Search results for: comprehensive emergency care and life support

Authors: Gamze Uslu, Sebnem Baydere, Alper K. Demir

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In this study, data loss tolerance of Support Vector Machines (SVM) based activity recognition model and multi activity classification performance when data are received over a lossy wireless sensor network is examined. Initially, the classification algorithm we use is evaluated in terms of resilience to random data loss with 3D acceleration sensor data for sitting, lying, walking and standing actions. The results show that the proposed classification method can recognize these activities successfully despite high data loss. Secondly, the effect of differentiated quality of service performance on activity recognition success is measured with activity data acquired from a multi hop wireless sensor network, which introduces high data loss. The effect of number of nodes on the reliability and multi activity classification success is demonstrated in simulation environment. To the best of our knowledge, the effect of data loss in a wireless sensor network on activity detection success rate of an SVM based classification algorithm has not been studied before.

Keywords: activity recognition, support vector machines, acceleration sensor, wireless sensor networks, packet loss

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Authors: Shu-Ching Chen, Li-Yun Lee

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The purpose of the study was to identify the factors associated with head and neck cancer-related lymphoedema (HNCRL)-related symptoms, body image, and HNCRL-related functional outcomes among patients with resected advanced head and neck cancer. A cross-sectional correlational design was conducted to examine the predictors of HNCRL-related functional outcomes in patients with resected advanced head and neck cancer. Eligible patients were recruited from a single medical center in northern Taiwan. Consecutive patients were approached and recruited from the Radiation Head and Neck Outpatient Department of this medical center. Eligible subjects were assessed for the Symptom Distress Scale–Modified for Head and Neck Cancer (SDS-mhnc), Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Head and Neck Cancer (BCSQ-H&N), Body Image Scale–Modified (BIS-m), The MD Anderson Head and Neck Lymphedema Rating Scale (MDAHNLRS), The Foldi’s Stages of Lymphedema (Foldi’s Scale), Patterson’s Scale, UCLA Shoulder Rating Scale (UCLA SRS), and Karnofsky’s Performance Status Index (KPS). The results showed that the worst problems with body HNCRL functional outcomes. Patients’ HNCRL symptom distress and performance status are robust predictors across over for overall HNCRL functional outcomes, problems with body HNCRL functional outcomes, and activity and social functioning HNCRL functional outcomes. Based on the results of this period research program, we will develop a Cancer Rehabilitation and Lymphedema Care Program (CRLCP) to use in the care of patients with resected advanced head and neck cancer.

Keywords: head and neck cancer, resected, lymphedema, symptom, body image, functional outcome

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Authors: Hadjoui Abdelhamid, Saimi Ahmed

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The hybrid h-p finite element method for the dynamic behavior of nonlinear rotors is described in this paper. The standard h-version method of discretizing the problem is retained, but modified to allow the use of polynomially-enriched beam elements. A hierarchically enriching element will thus not affect the nodal displacement and rotation, but will influence the values of the nodal bending moment and shear force is used. The deterministic movements of rotation and translation of the support which are coupled to the excitations due to unbalance are also taken into account. We study also the geometric dissymmetry of the shaft and the disc, thus the equations of motion of the rotor contain variable parametric coefficients over time that can lead to a lateral dynamic instability. The effects of movements combined support for bearings are analyzed and discussed through Campbell diagrams and spectral analyses. A program is made in Matlab. After validation of the program, several examples are studied. The influence of physical and geometric parameters on the natural frequencies of the shaft is determined through the study of these examples. Among these parameters, we include the variation in the diameter and the thickness of the rotor, the position of the disc.

Keywords: Campbell diagram, critical speeds, nonlinear rotor, version h-p of FEM

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Authors: Eman Elsebaie, A. Sedrak, R. Ziada

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Introduction: In the recent decades, heart failure (HF) has become one of the most prevalent cardio-vascular disease (CVDs), especially in the elderly and the main cause of hospitalization in Egypt cardiology departments. By 2030, the prevalence of HF is expected to increase by 25%. Total direct costs will increase to $818 billion, and the total indirect cost in terms of lost productivity is close to $275 billion. The current study was conducted to estimate the economic costs of services delivered for heart failure patients at the cardiology department in Cairo University Hospitals (CUHs). Aim: To gain an understanding of the cost of heart failure disease and its main drivers aiming to minimize associated health care costs. Subjects and Methods: Economic cost analysis study was conducted for a prospective group of all cases of HF admitted to the cardiology department in CUHs from end of March till end of April 2016 and another retrospective randomized sample from patients with HF, during the first 3 months of 2016 to measure estimated average cost per patient per day. Results: The mean age of the prospective group was 48.6 ± 17.16 years versus 52.3 ± 11.5 years for the retrospective group. The median (IQR) of Length of stay was 15 (15) days in the prospective group versus 9 (16) days in the retrospective group. The average HF inpatient cost/day in the cardiology department during April 2016 was 362.32 (255.5) L.E. versus 391.2(255.9) L.E. during January and February 2016. Conclusion: Up to 70% of expenditure in the management of HF is related to hospital admission. The average cost of such an admission was 5540.03 (IQR=7507.8) L.E. and 4687.4 (IQR=7818.8) L.E. with the average cost per day estimated at 362.32 (IQR=255.5) L.E. and 386.2(IQR=255.9) L.E. in prospective and retrospective groups respectively.

Keywords: health care cost, heart failure, hospitalization, inpatient

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Authors: Logaiswari Indiran, Zainab Khalifah, Kamariah Ismail

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Business incubators have now been recognized as effective tools in providing business assistance to start-up firms. In both developed and developing countries, the number of incubators is growing tremendously. As the birth rate of incubators increases, so do its challenges. Malaysia, as one of the developing countries in the Asian continent, has also established a number of business incubators to breed and foster the growth and survival of start-up firms. Thus, this study discusses the incubation model applied in Malaysia and the challenges faced by these incubators using secondary data including policies, previous literature, and reports related to Malaysian incubators. The findings of this study call the government to rethink the key role of incubator managers and staffs, internal structure of the incubator concept and process, intellectual properties management, strategic alliances with universities-industries and funding supports in enhancing the support provided by the business incubators in Malaysia. The key challenges highlighted in this study signal important policy lessons for other developing countries that aim to create and map an effective business incubator ecosystem.

Keywords: business incubators, incubation challenges, funding support, incubator managers, internal structure, start-up firms

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Authors: F. Felipe

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Air Defense Systems contain high-value assets that are expected to fulfill their mission for several years - in many cases, even decades - while operating in a fast-changing, technology-driven environment. Thus, it is paramount that decision-makers can assess how effective an Air Defense System is in the face of new developing threats, as well as to identify the bottlenecks that could jeopardize the security of the airspace of a country. Given the broad extent of activities and the great variety of assets necessary to achieve the strategic objectives, a systems approach was taken in order to delineate the core requirements and the physical architecture of an Air Defense System. Then, value-focused thinking helped in the definition of the measures of effectiveness. Furthermore, analytical methods were applied to create a formal structure that preliminarily assesses such measures. To validate the proposed methodology, a powerful simulation was also used to determine the measures of effectiveness, now in more complex environments that incorporate both uncertainty and multiple interactions of the entities. The results regarding the validity of this methodology suggest that the approach can support decisions aimed at enhancing the capabilities of Air Defense Systems. In conclusion, this paper sheds some light on how consolidated approaches of Systems Engineering and Operations Research can be used as valid techniques for solving problems regarding a complex and yet vital matter.

Keywords: air defense, effectiveness, system, simulation, decision-support

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Authors: Parimalakrishnan Sundararjan, Madheswaran Murugan, Dhanya Dharman, Yatindra Kumar, Sudhir Singh Gangwar, Guru Prasad Mohanta

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Antibiotic resistance AR is a global issue, India started to redress the issues of antibiotic resistance late and it plans to have: active surveillance of microbial resistance and promote appropriate use of antibiotics. The present study attempted to achieve appropriate use of antibiotics through pharmacists’ intervention at practice point. In a quasi-experimental prospective cohort study, the cases with bacteremia from four hospitals were identified during 2015 and 2016 for intervention. The pharmacists centered intervention: active screening of each prescription and comparing with the selection of antibiotics with susceptibility of the bacteria. Wherever irrationality noticed, it was brought to the notice of the treating physician for making changes. There were two groups: intervention group and control group without intervention. The active screening and intervention in 915 patients has reduced therapeutic regimen time in patients with bacteremia. The intervention group showed the decreased duration of hospital stay 3.4 days from 5.1 days. Further, multivariate modeling of patients who were in control group showed that patients in the intervention group had a significant decrease in both duration of hospital stay and infection-related mortality. Unlike developed countries, pharmacists are not active partners in patient care in India. This unique attempt of pharmacist’ invention was planned in consultation with hospital authorities which proved beneficial in terms of reducing the duration of treatment, hospital stay, and infection-related mortality. This establishes the need for a collaborative decision making among the health workforce in patient care at least for promoting rational use of antibiotics, an attempt to combat resistance.

Keywords: antibiotics resistance, intervention, bacteremia, multivariate modeling

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Authors: Chen-Ya Juan

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In recent years, the increasing number of children with special needs has brought a lot of attention by many scholars and experts in education, which enforced the preschool teachers face the harsh challenge in the classroom. To protect the right of equal education for all children, enhance the quality of children learning, and take care of the needs of children with special needs, the special education paraprofessional becomes one of the future employment trends for students of the department of the early childhood care and education. Problem-based learning is a problem-oriented instruction, which is different from traditional instruction. The instructor first designed an ambiguous problem direction, following the basic knowledge of early intervention, students had to find clues to solve the problem defined by themselves. In the class, the total instruction included 20 hours, two hours per week. The primary purpose of this paper is to investigate the relationship of student academic scores, self-awareness, learning motivation, learning attitudes, and early intervention knowledge. A total of 105 college students participated in this study and 97 questionnaires were effective. The effective response rate was 90%. The student participants included 95 females and two males. The average age of the participants was 19 years old. The questionnaires included 125 questions divided into four major dimensions: (1) Self-awareness, (2) learning motivation, (3) learning attitudes, and (4) early intervention knowledge. The results indicated (1) the scores of self-awareness were 58%; the scores of the learning motivations was 64.9%; the scores of the learning attitudes was 55.3%. (2) After the instruction, the early intervention knowledge has been increased to 64.2% from 38.4%. (3) Student’s academic performance has positive relationship with self-awareness (p < 0.05; R = 0.506), learning motivation (p < 0.05; R = 0.487), learning attitudes (p < 0.05; R = 0.527). The results implied that although students had gained early intervention knowledge by using PBL instruction, students had medium scores on self-awareness and learning attitudes, medium high in learning motivations.

Keywords: college students, children with special needs, problem-based learning, learning motivation

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Authors: L. R. Ferreira, R. Biscaro, C. C. Danziger, C. M. Galhardi, L. C. Biscaro, R. C. Biscaro, I. S. Vasconcelos, L. C. R. Ferreira, R. Reis, L. H. Oliveira

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Introduction: There is a worldwide trend for the employer to be aware of investing in health promotion that goes beyond occupational hygiene approaches with the implementation of a comprehensive program with integration between occupational health and safety, and social/psychosocial responsibility in the workplace. Work accommodation is a necessity in most companies as it allows the worker to return to its function respecting its physical limitations. This study had the objective to verify if the integration of health and safety in the companies, with the inclusion of the concept of TWH promoted by an occupational health service has impacted in the management of absenteeism of workers in work accommodation. Method: A retrospective and paired cohort study was used, in which the impact of the implementation of the Program for the Health/Safety Integration and Total Worker Health Concept (PHSITWHC) was evaluated using the indices of absenteeism, health attestations, days and hours of sick leave of workers that underwent job accommodation/rehabilitation. This was a cohort study and the data were collected from January to September of 2017, prior to the initiation of the integration program, and compared with the data obtained from January to September of 2018, after the implementation of the program. For the statistical analysis, the student's t-test was used, with statistically significant differences being made at p < 0.05. Results: The results showed a 35% reduction in the number of absenteeism rate in 2018 compared to the same period in 2017. There was also a significant reduction in the total numbers of days of attestations/absences (mean of 2,8) as well as days of attestations, absence and sick leaves (mean of 5,2) in 2018 data after the implementation of PHSITWHC compared to 2017 data, means of 4,3 and 25,1, respectively, prior to the program. Conclusion: It can be concluded that the inclusion of the PHSITWHC was associated with a reduction in the rate of absenteeism of workers that underwent job accommodation. It was observed that, once health and safety were approached and integrated with the inclusion of the TWH concept, it was possible to reduce absenteeism, and improve worker’s quality of life and wellness, and work accommodation management.

Keywords: absenteeism, health/safety integration, work accommodation management, total worker health

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Authors: Shahzad A. Mughal, Ameer A. P. Ghaloo, Faisal Laghari, Mohsin A. Mirza

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Job satisfaction and level of job stressors among employees of a university are considered as essential factors responsible for institutional success. Job satisfaction is usually believed as a single baseline variable for the evaluation of a university human resource area. The objectives of this study were to assess the level of job satisfaction and influence of job stressors among university teachers and their association with long term physical health of the employees in government sector universities in Pakistan. A cross-sectional study was conducted on university employees including faculty members and administrative staff of three government sector universities in Sindh province of Pakistan who have completed at least ten years of their job. The study period was six months. All the employees were randomly selected. The job satisfaction scale Questionnaire with yes and no options, together with questions regarding demographic factors, job stress or other working factors and physical health issues were administered in questionnaires. These questionnaires were handed out to 100 faculty members of both genders with permanent job and 50 non faculty staff of grade 17 and above with permanent employment status. Students’ T test and one way ANOVA was applied to categorical variables and Pearson’s correlation analysis was performed to evaluate the correlations between study variables. 121 successful responses were obtained (effective respondent rate 80.6%). The average score of overall job satisfaction was 65.6%. Statistical analysis revealed that the job satisfaction and work related stressors had negative impact on overall health status of the employees with resultant less efficacy and mental stress. The positive relation was perceived by employees for organizational support and high income with job satisfaction. Demographic features such as age and female gender were also linked to the level of job satisfaction and health related issues. The total variation among all responses regarding correlation between job satisfaction job stressors and health related issues was 55%. A study was conducted on University employees of government sector Universities in Pakistan, regarding association of job satisfaction and job stressors with long term physical health of the employees. Study revealed a moderate level of job satisfaction among the employees of all universities included in this study. Attitude and personal relations with heads of the departments and institution along with salary packages were considered as biggest job stressors related correlated directly with physical health. Demographic features and gender were associated factors for job satisfaction. Organizational support was the strongest factor for job satisfaction and results pointed out that by improving support level from University may improve the quality of job satisfaction and overall health of employees.

Keywords: job satisfaction, organizational support, physical health, university employees

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Authors: Narottam Puri, Gurvinder Kaur

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Background: The National Accreditation Board for Hospitals & Healthcare Providers (NABH) is India’s apex standard setting accrediting body in health care which evaluates and accredits healthcare organizations. NABH requires accredited organizations to become reaccredited every three years. It is often though that once the initial accreditation is complete, the foundation is set and reaccreditation is a much simpler process. Fortis Hospital, Shalimar Bagh, a part of the Fortis Healthcare group is a 262 bed, multi-specialty tertiary care hospital. The hospital was successfully accredited in the year 2012. On completion of its first cycle, the hospital underwent a reaccreditation assessment in the year 2015. This paper aims to gain a better understanding of the challenges that accredited hospitals face when preparing for a renewal of their accreditations. Methods: The study was conducted using a cross-sectional mixed methods approach; semi-structured interviews were conducted with senior leadership team and staff members including doctors and nurses. Documents collated by the QA team while preparing for the re-assessment like the data on quality indicators: the method of collection, analysis, trending, continual incremental improvements made over time, minutes of the meetings, amendments made to the existing policies and new policies drafted was reviewed to understand the challenges. Results: The senior leadership had a concern about the cost of accreditation and its impact on the quality of health care services considering the staff effort and time consumed it. The management was however in favor of continuing with the accreditation since it offered competitive advantage, strengthened community confidence besides better pay rates from the payors. The clinicians regarded it as an increased non-clinical workload. Doctors felt accountable within a professional framework, to themselves, the patient and family, their peers and to their profession; but not to accreditation bodies and raised concerns on how the quality indicators were measured. The departmental leaders had a positive perception of accreditation. They agreed that it ensured high standards of care and improved management of their functional areas. However, they were reluctant in sparing people for the QA activities due to staffing issues. With staff turnover, a lot of work was lost as sticky knowledge and had to be redone. Listing the continual quality improvement initiatives over the last 3 years was a challenge in itself. Conclusion: The success of any quality assurance reaccreditation program depends almost entirely on the commitment and interest of the administrators, nurses, paramedical staff, and clinicians. The leader of the Quality Movement is critical in propelling and building momentum. Leaders need to recognize skepticism and resistance and consider ways in which staff can become positively engaged. Involvement of all the functional owners is the start point towards building ownership and accountability for standards compliance. Creativity plays a very valuable role. Communication by Mail Series, WhatsApp groups, Quizzes, Events, and any and every form helps. Leaders must be able to generate interest and commitment without burdening clinical and administrative staff with an activity they neither understand nor believe in.

Keywords: NABH, reaccreditation, quality assurance, quality indicators

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Authors: Nurunnaher Nurunnaher

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This paper examines the impact of women’s participation in microcredit on women’s decision making in the slum areas of Dhaka city, Bangladesh. There is confusion in the literature about whether women’s empowerment is or is not a trickle down impact of poverty alleviation or household well-being, and the studies use more or less similar indicators to measure the status of household and the status of women. Studies very rarely conceptualize and operationalize the term ‘empowerment’ as the word is often used without proper care by policy makers and development practitioners instead of household wellbeing. Currently, decision making in many studies has been used as an indicator of women’s empowerment when assessing the impact of microcredit programs on women. Based on a qualitative and feminist study this paper operationalizes women’s empowerment through the development of a conceptual framework, the identification of assessment criteria and the development of proper indicators that guided the whole study. The testimonies of participants, both men and women, were the basis of exploration of women’s lived experiences, which is the most appropriate method to explore the impact of such programs on women’s empowerment. The study considers empowerment as a process that affects various levels of life and gender relationships. The study found that there is a positive change in women’s position in decision making when women have developed an independent economic base with credit money. However, predominantly, women’s decision making is shared with men with the final decision still in the men’s hands. It can be said that women’s microcredit participation has not significantly challenged the social norms, therefore it is not surprising that women who hand over credit to their husband rarely have any power in intra-household bargaining process. Nevertheless, overall it is evident that women are continuously struggling toward the freedom to have the authority over household, economic and personal matters. It is concluded that while making strategic choices or gaining empowerment requires several steps, women’s participation in decision-making has several implications on their lives and potentially challenges patriarchy.

Keywords: women, gender inequality/equality, decision making, empowerment, microcredit, slums, Dhaka, Bangladesh

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Authors: Enkelejda Koka, Denard Veshi

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Since 2011, in the name of ‘humanitarianism’ and deaths in the Mediterranean Sea, the legal and political justification delivered by Greece to manage the refugee crisis is pre-emptive interception. Although part of the EU, Greece adopted its own strategy. These practices have also created high risks for migrants generally resulting in non-rescue episodes and push-back practices having lethal consequences to the life of the irregular migrant. Thus, this article provides an analysis of the Greek ‘compassionate border work’ policy, a practice known as push-back. It is argued that these push-back practices violate international obligations, notably the ‘right to life’, the ‘duty to search and rescue’, the prohibition of inhuman or degrading treatment or punishment and the principle of non-refoulement.

Keywords: Greece, migrants, push-back policy, violation of international law

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Authors: Abdullah Kattan, Khalid Alzahrani, Saud Alsaleh, Loui Ezzat, Khalid Murad, Bader Alghamdi

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Background and Significance: Patients are often bothered by the excess skin laxity and redundancy that they are left with after losing weight. Body-contouring surgery offers a solution to this problem; however, there is scarce literature on the psychological and social effects of these surgeries. This study was conducted to assess the psychosocial impact of body-contouring surgery on patients after weight loss. Methodology: In this cross-sectional study, a specifically designed questionnaire was administered to forty three patients whom have undergone body-contouring surgery. All included patients had lost no less than 20 Kg before body-contouring surgery, and were interviewed at least 6 months after surgery. The twenty-question interviewer based questionnaire was used to assess the psychosocial status of the patients before and after undergoing body-contouring surgery. The questionnaire assessed the quality of life (social life, job performance and sexual activity), presence of symptoms of depression and overall satisfaction. Data was analyzed as paired variables in SPSS using McNemar’s test. Results: Among the 43 participants, 19 (44.2%) have undergone mammoplasty, 12 (27.9%) have undergone abdominoplasty and the remainder of the patients have undergone other various procedures including brachioplasty, thigh lifts and nick liposuction. The mean age of patients was 34 +/- 10, the sample included 24 (55.8%) females and 19 (44.2%) males. The patients’ quality of life significantly improved in the following areas; social life (P<0.001), job performance (P<0.002) and sexual activity (P<0.001). Moreover, 17 (39.5%) patients suffered symptoms of depression before body-contouring surgery; however, only 1 (2.3%) patient suffered symptoms of depression after surgery. Overall satisfaction rate was found to be 62.8%; with mammoplasty being the highest satisfaction rate procedure (66.6 %). Conclusion: Body-contouring surgery after weight loss has shown to improve the psychological and social aspects in patients. These findings have been found to be consistent with the majority of relevant published studies, further increasing reliability of our study.

Keywords: abdominoplasty, body-contouring, mammoplasty, psychosocial

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Authors: Judson P. LaGrone

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Simulation-based education in curricula was once a luxurious component of nursing programs but now serves as a vital element of an individual’s learning experience. A debriefing occurs after the simulation scenario or clinical experience is completed to allow the instructor(s) or trained professional(s) to act as a debriefer to guide a reflection with a purpose of acknowledging, assessing, and synthesizing the thought process, decision-making process, and actions/behaviors performed during the scenario or clinical experience. Debriefing is a vital component of the simulation process and educational experience to allow the learner(s) to progressively build upon past experiences and current scenarios within a safe and welcoming environment with a guided dialog to enhance future practice. The aim of this integrative review was to assess current practices of debriefing models in simulation-based education for health care professionals and students. The following databases were utilized for the search: CINAHL Plus, Cochrane Database of Systemic Reviews, EBSCO (ERIC), PsycINFO (Ovid), and Google Scholar. The advanced search option was useful to narrow down the search of articles (full text, Boolean operators, English language, peer-reviewed, published in the past five years). Key terms included debrief, debriefing, debriefing model, debriefing intervention, psychological debriefing, simulation, simulation-based education, simulation pedagogy, health care professional, nursing student, and learning process. Included studies focus on debriefing after clinical scenarios of nursing students, medical students, and interprofessional teams conducted between 2015 and 2020. Common themes were identified after the analysis of articles matching the search criteria. Several debriefing models are addressed in the literature with similarities of effectiveness for participants in clinical simulation-based pedagogy. Themes identified included (a) importance of debriefing in simulation-based pedagogy, (b) environment for which debriefing takes place is an important consideration, (c) individuals who should conduct the debrief, (d) length of debrief, and (e) methodology of the debrief. Debriefing models supported by theoretical frameworks and facilitated by trained staff are vital for a successful debriefing experience. Models differed from self-debriefing, facilitator-led debriefing, video-assisted debriefing, rapid cycle deliberate practice, and reflective debriefing. A reoccurring finding was centered around the emphasis of continued research for systematic tool development and analysis of the validity and effectiveness of current debriefing practices. There is a lack of consistency of debriefing models among nursing curriculum with an increasing rate of ill-prepared faculty to facilitate the debriefing phase of the simulation.

Keywords: debriefing model, debriefing intervention, health care professional, simulation-based education

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Authors: Tawfik Thelaidjia, Salah Chenikher

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Bearing fault diagnosis has attracted significant attention over the past few decades. It consists of two major parts: vibration signal feature extraction and condition classification for the extracted features. In this paper, feature extraction from faulty bearing vibration signals is performed by a combination of the signal’s Kurtosis and features obtained through the preprocessing of the vibration signal samples using Db2 discrete wavelet transform at the fifth level of decomposition. In this way, a 7-dimensional vector of the vibration signal feature is obtained. After feature extraction from vibration signal, the support vector machine (SVM) was applied to automate the fault diagnosis procedure. To improve the classification accuracy for bearing fault prediction, particle swarm optimization (PSO) is employed to simultaneously optimize the SVM kernel function parameter and the penalty parameter. The results have shown feasibility and effectiveness of the proposed approach

Keywords: condition monitoring, discrete wavelet transform, fault diagnosis, kurtosis, machine learning, particle swarm optimization, roller bearing, rotating machines, support vector machine, vibration measurement

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

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

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

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Authors: Daniel Etim Jacob, Samuel Onadeko, Edem A. Eniang, Imaobong Ufot Nelson

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This paper examined determinants of income diversification among households in support zones communities of national parks in Nigeria. This involved the use household data collected through questionnaires administered randomly among 1009 household heads in the study area. The data obtained were analyzed using probability and non-probability statistical analysis such as regression and analysis of variance to test for mean difference between parks. The result obtained indicates that majority of the household heads were male (92.57%0, between the age class of 21 – 40 years (44.90%), had non-formal education (38.16%), were farmers (65.21%), owned land (95.44%), with a household size of 1 – 5 (36.67%) and an annual income range of ₦401,000 - ₦600,000 (24.58%). Mean Simpson index of diversity showed a general low (0.375) level of income diversification among the households. Income, age, off-farm dependence, education, household size and occupation where significant (p<0.01) factors that affected households’ income diversification. The study recommends improvement in the existing infrastructures and social capital in the communities as avenues to improve the livelihood and ensure positive conservation behaviors in the study area.

Keywords: income diversification, protected area, livelihood, poverty, Nigeria

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Authors: Wei-Jong Yang, Yu-Siang Su, Pau-Choo Chung, Jar-Ferr Yang

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Moving object detection (MOD) is an important issue in advanced driver assistance systems (ADAS). There are two important moving objects, pedestrians and scooters in ADAS. In real-world systems, there exist two important challenges for MOD, including the computational complexity and the detection accuracy. The histogram of oriented gradient (HOG) features can easily detect the edge of object without invariance to changes in illumination and shadowing. However, to reduce the execution time for real-time systems, the image size should be down sampled which would lead the outlier influence to increase. For this reason, we propose the histogram of uniformly-oriented gradient (HUG) features to get better accurate description of the contour of human body. In the testing phase, the support vector machine (SVM) with linear kernel function is involved. Experimental results show the correctness and effectiveness of the proposed method. With SVM classifiers, the real testing results show the proposed HUG features achieve better than classification performance than the HOG ones.

Keywords: moving object detection, histogram of oriented gradient, histogram of uniformly-oriented gradient, linear support vector machine

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Authors: Thi Thu Van Nguyen

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In South Korea, Confucianism has not only played a crucial position in Korean traditional culture but also deeply rooted in people’s mind. Confucianism bears a special emphasis on the traditional family pattern characterized by paternalism. Therefore, non-paternity families are barely recognized and unwed mothers are faced with numerous prejudices in their life. Prejudice to unwed mothers in Korea is believed to stem from social discourses against lone motherhood which is the way how people look and talk about unwed mothers and from the early time these social discourses have big impacts on their daily lives. However, after the 1990s, along with the rapid transformation of family pattern and support from social welfare organizations, unwed mothers have gradually got to escape from the social prejudice then established themselves as a new family form. This study is aimed at researching social discourses on lone motherhood in Korea and the process of resistance, adaptation and negotiation of unwed mothers in three different stages: the antenatal, postnatal stages and social inclusion. The anthropological method is employed. Twenty single young mothers of the Korean Unwed Mothers Families' Association were engaged in the author’s detailed interviews. The study’s frame analysis is based on the theoretical framework on social discourses on lone motherhood by Simon Duncan and Rosalind Edwards (1999). This study is an effort to comprehend and investigate the difficulties experienced by unwed mothers living in negative social discourses and the way they overcome the difficulties.

Keywords: unwed mothers, gender, social discourses, social prejudice, Confucianism

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Authors: Nirav Vaghela, Sanket Parekh

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Objective: Musculoskeletal disorders (MSD) represent one of the most common and important occupational health problems in working populations, being responsible for a substantial impact on quality of life and incurring a major economic burden in compensation cost and lost wages. School teachers represent an occupational group among which there appears to be a high prevalence of MSD. Design: Three hundred and fourteen teachers were enrolled in this study. Teachers were interview with the Modified Nordic Questionnaire. Result: In current study total 314 participants have been recruited in that minimum age of participants is 22 and maximum age is 59 with mean 40.5± 9.88. Total prevalence of the MSD is 71.95% among the teachers. In that Female were more affected with 72% than the males with 28%. Conclusion: The teachers here in reported a high prevalence of musculoskeletal pain in the shoulder, knee and back.

Keywords: repetitive stress injury, pain, occupational hazards, disability, abneetism, physical health, quality of life

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Authors: Indunil Jayatilake, Warna Karunasena, Weena Lokuge

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An Australian manufacturer has fabricated an innovative GFRP sandwich panel made from E-glass fiber skin and a modified phenolic core for structural applications. Debonding, which refers to separation of skin from the core material in composite sandwiches, is one of the most common types of damage in composites. The presence of debonding is of great concern because it not only severely affects the stiffness but also modifies the dynamic behaviour of the structure. Generally, it is seen that the majority of research carried out has been concerned about the delamination of laminated structures whereas skin-core debonding has received relatively minor attention. Furthermore, it is observed that research done on composite slabs having multiple skin-core debonding is very limited. To address this gap, a comprehensive research investigating dynamic behaviour of composite panels with single and multiple debonding is presented. The study uses finite-element modelling and analyses for investigating the influence of debonding on free vibration behaviour of single and multilayer composite sandwich panels. A broad parametric investigation has been carried out by varying debonding locations, debonding sizes and support conditions of the panels in view of both single and multiple debonding. Numerical models were developed with Strand7 finite element package by innovatively selecting the suitable elements to diligently represent their actual behavior. Three-dimensional finite element models were employed to simulate the physically real situation as close as possible, with the use of an experimentally and numerically validated finite element model. Comparative results and conclusions based on the analyses are presented. For similar extents and locations of debonding, the effect of debonding on natural frequencies appears greatly dependent on the end conditions of the panel, giving greater decrease in natural frequency when the panels are more restrained. Some modes are more sensitive to debonding and this sensitivity seems to be related to their vibration mode shapes. The fundamental mode seems generally the least sensitive mode to debonding with respect to the variation in free vibration characteristics. The results indicate the effectiveness of the developed three-dimensional finite element models in assessing debonding damage in composite sandwich panels

Keywords: debonding, free vibration behaviour, GFRP sandwich panels, three dimensional finite element modelling

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Authors: Vladimir Littva, Peter Kutis

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Based on common practice, we know that an empathic approach to a patient is one of the characteristics of a physiotherapist. Although empathy is regarded as an essential condition of the psychotherapeutic relationship, it has taken quite a while for attention to be paid to it in clinical practice. Patients who are experiencing a sense of understanding from health care providers are more willing to cooperate, and treatment within the optimistic attunes a more comfortable framework of care. Age, experience, family, education and the working environment may have an impact on the degree of empathy for paramedics. Within the KEGA project no. 003KU-4-2021, we decided to investigate the level of empathy in the work of physiotherapists in Slovakia. Research sample and Methods: The sample comprised 194 respondents – physiotherapists working on the territory of Slovakia. 112 were men and 82 women. The age of respondents was between 21 and 64 years of age. 133 were married, 51 were single and ten were divorced. 98 were living in the countryside and 96 in towns. Twenty-two grew up without siblings, 95 with one sibling and 77 with two and more siblings. In the survey, we used the Empathy Assessment Questionnaire (EAQ) with 18 questions with four possible answers: strongly disagree, disagree, agree; and strongly agree, which we validated linguistically and psychometrically. All data were statistically processed by SPSS 25. Results: We evaluated the intrinsic reliability of the questionnaire EAQ using Cronbach's Alpha and the coefficient is 0.756 in the whole set. This means that the questionnaire is a quite strong and reliable measurement tool. The mean for individual questions ranged from 2.39 to 3.74 (maximum was 4). In Pearson's correlations, we confirmed the significant differences between the groups regarding sex in 8 questions out of 18, regarding age in 5 questions, regarding family status in 4 questions and regarding siblings in 4 questions out of 18 at the level 5% (p <0.05). Conclusion: The results obtained during the research show the importance of adequate communication with the patient due to his health and well-being. Empathy in the physiotherapists’ profession is very important. It would be worthwhile if the students of physiotherapy would receive a course during their study that would deal exclusively with empathy, empathic approach, burnout, or psycho-emotional hygiene.

Keywords: empathy, approach, clinical practice, physiotherapists

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Authors: Yagmur Soylu, Emir Ozeren, Erol Esen, Digdem M. Siyez, Ozlem Belkis, Ezgi Burc, Gülce Demirgurz

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The aim of the study is to determine the predictive power of personal growth initiative, socio-demographic variables (such as sex, grade, and working condition) on career adaptability and optimism of bachelor students in Dokuz Eylul University in Turkey. According to career construction theory, career adaptability is viewed as a psychosocial construct, which refers to an individual’s resources for dealing with current and expected tasks, transitions and traumas in their occupational roles. Career optimism is defined as positive results for future career development of individuals in the expectation that it will achieve or to put the emphasis on the positive aspects of the event and feel comfortable about the career planning process. Personal Growth Initiative (PGI) is defined as being proactive about one’s personal development. Additionally, personal growth is defined as the active and intentional engagement in the process of personal. A study conducted on college students revealed that individuals with high self-development orientation make more effort to discover the requirements of the profession and workspaces than individuals with low levels of personal development orientation. University life is a period that social relations and the importance of academic activities are increased, the students make efforts to progress through their career paths and it is also an environment that offers opportunities to students for their self-realization. For these reasons, personal growth initiative is potentially an important variable which has a key role for an individual during the transition phase from university to the working life. Based on the review of the literature, it is expected that individual’s personal growth initiative, sex, grade, and working condition would significantly predict one’s career adaptability. In the relevant literature, it can be seen that there are relatively few studies available on the career adaptability and optimism of university students. Most of the existing studies have been carried out with limited respondents. In this study, the authors aim to conduct a comprehensive research with a large representative sample of bachelor students in Dokuz Eylul University, Izmir, Turkey. By now, personal growth initiative and career development constructs have been predominantly discussed in western contexts where individualistic tendencies are likely to be seen. Thus, the examination of the same relationship within the context of Turkey where collectivistic cultural characteristics can be more observed is expected to offer valuable insights and provide an important contribution to the literature. The participants in this study were comprised of 1500 undergraduate students being included from thirteen faculties in Dokuz Eylul University. Stratified and random sampling methods were adopted for the selection of the participants. The Personal Growth Initiative Scale-II and Career Futures Inventory were used as the major measurement tools. In data analysis stage, several statistical analysis concerning the regression analysis, one-way ANOVA and t-test will be conducted to reveal the relationships of the constructs under investigation. At the end of this project, we will be able to determine the level of career adaptability and optimism of university students at varying degrees so that a fertile ground is likely to be created to carry out several intervention techniques to make a contribution to an emergence of a healthier and more productive youth generation in psycho-social sense.

Keywords: career optimism, career adaptability, personal growth initiative, university students

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Authors: Sinead Impey, Gaye Stephens, Lucy Hederman, Declan O'Sullivan

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Continued paper use in the clinical area post-Electronic Health Record (EHR) adoption is regularly linked to hardware and software usability challenges. Although paper is used as a workaround to circumvent challenges, including limited availability of a computer, this perspective does not consider the important role paper, such as the nurses’ handover sheet, play in practice. The purpose of this study is to confirm the hypothesis that paper use post-EHR adoption continues as paper provides both a cognitive tool (that assists with workflow) and a compensation tool (to circumvent usability challenges). Distinguishing the different motivations for continued paper-use could assist future evaluations of electronic record systems. Methods: Qualitative data were collected from three clinical care environments (ICU, general ward and specialist day-care) who used an electronic record for at least 12 months. Data were collected through semi-structured interviews with 22 nurses. Data were transcribed, themes extracted using an inductive bottom-up coding approach and a thematic index constructed. Findings: All nurses interviewed continued to use paper post-EHR adoption. While two distinct motivations for paper use post-EHR adoption were confirmed by the data - paper as a cognitive tool and paper as a compensation tool - further finding was that there was an overlap between the two uses. That is, paper used as a compensation tool could also be adapted to function as a cognitive aid due to its nature (easy to access and annotate) or vice versa. Rather than present paper persistence as having two distinctive motivations, it is more useful to describe it as presenting on a continuum with compensation tool and cognitive tool at either pole. Paper as a cognitive tool referred to pages such as nurses’ handover sheet. These did not form part of the patient’s record, although information could be transcribed from one to the other. Findings suggest that although the patient record was digitised, handover sheets did not fall within this remit. These personal pages continued to be useful post-EHR adoption for capturing personal notes or patient information and so continued to be incorporated into the nurses’ work. Comparatively, the paper used as a compensation tool, such as pre-printed care plans which were stored in the patient's record, appears to have been instigated in reaction to usability challenges. In these instances, it is expected that paper use could reduce or cease when the underlying problem is addressed. There is a danger that as paper affords nurses a temporary information platform that is mobile, easy to access and annotate, its use could become embedded in clinical practice. Conclusion: Paper presents a utility to nursing, either as a cognitive or compensation tool or combination of both. By fully understanding its utility and nuances, organisations can avoid evaluating all incidences of paper use (post-EHR adoption) as arising from usability challenges. Instead, suitable remedies for paper-persistence can be targeted at the root cause.

Keywords: cognitive tool, compensation tool, electronic record, handover sheet, nurse, paper persistence

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Authors: Abdelkadir Elhaouari

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The priciest thing in human life since his birth is his freedom, basing on this idea, the conflict exists till now, the fight against oppression, injustice, tyranny and slavery, searching for freedom and political resistances, and this makes the freedom is deeply related to the defense for its existence all over years. This project attempts using any way to preserve this freedom, and building and maintaining bases and rules to organize this life. Appeal is a one of the most important method that human uses to protect his freedom, and we will mention in this thesis our attempt to clarify this aspect to the individual. We can say that the law does not know just one color or one logic, and is not based on one rule to be taken by heart, but the law is neutrality, the diversity, abstraction and diligence diversity. The penal law is a valued law and it deserves to be studied and searched more… so that to attempt to master it. Our thesis is just a brief explanation of an important point in this law, where we attempt to clarify and simplify the image to the normal person, so that he can preserve his rights, and we hope that we had succeeded to choose the right topic for that.

Keywords: appeal, penalization, judgement, criminal

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Authors: Mohammad Arifur Rahman

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The research study aims to bring to light the contribution of sir Sayeed Ahmed in the realm of education and literature. Sir Sayeed Ahmed Khan (1817 –1898), commonly known as Sir Sayeed, was an Indian Muslim leader, Islamic modernist, philosopher and social reformer of the nineteenth century. He earned a reputation as a distinguished scholar while working as a jurist for British India. During the Indian Rebellion of 1857, he remained loyal to the British Empire and was noted for his actions in saving European lives. Believing that the future of Muslims was threatened by the rigidity of their orthodox outlook, Sir Sayeed began promoting Western–style scientific education by founding modern schools and journals and organizing Muslim entrepreneurs. He was one of the founders of the Aligarh Movement and Aligarh Muslim University. He began focusing on writing, from his early life, on various subjects, mainly educational issues. He launched his attempts to revive the spirit of progress within the Muslim community of India. Therefore, modern education became the pivot of his movement for the regeneration of the Indian Muslims. Sayeed Ahmed Khan found time for literary and scholarly pursuits. The range of his literary and scholarly interests was very wide, comprising all the major areas: education, law, philosophy, history, politics, archeology, journalism, Muslim modernism, literature, science and culture, mainly based on his comprehensive religious ideas should be well measured in view to making out him and his contribution to the context. The books written by himself and the books composed by him by some of the great writers like Altaf Hussein Hali, Hafee z Malick, Nasim Rashid, and Christian W. Troll were studied to understand him and his contribution. The readers of this paper would benefit from dispelling the hazy ideas about this great man of India who made an immense contribution. Further research should be undertaken to know more about the different sides of his thought and personality. The qualitative and the historical methods are adopted for the accomplishment of the work.

Keywords: thinker, reformer, educator and Philosopher, modernist

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Authors: Kostandinos Katsamangas, Fawad Inam

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Graphene was dispersed using a tip sonicator and the effect of surfactants were analysed. Sodium Dodecyl Sulphate (SDS) and Polyvinyl Alcohol (PVA) were compared to observe whether or not they had any effect on any de-wrinkling, and secondly whether they aided to achieve better dispersions. There is a huge demand for wrinkle free graphene as this will greatly increase its usefulness in various engineering applications. A comprehensive literature on de-wrinkling graphene has been discussed. Low magnification Scanning Electronic Microscopy (SEM) was conducted to assess the quality of graphene de-wrinkling. The utilization of the PVA has a significant effect on de-wrinkling whereas SDS had minimal effect on the de-wrinkling of graphene.

Keywords: Graphene, de-wrinkling, dispersion, surfactants, scanning electronic microscopy

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Authors: Hardisiswo Soedjana, Inne Caroline

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Deep dermal or full thickness burns are inevitably lead to post-burn contractures. These contractures remain to be one of the most concerning late complications of burn injuries. Surgical management includes releasing the contracture followed by resurfacing the defect accompanied by post-operative rehabilitation. Optimal treatment of post-burn contractures depends on the characteristics of the contractures. This study is aimed to describe clinical characteristics, problems, and management of post-burn contractures in adults and children. A retrospective analysis was conducted from medical records of patients suffered from contractures after burn injuries admitted to Hasan Sadikin general hospital between January 2016 and January 2018. A total of 50 patients with post burn contractures were included in the study. There were 17 adults and 33 children. Most patients were male, whose age range within 15-59 years old and 5-9 years old. Educational background was mostly senior high school among adults, while there was only one third of children who have entered school. Etiology of burns was predominantly flame in adults (82.3%); whereas flame and scald were the leading cause of burn injury in children (11%). Based on anatomical regions, hands were the most common affected both in adults (35.2%) and children (48.5%). Contractures were identified in 6-12 months since the initial burns. Most post-burn hand contractures were resurfaced with full-thickness skin graft (FTSG) both in adults and children. There were 11 patients who presented with recurrent contracture after previous history of contracture release. Post-operative rehabilitation was conducted for all patients; however, it is important to highlight that it is still challenging to control splinting and exercise when patients are discharged and especially the compliance in children. In order to improve quality of life in patients with history of deep burn injuries, prevention of contractures should begin right after acute care has been established. Education for the importance of splinting and exercise should be administered as comprehensible as possible for adult patients and parents of pediatric patients.

Keywords: burn, contracture, education, exercise, splinting

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Authors: Kazumoto Tanaka, Takayuki Fujino

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Sports games conducted as a group are a form of therapeutic exercise for aged people with decreased strength and for people suffering from permanent damage of stroke and other conditions. However, it is difficult for patients with different athletic abilities to play a game on an equal footing. This study specifically examines a computer video game designed for therapeutic exercise, and a game system with support given depending on athletic ability. Thereby, anyone playing the game can participate equally. This video-game, to be specific, is a popular variant of balloon volleyball, in which players hit a balloon by hand before it falls to the floor. In this game system, each player plays the game watching a monitor on which the system displays tailor-made video-game images adjusted to the person’s athletic ability, providing players with player-adaptive assist support. We have developed a multiplayer game system with an image generation technique for the tailor-made video-game and conducted tests to evaluate it.

Keywords: therapeutic exercise, computer video game, disability-adaptive assist, tailor-made video-game image

Procedia PDF Downloads 561