Search results for: advanced nurse practitioner

Authors: Fatma Refaat Ahmed, PhD, RN. Assistant Professor, Department of Nursing, College of Health Sciences, University of Sharjah, UAE. ([email protected]). Sally Mohamed Farghaly, Nursing Administration Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt. ([email protected])

Abstract:

Context: Intensive care unit (ICU) nurses often face pressure and constraints in their work, leading to the rationing of care when demands exceed available time and resources. Observations suggest that ICU nurses are frequently distracted from their core nursing roles by non-core tasks. This study aims to provide evidence on ICU nurses' multitasking activities and explore the association between nurses' personal and clinical characteristics and their time allocation. Research Aim: The aim of this study is to quantify the time spent by ICU nurses on multitasking activities and investigate the relationship between their personal and clinical characteristics and time allocation. Methodology: A self-observation form utilizing the "Diary" recording method was used to record the number of tasks performed by ICU nurses and the time allocated to each task category. Nurses also reported on the distractions encountered during their nursing activities. A convenience sample of 60 ICU nurses participated in the study, with each nurse observed for one nursing shift (6 hours), amounting to a total of 360 hours. The study was conducted in two ICUs within a university teaching hospital in Alexandria, Egypt. Findings: The results showed that ICU nurses completed 2,730 direct patient-related tasks and 1,037 indirect tasks during the 360-hour observation period. Nurses spent an average of 33.65 minutes on ventilator care-related tasks, 14.88 minutes on tube care-related tasks, and 10.77 minutes on inpatient care-related tasks. Additionally, nurses spent an average of 17.70 minutes on indirect care tasks per hour. The study identified correlations between nursing time and nurses' personal and clinical characteristics. Theoretical Importance: This study contributes to the existing research on ICU nurses' multitasking activities and their relationship with personal and clinical characteristics. The findings shed light on the significant time spent by ICU nurses on direct care for mechanically ventilated patients and the distractions that require attention from ICU managers. Data Collection: Data were collected using self-observation forms completed by participating ICU nurses. The forms recorded the number of tasks performed, the time allocated to each task category, and any distractions encountered during nursing activities. Analysis Procedures: The collected data were analyzed to quantify the time spent on different tasks by ICU nurses. Correlations were also examined between nursing time and nurses' personal and clinical characteristics. Question Addressed: This study addressed the question of how ICU nurses allocate their time across multitasking activities and whether there is an association between nurses' personal and clinical characteristics and time allocation. Conclusion: The findings of this study emphasize the need for a lean evaluation of ICU nurses' activities to identify and address potential gaps in patient care and distractions. Implementing lean techniques can improve efficiency, safety, clinical outcomes, and satisfaction for both patients and nurses, ultimately enhancing the quality of care and organizational performance in the ICU setting.

Keywords: motion study, ICU nurse, lean, nursing time, multitasking activities

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Authors: Amir Sattari

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For newly produced houses and energy renovations, an energy calculation needs to be conducted. This is done to verify whether the energy consumption criteria of the house -to reach the energy targets by 2020 and 2050- are in-line with the norms. The main purpose of this study is to confirm whether easy to use energy calculation software or hand calculations used by small companies or individuals give logical results compared to advanced energy simulation program used by researchers or bigger companies. There are different methods for calculating energy consumption. In this paper, two energy calculation programs are used and the relation of energy consumption with solar radiation is compared. A hand calculation is also done to validate whether the hand calculations are still reasonable. The two computer programs which have been used are TMF Energi (the easy energy calculation variant used by small companies or individuals) and IDA ICE - Indoor Climate and Energy (the advanced energy simulation program used by researchers or larger companies). The calculations are done for a standard house from the Swedish house supplier Fiskarhedenvillan. The method is based on having the same conditions and inputs in the different calculation forms so that the results can be compared and verified. The house has been faced differently to see how the orientation affects energy consumption in different methods. The results for the simulations are close to each other and the hand calculation differs from the computer programs by only 5%. Even if solar factors differ due to the orientation of the house, energy calculation results from different computer programs and even hand calculation methods are in line with each other.

Keywords: energy calculation, energy consumption, energy simulation, IDA ICE, TMF energi

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Authors: M. A. Moghaddas, M. Short, N. Wiley, A. Y. Yi, K. F. Graff

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The application of ultrasonic vibrations to machining processes has a long history, ranging from slurry-based systems able to drill brittle materials, to more recent developments involving low power ultrasonics for high precision machining, with many of these at the research and laboratory stages. The focus of this development is the application of high levels of ultrasonic power (1,000’s of watts) to standard, heavy duty machine tools – drilling being the immediate focus, with developments in milling in progress – with the objective of dramatically increasing system productivity through faster feed rates, this benefit arising from the thrust force reductions obtained by power ultrasonic vibrations. The presentation will describe development of an advanced drilling system based on a special, acoustically designed, rugged drill module capable of functioning under heavy duty production conditions, and making use of standard tool holder means, and able to obtain thrust force reductions while maintaining or improving surface finish and drilling accuracy. The characterization of the system performance will be described, and results obtained in drilling several materials (Aluminum, Stainless steel, Titanium) presented.

Keywords: dimensional accuracy, machine tool, productivity, surface roughness, thrust force, ultrasonic vibrations, ultrasonic-assisted drilling

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Authors: Ahmed Jibrin Uttu, Maimuna Waziri

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The root bark of Glossonema boveanum (Decne), a member of Apocynaceae family, is used by traditional medicine practitioner to treat urinary and respiratory tract infections, bacteremia, typhoid fever, bacillary dysentery, diarrhea and stomach pain. This present study aims to validate the medicinal claims ascribed to the root bark of the plant. Preliminary phytochemical study of the root bark extracts (n-hexane, ethyl acetate, chloroform and methanol extracts) showed the presence of alkaloids, carbohydrates, steroids, triterpenes, cardiac glycosides, saponins, tannins and flavonoids. Antimicrobial study of the extracts showed activities against Staphylococus aureus, Bacillus subtilis, Salmonella typhii, Shigella dysenteriae, Escherichia coli, Enterobacter cloacae, Streptococcus agalactiae and Candida albicans while Micrococcus luteus, Pseudomonas aeruginosa and Klebsiella Pneumoniae showed resistance to all the extracts. The inhibitory effect was compared with the standard drug ciprofloxacin and fluconazole. MIC and MBC for both extracts were also determined using the tube dilution method. This study concluded that the root bark of G. boveanum, used traditionally as a medicinal plant, has antimicrobial activities against some causative organisms.

Keywords: Glossonema boveanum (Decne.), phytochemical, antimicrobial, minimum inhibitory concentration, minimum bactericidal concentration

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Authors: Mohamed K. El-Fawkhry, Ahmed Shash, Ahmed Ismail Zaki Farahat, Sherif Ali Abd El Rahman, Taha Mattar

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High-carbon, silicon-rich steels are commonly suggested to obtain very fine bainitic microstructure at low temperature ranged from 200 to 300°C. Thereby, the resulted microstructure consists of slender of bainitic-ferritic plates interwoven with retained austenite. The advanced strength and ductility package of this steel is much dependent on the fineness of bainitic ferrite, as well as the retained austenite phase. In this article, Aluminum to Silicon ratio, and the isothermal transformation temperature have been adopted to obtain ultra high strength high carbon steel. Optical and SEM investigation of the produced steels have been performed. XRD has been used to track the retained austenite development as a result of the change in the chemical composition of developed steels and heat treatment process. Mechanical properties in terms of hardness and microhardness of obtained phases and structure were investigated. It was observed that the increment of aluminum to silicon ratio has a great effect in promoting the bainitic transformation, in tandem with improving the stability and the fineness of retained austenite. Such advanced structure leads to enhancement in the whole mechanical properties of the high carbon steel.

Keywords: high-carbon steel, silicon-rich steels, fine bainitic microstructure, retained austenite, isothermal transformation

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Authors: Grace Omowunmi Soyebi

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Data Mining is the extraction of information from a large database which helps in predicting a trend or behavior, thereby helping management make knowledge-driven decisions. One principal problem of most hospitals in rural areas is making use of the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved; this may cause an unexpected to happen to the patient. This Data Mining application is to be designed using a Structured System Analysis and design method, which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the Design and Implementation of a Computerized medical record system. This Computerized system will replace the file management system and help to easily retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: data mining, medical record system, systems programming, computing

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Authors: Novita Verayanti Manalu, Alvin Salim

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Background: Palliative care is caring holistically for patients and families to improve their quality of life. Experts stated that palliative care could be applied not only for terminally ill cases but also for acute illnesses. Therefore, this study wants to find out the level of knowledge about palliative care of the nurses along with the relationship with attitude and performance. Method: This study applies a cross-sectional survey design and allows the respondents to fill two questionnaires to determine the level of knowledge and attitude toward palliative care, while one questionnaire is filled out by the head nurse to evaluate nurses’ performance. The relationship was analyzed by Spearman rho’s correlation in alpha < 0,05 by SPSS. Results: The majority of respondents were females, aged above 25 years old, and married. Most of the nurses are staff nurses and the ratio of education level is not significantly different. The knowledge level is poor, while the attitude and performance are at an adequate level. Knowledge may affect attitude, but it doesn’t happen toward performance. Conclusion: There is a need for increased knowledge about palliative care to improve attitude and work performance. Future researchers might use this finding as a reference to conduct further study in improving knowledge of palliative care.

Keywords: knowledge, attitude, work performance, palliative care

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Authors: Lin Yanyan

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This research set out to understand early childhood practitioners’ perceptions of continuous professional development (CPD) opportunities and its relationship to career progression and leadership roles in Singapore. The small-scale qualitative inductive study was conducted in two phases. Phase one used close-ended questionnaires with a total of 24 early years practitioner participants, while phase two included a total of 5 participants who were invited to participate in the second part of the data collection. Semi-structured interviews were used at phase two to elicit deeper responses from parents and teachers. Findings from the study were then thematically coded and analysed. The findings from both questionnaires and interviews showed that early years practitioners perceived CPD to be important to their professional growth, but there was no conclusive link that CPD necessarily led to the progression of leadership roles in the early years. Participants experience of CPD was strongly determined by their employer- the preschool operator, being government-funded or a private entity, which resulted in key differences emerging between their responses. Participants also experienced road blocks in their pursuit of CPD, in the form of staff shortage, budget constraints and lack of autonomy as their employers imposed specific CPD courses on them to suit the organisational needs, rather than their personal or professional needs.

Keywords: continuous professional development (CPD), early years practitioners (EYP), career progression, leadership

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Authors: Schadrack Mwizerwa

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The characterization and prediction of landslides are crucial for assessing geological hazards and mitigating risks to infrastructure and communities. This research aims to develop a probabilistic framework for analyzing excavation-induced landslides, which is fundamental for assessing geological hazards and mitigating risks to infrastructure and communities. The study uses Hermite polynomial chaos, a non-stationary random process, to analyze the stability of a slope and characterize the failure probability of a real landslide induced by highway construction excavation. The correlation within the data is captured using the Karhunen-Loève (KL) expansion theory, and the finite element method is used to analyze the slope's stability. The research contributes to the field of landslide characterization by employing advanced random field approaches, providing valuable insights into the complex nature of landslide behavior and the effectiveness of advanced probabilistic models for risk assessment and management. The data collected from the Baiyuzui landslide, induced by highway construction, is used as an illustrative example. The findings highlight the importance of considering the probabilistic nature of landslides and provide valuable insights into the complex behavior of such hazards.

Keywords: Hermite polynomial chaos, Karhunen-Loeve, slope stability, probabilistic analysis

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Authors: Lei Zhao, Yi Song, Tim Dunne, Jiaxiang (Jason) Ren, Wenhan Yue, Lei Yang, Li Wen, Yu Liu

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Fasting dissolving magnesium (DM) alloy technology has contributed significantly to the “Shale Revolution” in oil and gas industry. This application requires DM downhole tools dissolving initially at a slow rate, rapidly accelerating to a high rate after certain period of operation time (typically 8 h to 2 days), a contradicting requirement that can hardly be addressed by traditional Mg alloying or processing itself. Premature disintegration has been broadly reported in downhole DM tool from field trials. To address this issue, “temporary” thin polymers of various formulations are currently coated onto DM surface to delay its initial dissolving. Due to conveying parts, harsh downhole condition, and high dissolving rate of the base material, the current delay coatings relying on pure polymers are found to perform well only at low temperature (typical < 100 ℃) and parts without sharp edges or corners, as severe geometries prevent high quality thin film coatings from forming effectively. In this study, a coating technology combining Plasma Electrolytic Oxide (PEO) coatings with advanced thin film deposition has been developed, which can delay DM complex parts (with sharp corners) in corrosive fluid at 150 ℃ for over 2 days. Synergistic effects between porous hard PEO coating and chemical inert elastic-polymer sealing leads to its delaying dissolution improvement, and strong chemical/physical bonding between these two layers has been found to play essential role. Microstructure of this advanced coating and compatibility between PEO and various polymer selections has been thoroughly investigated and a model is also proposed to explain its delaying performance. This study could not only benefit oil and gas industry to unplug their High Temperature High Pressure (HTHP) unconventional resources inaccessible before, but also potentially provides a technical route for other industries (e.g., bio-medical, automobile, aerospace) where primer anti-corrosive protection on light Mg alloy is highly demanded.

Keywords: dissolvable magnesium, coating, plasma electrolytic oxide, sealer

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Authors: Ashok E. Kalange

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Diagnosis according to Ayurveda is to find the root cause of a disease. Out of the eight different kinds of examinations, Nadi-Pariksha (pulse examination) is important. Nadi-Pariksha is done at the root of the thumb by examining the radial artery using three fingers. Ancient Ayurveda identifies the health status by observing the wrist pulses in terms of 'Vata', 'Pitta' and 'Kapha', collectively called as tridosha, as the basic elements of human body and in their combinations. Diagnosis by traditional pulse analysis – NadiPariksha - requires a long experience in pulse examination and a high level of skill. The interpretation tends to be subjective, depending on the expertise of the practitioner. Present work is part of the efforts carried out in making Nadi-Parikshan objective. Nadi Parikshan Yantra (three point pulse examination system) is developed in our laboratory by using three pressure sensors (one each for the Vata, Pitta and Kapha points on radial artery). The radial pulse data was collected of a large number of subjects. The radial pulse data collected is analyzed on the basis of relative amplitudes of the three point pulses as well as in frequency and time domains. The same subjects were examined by Ayurvedic physician (Nadi Vaidya) and the dominant Dosha - Vata, Pitta or Kapha - was identified. The results are discussed in details in the paper.

Keywords: Nadi Parikshan Yantra, Tridosha, Nadi Pariksha, human pulse data analysis

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Authors: Amenah Dhannoon, Ciaran Martin Hurley, Laura Wrafter, Podraic J. Regan

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Introduction: The COVID-19 pandemic continues to present unprecedented challenges for healthcare systems. This has resulted in the pragmatic shift in the practice of plastic surgery units worldwide. During this period, many units reported a significant fall in urgent melanoma referrals, leading to patients presenting with advanced disease requiring more extensive surgery and inferior outcomes. Our objective was to evaluate our unit's experience with both non-invasive and invasive melanoma during the COVID-19 pandemic and characterize our experience and contrast it to that experienced by our neighbors in the UK, mainland Europe and North America. Methods: a retrospective chart review was performed on all patients diagnosed with invasive and non-invasive cutaneous melanoma between March to December of 2019 (control) compared to 2020 (COVID-19 pandemic) in a single plastic surgery unit in Ireland. Patient demographics, referral source, surgical procedures, tumour characteristics, radiological findings, oncological therapies and follow-up were recorded. All data were anonymized and stored in Microsoft Excel. Results: A total of 589 patients were included in the study. Of these, 314 (53%) with invasive melanoma, compared to 275 (47%) with the non-invasive disease. Overall, more patients were diagnosed with both invasive and non-invasive melanoma in 2020 than in 2019 (p<0.05). However, significantly longer waiting times in 2020 (64 days) compared to 2019 (28 days) (p<0.05), with the majority of the referral being from GP in 2019 (83%) compared to 61% in 2020. Positive sentinel lymph node were higher in 2019 at 56% (n=28) compared to 24% (n=22) in 2020. There was no statistically significant difference in the tutor characteristics or metastasis status. Discussion: While other countries have noticed a fall in the melanoma diagnosis. Our units experienced a higher number of disease diagnoses. This can be due to multiple reasons. In Ireland, the government reached an early agreement with the private sector to continue elective surgery on an urgent basis in private hospitals. This allowed access to local anesthetic procedures and local skin cancer cases were triaged to non-COVID-19 provider centers. Our unit also adapted a fast, effective and minimal patient contact strategy for triaging skin cancer based on telemedicine. Thirdly, a skin cancer nurse specialist maintained patient follow-ups and triaging a dedicated email service. Finally, our plastic surgery service continued to maintain a virtual complex skin cancer multidisciplinary team meeting during the pandemic, ensuring local clinical governance has adhered to each clinical case. Conclusion: Our study highlights that with the prompt efficient restructuring of services, we could reserve successful management of skin cancer even in the most devastating times. It is important to reflect on the success during the pandemic and emphasize the importance of preparation for a potentially difficult future

Keywords: malignant melanoma, skin cancer, COVID-19, triage

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Authors: Shital Jhunjhunwala, Shweta Saraf

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Research Question: The study, based on a survey, empirically tests the impact of the board’s engagement in the decision-making process on firm outcomes. It also examines the moderating effect of board leadership and board independence on the relationship. Research Findings: Boards’ engagement in the decision-making process is found to be vital for firm performance, wherein effective monitoring by the board outperforms their strategic guidance role in achieving desired outcomes. The separation of CEO and Chairman positively moderates the board’s engagement in protecting stakeholders’ interests, but lack of independence and passive behaviour of independent directors raises concern on the efficacy of independent directors. Theoretical Implications: The study provides the framework for process-oriented corporate governance research, where investigation of boards’ behaviour inside the boardroom develops a deeper understanding of board processes. Practitioner Implications: The study highlights the necessity of developing boards’ focus in a company on monitoring managerial actions. It suggests the need to separate the position of CEO and Chairman for addressing the interest of all stakeholders. It recommends policymakers review the existing mandate on board independence and create alternate monitoring mechanisms for addressing agency conflict.

Keywords: board, decision-making process, engagement, independence, leadership, innovation, stakeholders, firm performance, qualitative, India

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Authors: Shervin Khazaeli, Shahab Haj-zamani

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Recently, advanced geotechnical engineering problems related to soil movement, particle loss, and modeling of local failure (i.e. discontinua) as well as modeling the in-contact structures (i.e. continua) are of the great interest among researchers. The aim of this research is to meet the requirements with respect to the modeling of the above-mentioned two different domains simultaneously. To this end, a coupled numerical method is introduced based on Discrete Element Method (DEM) and eXtended-Finite Element Method (X-FEM). In the coupled procedure, DEM is employed to capture the interactions and relative movements of soil particles as discontinua, while X-FEM is utilized to model in-contact structures as continua, which may consist of different types of discontinuities. For verification purposes, the new coupled approach is utilized to examine benchmark problems including different contacts between/within continua and discontinua. Results are validated by comparison with those of existing analytical and numerical solutions. This study proves that extended-finite-discrete element method can be used to robustly analyze not only contact problems, but also other types of discontinuities in continua such as (i) crack formations and propagations, (ii) voids and bimaterial interfaces, and (iii) combination of previous cases. In essence, the proposed method can be used vastly in advanced soil-structure interaction problems to investigate the micro and macro behaviour of the surrounding soil and the response of the embedded structure that contains discontinuities.

Keywords: contact problems, discrete element method, extended-finite element method, soil-structure interaction

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Authors: Matthew McNees

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An inductive aesthetic approach to sports yields critical and meaningful insight into sports philosophy, sports governance, and sports history. Critical reflection will always remain key to the analysis of the past, present and future of sporting institutions, but a philosophically imaginative method of induction allows certain salient connections to be articulated and potentially implemented between various sporting entities who exist as individuals, particularly between practitioner, owner/manager and observer (‘fan’ or interested party.) By honing in on the concept of beauty in sports, the primary reason for viewership, consumption or engagement with sports comes into focus as an aesthetic concept. While always a subjective or shadowy articulation, an aesthetic state often remains unnecessarily unrevealed due to claims about unconscious states, entire rhetorics (or counter-rhetorics) about beauty, and Misalliance among sporting development systems. Since aesthetics require an inductive state of subjectivity in determining various levels of beauty (which the so-called world of sports often thinks of as morality), the audience for aesthetics in sports also needs an inductive explanation of the concept in which one comes to see a process of viewership at work within themselves that is revealed by a simple need parried outward by a complex process of engagement. The potentially redemptive moment of revelation regarding the beauty of sports and the athlete within these systems creates in the viewer a new space of consciousness where the world of sports discovers some of its longed-for transparency, openness, parity and equity upon which its immediate future depends.

Keywords: aesthetics, governance, history, philosophy

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Authors: S. Nitiworakarn

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In recent years, focus-group discussions, as a resources of qualitative facts collection, have gained popularity amongst practices within social science studies. Despite this popularity, studying qualitative information, particularly focus-group meetings, creates a challenge to most practitioner inspectors. The Mons, also known as Raman is considered to be one of the earliest peoples in mainland South-East Asia and to be found in scattered communities in Thailand, around the central valley and even in Bangkok. The present project responds to the needs identified traditional Mon set menus based on the participation of Bang Kadi community in Bangkok, Thailand. The aim of this study was to generate Mon food set menus based on the participation of the community and to study Mon food in set menus of Bang Kadi population by focus-group interviews and discussions during May to October 2015 of Bang Kadi community in Bangkok, Thailand. Data were collected using (1) focus group discussion between the researcher and 147 people in the community, including community leaders, women of the community and the elderly of the community (2) cooking between the researcher and 22 residents of the community. After the focus group discussion, the results found that Mon set menus of Bang Kadi residents involved of Kang Neng Kua-dit, Kang Luk-yom, Kang Som-Kajaeb, Kangleng Puk-pung, Yum Cha-cam, Pik-pa, Kao-new dek-ha and Num Ma-toom and the ingredients used in cooking are mainly found in local and seasonal regime. Most of foods in set menus are consequent from local wisdom.

Keywords: focus groups, Mon Food, set menus, Bangkok

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Authors: Nicolò Vaiana, Giorgio Serino

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In this paper, an advanced Nonlinear Exponential Model (NEM), able to simulate the uniaxial dynamic behavior of seismic isolators having a continuously decreasing tangent stiffness with increasing displacement in the relatively large displacements range and a hardening or softening behavior at large displacements, is presented. The mathematical model is validated by comparing the experimental force-displacement hysteresis loops obtained during cyclic tests, conducted on a helical wire rope isolator and a recycled rubber-fiber reinforced bearing, with those predicted analytically. Good agreement between the experimental and simulated results shows that the proposed model can be an effective numerical tool to predict the force-displacement relationship of seismic isolation devices within the large displacements range. Compared to the widely used Bouc-Wen model, unable to simulate the response of seismic isolators at large displacements, the proposed one allows to avoid the numerical solution of a first order nonlinear ordinary differential equation for each time step of a nonlinear time history analysis, thus reducing the computation effort. Furthermore, the proposed model can simulate the smooth transition of the hysteresis loops from small to large displacements by adopting only one set of five parameters determined from the experimental hysteresis loops having the largest amplitude.

Keywords: base isolation, hardening behavior, nonlinear exponential model, seismic isolators, softening behavior

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Authors: Lei Ye, Min Liu, Yong-Li Gao, Jun Zhang

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Purpose: The aims of the study are to investigate the status of health-promoting lifestyle and to compare the healthy lifestyle of emergency nurses in different levels of hospitals in Sichuan province, China. The investigation is mainly about the health-promoting lifestyle, including spiritual growth, health responsibility, physical activity, nutrition, interpersonal relations, stress management. Then the factors were analyzed influencing the health-promoting lifestyle of emergency nurses in hospitals of Sichuan province in order to find the relevant models to provide reference evidence for intervention. Study Design: A cross-sectional research method was adopted. Stratified cluster sampling, based on geographical location, was used to select the health facilities of 1389 emergency nurses in 54 hospitals from Sichuan province in China. Method: The 52-item, six-factor structure Health-Promoting Lifestyle Profile II (HPLP- II) instrument was used to explore participants’ self-reported health-promoting behaviors and measure the dimensions of health responsibility, physical activity, nutrition, interpersonal relations, spiritual growth, and stress management. Demographic characteristics, education, work duration, emergency nursing work duration and self-rated health status were documented. Analysis: Data were analyzed through SPSS software ver. 17.0. Frequency, percentage, mean ± standard deviation were used to describe the general information, while the Nonparametric Test was used to compare the constituent ratio of general data of different hospitals. One-way ANOVA was used to compare the scores of health-promoting lifestyle in different levels hospital. A multiple linear regression model was established. P values which were less than 0.05 determined statistical significance in all analyses. Result: The survey showed that the total score of health-promoting lifestyle of nurses at emergency departments in Sichuan Province was 120.49 ± 21.280. The relevant dimensions are ranked by scores in descending order: interpersonal relations, nutrition, health responsibility, physical activity, stress management, spiritual growth. The total scores of the three-A hospital were the highest (121.63 ± 0.724), followed by the senior class hospital (119.7 ± 1.362) and three-B hospital (117.80 ± 1.255). The difference was statistically significant (P=0.024). The general data of nurses was used as the independent variable which includes age, gender, marital status, living conditions, nursing income, hospital level, Length of Service in nursing, Length of Service in emergency, Professional Title, education background, and the average number of night shifts. The total score of health-promoting lifestyle was used as dependent variable; Multiple linear regression analysis method was adopted to establish the regression model. The regression equation F = 20.728, R2 = 0.061, P < 0.05, the age, gender, nursing income, turnover intention and status of coping stress affect the health-promoting lifestyle of nurses in emergency department, the result was statistically significant (P < 0.05 ). Conclusion: The results of the investigation indicate that it will help to develop health promoting interventions for emergency nurses in all levels of hospital in Sichuan Province through further research. Managers need to pay more attention to emergency nurses’ exercise, stress management, self-realization, and conduct intervention in nurse training programs.

Keywords: emergency nurse, health-promoting lifestyle profile II, health behaviors, lifestyle

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Authors: Carlette Groome

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This paper examined the role of drama in the lives of four women. The researcher concluded that drama can be an avenue of healing and could be an effective means of social work intervention in the communities as well as female empowerment. The participants in the study were able to, through the dramatic process; re-write their life’s scripts by resolving paradoxes and conflicts related to the themes unearthed. The research conducted examined the role of drama in the lives of four women living in volatile communities in Jamaica, who were each exposed to violence in one, or multiple, forms. The women were trained by Sistren Theatre Collective in the use of drama for education (edutainment), and were actresses in Sistren's street theatre drama group. Using their own personal and collective experiences, they used drama to raise social consciousness at the community level, about violence and other issues affecting women. The study employed a narrative case study approach and was grounded in a constructivist paradigm. This paradigm was coupled with a basic interpretive qualitative method and the concept of the reflective practitioner provided the foundation for the analysis. Through individual conversations with the women, themes of abuse, resilience, self- esteem, and empowerment arose sharply. The women explored drama and understood it to be instrumental in healing different aspects of their lives. Also, through the dramatic process; they were able to re-write their life’s scripts by resolving paradoxes and conflicts related to the themes unearthed.

Keywords: women, drama, healing, community

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Authors: Ahmed Negm, George Aggidis, Xiandong Ma

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With the diverse nature of urban cities, customer demand patterns, landscape topologies or even seasonal weather trends; managing our water distribution networks (WDNs) has proved a complex task. These unpredictable circumstances manifest as pipe failures, intermittent supply and burst events thus adding to water loss, energy waste and increased carbon emissions. Whilst these events are unavoidable, advanced pressure management has proved an effective tool to control and mitigate them. Henceforth, water utilities have struggled with developing a real-time control method that is resilient when confronting the challenges of water distribution. In this paper we use deep reinforcement learning (DRL) algorithms as a novel pressure control strategy to minimise pressure violations and leakage under both burst and background leakage conditions. Agents based on asynchronous actor critic (A2C) and recurrent proximal policy optimisation (Recurrent PPO) were trained and compared to benchmarked optimisation algorithms (differential evolution, particle swarm optimisation. A2C manages to minimise leakage by 32.48% under burst conditions and 67.17% under background conditions which was the highest performance in the DRL algorithms. A2C and Recurrent PPO performed well in comparison to the benchmarks with higher processing speed and lower computational effort.

Keywords: deep reinforcement learning, pressure management, water distribution networks, leakage management

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Authors: Yousaf Ayub

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A co-gasification process, which involves the utilization of both biomass and plastic waste, has been developed to enable the production of blue and green hydrogen. To support this endeavor, an Aspen Plus simulation model has been meticulously created, and sustainability analysis is being conducted, focusing on economic viability, energy efficiency, advanced exergy considerations, and exergoeconomics evaluations. In terms of economic analysis, the process has demonstrated strong economic sustainability, as evidenced by an internal rate of return (IRR) of 8% at a process efficiency level of 70%. At present, the process has the potential to generate approximately 1100 kWh of electric power, with any excess electricity, beyond meeting the process requirements, capable of being harnessed for green hydrogen production via an alkaline electrolysis cell (AEC). This surplus electricity translates to a potential daily hydrogen production of around 200 kg. The exergy analysis of the model highlights that the gasifier component exhibits the lowest exergy efficiency, resulting in the highest energy losses, amounting to approximately 40%. Additionally, advanced exergy analysis findings pinpoint the gasifier as the primary source of exergy destruction, totaling around 9000 kW, with associated exergoeconomics costs amounting to 6500 $/h. Consequently, improving the gasifier's performance is a critical focal point for enhancing the overall sustainability of the process, encompassing energy, exergy, and economic considerations.

Keywords: blue hydrogen, green hydrogen, co-gasification, waste valorization, exergy analysis

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Authors: Digambar J. Darekar, Sharvari D. Darekar

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Childlessness is a universal problem. It particularly affects the mental health of childless couple. It leads to anxiety, frustration, nervousness, depression, loneliness, helplessness, hopelessness, etc. After reviewing the literature, it is found that mental health of married couples is negatively related to childlessness. To understand emotional and psychological problems of a childless couple, researcher surveyed and interviewed 50 childless couples with the help of medical practitioner and gynecologist. Personal adjustment and mental health inventory and marital adjustment inventory along with semi-structured interview questionnaire was used. On the basis of responses from the subject, distinction is made between the problems of male subjects and female subjects and common problem separately. The researcher found that childlessness leads to the conflict between in-laws, harassment, hopelessness, feeling of emptiness and vacuumed, frustration, lack of hope and desire for life, restlessness, loss of sleep, ideas of committing suicide, increased emotional distance and disturbed marital life. The childlessness leads to sorrow for women and anger for men. Men turns towards addiction and women tend to avoid social contact and face problems of social adjustments. Childless couples are sufferers of personal and marital adjustment problems which in turn affect their mental health adversely.

Keywords: childlessness, marital adjustments, mental health, social adjustment

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Authors: Tahsien Okasha

Abstract:

Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page.". The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: organ transplant, clinical pathway, postoperative care, same page

Procedia PDF Downloads 423

Authors: Crispin Rakibu Mbamba

Abstract:

Twenty-two years after the adoption of the United Nation Trafficking Protocol, evidence suggest that child trafficking continues to rise. Community level factors, like poverty which creates the conditions for children’s vulnerability is key to the rise in trafficking cases in Ghana. Albeit, growing evidence suggestthat despite the vulnerabilities, communities have the capacity to prevent and address child trafficking issues. This study contributes to this positive agenda by exploring the ways in which communities (and the key actors) in Ghana contribute to child trafficking interventions.The study objective is explored through in-depth interviews with practitioners (including social workers) from an organization working in trafficking hotspots in Ghana. Interviews wereanalyzed thematically with the help of HyperRESEARCH software. From the in-depth interviews, three themes were identified as the ways in which communities are involved in child trafficking interventions: 1) engagement of community leaders, 2) community-led anti-trafficking committees and 3) knowledge about trafficking. Albeit the cultural differences, evidence on the instrumental role of community chiefs and leaders provide important learning on how to harness trafficking intervention measures and ensure better child protection practices. Based on the findings, we recommend the need to intensify trafficking awareness campaigns in rural communities where education is lacking to contribute to United Nations (UN) promoting Just, Peaceful and Inclusive societies’ mandate.

Keywords: child trafficking, community interventions, knowledge on trafficking, human trafficking intervention

Procedia PDF Downloads 105

Authors: Michael Munther, Keivan Davami

Abstract:

One significant roadblock for additively manufactured (AM) parts is the buildup of residual tensile stresses during the fabrication process. These residual stresses are formed due to the intense localized thermal gradients and high cooling rates that cause non-uniform material expansion/contraction and mismatched strain profiles during powder-bed fusion techniques, such as direct metal laser sintering (DMLS). The residual stresses adversely affect the fatigue life of the AM parts. Moreover, if the residual stresses become higher than the material’s yield strength, they will lead to acute geometric distortion. These are limiting the applications and acceptance of AM components for safety-critical applications. Herein, we discuss laser shock peening method as an advanced technique for the manipulation of the residual stresses in AM parts. An X-ray diffraction technique is used for the measurements of the residual stresses before and after the laser shock peening process. Also, the hardness of the structures is measured using a nanoindentation technique. Maps of nanohardness and modulus are obtained from the nanoindentation, and a correlation is made between the residual stresses and the mechanical properties. The results indicate that laser shock peening is able to induce compressive residual stresses in the structure that mitigate the tensile residual stresses and increase the hardness of AM IN718, a superalloy, almost 20%. No significant changes were observed in the modulus after laser shock peening. The results strongly suggest that laser shock peening can be used as an advanced post-processing technique to optimize the service lives of critical components for various applications.

Keywords: additive manufacturing, Inconel 718, laser shock peening, residual stresses

Procedia PDF Downloads 115

Authors: H. N. S. Silva, S. N. Silva

Abstract:

Introduction: 88.3% of physicians decided to choose a ‘no-code’ or a DNR order if hospitalized and would choose to die less aggressively at home. However, their wishes were mostly over ridden. Objective: To assess the attitudes of nurses towards the end-of-the-life care they would like to receive for themselves and their attitudes towards terminal illnesses. Methods: A mixed method approach was used. A closed and open-ended questionnaire was administered to 73 participants and 5 registered nurses, who have more than 10 years of experience, working in hospitals both in Sri Lanka and abroad, were interviewed. Results: 94.1% of the participants stated that they would like to die at home, spending their last hours at home surrounded by their loved ones and engaging in religious activities but 57.7% of unmarried nurse said they would agree on euthanasia if they had a terminal disease, and also 66.2% of them stated they would agree in DNR order if they happen to be admitted to the ICU, but 82.5% wanted to diagnose if they had a terminal illness or cancer but did not agree on euthanasia. Qualitative analysis confirmed the findings and revealed that despite having adequate confidence about the hospital care, nurses would choose to die at home, surrounded by their loved once and engaging in religious activities. Euthanasia was believed to be inappropriate as it is religiously incorrect and as death is a natural process. Conclusion: The perception of death among nurses depends on their religious belief.

Keywords: death, do not resuscitate, euthanasia, nurses

Procedia PDF Downloads 502

Authors: Tahsien Okasha

Abstract:

Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page." .The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: postoperative care, organ transplant, clinical pathway, patient

Procedia PDF Downloads 446

Authors: Renee Moten

Abstract:

Introduction: Knee pain becomes chronic because the therapy used focuses only on the symptoms of knee pain and not the causes of knee pain. Preventing knee injuries is not in the toolbox of the traditional practitioner. This research was done to show that we must reduce the inflammation (holistically), reduce the swelling and regain flexibility before considering any type of exercise. This method of performing the correct exercise stops the bowing of the knee, corrects the walking gait, and starts to relieve knee, hip, back, and shoulder pain. Method: The holistic method that is used to heal knees is called the Knee Pain Recipe. It’s a six step system that only uses alternative medicine methods to reduce, relieve and restore knee joint mobility. The system is low cost, with no hospital bills, no physical therapy, and no painkillers that can cause damage to the kidneys and liver. This method has been tested on 200 women with knee, back, hip, and shoulder pain. Results: All 200 women reduce their knee pain by 50%, some by as much as 90%. Learning about ankle and foot flexibility, along with understanding the kinetic chain, helps improve the walking gait, which takes the pressure off the knee, hip and back. The knee pain recipe also has helped to reduce the need for a cortisone injection, stem cell procedures, to take painkillers, and surgeries. What has also been noted in the research was that if the women's knees were too far gone, the Knee Pain Recipe helped prepare the women for knee replacement surgery. Conclusion: It is believed that the Knee Pain Recipe, when performed by men and women from around the world, will give them a holistic alternative to drugs, injections, and surgeries.

Keywords: knee, surgery, healing, holistic

Procedia PDF Downloads 63

Authors: Yasir Ali, Zain Ul Abdin, Muhammad Wisal Khattak

Abstract:

Nowadays various advanced techniques are used to enhance the performance of materials in the field of construction engineering. Structures exposed to an aggressive, humid and hostile environment are experiencing severe negative impacts which lead to premature failure. Polyester resin is one of the advanced material used for improving performance of structural materials especially for repair/ refurbish purpose of structures and protection from contaminated environmental effect/ hazards. This study investigated the aptness of the polyester resin as coating agent on the mortar and assessed its performance in an ambient environment of Pakistan. Cubical specimens of mortar were fabricated. These specimens were tested for water absorption and compressive strength after one day and sixty days. These tests were performed under different exposure conditions (ambient environment and submerged in water). The specimens were coated with one, two and three layers and results were compared to control (no/ zero resin layer) specimens. Test results indicated that there is a significant decrease in water absorption of mortar coated with resin when compared to controlled specimens. The compressive strength test results revealed that resin coated specimen had higher strength when compared to controlled specimens. The results suggested that resin is a promising material and can be used effectively in structures which are exposed to high temperatures. The study would be helpful in improving performance of the structural material in a hazardous environment.

Keywords: ambient environment, coating, mortar, polyester resin

Procedia PDF Downloads 348

Authors: F. Javier Benitez, Francisco J. Real, Juan Luis Acero, Francisco Casas

Abstract:

Three emerging contaminants (amitriptyline hydrochloride, methyl salicylate and 2-phenoxyethanol) frequently found in waste-waters were selected to be individually degraded in ultra-pure water by the combined advanced oxidation process constituted by UV radiation and chlorine. The influence of pH, initial chlorine concentration and nature of the contaminants was firstly explored. The trend for the reactivity of the selected compounds was deduced: amitriptyline hydrochloride > methyl salicylate > 2-phenoxyethanol. A later kinetic study was carried out and focused on the specific evaluation of the first-order rate constants and the determination of the partial contribution to the global reaction of the direct photochemical pathway and the radical pathway. A comparison between the rate constant values among photochemical experiments without and with the presence of Cl₂ reveals a clear increase in the oxidation efficiency of the combined process with respect to the photochemical reaction alone. In a second stage, the simultaneous oxidation of mixtures of the selected contaminants in several types of water (ultrapure water, surface water from a reservoir, and two secondary effluents) was also performed by the same combination UV/Cl₂ under more realistic operating conditions. The efficiency of this combined system UV/Cl₂ was compared to other oxidants such as the UV/S₂O₈^2- and UV/H₂O₂ AOPs. Results confirmed that the UV/Cl₂ system provides higher elimination efficiencies among the AOPs tested.

Keywords: emerging contaminants, UV/chlorine advanced oxidation process, amitriptyline, methyl salicylate, 2-phenoxyethanol, chlorination, photolysis

Procedia PDF Downloads 325