Search results for: general hospital

Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

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Authors: Emrah Yildirim, Veli Ortacesme

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Manavgat region, located in Antalya province at South Turkey, has hosted many civilizations throughout the centuries. All of these civilizations cultivated the land in their surroundings by engaging in agriculture, livestock production and hunting. In the last 50 years, there have been dramatic changes in the region. The economy of the region switched from the agriculture to tourism. Due to the increase in the irrigable agricultural lands, several dams were built on Manavgat River. Developments in the agricultural mechanization and new product needs have changed the pattern of agriculture and regional landscape. Coastal zone of the region has transformed to tourism areas, Manavgat Town Center has grown up and the urbanization in general has increased. The population and urbanization have increased by 257 % and 276 %, respectively. The tourism and commercial areas cover 561,8 hectares today. All these developments had some negative effects on the environment. In this study, land use/land cover transformations were studied in Manavgat region by using aerial photos. The reasons and consequences of the land use transformations were discussed, and some recommendations regarding the sustainable use of this region’s landscape will be shared.

Keywords: land use, Manavgat region, south Turkey, transformation

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Authors: Linda Ana-Maria Ungureanu

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As space exploration opens to new actors, we are faced with the interesting question of regulating more complex structures that enable private experiments. From intellectual property implications to private and public law, there is a multitude of factors and legal structures that need to be taken into consideration when opening space, and these structures need to be harmonized with the International Space Treaties governing space exploration. In this sense, this article presents an overview of the legal and contractual framework applicable to private experiments conducted in space and/or in relation to off-world environments. Additionally, the article analyses the manner in which national space agencies regulate agreements concluded with private actors and research institutions. Finally, the article sets a series of de lege ferenda proposals for the regulation of general research and development rules and intellectual property matters that are connected to experiments and research conducted in space and/or concerning off-world environments.

Keywords: private space, intellectual property, contracts, ESA guidelines, EU legislation, Intellectual property law, international IP treaties

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Authors: Murtadha Kareem, Oliver Faust

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Wearable biosensor systems can be designed and developed for health monitoring. There is much interest in both scientific and industrial communities established since 2007. Fundamentally, the cost of healthcare has increased dramatically and the world population is aging. That creates the need to harvest technological improvements with small bio-sensing devices, wireless-communication, microelectronics and smart textiles, that leads to non-stop developments of wearable sensor based systems. There has been a significant demand to monitor patient's health status while the patient leaves the hospital in his/her personal environment. To address this need, there are numerous system prototypes which has been launched in the medical market recently, the aim of that is to provide real time information feedback about patient's health status, either to the patient himself/herself or direct to the supervising medical centre station, while being capable to give a notification for the patient in case of possible imminent health threatening conditions. Furthermore, wearable health monitoring systems comprise new techniques to address the problem of managing and monitoring chronic heart diseases for elderly people. Wearable sensor systems for health monitoring include various types of miniature sensors, either wearable or implantable. To be specific, our proposed system able to measure essential physiological parameter, such as heart rate signal which could be transmitted through Bluetooth to the cloud server in order to store, process, analysis and visualise the data acquisition. The acquired measurements are connected through internet of things to a central node, for instance an android smart phone or tablet used for visualising the collected information on application or transmit it to a medical centre.

Keywords: Wearable sensor, Heart rate, Internet of things, Chronic heart disease

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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Authors: Sutinon Yuchomsuk, Satchachon Changthom, Pruet Areesawangvong, Monsiri Jinapen

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Background: Esophageal squamous cell carcinoma can be presented with many symptoms, such as dysphagia or weight loss. However, in some circumstances, rare presentations can be found, e.g., dyspnea, which is more common in pulmonary malignancy. And dyspnea is also one of the most common presentations of COVID-19 infection. So, in this case, we can learn from many points in patient symptoms and findings leading to the diagnosis of esophageal squamous cell carcinoma. Method: This research is a case-report study including one patient from Mahasarakham Hospital, Thailand. Data were collected during December 2021. Result: A 55-year-old Thai male patient with an unknown past medical history presented with dyspnea and shortness of breath for the duration of three days prior to admission. His symptom also included cough, fever, and sore throat. Laboratory results indicated that the patient had COVID-19 pneumonia. Further investigation showed that he had cardiac tamponade and suspected pulmonary/esophageal cancer. Lung biopsy and pericardiocentesis were done, which were positive for carcinoma from pericardial effusion but negative for malignancy from the lung biopsy. Later esophagogastroduodenoscopy was done with endoscopic tissue biopsy; the result was positive for squamous cell carcinoma of the esophagus. Conclusion: Most commonly, esophageal cancer is presented with dysphagia or weight loss. However, in some rare cases, patients can also be presented with dyspnea due to cardiac tamponade. And in recent years, COVID-19 has become a pandemic all over the world, sometimes masking symptoms of other diseases. Such as in this case, the patient didn’t improve after the pneumonia was resolved, which led to the final diagnosis of metastatic esophageal cancer.

Keywords: esophageal cancer, cardiac tamponade, metastatic squamous cell carcinoma, COVID-19 infection

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Authors: Supaporn Prajongjai, Pannarungsri Inpayoung

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This research attempts to explore the perception and satisfaction of international tourists toward Thai economy, politics and Bangkok attributes. Due to tourism industry provides a high rate of revenue for Thailand, and the outcome from this business drives every section of Thailand such as business, residents’ living level. Unfortunately, some incidents in the country, such as some turmoil, have ruined the city’s image which obviously impacts to the tourism industry, the major source of revenue. The size of this research was 400 international tourists who visit Bangkok, Thailand during the 1st – 20th March 2009 and age between 20 – 65 years. The results reveal that tourists satisfy with all of Bangkok’s attributes including general attractions, heritage attraction, maintenance factors and cultural attraction. Also, tourists’ perception toward Thai politics is significantly related to their satisfaction of Bangkok’s attributes, but their perception toward Thai economy is not significantly correlated to their satisfaction of Bangkok’s attributes.

Keywords: international tourists' perception, tourists' satisfactions, Thai economy, tourism destination

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Authors: Anatoly V. Stepanov, Maria Y. Ilyushkina, Alexander S. Burnasov

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Expansion of tourism, especially after WWII, has led to significant improvements in the regional infrastructure. The present study has revealed a lot of progress in the advancement of industrial heritage narrative in the Central Urals. The evidence comes from the general public’s increased fascination with some of Europe’s oldest mining and industrial sites, and the agreement of many stakeholders that the Urals industrial heritage should be preserved. The development of tourist sites in Nizhny Tagil and Nevyansk, gold-digging in Beryosovsky, gemstone search in Murzinka, and the progress with the Urals Gemstone Ring project are the examples showing the immense opportunities of industrial heritage tourism development in the region that are still to be realized. Regardless of the economic future of the Central Urals, whether it will remain an industrial region or experience a deeper deindustrialization, the sprouts of the industrial heritage tourism should be advanced and amplified for the benefit of local communities and the tourist community at large as it is hard to imagine a more suitable site for the discovery of industrial and mining heritage than the Central Urals Region of Russia.

Keywords: industrial heritage, mining heritage, Central Urals, Russia

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Authors: Sudha Summarwar, Jyotsana Pandey, Deepali Lall

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The Malathion compound has the great tendency to be accumulated in the organs of the fishes both if it is present in traces or in higher amount in the aquatic environment. It has the tendency to be accumulated more in quantity in the organs directly exposed to it. The accumulation was found to be time and concentration dependent. The accumulation of malathion was maximum in gills and is the minimum in the brain. Effect of different sub-lethal concentrations (l/5th, l/l0th, l/15th, l/20th, and 1/25th fractions of 96 hr. LC50) of malathion compound on acid phosphatase (AcPase), alkaline phosphatase (AlPase), serum glutamic oxalacetic transaminase (SGOT) and Serum Glucose-6-Phosphatase (S-G-6-Pase), serum glutamic pyruvic transaminase (SGPT) in blood of Labeo rohita exposed for the period of 15. 30, 45, and 60 days, have been studied in present investigations. In general the alterations were concentrations and duration dependent.

Keywords: AcPase, AlPase, Labeo rohita, malathion, S-G-6-Pase, SGOT, SGPT

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Authors: Abdelbasit Gadour

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A great number of children in mainstream schools across Libya are currently living with emotional, behavioral difficulties. This study aims to explore teachers’ perceptions of children’s emotional and behavioral difficulties (EBD) and their attributions of the causes of EBD. The relevance of this area of study to current educational practice is illustrated in the fact that primary school teachers in Libya find classroom behavior problems one of the major difficulties they face. The information presented in this study was gathered from 182 teachers that responded back to the survey, of whom 27 teachers were later interviewed. In general, teachers’ perceptions of EBD reflect personal experience, training, and attitudes. Teachers appear from this study to use words such as indifferent, frightened, withdrawn, aggressive, disobedient, hyperactive, less ambitious, lacking concentration, and academically weak to describe pupils with emotional and behavioral difficulties (EBD). The implications of this study are envisaged as being extremely important to support teachers addressing children’s EBD and shed light on the contributing factors to EBD for a successful teaching-learning process in Libyan primary schools.

Keywords: children, emotional and behavior difficulties, learning, teachers'

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Authors: Thinakar Mani Balusamy, Ratnakar S. Kini, Bharat Narasimhan, Venkateswaran A. R, Pugazhendi Thangavelu, Mohammed Ali, Prem Kumar K., Kani Sheikh M., Sibi Thooran Karmegam, Radhakrishnan N., Mohammed Noufal

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Introduction: Pancreatic injury remains a complicated condition requiring an individualized case by case approach to management. In this study, we aim to analyze the varied presentations and treatment outcomes of traumatic pancreatic injury in a tertiary care center. Methods: All consecutive patients hospitalized at our center with traumatic pancreatic injury between 2013 and 2017 were included. The American Association for Surgery of Trauma (AAST) classification was used to stratify patients into five grades of severity. Outcome parameters were then analyzed based on the treatment modality employed. Results: Of the 35 patients analyzed, 26 had an underlying blunt trauma with the remaining nine presenting due to penetrating injury. Overall in-hospital mortality was 28%. 19 of these patients underwent exploratory laparotomy with the remaining 16 managed nonoperatively. Nine patients had a severe injury ( > grade 3) – of which four underwent endotherapy, three had stents placed and one underwent an endoscopic pseudocyst drainage. Among those managed nonoperatively, three underwent a radiological drainage procedure. Conclusion: Mortality rates were clearly higher in patients managed operatively. This is likely a result of significantly higher degrees of major associated non-pancreatic injuries and not just a reflection of surgical morbidity. Despite this, surgical management remains the mainstay of therapy, especially in higher grades of pancreatic injury. However we would like to emphasize that endoscopic intervention definitely remains the preferred treatment modality when the clinical setting permits. This is especially applicable in cases of main pancreatic duct injury with ascites as well as pseudocysts.

Keywords: endotherapy, non-operative management, surgery, traumatic pancreatic injury

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Authors: Sakchai Rachniyom

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Owing to the ASEAN community will formally take place in the few months; therefore, Thais should realize about the importance of English language. Since, it is regarded as a working language in the community. To promote Science students’ English proficiency, teacher should be able to teach in English language appropriately and effectively. The purposes of the quasi – experimental research are (1) to measure the learning achievement, (2) to evaluate students’ satisfaction on the teaching and learning and (3) to study the consequences of co – teaching method in order comprehend the learning achievement and improvement. The participants were 40 general science students teacher. Two types of research instruments were included; (1) an achievement test, and (2) a questionnaire. This research was conducted for 1 semester. The statistics used in this research were arithmetic mean and standard deviation. The findings of the study revealed that students’ achievement score was significantly increased at statistical level .05 and the students satisfied the teaching and learning at the highest level . The students’ involvement and teachers’ support were promoted. It was also reported students’ learning was improved by co – teaching method.

Keywords: co – teaching method, learning science in english, teacher, education

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Authors: A. Hilsana, Vinay U. Rao, M. Sudhakar

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Even though a number of non-steroidal anti-inflammatory drugs (NSAIDS) are available with different chemistries, they share a common solubility characteristic that is they are relatively more soluble in alkaline environment and practically insoluble in acidic environment. This work deals with developing a wax matrix drug delivery platform for controlled delivery of three model NSAIDS, Diclofenac sodium (DNa), Mefenamic acid (MA) and Naproxen (NPX) using the melt granulation technique. The aim of developing the platform was to have a general understanding on how an erodible matrix system modulates drug delivery rate and extent and how it can be optimized to give a delivery system which shall release the drug as per a common target product profile (TPP). Commonly used waxes like Cetostearyl alcohol and stearic acid were used singly an in combination to achieve a TPP of not 15 to 35% in 1 hour and not less than 80% Q in 24 hours. Full factorial design of experiments was followed for optimization of the formulation.

Keywords: NSAIDs, controlled delivery, target product profile, melt granulation

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Authors: Sahar Iqrar, Malik Adeel Anwar, Zain Akram, Maria Noor

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Introduction: Oral lichen planus is a chronic inflammatory condition of unknown etiology. Oral lichen planus may be related with several other diseases. Grinspan's Syndrome is characterized by a triad of oral lichen planus, hypertension, and diabetes mellitus. Other associations reported in the literature are with chronic liver disease and, with dyslipidemia. The nature of these associations is still not fully understood. Material and methods: Study was conducted in Department of Oral Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan. A total of n=89 clinically diagnosed patients of oral lichen planus of both gender and all age groups were recruited and detailed history were recorded in the designed performs. Results: A total of n=89 patients were taken with male to female ratio of 3:8 in which 24 were male and 65 females. Mean age was 48.8 ± 13.8 years. Age range of 10-74 years was seen. Among these patients suffering from oral lichen planus, 41.6% (n=37) had a positive history for hypertension with 59.5% (n=22) of these patients were taking different medication for their condition. Whereas Diabetes Mellitus was found in 24.7% (n=22) patients with 72.7% (n=16) of these patients using the hypoglycemic drug (oral or injectable) to control their blood glucose levels. Out of these n=89 lichen planus patients 21.3% had both hypertension and diabetes mellitus (fulfilling the criteria for Grinspan's Syndrome). Out of this Grinspan's Syndrome pool 94.7% (n=19) were taking drug atleast for one of the two conditions. Conclusion: As noticed form the medical history of the patients, most of them were using hypoglycemic drugs for diabetes mellitus and beta blockers, diuretics and calcium channel blockers for hypertension. These drugs are known for lichenoid reaction. Therefore, it should be ruled out at histopathological/ immunological and molecular level whether these patients are suffering from lichen planus or lichenoid drug reaction to truly declare them as patients with Grinspan’s Syndrome.

Keywords: diabetes mellitus, grinspan's syndrome, lichenoid drug reaction, oral lichen planus

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Authors: Elham Sharif, Nasser Rizk, Sirin Abu Aqel, Ofelia Masoud

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Background: Previous studies have investigated the association of rs1544410, rs7975232 and rs731236 polymorphisms in vitamin D receptor gene and its impact on diseases such as cancer, diabetes and hypertension in different ethnic backgrounds. Aim: The aim of this study is to investigate the association between VDR polymorphisms using three SNP’s (rs1544410, rs7975232 and rs731236) and the severity of the significant lesion in coronary arteries among angiographically diagnosed CAD. Methods: A prospective-retrospective study was conducted on 192 CAD patients enrolled from the cardiology department-Heart Hospital HMC, grouped in 96 subjects with significant stenosis and 96 with non-significant stenosis with a mean age between 30 and 75 years old. Genotyping was performed for the following SNPs rs1544410, rs7975232 and rs731236 using TaqMan assay by the Real Time PCR, ABI 7500 in Health Sciences Labs at Qatar University Biomedical Research Center. Results: The results showed that both groups have matched age and gender distribution but patients with the significant stenosis have significantly higher; BMI (p=0.047); smoking status (p=0.039); FBS (p= 0.031); CK-MB (p=0.025) and Troponin (p=0.002) than the patients with non–significant lesion. Among the traditional risk factors, smoking increases the odds of the severe stenotic lesion in CAD patients by 1.984, with 95% CI between 1.024 – 7.063, with p= 0.042.HWE showed deviations of the rs1544410 and rs731236 among the study subjects. The most frequent genotype in distribution of rs7975232 is the AA among the significant stenosis patients, while the heterozygous AC was the frequent genotype in distribution among the non-significant stenosis group. The carriers of CC genotype in rs7975232 increased the risk of having significant coronary arteries stenotic lesion by 1.83 with 95% CI (1.020 – 3.280), p=0.043. No association was found between the rs7975232 with vitamin D and VDBP. Conclusion: There is a significant association between rs7975232 and the severity of CAD lesion. The carrier of CC genotype in rs7975232 increased the risk of having significant coronary arteries atherosclerotic lesion especially in patients with smoking history independent of vitamin D.

Keywords: vitamin D, vitamin D receptor, polymorphism, coronary harat disease

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Authors: Vered Shenaar-Golan, Nava Wald, Uri Yatzkar

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Background: Parenting children with mental health problems poses multiple challenges, including coping with difficult behavior and negative child emotions. The impact on parents includes financial strain, negative social stigma, and negative feelings of guilt or blame, resulting in significant stress and lower levels of well-being. Given findings that self-compassion plays a significant role in reducing stress and improving well-being, the current study examined the role of self-compassion in the experience of parents raising a child with mental health problems. The study tested (1) whether child behavioral/emotional problem severity is associated with higher parental stress and lower parental well-being; (2) whether self-compassion is associated with lower parental stress and higher parental well-being; and (3) whether self-compassion is a stronger predictor of parental stress and well-being than child behavioral/emotional problem severity. Methods: Three hundred and six mothers and two hundred and fifty-six fathers of children attending a hospital child and adolescent psychiatric center were assessed at admission. Consenting parents completed four questionnaires: Child Strength and Difficulty – parent version, Self-compassion, Parent Feeling Inventory, and Well-Being. Results: Child behavioral/emotional problem severity was associated with higher parental stress and lower parental well-being, and self-compassion was a stronger predictor of parental stress and well-being levels than child behavioral/emotional problem severity. For children with internalizing but not externalizing behavioral/emotional problems, parental self-compassion was the only predictor of parental well-being beyond the severity of child behavioral/emotional problems. Conclusions: Cultivating self-compassion is important in reducing parental stress and increasing parental well-being, particularly with internalizing presentations, and should be considered when designing therapeutic interventions for parents.

Keywords: parenting children with mental health problems, self-compassion, parental stress, feelings, well-being

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Authors: Kwok Tak Kit

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The government and community have raised their awareness of the benefits of water reuse. Deforestation has a significant effect to climate change as it causes the drying out of the tropical rainforest and hence increases the chance of natural hazards. The loss of forests due to natural fire or human factors would be threatening the storage and supply of clean water. In this paper, we will focus on the discussion of the relationship of the natural water collection system, afforestation and country parks towards environmental sustainability and circular economy with a case study of water conservation policy and strategy in Hong Kong and Singapore for further research. The UN General Assembly launched the Water Action Decade in 2018 to mobilize action that will help to tackle the growing challenge of water scarcity through water conservation and protect and restore water-related ecosystems, including forests, wetlands, rivers, aquifers and lakes.

Keywords: afforestation, environmental sustainability, water conservation, circular economy, climate change, sustainable development goal

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Authors: Esra Öztürk, Erkul Karacaoglu

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Pyrochlores, having compounds of the general formula, A2B2O7 (A and B are metals/rare earths) are important class of materials thanks to having technological applications like in luminescence, ionic conductivity, nuclear waste immobilization etc. The rare earths included pyrochlore compounds have also potential photoluminescence characteristics. In this context, Er3+-activated Lu2Ti2O7 pyrochlore was chosen and synthesized through a high-temperature solid-state reaction route that was sintered under the open atmosphere in this study. The optimal reaction conditions to obtain expected single phase system, the thermal analysis (DTA/TG) were carried out. The X-ray powder diffraction (XRD) was used to determine phase properties of the sample. The photoluminescence (PL) results were done to obtain excitation, emission and decay time properties by a PL spectrometer under room temperature. According to the PL, there are excitation bands at 352 nm, 388 nm, 423 nm and 453 nm that are due to 4I15/2 → 2G7/2, 4I15/2 → 4G11/2 and 4I15/2 → 4F5/2 transitions of Er3+ ions, respectively. The emission bands are placed at 582 nm, 677 nm and 762 nm that are associated with 2H11/2, 4S3/2 → 4I15/2, 4F9/2 → 4I15/2, 4I9/2 → 4I15/2 transitions of Er3+ ions, respectively.

Keywords: Er3+, Lu2Ti2O7, photoluminescence, pyrochlore, rare-earths

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Authors: Stephanie Nihan, Jayson M. Fadrigalan, Pyay P. San, Steven M. Santos, Weihui Li

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People of all ages who use wheelchairs are left with the inconvenience of not having an easy way to take their vital signs. Typically, patients are required to visit the hospital in order to take the vital signs. VitalGO is a wheel chair system that equipped with medical devices to take vital signs and then transmit data to a mobile application for convenient, long term health monitoring. The vital signs include oxygen saturation, heart rate, and blood pressure, breathing rate and body temperature. Oxygen saturation and heart rate are monitored through pulse oximeter. Blood pressure is taken through a radar sensor. Breathing rate is derived through thoracic impedance while body temperature is measured through an infrared thermometer. The application receives data through bluetooth and stores in a database for review in a simple graphical interface. The application will have the ability to display this data over various time intervals such as a day, week, month, 3 months, 6 months and a year. The final system for the mobile app can also provide an interface for both the user and their physician(s) to record notes or keep record of daily symptoms that a patient might be having. The user’s doctor will be granted access by the user to view the patient information for assistance with a more accurate diagnosis. Also, this wheelchair accessory conveniently includes a foldable table/desk as somewhere to place an electronic device that may be used to access the app. The foldable table will overall contribute to the wheelchair user’s increased comfort and will give them somewhere to place food, a book, or any other form of entertainment that would normally be hard to juggle on their lap.

Keywords: wheel chair, vital sign, mobile application, telemedicine

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Authors: Faris Algahtani

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Background: In Saudi Arabia, it is essential to know what practices are employed and considered effective by special education teachers working with preschool children with intellectual disabilities, as a prerequisite for identifying areas for improvement. Preschool provision for these children is expanding through a network of Intellectual Disability Centres while, in primary schools, a policy of inclusion is pursued and, in mainstream preschools, pilots have been aimed at enhancing learning in readiness for primary schooling. This potentially widens the attainment gap between preschool children with and without intellectual disabilities, and influences the scope for improvement. Goal: The aim of the study was to explore special education teachers’ practices and perceived perceptions of those practices for preschool children with intellectual disabilities in Saudi Arabia Method: A qualitative interpretive approach was adopted in order to gain a detailed understanding of how special education teachers in an IDC operate in the classroom. Fifteen semi-structured interviews were conducted with experienced and qualified teachers. Data were analysed using thematic analysis, based on themes identified from the literature review together with new themes emerging from the data. Findings: American methods strongly influenced teaching practices, in particular TEACCH (Treatment and Education of Autistic and Communication related handicapped Children), which emphasises structure, schedules and specific methods of teaching tasks and skills; and ABA (Applied Behaviour Analysis), which aims to improve behaviours and skills by concentrating on detailed breakdown and teaching of task components and rewarding desired behaviours with positive reinforcement. The Islamic concept of education strongly influenced which teaching techniques were used and considered effective, and how they were applied. Tensions were identified between the Islamic approach to disability, which accepts differences between human beings as created by Allah in order for people to learn to help and love each other, and the continuing stigmatisation of disability in many Arabic cultures, which means that parents who bring their children to an IDC often hope and expect that their children will be ‘cured’. Teaching methods were geared to reducing behavioural problems and social deficits rather than to developing the potential of the individual child, with some teachers recognizing the child’s need for greater freedom. Relationships with parents could in many instances be improved. Teachers considered both initial teacher education and professional development to be inadequate for their needs and the needs of the children they teach. This can be partly attributed to the separation of training and development of special education teachers from that of general teachers. Conclusion: Based on the findings, teachers’ practices could be improved by the inclusion of general teaching strategies, parent-teacher relationships and practical teaching experience in both initial teacher education and professional development. Coaching and mentoring support from carefully chosen special education teachers could assist the process, as could the presence of a second teacher or teaching assistant in the classroom.

Keywords: special education, intellectual disabilities, early intervention , early childhood

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Authors: Ramanen Sugunesegran, Michael L. Williams

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Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

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Authors: Stephen Clear

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Brexit, the relationship between devolved administrations, and Westminster, as well as recent Supreme Court judgments, all evidence that traditional paradigms in the divide between legal and political constitutionalism are changing within the United Kingdom. Whilst not mutually exclusive concepts, these latest constitutional developments suggest that the UK is about to embark upon radical constitutional reform over the course of the next decade. Such will systematically redefine the roles and relationships of each of the three arms of the State. In mapping these three latest events, this paper starts by defining constitutionalism as a jurisprudential concept, from the Age of Enlightenment, through to its present day manifestations in 2020. Such thereafter explains why the UK is seeking to move further away from political constitutionalism, and instead towards an increased reliance on newly defined laws and rules, particularly given that the UK now has a government with a stronger working majority following the general election results in 2019. In doing so, this paper concludes by commenting upon recent concerns surrounding the potential for the politicization of the judiciary within the United Kingdom, at a time when the UK Prime Minister is seeking to redefine the country’s constitutional rulebook.

Keywords: United Kingdom, Brexit, constitutionalism, law, politics, constitutional reform, separation of powers

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Authors: El-Ghalia Filali, Cherif Gadouche, Mohamed Tahar

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A three-dimensional numerical simulation of flow through mini and microchannels with designed roughness is conducted here. The effect of the roughness height (surface roughness), geometry, Reynolds number on the friction factor and the Nusselt number is investigated. The study is carried out by employing CFD software, CFX. Our work focuses on a water flow inside a circular mini-channel of 1 mm and microchannels of 500 and 100 μm in diameter. The speed entry varies from 0.1 m/s to 20 m/s. The general trend can be observed that bigger sizes of roughness element lead to higher flow resistance. It is found that the friction factor increases in a nonlinear fashion with the increase in obstruction height. Particularly, the effect of roughness can no longer be ignored at relative roughness height higher than 3%. A significant increase in Poiseuille number is detected for all configurations considered. The same observation can be done for Nusselt number. The transition zone between laminar and turbulent flow depends on the channel diameter.

Keywords: hydrodynamics, heat transfer, minichannel, microchannel, roughness

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Authors: Anamika A. Sharma, Arezou Ahmadi R. A., Narendra B. Parihar, Manjusha Sajith

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Introduction: Hemodialysis is the most effective therapeutic technique for patient with ESRD second to renal transplantation. However it is a lifelong therapy which requires frequent hospital, or dialysis centers visits mainly twice and thrice weekly, thus considerably changes the normal way of patient’s living. So this study aimed to Assess Health-Related Quality of life in End-Stage Renal Disease (ESRD) Undergoing Twice and Thrice weekly Hemodialysis. Method: A prospective observational, cross-sectional study was carried out from September 2016 to April 2017 in end-stage renal disease patients undergoing hemodialysis. Socio-demographic and clinical details of patients were obtained from the medical records. WHOQOL-BREF questionnaire was used to Access Health-Related Quality Of Life. Quality of Life scores of Twice weekly and Thrice weekly hemodialysis was analyzed by Kruskal Wallis Test. Results: Majority of respondents were male (72.55%), married (89.31%), employed (58.02%), belong to middle class (71.00%) and resides in rural area (58.78%). The mean ages in the patient undergoing twice weekly and thrice weekly hemodialysis were 51.89 ± 15.64 years and 51.33 ± 15.70 years respectively. Average Quality of Life scores observed in twice weekly and thrice weekly hemodialysis was 52.07 ± 13.30 (p=0.0037) and 52.87 ± 13.47 (p=0.0004) respectively. The hemoglobin of thrice weekly dialysis patients (10.28 gm/dL) was high as compared to twice weekly dialysis (9.23 gm/dL). Patients undergoing thrice weekly dialysis had improved serum urea, serum creatinine values (95.85 mg/dL, 8.32 mg/dL) as compared to twice weekly hemodialysis ( 104.94 mg/dL, 8.68 mg/dL). Conclusion: Our study concluded that there was no significant difference between overall Health-Related Quality Of Life in twice weekly and thrice weekly hemodialysis. Frequent hemodialysis was associated with improved control of hypertension, serum urea, serum creatinine levels.

Keywords: end stage renal disease, health related quality of life, twice weekly hemodialysis, thrice weekly hemodialysis

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Authors: Farzaneh Badinloo, Niloufar Jalali-Moghadam, Reza Kormi-Nouri

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The aim of this study was to explore the short-term and working memory performances across age and gender in school aged children. Most of the studies have been interested in looking into memory changes in adult subjects. This study was instead focused on exploring both short-term and working memories of children over time. Totally 410 school child participants belonging to four age groups (approximately 8, 10, 12 and 14 years old) among which were 201 girls and 208 boys were employed in the study. digits forward and backward tests of the Wechsler children intelligence scale-revised were conducted respectively as short-term and working memory measures. According to results, there was found a general increment in both short-term and working memory scores across age (p ˂ .05) by which whereas short-term memory performance was shown to increase up to 12 years old, working memory scores showed no significant increase after 10 years old of age. No difference was observed in terms of gender (p ˃ .05). In conclusion, this study suggested that both short-term and working memories improve across age in children where 12 and 10 years of old are likely the crucial age periods in terms of short-term and working memories development.

Keywords: age, gender, short-term memory, working memory

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Authors: Odile Amoncou, Djedje-Kossu Zahui

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The integration of a Corporate Social Responsibility (CSR) approach within a company appears nowadays as a fundamental system of response to the different problems that threaten our planet. The abusive exploitation of natural resources, social inequalities, discrimination and poverty are some examples. Thus, faced with these different global problems, each company must include in its operating system measures or actions with the aim not only of achieving Sustainable Development Goals (SDGs) but also for the improvement of its performance and its brand internationally. The objective of this article is to assess the implementation of CSR by telecommunication companies. It is our belief that given its high energy consumption and proximity to society, the telecom sector must pay particular attention to environmental and social issues. Our study examines the CSR of three Ivorian telecom operators, namely ORANGE CI, MOOV Africa and MTN, by applying a series of performance indicators related to CSR management. We hope that our study will raise awareness about sustainability issues for all other Ivorian companies but also sub-Sahara African companies in general in order to encourage CEOs to make CSR concept a top priority.

Keywords: CSR, telecom, SDGs, cote d’Ivoire

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Authors: Dilek Turan Eroğlu

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Educators have been searching the more effective and appalling methods of teaching for ages. It has always been an issue among the teachers and scientists to improve the quality of education and to ensure that all students have equal opportunities to learn. However, when it comes to the effective ways of learning,the learners are exposed to the ways which are chosen and approved to be effective by their teachers not by the learners themselves. This is the main problem of this study as the learners are not always happy to be in their classes being treated with their teachers’ favourite styles. This paper is telling the results of a study which has been conducted with the university students in Turkey. The students have been interviewed and asked to respond some questions related to best practices to find out their favourite styles, medium, techniques and strategies. The study has been conducted using qualitative research methods i.e one to one interviews and group discussions. The results show that the learners have significantly different views than the educators when it comes to modern teaching styles. Their definition of the term “modern teaching styles” is different than the general understanding. The university students expect their teachers to be “early adopter”. of ICT tools and or the other electronic devices, but a modern teacher must have many other characteristics for them.

Keywords: effective, innovation, teaching, modern teaching styles

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Authors: Fuad Alzahrani, Yiannis Kyratsis

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Although emergency nurses, being the frontline workers in mass-gatherings, are essential for providing an effective public health response, little is known about the skills that emergency nurses have, or require, in order to respond effectively to a disaster event. This paper is designed to address this gap in the literature by conducting an empirical study on emergency nurses’ preparedness at the mass-gathering event of Hajj in Mecca city. To achieve this aim, this study conducted a cross-sectional survey among 106 emergency department nurses in all the public hospitals in Mecca in 2014. The results revealed that although emergency nurses’ role understanding is high; they have limited knowledge and awareness of how to respond appropriately to mass-gathering disaster events. To address this knowledge gap, the top three most beneficial types of education and training courses suggested are: hospital education sessions, the Emergency Management Saudi Course and workshop; and short courses in disaster management. Finally, recommendations and constructive strategies are developed to provide the best practice in enhancing disaster preparedness. This paper adds to the body of knowledge regarding emergency nurses and mass gathering disasters. This paper measures the level of disaster knowledge, previous disaster response experience and disaster education and training amongst emergency nurses in Mecca, Saudi Arabia. It is anticipated that this study will provide a foundation for future studies aimed at better preparing emergency nurses for disaster response. This paper employs new strategies to improve the emergency nurses’ response during mass gatherings for the Hajj. Increasing the emergency nurses’ knowledge will develop their effective responses in mass-gathering disasters.

Keywords: emergency nurses, mass-gatherings, hajj, disaster preparedness, disaster knowledge, perceived role, disaster training, previous disaster response experience

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Authors: T. Pathinathan, M. Peter

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Fuzzy graphs incorporate concepts from graph theory with fuzzy principles. In this paper, we make a study on the properties of fuzzy graphs which are non-cyclic and are of two-dimensional in structure. In particular, this paper presents 2D structure or the structure of double layer for a non-cyclic fuzzy graph whose underlying crisp graph is non-cyclic. In any graph structure, introducing 2D structure may lead to an inherent cycle. We propose relevant conditions for 2D structured non-cyclic fuzzy graphs. These conditions are extended even to fuzzy graphs of the 3D structure. General theoretical properties that are studied for any fuzzy graph are verified to 2D structured or double layered fuzzy graphs. Concepts like Order, Degree, Strong and Size for a fuzzy graph are studied for 2D structured or double layered non-cyclic fuzzy graphs. Using different types of fuzzy graphs, the proposed concepts relating to 2D structured fuzzy graphs are verified.

Keywords: double layered fuzzy graph, double layered non–cyclic fuzzy graph, order, degree and size

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Authors: Zahra Kouzehgari

Abstract:

Since the early emergence of chaos theory in the 1970s in mathematics and physical science, it has increasingly been developed and adapted in social sciences as well. The non-linear and dynamic characteristics of the theory make it a useful conceptual framework to interpret the complex social systems behavior. Regarding chaotic approach principals, sensitivity to initial conditions, dynamic adoption, strange attractors and unpredictability this paper aims to examine whether chaos approach could interpret the ancient social changes. To do this, at first, a brief history of the chaos theory, its development and application in social science as well as the principals making the theory, then its application in archaeological since has been reviewed. The study demonstrates that although based on existing archaeological records reconstruct the whole social system of the human past, the non-linear approaches in studying social complex systems would be of a great help in finding general order of the ancient societies and would enable us to shed light on some of the social phenomena in the human history or to make sense of them.

Keywords: archaeology, non-linear approach, chaos theory, ancient social systems

Procedia PDF Downloads 275