Search results for: nephrology nursing procedure

Authors: Shyam lamsal

Abstract:

Introduction: Karnali Academy of Health Sciences (KAHS) has been established in 2011, by an Act of parliament of Nepal, in Jumla, to provide health services in easy way in backward areas, to produce skilled health professionals & conduct research. The backward areas mentioned in act of KAHS are Humla, Jumla, Kalikot, Dolpa, Mugu districts of Karnali zone, Jajarkot district of Bheri zone & Bajura, Baghang & Achham districts of Seti zone in Nepal occupying around 25 % of the total national geography. Backward area of Nepal is specific to having worst health indicators with life expectancy (47 years), HDI (0.35), Literacy rate (58%), global acute malnutrition (13%), crude birth rate (33.6), crude death rate (9.6), Total fertility rate (4.2), infant mortality rate (61.5 per 1000 live births), under five mortality rate (59 per 1000 live births) and maternal mortality ratio (400 per 1000 live births). History of health facilities in backward region: All the nine districts of this region have a district hospital with very few grass root level health manpower. Government of Nepal regularly deploys one or two medical officers to each district who generally are not regular to their care. Jumla district itself was having one medical officer before the establishment of KAHS. Development activities: Establishment of 100 bedded specialty teaching hospital with 10 medical officers and five specialists, accredited its own nursing school for running diploma nursing programme, started “Karnali health survey” which covers 55 thousand households of backward region, started community care and school health camps, planning phase completed for 300 bedded teaching hospital construction. Future Plan: Expansion of the teaching hospital to 300 beds within 3 years, start health assistant and bachelor midwifery course in 2015 AD, start bachelor in laboratory and bachelor in public health course in 2016 AD and start MBBS course in 2018 AD. Deploy the medical officers and family physicians to all the district hospitals within 3 years. KAHS provides reservation up to 45% students from backward region with the commitment to stay for at least five years of their service period. Conclusion: This institution may be the example for the rest of the world in providing nursing care, education in remote areas as well as the best model for nursing manpower retention in remote areas of developing countries.

Keywords: backward area, nursing school

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Authors: M. Kotobuki, M. Koishi

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Li1.5Al0.5Ti1.5 (PO4)3(LATP) has received much attention as a solid electrolyte for lithium batteries. In this study, the LATP solid electrolyte is prepared by the co-precipitation method using Li3PO4 as a Li source. The LATP is successfully prepared and the Li ion conductivities of bulk (inner crystal) and total (inner crystal and grain boundary) are 1.1 × 10-3 and 1.1 × 10-4 S cm-1, respectively. These values are comparable to the reported values, in which Li2C2O4 is used as the Li source. It is conclude that the LATP solid electrolyte can be prepared by the co-precipitation method using Li3PO4 as the Li source and this procedure has an advantage in mass production over previous procedure using Li2C2O4 because Li3PO4 is lower price reagent compared with Li2C2O4.

Keywords: co-precipitation method, lithium battery, NASICON-type electrolyte, solid electrolyte

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Authors: Abdul Hakim Chikho

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Calculating the ultimate load of a column in a sway framed structure involves, in the currently used design method, the calculation of the column effective length and utilizing the interaction formulas or tables. Therefore, no allowance is usually made for the effects of the presence of semi rigid connections or the presence of infill panels. In this paper, a new and simple design procedure is recommend to calculate the ultimate load of a framed Column allowing for the presence of rotational end restraints, semi rigid connections, the column end moments resulted from the applied vertical and horizontal loading and infill panels in real steel structure. In order to verify the accuracy of the recommended method to predict good and safe estimations of framed column ultimate loads, several examples have been solved utilizing the recommended procedure, and the results were compared to those obtained using a second order computer program, and good correlation had been obtained. Therefore, the accuracy of the proposed method to predict the Behaviour of practical steel columns in framed structures has been verified.

Keywords: column ultimate load, semi rigid connections, steel column, infill panel, steel structure

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Authors: S. A. Faizi, S. Yoshitomi

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The optimal design procedure of buckling restrained braces (BRBs) in reinforced concrete (RC) building structures can provide the distribution of horizontal stiffness of BRBs at each story, which minimizes story drift response of the structure under the constraint of specified total stiffness of BRBs. In this paper, a simple rule is proposed to convert continuous horizontal stiffness of BRBs into sectional sizes of BRB which are available from standardized section list assuming realistic structural design stage.

Keywords: buckling restrained brace, building engineering, optimal damper placement, structural engineering

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Authors: Austyn Snowden

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Aim: To examine the construct validity of the Trait Emotional Intelligence Questionnaire Short form. Background: Emotional intelligence involves the identification and regulation of our own emotions and the emotions of others. It is therefore a potentially useful construct in the investigation of recruitment and retention in nursing and many questionnaires have been constructed to measure it. Design: Secondary analysis of existing dataset of responses to TEIQue-SF using concurrent application of Rasch analysis and confirmatory factor analysis. Method: First year undergraduate nursing and computing students completed Trait Emotional Intelligence Questionnaire-Short Form. Responses were analysed by synthesising results of Rasch analysis and confirmatory factor analysis.

Keywords: emotional intelligence, rasch analysis, factor analysis, nurse recruiters

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Authors: Qasim Kriri, Harsh B. Desai

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Water supply and sanitation in Saudi Arabia is portrayed by difficulties and accomplishments. One of the fundamental difficulties is water shortage. With a specific end goal to beat water shortage, significant ventures have been attempted in sea water desalination, water circulation, sewerage, and wastewater treatment. The motivation behind Statistical Process Control (SPC) is to decide whether the execution of a procedure is keeping up an acceptable quality level [AQL]. SPC is an analytical decision-making method. A fundamental apparatus in the SPC is the Control Charts, which follow the inconstancy in the estimations of the item quality attributes. By utilizing the suitable outline, administration can decide whether changes should be made with a specific end goal to keep the procedure in charge. The two most important quality factors in the distilled water which were taken into consideration were pH (Potential of Hydrogen) and TDS (Total Dissolved Solids). There were three stages at which the quality checks were done. The stages were as follows: (1) Water at the source, (2) water after chemical treatment & (3) water which is sent for packing. The upper specification limit, central limit and lower specification limit are taken as per Saudi water standards. The procedure capacity to accomplish the particulars set for the quality attributes of Berain water Factory chose to be focused by the proposed SPC system.

Keywords: acceptable quality level, statistical quality control, control charts, process charts

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Authors: Chang Yu Chuan

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Background and Aim: Pressure sore is not only the consequence of any gradual damage of the skin leading to tissue defects but also an important indicator of clinical care. If hospitalized patients develop pressure sores without proper care, it would result in delayed healing, wound infection, increase patient physical pain, prolonged hospital stay and even death, which would have a negative impact on the quality of care and also increase nursing manpower and medical costs. This project is aimed at decreasing the incidence of pressure sore in one ward of internal medicine. Our data showed 53 cases (0.61%) of pressure sore in 2015, which exceeded the average (0.5%) of Taiwan Clinical Performance Indicator (TCPI) for medical centers. The purpose of this project is to reduce the incidence rate of pressure sore in the ward. After data collection and analysis from January to December 2016, the reasons of developing pressure sore were found: 1. Lack of knowledge to prevent pressure among nursing staffs; 2. No relevant courses about preventing pressure ulcers and pressure wound care being held in this unit; 3. Low complete rate of pressure sore care education that family members should receive from nursing staffs; 4. Decompression equipment is not enough; 5. Lack of standard procedures for body-turning and positioning care. After team members brainstorming, several strategies were proposed, including holding in-service education, pressure sore care seed training, purchasing decompression mattress and memory pillows, designing more elements of health education tools, such as health education pamphlet, posters and multimedia films of body-turning and positioning demonstration, formulation and promotion of standard operating procedures. In this way, nursing staffs can understand the body-turning and positioning guidelines for pressure sore prevention and enhance the quality of care. After the implementation of this project, the pressure sore density significantly decreased from 0.61%(53 cases) to 0.45%(28 cases) in this ward. The project shows good results and good example for nurses working at the ward and helps to enhance quality of care.

Keywords: body-turning and positioning, incidence density, nursing, pressure sore

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Authors: Alireza Javadzadeh

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Background: The purpose of this prospective, randomized study was to compare the safety and efficacy of oral versus i.v. midazolam in providing sedation for pediatric upper gastrointestinal (GI) endoscopy. Methods: Sixty-one children (age < 16 years) scheduled for upper GI endoscopy were studied. Patients were randomly assigned to receive oral or i.v. midazolam. Measurements were made and compared for vital signs, level of sedation, pre- and post-procedure comfort, anxiety during endoscopy, ease of separation from parents, ease and duration of procedure, and recovery time. Results: Patients were aged 1–16 years (mean 7.5 ± 3.42 years); 30 patients received oral medication, and 31 received i.v. medication. There were no statistically significant differences in age or gender between groups. There were no significant differences in level of sedation, ease of separation from parents, ease of ability to monitor the patient during the procedure, heart rate, systolic arterial pressure, or respiratory rate. Oxygen saturation was significantly lower in the i.v. group than the oral group 10 and 30 min after removal of the endoscope, and recovery time was longer in the oral than the i.v. group. Conclusions: Oral administration of midazolam is a safe and effective method of sedation that significantly reduces anxiety and improves overall tolerance for children undergoing esophagogastroduodenoscopy.

Keywords: children, endoscopy, midazolam, oral, sedation

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Authors: Saeed Zeinali, Nasser Talebbeydokhti, Mehdi Saeidian, Shahrad Vosough

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In this article, bathymetry changes have been studied as a case study for Larak Island, located in The South of Iran. The advanced 2D model of Mike21 has been used for this purpose. A simple procedure has been utilized in this model. First, the hydrodynamic (HD) module of Mike21 has been used to obtain the required output for sediment transport model (ST module). The ST module modeled the area for tidal currents only. Bed level changes are resulted by series of modeling for both HD and ST module in 3 months time step. The final bathymetry in each time step is used as the primary bathymetry for next time step. This consecutive procedure been continued until bathymetry for the year 2020 is obtained.

Keywords: bed level changes, Larak Island, hydrodynamic, sediment transport

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Authors: Jansirani Natarajan, Mickael Antoinne Joseph

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The COVID-19 pandemic has interrupted face-to-face education and forced universities into an emergency remote teaching curriculum over a short duration. This abrupt transition in the Spring 2020 semester left both faculty and students without proper preparation for continuing higher education in an online environment. Online learning took place in different formats, including fully synchronous, fully asynchronous, and blended in our university through the e-learning platform MOODLE. Studies have shown that students’ engagement, is a critical factor for optimal online teaching. Very few studies have assessed online engagement with ERT during the COVID-19 pandemic. Purpose: Therefore, this study, sought to understand how the sudden transition to emergency remote teaching impacted nursing students’ engagement with online courses in a Middle Eastern public university. Method: A cross-sectional descriptive research design was adopted in this study. Data were collected through a self-reported online survey using Dixon’s online students’ engagement questionnaire from a sample of 177 nursing students after the ERT learning semester. Results The maximum possible engagement score was 95, and the maximum scores in the domains of skills engagement, emotional engagement, participation engagement, and performance engagement were 30, 25, 30, and 10 respectively. Dixson (2010) noted that a mean item score of ≥3.5 (total score of ≥66.5) represents a highly engaged student. The majority of the participants were females (71.8%) and 84.2% were regular BSN students. Most of them (32.2%) were second-year students and 52% had a CGPA between 2 and 3. Most participants (56.5%) had low engagement scores with ERT learning during the COVID lockdown. Among the four engagement domains, 78% had low engagement scores for the participation domain. There was no significant association found between the engagement and the demographic characteristics of the participants. Conclusion The findings supported the importance of engaging students in all four categories skill, emotional, performance, and participation. Based on the results, training sessions were organized for faculty on various strategies for engaging nursing students in all domains by using the facilities available in the MOODLE (online e-learning platform). It added value as a dashboard of information regarding ERT for the administrators and nurse educators to introduce numerous active learning strategies to improve the quality of teaching and learning of nursing students in the University.

Keywords: engagement, perception, emergency remote learning, COVID-19

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Authors: Zahra Bakhtiari

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This article explores the development and evolution of the concept of environmental justice, which has shifted from being dominated by white and middle-class individuals to a civil struggle by marginalized communities against environmental injustices. Environmental justice aims to achieve equity in decision-making and policy-making related to the environment. The concept of justice in this context includes four fundamental aspects: distribution, procedure, recognition, and capabilities. Recent scholars have attempted to broaden the concept of justice to include dimensions of participation, recognition, and capabilities. Focusing on all four dimensions of environmental justice is crucial for effective planning and policy-making to address environmental issues. Ignoring any of these aspects can lead to the failure of efforts and the waste of resources.

Keywords: environmental justice, distribution, procedure, recognition, capabilities

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Authors: Walter M. Millanzi, Stephen M. Kibusi

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Background: Currently, there has been a progressive shortage not only to the number but also the quality of medical practitioners for the most of nursing. Despite that, those who are present exhibit unethical and illegal practices, under standard care and malpractices. The concern is raised in the ways they are prepared, or there might be something missing in nursing curricula or how it is delivered. There is a need for transforming or testing new teaching modalities to enhance competent health workforces. Objective: to investigate the Effect of Facilitation in a Problem-based Environment (FPBE) on metacognition, self-directed learning and learning motivation to undergraduate nurse student in Tanzanian higher learning institutions. Methods: quasi-experimental study (quantitative research approach). A purposive sampling technique was employed to select institutions and achieving a sample size of 401 participants (interventional = 134 and control = 267). Self-administered semi-structured questionnaire; was the main data collection methods and the Statistical Package for Service Solution (v. 20) software program was used for data entry, data analysis, and presentations. Results: The pre-post test results between groups indicated noticeably significant change on metacognition in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05). SDL in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05. Motivation to learn in an intervention (M = 62.67, SD = 14.14) and the control (n = 267, M = 57.75), t (399) = 2.907, p < 0.01). A FPBE teaching pedagogy, was observed to be effective on the metacognition (AOR = 1.603, p < 0.05), SDL (OR = 1.729, p < 0.05) and Intrinsic motivation in learning (AOR = 1.720, p < 0.05) against conventional teaching pedagogy. Needless, was less likely to enhance Extrinsic motivation (AOR = 0.676, p > 0.05) and Amotivation (AOR = 0.538, p > 0.05). Conclusion and recommendation: FPBE teaching pedagogy, can improve student’s metacognition, self-directed learning and intrinsic motivation to learn among nurse students. Nursing curricula developers should incorporate it to produce 21st century competent and qualified nurses.

Keywords: facilitation, metacognition, motivation, self-directed

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Authors: S. Suman, G. N. Singh

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The present manuscript addresses the estimation procedure of population parameter using Poisson probability distribution when characteristic under study possesses a rare sensitive attribute. The generalized form of unrelated randomized response model is suggested in order to acquire the truthful responses from respondents. The resultant estimators have been proposed for two situations when the information on an unrelated rare non-sensitive characteristic is known as well as unknown. The properties of the proposed estimators are derived, and the measure of confidentiality of respondent is also suggested for respondents. Empirical studies are carried out in the support of discussed theory.

Keywords: Poisson distribution, randomized response model, rare sensitive attribute, non-sensitive attribute

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Authors: Anand Ankush, Wani Mohammed Farooq

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A procedure based on digraph and matrix method is developed for modelling and evaluation of sustainability of Mechanical System in a concurrent engineering environment.The sustainability parameters of a Mechanical System are identified and are called sustainability attributes. Consideration of attributes and their interrelations is rudiment in modeling and evaluation of sustainability index. Sustainability attributes of a Mechanical System are modelled in termsof sustainability digraph. The graph is represented by a one-to-one matrix for sustainability expression which is based on sustainability attributes. A variable sustainability relationship permanent matrix is defined to develop sustainability expression(VPF-t) which is also useful in comparing two systems in a concurrent environment. The sustainability index of Mechanical System is obtained from permanent of matrix by substituting the numerical values of attributes and their interrelations. A higher value of index implies better sustainability of system.The ideal value of index is obtained from matrix expression which is useful in assessing relative sustainability of a Mechanical System in a concurrent engineering environment. The procedure is not only useful for evaluation of sustainability of a Mechanical System at conceptual design stage but can also be used for design and development of systems at system design stage. A step-by-step procedure for evaluation of sustainability index is also suggested and is illustrated by means of an example.

Keywords: digraph, matrix method, mechanical system, sustainability

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Authors: G. A. Kuanaliyeva, G. T. Aigarinova, G. K. Shulanbekova

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This article is devoted to judicial control in criminal legal proceedings of the Republic of Kazakhstan in the light of the new Concept of legal policy till 2020. In article the general characteristic and concept of judicial control, and also its signs and types are considered. Different views of scientists are analyzed. Foreign experiment on application of judicial control is given. The author states also the point sight on this problem and gives the definition to concept of judicial control. The code of criminal procedure of the Republic of Kazakhstan (RK Criminal Procedure Code) doesn't consolidate concept of judicial control. The author in article suggests making change and addition to the existing Code of criminal procedure of the Republic of Kazakhstan by definition of judicial control. The decree of the President of the Republic of Kazakhstan of August 24, 2009 No. 858 approved the Concept of legal policy of the Republic for the period from 2010 to 2020. The new Concept of legal policy of the Republic of Kazakhstan, defines prospects of development of national legal system of the country on the following decade. The concept of legal policy completely mentions also institute of judicial control. Since finding of the independence by Kazakhstan the set of laws, including the rights directed on providing, freedoms and a legitimate interest of citizens was accepted. Certainly, in any country, whatever democratic it was, there are problems to human rights. However, it is obvious that Kazakhstan strongly intends to guarantee all Republic of Kazakhstan proclaimed in the Constitution the rights and freedoms of the citizens. Our country seeks for creation of the constitutional state, tries to provide a guarantee from various arbitrariness in activity of competent government bodies, officials. In the concept of legal policy of the Republic of Kazakhstan it is specified: "...priority of development of the criminal procedure right there is a further consecutive realization of the fundamental principles of the criminal legal proceedings directed on protection of the rights and freedoms of the person". Judicial control just also is such guarantee.

Keywords: rights and freedoms of the person, concept, legal policy, court, judicial control

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Authors: C. Vázquez, L. M. Gigirey, C. P. del Oro, S. Seoane

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Early detection of visual problems plays a key role in the aging process. However, although vision problems are common among older people, the percentage of aging people who perform regular optometric exams is low. In fact, uncorrected refractive errors are one of the main causes of visual impairment in this group of the population. Purpose: To evaluate functional vision of older residents in order to show the urgent need of visual screening programs in Galician nursing homes. Methodology: We examined 364 older adults aged 65 years and over. To measure vision of the daily living, we tested distance and near presenting visual acuity (binocular visual acuity with habitual correction if warn, directional E-Snellen) Presenting near vision was tested at the usual working distance. We defined visual impairment (distance and near) as a presenting visual acuity less than 0.3. Exclusion criteria included immobilized residents unable to reach the USC Dual Sensory Loss Unit for visual screening. Association between categorical variables was performed using chi-square tests. We used Pearson and Spearman correlation tests and the variance analysis to determine differences between groups of interest. Results: 23,1% of participants have visual impairment for distance vision and 16,4% for near vision. The percentage of residents with far and near visual impairment reaches 8,2%. As expected, prevalence of visual impairment increases with age. No differences exist with regard to the level of functional vision between gender. Differences exist between age group respect to distance vision, but not in case of near vision. Conclusion: prevalence of visual impairment is high among the older people tested in this pilot study. This means a high percentage of older people with limitations in their daily life activities. It is necessary to develop an effective vision screening program for early detection of vision problems in Galician nursing homes.

Keywords: functional vision, elders, aging, nursing homes

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Authors: Anwar Jarndal

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In this paper, a genetic-neural-network (GNN) based large-signal model for GaN HEMTs is presented along with its parameters extraction procedure. The model is easy to construct and implement in CAD software and requires only DC and S-parameter measurements. An improved decomposition technique is used to model self-heating effect. Two GNN models are constructed to simulate isothermal drain current and power dissipation, respectively. The two model are then composed to simulate the drain current. The modeling procedure was applied to a packaged GaN-on-Si HEMT and the developed model is validated by comparing its large-signal simulation with measured data. A very good agreement between the simulation and measurement is obtained.

Keywords: GaN HEMT, computer-aided design and modeling, neural networks, genetic optimization

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Authors: M.R Asghari Bejestani, Gh. R. Mohammad Khani, V.R. Nafisi

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Imagined speech recognition is one of the most interesting approaches to BCI development and a lot of works have been done in this area. Many different experiments have been designed and hundreds of combinations of feature extraction methods and classifiers have been examined. Reported classification accuracies range from the chance level to more than 90%. Based on non-stationary nature of brain signals, we have introduced 3 classification modes according to time difference in inter and intra-class samples. The modes can explain the diversity of reported results and predict the range of expected classification accuracies from the brain signal accusation procedure. In this paper, a few samples are illustrated by inspecting results of some previous works.

Keywords: brain computer interface, silent talk, imagined speech, classification, signal processing

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Authors: Natália Bruno Chaves, Richardes Caúla, Roosevelt do Vale, Daniela Toneti, Rafaela Carvalho, Renata Silva Lopes, Antônio Carlos Júnior, Adner Nobre, Viviane Santiago, Yara Alana Caldato, Estefania Rodriguez Urrego, André Buarque Lemos, Catarina Nucci Stetner, Marcos Mauro Barreto, Stefany Moreira Lima, Mara Cavalcante, Ticiane Ribeiro

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The Well Born (Nascer Bem – in Portuguese) Program was created in the Hapvida health network with the aim of improving access to safe and quality prenatal care for users. In addition to offering a line of prenatal care, the inclusion of obstetric nursing and the decentralization of childbirth, bring security that professionals did not indicate the route of delivery for professional convenience. The introduction of the nursing consultation came to reinforce the care to our users, strengthening their bond and reception. In 2021, the program maintained an average of 40% of normal births in the north, northeast and central-west regions of Brazil, an average above that observed in the rest of the country's private health systems, around 20%. In addition, the neonatal hospitalization rate of this population remained around 5.1%, a figure below the national average. With these data, the “Nascer Bem” program is affirmed as a safe and effective strategy for the promotion of safe normal birth.

Keywords: quality, safe, prenatal, obstetric nursing

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Authors: Aurora Cerri, Niko Pollojani

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The Tirana – Elbasan Road project is the most important highway project in Albania, constructed in the period May 2011 - ongoing. This project included construction of 38 km highway category road including 2.6 km of tunnel. It serves as a corridor connecting the Tirana, Capital of Albania and South-East area, and in the near future it is expected to continue in the direction of Macedonian border. Environmental Impact Assesment procedure for this project is provided by the Albanian Environmental Law No. 10431. This law establishes the regulation of procedures for identifying, assessment and reporting on the effects of certain projects on the environment, and the associated administrative procedures, during the decision-making process by the Ministry of Environment and Tourism for issuing environmental permit, and ensures that all relevant information concerning the environment are provided and considered. Due to the nature and size of the project, during the environmental impact assessment process, the European Union legislation, namely the EIA Directive 85/337 / EEC is considered. Moreover, in some cases, due to the lack of national standards and practical guidelines, when necessary those of EU member countries are considered. This paper presents an analysis of the EIA procedure followed on ‘Tirana – Elbasan’ Road project, with a focus on the application of the main stages of the procedure such as: screening, scoping, review, the EIA report; and consideration of alternatives, measures for impact prevention and reduction, and the public hearing T/discussion.

Keywords: highway, environmental impact assesment, Tirana, prevention

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Authors: Hsin-Yi Lo, Huang-Ju Jiun, Yu-Chiao Chu

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Hemodynamic monitoring is an important in the intensive care unit. Advances in medical technology in recent years, more diversification of intensive care equipment, there are many kinds of instruments available for monitoring of hemodynamics, Edwards Lifesciences Hemodynamic Monitoring (FloTrac) is one of them. The recent medical safety incidents in parameters were changed, nurses have not to notify doctor in time, therefore, it is hoped to analyze the current problems and find effective improvement strategies. In August 2021, the survey found that only 74.0% of FloTrac correctness of operation, reasons include lack of education, the operation manual is difficulty read, lack of audit mechanism, nurse doesn't know those numerical changes need to notify doctor, work busy omission, unfamiliar with operation and have many nursing records then omissions. Improvement methods include planning professional nurse education, formulate the secret arts of FloTrac, enacting an audit mechanism, establish FloTrac action learning, make「follow the sun」care map, hold simulated training and establish monitoring data automatically upload nursing records. After improvement, FloTrac correctness of operation increased to 98.8%. The results are good, implement to the ICU of the hospital.

Keywords: hemodynamic monitoring, edwards lifesciences hemodynamic monitoring, multiple strategies, intensive care

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Authors: Li-Ting Kung, Hui-Zhu Chen, Hsin-Tzu Lee, Wan-Yin Hsu

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Patients with spinal cord injury combined with diabetic nephropathy may under a lot of painful conditions due to complications related to the illness itself or treatments, such as recurrent pressure ulcers, autonomic and peripheral neuropathy, as well as dialysis, for long term. This case report illustrated the nursing experience of transferring a spine cord injure patient who received hemodialysis due to adverse lifestyle-induced diabetic nephropathy to the hospice ward. Nursing care was provided in this patient from July 25th to August 30th, 2015. The tool of 'Gordon’s 11-item functional health assessment' and clinical observation, interviews as well as physical examination were used as data collections. Based on results of health assessment as above, the patient’s health problems were identified as the following: impaired skin integrity, chronic pain, and hopeless. Besides to relieve the symptom of pain due to disease or the treatment of hemodialysis and provide wound care, the first author also played a role to assist the patient to achieve his goal of receiving the hospice palliative care. Finally, with much effort of nurses to communicate with medical teams between the surgical and hospice wards, the patient was transferred to the hospice ward to have fulfilled his last wish of having a good death. We hope this nursing experience can be applied to other similar cases in the future.

Keywords: diabetic nephropathy, hospice care, palliative care, spinal cord injury

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Authors: Mohamed Hafid, Marcel Lacroix

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This study presents a simple inverse heat transfer procedure for predicting the wall erosion and the time-varying thickness of the protective bank that covers the inside surface of the refractory brick wall of a melting furnace. The direct problem is solved by using the Finite-Volume model. The melting/solidification process is modeled using the enthalpy method. The inverse procedure rests on the Levenberg-Marquardt method combined with the Broyden method. The effect of the location of the temperature sensors and of the measurement noise on the inverse predictions is investigated. Recommendations are made concerning the location of the temperature sensor.

Keywords: melting furnace, inverse heat transfer, enthalpy method, levenberg–marquardt method

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Authors: Samar Mousa, Galini Mavromatidou, Rebecca Shirley

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Surgeons carry out numerous operations in the busy burns and plastic surgery department daily. Writing an accurate operation note with all the essential information is crucial for communication not only within the plastics team but also to the multi-disciplinary team looking after the patient, including other specialties, nurses and GPs. The Royal college of surgeons of England, in its guidelines of good surgical practice, mentioned that the surgeon should ensure that there are clear (preferably typed) operative notes for every procedure. The notes should accompany the patient into recovery and to the ward and should give sufficient detail to enable continuity of care by another doctor. The notes should include the Date and time, Elective/emergency procedure, Names of the operating surgeon and assistant, Name of the theatre anesthetist, Operative procedure carried out, Incision, Operative diagnosis, Operative findings, Any problems/complications, Any extra procedure performed and the reason why it was performed, Details of tissue removed, added or altered, Identification of any prosthesis used, including the serial numbers of prostheses and other implanted materials, Details of closure technique, Anticipated blood loss, Antibiotic prophylaxis (where applicable), DVT prophylaxis (where applicable), Detailed postoperative care instructions and Signature. Fourteen random days were chosen in December 2021 to assess the accuracy of operative notes and post-operative care. A total of 163 operative notes were examined. The average completion rates in all domains were 85.4%. An electronic operative note template was designed to cover all domains mentioned in the Royal College of surgeons' good surgical practice. It is kept in the hospital drive for all surgeons to use.

Keywords: operative notes, plastic surgery, documentation, electronic

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Authors: Rida Ahmad, Areej S. Habib, Sohail A. Dogar, Saqib H. Qazi

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Transverse testicular ectopia is a rare congenital disorder involving mal descent and mal-positioning of the testes, reported in the medical literature about 300 times. Many theories attempt to explain the failure of the testes to migrate to their correct location. While the age at presentation can vary; most cases present in early adolescents or late adulthood. It is often an incidental discovery made during an operative intervention, most commonly during hernia exploration. It can be isolated or present with a plethora of anomalies. We present the case of a 2-year-old male with transverse testicular ectopia who presented with vague abdominal pain. He was managed successfully with the Modified Ombredanne procedure and good outcome 6 months after the procedure.

Keywords: cryptorchidism, persistent Mullerian duct syndrome, transverse testicular ectopia, testicular mal-descent

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Authors: Ebru Dural, M. Zulfu Asık

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Laminated glass is a kind of safety glass, which is made by 'sandwiching' two glass sheets and a polyvinyl butyral (PVB) interlayer in between them. When the glass is broken, the interlayer in between the glass sheets can stick them together. Because of this property, the hazards of sharp projectiles during natural and man-made disasters reduces. They can be widely applied in building, architecture, automotive, transport industries. Laminated glass can easily undergo large displacements even under their own weight. In order to explain their true behavior, they should be analyzed by using large deflection theory to represent nonlinear behavior. In this study, a nonlinear mathematical model is developed for the analysis of laminated glass cylindrical shell which is free in radial directions and restrained in axial directions. The results will be verified by using the results of the experiment, carried out on laminated glass cylindrical shells. The behavior of laminated composite cylindrical shell can be represented by five partial differential equations. Four of the five equations are used to represent axial displacements and radial displacements and the fifth one for the transverse deflection of the unit. Governing partial differential equations are derived by employing variational principles and minimum potential energy concept. Finite difference method is employed to solve the coupled differential equations. First, they are converted into a system of matrix equations and then iterative procedure is employed. Iterative procedure is necessary since equations are coupled. Problems occurred in getting convergent sequence generated by the employed procedure are overcome by employing variable underrelaxation factor. The procedure developed to solve the differential equations provides not only less storage but also less calculation time, which is a substantial advantage in computational mechanics problems.

Keywords: laminated glass, mathematical model, nonlinear behavior, PVB

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Authors: Nareemarn Neelapaichit, Sookfong Wongsathapat, Noppawan Piaseu

Abstract:

Body image plays an important role in adolescents. Thai adolescents put high concern on their body image result in unsatisfied their body shapes. Therefore, inappropriate weight management methods have been used. This study examined the body image perception and the nutritional status of Thai adolescents. Body mass index screening was done on 181 nursing students of Ramathibodi School of Nursing to categorized obesity, overweight, normal weight and underweight respondents by using recommended body-mass index (BMI) cut-off points for Asian populations. Self report questionnaire on demographics and body image perception were completed. Results showed that the respondents were mainly female (93.4%) and their mean age were 19.2 years. The prevalence of obesity, overweight, normal weight and underweight of the nursing students were 5.5%, 7.2%, 55.2% and 32.0%, respectively. Of all the respondents, 57.5% correctly perceived themselves, with 37.0% overestimating and 5.5% underestimating their weight status. Of those in the obesity category, 20.0% correctly perceived themselves and 80.0% perceived themselves as overweight. For overweight category, total respondents correctly perceived themselves. Fifty two percent of the normal weight respondents perceived themselves as overweight and 2.0% perceived themselves as obesity. Of the underweight respondents, 77.6% correctly perceived themselves and 20.7% perceived themselves as normal weight. These findings show high occurrence of body image misperception among Thai adolescents. Being concerned with this situation can promote adolescents for healthy weight and practice appropriate weight management methods.

Keywords: nutritional status, body image perception, Thai adolescents, body-mass index (BMI)

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Authors: Svetlana L. Mishlanova, Evgeniia V. Ermakova, Mariia E. Timirkina

Abstract:

The paper is concerned with the study of metaphor production in essays written by Russian and English native speakers in the framework of cognitive metaphor theory. It considers metaphorical competence as individual’s ability to recognize, understand and use metaphors in speech. The work analyzes the influence of visual metaphor on production and density of conventional and novel verbal metaphors. The main methods of research include experiment connected with image interpretation, metaphor identification procedure (MIPVU) and visual conventional metaphors identification procedure proposed by VisMet group. The research findings will be used in the project aimed at comparing metaphorical competence of native and non-native English speakers.

Keywords: metaphor, metaphorical competence, conventional, novel

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Authors: Bassem Saleh, Hussam Nusair, Nariman Al Zubadi, Shams Al Shloul, Usama Saleh

Abstract:

The nursing round system (NRS) means checking patients on an hourly basis during the A (0700–2200 h) shift and once every 2 h during the B (2200–0700 h) by the assigned nursing staff. The overall goal of this prospective study is to implement an NRS in a major rehabilitation centre—Sultan Bin Abdulaziz Humanitarian City—in the Riyadh area of the Kingdom of Saudi Arabia. The purposes of this study are to measure the effect of the NRS on: (i) the use of patient call light; (ii) the number of incidences of patients’ fall; (iii) the number of incidences of hospital-acquired bed sores; and (iv) the level of patients’ satisfaction. All patients hospitalized in the male stroke unit will be involved in this study. For the period of 8 weeks (17 December 2009–17 February 2010) All Nursing staff on the unit will record each call light and the patient’s need. Implementation of the NRS would start on 18 February 2010 and last for 8 weeks, until 18 April 2010. Data collected throughout this period will be compared with data collected during the 8 weeks period immediately preceding the implementation of the NRS (17 December 2009–17 February 2010) in order to measure the impact of the call light use. The following information were collected on all subjects involved in the study: (i) the Demographic Information Form; (ii) authors’ developed NRS Audit Form; (iii) Patient Call Light Audit Form; (iv) Patient Fall Audit Record; (v) Hospital-Acquired Bed Sores Audit Form; and (vi) hospital developed Patient Satisfaction Records. The findings suggested that a significant reduction on the use of call bell (P < 0.001), a significant reduction of fall incidence (P < 0.01) while pressure ulcer reduced by 50% before and after the implementation of NRS. In addition, the implementation of NRS increased patient satisfaction by 7/5 (P < 0.05).

Keywords: call light, patient-care management, patient safety, patient satisfaction, rounds

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Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

Abstract:

Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

Procedia PDF Downloads 267