Search results for: satisfaction level

Authors: Malani Herath, Sohan Wijesekera, Jagath Munasingha

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The impact of recent floods become significant, and the extraordinary flood events cause considerable damage to lives, properties, environment and negatively affect the whole development of Colombo urban region. Even though the Colombo urban region experiences recurrent flood impacts, several spatial planning interventions have been taken from time to time since early 20th century. All past plans have adopted a traditional approach to flood management, using infrastructural measures to reduce the chance of flooding together with rigid planning regulations. The existing flood risk management practices do not operate to be acceptable by the local community particular the urban poor. Researchers have constantly reported the differences in estimations of flood risk, priorities, concerns of experts and the local community. Risk-based decision making in flood management is not only a matter of technical facts; it has a significant bearing on how flood risk is viewed by local community and individuals. Moreover, sustainable flood management is an integrated approach, which highlights joint actions of experts and community. This indicates the necessity of further societal discussion on the acceptable level of flood risk indicators to prioritize and identify the appropriate flood management measures in Colombo. The understanding and evaluation of flood risk by local people are important to integrate in the decision-making process. This research questioned about the gap between the acceptable level of flood risk to spatial planners and to the local communities in Colombo. A comprehensive literature review was conducted to prepare a framework to analyze the public perception in Colombo. This research work identifies the factors that affect the variation of flood risk and acceptable levels to both local community and planning authorities.

Keywords: Colombo basin, public perception, urban flood risk, multi-criteria analysis

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Authors: Karim Abouelmehdi, Loubna Dali, Elmoutaoukkil Abdelmajid, Hoda Elsayed, Eladnani Fatiha, Benihssane Abderahim

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The security of cloud services is the concern of cloud service providers. In this paper, we will mention different classifications of cloud attacks referred by specialized organizations. Each agency has its classification of well-defined properties. The purpose is to present a high-level classification of current research in cloud computing security. This classification is organized around attack strategies and corresponding defenses.

Keywords: cloud computing, classification, risk, security

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Authors: Foster Chilufya

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This study sought to determine factors that affect academic performance of mature age students in Science Education at University of Zambia. It was guided by Maslow’s Hierarchy of Needs. The theory provided relationship between achievement motivation and academic performance. A descriptive research design was used. Both Qualitative and Quantitative research methods were used to collect data from 88 respondents. Simple random and purposive sampling procedures were used to collect from the respondents. Concerning factors that motivate mature-age students to choose Science Education Programs, the following were cited: need for self-actualization, acquisition of new knowledge, encouragement from friends and family members, good performance at high school and diploma level, love for the sciences, prestige and desire to be promoted at places of work. As regards factors that affected the academic performance of mature-age students, both negative and positive factors were identified. These included: demographic factors such as age and gender, psychological characteristics such as motivation and preparedness to learn, self-set goals, self esteem, ability, confidence and persistence, student prior academic performance at high school and college level, social factors, institutional factors and the outcomes of the learning process. In order to address the factors that negatively affect academic performance of mature-age students, the following measures were identified: encouraging group discussions, encouraging interactive learning process, providing a conducive learning environment, reviewing Science Education curriculum and providing adequate learning materials. Based on these factors, it is recommended that, the School of Education introduces a program in Science Education specifically for students training to be teachers of science. Additionally, introduce majors in Physics Education, Biology Education, Chemistry Education and Mathematics Education relevant to what is taught in high schools.

Keywords: academic, performance, in-service, science

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Authors: Ochuko K. Overen, Golden Makaka, Edson L. Meyer, Sampson Mamphweli

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Low-cost housing provided for people with small incomes in South Africa are characterized by poor thermal performance. This is due to inferior craftsmanship with no regard to energy efficient design during the building process. On average, South African households spend 14% of their total monthly income on energy needs, in particular space heating; which is higher than the international benchmark of 10% for energy poverty. Adopting energy efficient passive solar design strategies and superior thermal building materials can create a stable thermal comfort environment indoors. Thereby, reducing energy consumption for space heating. The aim of this study is to analyse the thermal behaviour of a low-cost house integrated with passive solar design features. A low-cost passive solar house with superstructure fly ash brick walls was designed and constructed in Somerset East, South Africa. Indoor and outdoor meteorological parameters of the house were monitored for a period of one year. The ASTM E741-11 Standard was adopted to perform ventilation test in the house. In summer, the house was found to be thermally comfortable for 66% of the period monitored, while for winter it was about 79%. The ventilation heat flow rate of the windows and doors were found to be 140 J/s and 68 J/s, respectively. Air leakage through cracks and openings in the building envelope was 0.16 m3/m2h with a corresponding ventilation heat flow rate of 24 J/s. The indoor carbon dioxide concentration monitored overnight was found to be 0.248%, which is less than the maximum range limit of 0.500%. The prediction percentage dissatisfaction of the house shows that 86% of the occupants will express the thermal satisfaction of the indoor environment. With a good operation of the house, it can create a well-ventilated, thermal comfortable and nature luminous indoor environment for the occupants. Incorporating passive solar design in low-cost housing can be one of the long and immediate solutions to the energy crisis facing South Africa.

Keywords: energy efficiency, low-cost housing, passive solar design, rural development, thermal comfort

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Authors: O. Ubani, H. I. Atagana, M. S. Thantsha

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This study was conducted to measure the reduction in polycyclic aromatic hydrocarbons (PAHs) content in oil sludge by co-composting the sludge with pig, cow, horse and poultry manures under laboratory conditions. Four kilograms of soil spiked with 800 g of oil sludge was co-composted differently with each manure in a ratio of 2:1 (w/w) spiked soil:manure and wood-chips in a ratio of 2:1 (w/v) spiked soil:wood-chips. Control was set up similar as the one above but without manure. Mixtures were incubated for 10 months at room temperature. Compost piles were turned weekly and moisture level was maintained at between 50% and 70%. Moisture level, pH, temperature, CO2 evolution and oxygen consumption were measured monthly and the ash content at the end of experimentation. Bacteria capable of utilizing PAHs were isolated, purified and characterized by molecular techniques using polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE), amplification of the 16S rDNA gene using the specific primers (16S-P1 PCR and 16S-P2 PCR) and the amplicons were sequenced. Extent of reduction of PAHs was measured using automated soxhlet extractor with dichloromethane as the extraction solvent coupled with gas chromatography/mass spectrometry (GC/MS). Temperature did not exceed 27.5O°C in all compost heaps, pH ranged from 5.5 to 7.8 and CO2 evolution was highest in poultry manure at 18.78 µg/dwt/day. Microbial growth and activities were enhanced. Bacteria identified were Bacillus, Arthrobacter and Staphylococcus species. Results from PAH measurements showed reduction between 77 and 99%. The results from the control experiments may be because it was invaded by fungi. Co-composting of spiked soils with animal manures enhanced the reduction in PAHs. Interestingly, all bacteria isolated and identified in this study were present in all treatments, including the control.

Keywords: bioremediation, co-composting, oil refinery sludge, PAHs, bacteria spp, animal manures, molecular techniques

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Authors: G. H. Haddadi, S. Sajadi, R. Fardid, Z. Haddadi

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The heart is a radiosensitive organ, and its damage is a dose-limiting factor in radiotherapy. Different side effects including vascular plaque and heart fibrosis occur in patients with thorax irradiation. The present study aimed to evaluate the radioprotective efficacy of Hesperidin (HES), a naturally occurring citrus flavanoglycone, against γ-radiation induced tissue damage in the heart of male rats. Sixty-eight rats were divided into four groups. The rats in group 1 received PBS, and those in group 2 received HES. Also, the rats in group 3 received PBS and underwent γ-irradiation, and those in group 4 received HES and underwent γ-irradiation. They were exposed to 20 Gy γ-radiation using a single fraction cobalt-60 unit, and the dose of Hesperidin was (100 mg/kg/d, orally) for 7 days prior irradiation. Each group was divided into two subgroups. Samplings of rats in subgroup A was done 4-6 hours after irradiation. The samples were sent to laboratory for determination of Troponin’s I (TnI) serum level changes as a cardiac biomarker. The remaining animals (subgroups B) were sacrificed 8 weeks after radiotherapy for histopathological evaluation. In group 3, TnI obviously increased in comparison with group 1 (p < 0.05). The comparison of groups 1 and 4 showed no significant difference. Evaluation of histopathological parameters in subgroup B showed significant differences between groups 1 and 3 in some of the cases. Inflammation (p=0.008), pericardial effusion (p=0.001) and vascular plaque (p=0.001) increased in the rats exposed to 20 Gy γ-irradiation. Using oral administration of HES significantly decreased all the above factors when compared to group 4 (P > 0.016). Administration of 100 mg/kg/day Hesperidin for 7 days resulted in decreased Troponin I and radiation heart injury. This agent may have protective effects against radiation-induced heart damage.

Keywords: hesperidin, radioprotector, troponin I, cardiac inflammation, vascular plaque

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Authors: Layla Haidar, Shari Esquenazi-Karonika

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Introduction: Mental health includes one’s emotional, psychological, and interpersonal well-being; it ranges from “good” to “poor” on a continuum. At the individual-level, it affects how a person thinks, feels, and acts. Moreover, it determines how they cope with stress, relate to others, and interface with their surroundings. Research has yielded that mental health is directly related with short- and long-term physical health (including chronic disease), health risk behaviors, education-level, employment, and social relationships. As is the case with physical conditions like diabetes, heart disease, and cancer, mitigating the behavioral and genetic risks of debilitating mental health conditions like anxiety and depression can nurture a healthier quality of mental health throughout one’s life. In order to maximize the benefits of prevention, it is important to identify modifiable risks and develop protective habits earlier in life. Methods: The Adolescent Behaviors and Experiences Survey (ABES) dataset was used for this study. The ABES survey was administered to high school students (9th-12th grade) during January 2021- June 2021 by the Centers for Disease Control and Prevention (CDC). The data was analyzed to identify any associations between feelings of sadness, hopelessness, or increased suicidality among high school students with relation to their participation on one or more sports teams and their average daily consumed screen time. Data was analyzed using descriptive and multivariable analytic techniques. A multinomial logistic regression of each variable was conducted to examine if there was an association, while controlling for grade-level, sex, and race. Results: The findings from this study are insightful for administrators and policymakers who wish to address mounting concerns related to student mental health. The study revealed that compared to a student who participated on zero sports teams, students who participated in 1 or more sports teams showed a significantly increased risk of depression (p<0.05). Conversely, the rate of depression in students was significantly less in those who consumed 5 or more hours of screen time per day, compared to those who consumed less than 1 hour per day of screen time (p<0.05). Conclusion: These findings are informative and highlight the importance of understanding the nuances of student participation on sports teams (e.g., physical exertion, social dynamics of team, and the level of competitiveness within the sport). Likewise, the context of an individual’s screen time (e.g., social media, engaging in team-based video games, or watching television) can inform parental or school-based policies about screen time activity. Although physical activity has been proven to be important for emotional and physical well-being of youth, playing on multiple teams could have negative consequences on the emotional state of high school students potentially due to fatigue, overtraining, and injuries. Existing literature has highlighted the negative effects of screen time; however, further research needs to consider the type of screen-based consumption to better understand its effects on mental health.

Keywords: behavioral science, mental health, adolescents, prevention

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Authors: Boonrat Plangsorn

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Using ebooks can make not only a meaningful learning and achievement for students, but also can help teacher effectively enhance and improve their teaching. Nowadays, teachers try to develop ebooks for their class but it does not success in some cases because they do not have clear understanding on how to design, develop, and using ebooks that align with their teaching and learning objectives. Thus, the processes of using, designing, and producing ebooks have become one of important competency for teacher because it will enhance teacher’s knowledge for ebooks production. The purposes of this research were: (1) to develop the competency of producing and using ebooks of teachers in Chachengsao and (2) to promote the using ebooks of teachers in Chachengsao. The research procedures were divided into four phases. Phase I (study components and process of the designing and development of ebooks) was an interview in which the qualitative data were collected from five experts in instructional media. Phase II (develop teachers’ competency of producing ebooks) was a workshop for 28 teachers in Chachengsao. Phase III (study teachers’ using ebooks) was an interview in which the qualitative data were collected from seven teachers. Phase IV (study teachers’ using ebooks) was an interview in which the qualitative data were collected from six teachers. The research findings were as follows: 1. The components of ebooks comprised three components: ebooks structure, multimedia, and hyperlink. The eleven processes of design ebooks for education included (1) analyze the ebooks objective, (2) analyze learner characteristics, (3) set objective, (4) set learning content, (5) learner’s motivation, (6) design and construct activity, (7) design hyperlink, (8) produce script and storyboard, (9) confirm storyboard by expert, (10) develop ebooks, and (11) evaluate ebooks. 2. The evaluation of designing and development of ebooks for teacher workshop revealed the participants’ highest satisfaction (M = 4.65). 3. The teachers’ application of ebooks were found that obstacles of producing an ebooks: Time period of producing ebooks, a readiness of school resources, and small teacher network of producing and using ebooks. The result of using ebooks was students’ motivation. 4. The teachers’ ebooks utilization through educational research network of teacher in Chachengsao revealed that the characteristic of ebooks consist of picture, multimedia, voice, music, video, and hyperlink. The application of ebooks caused students interested in the contents; enjoy learning, and enthusiastic learning.

Keywords: ebooks, producing ebooks competency, using ebooks competency, educational research network

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Authors: Mazwane S., Makhura M. N., Ginege A.

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Digitalization in South Africa has received considerable attention from policymakers. The support for the development of the digital economy by the South African government has been demonstrated through the enactment of various national policies and strategies. This study sought to develop an index for agricultural digitalization by applying composite confirmatory analysis (CCA). Another aim was to determine the factors that affect the development of digitalization in PLAS farms. Data on the indicators of the three dimensions of digitalization were collected from 300 Proactive Land Acquisition Strategy (PLAS) farms in South Africa using semi-structured questionnaires. Confirmatory composite analysis (CCA) was employed to reduce the items into three digitalization dimensions and ultimately to a digitalization index. Standardized digitalization index scores were extracted and fitted to a linear regression model to determine the factors affecting digitalization development. The results revealed that the model shows practical validity and can be used to measure digitalization development as measures of fit (geodesic distance, standardized root mean square residual, and squared Euclidean distance) were all below their respective 95%quantiles of bootstrap discrepancies (HI95 values). Therefore, digitalization is an emergent variable that can be measured using CCA. The average level of digitalization in PLAS farms was 0.2 and varied significantly across provinces. The factors that significantly influence digitalization development in PLAS land reform farms were age, gender, farm type, network type, and cellular data type. This should enable researchers and policymakers to understand the level of digitalization and patterns of development, as well as correctly attribute digitalization development to the contributing factors.

Keywords: agriculture, digitalization, confirmatory composite model, land reform, proactive land acquisition strategy, South Africa

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Authors: Sin Ying Tan, Mohammed Alloghani, A. J. Aljaaf, Abir Hussain, Jamila Mustafina

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Industry 4.0 is a term frequently used to describe the new upcoming industry era. Higher education institutions aim to prepare students to fulfil the future industry needs. Advancement of digital technology has paved the way for the evolution of education and technology. Evolution of education has proven its conservative nature and a high level of resistance to changes and transformation. The gap between the industry's needs and competencies offered generally by education is revealing the increasing need to find new educational models to face the future. The aim of this study was to identify the main issues faced by both universities and students in preparing the future workforce. From December 2018 to April 2019, a regional qualitative study was undertaken in Liverpool, United Kingdom (UK). Interviews were conducted with employers, faculty members and undergraduate students, and the results were analyzed using the open coding method. Four main issues had been identified, which are the characteristics of the future workforce, student's readiness to work, expectations on different roles played at the tertiary education level and awareness of the latest trends. The finding of this paper concluded that the employers and academic practitioners agree that their expectations on each other’s roles are different and in order to face the rapidly changing technology era, students should not only have the right skills, but they should also have the right attitude in learning. Therefore, the authors address this issue by proposing a learning framework known as 'ASK SUMA' framework as a guideline to support the students, academicians and employers in meeting the needs of 'Industry 4.0'. Furthermore, this technology era requires the employers, academic practitioners and students to work together in order to face the upcoming challenges and fast-changing technologies. It is also suggested that an interactive system should be provided as a platform to support the three different parties to play their roles.

Keywords: attitude, expectations, industry needs, knowledge, skills

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Authors: Anita Richter

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Innovation is one of the key foundations of competitive advantage, generating growth and welfare worldwide. Consequently, all firms should innovate to bring new ideas to the market. Innovation is a vital growth driver, particularly for transition countries to move towards knowledge-based, high-income economies. However, numerous barriers, such as financial, regulatory or infrastructural constraints prevent, in particular, new and small firms in transition countries from innovating. Thus SMEs’ innovation output may benefit substantially from government support. This research paper aims to assess the effect of government interventions on innovation activities in SMEs in emerging countries. Until now academic research related to the innovation policies focused either on single country and/or high-income countries assessments and less on cross-country and/or low and middle-income countries. Therefore the paper seeks to close the research gap by providing empirical evidence from 8,500 firms in 15 transition countries (Eastern Europe, South Caucasus, South East Europe, Middle East and North Africa). Using firm-level data from the Business Environment and Enterprise Performance Survey of the World Bank and EBRD and policy data from the SME Policy Index of the OECD, the paper investigates how government interventions affect SME’s likelihood of investing in any technological and non-technological innovation. Using the Standard Linear Regression, the impact of government interventions on SMEs’ innovation output and R&D activities is measured. The empirical analysis suggests that a firm’s decision to invest into innovative activities is sensitive to government interventions. A firm’s likelihood to invest into innovative activities increases by 3% to 8%, if the innovation eco-system noticeably improves (measured by an increase of 1 level in the SME Policy Index). At the same time, a better eco-system encourages SMEs to invest more in R&D. Government reforms in establishing a dedicated policy framework (IP legislation), institutional infrastructure (science and technology parks, incubators) and financial support (public R&D grants, innovation vouchers) are particularly relevant to stimulate innovation performance in SMEs. Particular segments of the SME population, namely micro and manufacturing firms, are more likely to benefit from an increased innovation framework conditions. The marginal effects are particularly strong on product innovation, process innovation, and marketing innovation, but less on management innovation. In conclusion, government interventions supporting innovation will likely lead to higher innovation performance of SMEs. They increase productivity at both firm and country level, which is a vital step in transitioning towards knowledge-based market economies.

Keywords: innovation, research and development, government interventions, economic development, small and medium-sized enterprises, transition countries

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Authors: E. Abustam, M. Yusuf, M. I. Said

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One of functional properties of the meat is decrease of water holding capacity (WHC) during rigor mortis. At the time of pre-rigor, WHC is higher than post-rigor. The decline of WHC has implication to the other functional properties such as decreased cooking lost and yields resulting in lower elasticity and compactness of processed meat product. In many cases, the addition of phosphate in the meat will increase the functional properties of the meat such as WHC. Furthermore, liquid smoke has also been known in increasing the WHC of fresh meat. For food safety reasons, liquid smoke in the present study was used as a substitute to phosphate in production of chicken nuggets. This study aimed to know the effect of substitution of phosphate with liquid smoke on the quality of nuggets made from post-rigor chicken thigh and breast. The study was arranged using completely randomized design of factorial pattern 2x3 with three replications. Factor 1 was thigh and breast parts of the chicken, and factor 2 was different levels of liquid smoke in substitution to phosphate (0%, 50%, and 100%). The thigh and breast post-rigor broiler aged 40 days were used as the main raw materials in making nuggets. Auxiliary materials instead of meat were phosphate, liquid smoke at concentration of 10%, tapioca flour, salt, eggs and ice. Variables measured were flexibility, shear force value, cooking loss, elasticity level, and preferences. The results of this study showed that the substitution of phosphate with 100% liquid smoke resulting high quality nuggets. Likewise, the breast part of the meat showed higher quality nuggets than thigh part. This is indicated by high elasticity, low shear force value, low cooking loss, and a high level of preference of the nuggets. It can be concluded that liquid smoke can be used as a binder in making nuggets of chicken post-rigor.

Keywords: liquid smoke, nugget quality, phosphate, post-rigor

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Authors: Kaiwen Zheng, Wanting Zhou, Nan Tang, Lei Li, Yuanhang He

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The integrated circuit industry has become a cornerstone of the information society, finding widespread application in areas such as industry, communication, medicine, and aerospace. However, with the increasing complexity of integrated circuits, Hardware Trojans (HTs) implanted by attackers have become a significant threat to their security. In this paper, we proposed a hardware trojan detection method for large-scale circuits. As HTs introduce physical characteristic changes such as structure, area, and power consumption as additional redundant circuits, we proposed a machine-learning-based hardware trojan detection method based on the physical characteristics of gate-level netlists. This method transforms the hardware trojan detection problem into a machine-learning binary classification problem based on physical characteristics, greatly improving detection speed. To address the problem of imbalanced data, where the number of pure circuit samples is far less than that of HTs circuit samples, we used the SMOTETomek algorithm to expand the dataset and further improve the performance of the classifier. We used three machine learning algorithms, K-Nearest Neighbors, Random Forest, and Support Vector Machine, to train and validate benchmark circuits on Trust-Hub, and all achieved good results. In our case studies based on AES encryption circuits provided by trust-hub, the test results showed the effectiveness of the proposed method. To further validate the method’s effectiveness for detecting variant HTs, we designed variant HTs using open-source HTs. The proposed method can guarantee robust detection accuracy in the millisecond level detection time for IC, and FPGA design flows and has good detection performance for library variant HTs.

Keywords: hardware trojans, physical properties, machine learning, hardware security

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Authors: Magdalena B. Kaziuk, Waldemar Kosiba

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Background: In the XXI century we have to deal with the epidemic of obesity which is important risk factor for the cardiovascular and kidney diseases. Lipo proteins are directly involved in the atherosclerotic process. Non-high-density lipo protein (non-HDL) began following widespread recognition of its superiority over LDL as a measurement of vascular event risk. Non-HDL includes residual risk which persists in patients after achieved recommended level of LDL. Materials and Methods: The study covered 111 patients (52 females, 59 males, age 51,91±14 years), hospitalized on the intern department. Body composition was assessed using the bioimpendance method and anthropometric measurements. Physical activity data were collected during the interview. The nutritional status and the obesity type were determined with the Waist to Height Ratio and the Waist to Hip Ratio. A function of the kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using MDRD formula. Non-HDL was calculated as a difference between concentration of the Total and HDL cholesterol. Results: 10% of patients were found to be underweight; 23.9 % had correct body weight; 15,08 % had overweight, while the remaining group had obesity: 51,02 %. People with the android shape have higher non-HDL cholesterol versus with the gynoid shape (p=0.003). The higher was non-HDL, the lower eGFR had studied subjects (p < 0.001). Significant correlation was found between high non-HDL and incorrect dietary habits in patients avoiding eating vegetables, fruits and having low physical activity (p < 0.005). Conclusions: Android type of figure raises the residual risk of the heart disease associated with higher levels of non-HDL. Increasing physical activity in these patients reduces the level of non-HDL. Non-HDL seems to be the best predictor among all cholesterol measures for the cardiovascular events and worsening eGFR.

Keywords: obesity, non-HDL cholesterol, glomerular filtration rate, lifestyle

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Authors: Lauren Benyo Linford, Jared Warren, Jeremy Bekker, Gus Salazar

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In order to accurately identify areas needing improvement and track growth, the availability of valid and reliable measures of different facets of well-being is vital. Because no specific measures currently exist for many facets of well-being, the purpose of this study was to construct and validate measures of the following constructs: Purpose, Values, Mindfulness, Savoring, Gratitude, Optimism, Supportive Relationships, Interconnectedness, Compassion, Community, Contribution, Engaged Living, Personal Growth, Flow Experiences, Self-Compassion, Exercise, Meditation, and an overall measure of subjective well-being—the Survey on Flourishing. In order to assess their psychometric properties, each measure was examined for internal consistency estimates, and items with poor item-test correlations were dropped. Additionally, the convergent validity of the Survey on Flourishing (SURF) was assessed. Total score correlations of SURF and other commonly used measures of well-being such as the Positive and Negative Affect Schedule (PANAS), The Satisfaction with Life Scale (SWLS), the PERMA Profiler (measure of Positive Emotion, Engagement, Relationships, Meaning, and Achievement) were examined to establish convergent validity. The Kessler Psychological distress scale (K6) was also included to determine the divergent validity of the SURF measure. Three week test-retest reliability was also assessed for the SURF measure. Additionally, normative data from general population samples was collected for both the Self-Compassion and Survey on Flourishing (SURF) measures. The purpose of this study is to introduce each of these measures, divulge the psychometric findings of this study, as well as explore additional psychometric properties of the SURF measure in particular. This study will highlight how these measures can be used in future research exploring these positive psychology constructs. Additionally, this study will discuss the utility of these measures to guide individuals in their use of the online self-directed, self-administered My Best Self 101 positive psychology resources developed by the researchers. The goal of My Best Self 101 is to disseminate real, research-based measures and tools to individuals who are seeking to increase their well-being.

Keywords: measurement, psychometrics, test validation, well-Being

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Authors: L. Laurs, A. Blazeviciene, D. Milonas

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Introduction: Nursing as a profession is grounded in moral obligation. Nursing practice is grounded in ethical standards: to not harm, to promote justice, to be accountable, and to provide safe and competent care. The nature of the nurse-patient therapeutic relationship requires acting on the patient's behalf. Moral distress consists of negative stress symptoms that occur in situations that involve ethical situations that the nurse perceives as discordant with their professional values. Aim of the Study: The purpose of this study was to assess links between moral distress of registered nurses and factors related to patient care at the end of their life. Methods and Sample: A descriptive, cross-sectional, correlational design was applied in this study. Registered nurses were recruited from seven municipal multi-profile hospitals providing both general and specialized healthcare services in Lithuania (N=1055). Research instruments included two questionnaires: Obstacles and Facilitating at the End of Life Care and Moral Distress Scale (revised). Results: Spearman’s correlation analysis was performed to assess the relationship between nurses' attitudes towards patient care at the end of life and the experienced moral distress. A statistically significant correlation between moral distress and the following factors related to patient end-of-life care has been identified: conversations with physicians on patient end-of-life problems have a positive impact on job satisfaction; some patients may be excluded from decisions about their treatment and nursing because they are questioned about their ability to assess the situation. These situations increased moral distress. Patient consciousness should not be permanently suppressed by calming medications, and the patient should be provided with all nursing care services and moral distress. Conclusions: The moral distress of nurses is significantly related to the end-of-life care of patients and their determinants: moral distress increased due to lack of discussion with doctors about problem-solving and exclusion of patients from decision-making. And it diminished by refusing calming medications to permanently suppress a patient's consciousness and providing good care for patients.

Keywords: moral distress, registered nurses, end of life, care

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Authors: Ashit Syngle, Inderjit Verma, Pawan Krishan

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Therapeutic approaches used previously relied on disease-modifying antirheumatic drugs (DMARDs) that had only partial clinical benefit and were associated with significant toxicity. Spironolactone, an oral aldosterone antagonist, suppresses inflammatory mediators. Clinical efficacy of spironolactone compared with placebo in patients with active psoriatic arthritis despite treatment with prior traditional DMARDs. In the 24-week, placebo-controlled study patients (n=31) were randomized to placebo and spironolactone (2 m/kg/day). Patients on background concurrent DMARDs continued stable doses (methotrexate, leflunomide, and/or sulfasalazine). Primary outcome measures were the assessment of disease activity measures i.e. 28-joint disease activity score (DAS28) and diseases activity in psoriatic arthritis (DAPSA) at week 24. The key secondary endpoint was change from baseline in Health Assessment Questionnaire–Disability Index (HAQ-DI) at week 24. Additional efficacy outcome measures at week 24 included improvements in the markers of inflammation (ESR and CRP) and pro-inflammatory cytokines TNF-α, IL-6 and IL-1. At week 24, spironolactone significantly reduced disease activity measure DAS-28 (p<0.001) and DAPSA (p=0.001) compared with placebo. Significant improvements in key secondary measures HAQ-DI (disability index) were evident with spironolactone (p=0.02) versus placebo. After week 24, there was significant reduction in pro-inflammatory cytokines level TNF-α, IL-6 (p<0.01) as compared with placebo group. However, there was no significant improvement in IL-1 in both treatment and placebo groups. There were minor side effects which did not mandate stopping of spironolactone. No change in any biochemical profile was noted after spironolactone treatment. Spironolactone was effective in the treatment of PsA, improving disease activity, physical function and suppressing the level of pro-inflammatory cytokines. Spironolactone demonstrated an acceptable safety profile and was well tolerated.

Keywords: spironolactone, inflammation, inflammatory cytokine, psoriatic arthritis

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Authors: Hiroyuki Aoki, Toru Asada, Tomomi Tanii

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The properties of a spin-cast film of a polymer material are different from those in the bulk material because the polymer chains are frozen in an un-equilibrium state due to the rapid evaporation of the solvent. However, there has been little information on the un-equilibrated conformation and dynamics in a spin-cast film at the single chain level. The real-space observation of individual chains would provide direct information to discuss the morphology and dynamics of single polymer chains. The recent development of super-resolution fluorescence microscopy methods allows the conformational analysis of single polymer chain. In the current study, the conformation of a polymer chain in a spin-cast film by the super-resolution microscopy. Poly(methyl methacrylate) (PMMA) with the molecular weight of 2.2 x 10^6 was spin-cast onto a glass substrate from toluene and chloroform. For the super-resolution fluorescence imaging, a small amount of the PMMA labeled by rhodamine spiroamide dye was added. The radius of gyration (Rg) was evaluated from the super-resolution fluorescence image of each PMMA chain. The mean-square-root of Rg was 48.7 and 54.0 nm in the spin-cast films prepared from the toluene and chloroform solutions, respectively. On the other hand, the chain dimension in a bulk state (a thermally annealed 10- μm-thick sample) was observed to be 43.1 nm. This indicates that the PMMA chain in the spin-cast film takes an expanded conformation compared to the unperturbed chain and that the chain dimension is dependent on the solvent quality. In a good solvent, the PMMA chain has an expanded conformation by the excluded volume effect. The polymer chain is frozen before the relaxation from an un-equilibrated expanded conformation to an unperturbed one by the rapid solvent evaporation.

Keywords: chain conformation, polymer thin film, spin-coating, super-resolution optical microscopy

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Authors: Eva L. Suarez, Daniel E. Meeroff, Yan Yong

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The U.S. Federal Emergency Management Agency (FEMA) developed flood maps based on experts’ experience and estimates of the probability of flooding. Current flood-risk models evaluate flood risk with regional and subjective measures without impact from torrential rain and nuisance flooding at the neighborhood level. Nuisance flooding occurs in small areas in the community, where a few streets or blocks are routinely impacted. This type of flooding event occurs when torrential rainstorm combined with high tide and sea level rise temporarily exceeds a given threshold. In South Florida, this threshold is 1.7 ft above Mean Higher High Water (MHHW). The National Weather Service defines torrential rain as rain deposition at a rate greater than 0.3-inches per hour or three inches in a single day. Data from the Florida Climate Center, 1970 to 2020, shows 371 events with more than 3-inches of rain in a day in 612 months. The purpose of this research is to develop a data-driven method to determine comprehensive analytical damage-avoidance criteria that account for nuisance flood events at the single-family home level. The method developed uses the Failure Mode and Effect Analysis (FMEA) method from the American Society of Quality (ASQ) to estimate the Damage Avoidance (DA) preparation for a 1-day 100-year storm. The Consequence of Nuisance Flooding (CoNF) is estimated from community mitigation efforts to prevent nuisance flooding damage. The Probability of Nuisance Flooding (PoNF) is derived from the frequency and duration of torrential rainfall causing delays and community disruptions to daily transportation, human illnesses, and property damage. Urbanization and population changes are related to the U.S. Census Bureau's annual population estimates. Data collected by the United States Department of Agriculture (USDA) Natural Resources Conservation Service’s National Resources Inventory (NRI) and locally by the South Florida Water Management District (SFWMD) track the development and land use/land cover changes with time. The intent is to include temporal trends in population density growth and the impact on land development. Results from this investigation provide the risk of nuisance flooding as a function of CoNF and PoNF for coastal areas of South Florida. The data-based criterion provides awareness to local municipalities on their flood-risk assessment and gives insight into flood management actions and watershed development.

Keywords: flood risk, nuisance flooding, urban flooding, FMEA

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Authors: Bangun F., Crevits B., Bellet T., Banet A., Boy G. A., Katili I.

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This paper seeks the incoherencies in cognitive process during an accident of Powered Two Wheelers (PTW) by understanding the factual sequences of events and causal relations for each case of accident. The principle of this approach is undertaking in-depth investigations on case per case of PTW accidents based on elaborate data acquisitions on accident sites that officially stamped in Police Crash Report (PCRs) 2012 of Medan with criteria, involved at least one PTW and resulted in serious injury and fatalities. The analysis takes into account four modules: accident chronologies, perpetrator, and victims, injury surveillance, vehicles and road infrastructures, comprising of traffic facilities, road geometry, road alignments and weather. The proposal for improvement could have provided a favorable influence on the chain of functional processes and events leading to collision. Decision Aiding Processes (DAP) assists in structuring different entities at different decisional levels, as each of these entities has its own objectives and constraints. The entities (A) are classified into 6 groups of accidents: solo PTW accidents; PTW vs. PTW; PTW vs. pedestrian; PTW vs. motor-trishaw; and PTW vs. other vehicles and consecutive crashes. The entities are also distinguished into 4 decisional levels: level of road users and street systems; operational level (crash-attended police officers or CAPO and road engineers), tactical level (Regional Traffic Police, Department of Transportation, and Department of Public Work), and strategic level (Traffic Police Headquarters (TCPHI)), parliament, Ministry of Transportation and Ministry of Public Work). These classifications will lead to conceptualization of Problem Situations (P) and Problem Formulations (I) in DAP context. The DAP concerns the sequences process of the incidents until the time the accident occurs, which can be modelled in terms of five activities of procedural rationality: identification on initial human features (IHF), investigation on proponents attributes (PrAT), on Injury Surveillance (IS), on the interaction between IHF and PrAt and IS (intercorrelation), then unravel the sequences of incidents; filtering and disclosure, which include: what needs to activate, modify or change or remove, what is new and what is priority. These can relate to the activation or modification or new establishment of law. The PrAt encompasses the problems of environmental, road infrastructure, road and traffic facilities, and road geometry. The evaluation model (MP) is generated to bridge P and I since MP is produced by the intercorrelations among IHF, PrAT and IS extracted from the PCRs 2012 of Medan. There are 7 findings of incoherences: lack of knowledge and awareness on the traffic regulations and the risks of accidents, especially when riding between 0 < x < 10 km from house, riding between 22 p.m.–05.30 a.m.; lack of engagements on procurement of IHF Data by CAPO; lack of competency of CAPO on data procurement in accident-sites; no intercorrelation among IHF and PrAt and IS in the database systems of PCRs; lack of maintenance and supervision on the availabilities and the capacities of traffic facilities and road infrastructure; instrumental bias with wash-back impacts towards the TCPHI; technical robustness with wash-back impacts towards the CAPO and TCPHI.

Keywords: decision aiding processes, evaluation model, PTW accidents, police crash reports

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Authors: T. Poppendieker, H. Maurer, C. Segieth

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Over the past ten years, foam rolling has become a new trend in the fitness and health market. It is also a frequently used technique for self-massage. However, the scope of effects from foam rolling has only recently started to be researched and understood. The focus of this study is to examine the effects of prolonged foam rolling on muscle performance. Isometric muscle force was used as a parameter to determine an improving impact of the myofascial roller in two different application volumes. Besides the maximal muscle force, data were also collected on muscle activation during all tests. Twenty-four (17 females, 7 males) healthy students with an average age of 23.4 ± 2.8 years were recruited. The study followed a cross-over pre-/post design in which the order of conditions was counterbalanced. The subjects performed a one-minute and three-minute foam rolling application set on two separate days. Isometric maximal muscle force of the dominant calf was tested before and after the self-myofascial release application. The statistic software program SPSS 22 was used to analyze the data of the maximal isometric force of the calf muscle by a 2 x 2 (time of measurement x intervention) analysis of variance with repeated measures. The statistic significance level was set at p ≤ 0.05. Neither for the main effect of time of measurement (F(1,23) = .93, p = .36, f = .20) nor for the interaction of time of measurement x intervention (F(1,23) = 1.99, p = .17, f = 0.29) significant p-values were found. However, the effect size indicates a mean interaction effect with a tendency of greater pre-post improvements under the three-minute foam rolling condition. Changes in maximal force did not correlate with changes in EMG-activity (r = .02, p = .95 in the short and r = -.11, p = .65 in the long rolling condition). Results support findings of previous studies and suggest a positive potential for use of the foam roll as a means for keeping muscle force at least at the same performance level while leading to an increase in flexibility.

Keywords: application volume differences, foam rolling, isometric maximal force, self-myofascial release

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Authors: Nazirah Hassan, Andrew Kendrick

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Punishment inside the penal institution has always been practiced in order to maintain discipline and keep order. Nonetheless, criminologists have long debated that the enforcement of discipline by punishing inmates is often ineffective and has a detrimental impact on inmates’ conduct. This paper uses data from a sample of 289 incarcerated young offenders to investigate the prevalence of institutional misconduct. It explores punitive cultural practices inside institutions and how this culture affects the inmates’ conduct during confinement. The project focused on male and female young offenders aged 12 to 21 years old, in eight juvenile justice institutions. The research collected quantitative and qualitative data using a mixed-method approach. All participants completed the Direct and Indirect Prisoner behavior Checklist-Scaled Version Revised (DIPC-SCALED-R). In addition, exploratory interviews were carried out with sixteen inmates and eight institutional staff. Results of the questionnaire survey show that almost half of the inmates reported a higher level of involvement in perpetration. It demonstrates a remarkable convergence of direct, rather than indirect, perpetration. Also, inmates reported a higher level of tobacco used and behavior associated with negative attitudes towards staff and institutional rules. In addition to this, the qualitative data suggests that the punitive culture encourages the onset of misconduct by increasing the stressful and oppressive conditions within the institution. In general, physical exercise and locking up inmates are two forms of punishment that were ubiquitous throughout the institutions. Interestingly, physical exercise is not only enforced by institutional staff but also inmates. These findings are discussed in terms of existing literature and their practical implications are considered.

Keywords: institutional punishment, incarcerated young offenders, punitive culture, institutional misconduct

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Authors: Suvorov Vasyl, Filipchuk Viktor

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Developmental Dysplasia of the Hip (DDH) is a frequent pathology in pediatric orthopedist’s practice. Neglected or residual cases of DDH in walking patients are usually treated using pelvic osteotomies. Plastic changes take place in hinge points due to acetabulum reorientation during surgery. Classically described hinge points and a traditional division of pelvic osteotomies on reshaping and reorientation are currently debated. The purpose of this article was to evaluate biomechanical changes during the most commonly used pelvic osteotomies (Salter, Dega, Pemberton) for DDH treatment in pediatric patients. Methods: virtual pelvic models of 2- and 6-years old patients were created, material properties were assigned, pelvic osteotomies were simulated and biomechanical changes were evaluated using finite element analysis (FEA). Results: it was revealed that the patient's age has an impact on pelvic bones and cartilages density (in younger patients the pelvic elements are more pliable - p<0.05). Stress distribution after each of the abovementioned pelvic osteotomy was assessed in 2- and 6-years old patients’ pelvic models; hinge points were evaluated. The new term "restriction point" was introduced, which means a place where restriction of acetabular deformity correction occurs. Pelvic ligaments attachment points were mainly these restriction points. Conclusions: it was found out that there are no purely reshaping and reorientation pelvic osteotomies as previously believed; the pelvic ring acts as a unit in carrying out the applied load. Biomechanical overload of triradiate cartilage during Salter osteotomy in 2-years old patient and in 2- and 6-years old patients during Pemberton osteotomy was revealed; overload of the posterior cortical layer in the greater sciatic notch in 2-years old patient during Dega osteotomy was revealed. Level of Evidence – Level IV, prognostic.

Keywords: developmental dysplasia of the hip, pelvic osteotomy, finite element analysis, hinge point, biomechanics

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Authors: Sabitra Kaphle, Rebecca Fanany, Jenny Kelly

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Australia welcomes significant numbers of humanitarian arrivals every year with the commitment to provide equal opportunities and the resources required for integration into the new society. Over the last two decades, more than 24,000 South Sudanese people have come to call Australia home. Most of these refugees experienced several challenges whilesettlinginto the new social structures and service systems in Australia. The aim of the research is to explore the factors influencing social and cultural integration of South Sudanese refugees who have settled in Australia. Methodology: This studyused a phenomenological approach based on in-depth interviews designed to elicit the lived experiences of South Sudanese refugees settled in Australia. It applied the principles of narrative ethnography, allowing participants an opportunity to speak about themselves and their experiences of social and cultural integration-using their own words. Twenty-six participants were recruited to the study. Participants were long-term residents (over 10 years of settlement experience)who self-identified as refugees from South Sudan. Participants were given an opportunity to speak in the language of their choice, and interviews were conducted by a bilingual interviewer in their preferred language, time, and location. Interviews were recorded and transcribed verbatim and translated to Englishfor thematic analysis. Findings: Participants’ experiences portray the complexities of integrating into a new society due tothe daily challenges that South Sudaneserefugees face. Themes emerged from narrativesindicated that South Sudanese refugees express a high level of association with a Sudanese identity while demonstrating a significant level of integration into the Australian society. Despite this identity dilemma, these refugees show a high level of consensus about the experiencesof living in Australia that is closely associated with a group identity. In the process of maintaining identity andsocial affiliation, there are significant inter-generational cultural conflicts that participants experience in adapting to Australian society. It has been elucidated that identityconflict often emerges centeringon what constitutes authentic cultural practice as well as who is entitled to claim to be a member of the South Sudanese culture. Conclusions: Results of this study suggest that the cultural identity and social affiliations of South Sudanese refugees settling into Australian society are complex and multifaceted. While there are positive elements of theirintegration into the new society, inter-generational conflictsand identity confusion require further investigation to understand the context that will assist refugees to integrate more successfully into their new society. Given the length of stay of these refugees in Australia, government and settlement agencies may benefit from developing appropriate resources and process that are adaptive to the social and cultural context in which newly arrived refugees will live.

Keywords: cultural integration, inter-generational conflict, lived experiences, refugees, South sudanese

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Authors: Khalid A. Salman, Shereen Wagih, Tariq Munshi, Musaed Almalki, Safwan Zatari, Zahid Khan

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Aim: To measure exposure levels to family members and caregivers of Saudi patients treated with low dose I131 therapy, and household radiation exposure rate to predict different factors that can affect radiation exposure. Patients and methods: All adult self dependent patients with hyperthyroidism or cancer thyroid referred for low dose radioactive I131 therapy on outpatient basis are included. Radiation protection procedures are given to the participant and family members in details. TLD’s were dispensed to each participant in sufficient quantity for his/her family members living in the household. TLD’s are collected at fifth days post-dispense from patients who agreed to have a home visit during which the household is inspected and level of radiation contamination of surfaces was measured. Results: Thirty-two patients were enrolled in the current study, with a mean age of 43.1± 17.1 years Out of them 25 patients (78%) are females. I131 therapy was given in twenty patients (63%) for cancer thyroid of and for toxic goiter in the remaining twelve patients (37%), with an overall mean I131 dose of 24.1 ± 7.5mCi that is relatively higher in the former. The overall number of household family members and helpers of patients are 139, out of them77 are females (55.4%) & 62 are males (44.6%) with a mean age of 29.8± 17.6. The mean period of contact with the patient is 7.6 ±5.6hours. The cumulative radiation exposure shows that radiation exposure to all family members is below the exposure constraint (1mSv), with a range of 109 to 503uSv, and a mean value of 220.9±91 uSv. Numerical data shows a little higher exposure rate for family members of those who receive higher dose of I131 (patients with thyroid cancer) and household members who spent longer time with the patient, yet, the difference is statistically insignificant (P>0.05). Besides, no significant correlation was found between the degree of cumulative exposure of the family members to their gender, age, socioeconomic standard, educational level and residential factors. In the 21 home visits all data from bedrooms, reception areas and kitchens are below hazardous limits (0.5uSv/h) apart from bathrooms that give a slightly higher reading of 0.57±0.39 uSv/h in those with cancer thyroid who receive a higher radiation dose. A statistically significant difference was found between radiation exposure rate in bathrooms used by the patient versus those used by family members only, with a mean value of exposure rate of 0.701±0.21 uSv/h and 0.17±0.82 uSv/h respectively, with a p-value of 0.018 (<0.05). Conclusion: Family members of patients treated with low dose I131 on outpatient basis have a good compliance to radiation protection instruction if given properly with a cumulative radiation exposure rate evidently beyond the radiation exposure constraints of 1 mSv. Given I131 dose, hours spent with the patient, age, gender, socioeconomic standard, educational level and residential factors have no significant correlation with the cumulative radiation exposure. The patient bathroom exhibits more radiation exposure rate, needing more strict instructions for patient bathroom use and health hygiene.

Keywords: family members, radiation exposure, radioactive iodine therapy, radiation safety

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Authors: Niroshan K. Walgama Wellalage, Tieling Zhang, Richard Dwight

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State-based Markov deterioration models (SMDM) sometimes fail to find accurate transition probability matrix (TPM) values, and hence lead to invalid future condition prediction or incorrect average deterioration rates mainly due to drawbacks of existing nonlinear optimization-based algorithms and/or subjective function types used for regression analysis. Furthermore, a set of separate functions for each condition state with age cannot be directly derived by using Markov model for a given bridge element group, which however is of interest to industrial partners. This paper presents a new approach for generating Homogeneous SMDM model output, namely, the Modified Weibull approach, which consists of a set of appropriate functions to describe the percentage condition prediction of bridge elements in each state. These functions are combined with Bayesian approach and Metropolis Hasting Algorithm (MHA) based Markov Chain Monte Carlo (MCMC) simulation technique for quantifying the uncertainty in model parameter estimates. In this study, factors contributing to rail bridge deterioration were identified. The inspection data for 1,000 Australian railway bridges over 15 years were reviewed and filtered accordingly based on the real operational experience. Network level deterioration model for a typical bridge element group was developed using the proposed Modified Weibull approach. The condition state predictions obtained from this method were validated using statistical hypothesis tests with a test data set. Results show that the proposed model is able to not only predict the conditions in network-level accurately but also capture the model uncertainties with given confidence interval.

Keywords: bridge deterioration modelling, modified weibull approach, MCMC, metropolis-hasting algorithm, bayesian approach, Markov deterioration models

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Authors: Yaofei Jiang, Liangqing Wang, Yanjun Xu

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In recent years, geological explorations have been carried out on the Rumei hydropower station, China. After preliminary analysis of results, the mainly problem of slope in reservoir area is about the stability of accumulation body. It is found that there are 23 accumulations in various sizes in the reservoir area, and most of them are unfavorable geological bodies. Three typical (No. 1, 7, 17) accumulation body slopes were selected as subjects to investigate the stability of the slopes. Take No. 1 accumulation body slope as an example and basic geological condition investigation and formation mechanism analysis were carried out to study the stability and geological analysis of engineering influence of the slope. The accumulation body in the research area distributes along the river with natural slope of 32° ~ 37° which is the natural angle of repose of gravel. The formation mechanism is analyzed based on the composition and structure of the accumulation body. The middle and lower part of the body is dense full of gravel soil mixed with a small amount of sand gravel which is stable. In the upper part, gravel soil is interbedded with bad cemented gravel which as a weak surface is not conducive to slope stability. Under the natural condition before storing water, the underground water level is deep buried, mainly distributed in the bedrock, and the surface and groundwater discharge conditions of the accumulation body are good, which is beneficial to the stability of slope. The safety coefficient calculated by the limit equilibrium method is 1.14, which indicates the slope is basically stable. However, the safety coefficient drops to 1.02 when the normal storage level is 2895m, which is in a dangerous state. The accumulation body will be destabilized by a small-area instability to large-scale or overall instability.

Keywords: accumulation body slope, stability evaluation, geological engineering investigation, effect of storing water

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Authors: B. Niez, B. Moulia, J. Dlouha, E. Badel

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Trees adjust their development to the environmental conditions they experience. Storms events of last decades showed that acclimation of trees to mechanical stresses due to wind is a very important process that allows the trees to sustain for long years. In the future, trees will experience new wind patterns, namely, more often strong winds and fewer daily moderate winds. Moreover, these patterns will go along with drought periods that may interact with the capacity of trees to adjust their growth to mechanical stresses due to wind. It is necessary to understand the mechanisms of wood functional acclimations to environmental conditions in order to predict their behaviour and in order to give foresters and breeders the relevant tools to adapt their forest management. This work aims to study how trees adjust the mechanical and hydraulic functions of their wood to environmental stresses and how this acclimation may be beneficial for the tree to resist to future stresses. In this work, young poplars were grown under controlled climatic conditions that include permanent environmental stress (daily mechanical stress of the stem by bending and/or hydric stress). Then, the properties of wood formed under these stressed conditions were characterized. First, hydraulic conductivity and sensibility to cavitation were measured at the tissue level in order to evaluate the changes in water transport capacity. Secondly, bending tests and Charpy impact tests were carried out at the millimetric scale to locally measure mechanical parameters such as elastic modulus, elastic limit or rupture energy. These experimental data allow evaluating the impacts of mechanical and water stress on the wood material. At the stem level, they will be merged in an integrative model in order to evaluate the beneficial aspect of wood acclimation for trees.

Keywords: acclimation, environmental stresses, hydraulics, mechanics, wood

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Authors: Yong Hwang, Kang Yeol Suh, Yundeok Jang, Tae Hoon Kim

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Introduction: Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Acute kidney injury is a potential complication of severe rhabdomyolysis and the prognosis is substantially worse if renal failure develops. We try to identify the factors that were predictive of AKI in severe trauma patients with rhabdomyolysis. Methods: This retrospective study was conducted at the emergency department of a level Ⅰ trauma center. Patients enrolled that initial creatine phosphokinase (CPK) levels were higher than 1000 IU with acute multiple trauma, and more than 18 years older from Oct. 2012 to June 2016. We collected demographic data (age, gender, length of hospital day, and patients’ outcome), laboratory data (ABGA, lactate, hemoglobin. hematocrit, platelet, LDH, myoglobin, liver enzyme, and BUN/Cr), and clinical data (Injury Mechanism, RTS, ISS, AIS, and TRISS). The data were compared and analyzed between AKI and Non-AKI group. Statistical analyses were performed using IMB SPSS 20.0 statistics for Window. Results: Three hundred sixty-four patients were enrolled that AKI group were ninety-six and non-AKI group were two hundred sixty-eight. The base excess (HCO3), AST/ALT, LDH, and myoglobin in AKI group were significantly higher than non-AKI group from laboratory data (p ≤ 0.05). The injury severity score (ISS), revised Trauma Score (RTS), Abbreviated Injury Scale 3 and 4 (AIS 3 and 4) were showed significant results in clinical data. The patterns of CPK level were increased from first and second day, but slightly decreased from third day in both group. Seven patients had received hemodialysis treatment despite the bleeding risk and were survived in AKI group. Conclusion: We recommend that HCO3, CPK, LDH, and myoglobin should be checked and be concerned about ISS, RTS, AIS with injury mechanism at the early stage of treatment in the emergency department.

Keywords: acute kidney injury, emergencies, multiple trauma, rhabdomyolysis

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Authors: Lulu Liao, Huijing Chen, Yinan Zhao, Hongting Ning, Hui Feng

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Urinary tract infection rate is an important index of care quality in nursing homes. The aim of the study is to understand the nursing assistant's current knowledge and attitudes of urinary incontinence and to explore related stakeholders' viewpoint about urinary incontinence training. This explanatory sequential study used Knowledge, Practice, and Attitude Model (KAP) and Adult Learning Theories, as the conceptual framework. The researchers collected data from 509 nursing assistants in sixteen nursing homes in Hunan province in China. The questionnaire survey was to assess the knowledge and attitude of urinary incontinence of nursing assistants. On the basis of quantitative research and combined with focus group, training demands were identified, which nurse managers should adopt to improve nursing assistants’ professional practice ability in urinary incontinence. Most nursing assistants held the poor knowledge (14.0 ± 4.18) but had positive attitudes (35.5 ± 3.19) toward urinary incontinence. There was a significant positive correlation between urinary incontinence knowledge and nursing assistants' year of work and educational level, urinary incontinence attitude, and education level (p < 0.001). Despite a general awareness of the importance of prevention of urinary tract infections, not all nurse managers fully valued the training in urinary incontinence compared with daily care training. And the nursing assistants required simple education resources to equip them with skills to address problem about urinary incontinence. The variety of learning methods also highlighted the need for educational materials, and nursing assistants had shown a strong interest in online learning. Related education material should be developed to meet the learning need of nurse assistants and provide suitable training method for planned quality improvement in urinary incontinence.

Keywords: mixed methods, nursing assistants, nursing homes, urinary incontinence

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