Search results for: shift work nurses

Authors: Ali Alshahrani, Adel Almaai, Saad Garni

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Aim of the study: To explore duration and determinants of consultation time at a family medicine center. Methodology: This study was conducted at the Family Medicine Center in Ahad Rafidah City, at the southwestern part of Saudi Arabia. It was conducted on the working days of March 2013. Trained nurses helped in filling in the checklist. A total of 459 patients were included. A checklist was designed and used in this study. It included patient’s age, sex, diagnosis, type of visit, referral and its type, psychological problems and additional work-up. In addition, number of daily bookings, physician`s experience and consultation time. Results: More than half of patients (58.39%) had less than 10 minutes’ consultation (Mean+SD: 12.73+9.22 minutes). Patients treated by physicians with shortest experience (i.e., ≤5 years) had the longest consultation time while those who were treated with physicians with the longest experience (i.e., > 10 years) had the shortest consultation time (13.94±10.99 versus 10.79±7.28, p=0.011). Regarding patients’ diagnosis, those with chronic diseases had the longest consultation time (p<0.001). Patients who did not need referral had significantly shorter consultation time compared with those who had routine or urgent referral (11.91±8.42,14.60±9.03 and 22.42±14.81 minutes, respectively, p<0.001). Patients with associated psychological problems needed significantly longer consultation time than those without associated psychological problems (20.06±13.32 versus 12.45±8.93, p<0.001). Conclusions: The average length of consultation time at Ahad Rafidah Family Medicine Center is approximately 13 minutes. Less-experienced physicians tend to spend longer consultation times with patients. Referred patients, those with psychological problems, those with chronic diseases tend to have longer consultation time. Recommendations: Family physicians should be encouraged to keep their optimal consultation time. Booking an adequate number of patients per shift would allow the family physician to provide enough consultation time for each patient.

Keywords: consultation, quality, medicine, clinics

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Authors: Angelika Magiera, Weronika Penar, Czesław Klocek

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Intellectual disability (ID) affects approximately 1.55% of children and adults in the society of developed countries. Depending on the ID degree, the patient is burdened with additional disease entities. Intellectual disability does not only limits a person’s opportunities to participate in social life but also affects whole families. People with ID belong to the group of risk of mental illnesses, they are less emotionally stable, while families are predisposed to depression. The study was held in a day care center for people with intellectual disabilities (of various degrees of disability) on 26 people. Nurses and carers also took part. The age range of study groups ranged from 22 to 67 years. Therapeutic classes were held for four independent mixed groups (sex and intellectual disability degree) from 6 to 7 people each, lasting no more than 30 minutes. They were created by the facility's staff to make sure that a group is stable. The animal assisted activity took place with a 2.5-year-old Ragdoll cat. The animal has passed the exam (certificate entitling her to take part in felinotherapy) and had 1.5 years of work experience. Due to the different degrees of ID, an individual emotional state survey was conducted among the caregivers of those who were involved in the activity, to assess the impact of animal assisted activity with a cat on patients. A positive effect on the emotional state of people with different types of intellectual disability was observed. Caregivers and nurses of those participating in the study express willingness to continue these types of classes and consider them necessary for this group of people.

Keywords: intellectual disabilities, animal-assisted activity, cat, feline, emotions

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Authors: Salwa Obeisat

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Obesity had become a global issue and a major public health concern, because of its impact on the public health. Obstetric and midwifery evidences reported that maternal obesity an important issue, because of its associated complications like obstructed labors, infections, and hemorrhage. People who are obese are often stigmatized and blamed for their weight. Health care providers are not immune to obesity-related prejudice, and the literature features several examples of their negative attitudes towards obese patients. In Jordan, few studies were conducted to investigate obesity prevalence rate and its associated factors. The purposes of this study were to assess the health care providers' attitudes toward overweight and obese women during the childbirth in the North of Jordan and to investigate the relationships between health care providers' socio-demographic characteristics and their attitudes. A descriptive, cross-sectional design was utilized. A convenient sample was consisted of 95 midwives, 30 nurses and 62 obstetricians, who were working in the labor rooms. A self-administered questionnaire consisted of three sections: demographical data, Arabic version of Fat Phobia Scale (FPS), and Arabic version of Nurses' Attitudes toward Obesity and Obese Patients Scale (NATOOPS). Results: The study findings revealed that the majority of Jordanian health care providers held negative attitudes toward overweight and obese women during childbirth. Midwives held less negative attitudes than did obstetricians and nurses. The majority of participants were perceived the overweight and obese pregnant women during childbirth as overate people, shapeless, slow and unattractive. Age, specialty, education and years of experience were found to be associated with health care providers’ attitudes. The Conclusion: Health care providers negative attitudes toward overweight and obese pregnant women are a cause for concern. Therefore, maternal obesity was needed to be more adequately addressed in basic education courses, and in the continuing professional education classes of practicing health care providers.

Keywords: attitudes, obesity, prevalence rate, nurses, midwives, obstetrician, childbirth

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Authors: Jihad S. Daba, J. P. Dubois

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Understanding the statistics of non-isotropic scattering multipath channels that fade randomly with respect to time, frequency, and space in a mobile environment is very crucial for the accurate detection of received signals in wireless and cellular communication systems. In this paper, we derive stochastic models for the probability density function (PDF) of the shift in the carrier frequency caused by the Doppler Effect on the received illuminating signal in the presence of a dominant line of sight. Our derivation is based on a generalized Clarke’s and a two-wave partially developed scattering models, where the statistical distribution of the frequency shift is shown to be consistent with the power spectral density of the Doppler shifted signal.

Keywords: Doppler shift, filtered Poisson process, generalized Clark’s model, non-isotropic scattering, partially developed scattering, Rician distribution

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Authors: Merav Ben Natan, Heba Igbarin, Arwa Watted

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Introduction: The rising prevalence of autism spectrum disorders (ASD) has heightened the need to understand the challenges faced by children with ASD and their families in emergency departments (EDs). Children with ASD often experience additional health issues and heightened anxiety in the chaotic ED environment, which can impact their care and parental satisfaction. Purpose: This study aimed to examine factors identified by mothers as affecting their satisfaction with the care provided to their children in the ED, among mothers of children with ASD in comparison to mothers of children without ASD. Design and methods: In this correlational quantitative study, 128 Israeli mothers – 59 (46%) mothers of children with ASD and 69 (54%) of children without ASD - completed an online survey based on a Ministry of Health national survey of patient experience. Results: Mothers of children with ASD expressed lower satisfaction with the care provided. The difference was particularly evident concerning waiting times for examination of the child by nurses and physicians in the ED, whether the nurses were attentive and responsive to the mother's questions and concerns, whether the ED staff demonstrated coordination and cooperation with regard to medical care of the child, and whether work in the ED was conducted in an orderly and organized manner. The presence of communication difficulties in children predicted mothers' satisfaction with care. Conclusions: These findings suggest that certain needs of mothers and/or their children with ASD do not receive an appropriate response in the ED. Practice implications: It is important to raise the awareness of healthcare providers in EDs regarding the needs of children with ASD and their parents, especially children with communication difficulties. Strategies should be implemented to improve the experience of children with ASD and their parents in the ED.

Keywords: autism spectrum disorder, emergency department, parental satisfaction, healthcare challenges

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Authors: Afsheen Kashifa, Muhammad Saad Khan

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The present study examines the linguistic use of English as a permanent part of the regional languages of Pakistan. This research has delimited its investigation to the language used by the students of English language who speak different regional languages. It deals with the attitudes, causes, and effects of the language shift from regional and minority languages to English. It further gets insights from the feedback provided by the students as respondents that English is replacing the minority languages for being the language of prestige, convenience, and rich vocabulary. These concepts have been achieved through the use of questionnaires and semi-structured interviews. The findings of this research exhibit that the respondents speak English because of its vocabulary and easy way of communication; therefore, they enjoy a high place in society. This research also shows that the speakers of the regional languages are encouraged by their parents to speak English. Eventually, the words and expressions of English, the dominant language, have become a permanent part of the minority languages. Therefore, the minority languages are becoming endangered languages.

Keywords: language shift, language accommodation, language attrition, effects on minority languages

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Authors: Ho Jeong Jin, Chang Won Seo, Choon Sik Cho, Bong Yong Choi, Kwang Kyun Na, Sang Rok Lee

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In this paper, a radar signal processing technique using the LFM-FSK (Linear Frequency Modulation-Frequency Shift Keying) is proposed for reducing the false alarm rate based on the compressive sensing. The LFM-FSK method combines FMCW (Frequency Modulation Continuous Wave) signal with FSK (Frequency Shift Keying). This shows an advantage which can suppress the ghost phenomenon without the complicated CFAR (Constant False Alarm Rate) algorithm. Moreover, the parametric sparse algorithm applying the compressive sensing that restores signals efficiently with respect to the incomplete data samples is also integrated, leading to reducing the burden of ADC in the receiver of radars. 24 GHz FMCW signal is applied and tested in the real environment with FSK modulated data for verifying the proposed algorithm along with the compressive sensing.

Keywords: compressive sensing, LFM-FSK radar, radar signal processing, sparse algorithm

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Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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Authors: Kang-Gyu Park, Sun-Jong Park, Hong Jae Yim, Hyo-Gyung Kwak

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This paper attempts to evaluate the effect of fire damage on concrete by using nonlinear resonance vibration method, one of the nonlinear nondestructive method. Concrete exhibits not only nonlinear stress-strain relation but also hysteresis and discrete memory effect which are contained in consolidated materials. Hysteretic materials typically show the linear resonance frequency shift. Also, the shift of resonance frequency is changed according to the degree of micro damage. The degree of the shift can be obtained through nonlinear resonance vibration method. Five exposure scenarios were considered in order to make different internal micro damage. Also, the effect of post-fire-curing on fire-damaged concrete was taken into account to conform the change in internal damage. Hysteretic non linearity parameter was obtained by amplitude-dependent resonance frequency shift after specific curing periods. In addition, splitting tensile strength was measured on each sample to characterize the variation of residual strength. Then, a correlation between the hysteretic non linearity parameter and residual strength was proposed from each test result.

Keywords: nonlinear resonance vibration method, non linearity parameter, splitting tensile strength, micro damage, post-fire-curing, fire damaged concrete

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Authors: Mondher Labidi, Fethi Choubani

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In this paper, novel miniaturization technique of antenna is proposed using I-slot. Using this technique, gain of antenna can increased for 4dB (antenna only) to 6.6dB for the proposed I-slot antenna and a frequency shift of about 0.45 GHz to 1 GHz is obtained. Also a reduction of the shape size of the antenna is achieved (about 38 %) to operate in the Wi-Fi (2.45 GHz) band.RF Moreover the frequency shift can be controlled by changing the place or the length of the I-slot. Finally the proposed miniature antenna with an improved radiation efficiency and gain was built and tested.

Keywords: slot antenna, miniaturization, RF, electrical equivalent circuit (EEC)

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Authors: Bhairi Lakshminarayana, Surajit Sarker, Ch. Subrahmanyam

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The present study reports the development of noble metal free nano catalysts for low-temperature CO oxidation and water gas shift reaction. Mn-substituted CeO2 solid solution catalysts were synthesized by co-precipitation, combustion and hydrothermal methods. The formation of solid solution was confirmed by XRD with Rietveld refinement and the percentage of carbon and nitrogen doping was ensured by CHNS analyzer. Raman spectroscopic confirmed the oxygen vacancies. The surface area, pore volume and pore size distribution confirmed by N2 physisorption analysis, whereas, UV-visible diffuse reflectance spectroscopy and XPS data confirmed the oxidation state of the Mn ion. The particle size and morphology (spherical shape) of the material was confirmed using FESEM and HRTEM analysis. Ce0.8Mn0.2O2-δ was calcined at 400 °C, 600 °C and 800 °C. Raman spectroscopy confirmed that the catalyst calcined at 400 °C has the best redox properties. The activity of the designed catalysts for CO oxidation (0.2 vol%), carried out with GHSV of 21,000 h-1 and it has been observed that co-precipitation favored the best active catalyst towards CO oxidation and water gas shift reaction, due to the high surface area, improved reducibility, oxygen mobility and highest quantity of surface oxygen species. The activation energy of low temperature CO oxidation on Ce0.8Mn0.2O2- δ (combustion) was 5.5 kcal.K-1.mole-1. The designed catalysts were tested for water gas shift reaction. The present study demonstrates that Mn ion substituted ceria at 400 °C calcination temperature prepared by co-precipitation method promise to revive a green sustainable energy production approach.

Keywords: Ce0.8Mn0.2O2-ð, CO oxidation, physicochemical characterization, water gas shift reaction (WGS)

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Authors: Win-Jin Chang, Haw-Long Lee, Yu-Ching Yang

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Atomic finite element simulation is applied to investigate the vibration frequency of a single-layer gamma graphyne with an attached mass for the CCCC, SSSS, CFCF, SFSF boundary conditions using the commercial code ANSYS. The fundamental frequencies of the graphyne sheet are compared with the results of the previous study. The results of the comparison are very good in all considered cases. The attached mass causes a shift in the resonant frequency of the graphyne. The frequencies of the single-layer gamma graphyne with an attached mass for different boundary conditions are obtained, and the order based on the boundary condition is CCCC >SSSS > CFCF> SFSF. The highest frequency shift is obtained when the attached mass is located at the center of the graphyne sheet. This is useful for the design of a highly sensitive graphyne-based mass sensor.

Keywords: graphyne, finite element analysis, vibration analysis, frequency shift

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Authors: Edo Shonin, William Van Gordon, Mark D. Griffiths

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Due to its potential to concurrently improve Work-Related Wellbeing (WRW) and job performance; occupational stakeholders are becoming increasingly interested in meditation. Despite this, there is a scarcity of methodologically robust research examining the utility of meditation within occupational contexts. This study conducted the first randomized controlled trial to assess the effects of meditation on outcomes relating to both WRW and job performance. Office-based middle-hierarchy managers (n=152) were allocated to either an eight-week meditation intervention (Meditation Awareness Training: MAT) or an active control intervention. MAT participants demonstrated significant improvements (with strong effect-sizes) over control-group participants in levels of work-related stress, job satisfaction, psychological distress, and employer-rated job performance. It is concluded that MAT appears to be effective for improving both WRW and job performance in middle-hierarchy managers. There are a number of novel implications: (i) meditation can effectuate a perceptual shift in how employees experience their work and psychological environment and may thus constitute a cost-effective WRW intervention, (ii) meditation-based (i.e., present-moment-focused) working styles may be more effective than goal-based (i.e., future-orientated) working styles, and (iii) meditation may reduce the separation made by employees between their own interests and those of the organizations they work for.

Keywords: work-related stress, workplace wellbeing, occupational stress, job performance, meditation awareness training, mindfulness

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Authors: Linneth Nkateko Mabila, Patrick Hulisani Demana, Tebogo Maria Mothiba

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Background: Sustaining adherence to antiretroviral therapy (ART) over the long term by people, especially children living with Human-Immunodeficiency Virus (HIV), requires accurate and consistent monitoring, and this is a particular challenge for countries in sub-Saharan Africa. However, the regularity and punctuality in monthly antiretroviral treatment collections indicate medication adherence to a certain extent since it has been revealed to be a significant determinant of the outcome of ART. Aim: This study assessed and described the pattern of monthly antiretroviral treatment collections among a cohort of virally unsuppressed HIV-positive children initiated and managed on ART in the rural public clinics of Mopani District, Limpopo, and explored the nurses' perceptions and views of the findings. Methods: A facility-based mixed-methods study was conducted to assess the honoring of scheduled monthly treatment collection practices by a cohort of HIV-positive children under 15 years initiated and managed on ART by Nurse Initiated Management of Antiretroviral Treatment (NIMART)-trained professional nurses (PNs) from 01 January 2015 to 31 December 2015 in public PHC clinics of Mopani District Municipality. This was followed by the exploration of the nurses' perceptions and views regarding this issue to share their experiences and knowledge acquired through managing these children on ART. Results: From a total of 7105 analysable visits, only 44% (3134) were honored as scheduled, with 40% (2828) of children presenting to the clinics after the scheduled appointment date – they missed their appointments, and 11% (768) of treatment collections that took place before the scheduled appointment date. This finding was further confirmed by 90% (97) of the nurses, who reported that they have children who miss scheduled appointments in their public clinics. The primary reasons for children missing appointments were related to caregivers' forgetfulness and conflict between the school schedule and the dates of clinic visits. Conclusion: We confirmed a high prevalence of non-adherence to scheduled monthly ART collections and the existence of health system, social, and caregiver-related factors that threaten treatment adherence and proper clinical outcomes. These findings suggest an urgent need for intervention since non-adherence to ARV therapy can be life-threatening to the child and poses the danger of reduced life expectancy.

Keywords: antiretroviral therapy (art), nimart, virally unsuppressed children, missed appointments

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Authors: J. Dutton, L. Knight

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Achieving quality and respectful maternal health care is part of the global agenda to improve reproductive health and achieve universal reproductive rights. Barriers to quality of care in South African maternal health facilities exist at both systemic and individual levels. Addition to this, the normalization of gender violence within South Africa has a large impact on people seeking health care as well as those who provide care within health facilities. The hierarchical environment of South Africa’s public health system penalizes both patients and providers who battle to assume any assessable power. This paper explores how systemic and individual level barriers to quality of care affect the midwifery profession within South African maternal health services and create, at times, an environment of enmity rather than care. This paper analyzes and discusses the data collected from in-depth, semi-structured interviews with nurses and midwives at three maternal health facilities in South Africa. This study has taken a holistic approach to understand the realities of nurses and midwives in order to explore the ways in which experience informs their practice and treatment of pregnant women. Through collecting and analyzing narratives, linkages between nurses and midwives day-to-day and historical experiences and disrespectful care have been made. Findings from this study show that barriers to quality of care take form in complex and interrelated ways. The physical structure of the health facility, human resource shortages, and the current model of maternal health care, which often lacks a person-centered approach, is entangled within personal beliefs and attitudes of what it means to be a midwife to create an environment that is often not conducive to a positive birthing experience. This entanglement sits within a society of high rates of violence, inequality, and poverty. Having teased out the nuances of each of these barriers and the multiple ways they reinforce each other, the findings of this paper demonstrate that birth, and the work of a midwife, are situated in a mode of discipline and punishment within this context. For analytical purposes, this paper has broken down the individual barriers to quality care and discusses the current and historical significance before returning to the interrelated forms in which barriers to quality maternal health care manifest. In conclusion this paper questions the role of agency in the ability to subvert systemic barriers to quality care and ideas around shifting attitudes and beliefs of and about midwives. International and local policies and guidelines have a role to play in realizing such shifts, however, as this paper suggests, when policy does not speak to the local context there is the risk of it contributing to frustrations and impeding the path to quality and respectful maternal health care.

Keywords: disrespect and abuse in childbirth, midwifery, South African maternal health care, quality of care

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Authors: Arsalan Ghaderi

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Introduction: Inactivity is one of the most important risk factors for cardiovascular disease. According to the study prevalence of inactivity in Iran, about 67.5% and in the staff, and especially nurses, are similar. The inflammatory index (HS-CRP) is highly predictive of the progression of these diseases. Physical activity education is very important in preventing these diseases. One of the modern educational methods is web-based theory-based education. Methods: This is a semi-experimental interventional study which was conducted in Isfahan and Kurdistan universities of medical sciences in two stages. A cross-sectional study was done to determine the status of physical activity and its predictive factors. Then, intervention was performed, and six months later the data were retrieved. The data was collected using a demographic questionnaire, an integrative model of behavior prediction constructs, a standard physical activity questionnaire and (HS-CRP) test. Data were analyzed by SPSS software. Results: Physical activity was low in 66.6% of nurses, 25.4% were moderate and 8% severe. According to Pearson correlation matrix, the highest correlation was found between behavioral intention and skill structures (0.553**), subjective norms (0.222**) and self-efficacy (0.198**). The relationship between age and physical activity in the first study was reverse and significant. After intervention, there was a significant change in attitudes, self-efficacy, skill and behavioral intention in the intervention group. This change was significant in attitudes, self-efficacy and environmental conditions of the control group. HS-CRP index decreased significantly after intervention in both groups, but there was not a significant relationship between inflammatory index and physical activity score. The change in physical activity level was significant only in the control group. Conclusion: Despite the effect of educational intervention on attitude, self-efficacy, skill, and behavioral intention, the results showed that if factors such as environmental factors are not corrected, training and changing structures cannot lead to physical activity behavior. On the other hand, no correlation between physical activity and HS-CRP showed that this index can be influenced by other factors, and this should be considered in any intervention to reduce the HS-CRP index.

Keywords: HS-CRP, integrative model of behavior prediction, physical activity, nurses, web-based education

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Authors: Jeong-Won Kang

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Graphene, a single-atom sheet, has been considered as the most promising material for making future nanoelectromechanical systems as well as purely electrical switching with graphene transistors. Graphene-based devices have advantages in scaled-up device fabrication due to the recent progress in large area graphene growth and lithographic patterning of graphene nanostructures. Here we investigated its mechanical responses of circular graphene nanoflake under the nanoindentation using classical molecular dynamics simulations. A correlation between the load and the indentation depth was constructed. The nanoindented force in this work was applied to the center point of the circular graphene nanoflake and then, the resonance frequency could be tuned by a nanoindented depth. We found the hardening or the softening of the graphene nanoflake during its nanoindented-deflections, and such properties were recognized by the shift of the resonance frequency. The calculated mechanical parameters in the force vs deflection plot were in good agreement with previous experimental and theoretical works. This proposed schematics can detect the pressure via the deflection change or/and the resonance frequency shift, and also have great potential for versatile applications in nanoelectromechanical systems.

Keywords: graphene, pressure sensor, circular graphene nanoflake, molecular dynamics

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Authors: Fatima Zehra Allahverdi, Nukhet Bayer

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Objective: Three questions were formulated to examine stressful working units (intensive care units, emergency unit nurses) utilizing the self-perception theory and social support theory. This study provides a distinctive input by inspecting the combination of variables regarding stressful working environments. Method: The descriptive research was conducted with the participation of 400 nurses working at Ankara City Hospital. The study used Multivariate Analysis of Variance (MANOVA), regression analysis, and a mediation model. Hypothesis one used MANOVA followed by a Scheffe post hoc test. Hypothesis two utilized regression analysis using a hierarchical linear regression model. Hypothesis three used a mediation model. Result: The study utilized mediation analyses. Findings supported the hypotheses that intensive care units have significantly high scores in virtual communication and virtual tolerance. The number of years on the job, virtual communication, virtual tolerance, and phubbing significantly predicted 51% of the variance of perception of addiction. Interestingly, the number of years on the job, while significant, was negatively related to perception of addiction. Conclusion: The reasoning behind these findings and the lack of significance in the emergency unit is discussed. Around 7% of the variance of phubbing was accounted for through working in intensive care units. The model accounted for 26.80 % of the differences in the perception of addiction.

Keywords: phubbing, social media, working units, years on the job, stress

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Authors: Yiu K. C. Jacky, Tang S. K. Eric, W. Y. Tsang, C. Y. Li, C. K. Leung

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Objectives : (1) To enhance the competence of nurses on using IPMOE for drug administration; (2) To ensure the transition on implementation of IPMOE in safer and smooth way hospital-wide. Methodology: (1) Well-structured Governance: To make provision for IPMOE implementation, multidisciplinary governance structure at Corporate and Local levels are well established. (2) Staff Engagement: A series of staff engagement events were conducted including Staff Forum, IPMOE Hospital Visit, Kick-off Ceremony and establishment of IPMOE Webpage for familiarizing the forthcoming implementation with frontline staff. (3) Well-organized training program: from Workshop to Workplace Two different IPMOE training programs were tailor-made which aimed at introducing the core features of administration module. Fifty-five identical training classes and six train-the-trainer workshops were organized at 2-3Q 2015. Lending Scheme on IPMOE hardware for hands-on practicing was launched and further extended the training from workshop to workplace. (4) Standard Guidelines and Workflow: the related workflow and guidelines are developed which facilitates users to acquire the competence towards IPMOE and fully familiarize with the standardized contingency plan. (5) Facilities and Equipment: The installations of IPMOE hardware were promptly arranged for rollout. Besides, IPMOE training venue was well-established for staff training. (6) Risk Management Strategy: UCH Medication Safety Forum is organized in December 2015 for sharing “Tricks & Tips” on IPMOE which further disseminate at webpage for arousal of medication safety. Hospital-wide annual audit on drug administration was planned to figure out the compliance and deliberate the rooms for improvement. Results: Through the comprehensive training plan, over 1,000 UCH nurses attended the training program with positive feedback. They agreed that their competence on using IPMOE was enhanced. By the end of November 2015, 28 wards (over 1,000 Inpatient-bed) involving departments of M&G, SUR, O&T and O&G have been successfully rolled out IPMOE in 5-month. A smooth and safe transition of implementation of IPMOE was achieved. Eventually, we all get prepared for embedding IPMOE into daily nursing and work altogether for medication safety at UCH.

Keywords: drug administration, inpatient medication order entry system, medication safety, nursing informatics

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Authors: Zülfiye Bıkmaz, Aytolan Yıldırım

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This study was planned as a descriptive regressive study in order to determine the relationship between the competency levels of working nurses, the levels of competency expected by nursing students, the critical thinking disposition of nurses, their perceived autonomy levels, and certain socio demographic characteristics. It is also a methodological study with regard to the intercultural adaptation of the Nursing Competence Scale (NCS) in both working and student samples. The sample of the study group of nurses at a university hospital for at least 6 months working properly and consists of 443 people filled out questionnaires. The student group, consisting of 543 individuals from the 4 public university nursing 3rd and 4th grade students. Data collection tools consisted of a questionnaire prepared in order to define the socio demographic, economic, and personal characteristics of the participants, the ‘Nursing Competency Scale’, the ‘Autonomy Subscale of the Sociotropy – Autonomy Scale’, and the ‘California Critical Thinking Disposition Inventory’. In data evaluation, descriptive statistics, nonparametric tests, Rasch analysis and correlation and regression tests were used. The language validity of the ‘NCS’ was performed by translation and back translation, and the context validity of the scale was performed with expert views. The scale, which was formed into its final structure, was applied in a pilot application from a group consisting of graduate and student nurses. The time constancy of the test was obtained by analysis testing retesting method. In order to reduce the time problems with the two half reliability method was used. The Cronbach Alfa coefficient of the scale was found to be 0.980 for the nurse group and 0.986 for the student group. Statistically meaningful relationships between competence and critical thinking and variables such as age, gender, marital status, family structure, having had critical thinking training, education level, class of the students, service worked in, employment style and position, and employment duration were found. Statistically meaningful relationships between autonomy and certain variables of the student group such as year, employment status, decision making style regarding self, total duration of employment, employment style, and education status were found. As a result, it was determined that the NCS which was adapted interculturally was a valid and reliable measurement tool and was found to be associated with autonomy and critical thinking.

Keywords: nurse, nursing student, competence, autonomy, critical thinking, Rasch analysis

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Authors: Fumin Wang, Jiaqi Yin, Lajun Wang, Nan Chi

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In this article, we demonstrate a visible light communication (VLC) system over 8 meters free space transmission based on a commercial LED and a receiver in connection with an audio interface of a smart phone. The signal is in FSK modulation format. The successful experimental demonstration validates the feasibility of the proposed system in future wireless communication network.

Keywords: visible light communication, smartphone communication, frequency shift keying, wireless communication

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Authors: K. C. Wong, K. L. Siu, S. N. Ng, K. N. Yip, Y. Y. Yuen, K. W. Lee, K. W. Wong, C. C. Li, H. P. Lam

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Background: Occupational injuries among nursing profession were found related to repeated bedside nursing care, such as transfer, lifting and manual handling patients from previous studies. Likewise, undergraduate nursing students are also exposed to potential safety hazard due to their similar work nature of registered nurses. Especially, those students who worked as Temporary undergraduate nursing students (TUNS) which is a part-time clinical job in hospitals in Hong Kong who mainly assisted in providing bedside cares appeared to at high risk of work-related injuries. Several studies suggested the level of compliance with safe work behaviors was highly associated with work-related injuries. Yet, it had been limitedly studied among nursing students. This study was conducted to assess and compare the compliance with safe work behaviors and the levels of awareness of different workplace safety issues between undergraduate nursing students with or without TUNS experiences. Methods: This is a quantitative descriptive study using convenience sampling. 362 undergraduate nursing students in Hong Kong were recruited. The Safe Work Behavior relating to Patient Handling (SWB-PH) was used to assess their compliance of safe-work behaviors and the level of awareness of different workplace safety issues. Results: The results showed that most of the participants (n=250, 69.1%) who were working as TUNS. However, students who worked as TUNS had significantly lower safe-work behaviors compliance (mean SWB-PH score = 3.64±0.54) than those did not worked as TUNS (SWB-PH score=4.21±0.54) (p<0.001). Particularly, these students had higher awareness to seek help and use assistive devices but lower awareness of workplace safety issues and awareness of proper work posture than students without TUNS experiences. The students with TUNS experiences had higher engagement in help-seeking behaviors might be possibly explained by their richer clinical experiences which served as a facilitator to seek help from clinical staff whenever necessary. Besides, these experienced students were more likely to bear risks for occupational injuries and worked alone when no available aid which might be related to the busy working environment, heightened work pressures and high expectations of TUNS. Eventually, students who worked as TUNS might target on completing the assigned tasks and gradually neglecting the occupational safety. Conclusion: The findings contributed to an understanding of the level of compliance with safe work behaviors among nursing students with different clinical experiences. The results might guide the modification of current safety protocols and the introduction of multiple clinical training courses to improve nursing student’s engagement in safe work behaviors.

Keywords: Occupational safety, Safety compliance, Safe-work behavior, Nursing students

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Authors: Chariya Laohavich

Abstract:

Background: Some limitations and complications have been found associated with commercial mouthpiece in bronchoscopic procedure. Therefore, we invented the Rama-chest mouthpiece from plastic normal saline bottle. Objective: The aim of this study was to compare user satisfaction in Rama-chest mouthpiece with the commercial mouthpiece. Methods: A prospective randomized controlled trial between commercial mouthpiece and Rama-chest mouthpiece was conducted on patients who were underwent bronchoscopy and required mouthpiece insertion from May to June 2014. The questionnaire about satisfaction was completed by the bronchoscopists, assistant nurses, and patients. Results: Thirty procedures in both groups were investigated. Mean satisfaction scores filled by the bronchoscopists and assistant nurses were not different between both groups. However, higher satisfaction score filled by the patients was found in Rama-chest mouthpiece than the comparator (p=0.011). Complications such as abrasion, pain, and itching were observed in commercial mouthpiece but not found in Rama-chest mouthpiece. Conclusion: We have introduced Rama-chest mouthpiece and proved its usefulness comparable to the commercial mouthpiece.

Keywords: mouthpiece, bronchoscopist, bronchology, pulmonology and respiratory diseases

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Authors: Sarah Alamolhoda, Kevin J. Smith, Xiaotao Bi, Naoko Ellis

Abstract:

For millennials, biomass has been the most important source of fuel used to produce energy. Energy derived from biomass is renewable by re-growth of biomass. Various technologies are used to convert biomass to potential renewable products including combustion, gasification, pyrolysis and fermentation. Gasification is the incomplete combustion of biomass in a controlled environment that results in valuable products such as syngas, biooil and biochar. Syngas is a combustible gas consisting of hydrogen (H₂), carbon monoxide (CO), carbon dioxide (CO₂), and traces of methane (CH₄) and nitrogen (N₂). Cleaned syngas can be used as a turbine fuel to generate electricity, raw material for hydrogen and synthetic natural gas production, or as the anode gas of solid oxide fuel cells. In this work, syngas as a product of woody biomass gasification in British Columbia, Canada, was introduced to two consecutive fixed bed reactors to perform a catalytic water gas shift reaction followed by a catalytic methanation reaction. The water gas shift reaction is a well-established industrial process and used to increase the hydrogen content of the syngas before the methanation process. Catalysts were used in the process since both reactions are reversible exothermic, and thermodynamically preferred at lower temperatures while kinetically favored at elevated temperatures. The water gas shift reactor and the methanation reactor were packed with Cu-based catalyst and Ni-based catalyst, respectively. Simulated syngas with different percentages of CO, H₂, CH₄, and CO₂ were fed to the reactors to investigate the effect of operating conditions in the unit. The water gas shift reaction experiments were done in the temperature of 150 ˚C to 200 ˚C, and the pressure of 550 kPa to 830 kPa. Similarly, methanation experiments were run in the temperature of 300 ˚C to 400 ˚C, and the pressure of 2340 kPa to 3450 kPa. The Methanation reaction reached 98% of CO conversion at 340 ˚C and 3450 kPa, in which more than half of CO was converted to CH₄. Increasing the reaction temperature caused reduction in the CO conversion and increase in the CH₄ selectivity. The process was designed to be renewable and release low greenhouse gas emissions. Syngas is a clean burning fuel, however by going through water gas shift reaction, toxic CO was removed, and hydrogen as a green fuel was produced. Moreover, in the methanation process, the syngas energy was transformed to a fuel with higher energy density (per volume) leading to reduction in the amount of required fuel that flows through the equipment and improvement in the process efficiency. Natural gas is about 3.5 times more efficient (energy/ volume) than hydrogen and easier to store and transport. When modification of existing infrastructure is not practical, the partial conversion of renewable hydrogen to natural gas (with up to 15% hydrogen content), the efficiency would be preserved while greenhouse gas emission footprint is eliminated.

Keywords: renewable natural gas, methane, hydrogen, gasification, syngas, catalysis, fuel

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Authors: Helga Martins, Idália Matias

Abstract:

Background: Dementia is an important research topic since that life expectancy worldwide is increasing, so people are getting older. The aging of populations has a major impact on the increase in dementia, and nurses play a major role in taking care of these patients. Therefore, the implementation of nursing interventions based on evidence is vital so that we are aware of what we can do in clinical practice in order to provide patient cantered care to patients with dementia. Aim: To identify the nurse´s interventions in patients with dementia during clinical practice. Method: Literature review grounded on an electronic search in the EBSCOhost platform (CINAHL Plus with Full Text, MEDLINE with Full Text, and Nursing & Allied Health Collection), using the search terms of "dementia" AND "nurs*" AND “interventions” in the abstracts. The inclusion criteria were: original papers published up to June 2021. A total of 153 results after de duplicate removal we kept 104. After the application of the inclusion criteria, we included 15 studies This literature review was performed by two independent researchers. Results: A total of 15 results about nurses’ interventions in patients with dementia were included in the study. The major interventions are therapeutic communication strategies, environmental management of stressors involving family/caregivers; strategies to promote patient safety, and assistance in activities of daily living in patients who are clinically deteriorated. Conclusion: Taking care of people with dementia is a complex and demanding task. Nurses are required to have a set of skills and competences in order to provide nursing interventions. We highlight that is necessary an awareness in nursing education regarding providing nursing care to patients with dementia.

Keywords: dementia, interventions, nursing, review

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Authors: Rhaed Khiati, Muhammad Hanif

Abstract:

In the past decade, smart healthcare systems have been on an ascendant drift, especially with the evolution of hospitals and their increasing reliance on bioinformatics and software specializing in healthcare. Doctors have become reliant on technology more than ever, something that in the past would have been looked down upon, as technology has become imperative in reducing overall costs and improving the quality of patient care. With patient-doctor interactions becoming more necessary and more complicated than ever, systems must be developed while taking into account costs, patient comfort, and patient data, among other things. In this work, we proposed a smart hospital bed, which mixes the complexity and big data usage of traditional healthcare systems with the comfort found in soft beds while taking certain concerns like data confidentiality, security, and maintaining SLA agreements, etc. into account. This research work potentially provides users, namely patients and doctors, with a seamless interaction with to their respective nurses, as well as faster access to up-to-date personal data, including prescriptions and severity of the condition in contrast to the previous research in the area where there is lack of consideration of such provisions.

Keywords: big data, smart healthcare, distributed systems, bioinformatics

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Authors: Mariko Nishikawa, Masaaki Yamanaka, Ayami Kondo

Abstract:

Background: International visitors to Japan are at a risk of travel-related illnesses or injury that could result in hospitalization in a country where the language and customs are unique. Over twelve million international visitors came to Japan in 2015, and more are expected leading up to the Tokyo Olympics. One aspect of this is the potentially greater demand on healthcare services by foreign visitors. Nurses who take care of them have anxieties and concerns of their knowledge of the Japanese health system. Objectives: An effective distribution of travel-health information is vital for facilitating care for international visitors. Our research investigates whether a four-minute digital animation (Mari Info Japan), designed and developed by the authors and applied to a survey of 513 nurses who take care of foreigners daily, could clarify travel health procedures, reduce anxieties, while making it enjoyable to learn. Methodology: Respondents to a survey were divided into two groups. The intervention group watched Mari Info Japan. The control group read a standard guidebook. The participants were requested to fill a two-page questionnaire called Mari Meter-X, STAI-Y in English and mark a face scale, before and after the interventions. The questions dealt with knowledge of health promotion, the Japanese healthcare system, cultural concerns, anxieties, and attitudes in Japan. Data were collected from an intervention group (n=83) and control group (n=83) of nurses in a hospital, Japan for foreigners from February to March, 2016. We analyzed the data using Text Mining Studio for open-ended questions and JMP for statistical significance. Results: We found that the intervention group displayed more confidence and less anxiety to take care of foreign patients compared to the control group. The intervention group indicated a greater comfort after watching the animation. However, both groups were most likely to be concerned about language, the cost of medical expenses, informed consent, and choice of hospital. Conclusions: From the viewpoint of nurses, the provision of travel-health information by digital animation to international visitors to Japan was more effective than traditional methods as it helped them be better prepared to treat travel-related diseases and injury among international visitors. This study was registered number UMIN000020867. Funding: Grant–in-Aid for Challenging Exploratory Research 2010-2012 & 2014-16, Japanese Government.

Keywords: digital animation, health promotion, international visitor, Japan, nurse

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Authors: Waled A. Dawoud, Abdelazim M. Negm, Nasser M. Saleh

Abstract:

Offshore piling generates underwater sound at level high enough to cause physical damage or hearing impairment to the marine mammals. Several methods can be used to mitigate the effect of underwater noise from offshore pile driving on marine mammals which can be divided into three main approaches. The first approach is to keep the mammal out of the high-risk area by using aversive sound waves produced by acoustic mitigation devices such as playing-back of mammal's natural predator vocalization, alarm or distress sounds, and anthropogenic sound. The second approach is to reduce the amount of underwater noise from pile driving using noise mitigation techniques such as bubble curtains, isolation casing, and hydro-sound dampers. The third approach is to eliminate the overlap of underwater waves by using prolonged construction process. To investigate the effectiveness of different noise mitigation methods; a pile driven with 235 kJ rated energy diesel hammer near Jeddah Coast, Kingdom of Saudi Arabia was used. Using empirical sound exposure model based on Red Sea characteristics and limits of National Oceanic and Atmospheric Administration; it was found that the aversive sound waves should extend to 1.8 km around the pile location. Bubble curtains can reduce the behavioral disturbance area up to 28%; temporary threshold shift up to 36%; permanent threshold shift up to 50%; and physical injury up to 70%. Isolation casing can reduce the behavioral disturbance range up to 12%; temporary threshold shift up to 21%; permanent threshold shift up to 29%; and physical injury up to 46%. Hydro-sound dampers efficiency depends mainly on the used technology and it can reduce the behavioral disturbance range from 10% to 33%; temporary threshold shift from 18% to 25%; permanent threshold shift from 32% to 50%; and physical injury from 46% to 60%. To prolong the construction process, it was found that the single pile construction, use of soft start, and keep time between two successive hammer strikes more than 3 seconds are the most effective techniques.

Keywords: offshore pile driving, sound propagation models, noise effects on marine mammals, Underwater noise mitigation

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Authors: Zaia Derrar Kaddour

Abstract:

The study of a beam throughout an optical path is generally achieved by means of diffraction integral. Unfortunately, in some problems, this tool turns out to be not very friendly and hard to implement. Instead, the beam expansion method for computing field profiles appears to be an interesting alternative. The beam expansion method consists of expanding the field pattern as a series expansion in a set of orthogonal functions. Propagating each individual component through a circuit and adding up the derived elements leads easily to the result. The problem is then reduced to finding how the expansion coefficients change in a circuit. The beam expansion method requires a systematic study of each type of optical element that can be met in the considered optical path. In this work, we analyze the following fundamental elements: first order optical systems, hard apertures and waveguides. We show that the former element type is completely defined thanks to the Gouy phase shift expression we provide and the latters require a suitable mode conversion. For endorsing the usefulness and relevance of the beam expansion approach, we show here some of its applications such as the treatment of the thermal lens effect and the study of unstable resonators.

Keywords: gouy phase shift, modes, optical resonators, unstable resonators

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Authors: Yawen Wang, Hongchang Chen, Shaomei Li, Chao Gao, Jiangpeng Zhang

Abstract:

As the main challenge for target tracking is accounting for target scale change and real-time, we combine Mean-Shift and PCA-SIFT algorithm together to solve the problem. We introduce similarity comparison method to determine how the target scale changes, and taking different strategies according to different situation. For target scale getting larger will cause location error, we employ backward tracking to reduce the error. Mean-Shift algorithm has poor performance when tracking scale-changing target due to the fixed bandwidth of its kernel function. In order to overcome this problem, we introduce PCA-SIFT matching. Through key point matching between target and template, that adjusting the scale of tracking window adaptively can be achieved. Because this algorithm is sensitive to wrong match, we introduce RANSAC to reduce mismatch as far as possible. Furthermore target relocating will trigger when number of match is too small. In addition we take comprehensive consideration about target deformation and error accumulation to put forward a new template update method. Experiments on five image sequences and comparison with 6 kinds of other algorithm demonstrate favorable performance of the proposed tracking algorithm.

Keywords: target tracking, PCA-SIFT, mean-shift, scale-adaptive

Procedia PDF Downloads 433