Search results for: hospital building

Authors: Namrata D. Hiremath, Mahalaxmi Bhille, P. G. Sunitha Hiremath

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Computer systems play an integral role in all facets of the engineering profession. This calls for an understanding of the processor-level components of computer systems, their design and operation, and their impact on the overall performance of the systems. Systems users are always in need of faster, more powerful, yet cheaper computer systems. The focus of Computer Science engineering graduates is inclined towards software oriented base. To be an efficient programmer there is a need to understand the role of hardware architecture towards the same. It is essential for the students of Computer Science and Engineering to know the basic building blocks of any computing device and how the digital principles can be used to build them. Hence two courses Digital Electronics of 3 credits, which is associated with lab of 1.5 credits and Computer Organization of 5 credits, were introduced at the sophomore level. Activity was introduced with the objective to teach the hardware concepts to the students of Computer science engineering through structured lab. The students were asked to design and implement a component of a computing device using MultiSim simulation tool and build the same using hardware components. The experience of the activity helped the students to understand the real time applications of the SSI and MSI components. The impact of the activity was evaluated and the performance was measured. The paper explains the achievement of the ABET outcomes a, c and k.

Keywords: digital, computer organization, ABET, structured enquiry, course activity

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Authors: Karl Bryant Buan, Owaida Macadadaya Jr., Mon Eleazar Nonato, Zeke Andrew Palabrica, Charistabelle Mae Santiago

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This study explored the occupational health risks faced by employees in the Business Process Outsourcing (BPO) industry, particularly in the Telco Account department of Alorica. The study used a stratified sampling method and a diagnostic tool called Workplace Integrated Safety and Health (WISH) Assessment to measure and evaluate the employees' perception of workplace health and safety. The results showed that more than 50% of call center workers reported feeling emotionally drained, sleep deprived, burnt out, and in need of anxiety or stress medication due to their work. Additionally, there was a significant difference in the perception of employee diversity, specifically in terms of leadership commitment, participation, policies, programs, and practices. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) results revealed that most employees complained of discomfort in their lower back, shoulder, upper back, neck, and hip. The researchers recommended an implementation plan for alternative work set-up, a satisfaction survey for employees, team-building activities or programs, and motivational approaches through benefits, incentives, and rewards.

Keywords: WISH assessment, CMDQ, ANOVA, diverse SOGIESC

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Authors: R. Vidhya, M. Navamuniyammal M. Sivakumar, S. Reeta

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The unplanned urbanization affects the environment due to pollution, conditions of the atmosphere, decreased vegetation and the pervious and impervious soil surface. Considered to be a cumulative effect of all these impacts is the Urban Heat Island. In this paper, the urban heat island effect is studied for the Chennai city, TamilNadu, South India using satellite remote sensing data. LANDSAT 8 OLI and TIRS DATA acquired on 9th September 2014 were used to Land Surface Temperature (LST) map, vegetation fraction map, Impervious surface fraction, Normalized Difference Water Index (NDWI), Normalized Difference Building Index (NDBI) and Normalized Difference Vegetation Index (NDVI) map. The relationship among LST, Vegetation fraction, NDBI, NDWI, and NDVI was calculated. The Chennai city’s Urban Heat Island effect is significant, and the results indicate LST has strong negative correlation with the vegetation present and positive correlation with NDBI. The vegetation is the main factor to control urban heat island effect issues in urban area like Chennai City. This study will help in developing measures to land use planning to reduce the heat effects in urban area based on remote sensing derivatives.

Keywords: land surface temperature, brightness temperature, emissivity, vegetation index

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Authors: David Ross Cameron

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In an attempt to alleviate the educational planning problem, double-shift schools have been created throughout various regions in Jordan, namely communities closer to the Syrian border, where a large portion of the refugee population settled, allowing Jordanians to attend the morning-shift and Syrians to attend the afternoon-shift. Subsequently, overcrowded classrooms have added a significant amount of stress on school facilities and teacher capacities. Established national policies and the implementation of inclusive educational practices have been jeopardized. In particular, teachers’ and student’s attitudes of the importance of inclusive education provisions in the classroom have deteriorated. To have a more comprehensive understanding of the current situation and possible plan for intervention, a focus study was carried out at a double-shift Jordanian/Syrian girls’ public school in Irbid, Jordan. Interviews and surveys of 29 students with physical, learning, emotional and behavioral disabilities, 33 students without any special needs and nine teachers were included with a mixed-method social research approach to highlight the current attitudes that students and teachers held and factors that contributed to shaping their inclinations and beliefs of inclusive education.

Keywords: capacity building, development, double-shift, Irbid, inclusive education, Jordan, pedagogy, planning, policy, refugee, special education, special needs, vulnerable population

Procedia PDF Downloads 252

Authors: Qin Zhu

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Under the development concept of Park City, Tianfu Greenway system, as the basic and pre-configuration element of Chengdu Global Park construction, connects urban open space with linear and circular structures and undertakes and exerts the ecological, cultural and recreational functions of the park system. Chengdu greenway construction is in full swing. In the process of greenway planning and construction, the landscape effect of greenway on urban quality improvement is more valued, and the long-term impact of crowd experience on the sustainable development of greenway is often ignored. Therefore, it is very important to test the effectiveness of greenway construction from the perspective of users. Taking Jincheng Greenway in Chengdu as an example, this paper attempts to introduce multi-source data to construct a post-occupancy evaluation model of greenway and adopts behavior mapping method, questionnaire survey method, web text analysis and IPA analysis method to comprehensively evaluate the user 's behavior characteristics and satisfaction. According to the evaluation results, we can grasp the actual behavior rules and comprehensive needs of users so that the experience of building greenways can be fed back in time and provide guidance for the optimization and improvement of built greenways and the planning and construction of future greenways.

Keywords: multi-source data, greenway, IPA analysis, post -occupancy evaluation (POE)

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Authors: Mahnoush Mahmoudi, Ali Chaeedeh

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In the architecture of Iranian traditional houses, the ornamentations available in the inscriptions of houses entrance portal express the identity of architects and personality of houses owners and are rooted in their religious and national beliefs and faiths. The main hypothesis of this research is changing the physique and application of religious contents in compliance with the thoughts and beliefs of people in Dezfoul historical city in the epigraphs of houses entrance portals. The objective of this study is reviewing the development trend of texts, concepts and physique of inscriptions as well as analyzing the factors effective on the quality and diversity of application of inscriptions. The present research is an applied study and descriptive-analytical method has been applied, and the data was collected by library and survey studies. The population of this research includes historical houses, houses damaged in war (Iran & Iraq) and renovated and new tissue and new-built houses of Dezfoul, from Qajar era so far. Random sampling method has been applied in this study and dispersal area includes the city. Data analysis method in this study is qualitative and quantitative. The results of this study indicate that today the inscriptions available in the entrance portal of houses in Dezfoul comparing to inscriptions in Qajar1 and Pahlavi2 era is very simple and has lower aesthetic value. One of the causes for such superficial and contextual gap between inscriptions seems to be the war and renovations during and after destruction.

Keywords: architecture, islamic architecture, reconstruction, epigraph, inscription, entrance portal, Dezfoul

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Authors: Nancy Ayman Kamal Mohamed Mehrz

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Like the economies of other countries in the Mediterranean region, the tourism sector in our country has excellent economic prospects. Tourism companies are building tourism, a sector that faces various challenges in its activities. These problems have made business activities and competition between companies difficult. In this study, which was conducted to identify the problems of the tourism sector in the Central Anatolia region, most of the problems faced by the tourism sector and consumer information on consumer rights were used. The aim is to contribute to the awareness of workers and managers working in the tourism sector and to attract the attention of companies and legislators working in the tourism sector. E-tourism is one of the newest issues in the field of tourism. Infrastructure and Information Technology (or ICT) and partner government and tourism organizations are required to achieve this type of tourism. This study measures the views of managers and tourism managers in Leman City regarding e-tourism; In addition, the effect of the literacy level of the tourism management system on tourist attractions was also examined. This research has been carried out. One of the suburbs of Isfahan province. This research is a documentary research and source material that includes literature and surveys. The results obtained show that if managers use ICT, it can help the development of e-tourism in the region, and increasing managers' views about e-tourism and improving their literacy levels can affect the development of tourism.

Keywords: financial problems, the problems of tourism businesses, tourism businesses, internet, marketing, tourism, tourism management economic competitiveness, enhancing competitiveness

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Authors: Ofosuhene O. Apenteng, Noor Azina Ismail

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Over the last several years, concern has developed over how to minimize the spread of HIV/AIDS epidemic in many countries. AIDS epidemic has tremendously stimulated the development of mathematical models of infectious diseases. The transmission dynamics of HIV infection that eventually developed AIDS has taken a pivotal role of much on building mathematical models. From the initial HIV and AIDS models introduced in the 80s, various improvements have been taken into account as how to model HIV/AIDS frameworks. In this paper, we present the impact of migration on the spread of HIV/AIDS. Epidemic model is considered by a system of nonlinear differential equations to supplement the statistical method approach. The model is calibrated using HIV incidence data from Malaysia between 1986 and 2011. Bayesian inference based on Markov Chain Monte Carlo is used to validate the model by fitting it to the data and to estimate the unknown parameters for the model. The results suggest that the migrants stay for a long time contributes to the spread of HIV. The model also indicates that susceptible individual becomes infected and moved to HIV compartment at a rate that is more significant than the removal rate from HIV compartment to AIDS compartment. The disease-free steady state is unstable since the basic reproduction number is 1.627309. This is a big concern and not a good indicator from the public heath point of view since the aim is to stabilize the epidemic at the disease equilibrium.

Keywords: epidemic model, HIV, MCMC, parameter estimation

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Authors: Leszek Szpakowski, Daniel Celiński, Sławomir Pilip, Grzegorz Michalak

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The aim of the study was to analyse the usefulness of the 'E-rescuer' pilot project planned to be implemented in a chosen area of Eastern Poland in the cases of suspected sudden cardiac arrests in the extra-urban areas. Inventing an application allowing to dispatch simultaneously both Medical Emergency Teams and the E-rescuer to the place of the accident is the crucial assumption of the mentioned pilot project. The E-rescuer is defined to be the trained person able to take effective basic life support and to use automated external defibrillator. Having logged in using a smartphone, the E-rescuer's readiness is reported online to provide cardiopulmonary resuscitation exactly at the given location. Due to the accurately defined location of the E-rescuer, his arrival time is possible to be precisely fixed, and the substantive support through the displayed algorithms is capable of being provided as well. Having analysed the medical records in the years 2015-2016, cardiopulmonary resuscitation was considered to be effective when an early indication of circulation was provided, and the patient was taken to hospital. In the mentioned term, there were 2.291 cases of a sudden cardiac arrest. Cardiopulmonary resuscitation was taken in 621 patients in total including 205 people in the urban area and 416 in the extra-urban areas. The effectiveness of cardiopulmonary resuscitation in the extra-urban areas was much lower (33,8%) than in the urban (50,7%). The average ambulance arrival time was respectively longer in the extra-urban areas, and it was 12,3 minutes while in the urban area 3,3 minutes. There was no significant difference in the average age of studied patients - 62,5 and 64,8 years old. However, the average ambulance arrival time was 7,6 minutes for effective resuscitations and 10,5 minutes for ineffective ones. Hence, the ambulance arrival time is a crucial factor influencing on the effectiveness of cardiopulmonary resuscitation, especially in the extra-urban areas where it is much longer than in the urban. The key role of trained E-rescuers being nearby taking basic life support before the ambulance arrival can effectively support Emergency Medical Services System in Poland.

Keywords: basic life support, bystander, effectiveness, resuscitation

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Authors: Faouzi Ameur, Atef Belhaj Ali

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Located in the South-west of Saudi Arabia, Jeddah is more than a harbor. It is a big city of the Red Sea and the second town of Saudi Arabia, after Riyadh the capital. Jeddah profits from several economic assets due especially to its transit position towards the high sacred places of Islam like Mecca and Medina. During summer, this metropolis is transformed into a political capital and a tourist resort for foreigners and Saudis alike. The city of Jeddah was affected by serious sudden floods; two great ones took place in 2009, and in 2011. The human and material tools were considerable, since these events caused the death to hundreds of people, damaged thousands of buildings built on basins slopes, which, however had the authorizations necessary. To cope with these natural disasters, several urban hydraulic measures were undertaken like building dams and canals to collect surface waters. These urban measures aimed at the protection of inhabitants and belongings against the risks of floods as well as the interception and the drainage of streams. Although these protection measures are important, expensive, and effective, they are no longer enough or effective to cope with the evolution of the natural disasters that the city of Jeddah is constantly exposed to. These protective hydraulic measures did not make it possible to reach risk zero situations. They transferred the damages towards other zones. This paper purports to study the protection network systems in Jeddah and to understand their various impacts during floods on the city and on its inhabitants.

Keywords: Jeddah, Saudi Arabia, urbanization, hydraulic protection

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Authors: Md. Kausar Alam, Mohammad Yazdi, Peiman Zogh, Ramin Motamed

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The liquefaction-induced ground settlement has caused severe damage to structures in the past decades. However, the amount of building settlement caused by liquefaction is directly proportional to the intensity of the ground shaking. To reduce this soil liquefaction effect, it is essential to examine the influence of peak ground acceleration (PGA). Unfortunately, limited studies have been carried out on this issue. In this study, a series of moderate scale 1g shake table experiments were conducted at the University of Nevada Reno to evaluate the influence of PGA with the same duration in liquefiable soil layers. The model is prepared based on a large-scale shake table with a scaling factor of N = 5, which has been conducted at the University of California, San Diego. The model ground has three soil layers with relative densities of 50% for crust, 30% for liquefiable, and 90% for dense layer, respectively. In addition, a shallow foundation is seated over an unsaturated crust layer. After preparing the model, the input motions having various peak ground accelerations (i.e., 0.16g, 0.25g, and 0.37g) for the same duration (10 sec) were applied. Based on the experimental results, when the PGA increased from 0.16g to 0.37g, the foundation increased from 20 mm to 100 mm. In addition, the expected foundation settlement based on the scaling factor was 25 mm, while the actual settlement for PGA 0.25g for 10 seconds was 50 mm.

Keywords: foundation settlement, liquefaction, peak ground acceleration, shake table test

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Authors: Subzar Ahmad Bhat, Saraswati Setia, V. K.Sehgal

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During the past earthquakes, open ground storey buildings have performed poorly due to the soft storey defect. Indian Standard IS 1893:2002 allows analysis of open ground storey buildings without considering infill stiffness but with a multiplication factor 2.5 in compensation for the stiffness discontinuity. Therefore, the aim of this paper is to check the applicability of the multiplication factor of 2.5 and study behaviour of the structure after the application of the multiplication factor. For this purpose, study is performed on models considering infill stiffness using SAP 2000 (Version 14) by linear static analysis and response spectrum analysis. Total seven models are analysed and designed for the range of multiplication factor ranging from 1.25 to 2.5. The value of multiplication factor equal to 2.5 has been found on the higher side, resulting in increased dimension and percentage of reinforcement without significant enhancement beyond a certain multiplication factor. When the building with OGS is designed for values of MF higher than 1.25 considering infill stiffness soft storey effect shifts from ground storey to first storey. For the analysis of the OGS structure best way to analysis the structure is to analyse it as the frame with stiffness and strength of the infill taken into account. The provision of infill walls in the upper storeys enhances the performance of the structure in terms of displacement and storey drift controls.

Keywords: open ground storey, multiplication factor, IS 1893:2002 provisions, static analysis, response spectrum analysis, infill stiffness, equivalent strut

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Authors: Dennis L. Owuor, Okuthe P. Kogeda, Johnson I. Agbinya

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Mobile localization has attracted a great deal of attention recently due to the introduction of wireless networks. Although several localization algorithms and systems have been implemented and discussed in the literature, very few researchers have exploited the gap that exists between indoor localization, tracking, external storage of location information and outdoor localization for the purpose of digital forensics during and after a disaster. The contribution of this paper lies in the implementation of a robust system that is capable of locating, tracking mobile device users and store location information for both indoor and partially outdoor the cloud. The system can be used during disaster to track and locate mobile phone users. The developed system is a mobile application built based on Android, Hypertext Preprocessor (PHP), Cascading Style Sheets (CSS), JavaScript and MATLAB for the Android mobile users. Using Waterfall model of software development, we have implemented a three level system that is able to track, locate and store mobile device information in secure database (cloud) on almost a real time basis. The outcome of the study showed that the developed system is efficient with regard to the tracking and locating mobile devices. The system is also flexible, i.e. can be used in any building with fewer adjustments. Finally, the system is accurate for both indoor and outdoor in terms of locating and tracking mobile devices.

Keywords: indoor localization, digital forensics, fingerprinting, tracking and cloud

Procedia PDF Downloads 328

Authors: Rauf Razzaq, Kaiwu Dong, Muhammad Sharif, Ralf Jackstell, Matthias Beller

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Carbon dioxide (CO2), a key greenhouse gas produced from both anthropogenic and natural sources, has been recently considered to be an important C1 building-block for the synthesis of many industrial fuels and chemicals. Catalytic hydrogenation of CO2 using a heterogeneous system is regarded as an efficient process for CO2 valorization. In this regard CO2 reduction to CO via the reverse water gas shift reaction (RWGSR) has attracted much attention as a viable process for large scale commercial CO2 utilization. This process can generate syn-gas (CO+H2) which can provide an alternative route to direct CO2 conversion to methanol and/or liquid HCs from FT reaction. Herein, we report a highly active and selective silica supported copper catalyst with efficient CO2 reduction to CO in a slurry-bed batch autoclave reactor. The reactions were carried out at 200°C and 60 bar initial pressure with CO2/H2 ratio of 1:3 with varying temperature, pressure and fed-gas ratio. The gaseous phase products were analyzed using FID while the liquid products were analyzed by using FID detectors. It was found that Cu/SiO2 catalyst prepared using novel ammonia precipitation-urea gelation method achieved 26% CO2 conversion with a CO and methanol selectivity of 98 and 2% respectively. The high catalytic activity could be attributed to its strong metal-support interaction with highly dispersed and stabilized Cu+ species active for RWGSR. So, it can be concluded that reduction of CO2 to CO via RWGSR could address the problem of using CO2 gas in C1 chemistry.

Keywords: CO2 reduction, methanol, slurry reactor, synthesis gas

Procedia PDF Downloads 317

Authors: Karl-Erich Lindenschmidt, Apurba Das, Joel Trudell, Keanne Russell

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In this presentation, we explore options for mitigating ice-jam flooding along the Athabasca River in western Canada. Not only flood hazard, expressed in this case as the probability of flood depths and extents being exceeded, but also flood risk, in which annual expected damages are calculated. Flood risk is calculated, which allows a cost-benefit analysis to be made so that decisions on the best mitigation options are not based solely on flood hazard but also on the costs related to flood damages and the benefits of mitigation. The river ice model is used to simulate extreme ice-jam flood events with which scenarios are run to determine flood exposure and damages in flood-prone areas along the river. We will concentrate on three mitigation options – the placement of a dike, artificial breakage of the ice cover along the river, the installation of an ice-control structure, and the construction of a reservoir. However, any mitigation option is not totally failsafe. For example, dikes can still be overtopped and breached, and ice jams may still occur in areas of the river where ice covers have been artificially broken up. Hence, for all options, it is recommended that zoning of building developments away from greater flood hazard areas be upheld. Flood mitigation can have a negative effect of giving inhabitants a false sense of security that flooding may not happen again, leading to zoning policies being relaxed. (Text adapted from Lindenschmidt [2022] "Ice Destabilization Study - Phase 2", submitted to the Regional Municipality of Wood Buffalo, Alberta, Canada)

Keywords: ice jam, flood hazard, flood risk river ice modelling, flood risk

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Authors: Mohamed M. El-heweity, Ahmed Shamel Fahmy, Mostafa Shawky, Ahmed Sherif

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Cold-formed steel (CFS) lipped channel sections are popular as load-bearing members in building structures. These sections are used in the construction industry because of their high strength-to-weight ratio, lightweight, quick production, and ease of construction, fabrication, transportation, and handling. When those cold formed sections with high slenderness ratios are subjected to compression bending, they do not reach failure when reaching their ultimate bending stress, however, they sustain much higher loads due stress re-distribution. Hence, there is a need to study the sectional nominal capacity of CFS lipped channel beams with different web openings subjected to pure bending and uniformly distributed loads. By using finite element (FE) simulations using ANSYS APDL for numerical analysis. The results were verified and compared to previous experimental results. Then a parametric study was conducted and validated FE model to investigate the effect of different openings shapes on their nominal capacities. The results have revealed that CFS sections with hexagonal openings and intermediate notch can resist higher nominal capacities when compared to other sectional openings.

Keywords: cold-formed steel, nominal capacity, finite element, lipped channel beam, numerical study, web opening

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Authors: Sarocha Vivatvakin, Thanaporn Ratchataswan, Thiratest Leesutipornchai, Komkrit Ruangritchankul, Somboon Keelawat, Virachai Kerekhanjanarong, Patnarin Mahattanasakul, Saknan Bongsebandhu-Phubhakdi

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In this globalization era, much attention has been drawn to various molecular biomarkers, which may have the potential to predict the progression of cancer. Epidermal growth factor receptor (EGFR) is the classic member of the ErbB family of membrane-associated intrinsic tyrosine kinase receptors. EGFR expression was found in several organs throughout the body as its roles involve in the regulation of cell proliferation, survival, and differentiation in normal physiologic conditions. However, anomalous expression, whether over- or under-expression is believed to be the underlying mechanism of pathologic conditions, including carcinogenesis. Even though numerous discussions regarding the EGFR as a prognostic tool in head and neck cancer have been established, the consensus has not yet been met. The aims of the present study are to assess the correlation between the level of EGFR expression and demographic data as well as clinicopathological features and to evaluate the ability of EGFR as a reliable prognostic marker. Furthermore, another aim of this study is to investigate the probable pathophysiology that explains the finding results. This retrospective study included 30 squamous cell laryngeal carcinoma patients treated at King Chulalongkorn Memorial Hospital from January 1, 2000, to December 31, 2004. EGFR expression level was observed to be significantly downregulated with the progression of the laryngeal cancer stage. (one way ANOVA, p = 0.001) A statistically significant lower EGFR expression in the late stage of the disease compared to the early stage was recorded. (unpaired t-test, p = 0.041) EGFR overexpression also showed the tendency to increase recurrence of cancer (unpaired t-test, p = 0.128). A significant downregulation of EGFR expression was documented in advanced stage laryngeal cancer. The results indicated that EGFR level correlates to prognosis in term of stage progression. Thus, EGFR expression might be used as a prevailing biomarker for laryngeal squamous cell carcinoma prognostic prediction.

Keywords: downregulation, epidermal growth factor receptor, immunohistochemistry, laryngeal squamous cell carcinoma

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Authors: Renz Paolo B. Ramos, Jake S. Espina

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The Local Government Academy of the Philippines explains that Local legislation is both a power and a process by which it enacts ordinances and resolutions that have the force and effect of law while engaging with a range of stakeholders for their implementation. Legislative effectiveness is crucial for the development of any given area. This study's objective is to evaluate the legislative performance of the 10th Sangguniang of Kawayan, a legislative body in a fifth-class municipality in the Province of Biliran, during the height of the COVID-19 pandemic (2019-2021) with a focus on legislation, accountability, and participation, institution-building, and intergovernmental relations. The aim of the study was that a mixed-methods strategy was used to gather data. The Local Legislative Performance Appraisal Form (LLPAF) was completed, while Focus Interviews for Local Government Unit (LGU) personnel, a survey questionnaire for constituents, and ethnographic diary-writing were conducted. Convenience Sampling was utilized for LGU workers, whereas Simple Random Sampling was used to identify the number of constituents participating. Interviews were analyzed using thematic analysis, while frequency data analysis was employed to describe and evaluate the nature and connection of the data to the underlying population. From this data, the researchers draw opportunities and challenges met by the local legislature during the height of the pandemic.

Keywords: local legislation, local governance, legislative effectiveness, legislative analysis

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Authors: Jiyoung Kim, Chae Weon Chung

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Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates.

Keywords: epidural anesthesia, delivery outcomes, labor pain, perception

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Authors: Semaw A., Awet H., Yohannes M.

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Background: Hepatitis B Virus (HBV) is a major global public health problem. Individuals living in Sub-Sahara Africa have 60% lifetime risk of acquiring HBV infection. Evidences showed that 80-90% of those born from infected mothers developed chronic HBV. Perinatal HBV transmission is a major determinant of HBV carrier status, its chronic squeal and maintains HBV transmission across generations. Method: Institution based cross-sectional study was conducted among 406 pregnant mothers attending Antenatal clinics at Mekelle and Ayder referral hospital from January 30 to April 1/2014. Epidata version 3.1 was used for data entry and SPSS version 21 statistical software was used for data cleaning, management and finally determine associated factors of hepatitis B surface antigen adjusting important confounders using multivariable logistic regression analysis at 5% level of significance. Result: The overall prevalence of hepatitis B surface antigen among pregnant women was 33 (8.1%). The socio-demographic characteristic of the study population showed that there is high positivity among secondary school 189 (46.6%). In the multivariable logistic regression analysis, history of a contact with individuals who had history of hepatitis B infection or jaundice and lifetime number of multiple sexual partners were found to be significantly associated with HBsAg positivity at AOR = 3.73 95%C.I (1.373-10.182) and AOR = 2.57 95%C.I (1.173-5.654), respectively. Moreover, Human Immunodeficiency Virus (HIV) and HBV confection rate was found 3.6%. Conclusion: This study has shown that HBV prevalence in pregnant women is highly prevalent (8.1%) in the study area. Contact with individuals who had a history of hepatitis or have jaundice and report of multiple lifetime sexual partnership were associated with hepatitis B infection. Education about HBV transmission and prevention as well as screening all pregnant mothers shall be sought to reduce the serious public health crisis of HBV.

Keywords: HBsAg, hepatitis B, pregnant women, prevalence

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Authors: Benjamin Goldsmith, Felix Heisel

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The building industry must reduce its emissions in order to meet 2030 neutrality targets, and modular and/or offsite construction is seen as an alternative to conventional construction methods which could help achieve this goal. Modular construction has previously been shown to be less wasteful and has a lower global warming potential (GWP). While many studies have been conducted investigating the life cycle impacts of modular and conventional construction, few studies have compared different types of modular assembly and construction in order to determine which offer the greatest environmental benefits over their whole life cycle. This study seeks to investigate three different modular construction types -infill frame, core, and podium- in order to determine environmental impacts such as GWP as well as circularity indicators. The study will focus on the emissions of the production, construction, and end-of-life phases. The circularity of the various approaches will be taken into consideration in order to acknowledge the potential benefits of the ability to reuse and/or reclaim materials, products, and assemblies. The study will conduct hypothetical case studies for the three different modular construction types, and in doing so, control the parameters of location, climate, program, and client. By looking in-depth at the GWP of the beginning and end phases of various simulated modular buildings, it will be possible to make suggestions on which type of construction has the lowest global warming potential.

Keywords: modular construction, offsite construction, life cycle analysis, global warming potential, environmental impact, circular economy

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Authors: Sufrin Hannan, Budi Suharjo, Rita Nurmalina, Kirbrandoko

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The challenge for independent surveyor service companies now is growing with increasing uncertainty in business. Protection from the government for domestic independent surveyor industry from competitor attack, such as entering the global surveyors to Indonesia also no longer exists. Therefore, building customer loyalty becomes very important to create a long-term relationship between an independent surveyor with its customers. This study aims to develop a model that can be used to build customer loyalty by looking at various factors that determine customer loyalty, especially on independent surveyors for coal inspection in Indonesia. The development of this model uses the relationship marketing approach. Testing of the hypothesis is done by testing the variables that determine customer loyalty, either directly or indirectly, which amounted to 10 variables. The data were collected from 200 questionnaires filled by independent surveyor company decision makers from 51 exporting companies and coal trading companies in Indonesia and analyzed using Structural Equation Model (SEM). The results show that customer loyalty of independent surveyors is influenced by customer satisfaction, trust, switching-barrier, and relationship-bond. Research on customer satisfaction shows that customer satisfaction is influenced by the perceived quality and perceived value, while perceived quality is influenced by reliability, assurance, responsiveness, and empathy.

Keywords: relationship marketing, customer loyalty, customer satisfaction, switching barriers, relationship bonds

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Authors: Teresa Isabel Lozano Pérez, Sandra Soca Lozano

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In Cuba, the childcare is one of the programs prioritized by the Ministry of Public Health and the birth of a child becomes a desired and rewarding event for the family, which is prepared for the reception of a healthy child. When this does not happen and after the first months of the child's birth begin to appear developmental deviations that indicate the presence of a disorder, the event becomes a live event potentially negative and generates disruptions in the family health. A quantitative, descriptive, and cross-sectional research methodology was conducted to describe the impact on family health of diagnosis of autism in a sample of 25 families of children diagnosed with infantile autism at the University Pediatric Hospital Juan Manuel Marquez Havana, Cuba; in the period between January 2014 and May 2015. The sample was non probabilistic and intentional from the inclusion criteria selected. As instruments, we used a survey to identify the structure of the family, life events inventory and an instrument to assess the relative impact, adaptive resources of family and social support perceived (IRFA) to identify the diagnosis of autism as life event. The main results indicated that the majority of families studied were nuclear, small and medium and in the formation stage. All households surveyed identified the diagnosis of autism in a child as an event of great importance and negative significance for the family, taking in most of the families studied a high impact on the four areas of family health and impact enhancer of involvement in family health. All the studied families do not have sufficient adaptive resources to face this situation, sensing that they received social support frequently, mainly in information and emotional areas. We conclude that the diagnosis of autism one of the members of the families studied is valued as a life event highly significant with unfavorably way causing an enhancer impact of involvement in family health especially in the areas ‘health’ and ‘socio-psychological’. Among the social support networks health institutions, partners and friends are highlighted. We recommend developing intervention strategies in families of these children to support them in the process of adapting the diagnosis.

Keywords: family, family health, infantile autism, life event

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Authors: Dativa Maria Aliddeki, Fred Monje, Godfrey Nsereko, Benon Kwesiga, Daniel Kadobera, Alex Riolexus Ario

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Background: Cholera is a severe gastrointestinal disease caused by Vibrio cholera. It has caused several pandemics. On 26 February 2018, a suspected cholera outbreak, with one death, occurred in School X in Hoima Municipality, western Uganda. We investigated to identify the scope and mode of transmission of the outbreak, and recommend evidence-based control measures. Methods: We defined a suspected case as onset of diarrhea, vomiting, or abdominal pain in a student or staff of School X or their family members during 14 February–10 March. A confirmed case was a suspected case with V. cholerae cultured from stool. We reviewed medical records at Hoima Hospital and searched for cases at School X. We conducted descriptive epidemiologic analysis and hypothesis-generating interviews of 15 case-patients. In a retrospective cohort study, we compared attack rates between exposed and unexposed persons. Results: We identified 15 cases among 75 students and staff of School X and their family members (attack rate=20%), with onset from 25-28 February. One patient died (case-fatality rate=6.6%). The epidemic curve indicated a point-source exposure. On 24 February, a student brought fried fish from her home in a fishing village, where a cholera outbreak was ongoing. Of the 21 persons who ate the fish, 57% developed cholera, compared with 5.6% of 54 persons who did not eat (RR=10; 95% CI=3.2-33). None of 4 persons who recooked the fish before eating, compared with 71% of 17 who did not recook it, developed cholera (RR=0.0, 95%CIFisher exact=0.0-0.95). Of 12 stool specimens cultured, 6 yielded V. cholerae. Conclusion: This cholera outbreak was caused by eating fried fish, which might have been contaminated with V. cholerae in a village with an ongoing outbreak. Lack of thorough cooking of the fish might have facilitated the outbreak. We recommended thoroughly cooking fish before consumption.

Keywords: cholera, disease outbreak, foodborne, global health security, Uganda

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Authors: Brian Romansky

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There are many practical, commercially available robots and semi-autonomous systems that are currently available for use in a wide variety of construction tasks. Adoption of these technologies has the potential to reduce the time and cost to deliver a project, reduce variability and risk in delivery time, increase quality, and improve safety on the job site. These benefits come with a cost for equipment rental or contract fees, access to specialists to configure the system, and time needed for set-up and support of the machines while in use. Calculation of the net ROI (Return on Investment) requires detailed information about the geometry of the site, the volume of work to be done, the overall project schedule, as well as data on the capabilities and past performance of available robotic systems. Assembling the required data and comparing the ROI for several options is complex and tedious. Many project managers will only consider the use of a robot in targeted applications where the benefits are obvious, resulting in low levels of adoption of automation in the construction industry. This work demonstrates how data already resident in many BIM (Building Information Model) projects can be used to automate ROI estimation for a sample set of commercially available construction robots. Calculations account for set-up and operating time along with scheduling support tasks required while the automated technology is in use. Configuration parameters allow for prioritization of time, cost, or safety as the primary benefit of the technology. A path toward integration and use of automatic ROI calculation with a database of available robots in a BIM platform is described.

Keywords: automation, BIM, robot, ROI.

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Authors: Shih-Fang Lo, Tzu-Wei Guo, Chih-Hsuan Lee

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Tropical fisheries are vulnerable to the physical and biogeochemical oceanic changes associated with climate change. Warmer temperatures and extreme weather have beendamaging the abundance and growth patterns of aquatic organisms. In recent year, the shrinking of fish stock and labor shortage have increased the threat to global aquacultural production. Thus, building a climate-resilient and sustainable mechanism becomes an urgent, important task for global citizens. To tackle the problem, Taiwanese fishermen applies the artificial intelligence (AI) technology. In brief, the AI system (1) measures real-time water quality and chemical parameters infish ponds; (2) monitors fish stock through segmentation, detection, and classification; and (3) implements fishermen’sprevious experiences, perceptions, and real-life practices. Applying this system can stabilize the aquacultural production and potentially increase the labor force. Furthermore, this AI technology can build up a more resilient and sustainable system for the fishermen so that they can mitigate the influence of extreme weather while maintaining or even increasing their aquacultural production. In the future, when the AI system collected and analyzed more and more data, it can be applied to different regions of the world or even adapt to the future technological or societal changes, continuously providing the most relevant and useful information for fishermen in the world.

Keywords: aquaculture, artificial intelligence (AI), real-time system, sustainable fishery

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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

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Authors: Chee Young Kim, Tae Hyun Kim, Anbok Lee, Hyun-Ah Kim, Woosung Lim, Ku Sang Kim, Jinsun Lee, Yoo Seok Kim, Beom Seok Ko

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Background: CollatampTM is Gentamicin-containing collagen sponge well known for its hemostatic effect, commonly utilized in surgeries. We inserted CollatempTM wrapped by SurgicelTM (oxidized cellulose polymer) to fill up the defect after breast conserving surgery. The purpose of this study is to verify the furthermore cosmetic value of CollatampTM in breast conserving surgery conducted in breast cancer patients. Methods: 17 patients were enrolled in this study, underwent breast conserving surgery with CollatampTM wrapped by SurgicelTM insertion, in Inje University Busan Paik Hospital from October 2015 to September 2016. Patient satisfaction, cosmetic outcome, results at 6 months from operation was analyzed to verify the effectiveness and usefulness of CollatampTM for cosmetics. Patient satisfaction was investigated through interviews on a scale of good, fair, poor, and the cosmetic outcome was investigated through physical examination by a surgeon who did not participate in the operations. Results: Among 17 patients, nine of them gave ‘good’ for patient satisfaction, eight gave ‘fair’ and none of them ‘poor’. Also, cosmetic outcome came out with 11 ‘good’s, six ‘fair’s, no ‘poor’. In ‘good’ patient satisfaction group, the mean value of resection to breast volume ratio was 16%, compared to 24% of ‘fair’ group. The mean value of actual resection volume was 100.6cm3, 102.7cm3 each. In ‘good’ cosmetic outcome group, the mean value of resection to breast volume ratio was 18%, compared to 23% of ‘fair’ group. The mean value of actual resection volume was 99.2cm3, 105.9cm3 respectively. According to these results, patient satisfaction and cosmetic outcome after surgeries were more reliable on the resection to breast volume ratio, rather than the actual resection volume. There were eight cases of postoperative complications, consisting of a lymphedema, a seroma, and six patients had mild pain. Conclusions: Cosmetic effect of CollatampTM in breast conserving surgery was more reliable on the resection to breast volume ratio, rather than the actual resection volume. In this short term survey, patients were tend to be satisfied with the cosmetics, all giving either good or fair scores. However, long term outcomes should be further assessed.

Keywords: breast cancer, breast conserving surgery, collatamp, cosmetics

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Authors: Rachel Talbot, Nasuh Malas

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Stigma in child and adolescent psychiatry continues to be a significant barrier for youth to receive much needed psychiatric care. Parents misperceptions regarding mental health may interfere with their child’s care and negatively influence their child’s view of mental health. For some children, their first experience with psychiatry may occur during medical hospitalization when they are seen by the Psychiatry Consultation-Liaison (C/L) Service. Despite this unique role, there is limited data on how to address mental health stigma with patients and families within the context of Child and Adolescent C/L Psychiatry. This study explores the use of a brief introductory video with messages from the psychiatry C/L team, families who have accessed mental health consultation in the hospital, as well as clips of family and C/L team interactions to address parental stigma of psychiatry. Common stigmatized concerns shared by parents include concerns about confidentiality, later ramifications of mental healthcare, outsider status, and parental self-blame. There are also stigmatized concerns about psychiatric medication use including overmedication, sedation, long-term effects, medicating ‘real problems’ and personality blunting. Each of these are addressed during the video parents will see with the intent of reducing negative parental perceptions relating to mental healthcare. For this study, families are given a survey highlighting these concerns, prior to and after watching the video. Pre-and post-video responses are compared with the hypothesis that watching the video will effectively reduce parental stigma about psychiatric care. Data collection is currently underway and will be completed by the end of November 2017 with data analysis completed by January 2018. This study will also give vital information about the demographic differences in perceptions of stigma so future interventions can be targeted towards those with higher perceived stigma. This study posits that use of an introductory video is an effective strategy to combat stigma and help educate and empower families. In this way, we will be reducing further barriers for patients and families to seek out mental health resources and supports that are often desperately needed for these youths.

Keywords: child and adolescent psychiatry, consult-liaison psychiatry, media, stigma

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Authors: Hacer Kobya Bulut, Kıymet Yeşilçiçek Çalık, Birsel Canan Demirbağ, Hacer Erdöl, Songül Aktaş

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Introduction: As an expression of an emotion which always exists in life, crying is regarded as one of the problematic behaviors of patients by nurses. Towards such patients, nurses may exhibit emotional and behavioral reactions such as feeling helpless, anger, indifferent, defense, and opposition. However crying either meets a need, reduces the tension to cope with problems or helps patient to gain strength. Therefore, nurses must accept that crying is a normal mechanism that reduces emotional tension and should approach a crying patient accordingly. Objective: This study was carried out to evaluate the communicational behaviors of the nurses towards ‘crying patient’. Methods: This descriptive study was conducted with the nurses working at a university hospital in a city in the Eastern Black Sea in June-September 2015. The entire universe was tried to be reached without sampling. 90% of the population was reached and the study was completed with 309 nurses who volunteered to participate in the study. Data were collected through a questionnaire which was prepared reviewing the literature by researchers. Data were evaluated in SPSS analysis program using percentages, numbers and chi-square test with the 95% confidence interval and p <0.05significance level. Findings: The findings showed that the average age of nurses was 31.52 ± 7.96, work experience was 10:09 ± 7.69 and only 22.7% had training about ‘approach to crying patient’ during their education. 97.1% of the nurses often faced with crying patients in their professional lives, 62.8% stated that they faced crying women patients. When they see crying patients, 84.8% of the nurses ‘do not want the patient to cry’, 80.9% wonder ‘why they are crying’, % 79.6 ‘feel uneasiness’,% 79.3 ‘feel sorry’ and 41.4% ‘ feel helpless’. The question ‘Why do you think the patient is crying?’ was answered by 93.5% nurses as ‘they are suffering’, by 86.1% ‘they are helpless’, 80.9% ‘they are sad’, 79.6% ‘they need help’, 54.4% ‘because they feel inadequate,’ and 44.7% ‘they fail to control their crying behavior. ‘How do you approach to your patient when she/he is crying?’ question was answered by 82.5% of nurses as ‘I would console’, 77.3% as ‘I would ask the reason’, 63.1% as ‘I would try to stop her from crying’ all of which are actually inappropriate nursing approaches. However, 92.2% of the nurses stated that ‘I do not judge the crying patient’, ‘87.1% said ‘I allocate time to crying patients’ and 85.8% said ‘ I ask patient whether they want to cry alone’. The study showed that educational background and work experience of the nurses affected the appropriate approach to crying patients (P <0.05). Conclusion: As a result of the study, it was found out that nurses do not want patients to cry, so they exhibit inappropriate approach such as consoling the patients and they have difficulty in approaching crying patients.

Keywords: approach to patient, communication, crying patient, nurse, Turkey

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