Search results for: point of care testing (POCT)

Authors: Tassana Boontong, Vilaivan Thongcharoen, Orapan Thosingha, Suphamon Chansakul, Anorut Jenwitheesuk, Chanin Chakkrapopyodhin, Isara Phiwchai, Mattika Chaichan, Rungnapha Khiewchaum

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According to Thailand health policy, subdistrict health promoting hospitals (SHPHs) serve as forefront facilities for inclusive health care service. Those services include health promotion, disease prevention, primary medical care and rehabilitation. However, SHPHs residing in some distant area, such as SHPHs residing on the islands, would deliver different services relevant to health needs of the local people and the tourists. This research aimed to study health care delivery services at SHPHs on the islands in Thailand. Data were collected using questionnaires. The result revealed that in Thailand, there are 58 SHPHs on the islands. During data collection process, the researchers were not allowed to collect data in 5 SHPHs in the southern part due to Covid-19 pandemic. The report is based on 53 SHPHs on the islands. Numbers of health care personnel were 201, 72.14 % were female, with the ages ranged from 22 to 60 years (mean = 35.56 years). About 53% were community health personnel, while 26.08% were professional nurses. In regard to work experiences, the range of year varied from less than 1 year to 30 years, with the mean of 8.36 years. The majority of their responsibilities focused on providing primary medical care (86.34%), caring of people with chronic illnesses (85.30%) and providing medical care procedures for patients with chronic illnesses at home (84.36%). Nurses were main health care personnel in performing primary medical care. Due to difficulty transportation from the islands to the mainland, nurses had to provide prompt emergency medical care while the patients arrived with emergency and critical illnesses such as severe head trauma, stroke or coronary artery disease. Although some medical procedures were complex and not covered by nursing and midwifery license, they decided to protect patients from life- threatening conditions and make them stable before transportation. In SHPHs, the workload exceeded manpower, health care personnel had to work overtime almost every day. In the famous tourist islands, health care personnel had to carry 3-4 folds of their workload during the holidays because of the large crowds of foreign and Thai tourists. It is recommended that SHPHs on the islands should scale up the level of services to cover advanced medical care. Health care personnel, in particular, professional nurses, should be equipped with emergency and critical care skills. The expected outcomes of the services should emphasize on rescuing patients with emergency and life-threatening illnesses and providing comprehensive care for people living on or visiting the islands.

Keywords: distant area, islands, sub district health promoting hospital, heath care services, Thailand

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Authors: Anwar U. Haque, Waqar Asrar, Ashraf Ali Omar, Erwin Sulaeman, Jaffer Sayed Mohamed Ali

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Due to the interference effects, the intrinsic aerodynamic parameters obtained from the individual component testing are always fundamentally different than those obtained for complete model testing. Consideration and limitation for such testing need to be taken into account in any design work related to the component buildup method. In this paper, the scaled model of a straight rectangular canard of a hybrid buoyant aircraft is tested at 50 m/s in IIUM-LSWT (Low-Speed Wind Tunnel). Model and its attachment with the balance are kept rigid to have results free from the aeroelastic distortion. Based on the velocity profile of the test section’s floor; the height of the model is kept equal to the corresponding boundary layer displacement. Balance measurements provide valuable but limited information of the overall aerodynamic behavior of the model. Zero lift coefficient is obtained at -2.2o and the corresponding drag coefficient was found to be less than that at zero angles of attack. As a part of the validation of low fidelity tool, the plot of lift coefficient plot was verified by the experimental data and except the value of zero lift coefficient, the overall trend has under-predicted the lift coefficient. Based on this comparative study, a correction factor of 1.36 is proposed for lift curve slope obtained from the panel method.

Keywords: wind tunnel testing, boundary layer displacement, lift curve slope, canard, aerodynamics

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Authors: Aneta Nitsch-Osuch, Katarzyna Zycinska, Ewa Gyrczuk, Agnieszka Topczewska-Cabanek, Kazimierz Wardyn

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Introduction: Influenza is an important clinical and epidemiological problem and should be considered as a possible nosocomial infection. The aim of the study was to determine the influenza vaccine coverage rates among Polish nurses and to find out drivers and barriers for influenza vaccination among this group of health care workers (HCWs). Material and methods: The self- fulfilled survey with 26 questions about the knowledge, perception, and influenza coverage rates was distributed among 461 nurses. Results: Only 15% of nurses were vaccinated against influenza in the consecutive seasons. The majority (75%) of the regularly vaccinated nurses were ambulatory careworkers. The difference between the number of vaccinated hospitals and ambulatory care nurses was statistically significant (p < 0.05). The main motivating factors for an influenza vaccination were: a fear of the illness and its complications (97%) and a free of charge vaccine available at the workplace (87%). Ambulatory care nurses more often declared that they were vaccinated mainly to protect themselves while hospital care nurses more often declared the will to protect their patients, these differences in the perception and attitudes to an influenza vaccination among hospital and ambulatory care nurses were statistically significant (p < 0.05). The main barriers for an influenza vaccination among the nursing staff were: a lack of reimbursement of the vaccine (95%), a lack of insufficient knowledge about the effectiveness, and safety of the influenza vaccine (54%). The ambulatory care nurses more often found influenza vaccination as the ethical duty compared to hospital care nurses (p < 0.05). Conclusions: The influenza vaccine coverage rates among the Polish nurses are low and must be improved in the future. More educational activities dedicated to HCWs may result in the increased awareness of influenza vaccination benefits for both medical professionals and patients.

Keywords: influenza, vaccination, nurses, ambulatory careworkers

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Authors: Joshna Rani S., Ahmadi Banu

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Artificial Intelligence (AI) has a significant task to carry out in the medical care contributions of things to come. As AI, it is the essential capacity behind the advancement of accuracy medication, generally consented to be a painfully required development in care. Albeit early endeavors at giving analysis and treatment proposals have demonstrated testing, we anticipate that AI will at last dominate that area too. Given the quick propels in AI for imaging examination, it appears to be likely that most radiology, what's more, pathology pictures will be inspected eventually by a machine. Discourse and text acknowledgment are now utilized for assignments like patient correspondence and catch of clinical notes, and their utilization will increment. The best test to AI in these medical services areas isn't regardless of whether the innovations will be sufficiently skilled to be valuable, but instead guaranteeing their appropriation in day by day clinical practice. For far reaching selection to happen, AI frameworks should be affirmed by controllers, coordinated with EHR frameworks, normalized to an adequate degree that comparative items work likewise, instructed to clinicians, paid for by open or private payer associations, and refreshed over the long haul in the field. These difficulties will, at last, be survived, yet they will take any longer to do as such than it will take for the actual innovations to develop. Therefore, we hope to see restricted utilization of AI in clinical practice inside 5 years and more broad use inside 10 years. It likewise appears to be progressively evident that AI frameworks won't supplant human clinicians for a huge scope, yet rather will increase their endeavors to really focus on patients. Over the long haul, human clinicians may advance toward errands and work plans that draw on remarkably human abilities like sympathy, influence, and higher perspective mix. Maybe the lone medical services suppliers who will chance their professions over the long run might be the individuals who will not work close by AI

Keywords: artificial intellogence, health care, breast cancer, AI applications

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Authors: Theodorus Holtzhausen

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With a growing number of professionals in healthcare moving freely between countries and also in general a more mobile global workforce, awareness of cultural differences have become more urgent for health care workers to apply proper care. There is a slowly emerging trend in health care due to globalisation that may create a more uniform cultural base for administering healthcare, but it is still very vulnerable to being hijacked and misdirected by major commercial interests. Veterinary clinics and medical clinics promoting alternative remedies lacking evidence based support and simultaneously practicing medicine as a science have become more common. Such ‘holistic’ clinics see these remedies more as a belief system causing no harm with minimal impact but with added financial benefit to the facility. With the inarguable acceptance and realisation of the interconnection between evolutionary aspects of cognition, knowledge and culture as a global but vulnerable cognition-gaining process affecting us all, we can see the enormous responsibility we carry. Such a responsibility for creating global well-being calling for an universally applicable ethic. Such an ethic with the potential of having significant impact on our cognition gaining process.

Keywords: veterinary health care, ethics, wellbeing, veterinary clinics

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Authors: Kartik Gupta, Umar Khan, Mayur Parab, Dhiraj Chaudhari, Afzal Ansari

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The report focuses on the study related to the Design and Simulation of a stabilator (an all-movable horizontal stabilizer) for a fixed-wing aircraft. The project involves the development of a computerized direct optimization procedure for designing an aircraft all-movable stabilator. This procedure evaluates various design variables to synthesize an optimal stabilator that meets specific requirements, including performance, control, stability, strength, and flutter velocity constraints. The work signifies the CFD (Computational Fluid Dynamics) analysis of the airfoils used in the stabilator along with the CFD analysis of the Stabilizer and Stabilator of an aircraft named Thorp- T18 in software like XFLR5 and ANSYS-Fluent. A comparative analysis between a Stabilizer and Stabilator of equal surface area and under the same environmental conditions was done, and the percentage of drag reduced by the Stabilator for the same amount of lift generated as the Stabilizer was also calculated lastly, Wind tunnel testing was performed on a scale down model of the Stabilizer and Stabilator and the results of the Wind tunnel testing were compared with the results of CFD.

Keywords: wind tunnel testing, CFD, stabilizer, stabilator

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Authors: Carmen Silvia Gabriel, Maria de Fátima Paiva Brito, Mariane de Paula Candido, Vanessa Barato Oliveira

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Patient identification is a necessary practice to ensure patient safety in any healthcare environment, including emergency care units, test laboratories, home care and clinics. The present study aimed to provide evidence that can effectively contribute to practices concerning patient identification. Its objective was to investigate patient identification in basic healthcare units through patient safety standards. To do so, a descriptive and non-experimental research outline study was carried out to inquire how patient identification takes place in a particular situation. All technical manager nurses from the chosen healthcare facilities were included in the sample for the study. Data was collected in September of 2014 after approval from the Committee of Ethics. All researched institutions fit the same profile: they’re public facilities for general care with observation beds. None of them has a wristband identification protocol or policy. Only one institution mentioned using some kind of visual identification; namely, body tags separated by colors according to the type of care, but it still does not apply the recommended tags by the Brazilian Ministry of Health. This study allowed the authors to acknowledge how important the commitment from the whole healthcare team in the patient identification process is and also acknowledge how necessary it is to implement institutional policies that may aid the healthcare units in this area to promote a quality and safe patient care.

Keywords: patient safety, identification, nursing, emergency care units

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Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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The neonatal care of cats and dogs represents a challenge to veterinarians due to the small size of the newborns and their physiological particularities. In addition, many Veterinary Medicine colleges around the world do not include neonatology in the curriculum, which makes it less likely for the veterinarian to have basic knowledge regarding neonatal care and worsens the clinical care these patients receive. Therefore, lack of assistance and negligence have become frequent in the field, which contributes towards the high mortality rates. This study aims at describing cases and the main conditions pertaining to the neonatology clinical routine in cats and dogs, highlighting the importance of specialized care in this field of Veterinary Medicine. The study included 808 neonates admitted to the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, São Paulo, Brazil, between January 2018 and November 2019. Of these, 87.3% (705/808) were dogs and 12.7% (103/808) were cats. Among the neonates admitted, 57.3% (463/808) came from emergency c-sections due to dystocia, 8.7% (71/808) cane from vaginal deliveries with obstetric maneuvers due to dystocia, and 34% (274/808) were admitted for clinical care due to neonatal conditions. Among the neonates that came from emergency c-sections and vaginal deliveries, 47.3% (253/534) was born in respiratory distress due to severe hypoxia or persistent apnea and required resuscitation procedure, such as the Jen Chung acupuncture point (VG26), oxygen therapy with mask, pulmonary expansion with resuscitator, heart massages and administration of emergency medication, such as epinephrine. On the other hand, in the neonatal clinical care, the main conditions and alterations observed in the newborns were omphalophlebitis, toxic milk syndrome, neonatal conjunctivitis, swimmer puppy syndrome, neonatal hemorrhagic syndrome, pneumonia, trauma, low weight at birth, prematurity, congenital malformations (cleft palate, cleft lip, hydrocephaly, anasarca, vascular anomalies in the heart, anal atresia, gastroschisis, omphalocele, among others), neonatal sepsis and other local and systemic bacterial infections, viral infections (feline respiratory complex, parvovirus, canine distemper, canine infectious traqueobronchitis), parasitical infections (Toxocara spp., Ancylostoma spp., Strongyloides spp., Cystoisospora spp., Babesia spp. and Giardia spp.) and fungal infections (dermatophytosis by Microsporum canis). The most common clinical presentation observed was the neonatal triad (hypothermia, hypoglycemia and dehydration), affecting 74.6% (603/808) of the patients. The mortality rate among the neonates was 10.5% (85/808). Being knowledgeable about neonatology is essential for veterinarians to provide adequate care for these patients in the clinical routine. Adding neonatology to college curriculums, improving the dissemination of information on the subject, and providing annual training in neonatology for veterinarians and employees are important to improve immediate care and reduce the mortality rates.

Keywords: neonatal care, puppies, neonatal, conditions

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Authors: Nurin Amalina Widityani, Adinda Syifa Azhari, Twin Aji Kusumagiani, Eleonora Agustine

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Fertilizer industry activities contribute to environmental changes. Changes to the environment became one of a few problems in this era of globalization. Parameters that can be seen as criteria to identify changes in the environment can be seen from the aspects of physics, chemistry, and biology. One aspect that can be assessed quickly and efficiently to describe environmental change is the aspect of physics, one of which is the value of magnetic susceptibility (χ). The rock magnetism method can be used as a proxy indicator of environmental changes, seen from the value of magnetic susceptibility. The rock magnetism method is based on magnetic susceptibility studies to measure and classify the degree of pollutant elements that cause changes in the environment. This research was conducted in the area around the fertilizer plant, with five coring points on each track, each coring point a depth of 15 cm. Magnetic susceptibility measurements were performed by in-situ and ex-situ. In-situ measurements were carried out directly by using the SM30 tool by putting the tools on the soil surface at each measurement point and by that obtaining the value of the magnetic susceptibility. Meanwhile, ex-situ measurements are performed in the laboratory by using the Bartington MS2B tool’s susceptibility, which is done on a coring sample which is taken every 5 cm. In-situ measurement shows results that the value of magnetic susceptibility at the surface varies, with the lowest score on the second and fifth points with the -0.81 value and the highest value at the third point, with the score of 0,345. Ex-situ measurements can find out the variations of magnetic susceptibility values at each depth point of coring. At a depth of 0-5 cm, the value of the highest XLF = 494.8 (x10-8m³/kg) is at the third point, while the value of the lowest XLF = 187.1 (x10-8m³/kg) at first. At a depth of 6-10 cm, the highest value of the XLF was at the second point, which was 832.7 (x10-8m³/kg) while the lowest XLF is at the first point, at 211 (x10-8m³/kg). At a depth of 11-15 cm, the XLF’s highest value = 857.7 (x10-8m³/kg) is at the second point, whereas the value of the lowest XLF = 83.3 (x10-8m³/kg) is at the fifth point. Based on the in situ and exsit measurements, it can be seen that the highest magnetic susceptibility values from the surface samples are at the third point.

Keywords: magnetic susceptibility, fertilizer plant, Bartington MS2B, SM30

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Authors: Qiuhu Shao

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Community home-based care service system, which is based on the family pension, supported by community pension and supplied by institutions pension, is an effective pension system to solve the current situation of China's accelerated aging. However, due to the fundamental realities of our country, the government is not able to bear the unilateral supply of the old-age service of the community. Therefore, based on the theory of welfare pluralism, the participation of social organizations in the home-based care service center has become an important part of the diversified supply of the old-age service for the elderly. Meanwhile, the home-based care service industry is still in the early stage, the management is relatively rough, which resulted in a large number of social resources waste. Thus, scientific, objective and long-term implementation is needed for social organizations to participate in home-based care services to guide its performance management. In order to realize the design of the performance management system, the author has done a research work that clarifies the research status of social organization's participation in home-based care service. Relevant theories such as welfare pluralism, community care theory, and performance management theory have been used to demonstrate the feasibility of data envelopment analysis method in social organization performance research. This paper analyzes the characteristics of the operation mode of the home-based care service center, and hackles the national as well as local documents, standards and norms related to the development of the home-based care industry, particularly studies those documents in Nanjing. Based on this, the paper designed a set of performance management PDCA system for home-based care service center in Nanjing and clarified each step of the system in detail. Subsequently, the research methods of performance evaluation and performance management and feedback, which are two core steps of performance management have been compared and screened in order to establish the overall framework of the performance management system of the home-based care service center. Through a large number of research, the paper summarized and analyzed the characteristics of the home-based care service center. Based on the research results, combined with the practice of the industry development in Nanjing, the paper puts forward a targeted performance evaluation index system of home-based care service center in Nanjing. Finally, the paper evaluated and sub-filed the performance of 186 home-based care service centers in Nanjing and then designed the performance optimization direction and performance improvement path based on the results. This study constructs the index system of performance evaluation of home-based care service and makes the index detailed to the implementation level, and constructs the evaluation index system which can be applied directly. Meanwhile, the quantitative evaluation of social organizations participating in the home-based care service changed the subjective impression in the previous practice of evaluation.

Keywords: data envelopment analysis, home-based care, performance management, social organization

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Authors: Olutayo Stephen Shodipo

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This paper explores how individuals with disabilities understand and express their spirituality like everyone else can help provide church ministers and religious leaders with new knowledge of human experience and change the way pastoral care ministry is being practiced with this population. Disability literature has revealed studies on various aspects of disability. However, on the spirituality of people with disabilities, there is a gap. This paper offers a brief overview of what has been studied on the spiritual needs of adults with developmental disabilities (ADDs) and the church and the gap that still exists. Along with explaining this gap, it considers the reality of ADDs’ spiritual needs and why the church needs to validate their spirituality and religious expressions and create an inclusive environment where their spiritual experience and expressions can be enhanced and supported. This paper, then, aims to explore the diverse spiritual experiences of ADDs in faith communities, and their theological, moral, and social implications for Pastoral care ministry practices.

Keywords: spirituality, inclusive ministry, pastoral theology, developmental disability, pastoral care

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Authors: Yan Rongxin, Sun Wei, Li Weidan

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Based on the acoustics cascade sound theory, the mechanism of air leak sound producing, transmitting and signal detecting has been analyzed. A formula of the sound power, leak size and air pressure in the spacecraft has been built, and the relationship between leak sound pressure and receiving direction and distance has been studied. The center frequency in millimeter diameter leak is more than 20 kHz. The situation of air leaking from spacecraft to space has been simulated and an experiment of different leak size and testing distance and direction has been done. The sound pressure is in direct proportion to the cosine of the angle of leak to sensor. The portable ultrasonic leak detector has been developed, whose minimal leak rate is 10^-1 Pa·m³/s, the testing radius is longer than 20 mm, the mass is less than 1.0 kg, and the electric power is less than 2.2 W.

Keywords: leak testing, manned spacecraft, sound transmitting, ultrasonic

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Authors: Edwina Owusu Panin, Derrick Antwi

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Autism and cerebral palsy are fraternal twins in the world of communication and social interaction challenges. Caring for autistic and cerebral palsied female teenagers in Ghana can be difficult and stressful for parents. We highlight the findings of dealing with stress, where female teenagers are more daunting than male teenagers, related to the demand for a lot of attention linked to the puberty transition. This brief examines the challenges that parents face in caring for teenagers with autism and cerebral palsy in Ghana and the stress that can develop from parental care. The article also highlights the importance of identifying and addressing mental health and self-care issues in parents of disabled female teenagers, as these issues can significantly affect the well-being of both parents and their children. Parents of teenagers with disabilities often face a variety of challenges, including managing their children's care and medical needs, navigating the educational system, and addressing social and emotional needs. These challenges can be even more disheartening in Ghana, where resources and support for families of children with disabilities are limited. In a nutshell, the challenges of caring for female teenagers with autism and cerebral palsy can be significant in Ghana. The article outlines methods that parents in Ghana can take to manage their stress and provide a brighter future for their female teenagers. Parents are better able to cope with the challenges of parenting and provide the best care possible for their female teenagers with disabilities.

Keywords: autism, cerebral palsy, female teenagers, parental care

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Authors: Anne Prip, Kirsten Alling Møller, Dorte Lisbet Nielsen, Mary Jarden, Marie-Helene Olsen, Anne Kjaergaard Danielsen

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Background: The development in cancer care has shifted towards shorter hospital stays and more outpatient treatment. Today, cancer care and treatment predominantly takes place in outpatient settings where encounters between patients and health care professionals are often brief. This development will probably continue internationally as the global cancer burden seems to be growing significantly. Furthermore, the number of patients who require ambulatory treatments such as chemotherapy is increasing. Focusing on the encounters between health care professionals and patients during oncology treatment has thus become increasingly important due to a growing trend in outpatient cancer management. Objective: The aim of the systematic review was to summarize the literature from the perspective of the patient, on experiences of and the need for communication and relationships with the health care professional during chemotherapy treatment in an outpatient setting. Method: The review was designed and carried out according to the PRISMA guidelines and PICO framework. The systematic search was conducted in Medline, CINAHL, The Cochrane Library and Joanna Briggs Institute Evidence Based Practice Database. Results: In all, 1174 studies were identified by literature search. After duplicates were removed, the remaining studies (n = 1053) were screened for inclusion. Nine studies were included; qualitative (n = 5) and quantitative (n = 4) as they met the inclusions criteria. The review identified that communication and relationships between health care professionals and patients were important for the patients’ ability to cope with cancer and also had an impact on patients’ satisfaction with care in the outpatient clinic. Furthermore, the review showed that hope and positivity was a need and strategy for patients with cancer and was facilitated by health care professionals. Finally, it revealed that outpatient clinic visits framed and influenced communication and relationships. Conclusions: This review identified the significance of communication and the relationships between patients and health care professionals in the outpatient setting as it supports patients’ ability to cope with cancer. The review showed the need for health care professionals to pay attention to the relational aspects of communication in an outpatient clinic as encounters are often brief. Furthermore, the review helps to specify which elements of the communication are central in the patient-health care professional interaction from the patients' perspective. Finally, it shows a need for more research to investigate which type of interaction and intervention would be the most effective in supporting patients’ coping during chemotherapy in an outpatient clinic.

Keywords: ambulatory chemotherapy, communication, health care professional-patient relation, nurse-patient relation, outpatient care, systematic review

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Authors: Maria Konstadinou, Etienne Alderlieste, Anderson Peccin da Silva, Ben Arntz, Leonard van der Bijl, Wouter Verschueren

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The shear strength and compression properties of stiff Boom clay from Belgium at the depth of about 30 m has been investigated by means of cone penetration and laboratory testing. The latter consisted of index classification, constant rate of strain, direct, simple shear, and unconfined compression tests. The Boom clay samples exhibited strong swelling tendencies. The suction pressure was measured via different procedures and has been compared to the expected in-situ stress. The undrained shear strength and OCR profile determined from CPTs is not compatible with the experimental measurements, which gave significantly lower values. The observed response can be attributed to the presence of pre-existing discontinuities, as shown in microscale CT scans of the samples. The results of this study demonstrate that the microstructure of the clay prior to testing has an impact on the mechanical behaviour and can cause inconsistencies in the comparison of the laboratory test results with in-situ data.

Keywords: boom clay, laboratory testing, overconsolidation ratio, stress-strain response, swelling, undrained shear strength

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Authors: Magdalena Hasplova, Katerina Ivanova

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Perinatal palliative care is a relatively young and developing field that includes the care of a fetus or newborn with a life-threatening or limiting defect and his family. However, the training of midwives in perinatal palliative care is insufficient and midwives do not feel prepared for this aspect of their work. This fact can affect the barriers to communication with the mother or family of the endangered child. The main aim was to analyze the awareness of midwifery students on the issue of perinatal palliative care in the Czech Republic. Based on the analysis, draw attention to possible communication barriers that may be caused by insufficient information. The research was carried out using a qualitative method, the method of data collection was a semi-structured interview. Eleven female students took part in the research, and the respondents were selected using the Snowballing method. Some methods of grounded theory (open coding and category creation) were used to analyze the data. Based on the results of the research, questions were set in a questionnaire focused on communication barriers between mothers (family) and health care professionals in the care of newborns with life-threatening or limiting disabilities. Based on the analysis of data, categories 1 were determined. Knowledge of perinatal palliative care 2. Education 3. Practical experience 4. Readiness and concerns in the provision of perinatal palliative care 6. Supervision. The questions in the questionnaire were then derived taking into account the data obtained, and the operationalization of health literacy in the field of perinatal palliative care was performed. The analysis of the interviews revealed that the education of midwives in the Czech Republic in the issue of perinatal palliative care is not uniform. The research confirmed the insufficient knowledge and skills of midwifery students preparing to provide perinatal palliative care. Respondents reported feelings of unpreparedness in the areas of communication with a woman after perinatal loss, psychological support for a woman and her family, the care of a stillborn or dying child, or self-coping with death. The questions in the questionnaire then develop these areas. We assumed that by analyzing and interpreting the data obtained from our research, we will help to better understand the concerns and motivations of students in providing holistic perinatal palliative care. We came to the conclusion that it would be appropriate to set up a unified and comprehensive education on this issue in the Czech Republic. Healthcare professionals are in a unique position that can positively or negatively affect the intensity of perinatal loss. Already properly set up education of health professionals leads to overcoming barriers in communication between health professionals and the family, experiencing perinatal loss.

Keywords: midwife, perinatal loss, perinatal palliative care, communication, barriers, mothers, family

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Authors: Hadi Rezghimaleki, Masatoshi Kubouchi, Yoshihiko Arao

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The use of natural fiber composites (NFCs) is growing at a fast rate regarding industrial applications and principle researches due to their eco-friendly, renewable nature, and low density/costs. Drilling is one of the most important machining operations that are carried out on natural fiber composites. Delamination is a major concern in the drilling process of NFCs that affects the structural integrity and long-term reliability of the machined components. Flax fiber reinforced epoxy composite laminates were prepared by hot press technique. In this research, we evaluated drilling-induced delamination of flax/epoxy composites by X-ray computed tomography (CT), ultrasonic testing (UT), and optical methods and compared the results.

Keywords: natural fiber composites, flax/epoxy, X-ray CT, ultrasonic testing

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Authors: Wei-Na Li, Mei-Lan Piao, Nam Kim

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We proposed a novel computer-generated hologram (CGH) achieved scheme, wherein the CGH is generated from a point cloud which is transformed by a mapping relationship of a series of elemental images captured from a real three-dimensional (3D) object by using a lens array. This scheme is composed of three procedures: mapping from elemental images to point cloud, hologram generation, and hologram display. A mapping method is figured out to achieve a virtual volume date (point cloud) from a series of elemental images. This mapping method consists of two steps. Firstly, the coordinate (x, y) pairs and its appearing number are calculated from the series of sub-images, which are generated from the elemental images. Secondly, a series of corresponding coordinates (x, y, z) are calculated from the elemental images. Then a hologram is generated from the volume data that is calculated by the previous two steps. Eventually, a spatial light modulator (SLM) and a green laser beam are utilized to display this hologram and reconstruct the original 3D object. In this paper, in order to show a more auto stereoscopic display of a real 3D object, we successfully obtained the actual depth data of every discrete point of the real 3D object, and overcame the inherent drawbacks of the depth camera by obtaining point cloud from the elemental images.

Keywords: elemental image, point cloud, computer-generated hologram (CGH), autostereoscopic display

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Authors: Johannes Barlang

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Adhesive bonding plays a pivotal role in various industrial applications, ranging from automotive manufacturing to aerospace engineering. The peel strength of adhesives, a critical parameter reflecting the ability of an adhesive to withstand external forces, is crucial for ensuring the integrity and durability of bonded joints. This study provides a synopsis of the methodologies, influencing factors, and significance of peel testing in the evaluation of adhesive performance. Peel testing involves the measurement of the force required to separate two bonded substrates under controlled conditions. This study systematically reviews the different testing techniques commonly applied in peel testing, including the widely used 180-degree peel test and the T-peel test. Emphasis is placed on the importance of selecting an appropriate testing method based on the specific characteristics of the adhesive and the application requirements. The influencing factors on peel strength are multifaceted, encompassing adhesive properties, substrate characteristics, environmental conditions, and test parameters. Through an in-depth analysis, this study explores how factors such as adhesive formulation, surface preparation, temperature, and peel rate can significantly impact the peel strength of adhesively bonded joints. Understanding these factors is essential for optimizing adhesive selection and application processes in real-world scenarios. Furthermore, the study highlights the role of peel testing in quality control and assurance, aiding manufacturers in maintaining consistent adhesive performance and ensuring the reliability of bonded structures. The correlation between peel strength and long-term durability is discussed, shedding light on the predictive capabilities of peel testing in assessing the service life of adhesive bonds. In conclusion, this study underscores the significance of peel testing as a fundamental tool for characterizing adhesive performance. By delving into testing methodologies, influencing factors, and practical implications, this study contributes to the broader understanding of adhesive behavior and fosters advancements in adhesive technology across diverse industrial sectors.

Keywords: adhesively bonded joints, cleavage resistance, elastic adhesives, peel strength

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Authors: Shakiera Sallie, Angela James

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Global concern about healthcare-associated infections through the transmission of microorganisms, resulting in outbreaks in overcrowded intensive care units (ICU), is current. Medical equipment and surfaces in the immediate patient zone, the high-touch objects, may become contaminated. A study was conducted across six intensive care units in a healthcare facility to determine the understanding and practice of the cleaning of high-touch objects (HTO), and an intervention program was undertaken. A mixed-method approach with the selection of ICUs, HTOs, and healthcare personnel was undertaken. Data collection included Ultra-Violet instruments, a questionnaire, and an intervention. In the pre-intervention, 41 (52.5%) of the healthcare personnel (n=78) rated their understanding of HTOs as “sufficient”; post-intervention, it was 67 (75%), (n=89), p=0.0015, indicates an improvement. The UV stamp percentage compliance to indicate whether cleaning of the HTOs had taken place across the six intensive care units before the intervention ranged from 0% compliance to 88% compliance, and after, it ranged from 67% to 91%. An intervention program on the cleaning of HTOs and the transmission cycle of microorganisms in the ICUs enhanced the healthcare personnel’s understanding and practices on the importance of environmental cleaning.

Keywords: high touch objects, infections, intensive care units, intervention program, microorganisms

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Authors: Pei-Shan Liang

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Objective: This article explores the nursing experience of caring for a patient with terminal gastric cancer complicated by an abdominal aortic aneurysm. The patient experienced physical discomfort due to the disease, initially unable to accept the situation, leading to anxiety, and eventually accepting the need for surgery. Methods: The nursing period was from June 6 to June 10, 2024. Through observation, direct care, conversations, and physical assessments, and using Gordon's eleven functional health patterns for a one-on-one holistic assessment, interdisciplinary team meetings were held with the critical care team and family. Three nursing health issues were identified: pain related to the disease and invasive procedures, anxiety related to uncertainty about disease recovery, and decreased cardiac tissue perfusion related to hemodynamic instability. Results: Open communication techniques and empathetic care were employed to establish a trusting nurse-patient relationship, and patient-centered nursing interventions were developed. Pain was assessed using a 10-point pain scale, and pain medications were adjusted by a pharmacist. Initially, Fentanyl 500mcg with pump run at 1ml/hr was administered, later changed to Ultracet 37.5mg/325mg, 1 tablet every 6 hours orally, reducing the pain score to 3. Lavender aromatherapy and listening to crystal music were used as distractions to alleviate pain, allowing the patient to sleep uninterrupted for at least 7 hours. The patient was encouraged to express feelings and fears through LINE messages or drawings, and a psychologist was invited to provide support. Family members were present at least twice a day for over an hour each time, reducing psychological distress and uncertainty about the prognosis. According to the Beck Anxiety Inventory, the anxiety score dropped from 17 (moderate anxiety) to 6 (no anxiety). Focused nursing care was implemented with close monitoring of vital signs maintaining systolic blood pressure between 112-118 mmHg to ensure adequate myocardial perfusion. The patient was encouraged to get out of bed for postoperative rehabilitation and to strengthen cardiopulmonary function. A chest X-ray showed no abnormalities, and breathing was smooth with Triflow use, maintaining at least 5 seconds with 2 balls four times a day, and SpO2 >96%. Conclusion: The care process highlighted the importance of addressing psychological care in addition to maintaining life when the patient’s condition changes. The presence of family often provided the greatest source of comfort for the patient, helping to reduce anxiety and pain. Nurses must play multiple roles, including advocate, coordinator, educator, and consultant, using various communication techniques and fostering hope by listening to and accepting the patient’s emotional responses. It is hoped that this report will provide a reference for clinical nursing staff and contribute to improving the quality of care.

Keywords: intensive care, gastric cancer, aortic aneurysm, quality of care

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Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

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Authors: Ilim Moses Msughter

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The study was carried out to examine the availability of Ante-natal care services and the socio-cultural factors affecting the utilization of these services in Dutsin-Ma Local Government Area of Katsina State. Four specific objectives were outlined as thus to examine the availability of antenatal care services in Dutsin-Ma local government area, to identify the socio-cultural factors affecting the utilisation of ante-natal care services, to ascertain the challenges affecting utilisation of ante-natal care services and suggest strategies to improve efficiency in ante-natal service delivery and utilisation of same services. Data were collected from 110 respondents using a questionnaire and through the use of the interview. Data were analysed quantitatively and qualitatively. The findings revealed that ante-natal care services are available in the study area, but access to such services is hindered by several factors, which include religious and traditional beliefs, cost of services and poor attitudes of health care workers which has an adverse effect on people’s desire to visit ante-natal centres. The study recommended that Traditional Birth Attendants (TBA) need to be trained on how to handle pregnancy-related complications. It is also recommended that essential ante-natal drugs and services should be subsidised or made free by the government, and this must be closely monitored to ensure efficiency. Finally, human relation training should be organised for nurses and midwives to improve their attitudes towards patients during ante-natal visits.

Keywords: utilisation, religion, traditional birth attendant, ante-natal

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Authors: Ahmed El-Banbi, Ahmed El-Maraghi

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PVT properties are needed as input data in all reservoir, production, and surface facilities engineering calculations. In the absence of PVT reports on valid reservoir fluid samples, engineers rely on PVT correlations to generate the required PVT data. The accuracy of PVT correlations varies, and no correlation group has been found to provide accurate results for all oil types. The effect of inaccurate PVT data can be significant in engineering calculations and is well documented in the literature. Bubble point pressure can sometimes be obtained from external sources. In this paper, we show how to utilize the known bubble point pressure to improve the accuracy of calculated PVT properties from correlations. We conducted a systematic study using around 250 reservoir oil samples to quantify the effect of pre-knowledge of bubble point pressure. The samples spanned a wide range of oils, from very volatile oils to black oils and all the way to low-GOR oils. A method for shifting both undersaturated and saturated sections of the PVT properties curves to the correct bubble point is explained. Seven PVT correlation families were used in this study. All PVT properties (e.g., solution gas-oil ratio, formation volume factor, density, viscosity, and compressibility) were calculated using the correct bubble point pressure and the correlation estimated bubble point pressure. Comparisons between the calculated PVT properties and actual laboratory-measured values were made. It was found that pre-knowledge of bubble point pressure and using the shifting technique presented in the paper improved the correlation-estimated values by 10% to more than 30%. The most improvement was seen in the solution gas-oil ratio and formation volume factor.

Keywords: PVT data, PVT properties, PVT correlations, bubble point pressure

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Authors: Pranjal Johri, Misbah Ul-Islam

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Power Transformers are one of the most critical and failure prone entities in an electrical power system. It is an established practice that each design of a power transformer has to undergo numerous type tests for design validation and routine tests are performed on each and every power transformer before dispatch from manufacturer’s works. Different countries follow different standards for testing the transformers. Most common and widely followed standard for Power Transformers is IEC 60076 series. Though these standards put up a strict testing requirements for power transformers, however, few aspects of transformer characteristics and guaranteed parameters can be ensured by some additional tests. Based on certain observations during routine test of a transformer and analyzing the data of a large fleet of transformers, three propositions have been discussed and put forward to be included in test schedules and standards. The observations in the routine test raised questions on design flux density of transformer. In order to ensure that flux density in any part of the core & yoke does not exceed 1.9 tesla at 1.1 pu as well, following propositions need to be followed during testing:  From the data studied, it was evident that generally NLC at 1.1 pu is apporx. 3 times of No Load Current at 1 pu voltage.  During testing the power factor at 1.1 pu excitation, it must be comparable to calculated values from the Cold Rolled Grain Oriented steel material curves, including building factor.  A limit of 3 % to be extended for higher than rated voltages on difference in Vavg and Vrms, during no load testing.  Extended over excitation test to be done in case above propositions are observed to be violated during testing.

Keywords: power transfoemrs, no load current, DGA, power factor

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Authors: G. Culache, M. P. Byfield, N. S. Ferguson, A. Tyas

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Steel joints in building structures represent a weak link in the case of accidental transient loading. This type of loading can occur due to blast effects or impact with moving vehicles and will result in large deformations in the material as well as large rotations. This paper addresses the lack of experimental investigations into the response of moment resisting connections subjected to such loading. The current design philosophy was used to create test specimens with flush and extended end plates. The specimens were tested in a specially designed testing rig capable of delivering the sustained loading even beyond the point of failure. Types of failure that the authors attempted to obtain were bolt fracture, flange crushing and end plate fracture. Experimental data is presented, described and analyzed. The tests show that the strength and ductility can be significantly improved by replacing ordinary mild-steel bolts with their stainless steel equivalents. This minor modification is demonstrated to significantly improve the robustness when subjected to loading that results in high deformations and rotation, where loading is maintained during failure. Conclusions are drawn about the wider implications of this research and recommendations made on the direction of future research in this field.

Keywords: steel moment connections, high strain rates, dynamic loading, experimental testing

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Authors: Catharina Lindberg, Cecilia Fagerstrom, Ania Willman

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Patients in high-tech care environments are usually dependent on both formal/informal caregivers and technology, highlighting their vulnerability and challenging their autonomy. Autonomy presumes that a person has education, experience, self-discipline and decision-making capacity. Reference to autonomy in relation to patients in high-tech care environments could, therefore, be considered paradoxical, as in most cases these persons have impaired physical and/or metacognitive capacity. Therefore, to understand the prerequisites for patients to experience autonomy in high-tech care environments and to support them, there is a need to enhance knowledge and understanding of the concept of patient autonomy in this care context. The development of concepts and theories in a practice discipline such as nursing helps to improve both nursing care and nursing education. Theoretical development is important when clarifying a discipline, hence, a theoretical framework could be of use to nurses in high-tech care environments to support and defend the patient’s autonomy. A meta-synthesis was performed with the intention to be interpretative and not aggregative in nature. An amalgamation was made of the results from three previous studies, carried out by members of the same research group, focusing on the phenomenon of patient autonomy from a patient perspective within a caring context. Three basic approaches to theory development: derivation, synthesis, and analysis provided an operational structure that permitted the researchers to move back and forth between these approaches during their work in developing a theoretical framework. The results from the synthesis delineated that patient autonomy in a high-tech care context is: To be in control though trust, co-determination, and transition in everyday life. The theoretical framework contains several components creating the prerequisites for patient autonomy. Assumptions and propositional statements that guide theory development was also outlined, as were guiding principles for use in day-to-day nursing care. Four strategies used by patients to remain or obtain patient autonomy in high-tech care environments were revealed: the strategy of control, the strategy of partnership, the strategy of trust, and the strategy of transition. This study suggests an extended knowledge base founded on theoretical reasoning about patient autonomy, providing an understanding of the strategies used by patients to achieve autonomy in the role of patient, in high-tech care environments. When possessing knowledge about the patient perspective of autonomy, the nurse/carer can avoid adopting a paternalistic or maternalistic approach. Instead, the patient can be considered to be a partner in care, allowing care to be provided that supports him/her in remaining/becoming an autonomous person in the role of patient.

Keywords: autonomy, caring, concept development, high-tech care, theory development

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Authors: Mohamed Amine Haraoubia, Abdelaziz Hamzaoui, Najib Essounbouli

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The pursuit of the MPPT has led to the development of many kinds of controllers, one of which is the Fuzzy Logic Controller, which has proven its worth. To further tune this controller this paper will discuss and analyze the use of Genetic Algorithms to tune the Fuzzy Logic Controller. It will provide an introduction to both systems, and test their compatibility and performance.

Keywords: fuzzy logic controller, fuzzy logic, genetic algorithm, maximum power point, maximum power point tracking

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Authors: Bernd Engel, Sara Salman Hassan Al-Maeeni

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A substantial amount of natural resources are nowadays consumed at a growing rate, as humans all over the world used materials obtained from the Earth. Machinery manufacturing industry is one of the major resource consumers on a global scale. Even though the incessant finding out of the new material, metals, and resources, it is urgent for the industry to develop methods to use the Earth's resources intelligently and more sustainable than before. Re-engineering of machine tools regarding design and failure analysis is an approach whereby out-of-date machines are upgraded and returned to useful life. To ensure the reliable future performance of the used machine components, it is essential to investigate the machine component failure through the material, design, and surface examinations. This paper presents an experimental approach aimed at inspecting the shaft of the rotary draw bending machine as a case to study. The testing methodology, which is based on the principle of the three-point bending test, allows assessing the shaft elastic behavior under loading. Furthermore, the shaft elastic characteristics include the maximum linear deflection, and maximum bending stress was determined by using an analytical approach and finite element (FE) analysis approach. In the end, the results were compared with the ones obtained by the experimental approach. In conclusion, it is seen that the measured bending deflection and bending stress were well close to the permissible design value. Therefore, the shaft can work in the second life cycle. However, based on previous surface tests conducted, the shaft needs surface treatments include re-carburizing and refining processes to ensure the reliable surface performance.

Keywords: deflection, FE analysis, shaft, stress, three-point bending

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Authors: Xuan Zhao, Wen Jiang

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In this study, a web crawler was used to collect POI sample data from 38 districts and counties of Chongqing in 2022, and ArcGIS was combined to coordinate and projection conversion and realize data visualization. Nuclear density analysis and spatial correlation analysis were used to explore the spatial distribution characteristics of elderly care facilities in Chongqing, and K mean cluster analysis was carried out with GeoDa to study the spatial concentration degree of elderly care resources in 38 districts and counties. Finally, the driving force of spatial differentiation of elderly care facilities in various districts and counties of Chongqing is studied by using the method of geographic detector. The results show that: (1) in terms of spatial distribution structure, the distribution of elderly care facilities in Chongqing is unbalanced, showing a distribution pattern of ‘large dispersion and small agglomeration’ and the asymmetric pattern of ‘west dense and east sparse, north dense and south sparse’ is prominent. (2) In terms of the spatial matching between elderly care resources and the elderly population, there is a weak coordination between the input of elderly care resources and the distribution of the elderly population at the county level in Chongqing. (3) The analysis of the results of the geographical detector shows that the single factor influence is mainly the number of elderly population, public financial revenue and district and county GDP. The high single factor influence is mainly caused by the elderly population, public financial income, and district and county GDP. The influence of each influence factor on the spatial distribution of elderly care facilities is not simply superimposed but has a nonlinear enhancement effect or double factor enhancement. It is necessary to strengthen the synergistic effect of two factors and promote the synergistic effect of multiple factors.

Keywords: aging, elderly care facilities, spatial differentiation, geographical detector, driving force analysis, Mountain city

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