Search results for: Greek public hospital sector

Authors: Ana P. R. N. Barroso, Maurício N. Kleinberg, Frederico R. Silva, Rodrigo F. Guimarães, Marcelo M. V. Parente, Walney S. Araújo

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The fight against accelerated wear of the equipment used in the oil and gas sector is a challenge for minimizing maintenance costs. Corrosion being one of the main agents of equipment deterioration, we seek alternative materials that exhibit improved corrosion resistance at low cost of production. This study aims to evaluate the corrosion behavior of experimental alloys containing 15% and 17% of chromium (Cr) and 5% of molybdenum (Mo) in comparison with an AISI 444 commercial alloy. Microstructural analyzes were performed on samples of the alloys before and after the electrochemical tests. Two samples of each solubilized alloy were also taken for analysis of the corrosion behavior by testing potentiodynamic polarization (PP) and Electrochemical Impedance Spectroscopy (EIS) with immersion time of 24 hours in electrolytic solution with acidic character. The graphics obtained through electrochemical tests of PP and EIS indicated that among the experimental alloys, the alloy with higher chromium content (17%) had a higher corrosion resistance, confirming the beneficial effect of adding chromium. When comparing the experimental alloys with the AISI 444 commercial alloy, it is observed that the AISI 444 commercial alloy showed superior corrosion resistance to that of the experimental alloys for both assays, PP and EIS. The microstructural analyzes performed after the PP and EIS tests confirmed the results previously described. These results suggest that the addition of these levels of molybdenum did not favor the electrochemical behavior of experimental ferritic alloys for the electrolytic medium studied.

Keywords: corrosion, molybdenum, electrochemical tests, experimental alloys

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: Evidence exists that pneumonia is a frequently encountered complication after stroke which is associated with a higher rate of mortality and increased long-term disability Purpose: To determine the predictors associated with the risk of one-year disability in acute stroke. Methods: Data for this longitudinal follow-up study were extracted from a tertiary referral medical center’s stroke registry database in Northern Taipei. Eligible patients with acute stroke admitted to the hospital and completed a one-year follow up were recruited for analysis. Favorable outcome was defined as a modified Rankin Scale score ≤ 2. SAS version 9.2 was used for the multivariable regression analyses to examine the factors correlated with the one-year disability in stroke patients. Results: From January 2012 to December 2013, a total of 1373 (mean age: 70.49±15.4 years, 913(66.5%) males) consecutively administered acute stroke patients were recruited. Overall, the rate of one-year disability was 37.20%(404/1086) in those without post-stroke pneumonia. It increased to 82.93 %(238/287) in patients developed post-stroke pneumonia. Factors associated with increased risk of disability were age ≧ 75(OR= 4.845, p<.0001), female /gender (OR=1.568, p =.0062), previous stroke (OR= 1.868, p = <. 0001) ,dementia (OR= 2.872, p =.0047), ventilator use (OR= 4.653, p <. 0001),age ≧ 75 /pneumonia (OR=1.236, p <. 0001) , ICU admission (OR=3.314, p <.0001) , nasogastric tube insertion (OR= 4.28, p <.0001), speech therapy (OR= 1.79, p =.0142), urinary tract infection (OR= 1.865, p =.0018), estimated glomerular filtration rate (eGFR > 60 )(OR= 0.525, p= .0029), Admission NIHSS >11 (OR= 2.101, p = .0099), Length of hospitalization > 30(d) (OR= 5.182, p <.0001). Conclusion: Older age, severe neurological deficit, complications, rehabilitation intervention, length of hospitalization >30(d), and cognitive impairment were significantly associated with Post-stroke functional impairment, especially those with post-stroke pneumonia. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, disability

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Authors: João Pereira Dos Santos

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The uneven spatial distribution of start-ups and their respective survival may reflect comparative advantages resulting from the local institutional background. For the first time, we explore this idea using Data Envelopment Analysis (DEA) to assess relative efficiency of Portuguese municipalities in this specific context. We depart from the related literature where expenditure is perceived as a desirable input by choosing a measure of fiscal responsibility and infrastructural variables in the first stage. Comparing results for 2006 and 2010, we find that mean performance decreased substantially with 1) the effects of the Global Financial Crisis; 2) as municipal population increases and 3) as financial independence decreases. A second stage is then computed employing a double-bootstrap procedure to evaluate how the regional context outside the control of local authorities (e.g. demographic characteristics and political preferences) impacts on efficiency.

Keywords: entrepreneurship, political economy, public finance, accountability, crisis, efficiency, Portuguese municipalities

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Authors: Piyarat Parklug, Busaba Supawattanaobodee, Penpat Pinyowattanasilp

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The radioactive iodine thyroid uptake (RAIU) has been widely used to differentiate the cause of thyrotoxicosis and treatment. Twenty-four hours RAIU is routinely used to calculate the dose of radioactive iodine (RAI) therapy; however, 2 days protocol is required. This study aims to evaluate the modification of Penpat Pinyowattanasilp equation application by the exclusion of outlier data, 3 hours RAIU less than 20% and more than 80%, to improve prediction of 24-hour uptake. The equation is predicted 24 hours RAIU (P24RAIU) = 32.5+0.702 (3 hours RAIU). Then calculating separation first and second therapeutic doses in Graves’ disease patients. Methods; This study was a retrospective study at Faculty of Medicine Vajira Hospital in Bangkok, Thailand. Inclusion were Graves’ disease patients who visited RAI clinic between January 2014-March 2019. We divided subjects into 2 groups according to first and second therapeutic doses. Results; Our study had a total of 151 patients. The study was done in 115 patients with first RAI dose and 36 patients with second RAI dose. The P24RAIU are highly correlated with actual 24-hour RAIU in first and second therapeutic doses (r = 0.913, 95% CI = 0.876 to 0.939 and r = 0.806, 95% CI = 0.649 to 0.897). Bland-Altman plot shows that mean differences between predictive and actual 24 hours RAI in the first dose and second dose were 2.14% (95%CI 0.83-3.46) and 1.37% (95%CI -1.41-4.14). The mean first actual and predictive therapeutic doses are 8.33 ± 4.93 and 7.38 ± 3.43 milliCuries (mCi) respectively. The mean second actual and predictive therapeutic doses are 6.51 ± 3.96 and 6.01 ± 3.11 mCi respectively. The predictive therapeutic doses are highly correlated with the actual dose in first and second therapeutic doses (r = 0.907, 95% CI = 0.868 to 0.935 and r = 0.953, 95% CI = 0.909 to 0.976). Bland-Altman plot shows that mean difference between predictive and actual P24RAIU in the first dose and second dose were less than 1 mCi (-0.94 and -0.5 mCi). This modification equation application is simply used in clinical practice especially patient with 3 hours RAIU in range of 20-80% in a Thai population. Before use, this equation for other population should be tested for the correlation.

Keywords: equation, Graves’disease, prediction, 24-hour uptake

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Authors: Sita Yuliastuti Amijaya, Wiyatiningsih Wiyatiningsih, Paulus Bawole

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Weaving skills were not originally a way to earn money for the traditional people on Sumba Island. Weaving is a leisure activity carried out between farming and caring for families. It is quite understandable if the weavers are women. At this time, weaving crafts become a unique potential inherent in an area, so that the weaver women also have the potential to drive economic activity in regional tourism sector. This study aims to measure the sustainability of traditional weaving business activities in Anajiaka Village, Umbu Ratu Nggay Barat, Central Sumba Regency, which is able to support the creative economy. The analysis was performed using qualitative descriptive methods by comparing the criteria of smart living and smart economy in the study of smart city. This study found that business sustainability will be better maintained if it is bound in a joint commitment, for example by forming a group of craftsmen. Other challenges besides the commitment of the group members are aspects of local government support and related agencies, in the form of guidance, funding, and promotion. In addition, fabric order targets, maintaining family and community balance, are recognized as obstacles for craftsmen. The modern marketing model is not yet mastered by the craftsmen group, so it needs assistance for future development.

Keywords: agriculture, craftsmen, creativepreneur, smart economy, smart living

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Authors: N. J. Shanono, J. G. Ndiritu

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The poor performance of water resource systems (WRS) has been reportedly linked to not only climate variability and the water demand dynamics but also human behaviour-driven unlawful activities. Some of these unlawful activities that have been adversely affecting water sector include unauthorized water abstractions, water wastage behaviour, refusal of water re‐use measures, excessive operational losses, discharging untreated or improperly treated wastewater, over‐application of chemicals by agricultural users and fraudulent WRS operation. Despite advances in WRS planning, operation, and analysis incorporating such undesirable human activities to quantitatively assess their impact on WRS performance remain elusive. This study was then inspired by the need to develop a methodological framework for WRS performance assessment that integrates the impact of human behaviour with WRS performance assessment analysis. We, therefore, proposed a conceptual framework for assessing the impact of human behaviour on WRS performance using the concept of socio-hydrology. The framework identifies and couples four major sources of WRS-related values (water values, water systems, water managers, and water users) using three missing links between human and water in the management of WRS (interactions, outcomes, and feedbacks). The framework is to serve as a database for choosing relevant social and hydrological variables and to understand the intrinsic relations between the selected variables to study a specific human-water problem in the context of WRS management.

Keywords: conceptual framework, human behaviour; socio-hydrology; water resource systems

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Authors: Margarita Zavala, Julio Rolón, Gabriel Chavira, José González, Jorge Orozco, Roberto Pichardo

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Adolescence is a neuralgic stage in the formation of every human being, generally at this stage is when the middle school level is studied. In 2006 in Mexico incorporated “mentoring" space to assist students in their integration and participation in life. In public middle schools, is sometimes difficult to be aware of situations that affect students because of the number of them and traditional records management. Whit this they lose the opportunity to provide timely support as a preventive way. In order to provide this support, it is required to know the students by detecting the relevant information that has greater impact on their learning process. This research is looking to check if it is possible to identify student’s relevant information to detect when it is at risk, and then to propose a model to manage in a proper way such information.

Keywords: adolescence, mentoring, middle school students, mentoring system support

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Authors: Thilini Hathurusinghe, Uthpalie Siriwardhana, W. M. Ediri Arachchi, Ranga Thudugala, Indeewari Herath, Gayani Senanayake

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The foramen magnum is more prone to protect than other skeletal remains during high impact and severe disruptive injuries. Therefore, it is worthwhile to explore whether these measurements can be used to determine the human gender which is vital in forensic and anthropological studies. The idea was to find out the ability to use quantitative measurements of foramen magnum as an anatomical indicator for human gender estimation and to evaluate the gender-dependent variations of foramen magnum using quantitative measurements. Randomly selected 113 subjects who underwent CT head scans at Sri Jayawardhanapura General Hospital of Sri Lanka within a period of six months, were included in the study. The sample contained 58 males (48.76 ± 14.7 years old) and 55 females (47.04 ±15.9 years old). Maximum length of the foramen magnum (LFM), maximum width of the foramen magnum (WFM), minimum distance between occipital condyles (MnD) and maximum interior distance between occipital condyles (MxID) were measured. Further, AreaT and AreaR were also calculated. The gender was estimated using binomial logistic regression. The mean values of all explanatory variables (LFM, WFM, MnD, MxID, AreaT, and AreaR) were greater among male than female. All explanatory variables except MnD (p=0.669) were statistically significant (p < 0.05). Significant bivariate correlations were demonstrated by AreaT and AreaR with the explanatory variables. The results evidenced that WFM and MxID were the best measurements in predicting gender according to binomial logistic regression. The estimated model was: log (p/1-p) =10.391-0.136×MxID-0.231×WFM, where p is the probability of being a female. The classification accuracy given by the above model was 65.5%. The quantitative measurements of foramen magnum can be used as a reliable anatomical marker for human gender estimation in the Sri Lankan context.

Keywords: foramen magnum, forensic and anthropological studies, gender estimation, logistic regression

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Authors: Anna Lytvynova

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This essay presents labour as a performatively national phenomenon from a cultural perspective. Considering Engels’ proposition of labour as the epicentre of development of social structures and communities, it theorizes the formation and sustainment of group identities through labour identities. Taking labour in the cultural sector as the starting point case study, the essay further enunciates such labour and labour identity as a form of engaged citizenship. In doing so, this piece hopes to arrive at a potential contemporary understanding of labour as having a central and dynamic role in cultural organization and citizenship. A parallel goal is to de-link sociological models of cultural labor from narratives of art and culture as something that stands separate from the 'real world' and the economy and exists in precarity. Combining discourse from cultural sociology, performance studies, and economics and grounding it in historical archive, the essay makes a primarily discursive theoretical contribution. Taking North American theatre organizations as the exemplifying starting point, this project positions cultural workers not solely as workers in a professional industry but as active citizen-subjects who are deeply involved in their society’s democratic processes. The resulting discourse can be used to shape more effective labour policies, as well as help art and cultural organizations find more effective organizational structures to engage the arts in the economic, political, and social spheres.

Keywords: arts labour, cultural sociology, national identity, performativity

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Authors: Rezki Omar

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Openness cosmic shares dramatically in the order of something quite a bit of neglected priorities within the community at the level of thought and consciousness, and these priorities provider of legal and human rights awareness after a long delay in the process of awareness of human rights, there is no doubt that the long and arduous road. As is obvious to any observer public affairs as well as the specialist and the observer that there is growth and development in the scene and the legal movement is unprecedented, many when dealing with many of the details sought and tries as much as possible to know what is the natural rights, and duties that must comply with legally in no charge with the issue of what is going on, any attempt of weakness and lack of self-reliance and obstacles level during the search show him by virtue of the difficulty of the availability of legal information in some cases on a particular issue, whether or not the image is complete, legally insufficient. Law relationship to society basically a close relationship, there is no law society, a society is impossible without both at the level of domestic relations or international law: «There is a close link between law and society. The law remains influenced by the society in which it grew, as well as the law affects the society, which is governed by, the relationship between the community and law affected and the impact of relationship ». The law of the most important objectives of protecting members of society, and its role is based on the distribution of rights and duties in a fair way, and protect the public interest of the citizen’s basis. The word community when some sociologists are limited to the group that gathered, including cultural unity Cultural Group distinguish between society and the last. In the recent period issued a set of regulations in the various branches of law, which is different from the class and important one hand, and here is important study of the interaction between law and society, and how to make the laws effective in the community? The opposite is true as well. The law as a social phenomenon is impossible to understand and analyzed without taking into account the extent of their impact and vulnerability within the community and accepted. Must evoke the basis that it was developed to address the problems faced by citizens. The over-age and amplify the sanctions are a contradiction of that fundamental reform of the basic objectives of the offender more than anything else Calantqam and revenge, and if the process is not human mistakes. Michel Foucault believes that «tighten laws and regulations against criminals will not reduce the crime rate in the community, so you must activate the system of moral values of society after more deterrent, and the threat of scandal on a social level.» Besson and refers to the legislators, saying the law: «The only way to reduce the crime rate to strengthen the ethical system of the society, especially in the social Amnhoha sanctity of conscience, then you will not be forced to issue harsh sentences against criminals».In summary, it is necessary to combine the enactment of laws and activate the system of moral values and educational values on the ground, and to understand the causes of social problems at the root of all for the equation is complete, and that the law was drafted to serve the citizens and not to harm him.

Keywords: legislators, distinguish, awareness, insufficient

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Authors: Kalat P. Duniya

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A number of technologies expected to increase maize productivity have been introduced by several research programs at national and international level. To this end, the study sought to identify the factors influencing adoption intensity of certified maize varieties. The data used were obtained from a sample household survey of 406 maize farmers, conducted in the northern guinea savannah of Nigeria through multistage stratified sampling, structured questionnaire. A triple hurdle model was adopted to estimate the determinants of adoption intensity; considering awareness, adoption, and intensity as three separate stages. The result showed that the drivers of farmers’ awareness, adoption, and intensity of usage may not necessarily be the same, and where they are, not of the same magnitude and direction. However, factors which were found to be statistically significant were age, education, membership of association and frequency of extension advice. In addition, awareness and adoption of the technologies were likely to be increased with male respondents. Farmers that were members of either community organizations or cooperative organizations had a higher tendency of being aware and adopting certified maize seed varieties. It was also discovered that though some of the farmers were fully aware of the existence of some certified maize varieties, majority lacked detailed knowledge and technical know-how. There is a need for creation of awareness through an excellent trained extension and restructuring of the educational sector to improve on the adoption process as well as improve maize productivity in the country.

Keywords: adoption, awareness, maize farmers, Nigeria, regression

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Authors: Mohammad Rostami Mehr, Seyed Arya Mir Rashed, Arndt Lueder, Magdalena Missler-Behr

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This paper represents the conception that complex problems do not necessarily need a similar complex solution in order to cope with the complexity. Furthermore, a simple solution based on established methods can provide a sufficient way to deal with the complexity. To verify this conception, the presented paper focuses on the field of change management as a part of the new product development process in the automotive sector. In this field, dealing with increasing complexity is essential, while only non-flexible rigid processes that are not designed to handle complexity are available. The basic methodology of this paper can be divided into four main sections: 1) analyzing the complexity of the change management, 2) literature review in order to identify potential solutions and methods, 3) capturing and implementing expertise of experts from the change management field of an automobile manufacturing company and 4) systematical comparison of the identified methods from literature and connecting these with defined requirements of the complexity of the change management in order to develop a solution. As a practical outcome, this paper provides a method to capture the complexity of engineering changes (EC) and includes it within the EC evaluation process, following case-related process guidance to cope with the complexity. Furthermore, this approach supports the conception that dealing with complexity is possible while utilizing rather simple and established methods by combining them into a powerful tool.

Keywords: complexity management, new product development, engineering change management, flexibility

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Authors: Aliyu Bello Mohammed

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Vital registration or registration of vital events is one of the three major sources of demographic data in Nigeria. The other two are the population census and sample survey. The former is judged to be an indispensable source of demographic data because, it provide information on vital statistics and population trends between two census periods. Various literacy works however depict the vital registration in Nigeria as incapable of providing accurate data for the country. The study has both theoretical and practical significances. The trends and pattern of vital registration has not received adequate research interest in Sub-Saharan Africa in general and Nigeria in particular. This has created a gap in understanding the extent and consequence of the scourge in Africa sub-region. Practically, the study also captures the policy interventions of government and Non-Governmental Organizations (NGOs) that would help enlighten the public on the importance of vital registration in Nigeria. Furthermore, feasible policy strategies that will enhance trends and pattern vital registration in the society would emanate from the study. The study adopted a cross sectional survey design and applied multi stage sampling techniques to sample 230 respondents from the general public in the study area. The first stage involved the splitting of the local government into wards. The second stage involves selecting streets, while the third stage was the households. In all, 6 wards were sampled for the study. The study utilized both primary and secondary sources of data. The primary sources of data used were the questionnaire, focus group discussion (FGD) and in-depth interview (IDI) guides while the secondary sources of data were journals and books, newspapers and magazines. Twelve FGD sessions with 96 study participants and five IDI sessions with the heads of vital registration facilities were conducted. The quantitative data were analyzed using Statistical Package for Social Sciences (SPSS). Descriptive statistics like tables, frequencies and percentages were employed in presenting and interpreting the data. Information from the qualitative data was transcribed and ordered in themes to ensure that outstanding points of the responses are noted. The following conclusions were drawn from the study: the available vital registration facilities are not adequate and were not evenly distributed in the study area; lack of awareness and knowledge of the existence and the importance of vital registration by majority of the people in the local government; distance to vital registration centres from their residents; most births in the area were not registered, and even among the few births that were registered, majority of them were registered after the limited period for registration. And the study reveals that socio-economic index, educational level and distance of facilities to residents are determinants of access to vital registration facility. The study concludes by discussing the need for a reliable and accurate vital registration system if Nigeria’s vision of becoming one of the top 20 economies in the world in 2020 would be realized.

Keywords: trends, patterns, vital, registration and assessment

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Authors: Maha Aladdin, Khaled Nagaty, Abeer Hamdy

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The rapid advancement cellular networks and wireless networks have laid a solid basis for the Internet of Things. IoT has evolved into a unique standard that allows diverse physical devices to collaborate with one another. A service provider gives a variety of services that may be accessed via smart apps anywhere, at any time, and from any location over the Internet. Because of the public environment of mobile communication and the Internet, these services are highly vulnerable to a several malicious attacks, such as unauthorized disclosure by hostile attackers. As a result, the best option for overcoming these vulnerabilities is a strong authentication method. In this paper, a lightweight authentication scheme that is based on numerical series cryptography is proposed for the IoT environments. It allows mutual authentication between IoT devices Parametric study and formal proofs are utilized to illustrate that the pro-posed approach is resistant to a variety of security threats.

Keywords: internet of things, authentication, cryptography, security protocol

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Authors: Nuchjaree Kidjawan, Orapan Thosingha, Pawinee Vaipatama, Prakrankiat Youngkong, Sirinapha Malangputhong, Kitti Thamrongaphichartkul, Phatcharaporn Phetcharat

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NPI uses technology sensorization of things and processed by AI system. The main features are an individual interface pressure sensor system in contact with the mattress and a position management system where the sensor detects the determined pressure with automatic pressure reduction and distribution. The role of NPI is to monitor, identify the risk and manage the interface pressure automatically when the determined pressure is detected. This study aims to evaluate the effects of “Never Pressure Injury (NPI),” an innovative mattress, on the incidence of pressure injuries in critically ill patients. An observational case-control study was employed to compare the incidence of pressure injury between the case and the control group. The control group comprised 80 critically ill patients admitted to a critical care unit of Phyathai3 Hospital, receiving standard care with the use of memory foam according to intensive care unit guidelines. The case group comprised 80 critically ill patients receiving standard care and with the use of the Never Pressure Injury (NPI) innovation mattress. The patients who were over 20 years old and showed scores of less than 18 on the Risk Assessment Pressure Ulcer Scale – ICU and stayed in ICU for more than 24 hours were selected for the study. The patients’ skin was assessed for the occurrence of pressure injury once a day for five consecutive days or until the patients were discharged from ICU. The sample comprised 160 patients with ages ranging from 30-102 (mean = 70.1 years), and the Body Mass Index ranged from 13.69- 49.01 (mean = 24.63). The case and the control group were not different in their sex, age, Body Mass Index, Pressure Ulcer Risk Scores, and length of ICU stay. Twenty-two patients (27.5%) in the control group had pressure injuries, while no pressure injury was found in the case group.

Keywords: pressure injury, never pressure injury, innovation mattress, critically ill patients, prevent pressure injury

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Authors: Iram Malik, Mahrukh Shaukat, Abeer Malik, Hafiz Mushtaq Ahmad

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There has been a lot of research on cyberbullying but there is limited research on the topic of accidental cyberbullying on social media with a special focus on healthcare industry. This study emphasizes to uncover the factors that contribute to accidental cyberbullying on social media and how it affects individuals, professionals’ and organizations in health care sector. Nowadays social media is becoming a necessary part of our daily life; there is a need to look into how it is shaping our social life and behaviors displayed online. Instances of cyber bullying can have long-term repercussions due to over-sharing of information. The study used simple random sampling and the instrument of data collection was survey. A sample size of 250 healthcare professionals was chosen from the twin cities of Rawalpindi and Islamabad, Pakistan to examine the relationship between their attitude towards internet use, psychological distress, verbal aggression, envy, frustration, self-compassion, personality traits and accidental cyberbullying on social media. The results of the study have been encouraging. The findings show that psychological distress, aggression, envy, frustration and personality traits had direct effect on accidental cyberbullying whereas compassion, altruism lessened the effect of accidental cyberbullying behavior. It is our intent that the findings of this study could help raise awareness regarding fair use of social media, help policy makers in developing appropriate policies for avoiding cyberbullying in future.

Keywords: accidental cyberbullying, aggression, cyberbullying, frustration, social media

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Authors: Yuang Guo, Dewancker Bart

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The primary energy consumption of buildings throughout China was approximately 814 million tons of coal equivalents in 2014, which accounts for 19.12% of China's total primary energy consumption. Also, the energy consumption of public buildings takes a bigger share than urban residential buildings and rural residential buildings among the total energy consumption. To improve the level of energy demand, various design parameters were chosen. Meanwhile, a series of simulations by Energy Plus (EP-Launch) is performed using a base case model established in Open Studio. Through the results, 16%-23% of total energy demand reductions can be found in the severe cold zone of China, and it can also provide a reference for the architectural design of other similar climate zones.

Keywords: energy consumption, design parameters, indoor thermal comfort, simulation study, severe cold climate zone

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Authors: Roaa Al Sharif, Salsabil Abo Al-Azayem, Nimah Alsomali, Wjoud Alsaeed, Nawal Alshammari, Abdulaziz Alwatban, Yaseen Alrabae, Razan Orfali, Faisal Alqarni, Ahmad Alrasheedi

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from various countries have revealed that nurses possess only a basic understanding of the GCS. Regarding this matter, limited knowledge is available about the situation in Saudi Arabia. Overall, the available research suggests that there is room for improvement in the knowledge of the GCS among nurses in Saudi Arabia. Further training and education programs may be beneficial in enhancing nurses' understanding and application of the GCS in clinical practice. Objective: To determine the level of knowledge and competence in assessing the GCS among staff nurses and to identify factors that might influence their knowledge at King Fahd Medical City in Riyadh, Saudi Arabia. Methods: A descriptive, cross-sectional survey involving 199 KFMC staff nurses was conducted. Nurses were provided with a structured questionnaire, and data were collected and analyzed using SPSS version 16, employing descriptive statistics and Chi-square tests. Results: The majority, 81.4% of nurses, had an average level of knowledge in assessing the Glasgow Coma Scale (GCS). The mean score for measuring the level of knowledge among staff nurses in GCS assessment was 8.8 ± 1.826. Overall, 13.6% of respondents demonstrated good knowledge of the GCS, scoring between 11 and 15 points, while only 5% of nurses exhibited poor knowledge of the GCS assessment. There was a significant correlation between knowledge and nurses' departments (χ2(2) = 19.184, p < 0.001). χ2(2) = 19.184," representing a Chi-square statistic with 2 degrees of freedom used to test the association between categorical variables in the data analysis. Conclusion: The findings indicate that knowledge of GCS assessment among staff nurses in a single center in Saudi Arabia is moderate. Therefore, there is a need for continuous education programs to enhance their competence in using this assessment.

Keywords: Glasgow Coma Scale, brain injury, nurses’ knowledge assessment, continuous education programs

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Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

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Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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Authors: Idil Kanter Otcu

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Nowadays, due to the growing problems of energy supply and the drastic reduction of natural non-renewable resources, the development of new applications in the energy sector and steps towards greater efficiency in energy consumption are required. Since buildings account for a large share of energy consumption, increasing the structural density of buildings causes an increase in energy consumption. This increase in energy consumption means that energy efficiency approaches to building design and the integration of new systems using emerging technologies become necessary in order to curb this consumption. As new systems for productive usage of generated energy are developed, buildings that require less energy to operate, with rational use of resources, need to be developed. One solution for reducing the energy requirements of buildings is through landscape planning, design and application. Requirements such as heating, cooling and lighting can be met with lower energy consumption through planting design, which can help to achieve more efficient and rational use of resources. Within this context, rather than a planting design which considers only the ecological and aesthetic features of plants, these considerations should also extend to spatial organization whereby the relationship between the site and open spaces in the context of climatic elements and planting designs are taken into account. In this way, the planting design can serve an additional purpose. In this study, a landscape design which takes into consideration location, local climate morphology and solar angle will be illustrated on a sample building project.

Keywords: energy efficiency, landscape design, plant design, xeriscape landscape

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Authors: Navah Z. Ratzon, Rachel Shichrur

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Background: Many studies have assessed and identified the risk factors of safe driving, but there is relatively little research-based evidence concerning the ability to improve the driving skills of drivers in general and in particular of bus drivers, who are defined as a population at risk. Accidents involving bus drivers can endanger dozens of passengers and cause high direct and indirect damages. Objective: To examine the effectiveness of a metacognitive-functional intervention program for the reduction of risk factors among professional drivers relative to a control group. Methods: The study examined 77 bus drivers working for a large public company in the center of the country, aged 27-69. Twenty-one drivers continued to the intervention stage; four of them dropped out before the end of the intervention. The intervention program we developed was based on previous driving models and the guiding occupational therapy practice framework model in Israel, while adjusting the model to the professional driving in public transportation and its particular risk factors. Treatment focused on raising awareness to safe driving risk factors identified at prescreening (ergonomic, perceptual-cognitive and on-road driving data), with reference to the difficulties that the driver raises and providing coping strategies. The intervention has been customized for each driver and included three sessions of two hours. The effectiveness of the intervention was tested using objective measures: In-Vehicle Data Recorders (IVDR) for monitoring natural driving data, traffic accident data before and after the intervention, and subjective measures (occupational performance questionnaire for bus drivers). Results: Statistical analysis found a significant difference between the degree of change in the rate of IVDR perilous events (t(17)=2.14, p=0.046), before and after the intervention. There was significant difference in the number of accidents per year before and after the intervention in the intervention group (t(17)=2.11, p=0.05), but no significant change in the control group. Subjective ratings of the level of performance and of satisfaction with performance improved in all areas tested following the intervention. The change in the ‘human factors/person’ field, was significant (performance : t=- 2.30, p=0.04; satisfaction with performance : t=-3.18, p=0.009). The change in the ‘driving occupation/tasks’ field, was not significant but showed a tendency toward significance (t=-1.94, p=0.07,). No significant differences were found in driving environment-related variables. Conclusions: The metacognitive-functional intervention significantly improved the objective and subjective measures of safety of bus drivers’ driving. These novel results highlight the potential contribution of occupational therapists, using metacognitive functional treatment, to preventing car accidents among the healthy drivers population and improving the well-being of these drivers. This study also enables familiarity with advanced technologies of IVDR systems and enriches the knowledge of occupational therapists in regards to using a wide variety of driving assessment tools and making the best practice decisions.

Keywords: bus drivers, IVDR, human risk factors, metacognitive-functional intervention

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Authors: Khadija Radhi

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Food allergy is a serious public health problem, especially in developed countries. As one of the most significant allergies, peanut allergy was investigated in this research. Peanut was mixed with treacle under different heating conditions. The results of glycation analyses revealed that proteins from peanuts interacted with the carbohydrates. Further studies also indicated that Millard reactions were determined by different heating treatment. It is noted that denatured peanut proteins accelerated the first stage of Millard reactions but prevented the third one. From the ELISA results, it was found that Millard reactions between proteins with sugars had no effects on the allergenicity of peanuts. Besides, there was no significant difference in allergenicity between digested and non-digested peanut proteins. However, pre-boiled peanut with denatured proteins displayed lower allergenicity after mixing with sugars. Such results indicated that denaturation is the key factor to reduce the allergenicity of the peanut proteins and it seemed that the second-staged Maillard products had less allergenicity.

Keywords: allergenicity, heating treatment, peanut, Maillard reaction

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Authors: Assia Galleze, Abdurrahim Kocyigit, Nacira Cherif, Nidel Benhalilou, Nabila Attal, Chafia Touil Boukkoffa, Rachida Raache

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Introduction and aims: Chemotherapeutic agents used to inhibit cell division and reduce tumor growth, increase reactive oxygen species levels, which contributes to their genotoxicity [1]. The comet assay is an inexpensive and rapid method to detect the damage at cellular levels and has been used in various cancer populations undergoing chemotherapy [2,3]. The present study aim to assess the oxidative stress and the genotoxicity induced by chemotherapy by the determination of plasma malondialdehyde (MDA) level, protein carbonyl (PC) content, superoxide dismutase (SOD) activity and lymphocyte DNA damage in Algerian children with lymphoma. Materials and Methods: For our study, we selected thirty children with lymphoma treated in university hospital of Beni Messous, Algeria, and fifty unrelated subjects as controls, after obtaining the informed consent in accordance with the Declaration of Helsinki (1964). Plasma levels of MDA, PC and SOD activity were spectrophotometrically measured, while DNA damage was assessed by alkaline comet assay in peripheral blood leukocytes. Results and Discussion: Plasma MDA, PC levels and lymphocyte DNA damage, were found to be significantly higher in lymphoma patients than in controls (p < 0.001). Whereas, SOD activity in lymphoma patients was significantly lower than in healthy controls (p < 0.001). There were significant positive correlations between DNA damage, MDA and PC in patients (r = 0.96, p < 0.001, r = 0.97, p < 0.001, respectively), and negative correlation with SOD (r = 0.87, p < 0.01). Conclusion and Perspective: Our results indicated that, leukocytes DNA damage and oxidative stress were significantly higher in lymphoma patients, suggesting that the direct effect of chemotherapy and the alteration of the redox balance may influence oxidative/antioxidative status.

Keywords: chemotherapy, comet assay, DNA damage, lymphoma

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Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston

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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.

Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience

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Authors: J. Lück, S. Rudman

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Language has long been a site of struggle in South Africa with an educational language policy that favoured English and Afrikaans as high status languages and positioned other language users in deficit ways. Furthermore, a segregationist past led to individuals viewing each other as racial beings and racial categorisations still prevail in private and public life. It has been argued that it is important to explore how South African youth identities are being constructed, if past discourses still shape their identities or if they are negotiating new ways of being. The paper probes the role of language, discourse and embedded ideologies in the persistence or not of youth linguistic identities and discourses, the implications for their lived realities and for their construction of other language users and the possibilities of shifts occurring with an awareness of such discourses. It finds that past discourses continue to shape youth identities and are surging in the light of what is happening in the country today.

Keywords: discourse, ideologies, language, linguistic identities

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Authors: Tahraoui Boualem

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Researching the historical framework of international crime means examining the historical facts that have contributed to uncovering this serious crime affecting international interests, and the law by which the study of the subject of international crime is determined is international criminal law, which is a branch of public international law. In this context, the historical study of international crime means recognizing the existence of an international community governed by international law, which makes us acknowledge that ancient societies lacked such stable and recurring international relations. Therefore, an attempt to monitor international crime in those ancient societies is only to demonstrate a historical fact that those societies have known some features of this crime, and have contributed in one way or another to the development of international criminal law without defining its concept or legal nature. The international community has affirmed the principle of establishing peace, achieving security, and respecting human rights. As a basis for friendly relations between the people of the international community and in case of prejudice, such as the aggressors breaching the obligations imposed on them, whether in time of peace or war.

Keywords: historical framework, of international crime, peace or war., international law

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Authors: M. F. Amado, A. Amado, F. Poggi, J. Correia de Freitas

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Today it is widely understood that global energy consumption patterns are directly related to the ongoing urban expansion and development process. This expansion is based on the natural growth of human activities and has left most urban areas totally dependent on fossil fuel derived external energy inputs. This status-quo of production, transportation, storage and consumption of energy has become inefficient and is set to become even more so when the continuous increases in energy demand are factored in. The territorial management of land use and related activities is a central component in the search for more efficient models of energy use, models that can meet current and future regional, national and European goals. In this paper, a methodology is developed and discussed with the aim of improving energy efficiency at the municipal level. The development of this methodology is based on the monitoring of energy consumption and its use patterns resulting from the natural dynamism of human activities in the territory and can be utilized to assess sustainability at the local scale. A set of parameters and indicators are defined with the objective of constructing a systemic model based on the optimization, adaptation and innovation of the current energy framework and the associated energy consumption patterns. The use of the model will enable local governments to strike the necessary balance between human activities, economic development, and the local and global environment while safeguarding fairness in the energy sector.

Keywords: solar urban planning, solar smart city, urban development, energy efficiency

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Authors: Shahan Waheed, Muhammad Waqas, Asher Feroz

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Objectives: To determine the utility of base deficit in traumatic brain injury in assessing the severity and to correlate with the conventional computed tomography scales in grading the severity of head injury. Methodology: Observational cross-sectional study conducted in a tertiary care facility from 1st January 2010 to 31st December 2012. All patients with isolated traumatic brain injury presenting within 24 hours of the injury to the emergency department were included in the study. Initial Glasgow Coma Scale and base deficit values were taken at presentation, the patients were followed during their hospital stay and CT scan brain findings were recorded and graded as per the Rotterdam scale, the findings were cross-checked by a radiologist, Glasgow Outcome Scale was taken on last follow up. Outcomes were dichotomized into favorable and unfavorable outcomes. Continuous variables with normal and non-normal distributions are reported as mean ± SD. Categorical variables are presented as frequencies and percentages. Relationship of the base deficit with GCS, GOS, CT scan brain and length of stay was calculated using Spearman`s correlation. Results: 154 patients were enrolled in the study. Mean age of the patients were 30 years and 137 were males. The severity of brain injuries as per the GCS was 34 moderate and 109 severe respectively. 34 percent of the total has an unfavorable outcome with a mean of 18±14. The correlation was significant at the 0.01 level with GCS on presentation and the base deficit 0.004. The correlation was not significant between the Rotterdam CT scan brain findings, length of stay and the base deficit. Conclusion: The base deficit was found to be a good predictor of severity of brain injury. There was no association of the severity of injuries on the CT scan brain as per the Rotterdam scale and the base deficit. Further studies with large sample size are needed to further evaluate the associations.

Keywords: base deficit, traumatic brain injury, Rotterdam, GCS

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Authors: Farah Lazzali, Yamina Ait Meziane

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Recent earthquakes in Algeria have demonstrated the need for seismic risk reduction. In fact, the latest major earthquake that affected the Algiers-Boumerdes region in 2003 caused excessive levels of loss of life and property. Economic, social and environmental damage were also experienced. During the three days following the event, a relatively weak coordination of public authority was noted. Many localities did not receive any relief due to lack of information from concerned authorities and delay in connecting damaged roads. Following this event, Algerian government and civil society has recognized the urgent need for an appropriate and immediate seismic risk mitigation strategy. This paper describes procedures for emergency response following past earthquakes in Algeria and provides a brief review of risk mitigation activities since 1980. The paper also aims to provide measures to reduce earthquake risk through general strategy and practical implementation of the mitigation actions.

Keywords: earthquake, hazard, prevention, strategy, risk reduction

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Authors: Sifatullah Bahij, Safiullah Omary, Francoise Feugeas, Amanullah Faqiri

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Reinforced concrete (RC) is commonly used material in the construction sector, due to its low-cost and durability, and allowed the architectures and designers to construct structural members with different shapes and finishing. Usually, RC members are designed to sustain service loads efficiently without any destruction. However, because of the faults in the design phase, overloading, materials deficiencies, and environmental effects, most of the structural elements will require maintenance and repairing over their lifetime. Therefore, strengthening and repair of the deteriorated and/or existing RC structures are much important to extend their life cycle. Various techniques are existing to retrofit and strengthen RC structural elements such as steel plate bonding, external pre-stressing, section enlargement, fiber reinforced polymer (FRP) wrapping, etc. Although these configurations can successfully improve the load bearing capacity of the beams, they are still prone to corrosion damage which results in failure of the strengthened elements. Therefore, many researchers used fiber reinforced cementitious materials due to its low-cost, corrosion resistance, and result in improvement of the tensile and fatigue behaviors. Various types of cementitious materials have been used to strengthen or repair structural elements. This paper has summarized to accumulate data regarding on previously published research papers concerning the torsional behaviors of RC beams strengthened by various types of cementitious materials.

Keywords: reinforced concrete beams, strengthening techniques, cementitious materials, torsional strength, twisting angle

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