Search results for: patient safety incidents

Authors: Ehsan Ahmed Yahia

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Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

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Authors: Sarwar Beg, Gajanand Sharma, O. P. Katare, Bhupinder Singh

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The current studies entail development of self-nano emulsifying drug delivery systems (SNEDDS) of rosuvastatin, employing rational QbD-based approach for enhancing its oral bioavailability. SNEDDS were prepared using the blend of lipidic and emulsifying excipients, i.e., Peceol, Tween 80, and Transcutol HP. The prepared formulations evaluated for in vitro drug release, ex vivo permeation, in situ perfusion studies and in vivo pharmacokinetic studies in rats, which demonstrated 3-4 fold improvement in biopharmaceutical performance of the developed formulations. Cytotoxicity studies using MTT assay and histopathological studies in intestinal cells revealed the lack of cytotoxicity and thereby safety and efficacy of the developed formulations.

Keywords: SNEDDS, bioavailability, solubility, Quality by Design (QbD)

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Authors: Ozden Saygili, Eser Cakti

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Mosques and minarets can be severely damaged as a result of earthquakes. Non-linear behavior of minarets of Mihrimah Sultan and Süleymaniye Mosques and the minaret of St. Sophia are analyzed to investigate seismic response, damage and failure mechanisms of minarets during earthquake. Selected minarets have different height and diameter. Discrete elements method was used to create the numerical minaret models. Analyses were performed using sine waves. Two parameters were used for evaluating the results: the maximum relative dislocation of adjacent drums and the maximum displacement at the top of the minaret. Both parameters were normalized by the drum diameter. The effects of minaret geometry on seismic behavior were evaluated by comparing the results of analyses.

Keywords: discrete element method, earthquake safety, nonlinear analysis, masonry structures

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Authors: Sean Bryner S. Rey, Eric Tanjutco

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Modular execution strategies are performed to address the various challenges of any projects and are implemented on each project phase that covers Engineering, Procurement, Fabrication and Construction. It was until the recent years that the intent to surpass mechanical modularization approach were conceptualized to give solution to much greater demands of project components such as site location and adverse weather condition, material sourcing, construction schedule, safety risks and overall plot layout and allocation. The intent of this paper is to introduce the 3rd Generation Modular Execution with an overview of its advantages on project execution and will give emphasis on Engineering, Construction, Operation and Maintenance. Most importantly, the paper will present the key differentiator of 3rd Gen modular execution against other conventional project execution and the merits it bears for the industry.

Keywords: 3rd generation modular, process block, construction, operation & maintenance

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Authors: A. Chenafa, S. Boulenouar, M. Zitouni, M. Boukouria

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The sterilization of medical devices constitutes for all the medical professions, an inescapable obligation. It has for objective to prevent the infectious risk, both for the patient and for the medical team. The Dental surgeon as every healthcare professional has to master perfectly this subject and to train his staff to the various techniques of sterilization. It is the only way to assure the patients all the security for which they are entitled to wait when they undergo a dental care. It’s for it, that we undertook to lead an investigation aiming at estimating the sterilization practice at the dental surgeon of Sidi bel Abbes. The survey result showed a youth marked with the profession with a majority use of autoclave with cycle B and an almost total absence of the sterilization controls (test of Bowie and Dick). However, the majority of the dentists control and validate their sterilizers. Finally, our survey allowed us to describe some practices which must be improved regarding control, regarding qualification and regarding staff training. And suggestions were made in this sense.

Keywords: dental surgeon, medical devices, sterilization, survey

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Authors: Virginia Guillén Cañas, Miren Agurtzane Ortiz-Jauregi, Sonia Ruiz De Azua, Naiara Ozamiz

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We want to focus on relationship of the communicational skills in several key aspects of medicine. The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes’ improvement and efficiency of health services. We define empathy as it as Sympathy and connection to others and capability to communicate this understanding. Some outcomes favoring empathy are female gender, younger age, and specialty choice. Third gender or third sex is a concept in which allows a person not to be categorized in a dual way but as a continuous variable, giving the choice of moving along it. This point of view recognizes three or more genders. The subject of Ethics and Clinical Communication is dedicated to sensitizing students about the importance and effectiveness of a good therapeutic relationship. We are also interested in other communicational aspects related to empathy as active listening, assertivity and basic and advanced Social Skills. Objectives: 1. To facilitate the approach of the student in the Medicine Degree to the reality of the medical profession 2. Analyze interesting outcome variables in communication 3. Interactive process to detect the areas of improvement in the learning process of the Physician throughout his professional career needs. Design: A comparative study with a cross-sectional approach was conducted in successive academic year cohorts of health professional students at a public Basque university. Four communicational aspects were evaluated through these questionnaires in Basque, Spanish and English: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. Types of interventions for improving skills: Interpersonal skills training intervention, Empathy intervention, Writing about experiential learning, Drama through role plays, Communicational skills training, Problem-based learning, Patient interviews ´videos, Empathy-focused training, Discussion. Results: It identified the need for a cross cultural adaptation and no gender distinction. The students enjoyed all the techniques in comparison to the usual master class. There was medium participation but these participative methodologies are not so usual in the university. According to empathy, men have a greater empathic capacity to fully understand women (p < 0.05) With regard to assertiveness there have been no differences between men and women in self-assertiveness but nevertheless women are more heteroassertive than men. Conclusions: These findings suggest that educational interventions with adequate feedback can be effective in maintaining and enhancing empathy in undergraduate medical students.

Keywords: physician's communicational skills, patient satisfaction, third gender, cross cultural adaptation

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Authors: Fahad Suleiman

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Queuing, in medical system is the process of moving patients in a specific sequence to a specific service according to the patients’ nature of illness. The term scheduling stands for the process of computing a schedule. This may be done by a queuing based scheduler. This paper focuses on the medical consultancy system, the different queuing algorithms that are used in healthcare system to serve the patients, and the average waiting time. The aim of this paper is to build automatic queuing system for organizing the medical queuing system that can analyses the queue status and take decision which patient to serve. The new queuing architecture model can switch between different scheduling algorithms according to the testing results and the factor of the average waiting time. The main innovation of this work concerns the modeling of the average waiting time is taken into processing, in addition with the process of switching to the scheduling algorithm that gives the best average waiting time.

Keywords: queuing systems, queuing system models, scheduling algorithms, patients

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Authors: Mirim Kim, Won-Oak Oh

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Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

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Authors: A. Askerov, Y. Teterin, P. Yartcev, S. Novikov

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Introduction: Acute pancreatitis (AP) is a socially significant problem for public health and continues to be one of the most common causes of hospitalization of patients with pathology of the gastrointestinal tract. It is characterized by high mortality rates, which reaches 62-65% in infected pancreatic necrosis. Aims & Methods: The study group included 63 patients who underwent transluminal drainage (TLD) fluid collection (FC). All patients were performed transabdominal ultrasound, computer tomography of the abdominal cavity and retroperitoneal organs and endoscopic ultrasound (EUS) of the pancreatobiliary zone. The EUS was used as a final diagnostic method to determine the characteristics of FC. The indications for TLD were: the distance between the wall of the hollow organ and the FC was not more than 1 cm, the absence of large vessels on the puncture trajectory (more than 3 mm), and the size of the formation was more than 5 cm. When a homogeneous cavity with clear, even contours was detected, a plastic stent with rounded ends (“double pig tail”) was installed. The indication for the installation of a fully covered self-expanding stent was the detection of nonhomogeneous anechoic FC with hyperechoic inclusions and cloudy purulent contents. In patients with necrotic forms after drainage of the purulent cavity, a cystonasal drainage with a diameter of 7Fr was installed in its lumen under X-ray control to sanitize the cavity with a 0.05% aqueous solution of chlorhexidine. Endoscopic necrectomy was performed every 24-48 hours. The plastic stent was removed in 6 month, the fully covered self-expanding stent - in 1 month after the patient was discharged from the hospital. Results: Endoscopic TLD was performed in 63 patients. The FC corresponding to interstitial edematous pancreatitis was detected in 39 (62%) patients who underwent TLD with the installation of a plastic stent with rounded ends. In 24 (38%) patients with necrotic forms of FC, a fully covered self-expanding stent was placed. Communication with the ductal system of the pancreas was found in 5 (7.9%) patients. They underwent pancreaticoduodenal stenting. A complicated postoperative period was noted in 4 (6.3%) cases and was manifested by bleeding from the zone of pancreatogenic destruction. In 2 (3.1%) cases, this required angiography and endovascular embolization a. gastroduodenalis, in 1 (1.6%) case, endoscopic hemostasis was performed by filling the cavity with 4 ml of Hemoblock hemostatic solution. The combination of both methods was used in 1 (1.6%) patient. There was no evidence of recurrent bleeding in these patients. Lethal outcome occurred in 4 patients (6.3%). In 3 (4.7%) patients, the cause of death was multiple organ failure, in 1 (1.6%) - severe nosocomial pneumonia that developed on the 32nd day after drainage. Conclusions: 1. EUS is not only the most important method for diagnosing FC in AP, but also allows you to determine further tactics for their intraluminal drainage.2. Endoscopic intraluminal drainage of fluid zones in 45.8% of cases is the final minimally invasive method of surgical treatment of large-focal pancreatic necrosis. Disclosure: Nothing to disclose.

Keywords: acute pancreatitis, fluid collection, endoscopy surgery, necrectomy, transluminal drainage

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Authors: Ali Maji

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Highway development is an important factor for economic growth and development in both developed and developing countries. In Nigeria about two-third of transportation of goods and persons are done through highway network. It was this that made highway investment to enjoy position of relative high priority on the list of government expenditure programmes in Nigeria today. The paper noted that despite expansion of public investment in highway construction and maintenance of them, road traffic accident is increasing rate. This has acted as a drain of human capital which is a key to economic growth and development in Nigeria. In order to avoid this, the paper recommend introduction of Highway Safety Education (HSE) in Nigerian’s education system and investment in train transportation among other as a sure measure for curtailing highway accident.

Keywords: accident rate, high way development, human capital, national development

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Authors: Kenneth Harper

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Blockchain technology presents solutions for managing healthcare data, addressing critical challenges in privacy, integrity, and access. This paper explores how privacy-preserving technologies, such as zero-knowledge proofs (ZKPs) and homomorphic encryption (HE), enhance decentralized healthcare platforms by enabling secure computations and patient data protection. An examination of the mathematical foundations of these methods, their practical applications, and how they meet the evolving demands of healthcare data security is unveiled. Using real-world examples, this research highlights industry-leading implementations and offers a roadmap for future applications in secure, decentralized healthcare ecosystems.

Keywords: blockchain, cryptography, data privacy, decentralized data management, differential privacy, healthcare, healthcare data security, homomorphic encryption, privacy-preserving technologies, secure computations, zero-knowledge proofs

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Authors: Shivayogi Charantimath

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Radiotherapy and chemotherapy are effective for treating malignancies but are associated with side effects like oral mucositis. Chlorhexidine gluconate is one of the most commonly used mouthwash in prevention of signs and symptoms of mucositis. Evidence shows that chlorhexidine gluconate has side effects in terms of colonization of bacteria, bad breadth and less healing properties. Thus, it is essential to find a suitable alternative therapy which is more effective with minimal side effects. Curcumin, an extract of turmeric is gradually being studied for its wide-ranging therapeutic properties such as antioxidant, analgesic, anti-inflammatory, antitumor, antimicrobial, antiseptic, chemo sensitizing and radio sensitizing properties. The present study was conducted to evaluate the efficacy and safety of topical curcumin gel on radio-chemotherapy induced oral mucositis in cancer patients. The aim of the study is to evaluate the efficacy and safety of curcumin gel in the management of oral mucositis in cancer patients undergoing radio chemotherapy and compare with chlorhexidine. The study was conducted in K.L.E. Society’s Belgaum cancer hospital. 40 oral cancer patients undergoing the radiochemotheraphy with oral mucositis was selected and randomly divided into two groups of 20 each. The study group A [20 patients] was advised Cure next gel for 2 weeks. The control group B [20 patients] was advised chlorhexidine gel for 2 weeks. The NRS, Oral Mucositis Assessment scale and WHO mucositis scale were used to determine the grading. The results obtained were calculated by using SPSS 20 software. The comparison of grading was done by applying Mann-Whitney U test and intergroup comparison was calculated by Wilcoxon matched pairs test. The NRS scores observed from baseline to 1^st and 2^nd week follow up in both the group showed significant difference. The percentage of change in erythema in respect to group A was 63.3% for first week and for second week, changes were 100.0% with p = 0.0003. The changes in Group A in respect to erythema was 34.6% for 1^st week and 57.7% in second week. The intergroup comparison was significant with p value of 0.0048 and 0.0006 in relation to group A and group B respectively. The size of the ulcer score was measured which showed 35.5% [P=0.0010] of change in Group A for 1^st and 2^nd week showed totally reduction i.e. 103.4% [P=0.0001]. Group B showed 24.7% change from baseline to 1^st week and 53.6% for 2^nd week follow up. The intergroup comparison with Wilcoxon matched pair test was significant with p=0.0001 in group A. The result obtained by WHO mucositis score in respect to group A shows 29.6% [p=0.0004] change in first week and 75.0% [p=0.0180] change in second week which is highly significant in comparison to group B. Group B showed minimum changes i.e. 20.1% in 1^st week and 33.3% in 2^nd week. The p value with Wilcoxon was significant with 0.0025 in Group A for 1^st week follow up and 0.000 for 2^nd week follow up. Curcumin gel appears to an effective and safer alternative to chlorhexidine gel in treatment of oral mucositis.

Keywords: curcumin, chemotheraphy, mucositis, radiotheraphy

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Authors: Demelash Kassaye

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The Ethiopia case study reveals a unique model of community policing that has developed from a particular political context in which there is a history of violent political transition, a political structure characterized by ethnic federalism and a political ideology that straddles liberal capitalism and democracy on the one hand, and state-led development and centralized control on the other. The police see community policing as a way to reduce crime. Communities speak about community policing as an opportunity to take on policing responsibilities themselves. Both of these objectives are brought together in an overarching rhetoric of community policing as a way of ‘mobilizing for development’ – whereby the community cooperate with the police to reduce crime, which otherwise inhibits development progress. Community policing in Amhara has primarily involved the placement of Community Police Officers at the kebele level across the State. In addition, a number of structures have also been established in the community, including Advisory Councils, Conflict Resolving Committees, family police and the use of shoe shiner’s and other trade associations as police informants. In addition to these newly created structures, community policing also draws upon pre-existing customary actors, such as militia and elders. Conflict Resolving Committees, Community Police Officers and elders were reported as the most common first ports of call when community members experience a crime. The analysis highlights that the model of community policing in Amhara increased communities’ access to policing services, although this is not always attended by increased access to justice. Community members also indicate that public perceptions of the police have improved since the introduction of community policing, in part due to individual Community Police Officers who have, with limited resources, innovated some impressive strategies to improve safety in their neighborhoods. However, more broadly, community policing has provided the state with more effective surveillance of the population – a potentially oppressive function in the current political context. Ultimately, community policing in Amhara is anything but straightforward. It has been a process of attempting to demonstrate the benefits of newfound (and controversial) ‘democracy’ following years of dictatorship, drawing on generations of customary dispute resolution, providing both improved access to security for communities and an enhanced surveillance capacity for the state. For external actors looking to engage in community policing, this case study reveals the importance of close analysis in assessing potential merits, risks and entry points of programming. Factors found to be central in shaping the nature of community policing in the Amhara case include the structure of the political system, state-society relations, cultures dispute resolution and political ideology.

Keywords: community policing, community, militias, ethiopia

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Authors: Ayşe Yurdakul, Eckehard Schnieder

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Nowadays, there are multilingual and multidisciplinary communication problems because of the increasing technical progress. Each technical field has its own specific terminology and in each particular language, there are differences in relation to definitions of terms. Besides, there could be several translations in the certain target language for one term of the source language. First of all, these problems of semantic relations between terms include the synonymy, antonymy, hypernymy/hyponymy, ambiguity, risk of confusion and translation problems. Therefore, the iglos terminology management system of the Institute for Traffic Safety and Automation Engineering of the Technische Universität Braunschweig has the goal to avoid these problems by a methodological standardisation of term definitions on the basis of the iglos sign model and iglos relation types. The focus of this paper should be on standardisation of navigation terminology as an example.

Keywords: iglos, localisation, methodological approaches, navigation, positioning, definition problems, terminology

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Authors: Hassan Waseem

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Cytomegalovirus (CMV) is ubiquitously distributed viral agent responsible for different clinical manifestations that may vary according to the immunologic status of the patient. CMV can cause morbidity and mortality among fetuses and patients with compromised immune system. A cross-sectional study was carried out in Islamabad to investigate the prevalence and risk factors associated with CMV infection among pregnant women. Blood samples of 172 pregnant women visiting Mother and Child Healthcare, Pakistan Institute of Medical Sciences (PIMS) Islamabad were taken. In present study, serum samples of the women were checked for CMV-specific IgG and IgM antibodies by enzyme linked immunosorbent assay (ELISA). Clinical, obstetrical and socio-demographical characteristics of the women were collected by using structured questionnaires. Out of 172 pregnant women included in the study, 171 (99.4%) were CMV specific IgG positive and 30 (17.4%) were found positive for CMV-IgM antibodies. The CMV has taken an endemic form in Pakistan so, routine screening of CMV among pregnant women is recommended.

Keywords: Cytomegalovirus, blood transfusion, ELISA, seroprevalence

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Authors: Michael Kvopka, Ezekiel Kingston

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A 61-year-old man with no significant past medical history presented to a quaternary ophthalmic referral center with acute right-sided medial canthal pain, periorbital edema, and erythema despite oral antibiotic therapy. CT imaging confirmed the presence of right preseptal cellulitis and lacrimal sac aspiration identified multi-resistant Enterobacter cloacae. A diagnosis of acute right-sided dacryocystitis with preseptal cellulitis was made. He was successfully treated with broadening of antibiotic therapy to intravenous meropenem. The symptomatic resolution was noted on follow-up without evidence of disease recurrence. To the Authors’ best knowledge, this is the first reported case of multi-resistant E. cloacae dacryocystitis and preseptal cellulitis. The management of this patient required a multi-disciplinary approach, so the Authors believe this report is relevant to general ophthalmologists and oculoplastic sub-specialists.

Keywords: enterobacter, dacryocystitis, preseptal cellulitis, antibiotic resistance

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Authors: Nimra Parvez, Nawaz Ahmed

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Workplace aggression not only is a proven safety and health issue but it also is a problem witnessed at workplace which has far-reaching consequences. It hinders the overall productivity of the organizations and individual employees. The current study examined employee turnover intentions as a result of workplace aggression. The study was conducted on employees from the private sector. Self-report questionnaires that measured the workplace aggression and turnover intentions of employees were used to target a sample size of 200 employees. In the hypothesis, it was assumed that high levels of workplace aggression at any organization will result in subsequent high levels of employee turnover intentions. It was therefore identified that there has been a relationship between workplace aggression and employee turnover intentions. The results determined a positive relationship between the workplace bullying behaviors towards the individuals and the turnover intention.

Keywords: bullying, organizational commitment, turnover intention, workplace aggression

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Authors: Mirza Obaid Baig, MaimoonaYaqub

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A 51 year old lady; known case of diabetes mellitus, post wound debridement i.e. 4 open wounds of grade III presented to us with foot drop, with prominent sensory deficit over right lower leg/foot i.e. 0 on Nottingham scale for impaired sensation, marked pedal edema and 5/10 – 6/10 pain on VAS during day and night respectively, Wounds were poorly granulated and foul smelling. Physiotherapy sessions were planned including twice a day electrical muscle stimulation sessions, strategies to decrease edema and improve muscle action which resulted in noticeable improvement in motor and sensory ability, pain levels, edema and psychological status of patient. Thus, this study gives evidence of the effect of Electrical muscle stimulation in grade III open wounds associated with motor/sensory weakness post-surgery.

Keywords: EMS, foot drop, grade III wound, diabetes mellitus

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Authors: Thanh Nga Thai

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A major issue in air transportation is in flight safety. Recent developments in control engineering have an attractive potential for resolving new issues related to guidance, navigation, and control of flying vehicles. Many future atmospheric missions will require increased on board autonomy including fault diagnosis and the subsequent control and guidance recovery actions. To improve designing system diagnostic, an efficient FDI- fault detection and identification- methodology is necessary to achieve. Contribute to characteristic of different faults in sensor and actuator in the view of mathematics brings a lot of profit in some condition changes in the system. This research finds some profit to reduce a trade-off to achieve between fault detection and performance of the closed loop system and cost and calculated in simulation.

Keywords: fault detection and identification, sensor faults, actuator faults, flight control system

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Authors: Adinew Gebremeskel Tizazu

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Nowadays, in our world of technological development, there is an enhanced intention imposed on the building construction industry to improve the time, economy, and structural efficiency of structures. Modern profiled steel sheets are mostly designed as formwork and tensile reinforcement. This research is concerned with the optimal design of profiled steel sheets for composite slabs. Apart from satisfying the safety requirement, the design should be economical. For a given condition, there might be a large number of alternatives that satisfy the requirement set by the codes. But the designer must be in a position to choose the design, which is optimal against certain measures of optimality. Therefore, the designers have to do some optimization to arrive at such a design. In this research, the optimal cross-sectional dimensions of profiled steel sheets will be determined by considering different spans, loadings, and materials.

Keywords: profiled sheeting, optimal cross-sectional dimensions, cold-formed profiled sheets, composite slab

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Authors: Fereshteh Akbari, Farrokh Jalali Mosalam, Ali Hedayatifar, Amirreza Aminjavaheri

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The soil nailing is an effective method to stabilize slopes and retaining structures. Consequently, the lateral and vertical displacement of retaining walls are important criteria to evaluate the safety risks of adjacent structures. This paper is devoted to the optimization problems of retaining walls based on ABAQOUS Software. The various parameters such as nail length, orientation, arrangement, horizontal spacing, and bond skin friction, on lateral and vertical displacement of retaining walls are investigated. In order to ensure accuracy, the mobilized shear stress acting around the perimeter of the nail-soil interface is also modeled in ABAQOUS software. The observed trend of results is compared to the previous researches.

Keywords: retaining walls, soil nailing, ABAQOUS software, lateral displacement, vertical displacement

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Authors: W. S. Hsu, S. W. Chen, Y. T. Ku, Y. Chiang, J. R. Wang , J. H. Yang, C. Shih

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ALOHA code was used to calculate the concentration under the CO₂ storage burst condition for Maanshan nuclear power plant (NPP) in this study. Five main data are input into ALOHA code including location, building, chemical, atmospheric, and source data. The data from Final Safety Analysis Report (FSAR) and some reports were used in this study. The ALOHA results are compared with the failure criteria of R.G. 1.78 to confirm the habitability of control room. The result of comparison presents that the ALOHA result is below the R.G. 1.78 criteria. This implies that the habitability of control room can be maintained in this case. The sensitivity study for atmospheric parameters was performed in this study. The results show that the wind speed has the larger effect in the concentration calculation.

Keywords: PWR, ALOHA, habitability, Maanshan

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Authors: Jing (Claire) LI

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The topic of corporate social responsibility (CSR) is significant for pharmaceutical companies in China at this current stage. This is because, as a rapid growth industry in China in recent years, the pharmaceutical industry in China has been undergone continuous and terrible incidents relating to CSR. However, there is limited research and practice of CSR in Chinese pharmaceutical companies. Also, there is an urgent call for more research in an international context to understand the implications of corporate life cycle on CSR performance. To respond to the research need and research call, this study examines the relationship between corporate life cycle and CSR performance of Chinese listed companies in pharmaceutical industry. This research studies Chinese listed companies in pharmaceutical industry for the period of 2010-2017, where the data is available in database. Following the literature, this study divides CSR performance with regards to CSR dimensions, including shareholders, creditors, employees, customers, suppliers, the government, and the society. This study uses CSR scores of HEXUN database and financial measures of these CSR dimensions to measure the CSR performance. This study performed regression analysis to examine the relationship between corporate life cycle stages and CSR performance with regards to CSR dimensions for pharmaceutical listed companies in China. Using cash flow pattern as proxy of corporate life cycle to classify corporate life cycle stages, this study found that most (least) pharmaceutical companies in China are in maturity (decline) stage. This study found that CSR performance for most dimensions are highest (lowest) in maturity (decline) stage as well. Among these CSR dimensions, performing responsibilities for shareholder is the most important among all CSR responsibilities for pharmaceutical companies. This study is the first to provide important empirical evidence from Chinese pharmaceutical industry on the association between life cycle and CSR performance, supporting that corporate life cycle is a key factor in CSR performance. The study expands corporate life cycle and CSR literatures and has both empirical and theoretical contributions to the literature. From perspective of empirical contributions, the findings contribute to the argument that whether there is a relationship between CSR performance and various corporate life cycle stages in the literature. This study also provides empirical evidence that companies in different corporate life cycles have difference in CSR performance. From perspective of theoretical contributions, this study relates CSR and stakeholders to corporate life cycle stages and complements the corporate life cycle and CSR literature. This study has important implications for managers and policy makers. First, the results will be helpful for managers to have an understanding in the essence of CSR, and their company’s current and future CSR focus over corporate life cycle. This study provides a reference for their actions and may help them make more wise resources allocation decisions of CSR investment. Second, policy makers (in the government, stock exchanges, and securities commission) may consider corporate life cycle as an important factor in formulating future regulations for companies. Future research can explore the "process-based" differences in CSR performance and more industries.

Keywords: China, corporate life cycle, corporate social responsibility, pharmaceutical industry

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Authors: Sonia Regina Lyra

Abstract:

The desire for unequivocal clarity is understandable, but this can make one forget that things of the soul are experiential processes, or transformations, which should never be designated unilaterally if it is not wanted to transform something that moves, a living thing, into something static. Among the so-called ‘things of the soul’ there are especially spontaneous fantasies, that emerge during the processes, as a result from the use of the active imagination technique, for when fantasy is not forced, violated, or subjugated by an illegitimate, intellectually preconceived idea, then it is a legitimate and authentic product of the unconscious mind. This is how one can gain access to unadulterated information about everything that transcends the conscious mind. However, it is vital to discern between ego and non-ego, because this principle will result in a release of energy and a renewal of life, which will come to have meaning. This study will deal with the active imagination as a knowledge that depends on the individual experience of the therapist because the patient will be taken just to reach where the unconscious of the therapist was assimilated to his own conscience. In this way, the therapist becomes the method itself, being his personality, a fundamental part of an effective factor.

Keywords: active imagination, effective factor, synchronicity, symptom

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Authors: Lourenço José, Elsa Melo, Sandra Viera, Ana Pinheiro

Abstract:

Introduction: People with stroke in Angola face challenges in accessing appropriate healthcare and rehabilitation services. There is a lack of information on the quality of care provided and the development of early intervention plans Methods: Two different methods will be chosen. The exploratory, descriptive, and longitudinal study (E1) to characterize health care for people with stroke, housed in 2 hospitals in Luanda; the quality and transverse study (E2) concerning the development and evaluation of a strategic early intervention plan for a stroke patient. Ethical and deontological principles for an investigation will be proposed. Results: Contributor to the knowledge of the reality of providing care to the person after a stroke, in Angola; Propose and develop an early action plan. Contribute to integration to influence policy makers on the need for assistance with stroke, aiming at their functional, family and social rehabilitation, particularly in the labor market.

Keywords: stroke, functional recovery, quality of life, health

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Authors: Shanza Akram, Sameen Toor, Heba Harb Abu Alkass, Zainab Abdulsalam Altaha, Sara Taha Abdulla, Saleem Imran

Abstract:

Acute pulmonary embolism (PE) is a common disease and can be fatal. The clinical presentation is variable and nonspecific, making accurate diagnosis difficult. Testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly CT and D-dimer measurement, may not improve care while potentially leading to patient harm and unnecessary expense. CTPA is the investigation of choice for PE. Its easy availability, accuracy and ability to provide alternative diagnosis has lowered the threshold for performing it, resulting in its overuse. Guidelines have recommended the use of clinical pretest probability tools such as ‘Wells score’ to assess risk of suspected PE. Unfortunately, implementation of guidelines in clinical practice is inconsistent. This has led to low risk patients being subjected to unnecessary imaging, exposure to radiation and possible contrast related complications. Aim: To study the diagnostic yield of CT PA, clinical pretest probability of patients according to wells score and to determine whether or not there was an overuse of CTPA in our service. Methods: CT scans done on patients with suspected P.E in our hospital from 1st January 2014 to 31st December 2014 were retrospectively reviewed. Medical records were reviewed to study demographics, clinical presentation, final diagnosis, and to establish if Wells score and D-Dimer were used correctly in predicting the probability of PE and the need for subsequent CTPA. Results: 100 patients (51male) underwent CT PA in the time period. Mean age was 57 years (24-91 years). Majority of patients presented with shortness of breath (52%). Other presenting symptoms included chest pain 34%, palpitations 6%, collapse 5% and haemoptysis 5%. D Dimer test was done in 69%. Overall Wells score was low (<2) in 28 %, moderate (>2 - < 6) in 47% and high (> 6) in 15% of patients. Wells score was documented in medical notes of only 20% patients. PE was confirmed in 12% (8 male) patients. 4 had bilateral PE’s. In high-risk group (Wells > 6) (n=15), there were 5 diagnosed PEs. In moderate risk group (Wells >2 - < 6) (n=47), there were 6 and in low risk group (Wells <2) (n=28), one case of PE was confirmed. CT scans negative for PE showed pleural effusion in 30, Consolidation in 20, atelactasis in 15 and pulmonary nodule in 4 patients. 31 scans were completely normal. Conclusion: Yield of CT for pulmonary embolism was low in our cohort at 12%. A significant number of our patients who underwent CT PA had low Wells score. This suggests that CT PA is over utilized in our institution. Wells score was poorly documented in medical notes. CT-PA was able to detect alternative pulmonary abnormalities explaining the patient's clinical presentation. CT-PA requires concomitant pretest clinical probability assessment to be an effective diagnostic tool for confirming or excluding PE. . Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Combining Wells scores with clinical and laboratory assessment may reduce the need for CTPA.

Keywords: CT PA, D dimer, pulmonary embolism, wells score

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Authors: M. Y. Achouri, O. A. Alleg, M. C. L. Moulai, M. A. Selka

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This study aims to assess the perception and attitudes of community pharmacists in Sidi-Bel-Abbes (Algeria) towards generic drugs. This is a descriptive cross-sectional prospective survey and quantitative, conducted over a period of two months from April to May 2014. The target population consisted of 118 pharmacists practicing in pharmacies in Sidi-Bel-Abbes. Data collection was conducted through a questionnaire consisting of thirteen (13) items. Fifty six (67%) of community pharmacists in the town of Sidi-Bel-Abbes in the survey believe that generics have a lower quality compared to brand name medicines Only 42% of respondents viewed locally manufactured generic medicines as equal in quality compared to the imported generic medicines, and 63% believe that the generics substitution has led to change the relationship between a pharmacist and patient. In order to promote the practice of generic medicines in Algeria, an educational program should be implemented.

Keywords: generic drugs, perception, attitudes, community pharmacists

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Authors: Andrey Norov

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Based on the generalization of scientific and production experience and the latest developments of JSC “NIUIF”, the oldest (founded in September 1919) and the only Russian research institute for phosphorus-containing fertilizers, this paper shows the factors that determine the reasonable choice of a method for processing phosphate raw materials into complex fertilizers. These factors primarily include the composition of phosphate raw materials and the impurities contained in it, as well as some parameters of the process mode, wastelessness, ecofriendliness, energy saving, maximum use of the heat of chemical reactions, fire and explosion safety, efficiency, productive capacity, the required product range and the possibility of creating flexible technologies, compliance with BAT principles, etc. The presented data allow to choose the right technology for complex granular fertilizers, depending on the abovementioned factors.

Keywords: BAT, ecofriendliness, energy saving, phosphate raw materials, wastelessness

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Authors: Michał Rogala, Jakub Gajewski

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As the automotive industry develops, passive safety is becoming an increasingly important aspect when designing motor vehicles. A commonly used solution is energy absorption by thin-walled construction. One such structure is a closed thin-walled profile fixed to the vehicle stringers. The article presents numerical tests of conical thin-walled profiles filled with aluminum foam. The columns were loaded axially with constant energy. On the basis of the results obtained, efficiency indicators were calculated. The efficiency of the foam filling was evaluated. Artificial neural networks were used for data analysis. The application of regression analysis was used as a tool to study the relationship between the quantities characteristic of the dynamic crush.

Keywords: aluminium foam, crashworthiness, neural networks, thin-walled structure

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Authors: Sarah El Mokadem

Abstract:

Egypt has been the focus of international media since 2011 revolution and its repercussions. By the end of 2017, President Abdel Fattah El Sisi will have finished his first term of presidency. With an upcoming presidential election, all eyes are returning back to Egypt as there are speculations about whether the current regime will uphold or change points in the constitution determining the years of presidency term and the allowed number or reelections. In this paper, the researcher examines the reports related to Egypt in three international news channels with different ideologies. The research aims to identify the frames used to portray major issues in Egypt like the economic struggle, democracy levels and stability and safety of the country. All available reports from these three channels in 2017 on YouTube were analyzed which is the year before the presidential elections.

Keywords: content analysis, Egypt, image building, news channel ideology

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