Search results for: university hospital

Authors: Yessenia Parrado, Ana Barbosa, Daniela Mahe, Sebastian Toro, Jhon Garcia

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The purpose of this work is to present the identification and characterization of the barriers and enablers to public innovation in the Central Region of Colombia from a mixed methodology in a research carried out in 2020 by the Laboratory of Innovation, Creativity and New Technologies of the National University of Colombia in alliance with the National Planning Department. Based on the research, the index of barriers to regional and departmental public innovation was built, which reflects the level of difficulty of the territorial entities to overcome the barriers present around three dimensions: organizational structure of the entity, generation of public value, and governance processes. The index was built from the item response methodology and the multiple correspondence analysis from the application of an institutional information form for public entities and a perception form for public servants. This investigation had the participation of 36 entities and 1038 servers and servants from the departments of Huila, Meta, Boyacá, Cundinamarca, Tolima, and the Capital District. In this exercise, it was identified that the departmental indices range between 13 and 44 and that the regional index was 30 out of 100. From the analysis of the information, it was possible to establish that the main barriers are the lack of specialized agencies for public innovation exercises, lack of qualified personnel and work methodologies for public innovation, inadequate information management, lack of feedback between the learning from governmental and non-governmental entities, the inability of the initiatives to generate binding participation mechanisms and the lack of qualification of citizens to participate in these processes.

Keywords: item response, public innovation, quantitative analysis, compared analysis

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Authors: B. Ashraf, A. M. Malik

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The study was accomplished at the Department of Economics and Agriculture Economics, Pir Mahar Ali Shah ARID Agriculture University, Punjab, Pakistan during 2013-16 with a purpose to discover the effect of Islamic finance/banking on employment in Punjab, Pakistan. Islamic banking system is sub-component of conventional banking system in various countries of the world; however, in Pakistan, it has been established as a separate Islamic banking system. The Islamic banking operates under the doctrine of Shariah. It is claimed that the referred banking is free of interest (Riba) and addresses the philosophy and basic values of Islam in finance that reduces the factors of uncertainty, risk and others speculative activities. Two Islamic bank’s; Meezan Bank Limited (Pakistan) and Al-Baraka Bank Limited (Pakistan) from North Punjab (Bahawalnagar) and central Punjab (Lahore) west Punjab (Gujrat), Pakistan were randomly selected for the conduct of research. A total of 206 samples were collected from the define areas and banks through questionnaire. The data was analyzed by using the Statistical Package for Social Sciences (SPSS) version 21.0. Multiple linear regressions were applied to prove the hypothesis. The results revealed that the assets formation had significant positive; whereas, the technology, length of business (experience) and bossiness size had significant negative impact with employment generation in Islamic finance/banking in Punjab, Pakistan. This concludes that the employment opportunities may be created in the country by extending the finance to business/firms to start new business and increase the Public awareness by the Islamic banks through intensive publicity. However; Islamic financial institutions may be encouraged by Government as it enhances the employment in the country.

Keywords: assets formation, borrowers, employment generation, Islamic banks, Islamic finance

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Authors: Sharifa Alduraibi, Abir El Sadik, Ahmed Elzainy, Alaa Alduraibi, Ahmed Alsolai

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Introduction: Problem-based learning (PBL) is an active student-centered educational modality, influenced by the students' interest that required continuous motivation to improve their engagement. The new era of professional information technology facilitated the utilization of educational multimedia, such as videos, soundtracks, and photographs promoting students' learning. The aim of the present study was to introduce multimedia-enriched PBL scenarios for the first time in college of medicine, Qassim University, as an incentive for better students' engagement. In addition, students' performance and satisfaction were evaluated. Methodology: Two multimedia-enhanced PBL scenarios were implemented to the third years' students in the urinary system block. Radiological images, plain CT scan, and X-ray of the abdomen and renal nuclear scan correlated with their pathological gross photographs were added to the scenarios. One week before the first sessions, pre-recorded orientation videos for PBL tutors were submitted to clarify the multimedia incorporated in the scenarios. Other two traditional PBL scenarios devoid of multimedia demonstrating the pathological and radiological findings were designed. Results and Discussion: Comparison between the formative assessments' results by the end of the two PBL modalities was done. It revealed significant increase in students' engagement, critical thinking and practical reasoning skills during the multimedia-enhanced sessions. Students' perception survey showed great satisfaction with the new strategy. Conclusion: It could be concluded from the current work that multimedia created technology-based teaching strategy inspiring the student for self-directed thinking and promoting students' overall achievement.

Keywords: multimedia, pathology and radiology images, problem-based learning, videos

Procedia PDF Downloads 157

Authors: Konrad Rejdak

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Introduction: Neurodegenerative diseases are frequently accompanied by loss and unwanted change in functional independence, social relationships, and economic circumstances. Currently, the achievements of social robots to date is being projected to improve multidimensional quality of life among people with cognitive impairment and others. Objectives: Identification of particular human needs in the context of the changes occurring in course of neurodegenerative diseases. Methods: Based on the 110 surveys performed in the Medical University of Lublin from medical staff, patients, and caregivers we made prioritization of the users' needs as high, medium, and low. The issues included in the surveys concerned four aspects: user acceptance, functional requirements, the design of the robotic assistant and preferred types of human-robot interaction. Results: We received completed questionnaires; 50 from medical staff, 30 from caregivers and 30 from potential users. Above 90% of the respondents from each of the three groups, accepted a robotic assistant as a potential caregiver. High priority functional capability of assistive technology was to handle emergencies in a private home-like recognizing life-threatening situations and reminding about medication intake. With reference to the design of the robotic assistant, the majority of the respondent would like to have an anthropomorphic appearance with a positive emotionally expressive face. The most important type of human-robot interaction was a voice-operated system and by touchscreen. Conclusion: The results from our study might contribute to a better understanding of the system and users’ requirements for the development of a service robot intended to support patients with dementia.

Keywords: assistant robot, dementia, long term care, patients

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Authors: Hazaila Binti Hassan, Abu Yazid Bin Abu Bakar, Salleh Amat

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This study is to get the validity and reliability of the questionnaire for behaviour change on low-performing officers. This study aimed to develop and evaluate the behaviour of low performing officers. There are 75 items in this questionnaire which involves 5 subscales, which are the 5 dimensions intended to be studied: 1st emotional stability, 2nd psycho-spiritual enhancement, 3rd social skills development, 4th cognitive and rationality improvement and 5th behavioural alignment and adjustment. There are 2 processes in this research whereby to check the validity and reliability. Both use quantitative methods. Validity content testing has been conducted to validate the behavioural change questionnaire of the low performing officers. For the face validity, 4 people are involved, two are psychologists who carried out the program and the other two are officers of the same rank, i.e. supporting officers. They are involved in correction of sentences, languages, and grammar as well as the sentence structures so that it tallies with the purpose of studies. The questionnaire underwent content validity by the experts. Five experts are appointed to attend this session, 3 are directly involved in the construction of this questionnaire and 2 others are experts from the university with a background in questionnaire development. The result shows that the content validity obtained a high coefficient of 0.745 with a minimum and maximum value of more than 0.60 which satisfies the characteristic of Content Value Ratio. The Cronbach’s alpha result is 0.867. The highest scores are the behavioural alignment and adjustment sub-scale recorded the highest value, followed by social skills development sub-scale, cognitive and rational improvements sub-scale, psycho-spiritual enhancement sub-scale, and lastly emotional stability. Therefore, both of validity and reliability result were accepted that this questionnaire is valid and reliable can be used in the study of behaviour changes of low performing officers in the civil service.

Keywords: content validity, reliability, five dimension, low-performing officers, questionnaire

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Authors: Verónica Díaz

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A Cartesian graph, as a mathematical object, becomes a tool for configuration of change. Its best comprehension is done through everyday life problem-solving associated with its representation. Despite this, the current educational framework favors general graphs, without consideration of their argumentation. Students are required to find the mathematical function without associating it to the development of graphical language. This research describes the use made by students of configurations made prior to Cartesian graphs with regards to an everyday life problem related to a time and distance variation phenomenon. The theoretical framework describes the function conditions of study and their modeling. This is a qualitative, descriptive study involving six undergraduate case studies that were carried out during the first term in 2016 at University of Los Lagos. The research problem concerned the graphic modeling of a real person’s movement phenomenon, and two levels of analysis were identified. The first level aims to identify local and global graph interpretations; a second level describes the iconicity and referentiality degree of an image. According to the results, students were able to draw no figures before the Cartesian graph, highlighting the need for students to represent the context and the movement of which causes the phenomenon change. From this, they managed Cartesian graphs representing changes in position, therefore, achieved an overall view of the graph. However, the local view only indicates specific events in the problem situation, using graphic and verbal expressions to represent movement. This view does not enable us to identify what happens on the graph when the movement characteristics change based on possible paths in the person’s walking speed.

Keywords: cartesian graphs, higher education, movement modeling, problem solving

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Authors: Vânia Graça, Paula Quadros-Flores, Altina Ramos

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The use of Digital Technologies in teaching and learning processes is currently a reality, namely in initial teacher training. This study aims at knowing the digital reality of students in initial teacher training in order to improve training in the educational use of ICT and to promote digital technology integration strategies in an educational context. It is part of the IFITIC Project "Innovate with ICT in Initial Teacher Training to Promote Methodological Renewal in Pre-school Education and in the 1st and 2nd Basic Education Cycle" which involves the School of Education, Polytechnic of Porto and Institute of Education, University of Minho. The Project aims at rethinking educational practice with ICT in the initial training of future teachers in order to promote methodological innovation in Pre-school Education and in the 1st and 2nd Cycles of Basic Education. A qualitative methodology was used, in which a questionnaire survey was applied to teachers in initial training. For data analysis, the techniques of content analysis with the support of NVivo software were used. The results point to the following aspects: a) future teachers recognize that they have more technical knowledge about ICT than pedagogical knowledge. This result makes sense if we consider the objective of Basic Education, so that the gaps can be filled in the Master's Course by students who wish to follow the teaching; b) the respondents are aware that the integration of digital resources contributes positively to students' learning and to the life of children and young people, which also promotes preparation in life; c) to be a teacher in the digital age there is a need for the development of digital literacy, lifelong learning and the adoption of new ways of teaching how to learn. Thus, this study aims to contribute to a reflection on the teaching profession in the digital age.

Keywords: digital technologies, initial teacher training, pedagogical use of ICT, skills

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Authors: Kimberlyn Greene

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Employers today expect college graduates to not only develop and demonstrate content-specific knowledge but also 21st century skillsets such as critical thinking. International assessments suggest students enrolled in United States (U.S.) educational institutions are underperforming in comparison to their global peers in areas such as critical thinking and technology. This multi-case study examined how undergraduate digital literacy courses at a four-year university in the U.S., as implemented by instructors, fostered students’ development of critical thinking skills. The conceptual framework for this study presumed that as students engaged in complex thinking within the context of a digital literacy course, their ability to deploy critical thinking was contingent upon whether the course was designed with the expectation for students to use critical thinking skills as well as the instructor’s approach to implementing the course. Qualitative data collected from instructor interviews, classroom observations, and course documents were analyzed with an emphasis on exploring the course design and instructional methods that provided opportunities to foster critical thinking skill development. Findings from the cross-case analysis revealed that although the digital literacy courses were designed and implemented with the expectation students would deploy critical thinking; there was no explicit support for students to develop these skills. The absence of intentional skill development resulted in inequitable opportunities for all students to engage in complex thinking. The implications of this study suggest that if critical thinking is to remain a priority, then universities must expand their support of pedagogical and instructional training for faculty regarding how to support students’ critical thinking skill development.

Keywords: critical thinking skill development, curriculum design, digital literacy, pedagogy

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Authors: Vasileios A. Giouvanis, Christos D. Papanikolaou, Dimitrios S. Dimakas, Maria A. Sakellariou-Makrantonaki

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In countries with limited water resources, where the irrigation demands are higher than the 70% of the total water use, the demand for fresh water increases while the quality of this natural resource is downgraded. The aromatic and pharmaceutical plants hold a high position in the culture of the most civilizations through the centuries. The ‘Mountain Tea,’ species of the Greek flora, is part of a series of aromatic plants and herbs that are famous for their pharmaceutical properties as well as their byproducts and their essential oils. The aim of this research was to study the effects of full and deficit irrigation on the growing and productive characteristics of organically cultivated ‘Mountain Tea’ (Sideritis raeseri). The research took place at the University of Thessaly farm in Velestino, Magnesia - Central Greece, during the year 2017, which was the third growing season. The experiment consisted of three treatments in three replications. The experimental design was a fully randomized complete block. Surface drip irrigation was used to irrigate the experimental plots. In the first treatment, the 75% (deficit irrigation) of the daily water needs was applied. In the second treatment, the 100% (full irrigation) of the daily water needs was applied. The third treatment was not irrigated (rainfed). The crop water needs were calculated according to the daily measured evapotranspiration (ETc) using the Penman-Monteith method (FAO 56). The plants’ height, fresh and dry biomass production were measured. The results showed that only the irrigated ‘Mountain Tea’ can be cultivated at low altitude areas with satisfactory results. Moreover, there are no statistically significant differences (P < 0.05) at the growing and productive characteristics between full and deficit irrigation treatments, which proves that by deficit irrigation, an important amount of irrigation water can be saved.

Keywords: mountain tea, surface drip irrigation, deficit irrigation, water saving

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Authors: M. Weller Jones, J. Moffat, J. Taylor, J. Hartland, M. Natarajan

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Background: Uganda’s teenage pregnancy rate remains a significant problem for female and maternal health in the country. Teenage pregnancy is linked to higher rates of maternal and neonatal mortality and morbidity, including preterm labour, obstructed labour, vesicovaginal fistulae, infections, and maternal mental health morbidity. In 2015, the National Strategy to End Child Marriage and Teenage Pregnancy was launched in Uganda. Research is needed so that the interventions in this Strategy can be effectively applied at a local level. This study at Kitovu and Villa Maria Hospitals, two local community hospitals near Masaka, Uganda, aimed to measure change in the local teenage pregnancy rate over the past 5 years; and to explore the awareness and attitudes of teenagers and healthcare professionals towards 1) teenage pregnancy and, 2) the challenges female adolescents still currently face. Method: Teenage delivery rate, type of delivery, incidence of complications in labour and neonatal and maternal outcomes were collected from the labour ward admission books, at both hospitals, for a six month time period in 2011 and 2016. At Kitovu Hospital, qualitative data regarding the experience of, and attitudes towards teenage pregnancy was collected from interviews conducted with 12 maternity staff members and with eight female teenagers, aged 16-19, who were pregnant or post-partum. Results: The proportion of total births to teenage mothers fell from 14% in 2011 to 7% in 2016 (Kitovu), but it remains higher in rural locations (19%, Villa Maria). Beliefs about exacerbating factors included: poor access to contraception; misconceptions that contraception is damaging to women’s health; failing sex education in schools; and poor awareness of national campaigns to reduce teenage pregnancy. Staff felt that the best way to tackle teenage pregnancy was to improve sex education in schools and to sensitise families to these issues. Six of the eight teenagers wanted more frequent sex education and easier, cheap access to contraception. Only one teenager saw positive consequences stating that teenage pregnancy would ‘avoid operations later in life.’ Discussion: Teenage pregnancy is a recognised problem and strategies in the Masaka region should focus on improving sex education in schools and initiating an organisation that educates and supplies free contraception to teenagers.

Keywords: adolescents, attitudes, teenage pregnancy, Uganda

Procedia PDF Downloads 187

Authors: M. G. Talasbayen, N. N. Dyussenbayev, Y. D. Kali, R. A. Zholbarysov, Y. N. Duissenbayev, I. Z. Mammadinova, S. M. Nuradilov

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Background. Hemorrhagic stroke is an acute cerebrovascular accident resulting from rupture of a cerebral vessel or increased permeability of the wall and imbibition of blood into the brain parenchyma. Arterial hypertension is a common cause of hemorrhagic stroke. Male gender and age over 55 years is a risk factor for intracerebral hemorrhage. Treatment of intracerebral hemorrhage is aimed at the primary pathophysiological link: the relief of coagulopathy and the control of arterial hypertension. Early surgical treatment can limit cerebral compression; prevent toxic effects of blood to the brain parenchyma. Despite progress in the development of neuroimaging data, the use of minimally invasive techniques, and navigation system, mortality from intracerebral hemorrhage remains high. Materials and methods. The study included 78 patients (62.82% male and 37.18% female) with a verified diagnosis of hemorrhagic stroke in the period from 2019 to 2021. The age of patients ranged from 25 to 80 years, the average age was 54.66±11.9 years. Demographic, brain CT data (localization, volume of hematomas), methods of treatment, and disease outcome were analyzed. Results. The retrospective analyze demonstrate that 78.2% of all patients underwent surgical treatment: decompressive craniectomy in 37.7%, craniotomy with hematoma evacuation in 29.5%, and hematoma draining in 24.59% cases. The study of the proportion of deaths, depending on the volume of intracerebral hemorrhage, shows that the number of deaths was higher in the group with a hematoma volume of more than 60 ml. Evaluation of the relationship between the time before surgery and mortality demonstrates that the most favorable outcome is observed during surgical treatment in the interval from 3 to 24 hours. Mortality depending on age did not reveal a significant difference between age groups. An analysis of the impact of the surgery type on mortality reveals that decompressive craniectomy with or without hematoma evacuation led to an unfavorable outcome in 73.9% of cases, while craniotomy with hematoma evacuation and drainage led to mortality only in 28.82% cases. Conclusion. Even though the multimodal approaches, the development of surgical techniques and equipment, and the selection of optimal conservative therapy, the question of determining the tactics of managing and treating hemorrhagic strokes is still controversial. Nevertheless, our experience shows that surgical intervention within 24 hours from the moment of admission and craniotomy with hematoma evacuation improves the prognosis of treatment outcomes.

Keywords: hemorragic stroke, Intracerebral hemorrhage, surgical treatment, stroke mortality

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Authors: Nawaf A. Alqahtani, Ali M. Alqahtani, Khalid A. Alqahtani, Huda S. Abdullfattah, Ebtehal A. Alessa, Khalid S. Al Gelban, Ossama A. Mostafa

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Background: The internet is an exciting medium that is becoming an essential part of everyday life. Although the internet is fully observed in Saudi Arabia, young people may be vulnerable to problematic internet use, possibly leading to addiction. Aim of study: To explore the magnitude of internet addiction (IA) among medical students associated risk factors and its impact on students' academic achievement. Subjects and Methods: A cross sectional study was conducted in 2014 on 571 medical students (293 males and 278 females) at the College of Medicine, King Khalid University, Abha, Saudi Arabia. Data Collection was done through using the Arabic version of the Compulsive Internet Use Scale and a checklist of demographic characteristics. Results: Age of participants ranged from 19 to 26 years (Mean+SD: 21.9+1.5 years). Internet access was available to 97.4% of students at home and to 80.2% of students at their mobile phones. The most frequently accessed websites by medical students were the social media (90.7%), scientific website (50.4%) and the news websites (31.3%). IA was mild in 47.8% of medical students while 5.8% had moderate IA. None of the students had severe IA. Prevalence of IA was significantly higher among female medical students (p=0.002), availability of internet at home (p=0.022), and availability of internet at the students' mobile phone (p=0.041). The mean General Point Average (GPA) was highest among students with mild IA (4.0+0.6), compared with 3.6+0.6 among those with moderate addiction, and 3.9+0.6 among those who did not show IA. Differences in mean GPA according to grade of IA were statistically significant ((P=0.001). Conclusions: Prevalence of IA is high among medical students in Saudi Arabia. Risk factors for IA include female gender, availability of internet at home or at the mobile phone. IA has a significant impact on students' GPA. Periodic screening of medical students for IA and raising their awareness toward the possible risk of IA are recommended.

Keywords: internet addiction, medical students, risk factors, Saudi Arabia

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Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker

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Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.

Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation

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Authors: Islam Zeb

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Water of poor quality has a potential of probable contamination and a way to spread pollutant in the field and surrounding environment. A number of comprehensive reviews articles have been published which highlight irrigation water as a source of pathogenic microorganisms and heavy metals toxicity that leads to chronic diseases in human. Here a study was plan to determine the microbial status of irrigation water collected from various location of district Swat in various months. The analyses were carried out at Environmental Horticulture Laboratory, Department of Horticulture, The University of Agriculture Peshawar, during the year 2018 – 19. The experiment was laid out in Randomized Complete Block Design (RCBD) with two factors and three replicates. Factor A consist of different locations, and factor B represent various months. The results of microbial status for various locations in irrigation water showed the highest value for Total Bacterial Count, Enterobacteriacea, E. coli, Salmonella, and Listeria (9.05, 8.54, 6.01, 5.84, and 5.03 log cfu L-1 respectively) for samples collected from mingora location, whereas the lowest values for Total Bacterial Count, Enterobacteriacea, E. coli, Salmonella and Listeria (6.70, 6.38, 4.47, 4.42 and 3.77 log cfu L-1 respectively) were observed for matta location. Data for various months showed maximum Total Bacterial Count, Enterobacteriacea, E. coli, Salmonella, and Listeria (12.01, 11.70, 8.46, 8.41, and 6.88 log cfu L-1, respectively) were noted for the irrigation water samples collected in May/June whereas the lowest range for Total Bacterial Count, Enterobacteriacea, E. coli, Salmonella and Listeria (4.41, 4.08, 2.61, 2.55 and 3.39 log cfu L-1 respectively) were observed in Jan/Feb. A significant interaction was found for all the studied parameters it was concluded that maximum bacterial groups were recorded in the months of May/June from Mingora location, it might be due to favorable weather condition.

Keywords: contamination, irrigation water, microbes, SWAT, various months

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Authors: K. Rajarajeswaran, Krishna Prasad

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Introduction: Refractory shock is a typical consequence of sepsis that does not improve with standard vasopressor therapy. A possible adjuvant therapeutic option for treating refractory shock in sepsis is methylene blue. This study looked at the effects of intravenous methylene blue plus norepinephrine given as a single bolus infusion on mortality and hemodynamic improvement in patients suffering from refractory shock. Methodology: This six-month observational prospective study was carried out at an intensive care unit, teaching hospital, and medical college. It involved 112 patients who had been diagnosed with refractory septic shock and needed vasopressor medication. Group B received injection norepinephrine 0.01 µg/kg/min infusion alone, while Group A received injection methylene blue 2 mg/kg iv single bolus (fixed dose) in addition to injection norepinephrine 0.01 µg/kg/min infusion. Both groups' noradrenaline doses were titrated to reach the desired MAP of 60–75 mm Hg. The amount of norepinephrine needed to sustain a MAP of more than 60 mm Hg was the data gathered. Serum lactate, procalcitonin level, C-reactive protein, length of stay in the intensive care unit (ICU), sequential organ failure assessment (SOFA) score, and duration of mechanical ventilation, incidence of acute kidney injury (AKI), and mortality were compared. Results: A total of 112 patients with refractory shock were included in the study. With the use of IV methylene blue, 36 (59.3%) patients showed significant improvement in MAP within 2 hours (77.12 ± 8.90 vs 74.28 ± 21.84, p = 0.005). Responders were 4.009 times more likely to have vasopressor-free time within 24 hours (19.5% vs 6.1%, p = 0.022, odds ratio 5.017, 95% confidence interval, 1.110–14.283). The serum lactate was lower, and urine output was higher in group I than in group II (p <0.05). Group I had a significantly greater reduction in SOFA score in 12 hours than group II. However, there was no significant difference in terms of mortality, length of ICU stay, ventilator free days, and incidence of AKI. In the responder group, there was a significant increase in the MAP and decrease in vasopressor requirement pre- and post-infusion of methylene blue (p < 0.05). Responder had shorter vasopressor-free days as compared with non-responder (5.44 vs 6.99, p = 0.007). Conclusion: When administered as adjuvant therapy, a single-dose bolus infusion of Methylene Blue plus Norepinephrine may aid in meeting early resuscitation goals for the management of patients with septic shock. But the patients' death rate, ICU stay duration, ventilator-free days, or incidence of AKI were unchanged.

Keywords: norepinephrine, methylene blue, shock, vasopressor

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Authors: A. H. Bekhet, N. Helmy

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Background: Physical therapists are knowledgeable in treatment and prevention of musculoskeletal injuries; however, they have occupational musculoskeletal injuries because Physical therapy profession requires effort that may lead to work-related musculoskeletal disorders. No previous studies among physical therapists have been reported in Egypt. We aim to assess the prevalence and risk factors of musculoskeletal disorders among physical therapist’s seniors versus internship students. Method: We conducted a cross-sectional study in faculty of physical therapy Cairo university Prevalence and risk factors of musculoskeletal injuries were assessed using self-administered questionnaire with closed-ended questions. Seniors therapist was defined as a physical therapist with more than 5 years of work experience. Data were analyzed using SPSS 22.0 for Windows. Results: The study included 106 physical therapists (Junior = 72; senior = 34), the mean age of senior therapists was 30.1 (SD 6.3) years and junior therapists were 22.8 (SD 2.4). Female subjects constituted 83.9% of the studied sample. The mean hours of contact with patients was higher among junior therapists 6.4 (SD 2.6) vs. 5.7 (SD 2.1) among senior therapists. The prevalence of a musculoskeletal injury, once or more in their lifetime, was significantly higher among senior therapists (86% vs. 66.7%; p = 0.04). The highest risk factor in increasing the symptoms of the injury among junior therapists was maintaining a position for a prolonged period of time at 28% while performing manual therapy techniques was the highest risk factor among senior therapists at 32%. 53% of senior therapists have limited their patient contact time as a result of their injury in comparison to 25% of junior therapists (p = 0.09). Conclusion: the presented study shows that the prevalence of musculoskeletal injuries, once or more in their lifetime, is significantly higher among senior therapists.

Keywords: musculoskeletal injuries, occupational injuries, physical therapists, work related disorders

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Authors: Moizza Tahir, Uzma Bashir, Aisha Akhtar, Zainab Ansari, Sameen Ansari, Muhammad Ali Tahir

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Cancer burden has globally increased. Among cutaneous cancers basal cell carcinoma constitute vast majority of skin cancer. There is need for appropriate diagnostic, therapeutic and prognostic significance evaluation for skin cancers Present study report intraoperative frozen section (FS) histopathological clearance for excision of BCC in a tertiary care center and find the frequency of involvement of surgical margin with reference to anatomical site, with size and surgical technique. It was prospective open label interventional study conducted at Dermatology department of tertiary care hospital Rawalpindi Pakistan in lais on with histopathology department from January 2023 to April 2024. Total of thirty-six (n = 36) patients between age 45-80 years with basal cell carcinoma of 10-20mm on face were included following inclusion exclusion criteria by purposive sampling technique. Informed consent was taken. Surgical excision was performed and intraoperative frozen section histopathology clearance of tumor margin was taken from histopathologist on telephone. Surgical reconstruction was done. Final Histopathology report was reexamined on day 10th for margin and depth clearance. Descriptive statistics were calculated for age, gender, sun exposure, reconstructive technique, anatomical site, and tumor free margin report on frozen section analysis. Chi square test was employed for statistical significance of involvement of surgical margin with reference to anatomical site, size and decision on reconstructive surgical technique, p value of <0.05 was considered significant. Total of 36 patients of BCC were enrolled, males 12 (33.3%) and females were 24 (66.6%). Age ranged from 45 year to 80 year mean of 58.36 ±SD7.8. Size of BCC ranged from 10mm to 35mm mean of 25mm ±SD 0.63. Morphology was nodular 18 (50%), superficial spreading 11(30.6%), morphoeic 1 (2.8%) and ulcerative in 6(16.7%) cases. Intraoperative frozen section for histopathological margin clearance with 2-3 mm safety margin and surgical technique has p-value0.51, for anatomical site p value 0.24 and size p-0.84. Intraoperative frozen section (FS) histopathological clearance for BCC face with 2-3mm safety margin with reference to reconstructive technique, anatomical site and size of BCC were insignificant.

Keywords: basal cell carcinoma, tumor free amrgin, basal cell carcinoma and frozen section, safety margin

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Authors: Amando A. Radomes Jr., LLoyd Jun Benjamin T. Embernatre, Cherssy Kaye F. Eviota, Krizia Allyn L. Nunez, Jose Thaddeus B. Roble III

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Sitio Kantaling is one of the 34 villages in Danao City, Cebu, in the central Philippines. As of 2015, the eight households in the mountainous village extending over 40 hectares of land area, including 12 hectares of arable land, are the source of over a fifth of the agricultural products that go into the city. Over the years, however, the local government had been concerned with the decline in agricultural productivity because increasing number of residents are migrating into the urban areas of the region to look for better employment opportunities. One of the major reasons for the agricultural productivity decline is underdeveloped irrigation infrastructure. The local government had partnered with the University of San Carlos to conduct research on developing an irrigation system that could sustainably meet both agricultural and household consumption needs. From a macro-perspective, a dynamic simulation model was developed to understand the long-term behavior of the status quo and proposed the system. Data on population, water supply and demand, household income, and urban migration were incorporated in the 20-year horizon model. The study also developed a smart irrigation system design. Instead of using electricity to pump water, a network of aqueducts with three main nodes had been designed and strategically located to take advantage of gravity to transport water from a spring. Simulation results showed that implementing a sustainable irrigation system would be able to significantly contribute to the socio-economic progress of the local community.

Keywords: agriculture, aqueduct, simulation, sustainable irrigation system

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Authors: Oleg Ye Sysoyev, Artem Yu Dobryshkin, Nyein Sitt Naing

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Cylindrical shells are widely used in the construction of buildings and structures, as well as in the air structure. Thin-walled casings made of aluminum alloys are an effective substitute for reinforced concrete and steel structures in construction. The correspondence of theoretical calculations and the actual behavior of aluminum alloy structures is to ensure their trouble-free operation. In the laboratory of our university, "Building Constructions" conducted an experimental study to determine the effect of the system of attached masses on the natural oscillations of shallow cylindrical shells of aluminum alloys, the results of which were compared with theoretical calculations. The purpose of the experiment is to measure the free oscillations of an open, sloping cylindrical shell for various variations of the attached masses. Oscillations of an open, slender, thin-walled cylindrical shell, rectangular in plan, were measured using induction accelerometers. The theoretical calculation of the shell was carried out on the basis of the equations of motion of the theory of shallow shells, using the Bubnov-Galerkin method. A significant splitting of the flexural frequency spectrum is found, influenced not only by the systems of attached маsses but also by the values of the wave formation parameters, which depend on the relative geometric dimensions of the shell. The correspondence of analytical and experimental data is found, using the example of an open shell of alloy D19, which allows us to speak about the high quality of the study. A qualitative new analytical solution of the problem of determining the value of the oscillation frequency of the shell, carrying a system of attached masses is shown.

Keywords: open hollow shell, nonlinear oscillations, associated mass, frequency

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Authors: Elma C. Sultan

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The study concentrated on Vernacular Language Origin and Students’ Accent Neutralization of the College of Arts and Sciences fourth students in Samar State University, Catbalogan City answering respondent’s locale profile, vernacular language origin in terms of local dialect/s and domestic language/s used; the significant relationship between vernacular language origin and accent neutralization of the respondents; and the proposed activities to adopt in neutralizing students’ accent. It utilized the descriptive-correlational method of research determining the significant relationship between vernacular language origin and students’ accent neutralization. The researcher used: (1) questionnaire divided into three parts: the first part identified the students’ locale; the second part determined the respondents’ domestic language/s used while the third part identified their local language/s used, (2) validated accent neutralization assessment tool, (3) statistical treatments in the analysis of data: percentage to determine the profile of the students; chi-square test for independence to determine the significant relationship between vernacular language origin and students’ accent neutralization. Findings of the study showed that vowel and diphthong sound production, domestic and local languages in indigenous, and native dialects are significantly related to accent neutralization. While, slow reading speed has a higher possibility in affecting accent neutralization. These caused designing a 50-hour short-term program for accent neutralization focusing in the correct vowel and diphthong sounds production and appropriate reading speed in preparation for the respondents’ search for BPO employment. This short-term program ran for 5 hours in a day for five days in a week.

Keywords: accent neutralization, dialect, diphthongs, indigenous, language origin, language, native, reading speed, vernacular, vowels

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Authors: Kim Byeong-Gon, Lee Pureun-Haneul, Hong Jisu, Jang An-Soo

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Background: Diesel exhaust particles (DEPs) lead to trigger airway hyperresponsiveness (AHR) and airway dysfunction or inflammation in respiratory systems. Whether tight junction protein changes can contribute to development or exacerbations of airway diseases remain to be clarified. Objective: The aim of this study was to observe the effect of DEP on tight junction proteins in one airway both nose and lung in a mouse model. Methods: Mice were treated with saline (Sham) and exposed to 100 μg/m³ DEPs 1 hour a day for 5 days a week for 4 weeks and 8 weeks in a closed-system chamber attached to a ultrasonic nebulizer. Airway hyperresponsiveness (AHR) was measured and bronchoalveolar lavage (BAL) fluid, nasal lavage (NAL) fluid, lung and nasal tissue was collected. The effects of DEP on tight junction proteins were estimated using western blot, immunohistochemical in lung and nasal tissue. Results: Airway hyperresponsiveness and number of inflammatory cells were higher in DEP exposure group than in control group, and were higher in 4 and 8 weeks model than in control group. The expression of tight junction proteins CLND4, -5, and -17 in both lung and nasal tissue were significantly increased in DEP exposure group than in the control group. Conclusion: These results suggesting that CLDN4, -5 and -17 may be involved in the airway both nose and lung, suggesting that air pollutants cause to disruption of epithelial and endothelial cell barriers. Acknowledgment: This research was supported by Korea Ministry of Environment (MOE) as 'The Environmental Health Action Program' (2016001360009) and Soonchunhyang University Research Fund.

Keywords: diesel exhaust particles, air pollutant, tight junction, Claudin, Airway inflammation

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Authors: Sarah P. Wuebbolt, Ashlee N. Sawyer-Mays

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Non-medical prescription and other drug (NMPOD) use has been a significant public health issue for the last few decades, with problematic use increasing among university students more recently. The current study focused on associations between NMPOD use and mental health, well-being, and world beliefs among young adults. Young adults (N=513) completed online questionnaires assessing stress, demographic characteristics, self-esteem, NMPOD use, coping mechanisms, and anxiety. A substantial portion of participants reported using cannabis (48.5%, n=249), while smaller portions of participants reported using stimulants (26.7%, n = 137), sedatives (17.2%, n=88), opioids (10.8%, n=55), and hallucinogens (14.4%, n=74). Five hierarchical logistic regressions were performed to determine the independent relationships between mental health, well-being, and world belief factors and NMPOD use for the five classes of substances. After controlling for demographic factors (age, gender, race/ethnicity, sexual orientation, and religious affiliation), depression was associated with increased non-medical stimulant, opioid, and cannabis use; coping self-efficacy was associated with increased hallucinogen use, and attendance of worship services was associated with decreased non-medical cannabis and hallucinogen use. Results suggest that depression was strongly associated with non-medical stimulant, opioid, and cannabis use, and attendance of worship services was protective against cannabis and hallucinogen use. To the best of our knowledge, this is one of the first studies to investigate the relationships between mental health, well-being, world beliefs, and NMPOD use among young adults. The present study illuminates future targets for intervention, such as increased access to mental health diagnosis and treatment and the exploration of the roles of religion and shared community in the prevention of drug use among young adults.

Keywords: cannabis, mental health, non-medical prescription and other drug use, world beliefs

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Authors: Pratap Sing, Chaman. K. Jadon, H. P. Meena, D. L.yadav, S. L. Yadav, Uditi Dhakad

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The experiment was conducted at Agricultural Research Station, Agriculture University, Kota, Rajasthan, India during kharif and rabi 2020-21 and 2021-22 to study the biofficacy of diclosulam and its residual effect on succeeding wheat crop. The treatments comprised of Diclosulam 84 % WDG viz. 6.25, 12.50, 25.00 and 37.50 g/ha as pre emergence (PE), Pendimethalin 30% EC 3.33 l/ha, Sulfentrazon 48% SC 750 g/ha, hand weeding at 30 and 45 DAS and weedy check, were evaluated in randomized block design in three replications. The experimental soil was clay in texture and non-calcareous. Experimental field was mainly dominated by grasses-Echinochloa colonum, E.crusgalli,Cynodon dactylon, Sedges-Cyperus rotundus and broad leaved weeds Celosia argentea and Digera arvensis.The result revealed that application of Diclosulam 84 % WDG 25 g/ha PE was found effective in controlling mostly weed species and registered higher weed control efficiency 81.2, 74.3, 69.6 per cent at 30, 45 days after sowing and at harvest. Diclosulam 84 % WDG (6.25-25.0 g/ha) was found selective to the soybean crop as no any phytotoxicity symptoms were observed. Among the herbicidal treatments, Diclosulam 84 % WDG 25 g/ha registered maximum and significantly higher soybean seed yield (1889 and 1431 kg/ha during kharif 2020 and 2021, respectively and was at par with Sulfentrazone 48% SC 750 g/ha and over weedy check( 1027 and 667 kg/ha).The wheat crop growth, yield attributes and seed yield were not influenced due to carry over effect of the Diclosulam 84 % WDG( 6.25-25.0 g/ha) and no any phytotoxicity symptoms were observed. Henceforth, the Diclosulam 84 % WDG 25.0 g/ha as pre emergence may be used in the soybean for effective weed control without carry over effect on succeeding wheat crop.

Keywords: Diclosulam, soybean, carry over effect, succeeding wheat

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Authors: Ami Nkumbuye

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Background: Every year 1.3 million people die due to Road crashes, according to the Global status report. Road crashes remain the greatest killer aged between 15-29 years. Young people are paying an unacceptable price for their own safer mobility. 23,498 students attending class daily from home crossing the roads of 3 districts Kigali and Southern province is showing a similar trend with 40320 cross road daily. As most of them don't have any idea about the safety, they should have when they are crossing roads and traffic rules and signs as well. Despite the high number of mortality related to road crashes in Rwanda, we don't have any approved calendar to teach young people road safety as the most affected age group. Objective: The objective of this study was to identify the causes of road crashes and the outcome of victims after being involved in road crashes over a period of two years, from January 2020 to December 2021, in Huye district and Kigali City. Methods: A retrospective descriptive study with open questions and then data analysis, students were identified from 15 schools in Kigali City and Southern Province and through the Local Action Project supported by Global Youth Coalition for Road Safety and Youth for Road Safety (YOURS), students asked about the cause of road crashes through open and closed question and data analyzed. Result: There were 354 students from 15 schools: 198 males and 156 females. Their age ranged from 10 to 25 years. The commonest cause of road crashes among students attending schools daily was: high speed, lack of education on safe behavior on the road, drinking and driving, and poor road infrastructures, with 47%, 32%, 13% and 8 %, respectively. The hospital admission after road crashes for the victims was 32.3%. In most scenes where road crashes occur, students report that they didn't see any person who could provide post-crash care until the ambulance came, in some cases, resulted in bad outcomes for the victims after road crashes. Conclusion: This study revealed that high speed and lack of education n road safety are the major cause of road crashes among young people in Rwanda. If local Non-Governmental Organization and Decision makers work on these issues like never before, we can see a decrease in road crash among young people and adult as well. We would like to give a recommendation to two institutions: the first is the Rwanda National Police Traffic department to set 30km/m as the maximum speed limit in City and near schools. The second is for the Ministry of Education to put Road Safety and Post Crash Care curricula in both Primary and Secondary schools.

Keywords: road safety, post-crash care, young people, students

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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: Raquel Mateo Mendaza, Carmen Novo Urraca

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The current paper presents the elaboration of a corpus database that aligns two different corpora in order to simplify the search of information both for researchers and students of Old English. This database comprises the information contained in two main reference corpora, namely the Dictionary of Old English Corpus (DOEC), compiled at the University of Toronto, and the York-Toronto-Helsinki Parsed Corpus of Old English (YCOE). The first one provides information on all surviving texts written in the Old English language. The latter offers the syntactical and morphological annotation of several texts included in the DOEC. Although both corpora are closely related, as the YCOE includes the DOE source text identifier, the main problem detected is that there is not an alignment of texts that allows for the search of whole fragments to be further analysed in terms of morphology and syntax. The database proposed in this paper gathers all this information and presents it in a simple, more accessible, visual, and educational way. The alignment of fragments has been done in an automatized way. However, some problems have emerged during the creating process particularly related to the lack of correspondence in the division of fragments. For this reason, it has been necessary to revise the whole entries manually to obtain a truthful high-quality product and to carefully indicate the gaps encountered in these corpora. All in all, this database contains more than 60,000 entries corresponding with the DOE fragments annotated by the YCOE. The main strength of the resulting product is its research and teaching implications in the study of Old English. The use of this database will help researchers and students in the study of different aspects of the language, such as inflectional morphology, syntactic behaviour of given words, or translation studies, among others. By means of the search of words or fragments, the annotated information on morphology and syntax will be automatically displayed, automatizing, and speeding up the search of data.

Keywords: alignment, corpus database, morphosyntactic analysis, Old English

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Authors: Alexandra Shipley

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Background: Undergraduate paediatric teaching must overcome two major challenges: 1) balancing patient safety with active student engagement and 2) exposing students to a comprehensive range of pathologies within a relatively short clinical placement. Whilst lectures and shadowing on paediatric wards constitute the mainstay of learning, Simulation and Virtual Reality (VR) are emerging as effective teaching tools, which - immune to the unpredictability and seasonal variation of hospital presentations - could expose students to the entire syllabus more reliably, efficiently, and independently. We aim to evaluate the potential utility of Simulation and VR in addressing gaps within the traditional paediatric curriculum from the perspective of medical students. Summary of Work: Exposure to and perceived utility of various learning opportunities within the Paediatric and Emergency Medicine courses were assessed through a questionnaire completed by 5th year medical students (n=23). Summary of Results: Students reported limited exposure to several common acute paediatric presentations, such as bronchiolitis (41%), croup (32%) or pneumonia (14%), and to clinical emergencies, including cardiac/respiratory arrests or trauma calls (27%). Across all conditions, average self-reported confidence in assessment and management to the level expected of an FY1 is greater amongst those who observed at least one case (e.g. 7.6/10 compared with 3.6/10 for croup). Students rated exposure through Simulation or VR to be of similar utility to witnessing a clinical scenario on the ward. In free text responses, students unanimously favoured being ‘challenged’ through ‘hands-on’ patient interaction over passive shadowing, where it is ‘easy to zone out.’ In recognition of the fact that such independence is only appropriate in certain clinical situations, many students reported wanting more Simulation and VR teaching. Importantly, students raised the necessity of ‘proper debriefs’ after these sessions to maximise educational value. Discussion and Conclusion: Our questionnaire elicited several student-perceived challenges in paediatric education, including incomplete exposure to common pathologies and limited opportunities for active involvement in patient care. Indeed, these experiences seem to be important predictors of confidence. Quantitative and qualitative feedback suggests that VR and Simulation satisfy students’ self-reported appetite for independent engagement with authentic clinical scenarios. Take-aways: Our findings endorse further development of VR and Simulation as high-yield adjuncts to paediatric education.

Keywords: paediatric emergency education, simulation, virtual reality, medical education

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Authors: Herlin Vallejo, Jhon Osorio

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Quality is a concept that has gained importance in different scenarios over time, especially in the area of health. The nursing staff is one of the actors that contributes most to the care process and the satisfaction of the users in the evaluation of quality. However, until now, there are few tools to measure the quality of care in specialized performance scenarios. Patients receiving ambulatory cancer treatments can face various problems, which can increase their level of distress, so improving the quality of outpatient care for cancer patients should be a priority for oncology nursing. The experience of the patient in relation to the care in these services has been little investigated. The purpose of this study was to understand the perception that patients have about quality care in outpatient chemotherapy services. A qualitative, exploratory, descriptive study was carried out in 9 patients older than 18 years, diagnosed with cancer, who were treated at the Institute of Cancerology, in outpatient chemotherapy rooms, with a minimum of three months of treatment with curative intention and which had given your informed consent. The total of participants was determined by the theoretical saturation, and the selection of these was for convenience. Unstructured interviews were conducted, recorded and transcribed. The analysis of the information was done under the technique of content analysis. Three categories emerged that reflect the perception that patients have regarding quality care: patient-centered care, care with love and effects of care. Patients highlighted situations that show that care is centered on them, incorporating elements of patient-centered care from the institutional, infrastructure, qualities of care and what for them, in contrast, means inappropriate care. Care with love as a perception of quality care means for patients that the nursing staff must have certain qualities, perceive caring with love as a family affair, limits on care with love and the nurse-patient relationship. Quality care has effects on both the patient and the nursing staff. One of the most relevant effects was the confidence that the patient develops towards the nurse, besides to transform the unreal images about cancer treatment with chemotherapy. On the other hand, care with quality generates a commitment to self-care and is a facilitator in the transit of oncological disease and chemotherapeutic treatment, but from the perception of a healing transit. It is concluded that care with quality from the perception of patients, is a construction that goes beyond the structural issues and is related to an institutional culture of quality that is reflected in the attitude of the nursing staff and in the acts of Care that have positive effects on the experience of chemotherapy and disease. With the results, it contributes to better understand how quality care is built from the perception of patients and to open a range of possibilities for the future development of an individualized instrument that allows evaluating the quality of care from the perception of patients with cancer.

Keywords: nursing care, oncology service hospital, quality management, qualitative studies

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Authors: J. Magerman, P. Martin

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Nursing students' clinical abilities is highly dependent on the quality of the clinical experience obtained while placed in the clinical environment. The clinical environment has amongst other, key role players which include the clinical supervisor. The primary role of the clinical supervisor is to guide nursing students to become the best practice nursing professionals. However, globally literature alludes to the failure of educating institutions to deliver competent nursing professionals to meet the needs of patients and deliver quality patient care. At the participating university, this may be due to various factors such as large student numbers and social and environmental challenges experienced by clinical supervisors. The aim of this study was to explore and describe the lived experiences of clinical supervisors who supervise nursing students at a higher education institution. The study employed a qualitative research approach utilizing a descriptive phenomenological design. Purposive sampling was used to select participants, who supervised first and second year nursing studnets at the higher education institution under study. TH esample comprised of eight clinical supervisors who supervise first and secon year nursing studnets at teh institution under study. Data was collected by means of in-depht interviews. Data was analysed using Collaizzi's seven steps method of qualitative analysis. Five major themes identified , focussed on the experiences regarding time a sa constraint to job productivity, the impact of teh organisational culture on the fluidity of support, interpersonal relationships a sa dynamic communication process, impact on the self, and limited resources. Trustworthiness of the data was ensured by means of applying Guba's model of truth value, applicability, consistency and neutrality. Reflexivity was also used by the researcher to further enhance trustworthiness.

Keywords: clinical supervision, clinical supervisors, nursing students, clinical placements

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Authors: Arindam Chowdhury, Andres Tremante, Mohammadtaghi Moravej, Bodhisatta Hajra, Ioannis Zisis, Peter Irwin

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Extreme wind events, such as hurricanes, have caused significant damage to buildings, resulting in losses worth millions of dollars. The roof of a building is most vulnerable to wind-induced damage due to the high suctions experienced by the roof in extreme wind conditions. Wind turbines fitted to buildings can help generate energy, but to our knowledge, their application to wind load mitigation is not well known. This paper presents results from an experimental study to assess the effect of small wind turbines (developed and patented by the first and second authors) on the wind loads on a low rise building roof. The tests were carried out for an open terrain at the Wall of Wind (WOW) experimental facility at Florida International University (FIU), Miami, Florida, USA, for three cases – bare roof, roof fitted with wind turbines placed closer to the roof edges, and roof with wind turbines placed away from the roof edges. Results clearly indicate that the presence of the wind turbines reduced the mean and peak pressure coefficients (less suction) on the roof when compared to the bare deck case. Furthermore, the peak pressure coefficients were found to be lower (less suction) when the wind turbines were placed closer to the roof, than away from the roof. Flow visualization studies using smoke and gravel clearly showed that the presence of the turbines disrupted the formation of vortices formed by cornering winds, thereby reducing roof suctions and preventing lift off of roof coverings. This study shows that the wind turbines besides generating wind energy, can be used for mitigating wind induced damage to the building roof. Future research must be directed towards understanding the effect of these wind turbines on other roof geometries (e.g. hip/gable) in different terrain conditions.

Keywords: wall of wind, wind loads, wind turbine, building

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