Search results for: hospital industry
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7392

Search results for: hospital industry

1722 Synthesis and Characterization of Some Novel Carbazole Schiff Bases (OLED)

Authors: Baki Cicek, Umit Calisir

Abstract:

Carbazoles have been replaced lots of studies from 1960's to present and also still continues. In 1987, the first diode device had been developed. Thanks to that study, light emitting devices have been investigated and developed and also have been used on commercial applications. Nowadays, OLED (Organic Light Emitting Diodes) technology is using on lots of electronic screen such as (mobile phone, computer monitors, televisions, etc.) Carbazoles were subject a lot of study as a semiconductor material. Although this technology is used commen and widely, it is still development stage. Metal complexes of these compounds are using at pigment dyes because of colored substances, polymer technology, medicine industry, agriculture area, preparing rocket fuel-oil, determine some of biological events, etc. Becides all of these to preparing of schiff base synthesis is going on intensely. In this study, some of novel carbazole schiff bases were synthesized starting from carbazole. For that purpose, firstly, carbazole was alkylated. After purification of N-substituted-carbazole was nitrated to sythesized 3-nitro-N-substituted and 3,6-dinitro-N-substituted carbazoles. At next step, nitro group/groups were reduced to amines. Purified with using a type of silica gel-column chromatography. At the last step of our study, with sythesized 3,6-diamino-N-substituted carbazoles and 3-amino-N-substituted carbazoles were reacted with aldehydes to condensation reactions. 3-(imino-p-hydroxybenzyl)-N-isobutyl -carbazole, 3-(imino-2,3,4-trimethoxybenzene)-N-butylcarbazole, 3-(imino-3,4-dihydroxybenzene)-N-octylcarbazole, 3-(imino-2,3-dihydroxybenzene)-N-octylkarbazole and 3,6-di(α-imino-β-naphthol) -N-hexylcarbazole compounds were synthesized. All of synthesized compounds were characterized with FT-IR, 1H-NMR, 13C-NMR, and LC-MS.

Keywords: carbazole, carbazol schiff base, condensation reactions, OLED

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1721 Digital Platform for Psychological Assessment Supported by Sensors and Efficiency Algorithms

Authors: Francisco M. Silva

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Technology is evolving, creating an impact on our everyday lives and the telehealth industry. Telehealth encapsulates the provision of healthcare services and information via a technological approach. There are several benefits of using web-based methods to provide healthcare help. Nonetheless, few health and psychological help approaches combine this method with wearable sensors. This paper aims to create an online platform for users to receive self-care help and information using wearable sensors. In addition, researchers developing a similar project obtain a solid foundation as a reference. This study provides descriptions and analyses of the software and hardware architecture. Exhibits and explains a heart rate dynamic and efficient algorithm that continuously calculates the desired sensors' values. Presents diagrams that illustrate the website deployment process and the webserver means of handling the sensors' data. The goal is to create a working project using Arduino compatible hardware. Heart rate sensors send their data values to an online platform. A microcontroller board uses an algorithm to calculate the sensor heart rate values and outputs it to a web server. The platform visualizes the sensor's data, summarizes it in a report, and creates alerts for the user. Results showed a solid project structure and communication from the hardware and software. The web server displays the conveyed heart rate sensor's data on the online platform, presenting observations and evaluations.

Keywords: Arduino, heart rate BPM, microcontroller board, telehealth, wearable sensors, web-based healthcare

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1720 The Effect of Socio-Affective Variables in the Relationship between Organizational Trust and Employee Turnover Intention

Authors: Paula A. Cruise, Carvell McLeary

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Employee turnover leads to lowered productivity, decreased morale and work quality, and psychological effects associated with employee separation and replacement. Yet, it remains unknown why talented employees willingly withdraw from organizations. This uncertainty is worsened as studies; a) priorities organizational over individual predictors resulting in restriction in range in turnover measurement; b) focus on actual rather than intended turnover thereby limiting conceptual understanding of the turnover construct and its relationship with other variables and; c) produce inconsistent findings across cultures, contexts and industries despite a clear need for a unified perspective. The current study addressed these gaps by adopting the theory of planned behavior (TPB) framework to examine socio-cognitive factors in organizational trust and individual turnover intentions among bankers and energy employees in Jamaica. In a comparative study of n=369 [nbank= 264; male=57 (22.73%); nenergy =105; male =45 (42.86)], it was hypothesized that organizational trust was a predictor of employee turnover intention, and the effect of individual, group, cognitive and socio-affective variables varied across industry. Findings from structural equation modelling confirmed the hypothesis, with a model of both cognitive and socio-affective variables being a better fit [CMIN (χ2) = 800.067, df = 364, p ≤ .000; CFI = 0.950; RMSEA = 0.057 with 90% C.I. (0.052 - 0.062); PCLOSE = 0.016; PNFI = 0.818 in predicting turnover intention. The findings are discussed in relation to socio-cognitive components of trust models and predicting negative employee behaviors across cultures and industries.

Keywords: context-specific organizational trust, cross-cultural psychology, theory of planned behavior, employee turnover intention

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1719 Contribution of Income Diversification to Total Rural Households Income in the Upper East Region, Ghana

Authors: Yakubu Abdulai, Kenichi Matsui

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The agricultural industry has faced a variety of challenges in meeting the expanding income demand of the rural population. As a result, rural households must diversify their income sources to meet their income demand. Although income diversification strategies help rural households, it contributes to total household income, and the socio-demographic determinants are not known in the Upper East Region of Ghana. For these reasons, the purpose of this study was to determine the contribution of income diversification strategies to household income and the socio-demographic factors influencing it. We conducted a questionnaire survey among 360 rural households in the Upper East Region of Ghana. We asked about their socio-demographic information, their choice of income diversification strategies, and their remittances through rural-city migration. The questionnaire survey findings demonstrate that the main livelihood income source contributes 22%, and on-farm income diversification contributes the most to household total income (47%), followed by non-farm diversification income (16%) and off-farm diversification income (15%). Calculations from the income diversity index showed that the average income diversification strategy was 0.5 out of 1. The calculation of the income dependence index also showed that the average dependent on a particular source of income was 0.2 out of 1. All the respondents said household members temporarily migrate to contribute to household income through remittances. The results further reveal that their choice of income diversification is influenced by their age, educational background, experience, and farm size. The paper recommends the promotion of rural development policies that increase income-generating activities and educate rural households on how to increase returns from their investment.

Keywords: income diversification, poverty alleviation, rural households, upper east region

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1718 Pregnancy Rate and Outcomes after Uterine Fibroid Embolization Single Centre Experience in the Middle East from the United Arab Emirates at Alain Hospital

Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi

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Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.

Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery

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1717 ‘Undressed Star’, Sexual Scenes and Discourses in Mass Media: Exploring 1980s Taiwan Female Film Stars’ Onscreen Erotic Acting

Authors: Xinchen Zhu

Abstract:

In the history of Chinese-language film, female stars’ acting is connected with issues of national ideology, consumerism, and sexual politics. In the 1980s, Taiwan entered a period of ‘soft authoritarianism’ in which the economy prospered politics became more democratic, and mass culture became more diverse. Film censorship was more flexible and sexual scenes were increasingly shown on screen. Female stars’ bodies were eroticized and commercialized through sexual and nude scenes and, by challenging conservative film censorship and social taboos, became the focus of mass media. This article will explore how discourses in mass media constructed the erotic images of female stars and, conversely, impacted film censorship, filmmakers and film actresses in 1980s’ Taiwan. This article will regard the eroticized female film stars’ acting as a ‘field’ of internal interaction and continuous reproduction, where the ideology of male dominance and voices of female film stars conflict with each other. Based on textual analysis of female stars’ sexual acting and the debate in mass media, the argument is that the eroticized female bodies were gazed upon on and off the screen. In the discourses of mass media, the artistry of actresses’ erotic acting was not only ignored, devalued and delegitimized, these stars were also labelled as ‘undressed star’ or ‘nude star’ and construed as victims of the film industry. However, the female stars were able to speak through mass media platforms, emphasizing their efforts in erotic acting and highlighting modern female subjectivity.

Keywords: sexual scenes, Taiwan female stars, erotic acting, discourses in mass media, female subjectivity

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1716 Impact of Reverse Technology Transfer on Innovation Capabilities: An Econometric Analysis for Mexican Transnational Corporations

Authors: Lissette Alejandra Lara, Mario Gomez, Jose Carlos Rodriguez

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ransnational corporations (TNCs) as units in which it is possible technology and knowledge transfer across borders and the potential for generating innovation and contributing in economic development both in home and host countries have been widely acknowledged in the foreign direct investment (FDI) literature. Particularly, the accelerated expansion of emerging countries TNCs in the last decades has guided an uprising research stream that measure the presence of reverse technology transfer, defined as the extent to which emerging countries’ TNCs use outward FDI in a host country through certain mechanisms to absorb and transfer knowledge thus improving its technological capabilities in the home country. The objective of this paper is to test empirically the presence of reverse technology transfer and its impact on the innovation capabilities in Mexican transnational corporations (MXTNCs) as a part of the emerging countries TNCs that have successfully entered to industrialized markets. Using a panel dataset of 22 MXTNCs over the period 1994-2015, the results of the econometric model demonstrate that the amount of Mexican outward FDI and the research and development (R&D) expenditure in host developed countries had a positive impact on the innovation capabilities at the firm and industry level. There is also evidence that management of acquired brands and the organizational structure of Mexican subsidiaries improved these capabilities. Implications for internationalization strategies of emerging countries corporations and future research guidelines are discussed.

Keywords: emerging countries, foreign direct investment, innovation capabilities, Mexican transnational corporations, reverse technology transfer

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1715 Exploring the Cross-Cultural Practice of Transnational Community in Taiwan

Authors: Ya-Hsuan Wang

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This project of intercultural education aimed to explore pluricultural people’s interpretation and evaluation of the transnational community in Taiwan. Based on transnationalism and transculturalism, this study concerns the human right issues for immigrants and pluricultural people. Research participants as immigrants in Taiwan were asked about their typical thinking styles in the transnational community, their cultural integration in terms of transnational behaviors, and their collective memory of the transnational community. Interview questions included what key factors were involved in their identity negotiation, what roles the transnational community and collective memory would be for their identity negotiation and what were the positive or negative aspects impacting cross-border identity. Based on the experiences of pluricultural people and transnational communities, this project expected to enhance the depth and width of developing transcultural knowledge in textbook reform on History in K-12 schools. It is to transform cross-border identity into knowledge embedded with local culture in response to globalization and localization. The purpose of this paper is to portrait the cross-cultural practice of transnational community for Taiwan’s immigrants. It is to report their external socio-cultural expectation of ethnic economics, to understand their internal life course of national identity, and to clarify transnational community in relation to their cross-border identity. In conclusion, the cross-cultural practice of transnational community combined the external contexts such as ethnic economic interaction among transnational communities, social report and ethnic industry, and the internal contexts such as ethnic identity, language use, and collective memory in ethnic history.

Keywords: cross-cultural practice, immigrants, pluricultural people, transnational community

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1714 The Impact of Technology on Media Content Regulation

Authors: Eugene Mashapa

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The age of information has witnessed countless unprecedented technological developments, which signal the articulation of succinct technological capabilities that can match these cutting-edge technological trends. These changes have impacted patterns in the production, distribution, and consumption of media content, a space that the Film and Publication Board (FPB) is concerned with. Consequently, the FPB is keen to understand the nature and impact of these technological changes on media content regulation. This exploratory study sought to investigate how content regulators in high and middle-income economies have adapted to the changes in this space, seeking insights into innovations, technological and operational, that facilitate continued relevance during this fast-changing environment. The study is aimed at developing recommendations that could assist and inform the organisation in regulating media content as it evolves. Thus, the overall research strategy in this analysis is applied research, and the analytical model adopted is a mixed research design guided by both qualitative and quantitative research instruments. It was revealed in the study that the FPB was significantly impacted by the unprecedented technological advancements in the media regulation space. Additionally, there exists a need for the FPB to understand the current and future penetrations of 4IR technology in the industry and its impact on media governance and policy implementation. This will range from reskilling officials to align with the technological skills to developing technological innovations as well as adopting co-regulatory or self-regulatory arrangements together with content distributors, where more content is distributed in higher volumes and with increased frequency. Importantly, initiating an interactive learning process for both FPB employees and the general public can assist the regulator and improve FPB’s operational efficiency and effectiveness.

Keywords: media, regulation, technology, film and publications board

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1713 Prediction of Coronary Artery Stenosis Severity Based on Machine Learning Algorithms

Authors: Yu-Jia Jian, Emily Chia-Yu Su, Hui-Ling Hsu, Jian-Jhih Chen

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Coronary artery is the major supplier of myocardial blood flow. When fat and cholesterol are deposit in the coronary arterial wall, narrowing and stenosis of the artery occurs, which may lead to myocardial ischemia and eventually infarction. According to the World Health Organization (WHO), estimated 740 million people have died of coronary heart disease in 2015. According to Statistics from Ministry of Health and Welfare in Taiwan, heart disease (except for hypertensive diseases) ranked the second among the top 10 causes of death from 2013 to 2016, and it still shows a growing trend. According to American Heart Association (AHA), the risk factors for coronary heart disease including: age (> 65 years), sex (men to women with 2:1 ratio), obesity, diabetes, hypertension, hyperlipidemia, smoking, family history, lack of exercise and more. We have collected a dataset of 421 patients from a hospital located in northern Taiwan who received coronary computed tomography (CT) angiography. There were 300 males (71.26%) and 121 females (28.74%), with age ranging from 24 to 92 years, and a mean age of 56.3 years. Prior to coronary CT angiography, basic data of the patients, including age, gender, obesity index (BMI), diastolic blood pressure, systolic blood pressure, diabetes, hypertension, hyperlipidemia, smoking, family history of coronary heart disease and exercise habits, were collected and used as input variables. The output variable of the prediction module is the degree of coronary artery stenosis. The output variable of the prediction module is the narrow constriction of the coronary artery. In this study, the dataset was randomly divided into 80% as training set and 20% as test set. Four machine learning algorithms, including logistic regression, stepwise regression, neural network and decision tree, were incorporated to generate prediction results. We used area under curve (AUC) / accuracy (Acc.) to compare the four models, the best model is neural network, followed by stepwise logistic regression, decision tree, and logistic regression, with 0.68 / 79 %, 0.68 / 74%, 0.65 / 78%, and 0.65 / 74%, respectively. Sensitivity of neural network was 27.3%, specificity was 90.8%, stepwise Logistic regression sensitivity was 18.2%, specificity was 92.3%, decision tree sensitivity was 13.6%, specificity was 100%, logistic regression sensitivity was 27.3%, specificity 89.2%. From the result of this study, we hope to improve the accuracy by improving the module parameters or other methods in the future and we hope to solve the problem of low sensitivity by adjusting the imbalanced proportion of positive and negative data.

Keywords: decision support, computed tomography, coronary artery, machine learning

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1712 The Impact of a Sustainable Solar Heating System on the Growth of ‎Strawberry Plants in an Agricultural Greenhouse

Authors: Ilham Ihoume, Rachid Tadili, Nora Arbaoui

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The use of solar energy is a crucial tactic in the agricultural industry's plan ‎‎to decrease greenhouse gas emissions. This clean source of energy can ‎greatly lower the sector's carbon footprint and make a significant impact in ‎the ‎fight against climate change. In this regard, this study examines the ‎effects ‎of a solar-based heating system, in a north-south oriented agricultural ‎green‎house on the development of strawberry plants during winter. This ‎system ‎relies on the circulation of water as a heat transfer fluid in a closed ‎circuit ‎installed on the greenhouse roof to store heat during the day and ‎release it ‎inside at night. A comparative experimental study was conducted ‎in two ‎greenhouses, one experimental with the solar heating system and the ‎other ‎for control without any heating system. Both greenhouses are located ‎on the ‎terrace of the Solar Energy and Environment Laboratory of the ‎Mohammed ‎V University in Rabat, Morocco. The developed heating system ‎consists of a ‎copper coil inserted in double glazing and placed on the roof of ‎the greenhouse, a water pump circulator, a battery, and a photovoltaic solar ‎panel to ‎power the electrical components. This inexpensive and ‎environmentally ‎friendly system allows the greenhouse to be heated during ‎the winter and ‎improves its microclimate system. This improvement resulted ‎in an increase ‎in the air temperature inside the experimental greenhouse by 6 ‎‎°C and 8 °C, ‎and a reduction in its relative humidity by 23% and 35% ‎compared to the ‎control greenhouse and the ambient air, respectively, ‎throughout the winter. ‎For the agronomic performance, it was observed that ‎the production was 17 ‎days earlier than in the control greenhouse‎.‎

Keywords: sustainability, thermal energy storage, solar energy, agriculture greenhouse

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1711 Analyzing the Effect of Materials’ Selection on Energy Saving and Carbon Footprint: A Case Study Simulation of Concrete Structure Building

Authors: M. Kouhirostamkolaei, M. Kouhirostami, M. Sam, J. Woo, A. T. Asutosh, J. Li, C. Kibert

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Construction is one of the most energy consumed activities in the urban environment that results in a significant amount of greenhouse gas emissions around the world. Thus, the impact of the construction industry on global warming is undeniable. Thus, reducing building energy consumption and mitigating carbon production can slow the rate of global warming. The purpose of this study is to determine the amount of energy consumption and carbon dioxide production during the operation phase and the impact of using new shells on energy saving and carbon footprint. Therefore, a residential building with a re-enforced concrete structure is selected in Babolsar, Iran. DesignBuilder software has been used for one year of building operation to calculate the amount of carbon dioxide production and energy consumption in the operation phase of the building. The primary results show the building use 61750 kWh of energy each year. Computer simulation analyzes the effect of changing building shells -using XPS polystyrene and new electrochromic windows- as well as changing the type of lighting on energy consumption reduction and subsequent carbon dioxide production. The results show that the amount of energy and carbon production during building operation has been reduced by approximately 70% by applying the proposed changes. The changes reduce CO2e to 11345 kg CO2/yr. The result of this study helps designers and engineers to consider material selection’s process as one of the most important stages of design for improving energy performance of buildings.

Keywords: construction materials, green construction, energy simulation, carbon footprint, energy saving, concrete structure, designbuilder

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1710 Azadrachea indica Leaves Extract Assisted Green Synthesis of Ag-TiO₂ for Degradation of Dyes in Aqueous Medium

Authors: Muhammad Saeed, Sheeba Khalid

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Aqueous pollution due to the textile industry is an important issue. Photocatalysis using metal oxides as catalysts is one of the methods used for eradication of dyes from textile industrial effluents. In this study, the synthesis, characterization, and evaluation of photocatalytic activity of Ag-TiO₂ are reported. TiO₂ catalysts with 2, 4, 6 and 8% loading of Ag were prepared by green methods using Azadrachea indica leaves' extract as reducing agent and titanium dioxide and silver nitrate as precursor materials. The 4% Ag-TiO₂ exhibited the best catalytic activity for degradation of dyes. Prepared catalyst was characterized by advanced techniques. Catalytic degradation of methylene blue and rhodamine B were carried out in Pyrex glass batch reactor. Deposition of Ag greatly enhanced the catalytic efficiency of TiO₂ towards degradation of dyes. Irradiation of catalyst excites electrons from conduction band of catalyst to valence band yielding an electron-hole pair. These photoexcited electrons and positive hole undergo secondary reaction and produce OH radicals. These active radicals take part in the degradation of dyes. More than 90% of dyes were degraded in 120 minutes. It was found that there was no loss catalytic efficiency of prepared Ag-TiO₂ after recycling it for two times. Photocatalytic degradation of methylene blue and rhodamine B followed Eley-Rideal mechanism which states that dye reacts in fluid phase with adsorbed oxygen. 27 kJ/mol and 20 kJ/mol were found as activation energy for photodegradation of methylene blue and rhodamine B dye respectively.

Keywords: TiO₂, Ag-TiO₂, methylene blue, Rhodamine B., photo degradation

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1709 Risk Variables and Implications in Nigeria of Publicly Funded Construction Works Cessation

Authors: Nnadi Ezekiel Oluwaseun Ejiofor

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The foundation of this study is the identification of risk variables and their implications on abandoned construction projects in Nigeria. The study's particular goals are to pinpoint the risk factors that lead to the abandonment of public building projects in Nigeria. This study used a hybrid research design that included case studies and descriptive survey research methods. Professionals who work directly in the built environment and are employed by Ministries and Departmental Agencies (MDAs), the public sector, or the private sector are the study's target demographic. This study used a descriptive survey and case study research design to gather data. Nigeria is experiencing a high rate of project abandonment due to housing deficit issues. Factors contributing to this include The study reveals factors contributing to public project abandonment in Abuja FCT include poor cashflow 4.96, inconsistent government policies 4.89, lack of accountability, high corruption, incompetent contractors, non-availability of building materials, lack of utilities, wrong materials, infrastructural facilities, poor planning, and undefined contracts. The study reveals that abandoned projects have a huge impact on the construction industry, such as wastage of resources with a mean value of 3.35, distrust of economic growth, 3.28, and so on. The study found a significant relationship between risk factors and public building construction in Abuja through a T-test value of 0.037, rejecting the null hypothesis and indicating a positive correlation.

Keywords: cost, tetfund, construction projects, public university

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1708 Impact of Soci̇al Media in Tourism Marketing

Authors: Betül Garda

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Technological developments have diversified marketing activities of the tourism sector and it has increased tourism opportunities to compete on a global scale for tourism businesses. Tourism businesses have been forced to use its core skills and knowledge effectively with the increase in effectiveness of the technology in the global competitive environment. Tourism businesses have been reached beyond the traditional boundaries because of their commercial activities, so, the boundaries of the national market either eliminated or blurred. Therefore, the internet is the alternative promotion tool and distribution channel to providing unlimited facilities for tourism suppliers. For example, the internet provides an opportunity to reach customers on a global scale with direct email marketing, advertising, customer service, promotion, sales, and marketing. Tourism businesses have improved themselves with the continuous information flows and also they have provided the permanence of the changes. Especially in terms of tourism businesses, social media is emerging as an extremely important tool in the use of knowledge effectively. This research paper investigates the impact of social media on the tourism businesses. A social networking site is a type of social media that provides a platform for business and people to connect with each other. Social media is so flexible that it can be used for both leisure and business purposes. In the tourism industry, social networking sites are one of the essential tools that play an important and beneficial role. The topic that will be discussed in this research paper are consumer behavior, connection with consumers, effectiveness in terms of time and cost, creating brand awareness and building the image of the company, promoting company, targeting consumers in a conceptual frame.

Keywords: branding, promoting, social media in tourism, tourism marketing tools

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1707 Malnutrition Among Adult Hospitalized Orthopedic Patients: Nursing Role And Nutrition Screening

Authors: Ehsan Ahmed Yahia

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Introduction: The nursing role in nutrition screening and assessing hospitalized patients is important. Malnutrition is a common and costly problem, particularly among hospitalized patients, and can have an adverse effect on the healing process. The study's goal is to assess the prevalence of malnutrition among adult hospitalized orthopedic patients and to detect the barriers to the nutrition screening process. Aim of the study: This study aimed to (a) assess the prevalence of malnutrition in hospitalized orthopedic patients and (b) evaluate the relationship between malnutrition and selected clinical outcomes. Material and Methods: This prospective field study was conducted for three months between 03/2022 and 06/2022 in the selected orthopedic departments in a teaching hospital affiliated withCairo University, Egypt. with a total number of one hundred twenty (120) patients. Patients' assessment included checking for malnutrition using the Nutritional Risk Screening Questionnaire. Patients at risk for malnourishment were defined as NRS score ≥ 3. Clinical outcomes under consideration included 1) length of hospitalization, 2) mobilization after surgery and conservative treatment, and 3) rate of adverse events. Results: This study found that malnutrition is a significant problem among patients hospitalized in an orthopedic ward. The prevalence of malnutrition was the highest in patients with lumbar spine and pelvis fractures, followed by the proximal femur and proximal humerus fractures. Patients at risk for malnutrition had significantly prolonged hospitalization, delayed postoperative mobilization, and increased incidence of adverse events.27.8% of the study sample were at risk for malnutrition. The highest prevalence of malnourishment was found in Septic Surgery with 32%, followed by Traumatology with 19.6% and Arthroplasty with 15.3%. A higher prevalence of malnutrition was detected among patients with typical fractures, such as lumbar spine and pelvis (46.7%), proximal femur (34.4%), and proximal humeral (23.7%) fractures. Additionally, patients at risk for malnutrition showed prolonged hospitalization (14.7 ± 11.1 vs. 21.2 ± 11.7 days), delayed postoperative mobilization (2.3 ± 2.9 vs. 4.1 ± 4.9 days), and delayed to mobilize after conservative treatment (1.1 ± 2.7 vs. 1.8 ± 1.9 days). A significant statistical correlation of NRS with individual parameters (Spearman's rank correlation, p < 0.05) was observed. The rate of adverse incidents in patients at risk for malnutrition was significantly higher than that of patients with a regular nutritional status (37.2% vs. 21.1%, p < 0.001). Conclusions: Our results indicate that the prevalence of malnutrition in surgical patients is significant. The nutritional status of patients with typical fractures is especially at risk. Prolonged hospitalization, delayed postoperative mobilization, and delayed mobilization after conservative treatment is significantly associated with malnutrition. In addition, the incidence of adverse events in patients at risk for malnutrition is significantly higher.

Keywords: malnutrition, nutritional risk screening, surgery, nursing, orthopedic nurse

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1706 Avoiding Gas Hydrate Problems in Qatar Oil and Gas Industry: Environmentally Friendly Solvents for Gas Hydrate Inhibition

Authors: Nabila Mohamed, Santiago Aparicio, Bahman Tohidi, Mert Atilhan

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Qatar's one of the biggest problem in processing its natural resource, which is natural gas, is the often occurring blockage in the pipelines caused due to uncontrolled gas hydrate formation in the pipelines. Several millions of dollars are being spent at the process site to dehydrate the blockage safely by using chemical inhibitors. We aim to establish national database, which addresses the physical conditions that promotes Qatari natural gas to form gas hydrates in the pipelines. Moreover, we aim to design and test novel hydrate inhibitors that are suitable for Qatari natural gas and its processing facilities. From these perspectives we are aiming to provide more effective and sustainable reservoir utilization and processing of Qatari natural gas. In this work, we present the initial findings of a QNRF funded project, which deals with the natural gas hydrate formation characteristics of Qatari type gas in both experimental (PVTx) and computational (molecular simulations) methods. We present the data from the two fully automated apparatus: a gas hydrate autoclave and a rocking cell. Hydrate equilibrium curves including growth/dissociation conditions for multi-component systems for several gas mixtures that represent Qatari type natural gas with and without the presence of well known kinetic and thermodynamic hydrate inhibitors. Ionic liquids were designed and used for testing their inhibition performance and their DFT and molecular modeling simulation results were also obtained and compared with the experimental results. Results showed significant performance of ionic liquids with up to 0.5 % in volume with up to 2 to 4 0C inhibition at high pressures.

Keywords: gas hydrates, natural gas, ionic liquids, inhibition, thermodynamic inhibitors, kinetic inhibitors

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1705 Third Party Logistics (3PL) Selection Criteria for an Indian Heavy Industry Using SEM

Authors: Nadama Kumar, P. Parthiban, T. Niranjan

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In the present paper, we propose an incorporated approach for 3PL supplier choice that suits the distinctive strategic needs of the outsourcing organization in southern part of India. Four fundamental criteria have been used in particular Performance, IT, Service and Intangible. These are additionally subdivided into fifteen sub-criteria. The proposed strategy coordinates Structural Equation Modeling (SEM) and Non-additive Fuzzy Integral strategies. The presentation of fluffiness manages the unclearness of human judgments. The SEM approach has been used to approve the determination criteria for the proposed show though the Non-additive Fuzzy Integral approach uses the SEM display contribution to assess a supplier choice score. The case organization has a exclusive vertically integrated assembly that comprises of several companies focusing on a slight array of the value chain. To confirm manufacturing and logistics proficiency, it significantly relies on 3PL suppliers to attain supply chain superiority. However, 3PL supplier selection is an intricate decision-making procedure relating multiple selection criteria. The goal of this work is to recognize the crucial 3PL selection criteria by using the non-additive fuzzy integral approach. Unlike the outmoded multi criterion decision-making (MCDM) methods which frequently undertake independence among criteria and additive importance weights, the nonadditive fuzzy integral is an effective method to resolve the dependency among criteria, vague information, and vital fuzziness of human judgment. In this work, we validate an empirical case that engages the nonadditive fuzzy integral to assess the importance weight of selection criteria and indicate the most suitable 3PL supplier.

Keywords: 3PL, non-additive fuzzy integral approach, SEM, fuzzy

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1704 The Two Question Challenge: Embedding the Serious Illness Conversation in Acute Care Workflows

Authors: D. M. Lewis, L. Frisby, U. Stead

Abstract:

Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

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1703 Adding a Few Language-Level Constructs to Improve OOP Verifiability of Semantic Correctness

Authors: Lian Yang

Abstract:

Object-oriented programming (OOP) is the dominant programming paradigm in today’s software industry and it has literally enabled average software developers to develop millions of commercial strength software applications in the era of INTERNET revolution over the past three decades. On the other hand, the lack of strict mathematical model and domain constraint features at the language level has long perplexed the computer science academia and OOP engineering community. This situation resulted in inconsistent system qualities and hard-to-understand designs in some OOP projects. The difficulties with regards to fix the current situation are also well known. Although the power of OOP lies in its unbridled flexibility and enormously rich data modeling capability, we argue that the ambiguity and the implicit facade surrounding the conceptual model of a class and an object should be eliminated as much as possible. We listed the five major usage of class and propose to separate them by proposing new language constructs. By using well-established theories of set and FSM, we propose to apply certain simple, generic, and yet effective constraints at OOP language level in an attempt to find a possible solution to the above-mentioned issues regarding OOP. The goal is to make OOP more theoretically sound as well as to aid programmers uncover warning signs of irregularities and domain-specific issues in applications early on the development stage and catch semantic mistakes at runtime, improving correctness verifiability of software programs. On the other hand, the aim of this paper is more practical than theoretical.

Keywords: new language constructs, set theory, FSM theory, user defined value type, function groups, membership qualification attribute (MQA), check-constraint (CC)

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1702 Toxicological Validation during the Development of New Catalytic Systems Using Air/Liquid Interface Cell Exposure

Authors: M. Al Zallouha, Y. Landkocz, J. Brunet, R. Cousin, J. M. Halket, E. Genty, P. J. Martin, A. Verdin, D. Courcot, S. Siffert, P. Shirali, S. Billet

Abstract:

Toluene is one of the most used Volatile Organic Compounds (VOCs) in the industry. Amongst VOCs, Benzene, Toluene, Ethylbenzene and Xylenes (BTEX) emitted into the atmosphere have a major and direct impact on human health. It is, therefore, necessary to minimize emissions directly at source. Catalytic oxidation is an industrial technique which provides remediation efficiency in the treatment of these organic compounds. However, during operation, the catalysts can release some compounds, called byproducts, more toxic than the original VOCs. The catalytic oxidation of a gas stream containing 1000ppm of toluene on Pd/α-Al2O3 can release a few ppm of benzene, according to the operating temperature of the catalyst. The development of new catalysts must, therefore, include chemical and toxicological validation phases. In this project, A549 human lung cells were exposed in air/liquid interface (Vitrocell®) to gas mixtures derived from the oxidation of toluene with a catalyst of Pd/α-Al2O3. Both exposure concentrations (i.e. 10 and 100% of catalytic emission) resulted in increased gene expression of Xenobiotics Metabolising Enzymes (XME) (CYP2E1 CYP2S1, CYP1A1, CYP1B1, EPHX1, and NQO1). Some of these XMEs are known to be induced by polycyclic organic compounds conventionally not searched during the development of catalysts for VOCs degradation. The increase in gene expression suggests the presence of undetected compounds whose toxicity must be assessed before the adoption of new catalyst. This enhances the relevance of toxicological validation of such systems before scaling-up and marketing.

Keywords: BTEX toxicity, air/liquid interface cell exposure, Vitrocell®, catalytic oxidation

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1701 Investigating the Viability of Small-Scale Rapid Alloy Prototyping of Interstitial Free Steels

Authors: Talal S. Abdullah, Shahin Mehraban, Geraint Lodwig, Nicholas P. Lavery

Abstract:

The defining property of Interstitial Free (IF) steels is formability, comprehensively measured using the Lankford coefficient (r-value) on uniaxial tensile test data. The contributing factors supporting this feature are grain size, orientation, and elemental additions. The processes that effectively modulate these factors are the casting procedure, hot rolling, and heat treatment. An existing methodology is well-practised in the steel Industry; however, large-scale production and experimentation consume significant proportions of time, money, and material. Introducing small-scale rapid alloy prototyping (RAP) as an alternative process would considerably reduce the drawbacks relative to standard practices. The aim is to finetune the existing fundamental procedures implemented in the industrial plant to adapt to the RAP route. IF material is remelted in the 80-gram coil induction melting (CIM) glovebox. To birth small grains, maximum deformation must be induced onto the cast material during the hot rolling process. The rolled strip must then satisfy the polycrystalline behaviour of the bulk material by displaying a resemblance in microstructure, hardness, and formability to that of the literature and actual plant steel. A successful outcome of this work is that small-scale RAP can achieve target compositions with similar microstructures and statistically consistent mechanical properties which complements and accelerates the development of novel steel grades.

Keywords: rapid alloy prototyping, plastic anisotropy, interstitial free, miniaturised tensile testing, formability

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1700 Collaborative Platform for Learning Basic Programming (Algorinfo)

Authors: Edgar Mauricio Ruiz Osuna, Claudia Yaneth Herrera Bolivar, Sandra Liliana Gomez Vasquez

Abstract:

The increasing needs of professionals with skills in software development in industry are incremental, therefore, the relevance of an educational process in line with the strengthening of these competencies, are part of the responsibilities of universities with careers related to the area of Informatics and Systems. In this sense, it is important to consider that in the National Science, Technology and Innovation Plan for the development of the Electronics, Information Technologies and Communications (2013) sectors, it is established as a weakness in the SWOT Analysis of the Software sector and Services, Deficiencies in training and professional training. Accordingly, UNIMINUTO's Computer Technology Program has addressed the analysis of students' performance in software development, identifying various problems such as dropout in programming subjects, academic averages, as well as deficiencies in strategies and competencies developed in the area of programming. As a result of this analysis, it was determined to design a collaborative learning platform in basic programming using heat maps as a tool to support didactic feedback. The pilot phase allows to evaluate in a programming course the ALGORINFO platform as a didactic resource, through an interactive and collaborative environment where students can develop basic programming practices and in turn, are fed back through the analysis of time patterns and difficulties frequent in certain segments or program cycles, by means of heat maps. The result allows the teacher to have tools to reinforce and advise critical points generated on the map, so that students and graduates improve their skills as software developers.

Keywords: collaborative platform, learning, feedback, programming, heat maps

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1699 Can (E-)Mentoring Be a Tool for the Career of Future Translators?

Authors: Ana Sofia Saldanha

Abstract:

The answer is yes. Globalization is changing the translation world day after day, year after year. The need to know more about new technologies, clients, companies, project management and social networks is becoming more and more demanding and increasingly competitive. The great majority of the recently graduated Translators do not know where to go, what to do or even who to contact to start their careers in translation. It is well known that there are innumerous webinars, books, blogs and webpages with the so-called “tips do become a professional translator” indicating for example, what to do, what not to do, rates, how your resume should look like, etc. but are these pieces of advice coming from real translators? Translators who work daily with clients, who understand their demands, requests, questions? As far as today`s trends, the answer is no. Most of these pieces of advice are just theoretical and coming from “brilliant minds” who are more interested in spreading their word and winning “likes” to become, in some way, “important people in some area. Mentoring is, indeed, a highly important tool to help and guide new translators starting their career. An effective and well oriented Mentoring is a powerful way to orient these translators on how to create their resumes, where to send resumes, how to approach clients, how to answer emails and how to negotiate rates in an efficient way. Mentoring is a crucial tool and even some kind of “psychological trigger”, when properly delivered by professional and experienced translators, to help in the so aimed career development. The advice and orientation sessions which can bem 100% done online, using Skype for example, are almost a “weapon” to destroy the barriers created by opinions, by influences or even by universities. This new orientation trend is the future path for new translators and is the future of the Translation industry and professionals and Universities who must update their way of approaching the real translation world, therefore, minds and spirits need to be opened and engaged in this new trend of developing skills.

Keywords: mentoring, orientation, professional follow-up, translation

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1698 Factors That Contribute to Noise Induced Hearing Loss Amongst Employees at the Platinum Mine in Limpopo Province, South Africa

Authors: Livhuwani Muthelo, R. N. Malema, T. M. Mothiba

Abstract:

Long term exposure to excessive noise in the mining industry increases the risk of noise induced hearing loss, with consequences for employee’s health, productivity and the overall quality of life. Objective: The objective of this study was to investigate the factors that contribute to Noise Induced Hearing Loss amongst employees at the Platinum mine in the Limpopo Province, South Africa. Study method: A qualitative, phenomenological, exploratory, descriptive, contextual design was applied in order to explore and describe the contributory factors. Purposive non-probability sampling was used to select 10 male employees who were diagnosed with NIHL in the year 2014 in four mine shafts, and 10 managers who were involved in a Hearing Conservation Programme. The data were collected using semi-structured one-on-one interviews. A qualitative data analysis of Tesch’s approach was followed. Results: The following themes emerged: Experiences and challenges faced by employees in the work environment, hearing protective device factors and management and leadership factors. Hearing loss was caused by partial application of guidelines, policies, and procedures from the Department of Minerals and Energy. Conclusion: The study results indicate that although there are guidelines, policies, and procedures available, failure in the implementation of one element will affect the development and maintenance of employees hearing mechanism. It is recommended that the mine management should apply the guidelines, policies, and procedures and promptly repair the broken hearing protective devices.

Keywords: employees, factors, noise induced hearing loss, noise exposure

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1697 An Architectural Study on the Railway Station Buildings in Malaysia during British Era, 1885-1957

Authors: Nor Hafizah Anuar, M. Gul Akdeniz

Abstract:

This paper attempted on emphasize on the station buildings façade elements. Station buildings were essential part of the transportation that reflected the technology. Comparative analysis on architectural styles will also be made between the railway station buildings of Malaysia and any railway station buildings which have similarities. The Malay Peninsula which is strategically situated between the Straits of Malacca and the South China Sea makes it an ideal location for trade. Malacca became an important trading port whereby merchants from around the world stopover to exchange various products. The Portuguese ruled Malacca for 130 years (1511–1641) and for the next century and a half (1641–1824), the Dutch endeavoured to maintain an economic monopoly along the coasts of Malaya. Malacca came permanently under British rule under the Anglo-Dutch Treaty, 1824. Up to Malaysian independence in 1957, Malaya saw a great influx of Chinese and Indian migrants as workers to support its growing industrial needs facilitated by the British. The growing tin ore mining and rubber industry resulted as the reason of the development of the railways as urgency to transport it from one place to another. The existence of railway transportation becomes more significant when the city started to bloom and the British started to build grandeur buildings that have different functions; administrative buildings, town and city halls, railway stations, public works department, courts, and post offices.

Keywords: Malaysia, station building, architectural styles, facade elements

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1696 Different Feedings on Chemical Characteristics of Atlantic Salmon Fillet

Authors: Mahsa Jalili, Trude Johansen, Signe Dille Lovmo, Turid Rustad, Rolf Erik Olsen, Atle M. Bones

Abstract:

The quality of fish muscle is a key factor in fish industry, and dietary ingredients can influence fish quality. The aim of this study was to examine the impact of krill meal, soybean meal, Bactocell® and butyrate fortified feeds and control diet on characteristics of salmon fillet. Thirty Atlantic salmon (6 per each group) were farmed for 12 weeks. All the fish were killed and frozen immediately. The white muscle from top posterior part of dorsal fin was dissected to analyze fat content, carotenoid content, content of water-soluble and salt-soluble proteins, cathepsin B and cathepsin B-L activities. ANOVA test was used to analyze mean and standard error of mean values at 0.05 significance level. There were significant difference in cathepsin B activity, water-soluble proteins and salt-soluble proteins (p-value= 0.005, 0.009 and 0.002). The mean values of other factors were not significantly different among the groups. Cathepsin B activity was higher in soymeal group. Water-soluble proteins were reported higher in soy meal and krill groups and salt-soluble proteins were significantly higher in soy meal and butyrate rich diets. Although soy meal has proven effect on enteritis, it results in higher percentage of protein in fillets. On the other hand, this feeding may have role in textural deterioration of fillets owing to higher values of endogenous cathepsin B in soymeal group.

Keywords: aquaculture, food quality, Krill protein extract, prebiotics, probiotics, Salmo salar, soy

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1695 Diagnostic Delays and Treatment Dilemmas: A Case of Drug-Resistant HIV and Tuberculosis

Authors: Christi Jackson, Chuka Onaga

Abstract:

Introduction: We report a case of delayed diagnosis of extra-pulmonary INH-mono-resistant Tuberculosis (TB) in a South African patient with drug-resistant HIV. Case Presentation: A 36-year old male was initiated on 1st line (NNRTI-based) anti-retroviral therapy (ART) in September 2009 and switched to 2nd line (PI-based) ART in 2011, according to local guidelines. He was following up at the outpatient wellness unit of a public hospital, where he was diagnosed with Protease Inhibitor resistant HIV in March 2016. He had an HIV viral load (HIVVL) of 737000 copies/mL, CD4-count of 10 cells/µL and presented with complaints of productive cough, weight loss, chronic diarrhoea and a septic buttock wound. Several investigations were done on sputum, stool and pus samples but all were negative for TB. The patient was treated with antibiotics and the cough and the buttock wound improved. He was subsequently started on a 3rd-line ART regimen of Darunavir, Ritonavir, Etravirine, Raltegravir, Tenofovir and Emtricitabine in May 2016. He continued losing weight, became too weak to stand unsupported and started complaining of abdominal pain. Further investigations were done in September 2016, including a urine specimen for Line Probe Assay (LPA), which showed M. tuberculosis sensitive to Rifampicin but resistant to INH. A lymph node biopsy also showed histological confirmation of TB. Management and outcome: He was started on Rifabutin, Pyrazinamide and Ethambutol in September 2016, and Etravirine was discontinued. After 6 months on ART and 2 months on TB treatment, his HIVVL had dropped to 286 copies/mL, CD4 improved to 179 cells/µL and he showed clinical improvement. Pharmacy supply of his individualised drugs was unreliable and presented some challenges to continuity of treatment. He successfully completed his treatment in June 2017 while still maintaining virological suppression. Discussion: Several laboratory-related factors delayed the diagnosis of TB, including the unavailability of urine-lipoarabinomannan (LAM) and urine-GeneXpert (GXP) tests at this facility. Once the diagnosis was made, it presented a treatment dilemma due to the expected drug-drug interactions between his 3rd-line ART regimen and his INH-resistant TB regimen, and specialist input was required. Conclusion: TB is more difficult to diagnose in patients with severe immunosuppression, therefore additional tests like urine-LAM and urine-GXP can be helpful in expediting the diagnosis in these cases. Patients with non-standard drug regimens should always be discussed with a specialist in order to avoid potentially harmful drug-drug interactions.

Keywords: drug-resistance, HIV, line probe assay, tuberculosis

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1694 Staphylococcus Aureus Septic Arthritis and Necrotizing Fasciitis in a Patient With Undiagnosed Diabetes Mellitus.

Authors: Pedro Batista, André Vinha, Filipe Castelo, Bárbara Costa, Ricardo Sousa, Raquel Ricardo, André Pinto

Abstract:

Background: Septic arthritis is a diagnosis that must be considered in any patient presenting with acute joint swelling and fever. Among the several risk factors for septic arthritis, such as age, rheumatoid arthritis, recent surgery, or skin infection, diabetes mellitus can sometimes be the main risk factor. Staphylococcus aureus is the most common pathogen isolated in septic arthritis; however, it is uncommon in monomicrobial necrotizing fasciitis. Objectives: A case report of concomitant septic arthritis and necrotizing fasciitis in a patient with undiagnosed diabetes based on clinical history. Study Design & Methods: We report a case of a 58-year-old Portuguese previously healthy man who presented to the emergency department with fever and left knee swelling and pain for two days. The blood work revealed ketonemia of 6.7 mmol/L and glycemia of 496 mg/dL. The vital signs were significant for a temperature of 38.5 ºC and 123 bpm of heart rate. The left knee had edema and inflammatory signs. Computed tomography of the left knee showed diffuse edema of the subcutaneous cellular tissue and soft tissue air bubbles. A diagnosis of septic arthritis and necrotising fasciitis was made. He was taken to the operating room for surgical debridement. The samples collected intraoperatively were sent for microbiological analysis, revealing infection by multi-sensitive Staphylococcus aureus. Given this result, the empiric flucloxacillin (500 mg IV) and clindamycin (1000 mg IV) were maintained for 3 weeks. On the seventh day of hospitalization, there was a significant improvement in subcutaneous and musculoskeletal tissues. After two weeks of hospitalization, there was no purulent content and partial closure of the wounds was possible. After 3 weeks, he was switched to oral antibiotics (flucloxacillin 500 mg). A week later, a urinary infection by Pseudomonas aeruginosa was diagnosed and ciprofloxacin 500 mg was administered for 7 days without complications. After 30 days of hospital admission, the patient was discharged home and recovered. Results: The final diagnosis of concomitant septic arthritis and necrotizing fasciitis was made based on the imaging findings, surgical exploration and microbiological tests results. Conclusions: Early antibiotic administration and surgical debridement are key in the management of septic arthritis and necrotizing fasciitis. Furthermore, risk factors control (euglycemic blood glucose levels) must always be taken into account given the crucial role in the patient's recovery.

Keywords: septic arthritis, Necrotizing fasciitis, diabetes, Staphylococcus Aureus

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1693 Effect of Progressive Muscle Relaxation on the Postpartum Depression and General Comfort Levels

Authors: İlknur Gökşin, Sultan Ayaz Alkaya

Abstract:

Objective: Progressive muscle relaxation (PMR) include the deliberate stretching and relaxation of the major muscle groups of the human body. This study was conducted to evaluate the effect of PMR applied in women on the postpartum depression and general comfort level. Methods: The study population of this quasi-experimental study with pre-test, post-test and control group consisted of primipara women who had vaginal delivery in the obstetric service of a university hospital. The experimental and control groups consisted of 35 women each. The data were collected by questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) and the General Comfort Questionnaire (GCQ). The women were matched according to their age and education level and divided into the experimental and control groups by simple random selection. Postpartum depression risk and general comfort was evaluated at the 2nd and 5th days, 10th and 15th days, fourth week and eighth week after birth. The experimental group was visited at home and PMR was applied. After the first visit, women were asked to apply PMR regularly three times a week for eight weeks. During the application, the researcher called the participants twice a week to follow up the continuity of the application. No intervention was performed in the control group. For data analysis, descriptive statistics such as number, percentage, mean, standard deviation, significance test of difference between two means and ANOVA were used. Approval of the ethics committee and permission of the institution were obtained for the study. Results: There were no significant differences between the women in the experimental and control groups in terms of age, education status and employment status (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of EPDS pre-test, 1st, 2nd and 3rd follow-up mean scores (p>0.05). There was a statistically significant difference between EPDS pre-test and 3rd follow-up scores of the experimental group (p<0.05), whereas there was no such difference in the control group (p>0.05). There was no statistically significant difference between the experimental and control groups in terms of mean GCQ pre-test scores (p>0.05), whereas in the 1st, 2nd and 3rd follow-ups there was a statistically significant difference between the mean GCQ scores (p<0.05). It was found that there was a significant increase in the GCQ physical, psychospiritual and sociocultural comfort sub-scales, relief and relaxation levels of the experimental group between the pre-test and 3rd follow-ups scores (p<0.05). And, a significant decrease was found between pre-test and 3rd follow-up GCQ psychospiritual, environmental and sociocultural comfort sub-scale, relief, relaxation and superiority levels (p<0.05). Conclusion: Progressive muscle relaxation was effective on reducing the postpartum depression risk and increasing general comfort. It is recommended to provide progressive muscle relaxation training to women in the postpartum period as well as ensuring the continuity of this practice.

Keywords: general comfort, postpartum depression, postpartum period, progressive muscle relaxation

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