Search results for: veterinary clinics
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 420

Search results for: veterinary clinics

210 Neonatal Sepsis in Dogs Attend in Veterinary Hospital of the Sao Paulo State University, Botucatu, Brazil – Incidence, Clinical Aspects and Mortality

Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Vivane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

Neonatal sepsis is a systemic response to the acute generalized infection caused by one or more bacterial agents, representing the main infectious cause of neonatal mortality in dogs during the first three weeks of life. This study aims to describe the incidence of sepsis in neonate dogs, as well as the main clinical signs and mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. Seven hundred thirty-five neonates, 14% (98/703) presented neonatal sepsis. The main sources of infection for the neonates were intrauterine (72.5%, 71/98), lactogenic (13.2%, 13/98), umbilical (5.1%, 5/98) and unidentified sources (9.2%, 9/98). The main non-specific clinical signs observed in the newborns were weakness, depression, impaired or absent reflexes, hypothermia, hypoglycemia, dehydration, reduced muscle tonus and diarrhea. The newborns also manifested clinical signs of severe infection, such as hyperemia in the abdominal and anal regions, omphalitis, hematuria, abdomen and extremities with purplish-blue coloration necrosing injuries in the pads, bradycardia, dyspnea, epistaxis, hypotension and evolution to septic shock. Infections acquired during intrauterine life led to the onset of the clinical signs at the time of birth, with fast evolution during the first hours of life. On the other hand, infections acquired via milk or umbilical cord presented clinical signs later. The total mortality rate was 5.4% (38/703) and the mortality rate among the neonates with sepsis was 38.7% (38/98). The early mortality rate (0 to 2 days) accounted for 86.9% (33/38) and the late mortality rate (3 to 30 days) for 13.1% (5/38) of the deaths among the newborns with sepsis. The main bacterial agents observed were Staphylococcus spp., Streptococcus spp., Proteus spp. Mannheimia spp. and Escherichia coli. Neonatal sepsis evolves quickly and may lead to high mortality in a litter. The prognosis is usually favorable if the diagnosis is reached early and the antibiotic therapy instituted as soon as possible, even before the results of blood cultures and antibiograms. The therapeutic recommendations should meet the special physiological conditions of a neonate in terms of metabolism and excretion of medication. Therefore, it is of utmost importance that the veterinarian is knowledgeable regarding neonatology to provide effective intervention and improve the survival rates of these patients.

Keywords: Neonatal infection , bacteria, puppies, newborn

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209 Influence of IL-1β on Hamster Blastocyst Hatching via Regulation of Hatching Associated Proteases

Authors: Madhulika Pathak, Polani Seshagiri, Vani Venkatappa

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Blastocyst hatching is an indispensable process for successful implantation. One of the major reasons for implantation failure in IVF clinic is poor quality of embryo, which are not development/hatching-competent. Therefore, attempts are required to develop or enhance the culture system with a molecule recapitulating the autocrine/paracrine factors containing the environment of in-vivo endometrial milieu. We have tried to explore the functional molecules involved in the hamster hatching phenomenon. Blastocyst hatching is governed by several molecules that are entwined and regulate this process, among which cytokines are known to be expressed and are still least explored. Two of such cytokines we have used for our study are IL-1β and its natural antagonist IL-1ra to understand the functional dynamics of cytokines involved in the hatching process. Using hamster, an intriguing experimental model for hatching behavior, we have shown the mRNA (qPCR) and protein (ICC) expression of IL-1β, IL-1ra and IL-1 receptor type 1 throughout all the stages of morula, blastocyst and hatched blastocyst. Post-asserting the expression, the functional role is shown by supplementation studies, where IL-1β supplementation showed enhancement in hatching level (IL-1β treated: 84.1 ± 4.2% vs control: 63.7 ± 3.1 %, N=11), further confirmed by the diminishing effect of IL-1ra on hatching rate (IL-1ra treated: 27.5 ± 11.1% vs control: 67.9 ± 3.1%). The exogenous supplementation of IL-1ra decreased the survival rate of embryos and affected the viability in dose-dependent manner, establishing the importance of IL-1β in blastocyst cell survival. Previously, the cathepsin L and B were established as the proteases that were involved in the hamster hatching process. The inducing effect of IL-1β was correlated with enhanced mRNA level, as analyzed by qPCR, for both CAT L (by 1.9 ± 0.5 fold) and CAT B (by 3.5 ± 0.1) fold which was diminished in presence of IL-1ra (Cat L by 88 percent and Cat B by 94 percent. Moreover, using a specific fluorescent substrate-based assay kit, the enzymatic activity of these proteases was found to be increased in presence of IL-1β (Cat L by 2.1 ± 0.1 fold and CAT B by 2.3 ± 0.7 fold) and was curtailed in presence of IL-1ra. These observations provide functional insights with respect to the involvement of cytokines in the hatching process. This has implications in understanding the hatching biology and improving the embryo development quality in IVF clinics.

Keywords: Blastocyst, Cytokines, Hatching, Interleukin

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208 Preoperative versus Postoperative Radiation Therapy in Patients with Soft Tissue Sarcoma of the Extremity

Authors: AliAkbar Hafezi, Jalal Taherian, Jamshid Abedi, Mahsa Elahi, Behnam Kadkhodaei

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Background: Soft tissue sarcomas (STS) are generally treated with a combination of limb preservation surgery and radiation therapy. Today, preoperative radiation therapy is considered for accurate treatment volume and smaller field size. Therefore, this study was performed to compare preoperative with postoperative radiation therapy in patients with extremity STS. Methods: In this non-randomized clinical trial, patients with localized extremity STS referred to the orthopedic clinics in Iran from 2021 to 2023 were studied. Patients were randomly divided into two groups: preoperative and postoperative radiation therapy. The two groups of patients were compared in terms of acute (wound dehiscence and infection) and late (limb edema, subcutaneous fibrosis, and joint stiffness) complications and their severity, as well as local recurrence and other one-year outcomes. Results: A total of 80 patients with localized extremity STS were evaluated in two treatment groups. The groups were matched in terms of age, sex, history of diabetes mellitus, hypertension, smoking, involved side, involved extremity, lesion location, and tumor histopathology. The acute complications of treatment in the two groups of patients did not differ significantly (P > 0.05). Of the late complications, only joint stiffness between the two groups had significant statistical differences (P < 0.001). The severity of all three late complications in the postoperative radiation therapy group was significantly higher (P < 0.05). There was no significant difference between the two groups in terms of the rate of local recurrence of other one-year outcomes (P > 0.05). Conclusion: This study showed that in patients with localized extremity STS, the two therapeutic approaches of adjuvant and neoadjuvant radiation therapy did not differ significantly in terms of local recurrence and distant metastasis during the one-year follow-up period and due to fewer late complications in preoperative radiotherapy group, this treatment approach can be a better choice than postoperative radiation therapy.

Keywords: soft tissue sarcoma, extremity, preoperative radiation therapy, postoperative radiation therapy

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207 Assessing Trainee Radiation Exposure in Fluoroscopy-Guided Procedures: An Analysis of Hp(3)

Authors: Ava Zarif Sanayei, Sedigheh Sina

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During fluoroscopically guided procedures, healthcare workers, especially radiology trainees, are at risk of exposure to elevated radiation exposure. It is vital to prioritize their safety in such settings. However, there is limited data on their monthly or annual doses. This study aimed to evaluate the equivalent dose to the eyes of the student trainee, utilizing LiF: Mg, Ti (TLD-100) chips at the radiology department of a hospital in Shiraz, Iran. Initially, the dosimeters underwent calibration procedures with the assistance of ISO-PTW calibrated phantoms. Following this, a set of dosimeters was prepared To determine HP(3) value for a trainee involved in the main operation room and controlled area utilized for two months. Three TLD chips were placed in a holder and attached to her eyeglasses. Upon completion of the duration, the TLDs were read out using a Harshaw TLD reader. Results revealed that Hp(3) value was 0.31±0.04 mSv. Based on international recommendations, students in radiology training above 18 have an annual dose limit of 0.6 rem (6 mSv). Assuming a 12-month workload, staff radiation exposure stayed below the annual limit. However, the Trainee workload may vary due to different deeds. This study's findings indicate the need for consistent, precise dose monitoring in IR facilities. Students can undertake supervised internships for up to 500 hours, depending on their institution. These internships take place in health-focused environments offering radiology services, such as clinics, diagnostic imaging centers, and hospitals. Failure to do so might result in exceeding occupational radiation dose limits. A 0.5 mm lead apron effectively absorbs 99% of radiation. To ensure safety, technologists and staff need to wear this protective gear whenever they are in the room during procedures. Furthermore, maintaining a safe distance from the primary beam is crucial. In cases where patients need assistance and must be held for imaging, additional protective equipment, including lead goggles, gloves, and thyroid shields, should be utilized for optimal safety.

Keywords: annual dose limits, Hp(3), individual monitoring, radiation protection, TLD-100

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206 Prevalence of Disability among Children Two to Fourteen Years at Selected Districts in Greater Accra Region of Ghana

Authors: Yvonne Nanaama Brew, Bismark Jampim Abrokwah

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Children with disabilities in Ghana are not routinely registered, and this can imply that they may be neglected in national policy planning since global estimates may not be near the exact numbers. Although there are some studies with reports on the prevalence of disability among children in Ghana, reliable information on the prevalence, types of disability in children, and children who die with disabilities in the Greater Accra region are lacking. The current study seeks to investigate the incidence of disability among children two to fourteen years at selected districts in the Greater Accra region of Ghana. A cross-sectional design is adapted with a quantitative method for this study. Parents with disabled children who access child welfare clinics at the Greater Accra regional hospital, Maamobi hospital, Ga west, and Ga south district hospitals will be selected through purposive sampling for the study. An adapted UNICEF structured Ten Questions will be used to collect relevant data about participants. The responses to the questions will be either 'Yes' or 'No'. Parents with children who answer 'Yes' to a disability and purposively sampled parents with children who answer 'No' to disability will be invited to Child Health Clinic at the Greater Accra regional hospital for a free clinical assessment. Data will be entered into Microsoft Office Excel 2013 and imported into STATA version 15 for analysis. The study is expected to provide reliable disaggregated data on less than fourteen years of children with disabilities in the Greater Accra region. The findings and recommendations of the study will demonstrate the importance of early detection of disability and facilitate more quality and holistic planning of appropriate programmes that best safeguard the rights of children with disabilities in Ghana. It will help in policy and decision-making on children less than fourteen years with disabilities in Ghana. Also, findings will be useful for health facilities in Ghana to plan services for disabled children. Finally, the study is expected to add to the guides for the National Council of Persons with Disabilities to fulfill its legal mandate for disabled persons in Ghana.

Keywords: prevalence, disability, children, Ghana

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205 Evaluation of Complications Observed in Porcelain Fused to Metal Crowns Placed at a Teaching Institution

Authors: Shizrah Jamal, Robia Ghafoor, Farhan Raza

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Porcelain fused to metal crown is the most versatile variety of crown that is commonly placed worldwide. Various complications have been reported in the PFM crowns with use over the period of time. These include chipping of the porcelain, recurrent caries, loss of retention, open contacts, and tooth fracture. The objective of the present study was to determine the frequency of these complications in crowns cemented over a period of five years in a tertiary care hospital and also to report the survival of these crowns. A retrospective study was conducted in Dental clinics, Aga Khan University Hospital in which 150 PFM crowns cemented over a period of five years were evaluated. Patient demographics, oral hygiene habits, para-functional habits, crown insertion and follow-up dates were recorded in a specially designed proforma. All PFM crowns fulfilling the inclusion criteria were assessed both clinically and radiographically for the presence of any complication. SPSS version 22.0 was used for statistical analysis. Frequency distribution and proportion of complications were determined. Chi-square test was used to determine the association of complications of PFM crowns with multiple variables including tooth wear, opposing dentition and betel nut chewing. Kaplan- meier survival analysis was used to determine the survival of PFM crowns over the period of five years. Level of significance was kept at 0.05. A total of 107 patients, with a mean age of 43.51 + 12.4 years, having 150 PFM crowns were evaluated. The most common complication observed was open proximal contacts (8.7%) followed by porcelain chipping (6%), decementation (5.3%), and abutment fracture (1.3%). Chi square test showed that there was no statistically significant association of PFM crown complication with tooth wear, betel nut and opposing dentition (p-value <0.05). The overall success and survival rates of PFM crowns turned out to be 78.7 and 84.7% respectively. Within the limitations of the study, it can be concluded that PFM crowns are an effective treatment modality with high success and survival rates. Since it was a single centered study; the results should be generalized with caution.

Keywords: chipping, complication, crown, survival rate

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204 Extract and Naphthoquinone Derivatives from in vitro Culture of an Ascomycetous Marine Fungus with Antibacterial Activity

Authors: Uftah Ali M. Shushni, Viola Stuppec, Ulrike Lindequist

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Because of the evolving resistance of microorganisms to existing antibiotics, there is an increasing need for new antibiotics not only in human but also in veterinary medicine. As part of our ongoing work on the secondary metabolites produced by marine fungi, the organic extract of the culture filtrate of an Ascomycetous fungus, which was found on driftwood collected from the coast of the Greifswalder Bodden, Baltic Sea, Germany displayed antimicrobial activity against some fish and human pathogenic bacteria. Bioactivity-guided column chromatographic separation led to the isolation of 6-Deoxybostrycoidin. The structure was determined from the interpretation of spectroscopic data (UV, MS, and NMR). 6-Deoxybostrycoidin exhibited in vitro activity against Bacillus subtilis, Staphylococcus aureus and Flexibacter maritimus with minimal inhibitory concentrations of 25, 12.5 and 12.5 μg/ml respectively.

Keywords: marine fungi, fish pathogenic bacteria, microorganism, medicine

Procedia PDF Downloads 501
203 Impact of Hormone Replacement Therapy on Body Composition Analysis of Women during Perimenopause: A Framework for Action

Authors: Varsha Chorsiya, Pooja Aneja, Dhananjay Kaushik, Abhinav Yadav

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Intoduction: Women’s Health Initiatives (WHI) focuses on defining the risks and benefits of strategies that could potentially reduce the incidence of obesity, heart disease, breast cancer and colorectal cancer, and fractures in menopause women. The utility of the present research work determines to find the role of Hormone Replacement Therapy (HRT) in changing the different component of body composition during perimenopause period. Methods: A comparative cross-sectional study included 30 subjects, aged between 40 and 50 years which were assigned into 2 groups i.e. 15 subjects in HRT (Group A) and 15 subjects in non-HRT (Group B). The subjects were taken from the hospitals and clinics of Faridabad undergoing HRT in supervision of the consultant gynecologist. The informed consents were signed before including the participants in the study. The body composition and lipid profile were evaluated for all the subjects. Result and Discussion: The BMI, body density, percent body fats and fat mass in both groups showed statistically significant differences i.e. p < 0.05. Our study did not reveal any statistically significant difference between non-HRT and HRT for lipid profile composition of HDL, LDL, VLDL, ratio, triglycerides and total cholesterol although these indicators (LDL, VLDL, ratio, triglycerides and total cholesterol) showed difference clinically with a higher mean values for non-HRT as compared to HRT group. The mean value for HDL was higher for HRT group in contrast to non-HRT group. The result clearly showed that HRT group has a good lipid profile composition. Conclusion: In conclusion, our data show that HRT has statistically significant role in determining BMI, fat percent mass and fat mass. The lipid profile including LDL, HDL, VLDL, ratio, triglycerides and total cholesterol found to be clinically better in HRT group as compared to the non-HRT group. The rationale for non-significant lipid profile probably lie in the fact that hormonal changes need a particular time period and might become significant in post-menopausal period.

Keywords: body composition, hormone replacement therapy, perimenopause, women health

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202 Adoption of Electronic Logistics Management Information System for Life-Saving Maternal, Neonatal and Child Health Medicines: A Bangladesh Perspective

Authors: Mohammad Julhas Sujan, Md. Ferdous Alam

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Maternal, neonatal, and child health (MNCH) holds one of the prime focuses in Bangladesh’s national healthcare system. To save the lives of mothers and children, knowing the stock of MNCH medicines in different healthcare facilities and when to replenish them are essential. A robust information system not only facilitates efficient management of the essential MNCH medicines but also helps effective allocation of scarce resources. In Bangladesh, Supply chain management of the 25-essential life-saving medicines are currently tracked and monitored via an electronic logistics management information system (eLMIS). Our aim was to conduct a cross-sectional study with a year (2020) worth of data from 24 districts of Bangladesh to evaluate how eLMIS is helping the Government and other stakeholders in efficient supply chain management. Data were collected from 4711 healthcare facilities ranging from primary to secondary levels within a district. About 90% (4143) are community clinics which are considered primary health care facilities in Bangladesh. After eLMIS implementation, the average reporting rate across the districts has been increased (> 97%). The month of stock (MOS) of zinc is an average 6 months compared to Inj. Magnesium Sulphate which will take 2.5 years to consume according to the current average monthly consumption (AMC). Due to first approaching expiry, Tab. Misoprostol, 7.1% Chlorhexidine and Inj. Oxytocin may become unusable. Moreover, Inj. Oxytocin is temperature sensitive and may reduce its efficacy if it is stocked for a longer period. In contrast, Zinc should be sufficiently stocked to prevent sporadic stockouts. To understand how data are collected, transmitted, processed, and aggregated for MNCH medicines in a faster and timely manner, an electronic logistics management information system (eLMIS) is necessary. We recommend the use of such a system in developing countries like Bangladesh for efficient supply chain management of essential MNCH medicines.

Keywords: adaption, eLMIS, MNCH, live-saving medicines

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201 Segmenting 3D Optical Coherence Tomography Images Using a Kalman Filter

Authors: Deniz Guven, Wil Ward, Jinming Duan, Li Bai

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Over the past two decades or so, Optical Coherence Tomography (OCT) has been used to diagnose retina and optic nerve diseases. The retinal nerve fibre layer, for example, is a powerful diagnostic marker for detecting and staging glaucoma. With the advances in optical imaging hardware, the adoption of OCT is now commonplace in clinics. More and more OCT images are being generated, and for these OCT images to have clinical applicability, accurate automated OCT image segmentation software is needed. Oct image segmentation is still an active research area, as OCT images are inherently noisy, with the multiplicative speckling noise. Simple edge detection algorithms are unsuitable for detecting retinal layer boundaries in OCT images. Intensity fluctuation, motion artefact, and the presence of blood vessels also decrease further OCT image quality. In this paper, we introduce a new method for segmenting three-dimensional (3D) OCT images. This involves the use of a Kalman filter, which is commonly used in computer vision for object tracking. The Kalman filter is applied to the 3D OCT image volume to track the retinal layer boundaries through the slices within the volume and thus segmenting the 3D image. Specifically, after some pre-processing of the OCT images, points on the retinal layer boundaries in the first image are identified, and curve fitting is applied to them such that the layer boundaries can be represented by the coefficients of the curve equations. These coefficients then form the state space for the Kalman Filter. The filter then produces an optimal estimate of the current state of the system by updating its previous state using the measurements available in the form of a feedback control loop. The results show that the algorithm can be used to segment the retinal layers in OCT images. One of the limitations of the current algorithm is that the curve representation of the retinal layer boundary does not work well when the layer boundary is split into two, e.g., at the optic nerve, the layer boundary split into two. This maybe resolved by using a different approach to representing the boundaries, such as b-splines or level sets. The use of a Kalman filter shows promise to developing accurate and effective 3D OCT segmentation methods.

Keywords: optical coherence tomography, image segmentation, Kalman filter, object tracking

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200 Assessment of Intern Students' Attitudes towards Medical Errors

Authors: Nilgün Katrancı, Pınar Göv

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With the acceleration and assessment of quality and patient safety works in healthcare services in the 21st century, activities to reduce errors have gained importance. The prevention and reduction of unintended consequences related to healthcare services and errors made during the delivery of healthcare services can be achieved by understanding the causes of the errors. Communication is the basic reason most frequently seen in such cases. Nurses who communicate with patients more closely and for longer time play a more critical role in ensuring patient safety compared to other healthcare professionals. To reduce the risk of medical errors and increase the quality of care, it is important to raise the awareness of nurses about patient safety in training period. This descriptive study was conducted between February 2017 and May 2017 to assess intern students' attitudes towards and knowledge of patient safety and medical errors. The target population of the study consists of intern students at the Faculty of Nursing in Gaziantep University (N=180). The study did not apply any sample selection method, and the research group consisted of 90 female and 37 male senior students who were available and accepted to take part in the study (N=127). The study used personal information form and medical error attitude scale to collect data. The medical error attitude scale consists of 16 items and 3 sub-dimensions. The most frequently seen medical error in the clinics the interns worked at was found as ‘Failure to comply with asepsis rules’ with a rate of 67,7%. The most frequent case among reasons for not disclosing an error is ‘noticing and correcting the error before affecting the patient’ with the rate of 70,9%. The most frequently expressed implications of disclosing a serious error for the intern students participating in the study are ‘harming patient trust (78%)’ and ‘possibility of overreaction by patient (62,2%)’. According to the results of the study, the awareness of the students about the importance of medical errors and error reporting was found high (3,48 ± 0,49). Consequently, it is important to assess and positively improve the attitudes of nurses and other healthcare professionals towards medical errors for the determination of causes of medical errors and their prevention.

Keywords: healthcare service, intern student, medical error, patient safety

Procedia PDF Downloads 179
199 Assessment, Diagnosis and Treatment, Simulation for the Nurse Practitioner Student

Authors: Helen Coronel, Will Brewer, Peggy Bergeron, Clarissa Hall, Victoria Casson

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Simulation-based training provides the nurse practitioner (NP) student with a safe and controlled environment in which they can practice a real-life scenario. This type of learning fosters critical thinking skills essential to practice. The expectation of this study was that students would have an increase in their competency and confidence after performing the simulation. Approximately 8.4% of Americans suffer from depression. The state of Alabama is ranked 47th out of 50 for access to mental health care. As a result of this significant shortage of mental health providers, primary care providers are frequently put in the position of screening for and treating mental health conditions, such as depression. Family nurse practitioners are often utilized as primary care providers, making their ability to assess, diagnose and treat these disorders a necessary skill. The expected outcome of this simulation is an increase in confidence, competency and the empowerment of the nurse practitioner student’s ability to assess, diagnose and treat a common mood disorder they may encounter in practice. The Kirkpatrick Module was applied for this study. A non-experimental design using descriptive statistical analysis was utilized. The simulation was based on a common psychiatric mood disorder frequently observed in primary care and mental health clinics. Students were asked to watch a voiceover power point presentation prior to their on-campus simulation. The presentation included training on the assessment, diagnosis, and treatment of a patient with depression. Prior to the simulation, the students completed a pre-test, then participated in the simulation, and completed a post-test when done. Apple iPads were utilized to access a simulated health record. Major findings of the study support an increase in students’ competency and confidence when assessing, diagnosing, and treating an adult patient with depression.

Keywords: advanced practice, nurse practitioner, simulation, primary care, depression

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198 The Cost-Effectiveness of Pancreatic Surgical Cancer Care in the US vs. the European Union: Results of a Review of the Peer-Reviewed Scientific Literature

Authors: Shannon Hearney, Jeffrey Hoch

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While all cancers are costly to treat, pancreatic cancer is a notoriously costly and deadly form of cancer. Across the world there are a variety of treatment centers ranging from small clinics to large, high-volume hospitals as well as differing structures of payment and access. It has been noted that centers that treat a high volume of pancreatic cancer patients have higher quality of care, it is unclear if that care is cost-effective. In the US there is no clear consensus on the cost-effectiveness of high-volume centers for the surgical care of pancreatic cancer. Other European countries, like Finland and Italy have shown that high-volume centers have lower mortality rates and can have lower costs, there however, is still a gap in knowledge about these centers cost-effectiveness globally. This paper seeks to review the current literature in Europe and the US to gain a better understanding of the state of high-volume pancreatic surgical centers cost-effectiveness while considering the contextual differences in health system structure. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, “Europe” “socialized medicine”, “privatized medicine”, “for-profit”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

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197 Sero-Prevalence of Hepatitis B Surface Antigen and Associated Factors among Pregnant Mothers Attending Antenatal Care Service, Mekelle, Ethiopia: Evidence from Institutional Based Quantitative Cross-Sectional Study

Authors: Semaw A., Awet H., Yohannes M.

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Background: Hepatitis B Virus (HBV) is a major global public health problem. Individuals living in Sub-Sahara Africa have 60% lifetime risk of acquiring HBV infection. Evidences showed that 80-90% of those born from infected mothers developed chronic HBV. Perinatal HBV transmission is a major determinant of HBV carrier status, its chronic squeal and maintains HBV transmission across generations. Method: Institution based cross-sectional study was conducted among 406 pregnant mothers attending Antenatal clinics at Mekelle and Ayder referral hospital from January 30 to April 1/2014. Epidata version 3.1 was used for data entry and SPSS version 21 statistical software was used for data cleaning, management and finally determine associated factors of hepatitis B surface antigen adjusting important confounders using multivariable logistic regression analysis at 5% level of significance. Result: The overall prevalence of hepatitis B surface antigen among pregnant women was 33 (8.1%). The socio-demographic characteristic of the study population showed that there is high positivity among secondary school 189 (46.6%). In the multivariable logistic regression analysis, history of a contact with individuals who had history of hepatitis B infection or jaundice and lifetime number of multiple sexual partners were found to be significantly associated with HBsAg positivity at AOR = 3.73 95%C.I (1.373-10.182) and AOR = 2.57 95%C.I (1.173-5.654), respectively. Moreover, Human Immunodeficiency Virus (HIV) and HBV confection rate was found 3.6%. Conclusion: This study has shown that HBV prevalence in pregnant women is highly prevalent (8.1%) in the study area. Contact with individuals who had a history of hepatitis or have jaundice and report of multiple lifetime sexual partnership were associated with hepatitis B infection. Education about HBV transmission and prevention as well as screening all pregnant mothers shall be sought to reduce the serious public health crisis of HBV.

Keywords: HBsAg, hepatitis B, pregnant women, prevalence

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196 Sexual Health And Male Fertility: Improving Sperm Health With Focus On Technology

Authors: Diana Peninger

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Over 10% of couples in the U.S. have infertility problems, with roughly 40% traceable to the male partner. Yet, little attention has been given to improving men’s contribution to the conception process. One solution that is showing promise in increasing conception rates for IVF and other assisted reproductive technology treatments is a first-of-its-kind semen collection that has been engineered to mitigate sperm damage caused by traditional collection methods. Patients are able to collect semen at home and deliver to clinics within 48 hours for use in fertility analysis and treatment, with less stress and improved specimen viability. This abstract will share these findings along with expert insight and tips to help attendees understand the key role sperm collection plays in addressing and treating reproductive issues, while helping to improve patient outcomes and success. Our research was to determine if male reproductive outcomes can be increased by improving sperm specimen health with a focus on technology. We utilized a redesigned semen collection cup (patented as the Device for Improved Semen Collection/DISC—U.S. Patent 6864046 – known commercially as a ProteX) that met a series of physiological parameters. Previous research demonstrated significant improvement in semen perimeters (motility forward, progression, viability, and longevity) and overall sperm biochemistry when the DISC is used for collection. Animal studies have also shown dramatic increases in pregnancy rates. Our current study compares samples collected in the DISC, next-generation DISC (DISCng), and a standard specimen cup (SSC), dry, with the 1 mL measured amount of media and media in excess ( 5mL). Both human and animal testing will be included. With sperm counts declining at alarming rates due to environmental, lifestyle, and other health factors, accurate evaluations of sperm health are critical to understanding reproductive health, origins, and treatments of infertility. An increase in the health of the sperm as measured by extensive semen parameter analysis and improved semen parameters stable for 48 hours, expanding the processing time from 1 hour to 48 hours were also demonstrated.

Keywords: reprodutive, sperm, male, infertility

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195 Overcoming Barriers to Improve HIV Education and Public Health Outcomes in the Democratic Republic of Congo

Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

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194 Postpartum Depression Screening and Referrals for Lower-Income Women in North Carolina, USA

Authors: Maren J. Coffman, Victoria C. Scott, J. Claire Schuch, Ashley N. Kelley, Jeri L. Ryan

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Postpartum Depression (PPD) is a leading cause of postpartum morbidity. PPD affects 7.1% of postpartum women and 19.2% of postpartum women when including minor depression. Lower-income women and ethnic minorities are more at risk for developing PPD and face multiple attitudinal and institutional barriers to receiving care. This study aims to identify PPD among low-income women and connect them to appropriate services in order to reduce the illness burden and enhance access to care. Screenings were conducted in two Women, Infants, and Children (WIC) clinics in the city of Charlotte, North Carolina, USA, from April 2017 to April 2018. WIC is a supplemental nutrition program that provides healthcare and nutrition to low-income pregnant women, breastfeeding women, and children under the age of 5. Additionally, a qualitative study was conducted to better understand the PPD continuum of care in order to identify opportunities for improvement. Mothers with infants were screened for depression risk using the PHQ-2. Mothers who scored ≥ 2 completed two additional standardized screening tools (PHQ-7, to complete the PHQ-9, and the Edinburgh) to assess depressive symptomatology. If indicated they may be suffering from depression, women were referred for case management services. Open-ended questions were used to understand treatment barriers. Four weeks after the initial survey, a follow-up telephone call was made to see if women had received care. Seven focus groups with WIC staff and managers, referral agency staff, local behavioral health professionals, and students examining the screenings, are being conducted March - April, 2018 to gather information related to current screening practices, referrals, follow up and treatment. Mothers (n = 231 as of February, 2018) were screened in English (65%) or Spanish (35%). According to preliminary results, 29% of mothers screened were at risk for postpartum depression (PHQ-2 ≥ 2). There were significant differences in preliminary screening results based on survey language (

Keywords: health disparities, maternal health, mental health, postpartum depression

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193 The Toxicity Effects of HICIDE VD-9 on the Mortality of Lucilia cuprina under Laboratory Conditions

Authors: Mehdi Shahmoradi Moghadam, Saba Kavian, Mehdi Zabihzadeh, Amir Mohammad Alborzi, Reza Sadeghi

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Cypermethrin is one of the most widely used synthetic insecticides to control pests in veterinary, industrial and agricultural environments. In the present study, the mortalities of Lucilia Cuprina as the key pest of meat were studied after being exposed to HICIDE VD-9 (a ready-to-use disinfectant/insecticide containing cypermethrin, polyhexanide and quaternary ammonium compounds produced by Dana pharmed lotus Co., Iran) within 15 minutes. The experimental results showed that moralities percentage of egg, larvae and adults of Lucilia Cuprina were 48%, 81% and 70%, respectively. Based on the obtained results, it can be predicted that in addition to controlling the insect pests of blow flies, HICIDE VD-9, as a cost-effective and environmentally friendly disinfectant/insecticide, can be effective against other insects, e.g., biting flies, fleas, midges, mosquitoes and ticks.

Keywords: cypermethrin, HICIDE VD-9, Lucilia cuprina, mortality, toxicity

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192 'Coping with Workplace Violence' Workshop: A Commendable Addition to the Curriculum for BA in Nursing

Authors: Ilana Margalith, Adaya Meirowitz, Sigalit Cohavi

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Violence against health professionals by patients and their families have recently become a disturbing phenomenon worldwide, exacting psychological as well as economic tolls. Health workplaces in Israel (e.g. hospitals and H.M.O clinics) provide workshops for their employees, supplying them with coping strategies. However, these workshops do not focus on nursing students, who are also subjected to this violence. Their learning environment is no longer as protective as it used to be. Furthermore, coping with violence was not part of the curriculum for Israeli nursing students. Thus, based on human aggression theories which depict the pivotal role of the professional's correct response in preventing the onset of an aggressive response or the escalation of violence, a workshop was developed for undergraduate nursing students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel. The workshop aimed at reducing students' anxiety vis a vis the aggressive patient or family in addition to strengthening their ability to cope with such situations. The students practiced interpersonal skills, especially relevant to early detection of potential violence, as well as ‘a correct response’ reaction to the violence, thus developing the necessary steps to be implemented when encountering violence in the workplace. In order to assess the efficiency of the workshop, the participants filled out a questionnaire comprising knowledge and self-efficacy scales. Moreover, the replies of the 23 participants in this workshop were compared with those of 24 students who attended a standard course on interpersonal communication. Students' self-efficacy and knowledge were measured in both groups before and after the course. A statistically significant interaction was found between group (workshop/standard course) and time (before/after) as to the influence on students' self-efficacy (p=0.004) and knowledge (p=0.007). Nursing students, who participated in this ‘coping with workplace violence’ workshop, gained knowledge, confidence and a sense of self-efficacy with regard to workplace violence. Early detection of signs of imminent violence amongst patients or families and the prevention of its escalation, as well as the ability to manage the threatening situation when occurring, are acquired skills. Encouraging nursing students to learn and practice these skills may enhance their ability to cope with these unfortunate occurrences.

Keywords: early detection of violence, nursing students, patient aggression, self-efficacy, workplace violence

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191 Evaluation of a Staffing to Workload Tool in a Multispecialty Clinic Setting

Authors: Kristin Thooft

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— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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190 The Turkish Version of the Carer’s Assessment of Satisfaction Index (CASI-TR): Its Cultural Adaptation, Validation, and Reliability

Authors: Cemile Kütmeç Yilmaz, Güler Duru Asiret, Gulcan Bagcivan

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The aim of this study was to evaluate the reliability and validity of the Turkish version of the Carer’s Assessment of Satisfaction Index (CASI-TR). The study was conducted between the dates of June 2016 and September 2017 at the Training and Research Hospital of Aksaray University with the caregiving family members of the inpatients with chronic diseases. For this study, the sample size was calculated as at least 10 individuals for each item (item number (30)X10=300). The study sample included 300 caregiving family members, who provided primer care for at least three months for a patient (who had at least one chronic disease and received inpatient treatment in general internal medicine and palliative care units). Data were collected by using a demographic questionnaire and CASI-TR. Descriptive statistics, and psychometric tests were used for the data analysis. Of those caregivers, 76.7% were female, 86.3% were 65 years old and below, 43.7% were primary school graduates, 87% were married, 86% were not working, 66.3% were housewives, and 60.3% defined their income status as having an income covering one’s expenses. Care recipients often had problems in terms of walking, sleep, balance, feeding and urinary incontinence. The Cronbach Alpha value calculated for the CASI-TR (30 items) was 0,949. Internal consistency coefficients calculated for subscales were: 0.922 for the subscale of ‘caregiver satisfaction related to care recipient’, 0.875 for the subscale of ‘caregiver satisfaction related to themselves’, and 0.723 for the subscale of ‘dynamics of interpersonal relations’. Factor analysis revealed that three factors accounted for 57.67% of the total variance, with an eigenvalue of >1. assessed in terms of significance, we saw that the items came together in a significant manner. The factor load of the items were between 0.311 and 0.874. These results show that the CASI-TR is a valid and reliable scale. The adoption of the translated CASI in Turkey is found reliable and valid to assessing the satisfaction of caregivers. CASI-TR can be used easily in clinics or house visits by nurses and other health professionals for assessing caregiver satisfaction from caregiving.

Keywords: carer’s assessment of satisfaction index, caregiver, validity, reliability

Procedia PDF Downloads 179
189 Impact of Urbanization Growth on Disease Spread and Outbreak Response: Exploring Strategies for Enhancing Resilience

Authors: Raquel Vianna Duarte Cardoso, Eduarda Lobato Faria, José Jorge Boueri

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Rapid urbanization has transformed the global landscape, presenting significant challenges to public health. This article delves into the impact of urbanization on the spread of infectious diseases in cities and identifies crucial strategies to enhance urban community resilience. Massive urbanization over recent decades has created conducive environments for the rapid spread of diseases due to population density, mobility, and unequal living conditions. Urbanization has been observed to increase exposure to pathogens and foster conditions conducive to disease outbreaks, including seasonal flu, vector-borne diseases, and respiratory infections. In order to tackle these issues, a range of cross-disciplinary approaches are suggested. These encompass the enhancement of urban healthcare infrastructure, emphasizing the need for robust investments in hospitals, clinics, and healthcare systems to keep pace with the burgeoning healthcare requirements in urban environments. Moreover, the establishment of disease monitoring and surveillance mechanisms is indispensable, as it allows for the timely detection of outbreaks, enabling swift responses. Additionally, community engagement and education play a pivotal role in advocating for personal hygiene, vaccination, and preventive measures, thus playing a pivotal role in diminishing disease transmission. Lastly, the promotion of sustainable urban planning, which includes the creation of cities with green spaces, access to clean water, and proper sanitation, can significantly mitigate the risks associated with waterborne and vector-borne diseases. The article is based on a review of scientific literature, and it offers a comprehensive insight into the complexities of the relationship between urbanization and health. It places a strong emphasis on the urgent need for integrated approaches to improve urban resilience in the face of health challenges.

Keywords: infectious diseases dissemination, public health, urbanization impacts, urban resilience

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188 Public Health Campaign to Eradicate Hepatitis C Virus during the Covid-19 Emergency in the North-East of Italy

Authors: Emanuela Zilli, Antonio Madia, Milvia Marchiori, Paola Anello, Chiara Cabbia, Emanuela Velo, Delia Campagnolo, Michele Scomazzon, Emanuela Salvatico, S. Tikvina, Antonio Miotti

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Hepatitis C is an inflammation of the liver caused by the hepatitis C virus (HCV). Antiviral medicines can cure more than 95% of cases of hepatitis C infection, but access to diagnosis and treatment remains low. The ULSS 6 Euganea – Health Trust has implemented a campaign to eradicate hepatitis C in the province of Padua (North-East of Italy), which can be subdivided into three areas: North (300.000 inhabitants), Centre (400.000) and South (300.000). In September 2021, the project was launched in the Northern area; a set of brochures was distributed in outpatient services, general practitioners’ clinics and offices, community pharmacy services, social health districts, and through social networks. The Hepatology Service contacted 460 patients selected by the Clinical Laboratory (positivity for HCV antibodies): 83 patients (18.0%) had been already cured of HCV infection, missing or deceased; 377 patients (82.0%) met the criteria to be eligible for HCV eradication therapy and were therefore included in a Day Service specific agenda and followed by a multidisciplinary team of healthcare professionals, with a dedicated telephone line. Haemato-chemical tests, general medical check-ups and ultrasound tests with fibroscan were performed. Patients were tested for Sars-CoV-2 positivity; those not yet vaccinated against Covid-19 were encouraged to complete the vaccination scheme. All 377 patients (100%) received HCV eradication therapy at the community pharmacy service; a detailed explanation of how to take their medication was provided. At the end of the first phase, Covid-19 vaccination rate was 100% (377/377), including patients already vaccinated and new-vaccinated. Check-up appointments were arranged after 2 or 3 months, according to the treatment plan. The awareness campaign and the organization of HCV eradication therapy service by ULSS 6 Euganea are proving to be effective; the project is now going to be applied to Central and Southern areas of the province (1.132 patients).

Keywords: public health, HCV-eradication, Covid-19 emergency, health communication strategies

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187 Risk Factors and Regional Difference in the Prevalence of Fecal Carriage Third-Generation Cephalosporin-Resistant E. Coli in Taiwan

Authors: Wan-Ling Jiang, Hsin Chi, Jia-Lu Cheng, Ming-Fang Cheng

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Background: Investigating the risk factors for the fecal carriage of third-generation cephalosporin-resistant E.coli could contribute to further disease prevention. Previous research on third-generation cephalosporin-resistant prevalence in children in different regions of Taiwan is limited. This project aims to explore the risk factors and regional differences in the prevalence of third-generation cephalosporin-resistant and other antibiotic-resistant E. coli in the northern, southern, and eastern regions of Taiwan. Methods: We collected data from children aged 0 to 18 from community or outpatient clinics from July 2022 to May 2023 in southern, northern, and eastern Taiwan. The questionnaire was designed to survey the characteristics of participants and possible risk factors, such as clinical information, household environment, drinking water, and food habits. After collecting fecal samples and isolating stool culture with E.coli, antibiotic sensitivity tests and MLST typing were performed. Questionnaires were used to analyze the risk factors of third-generation cephalosporin-resistant E. coli in the three different regions of Taiwan. Results: In the total 246 stool samples, third-generation cephalosporin-resistant E.coli accounted for 37.4% (97/246) of all isolates. Among the three different regions of Taiwan, the highest prevalence of fecal carriage with third-generation cephalosporin-resistant E.coli was observed in southern Taiwan (42.7%), followed by northern Taiwan (35.5%) and eastern Taiwan (28.4%). Multi-drug resistant E. coli had prevalence rates of 51.9%, 66.3%, and 37.1% in the northern, southern, and eastern regions, respectively. MLST typing revealed that ST131 was the most prevalent type (11.8%). The prevalence of ST131 in northern, southern, and eastern Taiwan was 10.1%, 12.3%, and 13.2%, respectively. Risk factors analysis identified lower paternal education, overweight status, and non-vegetarian diet as statistical significance risk factors for third-generation cephalosporin-resistant E.coli. Conclusion: The fecal carriage rates of antibiotic-resistant E. coli among Taiwanese children were on the rise. This study found regional disparities in the prevalence of third-generation cephalosporin-resistant and multi-drug-resistant E. coli, with southern Taiwan having the highest prevalence. Lower paternal education, overweight, and non-vegetarian diet were the potential risk factors of third-generation cephalosporin-resistant E. coli in this study.

Keywords: Escherichia coli, fecal carriage, antimicrobial resistance, risk factors, prevalence

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186 Prevalence of Eimeria spp in Cattle in Anatolia Region, Turkey

Authors: Nermin Isik, Onur Ceylan

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Bovine coccidiosis is a protozoan infection caused by coccidia parasites of the genus Eimeria which develops in the small and the large intestine. The aim of this study was to determine the prevalence of Eimeria spp. in cattle. This study was conducted between March 2014 and April 2015, involved 624 fecal samples of cattle. Cattle were grouped according to their age as follows: 6-12, 12-24 and >24 months. In a retrospective study from these faecal samples of cattle submitted to the University of Selcuk, Faculty of Veterinary Medicine, Laboratory of Parasitology were evaluated regarding the prevalence of Eimeria spp. In the laboratory, faecal samples were examined by Fulleborn saturated salt flotation technique and examined under a microscope for the presence of protozoan oocysts. Eimeria oocysts were found in 4.8% of all the samples. Eimeria infection was detected in 11.8%, 5.3% and 0.4% of the cattle in the age groups, respectively. This study showed that Eimeria infection was commonly seen in 6-24-month-old cattle. Further epidemiological investigation on economic significance and species composition of bovine coccidiosis needs to be pursued.

Keywords: cattle, diarrhea, Eimeria spp, Turkey

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185 In vitro Antimicrobial Resistance Pattern of Bovine Mastitis Bacteria in Ethiopia

Authors: Befekadu Urga Wakayo

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Introduction: Bacterial infections represent major human and animal health problems in Ethiopia. In the face of poor antibiotic regulatory mechanisms, development of antimicrobial resistance (AMR) to commonly used drugs has become a growing health and livelihood threat in the country. Monitoring and control of AMR demand close coloration between human and veterinary services as well as other relevant stakeholders. However, risk of AMR transfer from animal to human population’s remains poorly explored in Ethiopia. This systematic research literature review attempted to give an overview on AMR challenges of bovine mastitis bacteria in Ethiopia. Methodology: A web based research literature search and analysis strategy was used. Databases are considered including; PubMed, Google Scholar, Ethiopian Veterinary Association (EVA) and Ethiopian Society of Animal Production (ESAP). The key search terms and phrases were; Ethiopia, dairy, cattle, mastitis, bacteria isolation, antibiotic sensitivity and antimicrobial resistance. Ultimately, 15 research reports were used for the current analysis. Data extraction was performed using a structured Microsoft Excel format. Frequency AMR prevalence (%) was registered directly or calculated from reported values. Statistical analysis was performed on SPSS – 16. Variables were summarized by giving frequencies (n or %), Mean ± SE and demonstrative box plots. One way ANOVA and independent t test were used to evaluate variations in AMR prevalence estimates (Ln transformed). Statistical significance was determined at p < 0.050). Results: AMR in bovine mastitis bacteria was investigated in a total of 592 in vitro antibiotic sensitivity trials involving 12 different mastitis bacteria (including 1126 Gram positive and 77 Gram negative isolates) and 14 antibiotics. Bovine mastitis bacteria exhibited AMR to most of the antibiotics tested. Gentamycin had the lowest average AMR in both Gram positive (2%) and negative (1.8%) bacteria. Gram negative mastitis bacteria showed higher mean in vitro resistance levels to; Erythromycin (72.6%), Tetracycline (56.65%), Amoxicillin (49.6%), Ampicillin (47.6%), Clindamycin (47.2%) and Penicillin (40.6%). Among Gram positive mastitis bacteria higher mean in vitro resistance was observed in; Ampicillin (32.8%), Amoxicillin (32.6%), Penicillin (24.9%), Streptomycin (20.2%), Penicillinase Resistant Penicillin’s (15.4%) and Tetracycline (14.9%). More specifically, S. aurues exhibited high mean AMR against Penicillin (76.3%) and Ampicillin (70.3%) followed by Amoxicillin (45%), Streptomycin (40.6%), Tetracycline (24.5%) and Clindamycin (23.5%). E. coli showed high mean AMR to Erythromycin (78.7%), Tetracycline (51.5%), Ampicillin (49.25%), Amoxicillin (43.3%), Clindamycin (38.4%) and Penicillin (33.8%). Streptococcus spp. demonstrated higher (p =0.005) mean AMR against Kanamycin (> 20%) and full sensitivity (100%) to Clindamycin. Overall, mean Tetracycline (p = 0.013), Gentamycin (p = 0.001), Polymixin (p = 0.034), Erythromycin (p = 0.011) and Ampicillin (p = 0.009) resistance increased from the 2010’s than the 2000’s. Conclusion; the review indicated a rising AMR challenge among bovine mastitis bacteria in Ethiopia. Corresponding, public health implications demand a deeper, integrated investigation.

Keywords: antimicrobial resistance, dairy cattle, Ethiopia, Mastitis bacteria

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184 Assessing the Quality of Maternity Care in Sub-Saharan Africa Using the Donabedian Quality of Care Framework: A Systematic Scoping Review

Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson

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Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.

Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum

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183 Postpartum Female Sexual Dysfunctions in Hungary: A Cross-Sectional Study

Authors: Katalin Szöllősi, László Szabó

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Introduction and purpose: Even though female sexual dysfunctions are common among women in the postpartum period, the profile of these disturbances has not been well investigated in Hungary yet. The aim of the study was to evaluate the postpartum female sexual functions in Hungary. This research sought to investigate the possible predictor factors which can influence postpartum female sexual functions. Method and sample: This was a cross-sectional study, including patients from two maternity clinics in Budapest. 113 women were recruited into our study 3 months after their childbirth. 53 had vaginal birth, 60 had a caesarian section. Data were collected from medical reports in addition by using self-developed questions and validated questionnaires in order to measure important predictors which may be responsible for postpartum sexual dysfunctions such as mode of delivery, parity, urinary incontinence and body image. Sexual functions were evaluated by the Hungarian version of the Female Sexual Function Index (FSFI). The Hungarian version of Body Image Questionnaire-Short Form14 (BSQ-SF14) was applied for assessing body image. Results: 82,3% of the participants began to have sexual intercourse within three months postpartum. 53,98% of the participants reported sexual dysfunctions (cut-off FSFI score 26,55). According to our results mode of delivery, parity, hemorrhoids, time of intercourse, resumption was not associated with female sexual dysfunctions. We found correlation at a tendential level between urinary incontinence and sexual dysfunctions (p=0,003, R=0,26). We found a negative correlation at a tendential level between the total score of BSQ-SF14 and FSFI (p=0,03, R=-0,269). Only 32,74% of women reported discussing sexual life with health care professionals. However, 67,25% of them would have had the need to be asked about their postpartum health issues. Conclusions and recommendations: The prevalence of female sexual dysfunctions were relatively high after childbirth. We found that incontinence and body image was associated with sexual dysfunctions; other risk factors remained unknown. Despite regular contact with health care professionals, women rarely get any information about postpartum sexual health issues. The high prevalence of dysfunctions indicates the need for further investigation to address other risk factors and proper counselling of women after childbirth.

Keywords: body image, postpartum, sexual dysfunction, urinary incontinence

Procedia PDF Downloads 89
182 Work-Related Risk Factors and Preventive Measures among Nurses and Dentists at Faculty of Oral and Dental Medicine

Authors: Marwa Mamdouh Shaban, Nagat Saied Habib, Shireen Ezz El-Din Taha, Eman Mahmoud Seif El-Naser

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Background: Dental nurses and dentists were constantly exposed to a number of specific work related health risk factors which develop and intensify with years. Awareness regarding these work-related health risk factors and implementation of preventive health care measures could provide a safe work environment for all dental nurses and dentists. Aim of the study: to assess the work-related health risk factors among dental nurses and dentists and preventive health care measures applied among dental nurses and dentists. Research design: A descriptive design was utilized. Sample: Convenience sample of 50 dental nurses and 150 dentists were included in the current study. Setting: This study was conducted at the dental clinics at faculty of oral and dental medicine, Al-Kasr Al Ainy Hospital. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a-Socio-demographic data sheet, b-Work-related health risk factors questionnaire, and c-structured observational checklist. Results: The most common work risk factors prevailing among dental nurses were emotional exhaustion (82%), low back pain (76%) and latex allergy (62%) and the most common work risk factors prevailing among dentists were percutaneous exposure incident (100%), emotional exhaustion (100%) and low back pain (93.3%). Also, statistically significant negative correlation (r=-0.274, at p = 0.045) between the incidence of chemical health risk factors and application of chemical preventive measures among dental nurses. A statistically significant negative correlation (r=-0.177, at p = 0.030) between the incidences of mechanical health risk factors among dentists and application of mechanical preventive measures. Conclusion: The studied dental nurses and dentists exposed to many work related health risk factors as latex allergy, percutaneous exposure incidents, low back pain and emotional exhaustion related to inappropriate application of preventive health care measures. Recommendation: Raise awareness of dental nurses and dentists about work-related health risk factors, design and implement health education program for preventive health care measures.

Keywords: work-related risk factors, preventive measures, nurses, dentists

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181 Effective Use of X-Box Kinect in Rehabilitation Centers of Riyadh

Authors: Reem Alshiha, Tanzila Saba

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Physical rehabilitation is the process of helping people to recover and be able to go back to their former activities that have been delayed due to external factors such as car accidents, old age and victims of strokes (chronic diseases and accidents, and those related to sport activities).The cost of hiring a personal nurse or driving the patient to and from the hospital could be costly and time-consuming. Also, there are other factors to take into account such as forgetfulness, boredom and lack of motivation. In order to solve this dilemma, some experts came up with rehabilitation software to be used with Microsoft Kinect to help the patients and their families for in-home rehabilitation. In home rehabilitation software is becoming more and more popular, since it is more convenient for all parties affiliated with the patient. In contrast to the other costly market-based systems that have no portability, Microsoft’s Kinect is a portable motion sensor that reads body movements and interprets it. New software development has made rehabilitation games available to be used at home for the convenience of the patient. The game will benefit its users (rehabilitation patients) in saving time and money. There are many software's that are used with the Kinect for rehabilitation, but the software that is chosen in this research is Kinectotherapy. Kinectotherapy software is used for rehabilitation patients in Riyadh clinics to test its acceptance by patients and their physicians. In this study, we used Kinect because it was affordable, portable and easy to access in contrast to expensive market-based motion sensors. This paper explores the importance of in-home rehabilitation by using Kinect with Kinectotherapy software. The software targets both upper and lower limbs, but in this research, the main focus is on upper-limb functionality. However, the in-home rehabilitation is applicable to be used by all patients with motor disability, since the patient must have some self-reliance. The targeted subjects are patients with minor motor impairment that are somewhat independent in their mobility. The presented work is the first to consider the implementation of in-home rehabilitation with real-time feedback to the patient and physician. This research proposes the implementation of in-home rehabilitation in Riyadh, Saudi Arabia. The findings show that most of the patients are interested and motivated in using the in-home rehabilitation system in the future. The main value of the software application is due to these factors: improve patient engagement through stimulating rehabilitation, be a low cost rehabilitation tool and reduce the need for expensive one-to-one clinical contact. Rehabilitation is a crucial treatment that can improve the quality of life and confidence of the patient as well as their self-esteem.

Keywords: x-box, rehabilitation, physical therapy, rehabilitation software, kinect

Procedia PDF Downloads 313