Search results for: technical intervention

Authors: Megan Weisbart

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Background/Significance: The Intensive Care Unit (ICU) environment contributes to nurse burnout. Burnout costs include decreased employee compassion, missed workdays, worse patient outcomes, diminished job performance, high turnover, and higher organizational cost. Meaningful recognition, nurturing of interpersonal connections, and mindfulness-based interventions are associated with decreased burnout. The purpose of this quality improvement project was to decrease Neonatal ICU (NICU) nurse burnout using a Wellness Bundle that fosters meaningful recognition, interpersonal connections and includes mindfulness-based interventions. Methods: The Professional Quality of Life Scale Version 5 (ProQOL5) was used to measure burnout before Wellness Bundle implementation, after six months, and will be given yearly for three years. Meaningful recognition bundle items include Online submission and posting of staff shoutouts, recognition events, Nurses Week and Unit Practice Council member gifts, and an employee recognition program. Fostering of interpersonal connections bundle items include: Monthly staff games with prizes, social events, raffle fundraisers, unit blog, unit wellness basket, and a wellness resource sheet. Quick coherence techniques were implemented at staff meetings and huddles as a mindfulness-based intervention. Findings: The mean baseline burnout score of 14 NICU nurses was 20.71 (low burnout). The baseline range was 13-28, with 11 nurses experiencing low burnout, three nurses experiencing moderate burnout, and zero nurses experiencing high burnout. After six months of the Wellness Bundle Implementation, the mean burnout score of 39 NICU nurses was 22.28 (low burnout). The range was 14-31, with 22 nurses experiencing low burnout, 17 nurses experiencing moderate burnout, and zero nurses experiencing high burnout. Conclusion: A NICU Wellness Bundle that incorporated meaningful recognition, fostering of interpersonal connections, and mindfulness-based activities was implemented to improve work environments and decrease nurse burnout. Participation bias and low baseline response rate may have affected the reliability of the data and necessitate another comparative measure of burnout in one year.

Keywords: burnout, NICU, nurse, wellness

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Authors: Scott R. Butler

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Ontario, Canada’s largest province, is in the midst of an interesting experiment in mandated asset management planning for local governments. At the beginning of 2021, Ontario’s 444 municipalities were responsible for the management of 302,864 lane kilometers of roads that have a replacement cost of $97.545 billion CDN. Roadways are by far the most complex, expensive, and extensive assets that a municipality is responsible for overseeing. Since adopting Ontario Regulation 588/47: Asset Management Planning for Municipal Infrastructure in 2017, the provincial government has established prescriptions for local road authorities regarding asset category and levels of service being provided. This provincial regulation further stipulates that asset data such as extent, condition, and life cycle costing are to be captured in manner compliant with qualitative descriptions and technical metrics. The Ontario Good Roads Association undertook an exercise to aggregate the road-related data contained within the 444 asset management plans that municipalities have filed with the provincial government. This analysis concluded that collectively Ontario municipal roadways have a $34.7 billion CDN in deferred maintenance. The ill-state of repair of Ontario municipal roads has lasting implications for province’s economic competitiveness and has garnered considerable political attention. Municipal efforts to address the maintenance backlog are stymied by the extremely limited fiscal parameters municipalities must operate within in Ontario. Further exacerbating the program are provincially designed programs that are ineffective, administratively burdensome, and not necessarily aligned with local priorities or strategies. This paper addresses how municipal asset management plans – and more specifically, the data contained in these plans – can be used to design innovative policy frameworks, flexible funding programs, and new levels of service that respond to these funding challenges, as well as emerging issues such as local economic development and climate change. To fully unlock the potential that Ontario Regulation 588/17 has imposed will require a resolute commitment to data standardization and horizontal collaboration between municipalities within regions.

Keywords: transportation, municipal asset management, subnational policy design, subnational funding program design

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Authors: K. Raghu, Sree Harsha

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The interrelationship between the technology and architecture of tall buildings is investigated from the emergence of tall buildings in late 19th century to the present. In the late 19th century early designs of tall buildings recognized the effectiveness of diagonal bracing members in resisting lateral forces. Most of the structural systems deployed for early tall buildings were steel frames with diagonal bracings of various configurations such as X, K, and eccentric. Though the historical research a filtering concept is developed original and remedial technology- through which one can clearly understand inter-relationship between the technical evolution and architectural esthetic and further stylistic transition buildings. Diagonalized grid structures – “diagrids” - have emerged as one of the most innovative and adaptable approaches to structuring buildings in this millennium. Variations of the diagrid system have evolved to the point of making its use non-exclusive to the tall building. Diagrid construction is also to be found in a range of innovative mid-rise steel projects. Contemporary design practice of tall buildings is reviewed and design guidelines are provided for new design trends. Investigated in depths are the behavioral characteristics and design methodology for diagrids structures, which emerge as a new direction in the design of tall buildings with their powerful structural rationale and symbolic architectural expression. Moreover, new technologies for tall building structures and facades are developed for performance enhancement through design integration, and their architectural potentials are explored. By considering the above data the analysis and design of 40-100 storey diagrids steel buildings is carried out using E-TABS software with diagrids of various angle to be found for entire building which will be helpful to reduce the steel requirement for the structure. The present project will have to undertake wind analysis, seismic analysis for lateral loads acting on the structure due to wind loads, earthquake loads, gravity loads. All structural members are designed as per IS 800-2007 considering all load combination. Comparison of results in terms of time period, top storey displacement and inter-storey drift to be carried out. The secondary effect like temperature variations are not considered in the design assuming small variation.

Keywords: diagrid, bracings, structural, building

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Authors: Chatrabhuti Pipop, Visessri Supattra, Charinpanitkul Tawatchai

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Durian is one of the top agricultural products exported by Thailand. There is the massive market potential for the durian industry. While the global demand for Thai durians, especially the demand from China, is very high, Thailand's durian supply is far from satisfying strong demand. Poor agricultural practices result in low yields and poor quality of fruit. Most irrigation systems currently used by the farmers are fixed schedule or fixed rates that ignore actual weather conditions and crop water requirements. In addition, the technologies emerging are too difficult and complex and prices are too high for the farmers to adopt and afford. Many farmers leave the durian trees to grow naturally. With improper irrigation and nutrient management system, durians are vulnerable to a variety of issues, including stunted growth, not flowering, diseases, and death. Technical development or research for durian is much needed to support the wellbeing of the farmers and the economic development of the country. However, there are a limited number of studies or development projects for durian because durian is a perennial crop requiring a long time to obtain the results to report. This study, therefore, aims to address the problem of durian production by developing an autonomous and precision irrigation system. The system is designed and equipped with an industrial programmable controller, a weather station, and a digital flow meter. Daily water requirements are computed based on weather data such as rainfall and evapotranspiration for daily irrigation with variable flow rates. A prediction model is also designed as a part of the system to enhance the irrigation schedule. Before the system was installed in the field, a simulation model was built and tested in a laboratory setting to ensure its accuracy. Water consumption was measured daily before and after the experiment for further analysis. With this system, the crop water requirement is precisely estimated and optimized based on the data from the weather station. Durian will be irrigated at the right amount and at the right time, offering the opportunity for higher yield and higher income to the farmers.

Keywords: Durian, precision irrigation, precision agriculture, smart farm

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Authors: Jessica Federman

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The current research offers a longitudinal and qualitative study design to examine how reciprocity improves relations between the homeless and various stakeholders within a community. The study examines a homeless shelter that sought to establish a facility within a community of Los Angeles, that was initially met with strong resistance and opposition from a variety of organizations due to deeply entrenched views about the negative impact of having homeless individuals within the community. The project tested an intervention model that targets the reduction of stigmatization of homeless individuals and promotes synergistic exchanges between conflicted organizational entities in communities. Years later, the data show that there has been a remarkable reversal in the perception of the agency by the very forces that initially prevented it from being established. This reversal was achieved by a few key strategic decisions. Community engagement was the first step toward changing people’s minds and demonstrating how the homeless shelter was helping to alleviate the problem of homelessness instead of contributing to it. Central to the non-profit’s success was the agency’s pioneering formulation of a treatment model known as, Reciprocal Community Engagement Model (RCEM). The model works by reintegrating the homeless back into society through relationship building within a network of programs that foster positive human connections. This approach aims to draw the homeless out of the debilitating isolation of their situation, reintegrate them through purposeful roles in the community while simultaneously providing a reciprocal benefit to the community at large. Through multilevel, simultaneous social interaction, RCEM has a direct impact not only on the homeless shelter’s clients but also for the community as well. The agency’s approach of RCEM led to their homeless clients getting out of the shelter and getting to work in the community directly alongside other community volunteers and for the benefit of other city and community organizations. This led to several opportunities for community members and residents to interact in meaningful ways. Through each successive exposure, the resident and community members’ distrust in one another was gradually eased and a mutually supportive relationship restored. In this process, the community member becomes the locus of change as much as the residents of the shelter. Measurements of community trust and resilience increased while negative perceptions of homeless people decreased.

Keywords: stigma, homelessness, reciprocity, identity

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Authors: Elizabeth Loza-Valerdi, Victor Pardiñas-Rios, Arnulfo Pluma-Pluma, Andres Breton-Toral, Julio Cercado-Jaramillo

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The purification processes for mixtures of isomeric monosaccharides using industrial chromatographic methods poses a serious technical challenge. Mixtures of 2 or 3 monosaccharides are difficult to separate by strictly physical or chemical techniques. Differential fermentation by microbial cultures is an increasingly interesting way of selective enrichment in a particular kind of monosaccharides when a mixture of them is present in the solution, and only one has economical value. Osmotolerant yeast cultures provide an interesting source of biocatalysts for the selective catabolism of monosaccharides in media containing high concentrations of total soluble sugars. A collection of 398 yeast strains has been obtained using endemic and unique sources of fruit juices, industrial syrups, honey, and other high sugar content substrates, either natural or man made, products and by-products from Mexico. The osmotolerance of the strains was assessed by plate assay both in glucose (20-40-60%w/w). Strains were classified according to their osmotolerance in low, medium or highly tolerant to high glucose concentrations. The purified cultures were tested by their ability to growth in a solid plate media or liquid media of Yeas Nitrogen Base (YNB), added with specific monosaccharides as sole carbon source (glucose, galactose, lactose and fructose). Selected strains were subsequently tested in fermentation experiments with mixtures of two monosaccharides (galactose/glucose and glucose/fructose). Their ability to grow and selectively catabolize one monosaccharide was evaluated. Growth, fermentation activity and products of metabolism were determined by plate counts, CO2 production, turbidity and chromatographic analysis by HPLC. Selective catabolism of one monosaccharide in liquid media containing two monosaccharides was confirmed for 8 strains. Ion Exchange chromatographic processes were used in production of high fructose or galactose syrup. Laboratory scale processes for the production of fructose or galactose enriched syrups is now feasible, with important applications in food (like high fructose syrup as edulcorant) and fermentation technology (for GOS production).

Keywords: osmotolerant yeasts, selective metabolism, fructose syrup, GOS

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Authors: Kyra Kannen, Sonja D. Roelen, Sebastian Schnieder, Jarek Krajewski, Steffen Holsteg, André Karger, Johanna Askeridis, Celina Slawik, Philip Mildner, Jens Piesk, Ruslan David, Holger Kürten, Benjamin Oster, Robert Malzan, Mike Ludemann

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Virtual Reality (VR) is increasingly recognized for its potential in transforming mental disorder treatment, offering advantages such as cost-effectiveness, time efficiency, accessibility, reduced stigma, and scalability. While the application of VR in the context of anxiety disorders has been extensively evaluated and demonstrated to be effective, the utilization of VR as a therapeutic treatment for depression remains under-investigated. Our goal is to pioneer immersive VR therapy modules for treating major depression, alongside a web-based system for home use. We develop a modular digital therapy platform grounded in psychodynamic therapy interventions which addresses stress reduction, exploration of social situations and relationship support, social skill training, avoidance behavior analysis, and psychoeducation. In addition, an automated depression monitoring system, based on acoustic voice analysis, is implemented in the form of a speech-based diary to track the affective state of the user and depression severity. The use of immersive VR facilitates patient immersion into complex and realistic interpersonal interactions with high emotional engagement, which may contribute to positive treatment acceptance and satisfaction. In a proof-of-concept study, 45 depressed patients were assigned to VR or web-platform modules, evaluating user experience, usability and additional metrics including depression severity, mindfulness, interpersonal problems, and treatment satisfaction. The findings provide valuable insights into the effectiveness and user-friendliness of VR and web modules for depression therapy and contribute to the refinement of more tailored digital interventions to improve mental health.

Keywords: virtual reality therapy, digital health, depression, psychotherapy

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Authors: Pieter De Vries, Renate Klaassen, Maria Ioannides

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This paper is about an explorative research into the use of emerging technologies for teaching and learning in higher engineering education. The assumption is that these technologies and applications, which are not yet widely adopted, will help to improve education and as such actively work on the ability to better deal with the mismatch of skills bothering our industries. Technologies such as 3D printing, the Internet of Things, Virtual Reality, and others, are in a dynamic state of development which makes it difficult to grasp the value for education. Also, the instruments in current educational research seem not appropriate to assess the value of such technologies. This explorative research aims to foster an approach to better deal with this new complexity. The need to find out is urgent, because these technologies will be dominantly present in the near future in all aspects of life, including education. The methodology used in this research comprised an inventory of emerging technologies and tools that potentially give way to innovation and are used or about to be used in technical universities. The inventory was based on both a literature review and a review of reports and web resources like blogs and others and included a series of interviews with stakeholders in engineering education and at representative industries. In addition, a number of small experiments were executed with the aim to analyze the requirements for the use of in this case Virtual Reality and the Internet of Things to better understanding the opportunities and limitations in the day-today learning environment. The major findings indicate that it is rather difficult to decide about the value of these technologies for education due to the dynamic state of change and therefor unpredictability and the lack of a coherent policy at the institutions. Most decisions are being made by teachers on an individual basis, who in their micro-environment are not equipped to select, test and ultimately decide about the use of these technologies. Most experiences are being made in the industry knowing that the skills to handle these technologies are in high demand. The industry though is worried about the inclination and the capability of education to help bridge the skills gap related to the emergence of new technologies. Due to the complexity, the diversity, the speed of development and the decay, education is challenged to develop an approach that can make these technologies work in an integrated fashion. For education to fully profit from the opportunities, these technologies offer it is eminent to develop a pro-active strategy and a sustainable approach to frame the emerging technologies development.

Keywords: emerging technologies, internet of things, pro-active strategy, virtual reality

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Authors: Ifigeneia V. Mavragani, Zacharenia Nikitaki, George Kalantzis, George Iliakis, Alexandros G. Georgakilas

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Complex DNA damage consisting of a combination of DNA lesions, such as Double Strand Breaks (DSBs) and non-DSB base lesions occurring in a small volume is considered as one of the most important biological endpoints regarding ionizing radiation (IR) exposure. Strong theoretical (Monte Carlo simulations) and experimental evidence suggests an increment of the complexity of DNA damage and therefore repair resistance with increasing linear energy transfer (LET). Experimental detection of complex (clustered) DNA damage is often associated with technical deficiencies limiting its measurement, especially in cellular or tissue systems. Our groups have recently made significant improvements towards the identification of key parameters relating to the efficient detection of complex DSBs and non-DSBs in human cellular systems exposed to IR of varying quality (γ-, X-rays 0.3-1 keV/μm, α-particles 116 keV/μm and 36Ar ions 270 keV/μm). The induction and processing of DSB and non-DSB-oxidative clusters were measured using adaptations of immunofluorescence (γH2AX or 53PB1 foci staining as DSB probes and human repair enzymes OGG1 or APE1 as probes for oxidized purines and abasic sites respectively). In the current study, Relative Biological Effectiveness (RBE) values for DSB and non-DSB induction have been measured in different human normal (FEP18-11-T1) and cancerous cell lines (MCF7, HepG2, A549, MO59K/J). The experimental results are compared to simulation data obtained using a validated microdosimetric fast Monte Carlo DNA Damage Simulation code (MCDS). Moreover, this simulation approach is implemented in two realistic clinical cases, i.e. prostate cancer treatment using X-rays generated by a linear accelerator and a pediatric osteosarcoma case using a 200.6 MeV proton pencil beam. RBE values for complex DNA damage induction are calculated for the tumor areas. These results reveal a disparity between theory and experiment and underline the necessity for implementing highly precise and more efficient experimental and simulation approaches.

Keywords: complex DNA damage, DNA damage simulation, protons, radiotherapy

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Authors: Muna Al-Siyabi

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When students bring mobile devices into the classrooms, they are frequently viewed as distractions from their daily educational practices rather than developing the twenty-first century skills. Such skills may involve sorting and extracting information, solving problems and evaluating results. Mobile devices, such as smartphones and tablets, have great potential for learning. Currently, schools and universities are embracing these devices with the aim of enhancing education. In Oman, mobile technologies have been introduced in the last ten years in two private schools to keep pace with the technological advancement. The researcher set out to examine the benefits and challenges of employing mobile learning in these two schools with the aim to inform the implementation of mobile technologies in more schools in Oman. The total of 16 teachers and 237 students responded to questionnaires, and 7 teachers and three student focus groups (of 13 students) were involved in interviews to explore how mobile technologies are used in these two schools. The questionnaires indicated that 87.5% of the sample teachers considered mobile learning helpful for learning and teaching. The teachers believed that mobile learning could promote learning, help teaching, offer vast resources, motivate students and save lesson time. Moreover, interviews with the teachers showed that mobile learning could offer several benefits like immediacy, saving lesson time, supporting differentiation, opportunities to learn anywhere, showing understanding, and offering vast resources. Most of the sample were also facing technical and classroom management challenges when employing mobile technologies in their lessons. In the interviews, most teachers complained of the difficulty to control their classes when they had mobile devices, which distracted their attention and understanding. They reported that their students were distracted by games and they needed to be trained to use mobile technologies for educational purposes. Most teachers recommended that certain parameters or restrictions should be established in any mobile learning project that restrict the usage of mobile technologies to educational purposes. In addition, teachers also emphasised that students needed to be trained on the advantages and limitations of mobile technologies. Teachers were also recommending that pedagogical training for using mobile technologies should be considered when implementing mobile learning in schools. These findings reveal that although of the challenges of managing their classes, teachers believe that mobile learning has great potential for learning. These results imply that mobile learning can be effectively implemented in school in Oman if certain factors and restrictions are considered.

Keywords: effective implementation, challenges, mobile learning, opportunities

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Authors: Moksha Singh

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The proponents of deinstitutionalization, including Goffman and others, in their works, have regarded institutions (orphanages to be specific) as regulated social arrangements that negatively impinge upon a resident’s development. They, therefore, propose alternative forms of care. However, even after five decades of this critique institutionalization remains the only hope for children with social, physical and mental disabilities in larger parts of the developing world such as the conflict affected state of Jammu and Kashmir in India. This paper is based on the experiences of children who lost their parents to insurgency and counter-insurgency operations and the rehabilitation process. This study is qualitative in nature and adopts descriptive-cum-exploratory research design. Using theoretical sampling, six orphanages and thirty one child residents who lost their parent(s) in the course of the armed conflict in the state of Jammu and Kashmir in India were studied in the year 2009-2010. It included interviews, observation, life histories and introspective accounts of the orphans and the management. The results were drawn through the qualitative examination, understanding, and interpretation of the primary and secondary data. The findings suggested that rehabilitation of these conflict-affected children is taking place mainly through residential child care facilities run by non-governmental bodies. Alternative forms of rehabilitation are not functional in the state because of various geopolitical and socio-cultural complexities. Even after five years of arriving at these conclusions and more, the state of Jammu and Kashmir still lacks a comprehensive rehabilitation plan for these children. This has further encouraged a mushroomed growth of legal and illegal institutions. Some of these institutions compromise the standard norms of functioning and yet remain the only hope for thousands rendered orphan. These institutions, therefore, are there to stay as other alternative forms of care are not available in the state. A comprehensive intervention policy is needed based on the cultural specifics of the state and incorporation of views of institutions offering aid, the state and the children. The paper introduces Small Group Residential Care Model through which it is expected that the restoration process can be made smooth and effective.

Keywords: armed conflict, children's rights, institutionalization, orphanages, rehabilitation

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Authors: Ursula D. C. Resende, Fabiano S. Bicalho, Sandro T. M. Gonçalves

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The growing demand for cheap and clean energy sources have been motivated by the study and development of distinct technologies and devices able to provide different amounts of energy. In order to supply energy for small loads, the energy from the electromagnetic spectrum can be harvested. This possibility is particularly interesting because this kind of energy is constantly available in the environment and the number of radiofrequency sources is permanently increasing, due to advances in telecommunications services. A rectenna, which is a combination of an antenna and a rectifier circuit, is an equipment that can efficiently perform the electromagnetic energy harvesting. However, since the amount of electromagnetic energy available in the environment is very small, limited values of power can be harvested by the rectenna. Therefore, several technical strategies have been investigated in order to increase this amount of power. In this work, a metamaterial electromagnetic lens is used to improve the electromagnetic energy harvesting. The rectenna investigated was designed and optimized to charge a Li-Ion battery using the electromagnetic energy from an internet Wi-Fi commercial router model TL-WR841HP operating in 2.45 GHz with maximal output power equal to 18 dBm. The rectenna consists of a high directive antenna, a double voltage rectifier circuit and a metamaterial lens. The printed antenna, constituted of two rectangular radiator elements, was projected and optimized by using the Computer Simulation Software (CST) in order to obtain high directivities and values of S11 parameter below -10 dB in 2.45 GHz. The antenna was printed over a double-sided copper fiberglass substrate, FR4, with characterized relative electric permittivity εr = 4.3 and tangent of losses δ = 0.01. The rectifier circuit, which incorporates a circuit for impedance matching and uses the Schottky diode HSMS-2852, was projected and optimized by using Advanced Design Software (ADS) and built over the same FR4 substrate. The metamaterial cell is composed of two Square Split Ring Resonator (S-SRR) and a thin wire in order to operate with negative values of εr and relative magnetic permeability in 2.45 GHz. In order to evaluate the performance of the purposed rectenna two experimental charging tests were performed, one without and other with the metamaterial lens. The result obtained demonstrate that the electromagnetic lens was able to significantly increase the levels of electric current delivered to the battery, approximately 44%.

Keywords: electromagnetic energy harvesting, electromagnetic lens, metamaterial, rectenna

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Authors: Mardiana Madjid, Nurpudji Astuti Taslim, Suryani As'ad, Haerani Rasyid, Agussalim Bukhari

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The high level of Urine Urea Nitrogen (UUN) indicates hypercatabolism occurs in hospitalized patients. High levels of Total Lymphocyte Count (TLC) indicates the immune system condition, adequate wound healing, and limit complication. Adequate dietary intake affects to decrease of hypercatabolism status in treated patient’s hospitals. Nitrogen Balance (NB) is simply the difference between nitrogen (N₂) intake and output. If more N₂ intake than output, then positive NB or anabolic will occur. This study aims to evaluate the effect of dietary intake in influencing balance nitrogen and total lymphocyte count. Method: A total of 43 patients admitted to a Wahidin Sudirohusodo Hospital between 2018 and 2019 for 10 days' treats are included. The inclusion criteria were patients who were treated for 10 days and receives food from the hospital orally. Patients did not experience gastrointestinal disorders such as vomiting and diarrhea and experience impair kidney function and liver function and expressed approval to participate in this study. During hospitalization, food intake, UUN, albumin serum, balance nitrogen, and TLC was assessed twice on day 1 and day 10. There is no Physician Clinical Nutritional intervention to correct food intake. UUN is 24 hours of urine collected on the second day after admission and the tenth day. Statistical analysis uses SPSS 24 with observational cohort methods. Result: The Forty-three participants completed the follow-up (27 men and 18 women). The age of fewer than 4 years is 22 people, 45 to 60 years is 16 people, and over 60 years is 4 people. The result of the study on day 1 obtained SGA score A, SGA score B, SGA score C are 8, 32, 3 until day 10 are 8, 31, 4, respectively. According to 24h dietary recalls, the energy intake during observation was from 522.5 ± 400.4 to 1011.9 ± 545.1 kcal/day P < 0.05, protein intake from 20.07 ± 17.2 to 40.3 ± 27.3 g/day P < 0.05, carbohydrates from 92.5 ± 71.6 to 184.8 ± 87.4 g/day, and fat from 5.5 ± 3.86 to 13.9 ± 13.9 g/day. The UUN during the observation was from 6.6 ± 7.3 to 5.5 ± 3.9 g/day, TLC decreased from 1622.9 ± 897.2 to 1319.9 ± 636.3/mm³ value target 1800/mm³, albumin serum from 3.07 ± 0.76 to 2.9 ± 0.57 g/day, and BN from -7.5 ± 7.2 to -3.1 ± 4.86. Conclusion: The high level of UUN needs to correct adequate dietary intake to improve NB and TLC status on hospitalized patients.

Keywords: adequate dietary intake, balance nitrogen, total lymphocyte count, urine urea nitrogen

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Authors: Waganesh Zeleke, Abebaw Minaye

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This study examined the act, means, and purpose of human trafficking in the case of Ethiopian migrant returnees from the Middle East and South Africa. Using a questionnaire survey data was gathered from 1078 returnees. Twelve focus group discussions were used to solicit detailed experience of returnee about the process of their 'unsafe' immigration. Both quantitative and qualitative analysis results revealed that against the mainstream thinking of human trafficking means such as forcing, coercing, abducting or threatening, traffickers used 'victims’ free will' means by providing false promises to and capitalizing on the vulnerability of migrants. The migrants’ living condition including unemployment, ambitious view to change their life, and low level of risk perception were found to be risk factors which made them vulnerable and target of the brokers and smugglers who served as a catalyst in the process of their 'unsafe' migration. Equal to the traffickers/brokers/agency, the migrants’ family, friends and Ethiopian embassies contributed to the deplorable situation of migrant workers. 64.4% of the returnees reported that their migration is self-initiated, and 20% reported peer pressure and 13.8 percent reported family pressure, and it is only 1.8% who reported having been pushed by brokers. The findings revealed that 69.5% of the returnees do not know about the lifestyle and culture of the host community before their leave. In a similar vein, 50.9% of the returnees reported that they do not know about the nature of the work they are to do and their responsibilities. Further, 81% of the returnees indicated that the pre-migration training they received was not enough in equipping them with the required skill. Despite the returnees experiences of various forms of abuse and exploitation in the journey and at the destination they still have a positive attitude for migration (t=9.7 mean of 18.85 with a test value of 15). The returnees evaluated the support provided by sending agencies and Ethiopian embassies in the destination to be poor. 51.8% of the migrants do not know the details of the contract they signed during migration. Close to 70% of the returnees expressed that they had not got any legal support from stakeholders when they faced problems. What is more is that despite all these 27.9% of the returnees indicated re-immigrating as their plan. Based on these findings on the context and experience of Ethiopian migrant returnees, implications for training, policy, research, and intervention are discussed.

Keywords: trafficking, migrant, returnee, Ethiopia, experience, reconceptualizing

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Authors: Jong-Hyo Park, Eunyoung Choi, Jae-Yeon Lim, Seon-Suk Lee, Yeong-Rong Koo, Ji-Ung Kwon, Kyung-Sung Kim, Jong-Ik Lee, Juhan Park, Hyun-Kyu Lee, Won-Kyoung Oh, Jisang Lee, Jiwon Choe

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Due to COVID-19, cyber violence among youths has soared as they spend more time online than before. In contrast to the deepening concerns, measurement tools that can assess the vulnerability of cyber violence in individual youths still need to be supplemented. The measurement tools lack consideration of various factors related to cyber violence among youths. Most of the tools are self-report questionnaires, and these adolescents' self-report questionnaire forms can underestimate the harmful behavior and overestimate the damage experience. Therefore, this study aims to develop a multi-report measurement tool for youths that can reliably measure individuals' ecological factors related to cyber violence. The literature review explored factors related to cyber violence, and the questions were constructed. The face validity of the questions was confirmed by conducting focus group interviews. Exploratory and confirmatory factor analyses (N=671) were also conducted for statistical validation. This study developed a multi-report measurement tool for cyber violence with 161 questions, consisting of six domains: online behavior, cyber violence awareness, victimization-perpetration-witness experience, coping efficacy (individuals, peers, teachers, and parents), psychological characteristics, and pro-social capabilities. In addition to self-report from a youth respondent, this measurement tool includes peers, teachers, and parents reporting for the respondent. It is possible to reliably measure the ecological factors of individual youths who are vulnerable or highly resistant to cyber violence. In schools, teachers could refer to the measurement results for guiding students, better understanding their cyber violence conditions, and assessing their pro-social capabilities. With the measurement results, teachers and police officers could detect perpetrators or victims and intervene immediately. In addition, this measurement tool could analyze the effects of the prevention and intervention programs for cyber violence and draw appropriate suggestions.

Keywords: adolescents, cyber violence, cyber violence measurement tool, measurement tool, multi-report measurement tool, youths

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Authors: Naveen Porika, Snigdho Majumdar, Niraj Sethi

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Water, food and energy securities are emerging as increasingly important and vital issues for India and the world. Hyderabad urban agglomeration (HUA), the capital city of Andhra Pradesh State in India, is the sixth largest city has a population of about 8.2 million. The Musi River, which is a tributary of Krishna river flows from west to east right through the heart of Hyderabad, about 80% of the water used by people is released back as sewage, which flows back into Musi every day with detrimental effects on the environment and people downstream of the city. The average daily sewage generated in Hyderabad city is 950 MLD, however, treatment capacity exists only for 541 Million Liters per Day (MLD) but only 407 MLD of sewage is treated. As a result, 543 MLD of sewage daily flows into Musi river. Hyderabad’s current estimated water demand stands at 320 Million Gallons per Day (MGD). However, its installed capacity is merely 270 MGD; by 2020 estimated demand will grow to 400 MGD. There is huge gap between current supply and demand, and this is likely to widen by 2021. Developing new fresh water sources is a challenge for Hyderabad, as the fresh water sources are few and far from the City (about 150-200 km) and requires excessive pumping. The constraints presented above make the conventional alternatives for supply augmentation unsustainable and unattractive .One such dependable and captive source of easily available water is the treated sewage. With proper treatment, water of desired quality can be recovered from the waste water (sewage) for recycle and reuse. Hyderabad Amberpet sewage treatment of capacity 339 MLD is Asia’s largest sewage treatment plant. Tertiary sewage treatment Standard basic engineering modules of 30 MLD,60 MLD, 120MLD & 180 MLD for sewage treatment plants has been developed which are utilized for developing Sewage Reclamation & Reuse model in Asia’s largest sewage treatment plant. This paper will focus on Hyderabad Water Supply & Demand, Sewage Generation & Treatment, Technical aspects of Tertiary Sewage Treatment and Utilization of developed standard modules for reclamation & reuse of treated sewage to overcome the deficit of 130 MGD as projected by 2021.

Keywords: water reclamation, reuse, Andhra Pradesh, hyderabad, musi river, sewage, demand and supply, recycle, Amberpet, 339 MLD, engineering modules, tertiary treatment

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Authors: Afsheen Masood, Sumaira Rashid, Shama Mazahir

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The main aim of this research is to evaluate the efficacy of a culturally adapted management program The Stepping Stones Positive Parenting Program (Tripple P; SSTP) for caregivers of children with autism spectrum disorders and Down syndrome. Positive psychology has catered new dimensions to the traditional perspectives of parenting. The current study was designed to determine the adoptions of positive parenting elements such as parenting styles, parental satisfaction, parental competency, and management of parental stress in alignment with behavioral problems of children with special needs after their parents get trained on Positive Parenting Techniques. This research study was devised in liaison with rehabilitation institute that is extending services for children with Autism Spectrum Disorder and Down syndrome. A Quasi experimental research design was employed with pre-test, post-test control group study in order to evaluate the changes in parenting patterns of parents with children (with Autism and Down syndrome). Caregivers of children diagnosed with Autism and Down syndrome between the age ranges of 25 to 45 years, n=20 from autism group and 20 from Down syndrome group (while their children with special needs in the age ranges of 8 to 14 years) participated in the current research. Parenting scale encompassing areas of parental efficacy, parental satisfaction was used in addition to Parenting Stress Index (SF), indigenously developed Child Behavior Problems Checklist and demographic sheet. Findings revealed statistically significant improvement for caregivers in intervention group from pretest to posttest situation. There was considerable decrease in reported mean behavioral issues of children with Down syndrome when parents in experimental group started practicing Positive Parenting Techniques with their special needs children. This change was somehow not recorded in parents of children with autism. Thus these findings establish the efficacy of culturally adapted parenting program that is evidence based and is established in western empirical research. This carries significant implication for practitioners in special needs domain and for school psychologists in Pakistan.

Keywords: Autism and Parenting, Downsyndrome and Parenting , Positive Parenting, Stepping Stone Positive Parenting Program, Mangement of Behavioral Problems with positive parenting

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Authors: Timmis W., Simms M., Thomas C.

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This case discusses the management of two floors of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk and second primary cancer development.

Keywords: alcohol dependence, biopsy, oral carcinoma, tobacco

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Authors: Erwin Chan, Aravind Subramaniyan, Siti Abdullah Fatehah, Steve Lian Kuling

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Foam assisted lift technology is proven across the industry to provide efficient deliquification in gas wells. Such deliquification is typically achieved by delivering the foamer chemical downhole via capillary strings. In highly liquid loaded wells where capillary strings are not readily available, foamer can be delivered via batch injection or bull-heading. The latter techniques differ from the former in that cap strings allow for liquid to be unloaded continuously, whereas foamer batches require that periodic batching be conducted for the liquid to be unloaded. Although batch injection allows for liquid to be unloaded in wells with suitable water to gas (WGR) ratio and condensate to gas (CGR) ratio without well intervention for capillary string installation, this technique comes with its own set of challenges - for foamer to de-liquify liquids, the chemical needs to reach perforation locations where gas bubbling is observed. In highly scaled perforation zones in certain wells, foamer delivered in batches is unable to reach the gas bubbling zone, thus achieving poor lift efficiency. This paper aims to discuss the techniques and challenges for unloading liquid via batch injection in scaled perforation wells X and Y, whose WGR is 6bbl/MMscf, whose scale build-up is observed at the bottom of perforation interval, whose water column is 400 feet, and whose ‘bubbling zone’ is less than 100 feet. Variables such as foamer Z dosage, batching technique, and well flow control valve opening times are manipulated during the duration of the trial to achieve maximum liquid unloading and gas rates. During the field trial, the team has found optimal values between the three aforementioned parameters for best unloading results, in which each cycle’s gas and liquid rates are compared with baselines with similar flowing tubing head pressures (FTHP). It is discovered that amongst other factors, a good agitation technique is a primary determinant for efficient liquid unloading. An average increment of 2MMscf/d against an average production of 4MMscf/d at stable FTHP is recorded during the trial.

Keywords: foam, foamer, gas lift, liquid unloading, scale, batch injection

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Authors: Hendri Purwadi, Christine McCloud

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Triage is a complex decision-making process that aims to categorize a victim’s level of acuity and the need for medical assistance. Two common triage systems have been widely used in Mass Casualty Incidents (MCIs) and disaster situation are START (Simple triage algorithm and rapid treatment) and SALT (sort, asses, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over START triage system. This systematic review aims to investigate and compare the effectiveness between SALT and START triage system in disaster and MCIs setting. Literatures were searched via systematic search strategy from 2009 until 2019 in PubMed, Cochrane Library, CINAHL, Scopus, Science direct, Medlib, ProQuest. This review included simulated-based and medical record -based studies investigating the accuracy and applicability of SALT and START triage systems of adult and children population during MCIs and disaster. All type of studies were included. Joana Briggs institute critical appraisal tools were used to assess the quality of reviewed studies. As a result, 1450 articles identified in the search, 10 articles were included. Four themes were identified by review, they were accuracy, under-triage, over-triage and time to triage per individual victim. The START triage system has a wide range and inconsistent level of accuracy compared to SALT triage system (44% to 94. 2% of START compared to 70% to 83% of SALT). The under-triage error of START triage system ranged from 2.73% to 20%, slightly lower than SALT triage system (7.6 to 23.3%). The over-triage error of START triage system was slightly greater than SALT triage system (START ranged from 2% to 53% compared to 2% to 22% of SALT). The time for applying START triage system was faster than SALT triage system (START was 70-72.18 seconds compared to 78 second of SALT). Consequently; The START triage system has lower level of under-triage error and faster than SALT triage system in classifying victims of MCIs and disaster whereas SALT triage system is known slightly more accurate and lower level of over-triage. However, the magnitude of these differences is relatively small, and therefore the effect on the patient outcomes is not significance. Hence, regardless of the triage error, either START or SALT triage system is equally effective to triage victims of disaster and MCIs.

Keywords: disaster, effectiveness, mass casualty incidents, START triage system, SALT triage system

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Authors: Samantha Burns, Melissa Brown, Judith Rankin

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Background: As a specialised intervention, NEWPIP provides a service which supports both parents and their babies from conception to two years, who are experiencing issues which may affect the quality of their relationship and development of the infant. This evaluation of the NEWPIP approach was undertaken in response to the need for rich, in-depth data to understand the lived experiences of the parents who experienced the service to improve the service. NEWPIP is currently one of 34 specialised parent–infant relationship teams across England. This evaluation contributes to increasing understanding of the impact and effectiveness of this specialised service to inform future practice. Aim: The aim of this evaluation was to explore the perspectives and experiences of parents or caregivers (service users), to assess the impact of the NEWPIP service on the parents themselves and the relationship with their baby. Methods: The exploratory nature of the aim and focus on service users’ experience and perspectives provided scope for a qualitative approach for this evaluation. This consisted of 10 semi-structured interviews with parents who had received the service within the last two years. Recruitment involved both purposive and convenience sampling. The interviews took place between February 2021 – March 2021, lasting between 30-90 minutes and were guided by open-ended questions from a topic guide. The interviews adopted a narrative approach to enable the parents to share their lived experiences. The researchers transcribed the interviews and analysed the data thematically by using a coding method which is grounded in the data. Results: The analysis and findings from the data gathered illuminated an approach which supports parents to build a better bond with their baby and provides a safe space for parents to heal through their relationships. While the parents shared their experiences, the interviews were intended to receive feedback, so questions were asked about what could be improved and what recommendations could be offered to Children North East. Guided by the voice of the parents, this evaluation provides recommendations to support the future of the NEWPIP approach. Conclusions: The NEWPIP approach appears to successfully provide early and flexible support for new parents, increasing a parent’s confidence in their ability to not only cope but thrive as a new parent.

Keywords: maternal health, mental health, parent infant relationship, therapy

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Authors: S. Pathak, R. Lazarus

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A 25-year-old male HIV patient (CD4 cells 20/µL and HIV viral load 14200000 copies/ml) with a past medical history of duodenal ulcer, pneumocystis carinii pneumonia, oesophageal candidiasis presented with fever and a seizure to hospital. The only recent travel had been a religious pilgrimage from Singapore to Malaysia 5 days prior; during the trip he sustained skin abrasions. The patient had recently started highly active antiretroviral therapy 2 months prior. Clinical examination was unremarkable other than a temperature of 38.8°C and perianal warts. Laboratory tests showed a leukocyte count 12.5x109 cells/L, haemoglobin 9.4 g/dL, normal biochemistry and a C-reactive protein 121 mg/L. CT head and MRI head were unremarkable and cerebrospinal fluid analysis performed after a delay (due to technical difficulties) of 11 days was unremarkable. Blood cultures (three sets) taken on admission showed Gram-negative rods in the anaerobic bottles only at the end of incubation with culture result confirmed by molecular sequencing showing Helicobacter cinaedi. The patient was treated empirically with ceftriaxone for seven days and this was converted to oral co-amoxiclav for a further seven days after the blood cultures became positive. A Transthoracic echocardiogram was unremarkable. The patient made a full recovery. Helicobacter cinaedi is a gram-negative anaerobic fastidious organism affecting patients with comorbidity. Infection may manifest as cellulitius, colitis or as in this case as bloodstream infection – the latter is often attributed to faeco-oral infection. Laboratory identification requires prolonged culture. Therapeutic options may be limited by resistance to macrolides and fluoroquinolones. The likely pathogen inoculation routes in the case described include gastrointestinal translocation due to proctitis at the site of perianal warts, or breach of the skin via abrasions occurring during the pilgrimage. Such organisms are increasing in prevalence as our patient population ages and patients have multiple comorbidities including HIV. It may be necessary in patients with unexplained fever to prolong incubation of sterile sites including blood in order to identify this unusual fastidious organism.

Keywords: fastidious, Helicobacter cinaedi, HIV, immunocompromised

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Authors: Manjusha R. Vagal, Shyam K. Shrivastava, Umesh Mahantshetty, Sudeep Gupta, Supriya Chopra, Reena Engineer, Amita Maheshwari, Atul Buduk

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Vaginal stenosis is a common side effect associated with pelvic radiotherapy in cervical cancer patients which contributes negatively to woman’s health and prevents adequate vaginal/cervical examination. Vaginal dilation with a dilator is routine practice and is internationally advocated as a prophylactic measure to preserve vaginal patency. This retrospective study was carried out with the aim to know the usefulness of vaginal dilation following pelvic radiation therapy in cervical cancer patients in India. Data from medical records of 183 cervical cancer patients, which met the study criteria, were collected related to the stage of the disease, treatment received, commencement period of dilation post radiation therapy, sexual status and side effects associated to dilation practice. Data related to vaginal dimensions as per the length of insertion of a small, medium and large dilator were collected on regular follow-ups until 36 months and/or more. Vaginal dimensions as measured with the length of medium dilator insertion were used for analysis of dilation therapy results using paired t-test. Patients who underwent vaginal dilation with dilator maintained vaginal patency, also the mean vaginal length significantly increased, from 8.02 cm ± 2.69 to 9.96 ± 2.89 cm with a p value <0.001. There was no significant difference found on vaginal patency with different intervals of initiation of dilation therapy. At the third year and more following dilation therapy, significant increase in vaginal length observed with a p value of 0.0001 in both sexually active and inactive patients. Compilation of vaginal dosage during brachytherapy was inadequate, and hence, the secondary objective of the study to determine the effect of radiotherapy on the outcome of rehabilitation intervention was not studied in detail. This retrospective study has found that dilation therapy with vaginal dilators post pelvic radiotherapy is effective in preventing vaginal stenosis and improving vaginal patency and cannot be substituted with vaginal intercourse. Sexual quality of life assessment in the Indian population needs much attention.

Keywords: dilator, sexually active, vaginal dilation, vaginal stenosis

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

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Authors: Bello Abdullahi, Yahaya M. Ibrahim, Ahmed D. Ibrahim, Kabir Bala

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Public sector tendering has traditionally been conducted using manual paper-based processes which are known to be inefficient, less transparent and more prone to manipulations and errors. The advent of the Internet and the World Wide Web has led to the development of numerous e-Tendering systems that addressed some of the problems associated with the manual paper-based tendering system. However, most of these systems rarely support the evaluation of tenders and where they do it is mostly based on the single decision maker which is not suitable in public sector tendering, where for the sake of objectivity, transparency, and fairness, it is required that the evaluation is conducted through a tender evaluation committee. Currently, in Nigeria, the public tendering process in general and the evaluation of tenders, in particular, are largely conducted using manual paper-based processes. Automating these manual-based processes to digital-based processes can help in enhancing the proficiency of public sector tendering in Nigeria. This paper is part of a larger study to develop an electronic tendering system that supports the whole tendering lifecycle based on Nigerian procurement law. Specifically, this paper presents the design and implementation of part of the system that supports group evaluation of tenders based on a technique called fuzzy multi-attributes group decision making. The system was developed using Object-Oriented methodologies and Unified Modelling Language and hypothetically applied in the evaluation of technical and financial proposals submitted by bidders. The system was validated by professionals with extensive experiences in public sector procurement. The results of the validation showed that the system called NPS-eTender has an average rating of 74% with respect to correct and accurate modelling of the existing manual tendering domain and an average rating of 67.6% with respect to its potential to enhance the proficiency of public sector tendering in Nigeria. Thus, based on the results of the validation, the automation of the evaluation process to support tender evaluation committee is achievable and can lead to a more proficient public sector tendering system.

Keywords: e-Tendering, e-Procurement, group decision making, tender evaluation, tender evaluation committee, UML, object-oriented methodologies, system development

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Authors: Pedro Esteban

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Most installations nowadays are exposed to many power quality problems, and they also face numerous challenges to comply with grid code and energy efficiency requirements. The reason behind this is that they are not designed to support nonlinear, non-balanced, and variable loads and generators that make up a large percentage of modern electric power systems. These problems and challenges become especially critical when designing green buildings and smart cities. These problems and challenges are caused by equipment that can be typically found in these installations like variable speed drives (VSD), transformers, lighting, battery chargers, double-conversion UPS (uninterruptible power supply) systems, highly dynamic loads, single-phase loads, fossil fuel generators and renewable generation sources, to name a few. Moreover, events like capacitor switching (from existing capacitor banks or passive harmonic filters), auto-reclose operations of transmission and distribution lines, or the starting of large motors also contribute to these problems and challenges. Active power filters (APF) are one of the fastest-growing power electronics technologies for solving power quality problems and meeting grid code and energy efficiency requirements for a wide range of segments and applications. They are a high performance, flexible, compact, modular, and cost-effective type of power electronics solutions that provide an instantaneous and effective response in low or high voltage electric power systems. They enable longer equipment lifetime, higher process reliability, improved power system capacity and stability, and reduced energy losses, complying with most demanding power quality and energy efficiency standards and grid codes. There can be found several types of active power filters, including active harmonic filters (AHF), static var generators (SVG), active load balancers (ALB), hybrid var compensators (HVC), and low harmonic drives (LHD) nowadays. All these devices can be used in applications in Smart Cities bringing several technical and economic benefits.

Keywords: power quality improvement, energy efficiency, grid code compliance, green buildings, smart cities

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Authors: Asma AlAmri, Ahmed Hassab Errasoul

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Background & Objectives: Psychiatric disorders are common, affecting approximately one of five adults (17.6%) of the population. While most patients can be successfully treated as outpatients, admission to psychiatric wards is required during relapses or as part of crisis intervention. The first 72h of admission could be particularly critical due to increased risk of physical violence, non-medical discharge and absconding. Many patients requiring interventions such as seclusion, physical restrain, PRN psychotropic medications. This study aims to investigate the relationship between demographical, clinical and pharmacological factors in one hand and certain outcomes (physical aggression, use of PRN medications, need for seclusions and non-medical discharges) within the first 72hours of admission to acute psychiatric wards in KKUH/Riyadh Methods: All admissions to psychiatric wards over a 20 month period, between (May 2015- January 2017) were included. Data was collected on demographics, diagnosis, psychotropic medications prescription, documented physical aggression, and seclusion, self-discharge and absconding. Results: 134 males and 171 females were admitted over the study period. Mean age was 34.2 years (SD 11.96).48.9% (n=149) were single and most patients (n=198) were either unemployed or in educations. Bipolar disorder was the most frequent diagnosis recorded on admission (39.3%, n=120); followed by Schizophrenia and related disorders (34.8%; n=106). Most patients (77.4%, n= 236) received regular psychotropic medications on admission. Vis a vis, 223 patients (73%) received PRN medications. Nominal regression model revealed positive relationship between “no psychotropics prescribed on admission” and self-discharge in women but not in men. No statistically significant relationship was found between age, gender, admission diagnosis and use of regular psychotropic medications on admission and need for seclusion, time spent in seclusion, documented physical aggression and use of PRN medications. Conclusion: Contrary to what is expected, our study does not show association between gender, physical aggression and need for seclusion. This could be due to poor documentation practices by nursing staff in male ward comparing with those in the female ward. Use of PRN psychotropics in the first 72 hours of admission was quite high possibly leading to a “ceiling effect”. A limitation of this study is the retrospective data collection.

Keywords: discharge against medical advice, physical aggression, psychotropics, seclusion

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Authors: Victoria Lewis, L. Dumbell

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The British Equestrian Federation (BEF) aims to develop a holistic coach education and certification program, moving away from traditional autocratic instruction in line with the UK Coaching Framework. This framework is based on generic coaching science research where the coach is cited as a pivotal aspect in developing sporting success. Theoretic knowledge suggests that the role of the sports coach is to develop the physical, tactical, technical and psychological attributes of the athlete and is responsible for the planning, organization and delivery of the training plan and competition schedule. However, to the best of the author’s knowledge, there is no empirical evidence to suggest that is the role required in equestrian sport as the rider takes responsibility for many of these tasks. This research aimed to address the void in current knowledge by gaining an understanding of coaching in equestrian sport in order to improve coaching education system through awareness of the role of the coach. Objectives were to examine the relationship between coach and rider at elite level in equestrian sport providing empirical evidence to suggest that the rider is, in part, ‘self –coached’. To identify the elite equestrian coaches’ role in coaching these ‘self-coached riders. A qualitative method using semi-structured interviews was used. A sample of elite coaches (N=3) and elite riders (N=3) were interviewed. Analysis of the transcripts revealed a total of 534 meaning units that were further grouped into sub-themes and general themes from the coaches’ perspective and the riders’ perspective. This led to the development of a final thematic structure revealing major dimensions that characterized coaching in elite equestrian sport. It was found that the riders at the elite level coach themselves the majority of the time, therefore, can be considered as ‘self-coached’ athletes. However, they do use elite coaches in a mentoring and consultancy role, where they seek guidance from the coach on specific problems, to sound ideas off or to seek reassurance that what they are doing is correct. Findings from this research suggest that the rider-coach relationship at the elite level is a professional one, based on trust and respect, but not a close relationship as seen in other sports. The results show the imperative need for the BEF to educate coaches in coaching the self-coached rider at the elite level, particularly in terms of mentoring skills. As well as incorporating rider education aimed at developing the independent, self-coached riders.

Keywords: coaching, elite sport, equestrian, self coached

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Authors: Regina Tedjasulaksana, Maria Martina Nahak, A. A. Gede Agung, Ni Made Widhiasti

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Strategic effort to realize the empowerment of community in school is through the peer group approach so that it needs to choose the students who are trained as the’ little dentist’ in order to have the cognitive and skills to participate in the school dental health effort (UKGS) program, such as providing oral health education to the other students. Aim: To assessed the effectiveness of peer group approach to enhance the oral health knowledge level of schoolchildren at primary school in Klungkung, Bali. Methods: Experimental study using the pre-post test without control group design. The differences of knowledge levels, tooth brushing behavior and oral hygiene status (using PHP-M index) of 10 students before and after trained as the little dentists were analyzed using paired t-test. The correlations between knowledge level and tooth brushing behavior and correlations between tooth brushing behavior and oral hygiene before and after trained as the little dentists were analyzed using Spearman. Furthermore, the trained little dentists provide oral health education to 102 students of grade 1 to 5 at their school once a week for 3 months. The students’ knowledge level scores of each grade were taken every 21 days as many as three times The difference of it was analyzed using Repeated Measured. Result: The mean scores among all little dentists before and after training for each of knowledge level were each 63.05 + 5.62 and 85.00 + 7.81, tooth brushing behavior were each 31.00 + 14.49 and 100.00 + 0.00 and oral hygiene status using PHP-M index were each 32.80 + 10.17 and 11.40 + 8.01. The knowledge level, tooth brushing behavior and oral hygiene status of 10 students before and after trained as the little dentists were different significantly (p<0.05). Before and after trained as the little dentists it showed that significant correlations between knowledge level with tooth brushing behavior (p<0.05) and significant correlations between tooth brushing behavior and oral hygiene (p<0.05). The mean scores of knowledge level among all students before (pre-test) and after (post-test (1),(2),(3)) getting oral health education from little dentists for each, of grade 1 were 40.00 + 17.97; 67.85 + 18.88; 81.72 +26.48 and 70.00 + 22.87, grade 2 were 40.00 + 17.97; 67.85 + 18.88; 81.72 + 26.48 and 70.00 + 22.87, grade 3 were 65.83 + 23.94; 72.50 + 26.08; 80.41 + 24.93 and 83.75 + 19.74, grade 4 were 88.57 + 12.92; 90.71 + 9.97; 92.85 + 10.69 and 93.57 + 6.33 and grade 5 were 86.66 + 13.40; 93.33 + 9.16; 94.16 + 10.17 and 98.33 + 4.81. The students’ knowledge level of grade 1,2 and 3 before and after getting oral health education from little dentists showed significant different (p<0.05), meanwhile there was no significant different on grade 4 and 5 (p<0.05) although mean scores showed an increase. Conclusion: Peer group approach can be used to enhance the oral health knowledge level of schoolchildren at primary school in Klungkung, Bali.

Keywords: small dentists, oral health, peer group approach, school children

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Authors: Yun Chen, Qihang Liu, Catherine Ticehurst, Chandrama Sarker, Fazlul Karim, Dave Penton, Ashmita Sengupta

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The application of ICESAT-2 altimetry data in river hydrology critically depends on the accuracy of the mean water surface elevation (WSE) at a virtual station (VS) where satellite observations intersect with water. The ICESAT-2 track generates multiple VSs as it crosses the different water bodies. The difficulties are particularly pronounced in large river basins where there are many tributaries and meanders often adjacent to each other. One challenge is to split photon segments along a beam to accurately partition them to extract only the true representative water height for individual elements. As far as we can establish, there is no automated procedure to make this distinction. Earlier studies have relied on human intervention or river masks. Both approaches are unsatisfactory solutions where the number of intersections is large, and river width/extent changes over time. We describe here an automated approach called “auto-segmentation”. The accuracy of our method was assessed by comparison with river water level observations at 10 different stations on 37 different dates along the Lower Murray River, Australia. The congruence is very high and without detectable bias. In addition, we compared different outlier removal methods on the mean WSE calculation at VSs post the auto-segmentation process. All four outlier removal methods perform almost equally well with the same R2 value (0.998) and only subtle variations in RMSE (0.181–0.189m) and MAE (0.130–0.142m). Overall, the auto-segmentation method developed here is an effective and efficient approach to deriving accurate mean WSE at river VSs. It provides a much better way of facilitating the application of ICESAT-2 ATL13 altimetry to rivers compared to previously reported studies. Therefore, the findings of our study will make a significant contribution towards the retrieval of hydraulic parameters, such as water surface slope along the river, water depth at cross sections, and river channel bathymetry for calculating flow velocity and discharge from remotely sensed imagery at large spatial scales.

Keywords: lidar sensor, virtual station, cross section, mean water surface elevation, beam/track segmentation

Procedia PDF Downloads 60