Search results for: setting times

Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney

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Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.

Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements

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Authors: Islam Abouelhamd

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Rives have long been recognized as one of the most important natural resources, They are important to ensure human health, civilization, and sustainable development, and the importance of rivers as the focal point of cities was established from the early times of civilization and will remain so. Urban design of Riverfront has been an issue of wide concern and extensive discussion since the 1970s, however, Cities seek a riverfront that is a place of public enjoyment, They want a Riverfront where there is ample visual and physical public access to both the water and the land, they want a place that contributes to the quality of life in all of its aspects; economic, social, and cultural, on another hand, Successful urban design of Riverfront requires an understanding of development processes, dimensions of urban design and an appreciation of the distinctiveness of Riverfront locations. A close association between cities and river is inherently over the history of civilization, and in fact, many urban cities in Egypt are located close to Nile River areas. Always trying to use the land closer to the river to take advantage of the benefits it provides, And in spite of the significant role played by the littoral fronts in the life of the city, the riverfronts have remained generally in Egypt and especially in Asyut city neglected. According to the knowledge gained from the literature review, review of case studies and the historical researches of Asyut Riverfront, this research aims to identify the urban transformations of Asyut riverfront and expect the Opportunities and Challenges which will play an important part of the future urban design issues and researches will prepare, especially in the case study area (northern areas of Asyut riverfront). After that, the case study data, historical framework and International experiences were collected and analyzed to Produce Primary indicators of the expectations of the riverfront urban design process inside the case study area, In addition to preparing the conclusions of the theoretical framework and recommendations for the paper.

Keywords: civilization, sustainable development, riverfront, urban transformations

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Authors: Mamta Jat

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Background: The increased longevity has resulted in the increase in the percentage of the global population aged 60 years or over. With this “demographic transition” towards ageing, “epidemiologic transition” is also taking place characterised by growing share of non-communicable diseases in the overall disease burden. So, many of the older adults are ageing with chronic disease and high levels of frailty which often results in lower levels of quality of life. Although frailty may be increasingly common in older adults, prevention or, at least, delay the onset of late-life adverse health outcomes and disability is necessary to maintain the health and functional status of the ageing population. This is an effort using SAGE data to assess levels of frailty and its socio-demographic correlates and its relation with quality of life in LMICs of India, China, Ghana, Mexico, Russia and South Africa in a comparative perspective. Methods: The data comes from multi-country Study on Global AGEing and Adult Health (SAGE), consists of nationally representative samples of older adults in six low and middle-income countries (LMICs): China, Ghana, India, Mexico, the Russian Federation and South Africa. For our study purpose, we will consider only 50+ year’s respondents. The logistic regression model has been used to assess the correlates of frailty. Multinomial logistic regression has been used to study the effect of frailty on QOL (quality of life), controlling for the effect of socio-economic and demographic correlates. Results: Among all the countries India is having highest mean frailty in males (0.22) and females (0.26) and China with the lowest mean frailty in males (0.12) and females (0.14). The odds of being frail are more likely with the increase in age across all the countries. In India, China and Russia the chances of frailty are more among rural older adults; whereas, in Ghana, South Africa and Mexico rural residence is protecting against frailty. Among all countries china has high percentage (71.46) of frail people in low QOL; whereas Mexico has lowest percentage (36.13) of frail people in low QOL.s The risk of having low and middle QOL is significantly (p<0.001) higher among frail elderly as compared to non–frail elderly across all countries with controlling socio-demographic correlates. Conclusion: Women and older age groups are having higher frailty levels than men and younger aged adults in LMICs. The mean frailty scores demonstrated a strong inverse relationship with education and income gradients, while lower levels of education and wealth are showing higher levels of frailty. These patterns are consistent across all LMICs. These data support a significant role of frailty with all other influences controlled, in having low QOL as measured by WHOQOL index. Future research needs to be built on this evolving concept of frailty in an effort to improve quality of life for frail elderly population, in LMICs setting.

Keywords: Keywords: Ageing, elderly, frailty, quality of life

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Authors: Omolola R. Ayepola, Nicole L. Brooks, Oluwafemi O. Oguntibeju

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The liver plays an important role in the regulation of blood glucose and is a target organ of hyperglycaemia. Hyperglycemia plays a crucial role in the onset of various liver diseases and may culminate into hepatopathy if untreated. Alteration in antioxidant defense and increase in oxidative stress that results in tissue injury is characteristic of diabetes. We evaluated the protective effects of kolaviron-a biflavonoid complex, on hepatic antioxidants, lipid peroxidation and apoptosis in the liver of diabetic rats. To induce type I diabetes, rats were injected with streptozotocin intraperitoneally at a single dose of 50 mg/kg. Oral treatment of diabetic rats with kolaviron (100 mg/kg) started on the 6th day after diabetes induction and continued for 6 weeks (5 times weekly). Diabetic rats exhibited a significant increase in the peroxidation of hepatic lipids as observed from the elevated level of malondialdehyde (MDA) estimated by High-Performance Liquid Chromatography. In addition, Oxygen Radical Absorbance Capacity (ORAC), ratio of reduced to oxidized glutathione (GSH/GSSG) and catalase (CAT) activity was decreased in the liver of diabetic rats. TUNEL assay revealed increased apoptotic cell death in the liver of diabetic rats. Examination of Pancreatic beta-cells by immunohistochemical methods revealed beta cell degeneration and reduction in beta cell/ islet area in the diabetic controls. Kolaviron-treatment increased the area of insulin immunoreactive beta-cells significantly. Kolaviron attenuated lipid peroxidation and apoptosis in the liver of diabetic rats, increased CAT activity GSH levels and the resultant GSH: GSSG. The ORAC of kolaviron-treated diabetic liver was restored to near-normal values. Kolaviron protects the liver against oxidative and apoptotic damage induced by hyperglycemia. The antidiabetic effect of kolaviron may also be related to its beneficial effects on beta-cell function.

Keywords: diabetes mellitus, kolaviron, oxidative stress, liver, apoptosis

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Authors: Siming Wang, Qing Ni, Yu Wu, Ruihai Xu, Hong Ye

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Porous electric heaters, compared to conventional electric heaters, exhibit excellent heating performance due to their large specific surface area. Porous electric heaters employ porous metallic materials or conductive porous ceramics as the heating element. The former attains a low heating power with a fixed current due to the low electrical resistivity of metal. Although the latter can bypass the inherent challenges of porous metallic materials, the fabrication process of the conductive porous ceramics is complicated and high cost. This work proposed a porous ceramic electric heater with dielectric honeycomb ceramic as a substrate and surface conductive coating as a heating element. The conductive coating was prepared by the sol-gel method using silica sol and methyl trimethoxysilane as raw materials and graphite powder as conductive fillers. The conductive mechanism and degradation reason of the conductive coating was studied by electrical resistivity and thermal stability analysis. The heating performance of the proposed heater was experimentally investigated by heating air and deionized water. The results indicate that the electron transfer is achieved by forming the conductive network through the contact of the graphite flakes. With 30 wt% of graphite, the electrical resistivity of the conductive coating can be as low as 0.88 Ω∙cm. The conductive coating exhibits good electrical stability up to 500°C but degrades beyond 600°C due to the formation of many cracks in the coating caused by the weight loss and thermal expansion. The results also show that the working medium has a great influence on the volume power density of the heater. With air under natural convection as the working medium, the volume power density attains 640.85 kW/m3, which can be increased by 5 times when using deionized water as the working medium. The proposed honeycomb ceramic electric heater has the advantages of the simple fabrication method, low cost, and high volume power density, demonstrating great potential in the fluid heating field.

Keywords: conductive coating, honeycomb ceramic electric heater, high specific surface area, high volume power density

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Authors: Suhaila Qari, Samia Moharram, Safaa Alowaidi

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Objectives: To determine the fatty acids profiles in female fish, R. sarba from the Red Sea during the spawning season. Methods: Monthly individual Rhabdosargus sarba were obtained from Bangalah market in Jeddah, Red Sea and transported to the laboratory in ice aquarium. The total length, standard length and weight were measured, fishes were dissected. Ovaries were removed, weighed and 10 ml of concentrated hydrochloric acid were added to 10g of the ovary in a conical flask and immersed in boiling water until the sample was dissolved and the fat was seen to collect on the surface. The conical was cooled and the fat was extracted by shaking with 30 ml of diethyl ether. The extract was bowled after allowing the layers to separate into a weighed flask. The extraction was repeated three times more and distilled off the solvent then the fat dried at 100oC, cooled and weighed. Then 50 mg of lipid was put in a tube, 5 ml of methanolic sulphuric acid was added and 2 ml of benzene, the tube well closed and placed in water bath at 90oC for an hour and half. After cooling, 8 ml water and 5 ml petroleum was added shacked strongly and the ethereal layer was separated in a dry tube, evaporated to dryness. The fatty acid methyl esters were analyzed using a Hewlett Packard (HP 6890) chromatography, asplit /splitless injector and flame ionization detector (FID). Results: In female Rhabdosargus sarba, a total of 29 fatty acids detected in ovaries throughout the spawning season. The main fatty acid group in total lipid was saturated fatty acid (SFA, 28.9%), followed by 23.5% of polyunsaturated fatty acids (PUFA) and 12.9% of monounsaturated fatty acids (MUFA). The dominant SFA were palmitic and stearic, the major MUFA were palmitoleic and oleic, and the major PUFA were C18:2 and C22:2. During spawning stages no significant differences in total SFA, MUFA and PUFA, the highest value of SFA was in late spawning (36.78%). However, the highest value of MUFA and PUFA was in spawning (16.70% and 24.96% respectively). During spawning season there were a significant differences in total SFA between March (late spawning stage) and December (nearly ripe stage), (P < 0.05).

Keywords: sparidae, Rhabdosargus sarba, fish, fatty acids, spawning, gonads, red sea

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Authors: Camille Plant, Katherine McGill, Pek Ang

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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.

Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry

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Authors: Christina Hagen, Pragathi Kamale Gurmurthy, Thorsten M. Buzug

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CFD simulations are performed in the upper airway of a patient suffering from obstructive sleep apnea (OSA) that is a sleep related breathing disorder characterized by repetitive partial or complete closures of the upper airways. The simulations are aimed at getting a better understanding of the pathophysiological flow patterns in an OSA patient. The simulation is compared to medical data of a sleep endoscopic examination under sedation. A digital model consisting of surface triangles of the upper airway is extracted from the MR images by a region growing segmentation process and is followed by a careful manual refinement. The computational domain includes the nasal cavity with the nostrils as the inlet areas and the pharyngeal volume with an outlet underneath the larynx. At the nostrils a flat inflow velocity profile is prescribed by choosing the velocity such that a volume flow rate of 150 ml/s is reached. Behind the larynx at the outlet a pressure of -10 Pa is prescribed. The stationary incompressible Navier-Stokes equations are numerically solved using finite elements. A grid convergence study has been performed. The results show an amplification of the maximal velocity of about 2.5 times the inlet velocity at a constriction of the pharyngeal volume in the area of the tongue. It is the same region that also shows the highest pressure drop from about 5 Pa. This is in agreement with the sleep endoscopic examinations of the same patient under sedation showing complete contractions in the area of the tongue. CFD simulations can become a useful tool in the diagnosis and therapy of obstructive sleep apnea by giving insight into the patient’s individual fluid dynamical situation in the upper airways giving a better understanding of the disease where experimental measurements are not feasible. Within this study, it could been shown on one hand that constriction areas within the upper airway lead to a significant pressure drop and on the other hand a good agreement of the area of pressure drop and the area of contraction could be shown.

Keywords: biomedical engineering, obstructive sleep apnea, pharynx, upper airways

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Authors: Domenico Carmelo Mongelli, Laura Carnieletto, Michele De Carli, Filippo Busato

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Starting from the current context in which the Russian invasion in Ukraine has highlighted Europe's dependence on natural gas imports for heating buildings, this study proposes solutions to resolve this dependency and evaluates related scenarios in the near future. In the first part of this work the methodologies and results of the economic impact are indicated by simulating a massive replacement of boilers powered by fossil fuels with electrically powered hightemperature air-water heat pumps for heating residential buildings in different European climates, without changing the current energy mix. For each individual European region, the costs for the purchase and installation of heat pumps for all residential buildings have been determined. Again for each individual European region, the economic savings during the operation phase that would be obtained in this future scenario of energy transition from fossil fuels to the electrification of domestic heating were calculated. For the European regions for which the economic savings were identified as positive, the payback times of the economic investments were analysed. In the second part of the work, hypothesizing different scenarios for a possible greater use of renewable energy sources and therefore with different possible future scenarios of the energy mix, the methodologies and results of the simulations on the economic analysis and on the environmental analysis are reported which have allowed us to evaluate the future effects of the energy transition from boilers to heat pumps for each European region. In the third part, assuming a rapid short-term diffusion of cooling for European residential buildings, the penetration shares in the cooling market and future projections of energy needs for cooling for each European region have been identified. A database was created where the results of this research relating to 38 European Nations divided into 179 regions were reported. Other previous works on the topics covered were limited to analyzing individual European nations, without ever going into detail about the individual regions within each nation, while the original contribution of the present work lies in the fact that the results achieved allow a specific numerical analysis and punctual for every single European region.

Keywords: buildings, energy, Europe, future

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Authors: María Dolores Caro, Eugenio M. Fedriani, Ángel F. Tenorio

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When lorries transport dangerous goods, there exist some legal stipulations in the European Union for assuring the security of the rest of road users as well as of those goods being transported. At this respect, lorry drivers cannot park in usual parking areas, because they must use parking areas with special conditions, including permanent supervision of security personnel. Moreover, drivers are compelled to satisfy additional regulations about resting and driving times, which involve in the practical possibility of reaching the suitable parking areas under these time parameters. The “European Agreement concerning the International Carriage of Dangerous Goods by Road” (ADR) is the basic regulation on transportation of dangerous goods imposed under the recommendations of the United Nations Economic Commission for Europe. Indeed, nowadays there are no enough parking areas adapted for dangerous goods and no complete study have suggested the best locations to build new areas or to adapt others already existing to provide the areas being necessary so that lorry drivers can follow all the regulations. The goal of this paper is to show how many additional parking areas should be built in the Iberian Peninsula to allow that lorry drivers may park in such areas under their restrictions in resting and driving time. To do so, we have modeled the problem via graph theory and we have applied a new efficient algorithm which determines an optimal solution for the problem of locating new parking areas to complement those already existing in the ADR for the Iberian Peninsula. The solution can be considered minimal since the number of additional parking areas returned by the algorithm is minimal in quantity. Obviously, graph theory is a natural way to model and solve the problem here proposed because we have considered as nodes: the already-existing parking areas, the loading-and-unloading locations and the bifurcations of roads; while each edge between two nodes represents the existence of a road between both nodes (the distance between nodes is the edge's weight). Except for bifurcations, all the nodes correspond to parking areas already existing and, hence, the problem corresponds to determining the additional nodes in the graph such that there are less up to 100 km between two nodes representing parking areas. (maximal distance allowed by the European regulations).

Keywords: dangerous goods, parking areas, Iberian peninsula, graph-based modeling

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Authors: R. Christopher, C. Brandt, N. Damons

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Background: The sequence of prevention model states that by constant assessment of injury, injury mechanisms and risk factors are identified, highlighting that collecting and recording of data is a core approach for preventing injuries. Several screening tools are available for use in the clinical setting. These screening techniques only recently received research attention, hence there is a dearth of inconsistent and controversial data regarding their applicability, validity, and reliability. Several systematic reviews related to common soccer injuries have been conducted; however, none of them addressed the screening tools for common soccer injuries. Objectives: The purpose of this study was to conduct a review of screening tools and their accuracy for common injuries in soccer. Methods: A systematic scoping review was performed based on the Joanna Briggs Institute procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed, and grey literature were used to access suitable studies. Some of the key search terms included: injury screening, screening, screening tool accuracy, injury prevalence, injury prediction, accuracy, validity, specificity, reliability, sensitivity. All types of English studies dating back to the year 2000 were included. Two blind independent reviewers selected and appraised articles on a 9-point scale for inclusion as well as for the risk of bias with the ACROBAT-NRSI tool. Data were extracted and summarized in tables. Plot data analysis was done, and sensitivity and specificity were analyzed with their respective 95% confidence intervals. I² statistic was used to determine the proportion of variation across studies. Results: The initial search yielded 95 studies, of which 21 were duplicates, and 54 excluded. A total of 10 observational studies were included for the analysis: 3 studies were analysed quantitatively while the remaining 7 were analysed qualitatively. Seven studies were graded low and three studies high risk of bias. Only high methodological studies (score > 9) were included for analysis. The pooled studies investigated tools such as the Functional Movement Screening (FMS™), the Landing Error Scoring System (LESS), the Tuck Jump Assessment, the Soccer Injury Movement Screening (SIMS), and the conventional hamstrings to quadriceps ratio. The accuracy of screening tools was of high reliability, sensitivity and specificity (calculated as ICC 0.68, 95% CI: 52-0.84; and 0.64, 95% CI: 0.61-0.66 respectively; I² = 13.2%, P=0.316). Conclusion: Based on the pooled results from the included studies, the FMS™ has a good inter-rater and intra-rater reliability. FMS™ is a screening tool capable of screening for common soccer injuries, and individual FMS™ scores are a better determinant of performance in comparison with the overall FMS™ score. Although meta-analysis could not be done for all the included screening tools, qualitative analysis also indicated good sensitivity and specificity of the individual tools. Higher levels of evidence are, however, needed for implication in evidence-based practice.

Keywords: accuracy, screening tools, sensitivity, soccer injuries, specificity

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Authors: Jennifer E Simpson

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Background and purpose: The ubiquitous use of the Internet and social media by children and young people has had a dual effect. The first is to open a world of possibilities and promise that is characterized by the ability to consume and create content, connect with friends, explore and experiment. The second relates to risks such as unsolicited requests, sexual exploitation, cyberbullying and commercial exploitation. This duality poses significant difficulties for a generation of foster carers and social workers who have no childhood experience to draw on in terms of growing up using the Internet, social media and digital devices. This presentation is concerned with the findings of a small qualitative study about the use of digital devices and the Internet by care-experienced young people to stay in touch with their families and the way this was managed by foster carers and social workers using specific parental mediation strategies. The findings highlight that restrictive strategies were used by foster carers and endorsed by social workers. An argument is made for an approach that develops a series of balanced solutions that move foster carers from such restrictive approaches to those that are grounded in co-use and are interpretive in nature. Methods: Using a purposive sampling strategy, 12 triads consisting of care-experienced young people (aged 13-18 years), their foster carers and allocated social workers were recruited. All respondents undertook a semi-structured interview, with the young people detailing what social media apps and other devices they used to contact their families via an Ecomap. The foster carers and social workers shared details of the methods and approaches they used to manage digital devices and the Internet in general. Data analysis was performed using a Framework analytic method to explore the various attitudes, as well as complementary and contradictory perspectives of the young people, their foster carers and allocated social workers. Findings: The majority of foster carers made use of parental mediation strategies that erred on the side of typologies that included setting rules and regulations (restrictive), ad-hoc checking of a young person’s behavior and device (monitoring), and software used to limit or block access to inappropriate websites (technical). It was noted that minimal use was made by foster carers of parental mediation strategies that included talking about content (active/interpretive) or sharing Internet activities (co-use). Amongst the majority of the social workers, they also had a strong preference for restrictive approaches. Conclusions and implications: Trepidations on the part of both foster carers and social workers about the use of digital devices and the Internet meant that the parental strategies used were weighted more towards restriction, with little use made of approaches such as co-use and interpretative. This lack of balance calls for solutions that are grounded in co-use and an interpretive approach, both of which can be achieved through training and support, as well as wider policy change.

Keywords: parental mediation strategies, risk, children in state care, online safety

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Authors: Shahin A. Abdel-Naby, James P. Colgan, Michael S. Pindzola

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A time-dependent close-coupling method is developed to calculate a total, double and triple autoionization rates for hollow atomic ions of four-electron systems. This work was motivated by recent observations of the four-electron Auger process in near K-edge photoionization of C+ ions. The time-dependent close-coupled equations are solved using lattice techniques to obtain a discrete representation of radial wave functions and all operators on a four-dimensional grid with uniform spacing. Initial excited states are obtained by relaxation of the Schrodinger equation in imaginary time using a Schmidt orthogonalization method involving interior subshells. The radial wave function grids are partitioned over the cores on a massively parallel computer, which is essential due to the large memory requirements needed to store the coupled-wave functions and the long run times needed to reach the convergence of the ionization process. Total, double, and triple autoionization rates are obtained by the propagation of the time-dependent close-coupled equations in real-time using integration over bound and continuum single-particle states. These states are generated by matrix diagonalization of one-electron Hamiltonians. The total autoionization rates for each L excited state is found to be slightly above the single autoionization rate for the excited configuration using configuration-average distorted-wave theory. As expected, we find the double and triple autoionization rates to be much smaller than the total autoionization rates. Future work can be extended to study electron-impact triple ionization of atoms or ions. The work was supported in part by grants from the American University of Sharjah and the US Department of Energy. Computational work was carried out at the National Energy Research Scientific Computing Center (NERSC) in Berkeley, California, USA.

Keywords: hollow atoms, autoionization, auger rates, time-dependent close-coupling method

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Authors: Chia-Wen Kuo

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Jesse Curran states that there is a "breath awareness" that "facilitates a present-minded capability" to catalyse an "epistemological rupture" in Emily Dickinson's poetry, particularly in the age of Anthropocene. In Dickinson's "Nature", non-humans are subjectified as nature ceases to be subordinated to human interests, and Dickinson's Eco-humility has driven us, readers, into mimicking nature for the making of a better world. In terms of sustainable architecture, Norman Foster is among the representatives who utilise BIM to reduce architectural waste while satiating the users' aesthetic craving for a spectacular skyline. Notably, the Gherkin - 30 St. Mary Axe in east-end London. In 2019, Foster and his team aspired to savour the London skyline with his new design - the Tulip, which has been certified by the LEED as a legitimate green building as well as a complementary extension of the Gherkin. However, Foster's proposition had been denied for numerous times by the mayor Sadiq Khan and the city council as the Tulip cannot blend in the public space around while its observatory functions like a surveillance platform. The Tulip, except for its aesthetic idiosyncrasy, fails to serve for the public good other than another ostentatious tourist attraction in London. The architectural team for Mode Gakuen Cocoon tower, completed in 2008, intended to honour Nature with the symbolism in the building's aesthetic design. It serves as an architectural cocoon that nurtures the students of "Special Technology and Design College" inside. The building itself turns into a Dickinsonian anthropomorphism, where humans are made humble to learn from the entomological beings for self-betterment in the age of Anthropocene. Despite bearing resemblance to a tulip as well as its LEED credential, Norman Foster’s Tulip merely pays tribute to the Nature in a relatively superficial manner without constructing an apparatus that substantially benefit the Londoners as all green cities should embrace Emily Dickinson’s “breath awareness” and be built and treated as an extensive as well as expansive form of biomimicry.

Keywords: green city, sustianable architecture, London, Tokyo

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Authors: Ademola Ibukunolu Atanda

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Research undertakings are meant to proffer solutions to issues and challenges in society. This justifies the need for research in ivory towers. Multinational and non-governmental organisations, as well as foundations, commit financial resources to support research endeavours. In recent times, the direction and dimension of research undertaking encourage collaborations, whereby experts from different disciplines or specializations would bring their expertise in addressing any identified problem, whether in humanities or sciences. However, the extent to which collaborative research undertakings are perceived and embraced by academic staff would determine the impact collaborative research would have on society. To this end, this study investigated academic staff’s perception and willingness to be involved in collaborative research for the purpose of proffering solutions to societal problems. The study adopted a descriptive research design. The population comprised academic staff in southern Nigeria. The sample was drawn through a convenient sampling technique. The data were collected using a questionnaire titled “Perception and Willingness to Participate in Collaborative Research Questionnaire (PWPCRQ)’ using Google Forms. Data collected were analyzed using descriptive statistics of simple percentages, mean and charts. The findings showed that Academic Staff’s readiness to participate in collaborative research is to a great extent (89%) and they participate in collaborative research very often (51%). The Academic Staff was involved more in collaboration research among their colleagues within their universities (1.98) than participation in inter-disciplines collaboration (1.47) with their colleagues outside Nigeria. Collaborative research was perceived to impact on development (2.5). Collaborative research offers the following benefits to members’ aggregation of views, the building of an extensive network of contacts, enhancement of sharing of skills, facilitation of tackling complex problems, increased visibility of research network and citations and promotion of funding opportunities. The study concluded that Academic staff in universities in the South-West of Nigeria participate in collaborative research but with their colleagues within Nigeria rather than outside the country. Based on the findings, it was recommended that the management of universities in South-West Nigeria should encourage collaborative research with some incentives.

Keywords: collaboration, research, development, participation

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Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi

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Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.

Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery

Procedia PDF Downloads 140

Authors: Obadire F. O., Obadire, S. O., Adeoti R. F., Pirgozliev V.

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An experiment was conducted to determine the efficacy of utilizing African black plum seed nut (ABPNBD) meal on hematological and biochemical indices of broiler chicken ration formulated to substitute wheat offal. A total of 150- 1day-old, male Agrited birds were reared for 28 days of the experiment. The birds were assigned to five dietary treatments, with ten birds per treatment replicated 3 times. Experimental diets were formulated by supplementing the milled African black plum nut at (0, 5, 10, 12.5, and 15%) inclusion levels in the starter broiler’s ratio designated as T1 (control diet containing no ABPBD), Treatments (T2, 3,4 and 5) contained ABPNBD at 5, 10, 12.5, and 15%, respectively, in a completely randomized design. The hematological and biochemical indices of the birds were determined. The result revealed that all hematological parameters measured were significant (P <0.05) except for WBC. Increasing inclusion levels of ABPNBD decreased the PCV, HB, and RBC of the birds across the treatment groups. Birds fed 12.5 and 15% ABPNBD diets recorded the least of the parameters. The result of the serum biochemical indices showed significant (P < 0.05) influence for all parameters measured except for alanine transaminase (ALT), (AST), and creatinine. The total protein (TP), albumin, globulin, and glucose values were reduced across the treatment group as ABPNBD inclusion increased. Birds fed above 10% ABPNBD recorded the lowest value of TP, albumin, globulin, and glucose when compared with birds on a control diet and other treatments. The uric acid ranged from 3.85 to 2 .13 mmol/L, while creatinine ranged from 62.00 to 53.50 mmol/l. AST ranged between 8.50 u/l (5%) to 7.90 u/l (10%). ALT ranged between 7.50 u/l (12.5%) to 5.50 u/l (5 and 10%). In conclusion, dietary inclusion of African black plum up to 10% has no detrimental effect on the health of the starter chickens. Meanwhile, inclusion above 10% revealed a negative effect on some blood parameters measured. Therefore, African black plum should be supplemented with probable probiotics or subjected to different processing methods if to be used at a 15% inclusion level for optimal results.

Keywords: African black plum seed, starter broiler chickens, hematological and serum biochemical indices, (Vitex doniana)

Procedia PDF Downloads 28

Authors: R. Tariq, R. Lee

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Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.

Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation

Procedia PDF Downloads 151

Authors: D. F. Zeynalov, T. V. Kartseva, O. V. Sorokin

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Currently, approaches to assess cardiointervalography are based on the calculation of data variance intervals RR. However, they do not allow the evaluation of features related to a period of the cardiac cycle, so how electromechanical phenomena during cardiac subphase are characterized by differently directed changes. Therefore, we have proposed a method of subphase analysis of the cardiac cycle, developed in the department of hominal physiology Novosibirsk State Medical University to identify the features of the dispersion subphase of the cardiac cycle. In the present paper we have examined the 5-minute intervals cardiointervalography (CIG) to isolate RR-, QT-, ST-ranges in healthy children and children with acute respiratory diseases (ARD) in comparison. It is known that primary school-aged children suffer at ARD 5-7 times per year. Consequently, it is one of the most relevant problems in pediatrics. It is known that the spectral indices and indices of temporal analysis of heart rate variability are highly sensitive to the degree of intoxication during immunological process. We believe that the use of subphase analysis of heart rate will allow more thoroughly evaluate responsiveness of the child organism during the course of ARD. The study involved 60 primary school-aged children (30 boys and 30 girls). In order to assess heart rhythm regulation, the record CIG was used on the "VNS-Micro" device of Neurosoft Company (Ivanovo) for 5 minutes in the supine position and 5 minutes during active orthostatic test. Subphase analysis of variance QT-interval and ST-segment was performed on the "KardioBOS" software Biokvant Company (Novosibirsk). In assessing the CIG in the supine position and in during orthostasis of children with acute respiratory diseases only RR-intervals are observed typical trend of general biological reactions through pressosensitive compensation mechanisms to lower blood pressure, but compared with healthy children the severity of the changes is different, of sick children are more pronounced indicators of heart rate regulation. But analysis CIG RR-intervals and analysis subphase ST-segment have yielded conflicting trends, which may be explained by the different nature of the intra- and extracardiac influences on regulatory mechanisms that implement the various phases of the cardiac cycle.

Keywords: acute respiratory diseases, cardiointervalography, subphase analysis, cardiac cycle

Procedia PDF Downloads 259

Authors: Ibrahim M. I. Hamoda, Ahmed R. Z. Baghdadi, Mohammed K. Mohamed, Nawal A. Abu-Shady

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Background: Most of patients with vestibular dysfunction suffering from balance disorders, Abnormality in balance increase effort and exertion which affect the independency, so this study might be a guide in managing balance problem and consequently improve walking with less exertion and maximum function. Purpose: to analyze and discuss the effect of transcranial magnetic therapy on balance in patients with vestibular dysfunction. Methods: forty subjects from both sexes were classified to divided randomly into two equal groups; Group I study group: this group received transcranial magnetic therapy, with a selected physical therapy program for improving balance and vestibular disorders (Balance training, Cawthorne-Cooksey Exercises) and group II (control group): this group received a selected physical therapy program as group I without transcranial magnetic therapy. This treatment procedure will be applied three times weekly for three months. The mean age was 54.53±3.44 and 55.33±2.32 years and BMI 35.7±3.03 and 35.73±1.03 kg/m2 for group I and II respectively. The Biodex Balance System, Berge balances scale (BBS) and brain MRI were used for assessment. Assessments were conducted before and after treatment. The treatment program for group I included balance training, Cawthorne-Cooksey Exercises and pulsed magnetic therapy (Parameters used in the program of 20 minutes, Intensity 2 gausses, Frequency 1 Hz). This selected program was done in approximately one hour every other day for three month. The treatment program group II Patients received the same program as group A without transcranial magnetic therapy. Results: The One-way ANOVA revealed that there were no significant differences in BBS scores, overall balance index, Anterior / posterior balance index, Medial / lateral balance index and dynamic limits of stability between both groups. Moreover, the BBS scores increased and overall balance index, Anterior / posterior balance index, Medial / lateral balance index and dynamic limits of stability decreased significantly after treatment in group I and II compared with before treatment. Interpretation/Conclusion: Adding pulsed magnetic therapy to balance training, Cawthorne-Cooksey Exercises has no effect on static and dynamic balance in patients with balance problems due to benign positional paroxysmal vertigo.

Keywords: balance, transcranial magnetic therapy, vestibular dysfunction, biomechanic

Procedia PDF Downloads 465

Authors: A. T. Toci, M. V. B. Zanoni

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The advanced oxidation processes have been defined as destructive technologies treatment of wastewater. These involve the formation of powerful oxidizing agents (usually hydroxyl radical .OH) capable of reacting with organic compounds present in wastewater, transforming damaging substances in CO2 and H2O (mineralization) or other innocuous products. However, the photochemical degradation with singlet oxygen has been little explored as oxidative pathway for the treatment of effluents containing food colorants. The molecular oxygen is an effective suppressor of organic molecules in the triplet excited state. One of the possible results of the physical withdrawal is the formation of singlet oxygen. Studies with singlet oxygen (1O2) show an high reactivity of the excited state of the molecule with olefins, aromatic hydrocarbons and a number of other organic and inorganic compounds. Its reactivity is about 2500 times larger than the oxygen in the ground state. Thus, in this work, it was studied the degradation of some dyes used in food industry (tartrazine, sunset yellow, erythrosine and carmoisine) by singlet oxygen. The sensitizer used for generating the 1O2 was methylene blue, which has a quantum yield generation of 0.50. Samples were prepared in water at a concentration of 5 ppm and irradiated with a sunlight simulator (Newport brand, model no. 67005) by consecutive 8h. The absorption spectra of UV-Vis molecules were made each hour irradiation. The degradation kinetics for each dye was determined using the maximum length of each dye absorption. The analysis by UV-Vis revealed that the processes were very efficient for the colorants sunset yellow and carmoisine. Both presented degradation kinetics of order zero with degradation constants 0.416 and 0.104, respectively. In the case of sunset yellow degradation reached 53% after 7h irradiation, Demonstrating the process efficiency. The erithrosine presented during the period irradiated a oscillating degradation kinetics, which requires further study. In the other hand, tartrazine was stable in the presence of 1O2. The investigation of the dyes degradation products owned degradation by 1O2 are underway, the techniques used for this are MS and NMR. The results of this study will enable the application of the cleanest methods for the treatment of industrial effluents, as there are other non-toxic and polluting molecules to generate 1O2.

Keywords: food colourants, singlet oxygen, degradation, wastewater, oxidative

Procedia PDF Downloads 389

Authors: Arsalan Hassan Pour, Mansoureh Jeihani, Samira Ahangari

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Distracted driving has been one of the most integral concerns surrounding our daily use of vehicles since the invention of the automobile. While much attention has been recently given to cell phones related distraction, commercial billboards along roads are also candidates for drivers' visual and cognitive distractions, as they may take drivers’ eyes from the road and their minds off the driving task to see, perceive and think about the billboard’s content. Using a driving simulator and a head-mounted eye-tracking system, speed change, acceleration, deceleration, throttle response, collision, lane changing, and offset from the center of the lane data along with gaze fixation duration and frequency data were collected in this study. Some 92 participants from a fairly diverse sociodemographic background drove on a simulated freeway in Baltimore, Maryland area and were exposed to three different billboards to investigate the effects of billboards on drivers’ behavior. Participants glanced at the billboards several times with different frequencies, the maximum of which occurred on the billboard with the highest cognitive load. About 74% of the participants didn’t look at billboards for more than two seconds at each glance except for the billboard with a short visible area. Analysis of variance (ANOVA) was performed to find the variations in driving behavior when they are invisible, readable, and post billboards area. The results show a slight difference in speed, throttle, brake, steering velocity, and lane changing, among different areas. Brake force and deviation from the center of the lane increased in the readable area in comparison with the visible area, and speed increased right after each billboard. The results indicated that billboards have a significant effect on driving performance and visual attention based on their content and visibility status. Generalized linear model (GLM) analysis showed no connection between participants’ age and driving experience with gaze duration. However, the visible distance of the billboard, gender, and billboard content had a significant effect on gaze duration.

Keywords: ANOVA, billboards, distracted driving, drivers' behavior, driving simulator, eye-Tracking system, GLM

Procedia PDF Downloads 116

Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

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Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

Procedia PDF Downloads 332

Authors: Imam Muthohar, Budi Hartono, Sigit Priyanto, Hardiansyah Hardiansyah

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The eruption of Merapi Volcano in Yogyakarta, Indonesia in 2010 caused many casualties due to minimum preparedness in facing disaster. Increasing population capacity and evacuating to safe places become very important to minimize casualties. Regional government through the Regional Disaster Management Agency has divided disaster-prone areas into three parts, namely ring 1 at a distance of 10 km, ring 2 at a distance of 15 km and ring 3 at a distance of 20 km from the center of Mount Merapi. The success of the evacuation is fully supported by road network infrastructure as a way to rescue in an emergency. This research attempts to model evacuation process based on the rise of refugees in ring 1, expanded to ring 2 and finally expanded to ring 3. The model was developed using SATURN (Simulation and Assignment of Traffic to Urban Road Networks) program version 11.3. 12W, involving 140 centroid, 449 buffer nodes, and 851 links across Yogyakarta Special Region, which was aimed at making a preliminary identification of road networks considered vulnerable to disaster. An assumption made to identify vulnerability was the improvement of road network performance in the form of flow and travel times on the coverage of ring 1, ring 2, ring 3, Sleman outside the ring, Yogyakarta City, Bantul, Kulon Progo, and Gunung Kidul. The research results indicated that the performance increase in the road networks existing in the area of ring 2, ring 3, and Sleman outside the ring. The road network in ring 1 started to increase when the evacuation was expanded to ring 2 and ring 3. Meanwhile, the performance of road networks in Yogyakarta City, Bantul, Kulon Progo, and Gunung Kidul during the evacuation period simultaneously decreased in when the evacuation areas were expanded. The results of preliminary identification of the vulnerability have determined that the road networks existing in ring 1, ring 2, ring 3 and Sleman outside the ring were considered vulnerable to the evacuation of Mount Merapi eruption. Therefore, it is necessary to pay a great deal of attention in order to face the disasters that potentially occur at anytime.

Keywords: model, evacuation, SATURN, vulnerability

Procedia PDF Downloads 150

Authors: Ammar Asma, Bouafia Nabiha, Ben Cheikh Asma, Ezzi Olfa, Mahjoub Mohamed, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Ventilator-associated pneumonia (VAP) is currently recognized as one of the most relevant causes of morbidity and mortality among intensive care unit (ICU) patients worldwide. Identifying modifiable risk factors for VAP could be helpful for future controlled interventional studies aiming at improving prevention of VAP. The purposes of this study were to determine the incidence and risk factors for VAP in in a Tunisian medical ICU. Materials / Methods: A retrospective case-control study design based on the prospective database collected over a 14-month period from September 15th, 2015 through November 15th, 2016 in an 8-bed medical ICU. Patients under ventilation for over 48 h were included. The number of cases was estimated by Epi-info Software with the power of statistical test equal to 90 %. Each case patient was successfully matched to two controls according to the length of mechanical ventilation (MV) before VAP for cases and the total length of MV in controls. VAP in the ICU was defined according to American Thoracic Society; Infectious Diseases Society of America guidelines. Early onset or late-onset VAP were defined whether the infectious process occurred within or after 96 h of ICU admission. Patients’ risk factors, causes of admission, comorbidities and respiratory specimens collected were reviewed. Univariate and multivariate analyses were performed to determine variables associated with VAP with a p-value < 0.05. Results: During the period study, a total of 169 patients under mechanical ventilation were considered, 34 patients (20.11%) developed at least one episode of VAP in the ICU. The incidence rate for VAP was 14.88/1000 ventilation days. Among these cases, 9 (26.5 %) were early-onset VAP and 25 (73.5 %) were late-onset VAP. It was a certain diagnosis in 66.7% of cases. Tracheal aspiration was positive in 80% of cases. Multi-drug resistant Acinerobacter baumanii was the most common species detected in cases; 67.64% (n=23). The rate of mortality out of cases was 88.23% (n= 30). In univariate analysis, the patients with VAP were statistically more likely to suffer from cardiovascular diseases (p=0.035) and prolonged duration of sedation (p=0.009) and tracheostomy (p=0.001), they also had a higher number of re-intubation (p=0.017) and a longer total time of intubation (p=0.012). Multivariate analysis showed that cardiovascular diseases (OR= 4.44; 95% IC= [1.3 - 14]; p=0.016), tracheostomy (OR= 4.2; 95% IC= [1.16 -15.12]; p= 0.028) and prolonged duration of sedation (OR=1.21; 95% IC= [1.07, 1.36]; p=0.002) were independent risk factors for the development of VAP. Conclusion: VAP constitutes a therapeutic challenge in an ICU setting, therefore; strategies that effectively prevent VAP are needed. An infection control-training program intended to all professional heath care in this unit insisting on bundles and elaboration of procedures are planned to reduce effectively incidence rate of VAP.

Keywords: case control study, intensive care unit, risk factors, ventilator associated pneumonia

Procedia PDF Downloads 380

Authors: Fahimeh Rafiezade, Fatemeh Kakoyi Dinaki, Maryam Soufi

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This research studies and identifies the important elements of the living style of the residents of one of the neighborhoods of Tehran. The study will also study the role, the degree, and extent of the influence of neighborhood trainings in the lives of these people. Saraymahaleh is one of the centers established by Tehran municipality in various neighborhoods of Tehran in order to provide educational, cultural, etc. services. We carried out our study according to demography, field study, observation, 30 interviews, and 2 focus group discussions (FGD) at Sahebalzaman neighborhood in district 18 of Tehran municipality. We interpreted our observations and interviews with the neighborhoods’ supervisors and city council assistants (Shorayar), supervisor of Saraymahaleh and people who refer to them. We used this information to study the citizens’ lifestyle, values, behavioral, motivational, and attitude preferences in their religious and environmental orientations, cultural consumptions, and spare times, and the influence of Saraymahaleh on these aspects according to specific economic, cultural, and ethnic characteristics. Sahebalzaman neighborhood is considered an underprivileged district in terms of economy, high illiteracy, and low but structured migration of young people. The interviews we made helped us classify the people referring to Saraymahaleh based on their demographic attributes and attitudes and the reason of referring and finally the influence of the rendered services on their lifestyles. The studies indicate that women made the most part of people referring to Saraymahaleh Sahebalzaman. They were mostly young, in their midlives, and generally unemployed without a specialized skill. People referred to Saraymahaleh Sahebalzaman mostly to receive services or for entertainment and recreation purposes, i.e. they did not take part actively. In addition to creating welfare and cultural facilities, Saraymahaleh increases the level of skill training, empowerment, innovation and creativity, and issues skill certificates and documents that helps to increase job and income producing opportunities for the neighborhood residents, improve the quality of their live, and increase their hope for life.

Keywords: lifestyle, living in neighborhood, Saraymahaleh, Tehran municipality, urban life, demography

Procedia PDF Downloads 360

Authors: Maryam Jabeen

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In recent times, there has been a notable surge in attention towards diverse literacy concepts such as media literacy, information literacy, and digital literacy. These concepts have garnered escalating interest, spurring the emergence of novel approaches, particularly in the aftermath of the Covid-19 crisis. However, amidst discussions of crises, the domain of crisis literacy remains largely uncharted within academic exploration. Crisis literacy, also referred to as disaster literacy, denotes an individual's aptitude to not only comprehend but also effectively apply information, enabling well-informed decision-making and adherence to instructions about disaster mitigation, preparedness, response, and recovery. This theoretical and descriptive study seeks to transcend foundational literacy concepts, underscoring the urgency for an in-depth exploration of crisis literacy and its interplay with the realm of media communication. Given the profound impact of the pandemic experience and the looming uncertainty of potential future crises, there arises a pressing need to elevate crisis literacy, or disaster literacy, towards heightened autonomy and active involvement within the spheres of critical disaster preparedness, recovery initiatives, and media communication domains. This research paper is part of my ongoing Ph.D. research study, which explores on a broader level the Encoding and decoding of media communications in relation to crisis literacy. The primary objective of this research paper is to expound upon a descriptive, theoretical research endeavor delving into this domain. The emphasis lies in highlighting the paramount significance of media communications in literacy of crisis, coupled with an accentuated focus on its role in providing information to marginalized populations amidst crises. In conclusion, this research bridges the gap in crisis literacy correlation to media communications exploration, advocating for a comprehensive understanding of its dynamics and its symbiotic relationship with media communications. It intends to foster a heightened sense of crisis literacy, particularly within marginalized communities, catalyzing proactive participation in disaster preparedness, recovery processes, and adept media interactions.

Keywords: covid-19, crisis literacy, crisis, marginalized, media and communications, pandemic, vulnerable people

Procedia PDF Downloads 48

Authors: Stefano Barone

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Seismic retrofit of buildings through base isolation represents a consolidated protection strategy against earthquakes. It consists in decoupling the ground motion from that of the structure and introducing anti-seismic devices at the base of the building, characterized by high horizontal flexibility and medium/high dissipative capacity. This allows to protect structural elements and to limit damages to non-structural ones. For these reasons, full functionality is guaranteed after an earthquake event. Base isolation is applied extensively to both new and existing buildings. For the latter, it usually does not require any interruption of the structure use and occupants evacuation, a special advantage for strategic buildings such as schools, hospitals, and military buildings. This paper describes the application of seismic isolation to three existing masonry buildings in Italy: Villa “La Maddalena” in Macerata (Marche region), “Giacomo Matteotti” and “Plinio Il Giovane” school buildings in Perugia (Umbria region). The seismic hazard of the sites is characterized by a Peak Ground Acceleration (PGA) of 0.213g-0.287g for the Life Safety Limit State and between 0.271g-0.359g for the Collapse Limit State. All the buildings are isolated with a combination of free sliders type TETRON® CD with confined elastomeric disk and anti-seismic rubber isolators type ISOSISM® HDRB to reduce the eccentricity between the center of mass and stiffness, thus limiting torsional effects during a seismic event. The isolation systems are designed to lengthen the original period of vibration (i.e., without isolators) by at least three times and to guarantee medium/high levels of energy dissipation capacity (equivalent viscous damping between 12.5% and 16%). This allows the structures to resist 100% of the seismic design action. This article shows the performances of the supplied anti-seismic devices with particular attention to the experimental dynamic response. Finally, a special focus is given to the main site activities required to isolate a masonry building.

Keywords: retrofit, masonry buildings, seismic isolation, energy dissipation, anti-seismic devices

Procedia PDF Downloads 53

Authors: Chih-Yang Liao

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Baseball is usually played outdoors in the warmest months of the year. Therefore, baseball players are susceptible to the influence of the hot environment. It has been shown that hitting performance is increased in games played in warm weather, compared to in cold weather, in Major League Baseball. Intermittent cooling during sporting events can prevent the risk of hyperthermia and increase endurance performance. However, the effects of cooling during baseball games played in a hot environment are unclear. This study adopted a cross-over design. Ten Division I collegiate male baseball players in Taiwan volunteered to participate in this study. Each player played two simulated baseball games, with one day in between. Five of the players received intermittent cooling during the first simulated game, while the other five players received intermittent cooling during the second simulated game. The participants were covered in neck and forehand regions for 6 min with towels that were soaked in icy salt water 3 to 4 times during the games. The participants received the cooling treatment in the dugout when they were not on the field for defense or hitting. During the 2 simulated games, the temperature was 31.1-34.1°C and humidity was 58.2-61.8%, with no difference between the two games. Ratings of perceived exertion, thermal sensation, tympanic and forehead skin temperature immediately after each defensive half-inning and after cooling treatments were recorded. Ratings of perceived exertion were measured using the Borg 10-point scale. The thermal sensation was measured with a 6-point scale. The tympanic and skin temperature was measured with infrared thermometers. The data were analyzed with a two-way analysis of variance with repeated measurement. The results showed that intermitted cooling significantly reduced ratings of perceived exertion and thermal sensation. Forehead skin temperature was also significantly decreased after cooling treatments. However, the tympanic temperature was not significantly different between the two trials. In conclusion, intermittent cooling in the neck and forehead regions was effective in alleviating the perceived exertion and heat sensation. However, this cooling intervention did not affect the core temperature. Whether intermittent cooling has any impact on hitting or pitching performance in baseball players warrants further investigation.

Keywords: baseball, cooling, ratings of perceived exertion, thermal sensation

Procedia PDF Downloads 133

Authors: Min Chang Shin, Byung Hun Jeong, Jeong Sik Han, Jung Hoon Park

Abstract:

In modern times, as flight speeds have increased due to improvements in aircraft and missile engine performance, thermal loads have also increased. Because of the friction heat of air flow with high speed on the surface of the vehicle, it is not easy to cool the superheat of the vehicle by the simple air cooling method. For this reason, a cooling method through endothermic heat is attracting attention by using a fuel that causes an endothermic reaction in a high-speed vehicle. There are two main ways of cooling the fuel through the endothermic reaction. The first is physical heat absorption. When the temperature rises, there is a sensible heat that accompanies it. The second is the heat of reaction corresponding to the chemical heat absorption, which absorbs heat during the fuel decomposes. Generally, since the decomposition reaction of the fuel proceeds at a high temperature, it does not achieve a great efficiency in cooling the high-speed flight body. However, when the catalyst is used, decomposition proceeds at a low temperature thereby increasing the cooling efficiency. However, when the catalyst is used as a powder, the catalyst enters the engine and damages the engine or the catalyst can deteriorate the performance due to the sintering. On the other hand, when used in the form of pellets, catalyst loss can be prevented. However, since the specific surface of pellet is small, the efficiency of the catalyst is low. And it can interfere with the flow of fuel, resulting in pressure loss and problems with fuel injection. In this study, we tried to maximize the performance of the catalyst by preparing a hollow fiber type pellet for zeolite ZSM-5, which has a higher amount of heat absorption, than other conventional pellets. The hollow fiber type pellet was prepared by phase inversion method. The hollow fiber type pellet has a finger-like pore and sponge-like pore. So it has a higher specific surface area than conventional pellets. The crystal structure of the prepared ZSM-5 catalyst was confirmed by XRD, and the characteristics of the catalyst were analyzed by TPD/TPR device. This study was conducted as part of the Basic Research Project (Pure-17-20) of Defense Acquisition Program Administration.

Keywords: catalyst, endothermic reaction, high-speed vehicle cooling, zeolite, ZSM-5

Procedia PDF Downloads 296