pendant drop tensiometer are designed and proposed to be fabricated to measure the viscosity, surface tension and wettability of various blood samples. Once prognosis and diagnosis data has been generated, automated linear and nonlinear classifiers have been applied into the automated reasoning and presentation of results. A support vector machine (SVM) classifies data on a linear fashion. Discriminant analysis and nonlinear embedding’s are coupled with nonlinear manifold detection in data and detected decisions are made accordingly. In this way, physical properties can be used, using linear and non-linear classification techniques, for screening of various diseases in humans and cattle. Experiments are carried out to validate the physical properties measurement devices. This framework can be further developed towards a real life portable disease screening cum diagnostics tool. Small-scale production of screening cum diagnostic devices is proposed to carry out independent test.

Keywords: blood, physical properties, diagnostic, nonlinear, classifier, device, surface tension, viscosity, wettability

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Authors: Akpokiere Ugbede Roseline

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Chemistry is an activity oriented subject in which many students achievement over the years are not encouraging. Among the reasons found to be responsible for student’s poor performance in chemistry are ineffective teaching strategies. This study, therefore, sought to determine the effect of guided inquiry, guided inquiry with demonstration, and demonstration with conventional approach on pre-service teachers’ cognitive attainment and practical skills acquisition on stoichiometry and chemical reactions in practical chemistry, Two research questions and hypotheses were each answered and tested respectively. The study was a quasi-experimental research involving 50 students in each of the experimental groups and 50 students in the control group. Out of the five instruments used for the study, three were on stimulus and two on response (Test of Cognitive Attainment and Test of Practical Skills in Chemistry) instruments administered, and dataobtained were analyzed with t-test and Analysis of Variance. Findings revealed, among others, that there was a significant effect of treatments on students' cognitive attainment and on practical skills acquisition. Students exposed to guided inquiry (with/without demonstration) strategies achieved better than those exposed to demonstration with conventional strategy. It is therefore recommended, among others, that Lecturers in Colleges of Education should utilize the guided inquiry strategy for teaching concepts in chemistry.

Keywords: instructional strategy, practical chemistry, learning outcomes, pre-service teachers

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Authors: Jaci Mastrandrea

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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening is directly correlated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project is to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline from March 15th, 2022, to April 29th, 2022. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated and evidence-based PC referral criteria. The tool was initially implemented using paper forms and later was integrated into the Epic-Beacon EHR system. Patients were screened by registered nurses on the SLCTC treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher were considered to be a positive screen. Scores of five or higher triggered a PC referral order in the patient’s EHR for the oncologist to review and approve. All patients with a positive screen received an educational handout on the topic of PC, and the EHR was flagged for follow-up. Results: Prior to implementation of the PSCNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the first 100 patient screenings completed within the eight-week data collection period. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting the criteria were flagged in the EHR for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.

Keywords: oncology, palliative care, symptom management, symptom screening, ambulatory oncology, cancer, supportive care

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Authors: Kirsty Biggs, Peter Larsen-Disney

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Background: The UK cervical screening programme significantly reduces cancer mortality through the early detection of abnormal cells. Despite this, over a quarter of eligible women choose not to attend their appointment. Objective: To qualitatively explore patients’ barriers to attending cervical smear appointments and identify key trends of cervical screening behaviour, knowledge, and attitudes in primary and secondary care. Methods: A cross-sectional study was conducted to evaluate smear services in Brighton and Hove using questionnaires in general practice and colposcopy. 226 patients participated in the voluntary questionnaire between 10/11/2017 and 02/02/2018. 118 patients were recruited from general practice surgeries and 108 from the colposcopy department. Women were asked about their smear knowledge, self-perceived risks factors, prior experiences and reasons for non-attendance. Demographic data was also collected. Results: Approximately a third of women did not engage in smear testing services. This was consistent across primary and secondary care groups. Over 90% were aware of the role of the screening process in relation to cervical cancer; however, over two thirds believed the smear was also a tool to screen for other pathologies. The most commonly cited reasons for non-attendance were negative emotions or previous experiences. Inconvenient appointment times were also commonly described. In a comparison of attenders versus non-attenders previous negative experiences (p < 0.01) and number of identified risk factors (p = 0.02) were statistically significant with non-attenders describing more prior negative smears and identifying more risk factors. Smear knowledge, risk perception and perceived importance of screening were not significant. Negative previous experiences were described in relation to poor bedside manner, pain, embarrassment and staff competency. Conclusions: In contrary to the literature, our white Caucasian cohort experienced significant barriers to accessing smear services. Women’s prior negative experiences are overriding their perceived importance to attend the screening programme; therefore, efforts need to focus on improving clinical experiences through auditing tools, training and providing a supportive appointment setting. Positive changes can also be expected by improving appointment availabilities with extended hours and self-booking systems.

Keywords: barriers, cervical, Papanicolaou, screening, smear

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Authors: Shenaz Ahmed, Hussain Jafri, Muhammed Faran, Wajeeha Naseer Ahmed, Yasmin Rashid, Yasmin Ehsan, Shabnam Bashir, Mushtaq Ahmed

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Low uptake of cascade screening for βeta-Thalassaemia Major (β-TM) in the ‘Punjab Thalassaemia Prevention Project’ (PTPP) in Pakistan led to the development of a ‘decision support intervention for relatives’ (DeSIRe). This paper presents the experiences of relatives of children with β-TM of the DeSIRe following its use by PTPP field officers in routine clinical practice. Fifty-four semi-structured qualitative interviews were conducted (April to June 2021) with relatives in seven cities in the Punjab province (Lahore, Sheikhupura, Nankana Sahab, Kasur, Gujranwala, Multan, and Faisalabad). Thematic analysis shows that participants were satisfied with the content of the DeSIRe and its delivery by the field officers in a family meeting. They understood the main purpose of the DeSIRe was to improve their knowledge of β-TM and its inheritance, to enable them to make decisions about thalassemia carrier testing, particularly before marriage. While participants raised concerns about the stigma of testing positive, they believed the DeSIRe was an appropriate intervention, which supported relatives to make informed decisions. Our findings show the DeSIRe is appropriate for use by healthcare professionals in routine practice in a low-middle income country and has the potential to facilitate shared decision-making about cascade screening for thalassemia. Further research is needed to prove the efficacy of the DeSIRe.

Keywords: thalassemia, Pakistan, cascade screening, decision support

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Authors: Kaoutar Ben Azzou, Hanaa Talei

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Human resources is an important department in each organization as it manages the life cycle of employees from recruitment training to retirement or termination of contracts. The recruitment process starts with a job opening, followed by a selection of the best-fit candidates from all applicants. Matching the best profile for a job position requires a manual way of looking at many CVs, which requires hours of work that can sometimes lead to choosing not the best profile. The work presented in this paper aims at reducing the workload of HR personnel by automating the preliminary stages of the candidate screening process, thereby fostering a more streamlined recruitment workflow. This tool introduces an automated system designed to help with the recruitment process by scanning candidates' CVs, extracting pertinent features, and employing machine learning algorithms to decide the most fitting job profile for each candidate. Our work employs natural language processing (NLP) techniques to identify and extract key features from unstructured text extracted from a CV, such as education, work experience, and skills. Subsequently, the system utilizes these features to match candidates with job profiles, leveraging the power of classification algorithms.

Keywords: automated recruitment, candidate screening, machine learning, human resources management

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Authors: Nisha Harry, Keshia Sing

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Orientation: The Multifactor Leadership Questionnaire (MLF) and the sense of coherence-29 (SCS) is an effective tools to assess the prevalence and underlying structures of empirically based taxonomies related to leadership and wellbeing. Research purpose: The purpose of the study was to test the psychometric properties of the SCS and Multifactor Leadership Questionnaire (MLQ) to screen for psychological wellness indices within the banking industry in South Africa. Motivation for the study: The contribution of these two instruments for the purpose of determining psychological wellness in a banking work environment is unique. Research design, approach, or method: The sample consisted of (N = 150) financial staff employed in a South African banking organisation. The age of the sample was: 37% (30 -40 yrs), 31% (20-30 yrs), 26% (40- 50 yrs), and 6% (50+yrs), of which 52% were males, 48% were females. The white race group was the majority at 29%, African at 26%, Coloured at 23%, and Indian was 22%. Main findings: Results from the exploratory factor analysis revealed a two-factor structure as the most satisfactory. Confirmatory factor analyses revealed the two-factor model displayed better good of-fit indices. Practical implications: The factor structure of the Sense of Coherence-29 scale (SCS), and the Multifactor Leadership Questionnaire (MLQ), have a value-added focus to determine psychological wellness within banking staff. It is essential to take into account these constructs when developing employee wellness interventions. Contribution/value add: Understanding the psychometric properties of the SCS, the self-reported form, and the MLQ questionnaire contributes to screening psychological wellness indices such as coping within the banking industry in a developing country like South Africa. Leaders are an important part of the implementation process of organisational employee wellness practices.

Keywords: factorial structure, leadership, measurement invariance, psychological wellness, sense of coherence

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Authors: Jaci Marie Mastrandrea, Rosario Haro

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Background: The National Comprehensive Cancer Network (NCCN) recommends that healthcare institutions have established processes for integrating palliative care (PC) into cancer treatment and that all cancer patients be screened for PC needs upon initial diagnosis as well as throughout the entire continuum of care (National Comprehensive Cancer Network, 2021). Early PC screening and intervention is directly associated with improved patient outcomes. The Sky Lakes Cancer Treatment Center (SLCTC) is an institution that has access to PC services yet does not have protocols in place for identifying patients with palliative needs or a standardized referral process. The aim of this quality improvement project was to improve early access to PC services by establishing a standardized screening and referral process for outpatient oncology patients. Method: The sample population included all adult patients with an oncology diagnosis who presented to the SLCTC for treatment during the project timeline. The “Palliative and Supportive Needs Assessment'' (PSNA) screening tool was developed from validated, evidence-based PC referral criteria. The tool was initially implemented using paper forms, and data was collected over a period of eight weeks. Patients were screened by nurses on the SLCTC oncology treatment team. Nurses responsible for screening patients received an educational inservice prior to implementation. Patients with a PSNA score of three or higher received an educational handout on the topic of PC and education about PC and symptom management. A score of five or higher indicates that PC referral is strongly recommended, and the patient’s EHR is flagged for the oncology provider to review orders for PC referral. The PSNA tool was approved by Sky Lakes administration for full integration into Epic-Beacon. The project lead collaborated with the Sky Lakes’ information systems team and representatives from Epic on the tool’s aesthetic and functionality within the Epic system. SLCTC nurses and physicians were educated on how to document the PSNA within Epic and where to view results. Results: Prior to the implementation of the PSNA screening tool, the SLCTC had zero referrals to PC in the past year, excluding referrals to hospice. Data was collected from the completed screening assessments of 100 patients under active treatment at the SLCTC. Seventy-three percent of patients met criteria for PC referral with a score greater than or equal to three. Of those patients who met referral criteria, 53.4% (39 patients) were referred for a palliative and supportive care consultation. Patients that were not referred to PC upon meeting criteria were flagged in EPIC for re-screening within one to three months. Patients with lung cancer, chronic hematologic malignancies, breast cancer, and gastrointestinal malignancy most frequently met the criteria for PC referral and scored highest overall on the scale of 0-12. Conclusion: The implementation of a standardized PC screening tool at the SLCTC significantly increased awareness of PC needs among cancer patients in the outpatient setting. Additionally, data derived from this quality improvement project supports the national recommendation for PC to be an integral component of cancer treatment across the entire continuum of care.

Keywords: oncology, palliative and supportive care, symptom management, outpatient oncology, palliative screening tool

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Authors: Yunzi Chen, James Laybourne, Sarah Steven, Peter Carey, David Steel, Maria Sandinha

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Introduction: Bariatric surgery is popular with the rising incidence of obesity. Its well-known benefits include significant and rapid glycaemic control. However, cases of paradoxical worsening in diabetic retinopathy (DR) despite improved glycaemic control have been reported. Purpose: clarification on the evolution of diabetic retinopathy after bariatric surgery. Method: retrospective study of 40 patients with Type 2 diabetes who underwent bariatric surgery in a UK specialist bariatric unit between 2009 and 2011. Pre-operative and post-operative visual acuity (VA), weight, HbA1c and annual DRSS screening results were analysed. Median follow up was 50 months. Results: No significant change in VA was found during the post-operative period. 85% of patients improved HbA1c post-operatively of which 53% achieved non-diabetic HbA1c of <6.1% - despite this, 2 patients developed new DR. First post-operative screening showed 80% of patients experienced no change, 8% improved but 13% of patients developed new DR (1 case with sight-threatening maculopathy). 80% of these cases persisted up to 24 months. The proportion of patients developing new or worse DR fluctuated over time, peaking at the 3rd annual screening with 26% (15% regressed, 56% stable). The probability of developing new or worse DR postoperatively was significantly associated with a high pre-operative HbA1c (>8%) and male gender. Conclusions: bariatric surgery does not guarantee long-term improvement or prevention of DR. Asymptomatic changes in DR occurred up to 5 years postoperatively. We therefore consider it prudent to continue screening in this cohort of patients.

Keywords: bariatric surgery, diabetic retinopathy, obesity, type 2 diabetes mellitus

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Authors: Valentina Milanova, Kalina Mihaylova, Iva Lazarova

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The mechanisms by which female genital infections are detected are varied and include clinician-collected high vaginal swabs, clinician-collected endocervical swabs, patient-collected vaginal swabs, and first-pass urine samples. Vaginal health screening has chronically low rates of uptake. This highlights the unmet need for a screening tool with comparable diagnostic accuracy which is familiar, convenient and easy to use for people. The Daye™ medical grade tampon offers an alternative to traditional sampling methods with the potential of increasing screening uptake among people previously too embarrassed or busy to attend gynecological appointments. In this white paper, the results of stability studies and a comparative clinical trial are discussed to assess the suitability of the device for the collection of vaginal samples for various clinical assessments. The tampon has demonstrated good sample stability and comparable sample quality compared to a self-collected vaginal swab and a clinician-collected cervical swab.

Keywords: vaginal microbiome, vaginal infections, gynaecological infections, female health, menstrual tampons, in vitro diagnostics

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Authors: Hui-Chen Tsai, Chien-Jen Ho, Bo-Wei Power Liang, Ying Shen, Yi-Hsin Lai

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Former Taiwan Metal Mining Corporation and its associated 3 wasted flue gas tunnels, hereinafter referred to as 'TMMC', was contaminated with heavy metals, Polychlorinated biphenyls (PCBs) and Total Petroleum Hydrocarbons (TPHs) in soil. Since the contamination had been exposed and unmanaged in the environment for more than 40 years, the extent of the contamination area is estimated to be more than 25 acres. Additionally, TMMC is located in a remote, mountainous area where almost no residents are residing in the 1-km radius area. Thus, it was deemed necessary to conduct an ecological risk assessment in order to evaluate the details of future contaminated site management plan. According to the winter and summer, ecological investigation results, one type of endangered, multiple vulnerable and near threaten plant was discovered, as well as numerous other protected species, such as Crested Serpent Eagle, Crested Goshawk, Black Kite, Brown Shrike, Taiwan Blue Magpie were observed. Ecological soil screening level (Eco-SSLs) developed by USEPA was adopted as a reference to conduct screening assessment. Since all the protected species observed surrounding TMMC site were birds, screening ecological risk assessment was conducted on birds only. The assessment was assessed mainly based on the chemical evaluation, which the contamination in different environmental media was compared directly with the ecological impact levels (EIL) of each evaluation endpoints and the respective hazard quotient (HQ) and hazard index (HI) could be obtained. The preliminary ecological risk assessment results indicated HI is greater than 1. In other words, the biological stressors (birds) were exposed to the contamination, which was already exceeded the dosage that could cause unacceptable impacts to the ecological system. This result was mainly due to the high concentration of arsenic, metal and lead; thus it was suggested the above mention contaminants should be remediated as soon as possible or proper risk management measures should be taken.

Keywords: screening, ecological risk assessment, ecological impact levels, risk management

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Authors: Majed Aldusaimani

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Introduction: The researcher aims to verify the extent of the criminal investigator's commitment to the Islamic morals set out in the Holy Quran, their application in his work, and to understand the point of view of police officers, clerks and suspects regarding the investigator's commitment to moral and ethics in practice. Research question: Are the criminal investigators at the Bureau of Investigation and Public Prosecution in the Kingdom of Saudi Arabia committed to the application of the practical morals set out in the Holy Quran in the view of the police officers, clerks and suspects with whom they work? Objectives of the study: 1. Identifying the standing of morality in Islam. 2. Identifying the practical morals outlined in the Holy Quran. 3. Identifying the most important practical morals in the Holy Quran that must be met by the criminal investigator from the viewpoint of the investigator himself. 4. Identifying the criminal investigator's commitment to the practical morals set out in the Holy Quran as perceived from the perspectives of police officers, clerks and suspects. Methodology: This study will use a descriptive methodology through quantitative and qualitative analysis of the data from respondents, who will be asked to answer questions about the extent of the commitment to the practical morals set out in the Holy Quran of the criminal investigators at the Bureau of Investigation and Public Prosecution that they have encountered.

Keywords: Islamic, investigator, Morals, Quran

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Authors: Mihail Nagea, Olivera Lupescu, Elena Taina Avramescu, Cristina Patru

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Classical education of orthopedic surgeons involves lectures, self study, workshops and cadaver dissections, and sometimes supervised practical training within surgery, which quite seldom gives the young surgeons the feeling of being unable to apply what they have learned especially in surgical practice. The purpose of this paper is to present a different approach from the classical one, which enhances the practical skills of the orthopedic trainees and prepare them for future practice. The paper presents the content of the research project 2015-1-RO01-KA202-015230, ERASMUS+ VET ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery’ which, using e learning as a basic tool , delivers to the trainees not only courses, but especially practical information through videos and case scenarios including gait analysis in order to build patient focused therapeutic plans, adapted to the characteristics of each patient. The outcome of this project is to enhance the practical skills in orthopedic surgery and the results are evaluated following the answers to the questionnaires, but especially the reactions within the case scenarios. The participants will thus follow the idea that any mistake within solving the cases might represent a failure of treating a real patient. This modern approach, besides using interactivity to evaluate the theoretical and practical knowledge of the trainee, increases the sense of responsibility, as well as the ability to react properly in real cases.

Keywords: interdisciplinary approach, gait analysis, orthopedic surgery, vocational training

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Authors: Yadavalli Venkata Sridhar

Abstract:

Finalization of Substation sizing and location is an important task to be carried out by electrical designers in an oil field. Practical issues influence the selection of size and location of the source substations that feed multiple production facilities are listed. Importance of selection of appropriately rated short circuit level for 11KV switchboards and constraints pertaining to availability of manufacturers are highlighted. Without being lost in the research of absolute optimum solution, under time constraints, the importance of practical approach is brought out. Focus on identifying near optimum solutions by process of elimination of unfeasible substation locations with the support of cost figures, is emphasized through a case study.

Keywords: substation, size, location, oil field

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Authors: Arslan Usman, Abdul Sattar, Hamid Latif, Afshan Ashfaq, Muhammad Rafique, Martin Koch

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Two-dimensional materials have promising applications in optoelectronic and photonics; MoS₂ is the pioneer 2D material in the family of transition metal dichalcogenides. Its optical, optoelectronic, and structural properties are of practical importance along with its exciton dynamics. Exciton, along with exciton complexes, plays a vital role in realizing quantum devices. MoS₂ monolayers were synthesized using chemical vapour deposition (CVD) technique on SiO₂ and hBN substrates. Photoluminescence spectroscopy (PL) was used to identify the monolayer, which also reflects the substrate based peak broadening due to screening effects. In-plane and out of plane characteristic vibrational modes E¹₂g and A₁g, respectively, were detected in a different configuration on the substrate. The B-excitons and trions showed a dominant feature at low temperatures due to electron-phonon coupling effects, whereas their energies are separated by 100 meV.

Keywords: 2D materials, photoluminescence, AFM, excitons

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Authors: Fatma Acheuk, Akila Hamichi, Siham Semmar

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The crude ethanolic extract from Solenostemma argel was obtained by maceration of leaves and stems of the plant. Phytochimical study revealed the richness of the species on flavonoids, alkaloids, tannins and glycosides. Antimicrobial activity of the growth of clinical isolates of Eschirichia coli, Pseudomonas aeriginosa, Staphylococus aureus and Bacillus Subtilis was carried out using agar disc diffusion. The results of the study revealed that the test compound has antimicrobial activity against gram-positive bacteria which are resistant to commonly antimicrobial agents used. However, no effect was observed on other species tested.

Keywords: Solenostemma argel, crude extract, phytochemical screening, antimicrobial activity

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Authors: Ibrahim Isah Lakan, Nasiru Ibrahim

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These Phytochemical screening, Antimicrobial activities and mineral Determination of aqueous extract of Stachtarpheta indica were assessed. The result reveals the presence of flavonoids, tannins, saponins, alkaloids, glycosides and anthraquinones. The disc diffusion of aqueous extract showed Escherichia coli, 13 and antibiotic, 19 mm; Bacillus subtilis, 10 and anti –biotic, 17 mm; Klebsiller pnemuoniae , 14 and antibiotic, 24mm and Pseudmonas aeruginosa, 24 and antibiotic, 36 mm which are all comparable with the standard antibiotic cyprotomycin. The mineral content determination by flame photometer revealed that 1.25 (Na+), 0.85 (K +), 1.75 (Ca 2+) % which is a clear indication of the safety of the extract for the hypertensive patients and could be used to lower blood pressure.

Keywords: microbials, mineral, phytochemicals, stachtarpheta indica extracts

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Authors: Azza T. Tahera, Eman M. Ahmeda, Nadia A. Khalila, Yassin M. Nissanb

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New 3-(pyridin-4-yl)-[1,2,4] triazolo [4,3-b] pyridazine derivatives 2a-i, 4a,b and 6a,b were designed, synthesized and evaluated as cytotoxic agents. All compounds were investigated for their in vitro cytotoxicity at a single dose 10-5M concentration towards 60 cancer cell lines according to USA NCI protocol. The preliminary screening results showed that the majority of tested compounds exhibited remarkable activity against SR (leukemia) cell panel. Molecular docking for all synthesized compounds was performed on the active site of c-Met kinase. The most active compounds, 2f and 4a were further evaluated at a seven dose level screening and their IC50 as a c-Met kinase inhibitors were determined in vitro.

Keywords: triazolopyridazines, pyridazines, cytotoxic activity, cell panel

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Authors: Gagan Dhawan

Abstract:

Mycobacterium tuberculosis was described as ‘captain of death’ with an inherent property of multiple drug resistance majorly caused by the competent mechanism of efflux pumps. In this study, various open source tools combining chemo-informatics with bioinformatics were used for efficient in-silico drug designing. The efflux pump, Rv1218c, belonging to the ABC transporter superfamily, which is predicted to be a tetronasin-transporter in M. tuberculosis was targeted. Recent studies have shown that Rv1218c forms a complex with two more efflux pumps (Rv1219c and Rv1217c) to provide multidrug resistance to the bacterium. The 3D structure of the protein was modeled (as the structure was unavailable in the previously collected databases on this gene). The TMHMM analysis of this protein in TubercuList has shown that this protein is present in the outer membrane of the bacterium. Virtual screening of compounds from various publically available chemical libraries was performed on the M. tuberculosis protein using various open source tools. These ligands were further assessed where various physicochemical properties were evaluated and analyzed. On comparison of different physicochemical properties, toxicity and docking, the ligand 2-(hydroxymethyl)-6-[4, 5, 6-trihydroxy-2-(hydroxymethyl) tetrahydropyran-3-yl] oxy-tetrahydropyran-3, 4, 5-triol was found to be best suited for further studies.

Keywords: drug resistance, efflux pump, molecular docking, virtual screening

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Authors: Arundhati Devi Maibam, K. Ingocha Singh

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Cervical cancer is preventable if detected early. Determination of risk factors is essential to plan screening programmes to prevent the disease. To study the demographic risk factors of cervical cancer among Manipuri women, information on age, marital status, educational level, monthly family income and socioeconomic status were collected through a pre-tested interview schedule. In this study, 64 incident cases registered at the RT Dept, RIMS (Regional Institute of Medical Sciences), Imphal, Manipur, India during 2008-09 participated. Data were entered in Microsoft Excel and the results were expressed in percentages. Among the 64 patients with cervical cancer, 56 (88.9%) were in the age group of 40+ years. The majority of the patients were from rural areas (68.75%) and 31.25% were from urban areas. The majority of the patients were Hindus (73%), 55(85.9%) were of low educational level, 43(67.2%) were married, and 36 (56.25%) belonged to Class IV socioeconomic status. In conclusion, if detected early, cervical cancer is preventable and curable. The potential risk factors need to be identified and women in the risk group need to be motivated for screening. Affordable screening programmes and health care resources will help in lessening the burden of the disease.

Keywords: cervical cancer, Manipuri women, RIIMS, socio-demographic risk factors

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Authors: Mai Ali

Abstract:

Background: Preparing Hypo-screen-bags in advance streamlines the time-consuming process of administering glucose systemic correction. Additionally, Hypo-Screen Grab Bags are widely adopted in UK hospitals. Aim: The aim of the study is to improve hypoglycemia screening efficiency and equipment accessibility by streamlining item access to grab bag restocking staff. Methodology: The study centered on neonatal wards at LGI & St. James Neonatal Unit and related units. A web-based survey was conducted to evaluate local practices, gathering 21 responses from relevant general staff. The survey outcomes: (1) The demand for accessible grab bags is evident for smoother processes. (2) The potential to enhance efficiency through improved preparation of hypo-screen grab bags. Intervention: A Hypo-Screen Grab Bag was designed, including checklists for stocked items and required samples. Medical staff oversee restocking after use. Conclusion: The study successfully improved hypoglycemia screening efficiency and aided junior staff with accessible supplies and a user-friendly checklist.

Keywords: neonatal hypoglycemia, grab bag, hypo-screening, junior staff

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