Search results for: emergency decree in Turkey

Authors: Eyup Dogan

Abstract:

The number of research articles analyzing the integration properties of energy variables has rapidly increased in the energy literature for about a decade. The stochastic behaviors of energy variables are worth knowing due to several reasons. For instance, national policies to conserve or promote energy consumption, which should be taken as shocks to energy consumption, will have transitory effects in energy consumption if energy consumption is found to be stationary in one country. Furthermore, it is also important to know the order of integration to employ an appropriate econometric model. Despite being an important subject for applied energy (economics) and having a huge volume of studies, several known limitations still exist with the existing literature. For example, many of the studies use aggregate energy consumption and national level data. In addition, a huge part of the literature is either multi-country studies or solely focusing on the U.S. This is the first study in the literature that considers a form of energy consumption by sectors at sub-national level. This research study aims at investigating unit root properties of electricity consumption for 12 regions of Turkey by four sectors in addition to total electricity consumption for the purpose of filling the mentioned limits in the literature. In this regard, we analyze stationarity properties of 60 cases . Because the use of multiple unit root tests make the results robust and consistent, we apply Dickey-Fuller unit root test based on Generalized Least Squares regression (DFGLS), Phillips-Perron unit root test (PP) and Zivot-Andrews unit root test with one endogenous structural break (ZA). The main finding of this study is that electricity consumption is trend stationary in 7 cases according to DFGLS and PP, whereas it is stationary process in 12 cases when we take into account the structural change by applying ZA. Thus, shocks to electricity consumption have transitory effects in those cases; namely, agriculture in region 1, region 4 and region 7, industrial in region 5, region 8, region 9, region 10 and region 11, business in region 4, region 7 and region 9, total electricity consumption in region 11. Regarding policy implications, policies to decrease or stimulate the use of electricity have a long-run impact on electricity consumption in 80% of cases in Turkey given that 48 cases are non-stationary process. On the other hand, the past behavior of electricity consumption can be used to predict the future behavior of that in 12 cases only.

Keywords: unit root, electricity consumption, sectoral data, subnational data

Procedia PDF Downloads 410

Authors: Esra Ceren Kara, Ufuk Seri̇n

Abstract:

The Byzantine Empire, which persisted from the 4th to 15th centuries, covered a significant period in history and bequeathed a significant cultural heritage throughout its territories, including Turkey. However, despite its historical and cultural importance, the approach of the political authorities, which emphasizes the Seljuk and Ottoman heritage, to Byzantium in Turkey is reluctant and problematic. Byzantine history and culture have long been neglected and attained negative connotations. This has led to a lack of awareness and understanding of Byzantine heritage among the public and inadequate conservation efforts. This research aims to address this problem by proposing a reinterpretation and presentation of Byzantine heritage in Turkey that emphasizes its cultural value and presents it to the public as a part of a common cultural heritage in order to accomplish effective conservation, raise awareness and provide a better understanding of the Byzantium. In this article, the ways to interpret, present and integrate the Medieval Byzantine heritage into today’s world are analyzed through the selected case study of Trebizond (Trabzon) with a holistic approach by putting emphasis on the Byzantine religious edifices, churches, chapels and monasteries. Although the vestiges of this period are still intact and in use today, their past is unknown to many of their users. This situation is even more evident in the case of the converted churches, which are now used as mosques or mosque-museums. In the city center of Trebizond, 9 out of 12 religious edifices that are still in use were built during the Medieval Byzantine period and converted into mosques under Ottoman and Turkish rule. Currently, these monuments serve as mosques and mosque-museums. However, with the exception of Hagia Sophia and Girls Monastery, their Byzantine past is obscure to many locals. Thus, the promotion of local awareness and conservation of the Medieval Byzantine heritage in the city is required. With this premise, this research will investigate the values and opportunities offered by the Byzantine cultural heritage in Trebizond and the threats to its conservation, and it will offer proposals for a more effective interpretation and presentation so as to foster local awareness and integration of the Medieval Byzantine heritage.

Keywords: Byzantium/Byzantine, Trebizond, cultural heritage, interpretation and presentation, conservation, religious architecture, converted churches interpretation and presentation

Procedia PDF Downloads 78

Authors: Meltem Karatepe Kaya

Abstract:

The concept of corporate governance is not new but, due to the recent international financial crisis, it has become prominent in contemporary business, accounting and legal debates. There is a wealth of anecdotal evidence which shows that protection of minority shareholders is an important issue in the corporate governance literature. Minority shareholders typically hold low amounts of stocks, so the benefits gained from their participation in shareholder meetings are very asymmetric to the cost. Therefore, the presence of a good corporate governance structure is the proper protection of and respect for the rights and interests of shareholders, particularly those of minority shareholders. The research will attempt to find answers to the following questions: Why minority shareholders’ rights should be protected? How minority shareholders’ rights could be improved? Does the legal framework in the United Kingdom provide adequate protection for minority shareholders? This study will assess regulations about the legal protections of minority shareholders and try to find answer this question: ’Why is it inevitable for company law to treat in a successful way the problems arising from minority shareholders' conflict with other shareholders of a company?’The protection of minority shareholders is not only a corporate governance objective in its own right but also has added importance particularly in developing countries. In the United Kingdom(UK) and the United States of America(USA), there are diffused ownership structures so that any shareholders do not influence the management of the company. This is in stark contrast to companies in developing countries such as Turkey where controlling shareholders and related insiders are a well-known feature of ownership structures, and where companies are often governed and managed by controlling shareholders such as family firms and associated companies through cross-shareholdings and pyramiding ownership structures. In Turkey, the agency problem is not between shareholders and management. Rather it gives rise to another dimension of the agency problem – a conflict of interest between majority shareholders (controlling) and minority shareholders. This research will make a particularly useful contribution to knowledge-based information and understanding of company law in the UK, particularly minority shareholders' remedies. It will not only give information about law and regulations of minority shareholders' remedies but also it will provide some knowledge about doctrinal discussions and relevant cases. The major contribution to study will be in the knowledge of law and regulation in the legal protections of minority shareholders in the United Kingdom and Turkey. In this study, the recommendations will be given for the development of the legal framework and practices of protections for minority shareholders and small investors.

Keywords: controlling shareholders, corporate governance, derivative actions, minority shareholders

Procedia PDF Downloads 173

Authors: A. Al Hajeri, M. E. Minton, B. Haskins, F. H. Cummins

Abstract:

The pre-hospital endotracheal intubation is fraught with difficulties; one solution offered has been video laryngoscopy (VL) which permits better visualization of the glottis than the standard method of direct laryngoscopy (DL). This method has resulted in a higher first attempt success rate and fewer failed intubations. However, VL has mainly been evaluated by experienced providers (experienced anesthetists), and as such the utility of this device for those whom infrequently intubate has not been thoroughly assessed. We sought to evaluate this equipment to determine whether in the hands of novice providers this equipment could prove an effective airway management adjunct. DL and two VL methods (C-Mac with distal screen/C-Mac with attached screen) were evaluated by simulating practice on a Laerdal airway management trainer manikin. Twenty Emergency Medical Technicians (basics) were recruited as novice practitioners. This group was used to eliminate bias, as these clinicians had no pre-hospital experience of intubation (although they did have basic airway skills). The following areas were assessed: Time taken to intubate, number of attempts required to successfully intubate, ease of use of equipment VL (attached screen) took on average longer for novice clinicians to successfully intubate and had a lower success rate and reported higher rating of difficulty compared to DL. However, VL (with distal screen) and DL were comparable on intubation times, success rate, gastric inflation rate and rating of difficulty by the user. This study highlights the routine use of VL by inexperienced clinicians would be of no added benefit over DL. Further studies are required to determine whether Emergency Medical Technicians (Paramedics) would benefit from this airway adjunct, and ascertain whether after initial mastery of VL (with a distal screen), lower intubation times and difficulty rating may be achievable.

Keywords: direct laryngoscopy, endotracheal intubation, pre-hospital, video laryngoscopy

Procedia PDF Downloads 410

Authors: Claudio D'Alonzo

Abstract:

According to recent tendencies, progress on resource efficiency is possible and it will lead to economic, environmental, and social benefits. The passage to a circular economy system, in which all the materials and energy will maintain their value for as long as possible, waste is reduced and only a few resources are used, is one of the most relevant parts of the European Union's environmental policy to develop a sustainable, competitive and low-carbon economy. A definition of circular economy can be found in Decision 1386/2013/EU of the European Parliament and of the Council on a General Union Environment Action Programme to 2020 named “Living well, within the limits of our planet”. The purpose of renewing waste management systems in the UE and making the European model one of the most effective in the world, a revised waste legislative framework entered into force in July 2018. Regarding the Italian legislation, the laws to be modified are the Legislative Decree 3 April 2006, n. 152 and the laws ruling waste management, end-of-waste, by-products and, the regulatory principles regarding circular economy. European rules on end-of-waste are not fully harmonised and so there are legal challenges. The target to be achieved is full consistency between the laws implementing waste and chemicals policies. Only in this way, materials will be safe, fit-for-purpose and designed for durability; additionally, they will have a low environmental impact.

Keywords: circular economy, end-of-waste, legislation, secondary raw materials

Procedia PDF Downloads 83

Authors: Yasemin İlkay

Abstract:

Street is not only a crucial spatial unit in urban design and planning discipline but also the context of walking practice in urban space. Moreover, psychogeography concentrates on both ‘walking’ and, therefore, the differentiated forms of (urban) streets to examine the influence of the built environment on the feelings and attitudes of human beings. This paper focuses on ‘walking practice’ in university campuses with reference to spatial appropriation forms via a psychogeographic lens on the phenomenon of alle in two different cities of Turkey, Ankara, the capital city, and Van, in the eastern part of the country. Alle, as an extension of ‘street’ in university campuses, is the constructive spatial structure in university campuses, and as a result, it should be the (both physical and mental) spine of design policy while conceiving and constructing a university campus. The main question of the paper is: How does the interrelation of ‘campus design’ and ‘walking practice’ on alle penetrate reciprocally on the spatial representations of citizens within their urban daily lives. The body contacts with and at urban space (with other objects and subjects) via its movements and stops; this interaction occurs through the spatial pattern of occupancy and vacancy. Walking practice leads to a set of cognitive mental representations in relation to the repertoire of place attachment and spatial appropriation. University campuses are autonomous and fruitful urban spaces to investigate such an interaction. There are both physical/real and psychogeographic representations of the same urban spaces and urban spatial practices. This separation would indicate the invisible dimensions of the difference between ‘what is conceived’ and ‘what is perceived.’ This study aims to compare and contrast the role of alle in both campus design and spatial appropriation via walking at two differentiated university campuses by collecting the mental representations, doing in-depth interviews, and attending walks with the interviewees by psychogeographic techniques. Campus design and spatial appropriation will be compared [with reference to the conception and perception of alle] in three scales: (1) the historical spatial development stories and design approaches of university campuses, (2) the spatial pattern of campuses on the basis of alle, and (3) sub-behavioral regions of the alle in campuses in relation with mental representations and psychogeographic attentive walks. The sub-questions of the research are: [1] How and why do the design approaches differentiate in two university campuses in Turkey, [2] How the interrelation among alle design and spatial appropriation differs in these two cases, and [3] What do the differentiated gaps among real and psychographic maps indicate about the design and spatial appropriation interrelation. METU, as a well-designed, readable campus with its alle, promise a rich walking practice with in-depth and fruitful spatial appropriation regions; however, Van YYÜ limits both the practice and place attachment with its partial design with an alle which is later added to the campus. This research both displays the role of alle in the campus design, walking practice and spatial appropriation and opens a new methodological path to discover hidden knowledge within urban spaces.

Keywords: alle, campus design, cognitive geography, psychogeography, spatial appropriation, Turkey

Procedia PDF Downloads 103

Authors: Mehmet Demir Kaya, Engin Gökhan Kulan, Onur İleri, Süleyman Avcı

Abstract:

This research was conducted to determine the difference in seed vigor between the seed lots cultivated in main and second crop of soybean in Turkey. Seeds from soybean cv. Cinsoy and Umut-2002 were evaluated in the laboratory for germination, emergence, cool test at 18°C for 10 days, and cold test at 10°C for 4 days and 25°C for 6 days. Result showed that the initial oil contents of Cinsoy and Umut-2002 and seeds were determined to be 19.8 and 20.1% in main crop, and 18.7 and 22.1% in second crop, respectively. It was determined that a clear difference between main and second crop soybean seed lots for seed vigor was found. Germination and emergence percentage were higher in the seed from second crop cultivation of the cultivars. There was no significant difference in germination percentage in cool and cold test while seedling growth was better in the seeds of second crop soybean. The highest seed vigor index (477.6) was found in the seeds of the cultivars grown at second crop. Standard germination percentage did not give a sensitive separation for determining seed vigor of soybean lots. It was concluded that second crop soybean seeds were found the most suitable for seed production while main crop soybean gave higher protein lower oil content.

Keywords: Glycine max L., germination, emergence, protein content, vigor test

Procedia PDF Downloads 458

Authors: Angelis P. Barlampas

Abstract:

Purpose of Learning Objective: This case depicts the need for cooperation between the emergency department and the radiologist to achieve the best diagnostic result for the patient. The clinical picture must correlate well with the radiology report and when it does not, this is not necessarily someone’s fault. Careful interpretation and good knowledge of the limitations, advantages and disadvantages of each imaging procedure are essential for the final diagnostic goal. Methods or Background: A patient was brought to the emergency department by their relatives. He was suddenly confused and his mental status was altered. He hadn't any history of mental illness and was otherwise healthy. A computing tomography scan without contrast was done, but it was unremarkable. Because of high clinical suspicion of probable neurologic disease, he was admitted to the hospital. Results or Findings: Another T was done after 48 hours. It showed a hypodense region in both thalamic areas. Taking into account that the first CT was normal, but the initial clinical picture of the patient was alerting of something wrong, the repetitive CT exam is highly suggestive of a probable diagnosis of bilateral thalamic infractions. Differential diagnosis: Primary bilateral thalamic glioma, Wernicke encephalopathy, osmotic myelinolysis, Fabry disease, Wilson disease, Leigh disease, West Nile encephalitis, Greutzfeldt Jacob disease, top of the basilar syndrome, deep venous thrombosis, mild to moderate cerebral hypotension, posterior reversible encephalopathy syndrome, Neurofibromatosis type 1. Conclusion: As is the case of limitations for any imaging procedure, the same applies to CT. The acute ischemic attack can not depict on CT. A period of 24 to 48 hours has to elapse before any abnormality can be seen. So, despite the fact that there are no obvious findings of an ischemic episode, like paresis or imiparesis, one must be careful not to attribute the patient’s clinical signs to other conditions, such as toxic effects, metabolic disorders, psychiatric symptoms, etc. Further investigation with MRI or at least a repeated CT must be done.

Keywords: CNS, CT, thalamus, emergency department

Procedia PDF Downloads 121

Authors: Ivana R. Moser, Joao C. Souza

Abstract:

Building fires are random phenomena that can be extremely violent, and safe evacuation of people is the most guaranteed tactic in saving lives. The correct evacuation of buildings, and other spaces occupied by people, means leaving the place in a short time and by the appropriate way. It depends on the perception of spaces by the individual, the architectural layout and the presence of appropriate routing systems. As historical buildings were constructed in other times, when, as in general, the current security requirements were not available yet, it is necessary to adapt these spaces to make them safe. Computer models of evacuation simulation are widely used tools for assessing the safety of people in a building or agglomeration sites and these are associated with the analysis of human behaviour, makes the results of emergency evacuation more correct and conclusive. The objective of this research is the performance evaluation of historical interest buildings, regarding the safe evacuation of people, through computer simulation, using PTV Viswalk software. The buildings objects of study are the Colégio Catarinense, centennial building, located in the city of Florianópolis, Santa Catarina / Brazil. The software used uses the variables of human behaviour, such as: avoid collision with other pedestrians and avoid obstacles. Scenarios were run on the three-dimensional models and the contribution to safety in risk situations was verified as an alternative measure, especially in the impossibility of applying those measures foreseen by the current fire safety codes in Brazil. The simulations verified the evacuation time in situations of normality and emergency situations, as well as indicate the bottlenecks and critical points of the studied buildings, to seek solutions to prevent and correct these undesirable events. It is understood that adopting an advanced computational performance-based approach promotes greater knowledge of the building and how people behave in these specific environments, in emergency situations.

Keywords: computer simulation, escape routes, fire safety, historic buildings, human behavior

Procedia PDF Downloads 187

Authors: Recep Keşli, Hayriye Tokay, Cengiz Demir, İsmail Ceyhan

Abstract:

Objective: In many countries, tuberculosis (TB) is still one of the most important diseases. Tuberculosis is among top 10 causes of death worldwide. The early diagnosis of active tuberculosis still depends on the presence of acid resistant bacilli (ARB) in stained smears. In this study, we aimed to investigate the diagnostic performances of Erlich Ziehl Neelsen (EZN), Kinyoun and two different fluorescent stains. Methods: The specimens were obtained from the patients who applied to Chest Diseases Departments of Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, and Afyon Kocatepe University, ANS Research and Practice Hospital. The study was carried out in the Medical Microbiology Laboratory, School of Medicine, Afyon Kocatepe University. All the non-sterile specimens were homogenized and decontaminated according to the EUCAST instructions. Samples were inoculated onto the Löwenstein-Jensen agars (bio-Merieux Marcy l'Etoile, France) and then incubated at 37˚C, for 40 days. Four smears were prepared from each specimen. Slides were stained with commercial EZN (BD, Sparks, USA), Kinyoun (SALUBRIS Istanbul, Turkey), Auramine (SALUBRIS Istanbul, Turkey) and Rhodamine (SALUBRIS Istanbul, Turkey) kit. While EZN and Kinyoun stainings were examined by light microscope, Auramine and Rhodamine slides were examined by fluorescence microscopy. Results: A total of 158 respiratory system samples (sputum, broncho alveolar lavage fluid…etc) were enrolled into the study. A hundred and two of the samples that processed were found as culture positive. The sensitivity, specificity, positive predictive, and negative predictive values were detected as 100%, 67.5%, 73.5%, and 100% for EZN, 100%, 70.9%, 77.4%, and 100% for Kinyoun, 100%,77.8%, 84.3%, 100% for Auramine, and 100%, 80% , 86.3%, and 100% for Rhodamine respectively. Conclusions: According to our study auramine and rhodamine staining methods showed the best diagnostic performance among the four investigated staining methods. In conclusion, the fluorochrome staining method may be accepted as the most reliable, rapid and useful method for diagnosis of the mycobacterial infections truly.

Keywords: acid resistant bacilli (ARB), auramine, Ehrlich-Ziehl-Neelsen (EZN), Kinyoun, Rhodamine

Procedia PDF Downloads 276

Authors: Ebru Acuner, Gulgun Kayakutlu, M. Ozgur Kayalica, Sermin Onaygil

Abstract:

In Turkey, emigration, especially from Syria, has been continuously increasing together with rapid urbanization. In parallel to this, total energy consumption has been growing, rapidly. Unfortunately, domestic energy sources could not meet this energy demand. Hence, there is a need for reliable predictions. For this reason, before making a survey study for the migrated people, an informative questionnaire was prepared to take the opinions of the experts on the main drivers that shape the energy consumption behavior of the migrated people. Totally, 17 experts were answered, and they were analyzed by means of Netica program considering Bayesian belief analysis method. In the analysis, factors affecting energy consumption behaviors as well as strategies, institutions, tools and financing methods to change these behaviors towards efficient consumption were investigated. On the basis of the results, it can be concluded that changing the energy consumption behavior of the migrated people is crucial. In order to be successful, electricity and natural gas prices and tariffs in the market should be arranged considering energy efficiency. In addition, support mechanisms by not only the government but also municipalities should be taken into account while preparing related policies. Also, electric appliance producers should develop and implement strategies and action in favor of the usage of more efficient appliances. Last but not least, non-governmental organizations should support the migrated people to improve their awareness on the efficient consumption for the sustainable future.

Keywords: Bayesian belief, behavior, energy consumption, energy efficiency, migrated people

Procedia PDF Downloads 111

Authors: Alldila Hendy, Agi Satria

Abstract:

Background: A colostomy procedure is an important part in the management of surgical procedures in some diseases involving the gastrointestinal tract. So it is necessary to find the factors that influence the occurrence of complications. Methods: This is a retrospective cross-sectional analytic study in Cipto Mangunkusumo Hospital noting medical records of patients after the colostomy from January 2012 to December 2014 at the Division of Digestive Surgery. Results: In 136 cases of post-colostomy, 66 cases have complications, 14 is early-onset, and 52 is late-onset. 70 is without complications. Most complications are dermatitis, which is 31 (22.8%), cases of infection/abscess/fistula and intestinal obstruction are 13 (9.6%) and 5 patients (4.4%). A rare complication is colostomy retraction by 2 patients (1.5%), colostomy prolapse and necrosis/gangrene, which is only 3 patients (2.2%). A colostomy procedure in emergency surgery is riskier than elective surgery for complications after colostomy (p < 0.007, OR 2.85), Based on the operator who performs a colostomy procedure, the consultant had a lower risk of complications than fellow or resident (p < 0.0001). Based on the age factor, where the age of about 50 years has a risk of complications after colostomy (p < 0.018). Conclusion: The timing of operation (emergency or elective), age, and operator who perform a colostomy procedure have a significant relationship with an increased prevalence of complications after colostomy in RSCM.

Keywords: colostomy, complications, factors, procedure

Procedia PDF Downloads 270

Authors: Jerome Dalphinis, Vishal Patel

Abstract:

The Bailiwick of Jersey is an island British crown dependency situated off the coast of France. Jersey General Hospital’s emergency department sees approximately 40,000 patients a year. It’s outside the NHS, with secondary care being free at the point of care. Sedation is a continuum which extends from a normal conscious level to being fully unresponsive. Procedural sedation produces a minimally depressed level of consciousness in which the patient retains the ability to maintain an airway, and they respond appropriately to physical stimulation. The goals of it are to improve patient comfort and tolerance of the procedure and alleviate associated anxiety. Indications can be stratified by acuity, emergency (cardioversion for life-threatening dysrhythmia), and urgency (joint reduction). In the emergency department, this is most often achieved using a combination of opioids and benzodiazepines. Some departments also use ketamine to produce dissociative sedation, a cataleptic state of profound analgesia and amnesia. The response to pharmacological agents is highly individual, and the drugs used occasionally have unpredictable pharmacokinetics and pharmacodynamics, which can always result in progression between levels of sedation irrespective of the intention. Therefore, practitioners must be able to ‘rescue’ patients from deeper sedation. These practitioners need to be senior clinicians with advanced airway skills (AAS) training. It can lead to adverse effects such as dangerous hypoxia and unintended loss of consciousness if incorrectly undertaken; studies by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) have reported avoidable deaths. The Royal College of Emergency Medicine, UK (RCEM) released an updated ‘Safe Sedation of Adults in the Emergency Department’ guidance in 2017 detailing a series of standards for staff competencies, and the required environment and equipment, which are required for each target sedation depth. The emergency department in Jersey undertook audit research in 2018 to assess their current practice. It showed gaps in clinical competency, the need for uniform care, and improved documentation. This spurred the development of a checklist incorporating the above RCEM standards, including contraindication for procedural sedation and difficult airway assessment. This was approved following discussion with the relevant heads of departments and the patient safety directorates. Following this, a second audit research was carried out in 2019 with 17 completed checklists (11 relocation of joints, 6 cardioversions). Data was obtained from looking at the controlled resuscitation drugs book containing documented use of ketamine, alfentanil, and fentanyl. TrakCare, which is the patient electronic record system, was then referenced to obtain further information. The results showed dramatic improvement compared to 2018, and they have been subdivided into six categories; pre-procedure assessment recording of significant medical history and ASA grade (2 fold increase), informed consent (100% documentation), pre-oxygenation (88%), staff (90% were AAS practitioners) and monitoring (92% use of non-invasive blood pressure, pulse oximetry, capnography, and cardiac rhythm monitoring) during procedure, and discharge instructions including the documented return of normal vitals and consciousness (82%). This procedural sedation checklist is a safe intervention that identifies pertinent information about the patient and provides a standardised checklist for the delivery of gold standard of care.

Keywords: advanced airway skills, checklist, procedural sedation, resuscitation

Procedia PDF Downloads 117

Authors: Langhit Kurar, Loren Charles

Abstract:

Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

Procedia PDF Downloads 180

Authors: Sathyaseelan Subramaniam, Jacqueline Bober, Jennifer Chao, Shahriar Zehtabchi

Abstract:

Background: Emergency physicians frequently evaluate skin and soft tissue infections in order to differentiate abscess from cellulitis. This helps determine which patients will benefit from incision and drainage. Our objective was to determine the operating characteristics of point-of-care ultrasound (POCUS) compared to clinical examination in identifying abscesses in emergency department (ED) patients with features of skin and soft tissue infections. Methods: We performed a comprehensive search in the following databases: Medline, Web of Science, EMBASE, CINAHL and Cochrane Library. Trials were included if they compared the operating characteristics of POCUS with clinical examination in identifying skin and soft tissue abscesses. Trials that included patients with oropharyngeal abscesses or that requiring abscess drainage in the operating room were excluded. The presence of an abscess was determined by pus drainage. No pus seen on incision or resolution of symptoms without pus drainage at follow up, determined the absence of an abscess. Quality of included trials was assessed using GRADE criteria. Operating characteristics of POCUS are reported as sensitivity, specificity, positive likelihood (LR+) and negative likelihood (LR-) ratios and the respective 95% confidence intervals (CI). Summary measures were calculated by generating a hierarchical summary receiver operating characteristic model (HSROC). Results: Out of 3203 references identified, 5 observational studies with 615 patients in aggregate were included (2 adults and 3 pediatrics). We rated the quality of 3 trials as low and 2 as very low. The operating characteristics of POCUS and clinical examination in identifying soft tissue abscesses are presented in the table. The HSROC for POCUS revealed a sensitivity of 96% (95% CI = 89-98%), specificity of 79% (95% CI = 71-86), LR+ of 4.6 (95% CI = 3.2-6.8), and LR- of 0.06 (95% CI = 0.02-0.2). Conclusion: Existing evidence indicates that POCUS is useful in identifying abscesses in ED patients with skin or soft tissue infections.

Keywords: abscess, point-of-care ultrasound, pocus, skin and soft tissue infection

Procedia PDF Downloads 369

Authors: İrem Yetkin, Feray Maden, Seda Tosun, Yenal Akgün, Özgür Kilit, Koray Korkmaz, Gökhan Kiper, Mustafa Gündüzalp

Abstract:

Forced migration, whether caused by conflicts or other factors, frequently places individuals in vulnerable situations, necessitating immediate access to shelter. To promptly address the immediate needs of affected individuals, temporary shelters are often established. These shelters are characterized by their adaptable and functional nature, encompassing lightweight and sustainable structural systems, rapid assembly capabilities, modularity, and transportability. The shelter design is contingent upon demand, resulting in distinct phases for different structural forms. A multi-phased shelter approach covers emergency response, temporary shelter, and permanent reconstruction. Emergency shelters play a critical role in providing immediate life-saving aid, while temporary and transitional shelters, which are also called “t-shelters,” offer longer-term living environments during the recovery and rebuilding phases. Among these, temporary shelters are more extensively covered in the literature due to their diverse inhabiting functions. The roles of emergency shelters and temporary shelters are inherently separate, addressing distinct aspects of sheltering processes. Given their prolonged usage, temporary shelters are built for greater durability compared to emergency shelters. Nonetheless, inadequacies in temporary shelters can lead to challenges in ensuring habitability. Issues like non-expandable structures unsuitable for accommodating large families, the use of short-term shelters that worsen conditions, non-waterproof materials providing insufficient protection against bad weather conditions, and complex installation systems contribute to these problems. Given the aforementioned problems, there arises a need to develop adaptive shelters featuring lightweight components for ease of transport, possess the ability for rapid assembly, and utilize durable materials to withstand adverse weather conditions. In this study, first, the state-of-the-art on temporary shelters is presented. Then, an adaptive temporary shelter composed of foldable plates is proposed, which can easily be assembled and transportable. The proposed shelter is deliberated upon its movement capacity, transportability, and flexibility. This study makes a valuable contribution to the literature since it not only offers a systematic analysis of temporary shelters utilizing kinetic systems but also presents a practical solution that meets the necessary design requirements.

Keywords: deployable structures, foldable plates, forced migration, temporary shelters

Procedia PDF Downloads 72

Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

Abstract:

In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

Procedia PDF Downloads 147

Authors: Ryan Adams

Abstract:

Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

Procedia PDF Downloads 393

Authors: Y. Sarı Nayim, B. N. Nayim

Abstract:

This research proposal includes the defining and evaluation of the semi-natural and cultural ecosystems at Bartın University main campus in Turkey in terms of landscape mosaics. The ecosystem mosaic of the main campus was divided into zones based on ecological classification technique. Based on the results from the study, it was found that 6 different ecosystem mosaics should be used as a base in the planning and design of the existing and future landscape planning of Kutlubeyyazıcılar campus. The first landscape zone involves the 'social areas'. These areas include yards, dining areas, recreational areas and lawn areas. The second landscape zone is 'main vehicle and pedestrian areas'. These areas include vehicle access to the campus landscape, moving in the campus with vehicles, parking and pedestrian walk ways. The third zone is 'landscape areas with high visual landscape quality'. These areas will be the places where attractive structural and plant landscape elements will be used. Fourth zone will be 'landscapes of building borders and their surroundings.' The fifth and important zone that should be survived in the future is 'Actual semi-natural forest and bush areas'. And the last zone is 'water landscape' which brings ecological value to landscape areas. While determining the most convenient areas in the planning and design of the campus, these landscape mosaics should be taken into consideration. This zoning will ensure that the campus landscape is protected and living spaces in the campus apart from the areas where human activities are carried out will be used properly.

Keywords: campus landscape planning and design, landscape ecology, landscape mosaics, Bartın

Procedia PDF Downloads 366

Authors: Okan Cakir, Okan Tatli

Abstract:

Acute motor and sensory axonal neuropathy (AMSAN) syndrome usually occurs following a postviral infection in two to four weeks and is a polyneuropathy characterized by axonal and sensorial degeneration as a rare variant of Gullian-Barre syndrome. In our case, we wanted to mention that a rare case of AMSAN Syndrome due to prior surgery. A 61-year-old male case admitted to emergency department with complaints of weakness in feet, numbness and incapability to walk. In his history, it was learned that endovascular aneurysm repair (EVAR) had applied for abdominal aort aneurysm two weeks ago before admission, his complaints had been for a couple of days increasingly and bilaterally, and there had been no infection disease history for four weeks. In physical examination, general status was good, vital signs were stable, and there was a mild paresis in dorsal flexion of feet in bilaterally lower extremities. No nuchal rigidity was determined. Other system examinations were normal. Urea:52 mg/dL (normal range: 15-44 mg/dL), creatinine: 1,05 mg/dL (normal range: 0,81-1,4 mg/dL), potassium: 3,68 mmol/L (normal range: 3,5-5,5 mmol/L), glycaemia: 142 mg/dL, calcium: 9,71 mg/dL (normal range: 8,5-10,5 mg/dL), erythrocyte sedimentation rate (ESR): 74 mm/h (normal range: 0-15 mm/h) were determined in biochemical tests. The case was consulted to neurology department and hospitalized. In performing electromyography, it was reported as a bilateral significant axonal degeneration with sensory-motor polyneuropathy. Normal ranges of glycaemia and protein levels were detected in lumbal punction. Viral markers and bucella, toxoplasma, and rubella markers were in normal range. Intravenous immunoglobulin (IVIG) was applied as a treatment, physical treatment programme was planned and the case discharged from neurology department. In our case, we mentioned that it should be considered polyneuropathy as an alternative diagnosis in cases admitting symptoms like weakness and numbness had a history of prior surgery.

Keywords: AMSAN Syndrome, emergency department, prior surgery, weakness

Procedia PDF Downloads 340

Authors: Mohammad Amini, Aliakbar Alijarahi

Abstract:

This research that is collected and title as ‘ the search of possibility of running six sigma process in IT education center ‘ goals to test possibility of running the six sigma process and using in IT education center system. This process is a good method that is used for reducing process, errors. To evaluate running off six sigma in the IT education center, some variables relevant to this process is selected. These variables are: - The amount of support from organization master boss to process. - The current specialty. - The ability of training system for compensating reduction. - The amount of match between current culture whit six sigma culture . - The amount of current quality by comparing whit quality gain from running six sigma. For evaluation these variables we select four question and to gain the answers, we set a questionnaire from with 28 question and distribute it in our typical society. Since, our working environment is a very competition, and organization needs to decree the errors to minimum, otherwise it lasts their customers. The questionnaire from is given to 55 persons, they were filled and returned by 50 persons, after analyzing the forms these results is gained: - IT education center needs to use and run this system (six sigma) for improving their process qualities. - The most factors need to run the six sigma exist in the IT education center, but there is a need to support.

Keywords: education, customer, self-action, quality, continuous improvement process

Procedia PDF Downloads 340

Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

Abstract:

In a disaster event, sharing patient information between the pre-hospital Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre- EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors that are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality, and the data were analyzed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system that can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analyzed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospital staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: emergency medical teams, communication, information and communication technologies, disaster

Procedia PDF Downloads 126

Authors: Phatthara Surachon, Tosaphol Ratniyomchai, Thanatchai Kulworawanichpong

Abstract:

This paper presents an aerodynamic brake study of reducing braking distance for high-speed trains (HST) using aerodynamic brakes as inspiration from the applications on the commercial aircraft wings. In case of emergency, both braking distance and stopping time are longer than the usual situation. Therefore, the passenger safety and the HST driving control management are definitely obtained by reducing the time and distance of train braking during emergency situation. Due to the limited study and implementation of the aerodynamic brake in HST, the possibility in use and the effectiveness of the aerodynamic brake to the train dynamic movement during braking are analyzed and considered. Regarding the aircraft’s flaps that applied in the HST, the areas of the aerodynamic brake acted as an additional drag force during train braking are able to vary depending on the operating angle and the required dynamic braking force. The HST with a varying speed of 200 km/h to 350 km/h is taken as a case study of this paper. The results show that the stopping time and the brake distance are effectively reduced by the aerodynamic brakes. The mechanical brake and its maintenance are effectively getting this benefit by extending its lifetime for longer use.

Keywords: high-speed train, aerodynamic brake, brake distance, drag force

Procedia PDF Downloads 198

Authors: Nesli Aydin

Abstract:

Waste management decision making in developing countries has moved towards being more pragmatic, transparent, sustainable and comprehensive. Turkey is required to make its waste related legislation compatible with European Legislation as it is a candidate country of the European Union. Improper Turkish practices such as open burning and open dumping practices must be abandoned urgently, and robust waste management systems have to be structured. The determination of an optimum waste management system in any region requires a comprehensive analysis in which many criteria are taken into account by stakeholders. In conducting this sort of analysis, there are two main criteria which are evaluated by waste management analysts; economic viability and environmentally friendliness. From an analytical point of view, a central characteristic of sustainable development is an economic-ecological integration. It is predicted that building a robust waste management system will need significant effort and cooperation between the stakeholders in developing countries such as Turkey. In this regard, this study aims to provide data regarding the cost and environmental burdens of waste treatment technologies such as an incinerator, an autoclave (with different capacities), a hydroclave and a microwave coupled with updated information on calculation methods, and a framework for comparing any proposed scenario performances on a cost and environmental basis.

Keywords: decision making, economic viability, environmentally friendliness, waste management systems

Procedia PDF Downloads 305

Authors: Catherine Oluyemo

Abstract:

In Africa, patriarchy has manifested itself in the socio-cultural, political, economic and legal institutions. The decree of the father as the male head of the family has contributed to the powerlessness of women in African nations. To buttress this perception, in his work Meno, Plato made a declaration in the platonic dialogue that the desirable quality of a man should be the capacity to administer the state, and in the administration of it to benefit his friends and harm his enemies; and he must also be careful not to suffer harm himself. Furthermore, he said: a woman's good worth may also be easily described as ordering her house, keep what is indoors, and obey her husband. The works of Aristotle portrayed women as morally, intellectually, and physically inferior to men; they saw women as the property of men; claimed that women's role in society was to reproduce and serve men in the household; and saw male domination of women as natural and virtuous. This has been sustained for ages and is incessantly impinging on the involvement of women in African leadership positions. The purpose of this paper is to make sense of the concept of patriarchy in relations to women participation in Africa leadership, and its challenges in the participation of women in the leadership positions of Africa. It seeks to discover what women should do to make their voices heard, to participate in leadership arrangements so as to actualize their potentials in contributing to the development of Africa.

Keywords: women, leadership, patriarchy, development, actualize, potentials

Procedia PDF Downloads 349

Authors: Neşe Işık, Şenol Altıok, Galip Devrim Eryılmaz, Aydın durukan, Hasan Özgür Daş

Abstract:

In this study, an active landslide zone affecting the road alignment on the Tortum-Uzundere (Erzurum/Turkey) highway was investigated. Due to the landslide movement, problems have occurred in the existing road pavement, which has caused both safety problems and reduced driving comfort in the operation of the road. In order to model the landslide, drilling, geophysical and inclinometer studies were carried out in the field within the scope of ground investigation. Laboratory tests were carried out on soil and rock samples obtained from the borings. When the drilling and geophysical studies were evaluated together, it was determined that the study area has a complex geological structure. In addition, according to the inclinometer results, the direction and speed of movement of the landslide mass were observed. In order to create an idealized geological profile, all field and laboratory studies were evaluated together and then the sliding surface of the landslide was determined by back analysis method. According to the findings obtained, it was determined that the landslide was massively large, and the movement occurred had a deep sliding surface. As a result of the numerical analyses, it was concluded that the Slope angle reduction is the most economical and environmentally friendly method for the control of the landslide mass.

Keywords: landslide, geotechnical methods, geophysics, monitoring, highway

Procedia PDF Downloads 68

Authors: Alisher Agzamov, Hanan Al Harbi

Abstract:

BACKGROUND: The timely assessment and treatment of ICU Surgical and Medical Oncology patients is important for Oncology surgeons and Medical Oncologists and Intensivists. We hypothesized that the use of Robot Physician’s (RP - 7) ICU management and care in ICU can improve ICU physician rapid response to unstable ICU Oncology patients. METHODS: This is a prospective study using a before-after, cohort-control design to test the effectiveness of RP. We have used RP to make multidisciplinary ICU rounds in the ICU and for Emergency cases. Data concerning several aspects of the RP interaction including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RP were documented. The effect of RP on ICU length of stay and cost was assessed. RESULTS: The use of RP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RP: 10.2 +/- 3.3 minutes vs conventional: 220 +/- 80 minutes). The response latencies to Oncology Emergency (8.0 +/- 2.8 vs 150 +/- 55 minutes) and for Respiratory Failure (12 +/- 04 vs 110 +/- 45 minutes) were reduced (P < .001), as was the LOS for patients with AML (5 days) and ARDS (10 day). There was an increase in ICU occupancy by 20 % compared with the prerobot era, and there was an ICU cost savings of KD2.5 million attributable to the use of RP. CONCLUSION: The use of RP enabled rapid face-to-face ICU Intensivist - physician response to unstable ICU Oncology patients and resulted in decreased ICU cost and LOS.

Keywords: robot physician, oncology patients, rp - 7 in icu management, cost and icu occupancy

Procedia PDF Downloads 81

Authors: Şemsettin Şahin, Ahmet Oğuz Aktürk, İsmail Çelik

Abstract:

This study investigated the views of teachers, students and students' parents on the FATIH (Movement of Enhancing Opportunities and Improving Technology) Project, which was put into service by the Ministry of National Education in cooperation with the Ministry of Transportation in Turkey in November 2010 for the purpose of increasing students' success and planned to be completed within 5 years. The study group consisted of teachers employed in a pilot school in the province of Karaman in central Turkey included within the scope of the FATIH Project, students attending this school and parents whose children are students in that school. The research data were collected through forms developed by the researchers to determine the views of teachers, students and students' parents on the FATIH Project. The descriptive analysis method, one of the qualitative research methods, was used in the study. An analysis of the data revealed that a large majority of the teachers and the students believed that if computers were used to serve their set purpose, then they could make considerable contributions to education. A large majority of the students' parents, on the other hand, regard the use of computers in education as a great opportunity for the students. The views of the teachers, students and students' parents on the FATIH Project usually overlap. Most of the participants in the study pointed out that the FATIH Project was intended to use technology effectively in education. Moreover, each individual participant described their role in the FATIH Project in accordance with their relative position and stated that they could perform whatever was expected of them for the effective and efficient use and progress of the project. The views of the participants regarding the FATİH Project vary according to the kind of the participants.

Keywords: education, FATIH project, technology, students

Procedia PDF Downloads 441

Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

Abstract:

Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

Procedia PDF Downloads 289

Authors: Ali Bolat, Ali Bayat, Mustafa Gullu

Abstract:

Maize can be cultivated both under main and second crop conditions in Turkey. Main pests of maize under second crop conditions are Sesamia nonagrioides Lefebvre (Lepidoptera: Noctuidae) and Ostrinia nubilalis Hübner (Lepidoptera: Crambidae). Aerial spraying applications to control these two main maize pests can be carried out until 2006 in Turkey before it was banned due to environmental concerns like drifting of sprayed pestisides and low biological efficiency. In this context, pulverizers which can spray tall maize plants ( > 175 cm) from the ground have begun to be used. However, the biological efficiency of these sprayers is unknown. Some methods have been tested to increase the success of ground spraying in field experiments conducted in second crop maize in 2008 and 2009. For this aim, 6 spraying methods (air assisted spraying with TX cone jet, domestic cone nozzles, twinjet nozzles, air induction nozzles, standard domestic cone nozzles and tail booms) were used at two application rates (150 and 300 l.ha-1) by a sprayer. In the study, biological efficacy evaluations of each methods were measured in each parcel. Biological efficacy evaluations included counts of number of insect damaged plants, number of holes in stems and live larvae and pupa in stems of selected plants. As a result, the highest biological efficacy value (close to 70%) was obtained from Air Assisted Spraying method at 300 l / ha application volume.

Keywords: air assisted sprayer, drift nozzles, biological efficiency, maize plant

Procedia PDF Downloads 213