Search results for: intensive care units

Authors: Irfan Turetgen

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Closed-circuit cooling towers are cooling units that operate according to the indirect cooling principle. Unlike the open-loop cooling tower, the filler material includes a closed-loop water-operated heat exchanger. The main purpose of this heat exchanger is to prevent the cooled process water from contacting with the external environment. In order to ensure that the hot water is cooled, the water is cooled by the air flow and the circulation water of the tower as it passes through the pipe. They are now more commonly used than open loop cooling towers that provide cooling with plastic filling material. As with all surfaces in contact with water, there is a biofilm formation on the outer surface of the pipe. Although biofilm has been studied very well on plastic surfaces in open loop cooling towers, studies on biofilm layer formed on the heat exchangers of the closed circuit tower have not been found. In the recent study, natural biofilm formation was observed on the heat exchangers of the closed loop tower for 6 months. At the same time, nano-silica coating, which is known to reduce the formation of the biofilm layer, a comparison was made between the two different surfaces in terms of biofilm formation potential. Test surfaces were placed into biofilm reactor along with the untreated control coupons up to 6-months period for biofilm maturation. Natural bacterial communities were monitored to analyze the impact to mimic the real-life conditions. Surfaces were monthly analyzed in situ for their microbial load using epifluorescence microscopy. Wettability is known to play a key role in biofilm formation on surfaces, because characteristics of surface properties affect the bacterial adhesion. Results showed that surface-conditioning with nano-silica significantly reduce (up to 90%) biofilm formation. Easy coating process is a facile and low-cost method to prepare hydrophobic surface without any kinds of expensive compounds or methods.

Keywords: biofilms, cooling towers, fill material, nano silica

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Authors: G. Rajeshwari, V. D. M. Jabez Daniel

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Radio Frequency Identification systems are used for automated identification in various applications such as automobiles, health care and security. It is also called as the automated data collection technology. RFID readers are placed in any area to scan large number of tags to cover a wide distance. The placement of the RFID elements may result in several types of collisions. A major challenge in RFID system is collision avoidance. In the previous works the collision was avoided by using algorithms such as ALOHA and tree algorithm. This work proposes collision reduction and increased throughput through reading enhancement method with tree algorithm. The reading enhancement is done by improving interrogation procedure and increasing the data handling capacity of RFID reader with parallel processing. The work is simulated using Xilinx ISE 14.5 verilog language. By implementing this in the RFID system, we can able to achieve high throughput and avoid collision in the reader at a same instant of time. The overall system efficiency will be increased by implementing this.

Keywords: antenna, anti-collision protocols, data management system, reader, reading enhancement, tag

Procedia PDF Downloads 298

Authors: Adiba Matin, Daniel Cabrera, Javiera Bellolio, Jasmine Stewart, Dana Gerberi (librarian), Nathan Cummins, Fernanda Bellolio

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OBJECTIVES: Artificial intelligence (AI) tools are becoming more prevalent in healthcare settings, particularly for diagnostic and therapeutic recommendations, with an expected surge in the incoming years. The bedside use of this technology for clinicians opens the possibility of disagreements between the recommendations from AI algorithms and clinicians’ judgment. There is a paucity in the literature analyzing nature and possible outcomes of these potential conflicts, particularly related to ethical considerations. The goal of this scoping review is to identify, analyze and classify current themes and potential strategies addressing ethical conflicts originating from the conflict between AI and human recommendations. METHODS: A protocol was written prior to the initiation of the study. Relevant literature was searched by a medical librarian for the terms of artificial intelligence, healthcare and liability, ethics, or conflict. Search was run in 2021 in Ovid Cochrane Central Register of Controlled Trials, Embase, Medline, IEEE Xplore, Scopus, and Web of Science Core Collection. Articles describing the role of AI in healthcare that mentioned conflict between humans and AI were included in the primary search. Two investigators working independently and in duplicate screened titles and abstracts and reviewed full-text of potentially eligible studies. Data was abstracted into tables and reported by themes. We followed methodological guidelines for Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). RESULTS: Of 6846 titles and abstracts, 225 full texts were selected, and 48 articles included in this review. 23 articles were included as original research and review papers. 25 were included as editorials and commentaries with similar themes. There was a lack of consensus in the included articles on who would be held liable for mistakes incurred by following AI recommendations. It appears that there is a dichotomy of the perceived ethical consequences depending on if the negative outcome is a result of a human versus AI conflict or secondary to a deviation from standard of care. Themes identified included transparency versus opacity of recommendations, data bias, liability of outcomes, regulatory framework, and the overall scope of artificial intelligence in healthcare. A relevant issue identified was the concern by clinicians of the “black box” nature of these recommendations and the ability to judge appropriateness of AI guidance. CONCLUSION AI clinical tools are being rapidly developed and adopted, and the use of this technology will create conflicts between AI algorithms and healthcare workers with various outcomes. In turn, these conflicts may have legal, and ethical considerations. There is limited consensus about the focus of ethical and liability for outcomes originated from disagreements. This scoping review identified the importance of framing the problem in terms of conflict between standard of care or not, and informed by the themes of transparency/opacity, data bias, legal liability, absent regulatory frameworks and understanding of the technology. Finally, limited recommendations to mitigate ethical conflicts between AI and humans have been identified. Further work is necessary in this field.

Keywords: ethics, artificial intelligence, emergency medicine, review

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Authors: Alexandre D. Ferraz, Dario H. Alliprandini, Mauro Sampaio

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Companies and other institutions are constantly seeking better organizational performance and greater competitiveness. In order to fulfill this purpose, there are many tools, methodologies and models for increasing performance. However, the Lean Management approach seems to be the most effective in terms of achieving a significant improvement in productivity relatively quickly. Although Lean tools are relatively easy to understand and implement in different contexts, many organizations are not able to transform themselves into 'Lean companies'. Most of the efforts in its implementation have shown single benefits, failing to achieve the desired impact on the performance of the overall enterprise system. There is also a growing perception of the importance of management in Lean transformation, but few studies have empirically investigated and described the 'Lean Management'. In order to understand more clearly the ideas that guide Lean Management and its influence on the maturity level of the production system, the objective of this research is analyze the relationship between the Lean Management principles and the Lean maturity level in the organizations. The research also analyzes the principles of Lean Management and its relationship with the 'Lean culture' and the results obtained. The research was developed using the case study methodology. Three manufacturing units of a German multinational company from industrial automation segment, located in different countries were studied, in order to have a better comparison between the practices and the level of maturity in the implementation. The primary source of information was the application of a research questionnaire based on the theoretical review. The research showed that higher the level of Lean Management principles, higher are the Lean maturity level, the Lean culture level, and the level of Lean results obtained in the organization. The research also showed that factors such as time for application of Lean concepts and company size were not determinant for the level of Lean Management principles and, consequently, for the level of Lean maturity in the organization. The characteristics of the production system showed much more influence in different evaluated aspects. The present research also left recommendations for the managers of the plants analyzed and suggestions for future research.

Keywords: lean management, lean principles, lean maturity level, lean manufacturing

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Authors: Ram Sharan Mehta

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The number of new cancer cases annually is estimated to rise from 10.9 million in 2002 to more than 16 million by 2020, if current trends continue. Much of this increase in absolute numbers derives from the ageing of populations worldwide. The objectives of this study were to find out the demographic characteristics of the admitted cancer patients in BPKIHS. It was hospital based descriptive cross-sectional study conducted reviewing all the records of admitted diagnosed cancer patients in BPKIHS from 15th October 2004 to 14th October 2012. Using total enumerative sampling technique all 1379 diagnosed cancer patients record were reviewed after obtaining the permission from concerned authorities. Using SPSS-15 software package data was analyzed. It was found that majority (71%) of cancer patients were of age more than 40 years and equal of both sexes. Most of the clients were form Sunsari (31.1%), Morang (16.6%) and Jhapa (17%) districts. The mean hospitalization day is 8.32 and very few patients (5.2%) were only cured. The numbers of cancer patients are markedly increases in BPKIHS, especially in advanced stage. It is mandatory to start the cancer information and education programme in eastern region of Nepal and proper management of cancer patients using chemotherapy, radiotherapy and surgery at BPKIHS for quality patient care.

Keywords: lung, cancer, patients, Nepal

Procedia PDF Downloads 369

Authors: Ruyuf Y. Alnafisah, Nouf S. Alammari, Amani S. Alqahtani

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Background: Beverage choice can have implications for the risk of non-communicable diseases. However, there is a lack of knowledge in assessing the nutritional content of these beverages. This study aims to describe the nutrient content of pre-packaged beverages available in the Saudi market. Design: Data were collected from the Saudi Branded Food Data-base (SBFD). Nutrient content was standardized in terms of units and reference volumes to ensure consistency in analysis. Results: A total of 1490 beverages were analyzed. The highest median levels of the majority of nutrients were found among dairy products; energy (68.4(43-188]kcal/100 ml in a milkshake); protein (8.2(0.5-8.2]g/100 ml in yogurt drinks); total fat (2.1(1.3-3.5]g/100 ml in milk); saturated fat (1.4(0-1.4]g/100 ml in yogurt drinks); cholesterol (30(0-30]mg/100 ml in yogurt drinks); sodium (65(65-65].4mg/100 ml in yogurt drinks); and total sugars (12.9(7.5-27]g/100 ml in milkshake). Carbohydrate level was the highest in nectar (13(11.8-14.2] g/100ml]; fruits drinks (12.9(11.9-13.9] g/100ml), and sparkling juices (12.9(8.8-14] g/100ml). The highest added sugar level was observed among regular soft drinks (12(10.8-14] g/100ml). The average rate of nutrient declaration was 60.95%. Carbo-hydrate had the highest declaration rate among nutrients (99.1%), and yogurt drinks had the highest declaration rate among beverage categories (92.7%). The median content of vitamins A and D in dairy products met the mandatory addition levels. Conclusion: This study provides valuable insights into the nutrient content of pre-packaged beverages in the Saudi market. It serves as a foundation for future research and monitoring. The findings of the study support the idea of taxing sugary beverages and raise concerns about the health effects of high sugar in fruit juices. Despite the inclusion of vitamins D and A in dairy products, the study highlights the need for alternative strategies to address these deficiencies.

Keywords: pre-packaged beverages, nutrients content, nutrients declaration, daily percentage value, mandatory addition of vitamins

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Authors: Madhalasa Iyer

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The increase in sustainable practices have encouraged the research and production of alternative fuels. New techniques of bio flocculation with the addition of yeast and bacteria strains have increased the efficiency of biofuel production. Fatty acid methyl ester (FAME) analysis in previous research has indicated that yeast can serve as a plausible enhancer for microalgal lipid production. The research hopes to identify the yeast and microalgae treatment group that produces the largest algae biomass. The mass of the dried algae is used as a proxy for TAG production correlating to the cultivation of biofuels. The study uses a model bioreactor created and built using PVC pipes, 8-port sprinkler system manifold, CO2 aquarium tank, and disposable water bottles to grow the microalgae. Nannochloropsis sp., and Isochrysis galbanawere inoculated separately in experimental group 1 and 2 with no treatments and in experimental groups 3 and 4 with each algaeco-cultured with Saccharomyces cerevisiae in the medium of standard garden stone fertilizer. S. cerevisiae was grown in a petri dish with nutrient agar medium before inoculation. A Secchi stick was used before extraction to collect data for the optical density of the microalgae. The biomass estimator was then used to measure the approximate production of biomass. The microalgae were grown and extracted with a french press to analyze secondary measurements using the dried biomass. The experimental units of Isochrysis galbana treated with the baker’s yeast strains showed an increase in the overall mass of the dried algae. S. cerevisiae proved to be an accurate and helpful addition to the solution to provide for the growth of algae. The increase in productivity of this fuel source legitimizes the possible replacement of non-renewable sources with more promising renewable alternatives. This research furthers the notion that yeast and mutants can be engineered to be employed in efficient biofuel creation.

Keywords: biofuel, co-culture, S. cerevisiae, microalgae, yeast

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Authors: Kate Smith, Shuming Liu, Yi Liu, Dragan Savic, Gustaf Olsson, Tian Chang, Xue Wu

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In a water supply system, a great deal of care goes into sourcing, treating and delivering water to consumers, but less thought is given to the energy consumed during these processes. This study uses 2011 data to quantify energy use for urban water supply in China and investigates population density as a possible influencing factor. The objective is to provide information that can be used to develop energy-conscious water infrastructure policy, calculate the energy co-benefits of water conservation and compare energy use between China and other countries. The average electrical energy intensity and per capita electrical energy consumption for urban water supply in China in 2011 were 0.29 kWh/m3 and 33.2 kWh/cap•yr, respectively. Comparison between provinces revealed a direct correlation between energy intensity of urban water supply and population served per unit length of pipe. This could imply energy intensity is lower when more densely populated areas are supplied by relatively dense networks of pipes. This study also found that whereas the percentage of energy used for urban water supply tends to increase with the percentage of population served this increase is slower where water supply is more energy efficient and where a larger percentage of population is already supplied.

Keywords: china, electrical energy use, water-energy nexus, water supply

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Authors: Gamith Mendis

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Even though the doctors are knowledgeable, there's a gap between knowing and being ethical. This is a barrier to establish an ethical doctor-patient relationship. Current health system has oriented in a way that gives a meaning to both the doctor and the patient through intermediate entities. For the doctor, the meaning of the doctor-patient relationship is given through the financial benefits, promotions, and social status. For the patient, the meaning is given through curing of the disease. It is obvious that both are independent entities between the doctor and the patient. As the philosophers like Husserl and Heidegger have pointed out, our subjective world will give the immediate meaningfulness to us. We should seek this immediate meaningfulness of the doctor-patient relationship. The present research has used the existential methodology as guided self-reflections on the lived experiences of a doctor and his students. In this approach, two important aspects have been understood. The first is, establishing the fact that being ethical is itself giving meaningfulness to the doctor’s being without any mediate entities. Simply, it is enjoying being an honest being. The second is by being-with-the-patient while treating the disease; both the doctor and the patient can enjoy the meaningfulness of their human relationship. The medical students and the doctors should focus on this meaningfulness. For that, this discussion should be actively incorporated into the medical curriculum with programs of practical guidance to medical students and should be discussed in patient-care reviews in the health setting within a satisfactory framework.

Keywords: doctor-patient relationship, medical education, medical ethics, medical humanities, qualitative health research

Procedia PDF Downloads 147

Authors: E. Saeedian, M. Shakerian, A. Zarif Sanayei, Z. Rakeb, F. N. Alizadeh, S. Sarshough, S. Sina

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Radiological protection for plants and animals is an area of regulatory importance. Acute doses of 0.1 Gy/d (10 rad/d) or below are highly unlikely to produce permanent, measurable negative effects on populations or communities of plants or animals. The advancement of radio diagnostics for domestic animals, particularly dogs and cats, has gained popularity in veterinary medicine. As pets are considered to be members of the family worldwide, they are entitled to the same care and protection. It is important to have a system of radiological protection for nonhuman organisms that complies with the focus on human health as outlined in ICRP publication 19. The present study attempts to assess surface-skin entrance doses in small pets undergoing abdominal radio diagnostic procedures utilizing a direct measurements technique with a thermoluminescent dosimeter. These measurements allow the determination of the entrance skin dose (ESD) by calculating the amount of radiation absorbed by the skin during exposure. A group of Thirty TLD-100 dosimeters produced by Harshaw Company, each with repeatability greater than 95% and calibration using ¹³⁷Cs gamma source, were utilized to measure doses to ten small pets, including cats and dogs in the radiological department in a veterinary clinic in Shiraz, Iran. Radiological procedures were performed using a portable imaging unit (Philips Super M100, Philips Medical System, Germany) to acquire images of the abdomen; ten exams of abdomen images of different pets were monitored, measuring the thicknesses of the two projections (lateral and ventrodorsal) and the distance of the X-ray source from the surface of each pet during the exams. A group of two dosimeters was used for each pet which has been stacked on their skin on the abdomen region. The outcome of this study involved medical procedures with the same kVp, mAs, and nearly identical positions for different diagnostic X-ray procedures executed over a period of two months. The result showed the mean ESD value was 260.34±50.06 µGy due to the approximate size of pets. Based on the results, the ESD value is associated with animal size, and larger animals have higher values. If a procedure doesn't require repetition, the dose can be optimized. For smaller animals, the main challenge in veterinary radiology is the dose increase caused by repetitions, which is most noticeable in the ventrodorsal position due to the difficulty in immobilizing the animal. Animals are an area of regulatory importance. Acute doses of 0.1 Gy/d (10 rad/d) or below are highly unlikely to produce permanent, measurable negative effects on populations or communities of plants or animals. The advancement of radio diagnostics for domestic animals, particularly dogs and cats, has gained popularity in veterinary medicine. As pets are considered to be members of the family worldwide, they are entitled to the same care and protection. It is important to have a system of radiological protection for nonhuman organisms that complies with the focus on human health as outlined in ICRP publication 19. The present study attempts to assess surface-skin entrance doses in small pets undergoing abdominal radio diagnostic procedures utilizing direct measurements.

Keywords: direct dose measuring, dosimetry, radiation protection, veterinary medicine

Procedia PDF Downloads 65

Authors: Syamimi Shamsuddin, Hanafiah Yussof, Fazah Akhtar Hanapiah, Salina Mohamed, Nur Farah Farhan Jamil, Farhana Wan Yunus

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Robot-based intervention for children with autism is an evolving research niche in human-robot interaction (HRI). Recent studies in this area mostly covered the role of robots in the clinical and experimental setting. Our previous work had shown that interaction with a robot pose no adverse effects on the children. Also, the presence of the robot, together with specific modules of interaction was associated with less autistic behavior. Extending this impact on school-going children, interactions that are in-tune with special education lessons are needed. This methodological paper focuses on how a robot can be incorporated in a current learning environment for autistic children. Six interaction scenarios had been designed based on the existing syllabus to teach communication skills, using the Applied Behavior Analysis (ABA) technique as the framework. Development of the robotic experience in class also covers the required set-up involving participation from teachers. The actual research conduct involving autistic children, teachers and robot shall take place in the next phase.

Keywords: autism spectrum disorder, ASD, humanoid robot, communication skills, robot-assisted learning

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Authors: Su Yin Chiam, Qing Xin Zhang, Jaehoon Chung

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Complementary metal-oxide-semiconductor (CMOS) integrated circuits (ICs) have obtained increased attention in the biosensor community because CMOS technology provides cost-effective and high-performance signal processing at a mass-production level. In order to supply biological samples and reagents effectively to the sensing elements, there are increasing demands for seamless integration of microfluidic components on the fabricated CMOS wafers by post-processing. Although the PDMS microfluidic channels replicated from separately prepared silicon mold can be typically aligned and bonded onto the CMOS wafers, it remains challenging owing the inherently limited aligning accuracy ( > ± 10 μm) between the two layers. Here we present a new post-processing method to create three-dimensional microfluidic components using two different polarities of photoresists, an epoxy-based negative SU-8 photoresist and positive SPR220-7 photoresist. The positive photoresist serves as a sacrificial layer and the negative photoresist was utilized as a structural material to generate three-dimensional structures. Because both photoresists are patterned using a standard photolithography technology, the dimensions of the structures can be effectively controlled as well as the alignment accuracy, moreover, is dramatically improved (< ± 2 μm) and appropriately can be adopted as an alternative post-processing method. To validate the proposed processing method, we applied this technique to build cell-trapping structures. The SU8 photoresist was mainly used to generate structures and the SPR photoresist was used as a sacrificial layer to generate sub-channel in the SU8, allowing fluid to pass through. The sub-channel generated by etching the sacrificial layer works as a cell-capturing site. The well-controlled dimensions enabled single-cell capturing on each site and high-accuracy alignment made cells trapped exactly on the sensing units of CMOS biosensors.

Keywords: SU-8, microfluidic, MEMS, microfabrication

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Authors: Betsy Hannam

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Background: Staff nurses felt overwhelmed to learn new skills or complete competencies during their shift. Med/Surg units need to provide dedicated, uninterrupted time to complete training and mandatory competencies and practice skills. Purpose: To improve nurse satisfaction and competence by creating a Skills Day with uninterrupted time to complete competencies, brush up on skills, and evaluate skills learned through pre- and post-tests. Methods: The USL and CNL interviewed nurses to obtain input regarding skills needing reinforcement and included mandatory competencies relevant to Med/Surg to create the Skills Day agenda. Content experts from multiple disciplines were invited to educate staff to help address knowledge gaps. To increase attendance, multiple class days were offered. Results: 2018 Skills Day was held for an inpatient unit with 95% participation (n=35 out of 37RNs). The average pretest score, comprised of content questions from topics discussed, was 57%, and post test scoresaveraged 80%. 94% of test scores improved or remained the same. RNs were given an evaluation at the end of the day, where100% of staff noted Skills Day as beneficial, and 97% requested to repeat next year. Another Med/Surg unit asked to join Skills Day in 2019. In 2019, with 89% participation (n=57 out 64 RNs), the average pretest score was 68%, and the average post test score was 85%. 97% of scores improved or remained the same. 98% reported the class as beneficial, and 96% requested to repeat next year. Skills Day 2020-2022 on hold due to COVID. Looking forward to Skills Day 2023. Conclusion: Skills Day allows nurses to maintain competencies and improve knowledge in areas of interest without the stress of a patient assignment. Having unit leaders organize Skills Day, with the involvement of content experts from multiple disciplines, showed to be a successful and innovative team approach to support professional development.

Keywords: education, competency, skills day, medical/surgical

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Authors: Elaine Llantos Elayda, John Mark S. Distor

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This paper explores the lived experiences of clinical psychology interns' who have encountered suicidal clients during their internship. Employing qualitative phenomenological investigation, semi-structured interviews were conducted and analyzed using interpretative phenomenological analysis (IPA). The study employed purposive sampling to gather valuable data. The results highlighted that those encounters with suicidal clients triggered various reactions among interns, leading to self-doubt and a sense of unpreparedness in handling such cases. Many interns struggled with managing their own emotions, especially when clients' traumas mirrored their own experiences. The study emphasized the importance of a robust support system in helping interns cope with the challenges of their work. Supervision and professional support played critical roles in interns' development, providing guidance and enhancing their confidence in managing distressing situations. Despite the challenges, the interns found purpose in witnessing significant client progress and emphasized the importance of self-care and ongoing training to prepare future clinicians for similar experiences.

Keywords: polytechnic university of the Philippines, clinical psychology interns, suicidal clients, clinical psychology training

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Authors: Miroslava Šidlovská, Ida Petrovičová, Tomáš Pilka, Branislav Kolena

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Phthalates are ubiquitous environmental pollutants well-known because of their endocrine disrupting activity in human organism. The aim of our study was, by biological monitoring, investigate exposure to phthalates of Roma ethnicity group i.e. children and adults from 5 families (n=29, average age 11.8 ± 7.6 years) living in western Slovakia. Additionally, we analysed some associations between anthropometric measures, questionnaire data i.e. socio-economic status, eating and drinking habits, practise of personal care products and household conditions in comparison with concentrations of phthalate metabolites. We used for analysis of urine samples high performance liquid chromatography and tandem mass spectrometry (HPLC-MS/MS) to determine concentrations of phthalate metabolites monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-iso-butyl phthalate (MiBP), mono(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), mono(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP) and mono(2-etylhexyl) phthalate (MEHP). Our results indicate that ethnicity, lower socioeconomic status and different housing conditions in Roma population can affect urinary concentration of phthalate metabolites.

Keywords: biomonitoring, ethnicity, human exposure, phthalate metabolites

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Authors: Jiani Gao, Qingping Luo, Xinlei Fang

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In order to try to achieve better rights and interests for both doctors and patients in the new medical environment, the paper will focus on the renewal and development of medical buildings. In today's highly developed society, many factors have a profound guiding significance for the development of medical buildings. By doing social research, the paper has found that these factors come from all aspects. These factors include the optimization of traditional medical model, rapid alternation of medical technology and equipment, the reform of the social, medical security system, changes in the age structure of the population, the birth of intelligent medical care under the Internet, and the deepening of the concept of green sustainable building development, etc. The purpose of this paper is to capture sensitively these various factors that may affect the evolution of medical buildings in the context of the current era, and to put forward, by using an adaptable development strategy, some feasible suggestions on the design of medical buildings when facing these changes and challenges. Specifically speaking, the adaptable development strategy includes some basic principles and methods, such as using modular design, adopting scalable streamline, selecting a long-span structural system and using replaceable materials and components, etc.

Keywords: medical architecture, adaptable development, medical model, space design

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Authors: Liqun Zou, Ling Wang, Xiaoli Chen

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Objective: Through the questionnaire about emergency nurses’ knowledge and attitudes regarding pain management to understand whether they are well mastered and practiced the related knowledge about pain management, providing a reference for continuous improvement of the quality of nursing care in acute pain and for improving the effect of management on emergency pain patients. Method: The Chinese version questionnaire about KASRP (knowledge and attitudes survey regarding pain) was handed out to 132 emergency nurses to do a study about the knowledge and attitude of pain management. Meanwhile, SPSS17.0 was used to do a descriptive analysis and variance analysis on collected data. Results: The emergency nurses’ correct answer rate about KASRP questionnaire is from 25% to 65% and the average correct rate is (44.65 + 7.85)%. In addition, there are 10 to 26 items being given the right answer. Therefore, the average correct items are (17.86 ± 3.14). Moreover, there is no statistical significant on the differences about the correct rate for different age, gender and work experience to answer; however, the difference of the correct rate in different education background and the professional title is significant. Conclusion: There is a remarkable lack of knowledge and attitude towards pain management in emergency nurses, whose basic knowledge of pain is sufficient. Besides, there is a deviation between the knowledge of pain management and clinical practice, which needs to be improved.

Keywords: emergency nurse, pain, KASRP questionnaire, pain management

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Authors: Heiko Diefenbach, Christoph H. Glock

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Order picking, i.e., the order-based retrieval of items in a warehouse, is an important time- and cost-intensive process for many logistic systems. Despite the ongoing trend of automation, most order picking systems are still manual picker-to-parts systems, where human pickers walk through the warehouse to collect ordered items. Human work in warehouses is not free from errors, and order pickers may at times pick the wrong or the incorrect number of items. Errors can cause additional costs and significant correction efforts. Moreover, age might increase a person’s likelihood to make mistakes. Hence, the negative impact of picking errors might increase for an aging workforce currently witnessed in many regions globally. A significant amount of research has focused on making order picking systems more efficient. Among other factors, storage assignment, i.e., the assignment of items to storage locations (e.g., shelves) within the warehouse, has been subject to optimization. Usually, the objective is to assign items to storage locations such that order picking times are minimized. Surprisingly, there is a lack of research concerned with picking errors and respective prevention approaches. This paper hypothesize that the storage assignment of items can affect the probability of pick errors. For example, storing similar-looking items apart from one other might reduce confusion. Moreover, storing items that are hard to count or require a lot of counting at easy-to-access and easy-to-comprehend self heights might reduce the probability to pick the wrong number of items. Based on this hypothesis, the paper discusses how to incorporate error-prevention measures into mathematical models for storage assignment optimization. Various approaches with respective benefits and shortcomings are presented and mathematically modeled. To investigate the newly developed models further, they are compared to conventional storage assignment strategies in a computational study. The study specifically investigates how the importance of error prevention increases with pickers being more prone to errors due to age, for example. The results suggest that considering error-prevention measures for storage assignment can reduce error probabilities with only minor decreases in picking efficiency. The results might be especially relevant for an aging workforce.

Keywords: an aging workforce, error prevention, order picking, storage assignment

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Authors: Anuruddha Jagoda, Samiddhi Samarakoon, Anil Jasinghe

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In its simplest form, data quality can be defined as 'fitness for use' and it is a concept with multi-dimensions. Emergency Departments(ED) require information to treat patients and on the other hand it is the primary source of information regarding accidents, injuries, emergencies etc. Also, it is the starting point of various patient registries, databases and surveillance systems. This interventional study was carried out to improve data quality at the ED of the National Hospital of Sri Lanka (NHSL) by introducing an e health solution to improve data quality. The NHSL is the premier trauma care centre in Sri Lanka. The study consisted of three components. A research study was conducted to assess the quality of data in relation to selected five dimensions of data quality namely accuracy, completeness, timeliness, legibility and reliability. The intervention was to develop and deploy an electronic emergency department information system (eEDIS). Post assessment of the intervention confirmed that all five dimensions of data quality had improved. The most significant improvements are noticed in accuracy and timeliness dimensions.

Keywords: electronic health records, electronic emergency department information system, emergency department, data quality

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Authors: Z. Karakus, Z. Ozer

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Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement, or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery, and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

Keywords: e-learning, medication administration, nursing, nursing students

Procedia PDF Downloads 251

Authors: Alive Ntunja, Wilma ten Ham-Baloyi, June Teare, Oyedele Opeoluwa, Paula Melariri

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Sanitation workers are also known as “garbage workers” who play a significant role in the sanitation chain. For many generations sanitation workers’ level of knowledge regarding hygiene practices remains low due to a lack of educational programs on hygiene. As a result, they are widely exposed to hygiene-related diseases such as cholera, skin infections and various other diseases, increasing their risk of mortality to 40%. This review aimed to explore the global impact of educational programs on the hygiene knowledge and practices of sanitation workers. The systematic literature search was conducted for studies published between 2013 and 2023 using the following databases: MEDLINE (via EBSCOHost), PubMed, and Google Scholar to identify quantitative studies on the subject. Study quality was assessed using the Joanna Briggs Institute Critical Evaluation Instruments. Data extracted from the included articles was presented using a summary of findings table and presented graphically through charts and tables, employing both descriptive and inferential statistical methods. A one-way repeated measures ANOVA assessed the pooled effect of the intervention on mean scores across studies. Statistical analysis was performed using Microsoft Office 365 (2019 version), with significance set at p<0.05. The PRISMA flow diagram was used to present the article selection process. The systematic review included 15 eligible studies from a total of 2 777 articles. At least 60% (n=9) of the reviewed studies found educational program relating to hygiene to have a positive impact on sanitation workers’ hygiene knowledge and practices. The findings further showed that the stages (pre-post) of knowledge intervention used lead to statistically significant differences in mean score obtained [F (1,7) = 22.166, p = 0.002]. Likewise, it can be observed that the stages of practice intervention used lead to statistically significant differences in mean score obtained [F (1,7) = 21.857, p = 0.003]. However, most (n=7) studies indicated that, the efficacy of programs on hygiene knowledge and practices is indirectly influenced by educational background, age and work experience (predictor factors). Educational programs regarding hygiene have the potential to significantly improve sanitation workers knowledge and practices. Findings also suggest the implementation of active and intensive intervention programs, to improve sanitation workers hygiene knowledge and practices.

Keywords: educational programs, hygiene knowledge, practices, sanitation workers

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Authors: J. Ritonja

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The biochemical technology has been developing extremely fast since the middle of the last century. The main reason for such development represents a requirement for large production of high-quality biologically manufactured products such as pharmaceuticals, foods, and beverages. The impact of the biochemical industry on the world economy is enormous. The great importance of this industry also results in intensive development in scientific disciplines relevant to the development of biochemical technology. In addition to developments in the fields of biology and chemistry, which enable to understand complex biochemical processes, development in the field of control theory and applications is also very important. In the paper, the control for the biochemical reactor for the milk fermentation was studied. During the fermentation process, the biophysical quantities must be precisely controlled to obtain the high-quality product. To control these quantities, the bioreactor’s stirring drive and/or heating system can be used. Available commercial biochemical reactors are equipped with open loop or conventional linear closed loop control system. Due to the outstanding parameters variations and the partial nonlinearity of the biochemical process, the results obtained with these control systems are not satisfactory. To improve the fermentation process, the self-tuning adaptive control system was proposed. The use of the self-tuning adaptive control is suggested because the parameters’ variations of the studied biochemical process are very slow in most cases. To determine the linearized mathematical model of the fermentation process, the recursive least square identification method was used. Based on the obtained mathematical model the linear quadratic regulator was tuned. The parameters’ identification and the controller’s synthesis are executed on-line and adapt the controller’s parameters to the fermentation process’ dynamics during the operation. The use of the proposed combination represents the original solution for the control of the milk fermentation process. The purpose of the paper is to contribute to the progress of the control systems for the biochemical reactors. The proposed adaptive control system was tested thoroughly. From the obtained results it is obvious that the proposed adaptive control system assures much better following of the reference signal as a conventional linear control system with fixed control parameters.

Keywords: adaptive control, biochemical reactor, linear quadratic regulator, recursive least square identification

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Authors: Tamer Mokhtar Mohamed Ahmed

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Throughout the ages the Caliphs, Sultans and rulers have paid great care to tomb covers and in particular to the cover of the tomb of the Prophet Muhammad as well as other prophets. For that purpose they established waqfs and ensured that the covers appeared in the most magnificent manner to befit their purpose, as we can see in the beautiful examples in museums across the world. In fact tomb covers are some of the most beautiful examples of Islamic art in their detail of craftsmanship which have made them great works of art. It became the custom that the Kiswa or the tomb covers were made of silk or satin with gold and silver threads. Museums across the word preserve examples of the highest craftsmanship of tomb covers produced in the capital of the Ottomans and other capital cities, all differing in their designs or colors reflecting the work of the individual cities like Cairo, Istanbul or Bursa. Other than the cover for the tomb of the Prophet, many other tomb covers were produced for the tombs of other prophets and their wives in Hebron. In addition tomb covers were made for the sufi saints as well as for the Ottoman sultans and for their wives and children. In this paper I will Study the Kiswa or the tomb covers in Ottoman period.

Keywords: kiswa, ottoman period, textiles, silk, tomb of the Prophet Muhammad

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Authors: Mohamed H. Sorour, Hayam F. Shaalan, Heba A. Hani, Eman S. Sayed, Amany A. El-Mansoup

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Heavy metals (HMs) present an increasing threat to aquatic and soil environment. Thus, techniques should be developed for the removal and/or recovery of those HMs from point sources in the generating industries. This paper reports our endeavors concerning the development of in-house developed weak cation exchange polyacrylate hydrogel kaolin composites for heavy metals removal. This type of composite enables desirable characteristics and functions including mechanical strength, bed porosity and cost advantages. This paper emphasizes the effect of varying crosslinker (methylenebis(acrylamide)) concentration. The prepared cation exchanger has been subjected to intensive characterization using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray fluorescence (XRF) and Brunauer Emmett and Teller (BET) method. Moreover, the performance was investigated using synthetic and real wastewater for an industrial complex east of Cairo. Simulated and real wastewater compositions addressed; Cr, Co, Ni, and Pb are in the range of (92-115), (91-103), (86-88) and (99-125), respectively. Adsorption experiments have been conducted in both batch and column modes. In general, batch tests revealed enhanced cation exchange capacities of 70, 72, 78.2 and 99.9 mg/g from single synthetic wastes while, removal efficiencies of 82.2, 86.4, 44.4 and 96% were obtained for Cr, Co, Ni and Pb, respectively from mixed synthetic wastes. It is concluded that the mixed synthetic and real wastewaters have lower adsorption capacities than single solutions. It is worth mentioned that Pb attained higher adsorption capacities with comparable results in all tested concentrations of synthetic and real wastewaters. Pilot scale experiments were also conducted for mixed synthetic waste in a fluidized bed column for 48 hour cycle time which revealed 86.4%, 58.5%, 66.8% and 96.9% removal efficiency for Cr, Co, Ni, and Pb, respectively with maximum regeneration was also conducted using saline and acid regenerants. Maximum regeneration efficiencies for the column studies higher than the batch ones about by about 30% to 60%. Studies are currently under way to enhance the regeneration efficiency to enable successful scaling up of the adsorption column.

Keywords: polyacrylate hydrogel kaolin, ultrasonic irradiation, heavy metals, adsorption and regeneration

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Authors: Melis Inalpulat, Tugce Civelek, Unal Kizil, Levent Genc

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Livestock production is one of the most important components of rural economy. Due to the urban expansion, rural areas close to expanding cities transform into urban districts during the time. However, the legislations have some restrictions related to livestock farming in such administrative units since they tend to create environmental concerns like odor problems resulted from excessive manure production. Therefore, the existing animal operations should be moved from the settlement areas. This paper was focused on determination of suitable lands for livestock production in Canakkale province of Turkey using remote sensing (RS) data and GIS techniques. To achieve the goal, Formosat 2 and Landsat 8 imageries, Aster DEM, and 1:25000 scaled soil maps, village boundaries, and village livestock inventory records were used. The study was conducted using suitability analysis which evaluates the land in terms of limitations and potentials, and suitability range was categorized as Suitable (S) and Non-Suitable (NS). Limitations included the distances from main and crossroads, water resources and settlements, while potentials were appropriate values for slope, land use capability and land use land cover status. Village-based S land distribution results were presented, and compared with livestock inventories. Results showed that approximately 44230 ha area is inappropriate because of the distance limitations for roads and etc. (NS). Moreover, according to LULC map, 71052 ha area consists of forests, olive and other orchards, and thus, may not be suitable for building such structures (NS). In comparison, it was found that there are a total of 1228 ha S lands within study area. The village-based findings indicated that, in some villages livestock production continues on NS areas. Finally, it was suggested that organized livestock zones may be constructed to serve in more than one village after the detailed analysis complemented considering also political decisions, opinion of the local people, etc.

Keywords: GIS, livestock, LULC, remote sensing, suitable lands

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Authors: Mihaela Munteanu (Pila), Silvius Stanciu

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This paper presents the aspects of the official control of fishery in the Republic of Moldova. Currently, the regulations and the activity of national institutions with responsibilities in the field of food quality are in a process of harmonization with the European rules, aiming at European integration, quality improvement and providing a higher level of food safety. The National Agency for Food Safety is the main national body with responsibilities in the field of food safety. In the field of fishery products, the Agency carries out an intensive activity of informing the citizen and controlling the products marketed. The paper presents the dangers related to the consumption of fish and fishery products traded on the national market, the sanitary-veterinary inspections conducted by the profile institution and the improper situations identified. The national market of fishery products depends largely on imports, mainly focused on ocean fish. The research carried out has shown that during the period 2011-2018, following the inspections carried out on fishery products traded on the national market, a number of inconsistencies have been identified. Thus, indigenous products were frequently detected with sensory characteristics unfit for consumption, and being commercialized in inappropriate locations or contaminated with chemical pollutants. On import products controlled, the most frequent inconsistent situations have been represented by inconsistent sensory aspects and by parasite contamination. Taking into account the specific aspects of aquatic products, including the high level of alterability, special conditions of growth, marketing, culinary preparation and consumption are necessary in order to decrease the risk of disease over the population. Certificates, attestations and other documents certifying the quality of batches, completed by additional laboratory examinations, are necessary in order to increase the level of confidence on the quality of products marketed in the Republic. The implementation of various control procedures and mechanisms at national level, correlated with the focused activity of the specialized institutions, can decrease the risk of contamination and avoid cases of disease on the population due to the consumption of fishery products.

Keywords: fishery products, food safety, quality control, Republic of Moldova

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Authors: Agnieszka Rolinska, Marta Makara-Studzinska

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Introduction: In recent years, there has been an intensive development of research into the physiological relationships between the experienced stress and obesity. Moreover, strong chronic stress leads to the disorganization of a person’s activeness on various levels of functioning, including the behavioral and cognitive sphere (also in one’s diet). Aim: The present work addresses the following research questions: Is there a relationship between an increase in stress related to the disease and the need for the cyclicality of diabetologic education in gestational diabetes? Are there any differences in terms of the experienced stress during the last three months of pregnancy in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Are there any differences in terms of stress coping styles in women with gestational diabetes and in normal pregnancy between the patients with normal weight gains and those with abnormal weight gains? Method: The study involved pregnant women with gestational diabetes (treated with diet, without insulin therapy) and in normal pregnancy – 206 women in total. The following psychometric tools were employed: Perceived Stress Scale (PSS; Cohen, Kamarck, Mermelstein), Coping Inventory for Stressful Situations (CISS; Endler, Parker) and authors’ own questionnaire. Gestational diabetes mellitus was diagnosed on the basis of the results of fasting oral glucose tolerance test (75 g OGTT). Body weight measurements were confirmed in a diagnostic interview, taking into account medical data. Regularities in weight gains in pregnancy were determined according to the recommendations of the Polish Gynecological Society and American norms determined by the Institute of Medicine (IOM). Conclusions: An increase in stress related to the disease varies in patients with differing requirements for the cyclical nature of diabetologic education (i.e. education which is systematically repeated). There are no differences in terms of recently experienced stress and stress coping styles between women with gestational diabetes and those in normal pregnancy. There is a relationship between weight gains in pregnancy and the stress experienced in life as well as stress coping styles – both in pregnancy complicated by diabetes and in physiological pregnancy. In the discussion of the obtained results, the authors refer to scientific reports from English-language magazines of international range.

Keywords: diabetologic education, gestational diabetes, stress, weight gain in pregnancy

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Authors: Rachel F. Ajayi, Unathi Sidwaba, Usisipho Feleni, Samantha F. Douman, Ezo Nxusani, Lindsay Wilson, Candice Rassie, Oluwakemi Tovide, Priscilla G.L. Baker, Sibulelo L. Vilakazi, Robert Tshikhudo, Emmanuel I. Iwuoha

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Pyrazinamide (PZA) is among the first-line pro-drugs in the tuberculosis (TB) combination chemotherapy used to treat Mycobacterium tuberculosis. Numerous reports have suggested that hepatotoxicity due to pyrazinamide in patients is due to inappropriate dosing. It is therefore necessary to develop sensitive and reliable techniques for determining the PZA metabolic profile of diagnosed patients promptly and at point-of-care. This study reports the determination of PZA based on nanobiosensor systems developed from disuccinimidyl octanedioate modified Cytochrome P450-2E1 (CYP2E1) electrodeposited on gold substrates derivatised with (poly(8-anilino-1-napthalene sulphonic acid) PANSA/PVP-AgNPs nanocomposites. The rapid and sensitive amperometric PZA detection gave a dynamic linear range of 2 µM to 16 µM revealing a limit of detection of 0.044 µM and a sensitivity of 1.38 µA/µM. The Michaelis-Menten parameters; KM, KMapp and IMAX were also calculated and found to be 6.0 µM, 1.41 µM and 1.51 µA respectively indicating a nanobiosensor suitable for use in serum.

Keywords: tuberculosis, cytochrome P450-2E1, disuccinimidyl octanedioate, pyrazinamide

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Authors: Margaret S. Wright

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Background/Significance: During many recent public health emergencies/disasters, public health nursing data has been missing or delayed, potentially impacting the decision-making and response. Data used as evidence for decision-making in response, planning, and mitigation has been erratic and slow, decreasing the ability to respond. Methodology: Applying best practices in data management and data use in public health settings, and guided by the concepts outlined in ‘Disaster Standards of Care’ models leads to the development of recommendations for a model of best practices in data management and use in public health disasters/emergencies by public health nurses. As the ‘patient’ in public health disasters/emergencies is the community (local, regional or national), guidelines for patient documentation are incorporated in the recommendations. Findings: Using model public health nurses could better plan how to prepare for, respond to, and mitigate disasters in their communities, and better participate in decision-making in all three phases bringing public health nursing data to the discussion as part of the evidence base for decision-making.

Keywords: data management, decision making, disaster planning documentation, public health nursing

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Authors: Mircan Kaya

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A multi-disciplinary approach is required in any intervention project for historical monuments. Due to the complexity of their geometry, the variable and unpredictable characteristics of original materials used in their creation, heritage structures are peculiar. Their histories are often complex, and they require correct diagnoses to decide on the techniques of intervention. This approach should not only combine technical aspects but also historical research that may help discover phenomena involving structural issues, and acquire a knowledge of the structure on its concept, method of construction, previous interventions, process of damage, and its current state. In addition to the traditional techniques like bed joint reinforcement, the repairing, strengthening and restoration of historical buildings may require several other modern methods which may be described as innovative techniques like pre-stressing and post-tensioning, use of shape memory alloy devices and shock transmission units, shoring, drilling, and the use of stainless steel or titanium. Regardless of the method to be incorporated in the strengthening process, which can be traditional or innovative, it is crucial to recognize that structural strengthening is the process of upgrading the structural system of the existing building with the aim of improving its performance under existing and additional loads like seismic loads. This process is much more complex than dealing with a new construction, owing to the fact that there are several unknown factors associated with the structural system. Material properties, load paths, previous interventions, existing reinforcement are especially important matters to be considered. There are several examples of seismic strengthening with traditional and innovative techniques around the world, which will be discussed in this paper in detail, including their pros and cons. Ultimately, however, the main idea underlying the philosophy of a successful intervention with the most appropriate techniques of strengthening a historic monument should be decided by a proper assessment of the specific needs of the building.

Keywords: bed joint reinforcement, historical monuments, post-tensioning, pre-stressing, seismic strengthening, shape memory alloy devices, shock transmitters, tie rods

Procedia PDF Downloads 261