Search results for: dependency routine

Authors: Vidhi Chandra, Arshpreet Singh Grewal

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A five-year-old male child born from non-consanguineous marriage, who presented with complaints of growth retardation and no appreciable increase in the penile size since birth and he was posted for de-gloving of penis with dissection of corpora under anaesthesia. After thorough preoperative evaluation it was revealed that patient had peculiar facial dysmorphism that of Robinow Syndrome, high arched palate, Mallampati grade III, mesomelic limbs, scoliotic spine and short stature. All routine investigation were within normal limit, electrocardiography (ECG) and 2D-Echocardiography (ECHO) were normal. In antero-posterior roentgenogram chest showed butterfly and hemivertebrae at multiple levels. The patient was considered to be ASA II. On the day of surgery after ensuring fasting of 6 hours, patient was taken in operation theatre, all standard ASA monitoring was done with ECG, non-invasive blood pressure, peripheral oxygen saturation (SpO2) and body temperature. The patient was pre-oxygenated with 100% oxygen with anatomical face mask. General anaesthesia was induced with Sevoflurane 1-8%, and airway was secured with an appropriate size supraglottic airway and anaesthesia was maintained with nitrous oxide and oxygen in 1:1 ratio along with sevoflurane 2%. An ultrasound guided caudal block was given owing to the skeletal deformities making it difficult even under USG guidance. Post operatively patient was given supportive care with proper hydration, antibiotics, anti-inflammatory and analgesics. He was discharged the next day and followed up weekly for a month. DISCUSSION Robinow syndrome is genetically inherited as autosomal dominant, autosomal recessive or heterogenous disorder involving tyrosine kinase ROR2 gene located on chromosome 9. It has low incidence with no preponderance for any gender. Though intelligence is normal but developmental delay and mental retardation occurs in 20%cases

Keywords: Robinow Syndrome, dwarfism, paediatric, anaesthesia

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Authors: O. J. Osunkeye, P. O. Fakolade, B. E. Olorede

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Broilers productions depend on the provision of adequate and goo quality feed containing all the nutrients, including proteins, carbohydrate, fats, vitamins, minerals and water. All these nutrients have to be provided at a required amount to support maximum productivity and normal physiological functions and demands. Among these nutrients proteins are particularly important, since they are essential for meat and muscle production, optimum growth and health status. Poultry production industry in the developing countries is been threatened because of the over dependency on Soybean meal as one of the key/major conventional protein stuff for feeding livestock. Even the competition between man and livestock for Soybean and other protein sources made the price of this feed stuff to be on the increase. Hence the needs to seek for an alternative feed stuff which is cheap and less competitive. This study showed the blood profile, organ and carcass characteristics and performance of broilers fed with Cowpea Testa Meal (CTM) based diets. Four diets were formulated with Cowpea Testa replacing Soybean at 0%, 15%, 30%, and 50% graded levels. One hundred and twenty day-old unsexed broiler birds were allotted to these four treatments with 3 replicates of 10 birds per replicate. The results showed no significant differences in all the haematological parameters measured (P>0.05), the serum metabolites analysis revealed significant different in Cholesterol (99.8 mg/dl, 112.84 mg/dl, 131.07 mg/dl and 97.66 mg/dl respectively) (P<0.05) among others. There were significant differences within the diets for average daily weight gain, average feed intake and feed to gain ratio. The birds on control (0%) and CTM gained more weight than those fed with 30% and 50% CTM diets. The organs and carcass primal cuts of the broilers expressed significant different for the spleen (0.12 g, 0.09 g, 0.11 g and 0.14 g respectively), lungs (0.97 g, 0.72 g, 0.77 g and 1.01g respectively) and proventriculus (0.96 g, 0.99 g, 0.81 g and 0.85 g respectively) (P<0.05). For the carcass, there were no significant differences (P<0.05) in the breast, thigh, drumstick, wing and neck except for the Back (21.27 g, 21.04 g, 17.71 g, and 17.89 g respectively). In conclusion, CTM inclusion in broiler’s diet could be used as an alternative feed stuff in replacement of Soybean meal up to 15% without any adverse effects as revealed by the blood profile and to increase the growth performance of the birds.

Keywords: physiological functions, cholesterol, blood profiles, CTM and carcass analysis

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Authors: Huang Chiung Chiu

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This article is about the nursing experience of assisting an outpatient with premature menopause, osteoporosis and sarcopenia through a multi-discipline care model. The nursing period is from September 22nd, 2020, to December 7th, 2020, collecting data through interviews with the patient, observation, and physical assessment. It was found that the main health problems were insufficient nutrition, less physical need, insomnia, and potentially dangerous falls. As an outpatient nurse, the author observed that in recent years, the age group of women with premature menopause, osteoporosis and sarcopenia had shifted downward. Integrated multi-disciplinary interventions were provided upon the initial diagnosis of osteoporosis and sarcopenia. Under the outpatient care setting, the collaborative team works between the doctors, nutritionists, osteoporosis educators, rehabilitates, physical therapists and other specialized teams were applied to provide individualized, integrated multi-disciplinary care. Through empathy and the establishment of attentive care, companionship and trust, we discussed care plans and treatment guidelines with the case, providing accurate, complete disease information and feedback education to strengthen the patient’s knowledge and motivation for exercise. Nursing guidance regarding the dietary nutrition and adjustment of daily routine was provided to increase the self-care ability, improve the health problems of muscle weakness and insomnia, and prevent falls. For patients with postmenopausal osteoporosis and sarcopenia, it is recommended that the nurses coordinate the multi-discipline integrated care model, adjust patients’ lifestyle and diet, and establish a regular exercise plan so that the cases can be evaluated holistically to improve the quality of care and physical and mental comfort.

Keywords: multi-discipline care model, premature menopause, osteoporosis, sarcopenia, insomnia

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Authors: Monika Haanpää

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Well-functioning workplaces are often characterized by good co-operation, adequate flow of information, open interaction between workers and a supportive work environment. The workplace is a mosaic of human personalities and the influx of people, who speak different languages and who are from different cultural backgrounds, may bring about new challenges and enrich this environment. However, this influx of people could also pose a problem as the adaptation of immigrant people to new terms of work may depend heavily on the level of language skills, the stage of culture shock, professional identity, and personality. Migration is not a rare phenomenon in Finland anymore; nobody is surprised to see people from different countries and different backgrounds in the schools, on the streets or in shops. However, this does not mean that immigration is an easy process for people coming from other countries. The experience of workers, with diverse language and backgrounds, has rarely been researched, particularly from the superior's point of view. In addition, the vast majority of researchers have paid more attention to multicultural kindergartens in terms of immigrant children and their families. Hence, there is a need to show the problem which exists in the recruitment of the increasing number of workers who come from different countries. Opinions about kindergartens, as multicultural workplaces, have been gathered through interviews with immigrant workers responsible for education. In addition, a questionnaire for native Finnish workers and superiors in kindergartens was carried out. The collected material has been analyzed qualitatively, focusing on topics such as: the kindergarten as a multicultural workplace, factors influencing career success of workers with diverse language and cultural backgrounds, the social relations in the multicultural workplaces and teachers’ changing professional identity. The results of the research provided a novel aspect of the multicultural workplace and emphasized a dependency of immigrant workers’ on language skills in Finnish; affecting professional success. In addition, they showed the good relations between other native Finnish co-workers and superiors. The results also illustrate why writing skills in Finnish are so important in kindergartens. Part of the investigation also questions some results of the research i.e. which is more important in the kindergarten as a multicultural workplace: personality, good professional skills or good language skills.

Keywords: kindergarten, multicultural workplace, social relations at work, work satisfaction

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Authors: M. Cabrera, W. Tizani, J. Ninic, F. Wang

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Open section beam to concrete-filled tubular column structures has been increasingly utilized in construction over the past few decades due to their enhanced structural performance, as well as economic and architectural advantages. However, the use of this configuration in construction is limited due to the difficulties in connecting the structural members as there is no access to the inner part of the tube to install standard bolts. Blind-bolted systems are a relatively new approach to overcome this limitation as they only require access to one side of the tubular section to tighten the bolt. The performance of these connections in concrete-filled steel tubular sections remains uncharacterized due to the complex interactions between concrete, bolt, and steel section. Over the last years, research in structural performance has moved to a more sophisticated and efficient approach consisting of machine learning algorithms to generate metamodels. This method reduces the need for developing complex, and computationally expensive finite element models, optimizing the search for desirable design variables. Metamodels generated by a data fusion approach use numerical and experimental results by combining multiple models to capture the dependency between the simulation design variables and connection performance, learning the relations between different design parameters and predicting a given output. Fully characterizing this connection will transform high-rise and multistorey construction by means of the introduction of design guidance for moment-resisting blind-bolted connections, which is currently unavailable. This paper presents a review of the steps taken to develop metamodels generated by means of artificial neural network algorithms which predict the connection stress and stiffness based on the design parameters when using Extended Hollo-Bolt blind bolts. It also provides consideration of the failure modes and mechanisms that contribute to the deformability as well as the feasibility of achieving blind-bolted rigid connections when using the blind fastener.

Keywords: blind-bolted connections, concrete-filled tubular structures, finite element analysis, metamodeling

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Authors: Farhat Imtiaz, Umar Farooq

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In this work, we developed a computational model to predict ply level failure in impacted composite laminates. Data obtained from physical testing from flat and round nose impacts of 8-, 16-, 24-ply laminates were considered. Routine inspections of the tested laminates were carried out to approximate ply by ply inflicted damage incurred. Plots consisting of load–time, load–deflection, and energy–time history were drawn to approximate the inflicted damages. Impact test generated unwanted data logged due to restrictions on testing and logging systems were also filtered. Conventional filters (built-in, statistical, and numerical) reliably predicted load thresholds for relatively thin laminates such as eight and sixteen ply panels. However, for relatively thick laminates such as twenty-four ply laminates impacted by flat nose impact generated clipped data which can just be de-noised using oscillatory algorithms. The literature search reveals that modern oscillatory data filtering and extrapolation algorithms have scarcely been utilized. This investigation reports applications of filtering and extrapolation of the clipped data utilising fast Fourier Convolution algorithm to predict load thresholds. Some of the results were related to the impact-induced damage areas identified with Ultrasonic C-scans and found to be in acceptable agreement. Based on consistent findings, utilizing of modern data filtering and extrapolation algorithms to data logged by the existing machines has efficiently enhanced data interpretations without resorting to extra resources. The algorithms could be useful for impact-induced damage approximations of similar cases.

Keywords: fibre reinforced laminates, fast Fourier algorithms, mechanical testing, data filtering and extrapolation

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Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

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

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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

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Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu

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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).

Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium

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Authors: Oluwasefunmi Eunice Irewole, Enrique Armas Arévalos

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Agriculture has played a crucial role in the economy and the development of many countries. Moreover, the basic needs for human survival are; food, shelter, and cloth are link on agricultural production. Most developed countries see that agriculture provides them with food and raw materials for different goods such as (shelter, medicine, fuel and clothing) which has led to an increase in incomes, livelihoods and standard of living. This study aimed at analysing the relationship between International competitiveness of agricultural products, with the area, fertilizer, labour force, economic growth, foreign direct investment, exchange rate and inflation rate in Latin America during the period of 1991-to 2019. In this study, panel data econometric methods were used, as well as cross-section dependence (Pesaran test), unit root (cross-section Augumented Dickey Fuller and Cross-sectional Im, Pesaran, and Shin tests), cointergration (Pedroni and Fisher-Johansen tests), and heterogeneous causality (Pedroni and Fisher-Johansen tests) (Hurlin and Dumitrescu test). The results reveal that the model has cross-sectional dependency and that they are integrated at one I. (1). The "fully modified OLS and dynamic OLS estimators" were used to examine the existence of a long-term relationship, and it was found that a long-term relationship existed between the selected variables. The study revealed a positive significant relationship between International Competitiveness of the agricultural raw material and area, fertilizer, labour force, economic growth, and foreign direct investment, while international competitiveness has a negative relationship with the advantages of the exchange rate and inflation. The economy policy recommendations deducted from this investigation is that Foreign Direct Investment and the labour force have a positive contribution to the increase of International Competitiveness of agricultural products.

Keywords: revealed comparative advantage, agricultural products, area, fertilizer, economic growth, granger causality, panel unit root

Procedia PDF Downloads 96

Authors: Sara Alhabli, Eman Elashiry, Osama Felemban, Abdullah Almushayt, Faisal Dardeer, Ahmed Mohammad, Fajr Orri, Nada Bamashmous

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Background: In December of 2019, the coronavirus (SARS-CoV-2) first appeared and quickly spread to become a worldwide pandemic. This study aimed to evaluate the prevalence and types of pediatric dental emergencies during the COVID-19 lockdown in Jeddah, Saudi Arabia, at the University Dental Hospital (UDH) of King Abdulaziz University (KAU) and identified the management provided for these dental emergency visits. Materials and Methods: Data collection was done retrospectively from electronic dental records for children aged 0-18 that attended the UDH emergency clinic during the period from March 1st, 2020, to September 30th, 2020. An electronic form formulated specifically for this study was used to collect the required data from electronic patient records, including demographic data, emergency classification, management, and referrals. Results: A total of 3146 patients were seen at the emergency clinics during this period, of which 661 were children (21%). Types of emergency conditions included 0.8% emergency cases, 34% urgent, and 65.2% non-urgent conditions. Severe dental pain (73.1%) and abscesses (20%) were the most common urgent dental conditions. Most non-urgent conditions presented for initial or periodic visits, recalls, or routine radiographs (74%). Treatments rarely involved restorations, with 8% among urgent conditions and 5.4% among non-urgent conditions. Antibiotics were only prescribed to 6.9% of urgent conditions. Conclusions: The largest group of children presenting at the emergency dental clinics were found to be children with non-urgent conditions. Tele dentistry can be a solution to avoid large numbers of non-urgent patients presenting to emergency clinics. Additionally, dental care for non-urgent conditions during the pandemic should focus more on procedures with less aerosol generation.

Keywords: COVID-19 pandemic, dental emergencies, oral health, pediatric dentistry, children

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Authors: Yuzhen Hu, Sirui Wang

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As a training base for intellectual talents, universities have a large number of students. Teaching is a primary activity in universities, and during the teaching process, a large number of people gather both inside and outside the teaching buildings, posing a strong risk of close contact. The class schedule is the fundamental basis for teaching activities in universities and plays a crucial role in the management of teaching order. Different class schedules can lead to varying degrees of indoor gatherings and trajectories of class attendees. In recent years, highly contagious diseases have frequently occurred worldwide, and how to reduce the risk of infection has always been a hot issue related to public safety. "Reducing gatherings" is one of the core measures in epidemic prevention and control, and it can be controlled through scientific scheduling in specific environments. Therefore, the scientific prevention and control goal can be achieved by considering the reduction of the risk of excessive gathering of people during the course schedule arrangement. Firstly, we address the issue of personnel gathering in various pathways on campus, with the goal of minimizing congestion and maximizing teaching effectiveness, establishing a nonlinear mathematical model. Next, we design an improved genetic algorithm, incorporating real-time evacuation operations based on tracking search and multidimensional positive gradient cross-mutation operations, considering the characteristics of outdoor crowd evacuation. Finally, we apply undergraduate course data from a university in Harbin to conduct a case study. It compares and analyzes the effects of algorithm improvement and optimization of gathering situations and explores the impact of path blocking on the degree of gathering of individuals on other pathways.

Keywords: the university timetabling problem, risk prevention, genetic algorithm, risk control

Procedia PDF Downloads 78

Authors: Samaneh Yavari, Christiane Pferrer, Elisabeth Engelke, Alexander Starke, Juergen Rehage

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Background: Nowadays, bovine limb interventions, especially any claw surgeries, raises selection of the most qualified and appropriate local anesthesia technique applicable for any superficial or deep interventions of the limbs. Currently, two local anesthesia methods of Intravenous Regional Anesthesia (IVRA), as well as Nerve Blocks, have been routine to apply. However, the lack of studies investigating the quality and duration as well as quantity and onset of full (complete) local anesthesia, is noticeable. Therefore, the aim of our study was comparing the onset and quality of both IVRA and our modified NBA at the hind limb of dairy cows. For this abstract, only the onset of full local anesthesia would be consider. Materials and Methods: For that reason, we used six healthy non pregnant non lactating Holestein Frisian cows in a cross-over study design. Those cows divided into two groups to receive IVRA and our modified four-point NBA. For IVRA, 20 ml procaine without epinephrine was injected into the vein digitalis dorsalis communis III and for our modified four-point NBA, 10-15 ml procaine without epinephrine preneurally to the nerves, superficial and deep peroneal as well as lateral and medial branches of metatarsal nerves. For pain stimulation, electrical stimulator Grass S48 was applied. Results: The results of electrical stimuli revealed the faster onset of full local anesthesia (p < 0.05) by application of our modified NBA in comparison to IVRA about 10 minutes. Conclusion and discussion: Despite of available references showing faster onset of foot local anesthesia of IVRA, our study demonstrated that our modified four point NBA not only can be well known as a standard foot local anesthesia method applicable to desensitize the hind limb of dairy cows, but also, selection of this modified validated local anesthesia method can lead to have a faster start of complete desensitization of distal hind limb that is remarkable in any bovine limb interventions under time constraint.

Keywords: IVRA, four point NBA, dairy cow, hind limb, full onset

Procedia PDF Downloads 144

Authors: Olanike A. Ojo, Akindele M. Ojo, Jacob H. Tsado, Ramatu U. Kutigi

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The study was carried out on analysis of the effect of farmers’ socio-economic factors on the net farm income of catfish farmers in Kwara State, Nigeria. Primary data were collected from selected catfish farmers with the aid of well-structured questionnaire and a multistage sampling technique was used to select 102 catfish farmers in the area. The analytical techniques involved the use of descriptive statistics and multiple regression analysis. The findings of the analysis of socio-economic characteristics of catfish farmers reveal that 60% of the catfish farmers in the study area were male gender which implied the existence of gender inequality in the area. The mean age of 47 years was an indication that they were at their economically productive age and could contribute positively to increased production of catfish in the area. Also, the mean household size was five while the mean year of experience was five. The latter implied that the farmers were experienced in fishing techniques, breeding and fish culture which would assist in generating more revenue, reduce cost of production and eventual increase in profit levels of the farmers. The result also revealed that stock capacity (X3), accessibility to credit (X7) and labour (X4) were the main determinants of catfish production in the area. In addition, farmer’s sex, household size, no of ponds, distance of the farm from market, access to credit were the main socio-economic factors influencing the net farm income of the catfish farmers in the area. The most serious constraints militating against catfish production in the study area were high mortality rate, insufficient market, inadequate credit facilities/ finance and inadequate skilled labour needed for daily production routine. Based on the findings, it is therefore recommended that, to reduce the mortality rate of catfish extension agents should organize training workshops on improved methods and techniques of raising catfish right from juvenile to market size.

Keywords: credit, income, stock, mortality

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Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old. Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed. Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding. Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding.

Keywords: exclusive breastfeeding, cessation, median duration, Ankesha Guagusa Woreda

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Authors: Taddese Alemu Zerfu, Melaku Umeta Deressa, Kaleab Baye

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Background: Maternal and child under-nutrition is the underlying cause of 3•5 million annual deaths, globally. Anemia during pregnancy is among the leading nutritional disorders with serious short and long term consequences to both the mother and fetus. Objective: Examine the effect of dietary diversity on maternal anemia, nutritional status and key pregnancy outcomes of pregnancy. Methods: A prospective cohort study design, involving a total of 432 eligible pregnant women, in their second antenatal care visit was conducted between August 2014 to March, 2015. The individual dietary diversity status of mothers was used as the exposure variable to select, enroll and follow the mothers. All mothers were enrolled during second antenatal care visit and followed until delivery. Epi-data, SPSS and STATA software are used to enter and analyze the data. Chi-square test, independent 't'-test, and GLM are used to calculate risk, association and differences between key variables at P < 0.05. Results: Study participants did not differ in many of the basic characteristics (p < 0.05). The incidence of maternal anemia increased significantly from 28.6% to 32.1% between baseline and term. Pregnant mothers with inadequate dietary diversity groups had more (56% at baseline and 68% at term) risk of anemia than the comparison (adequate) groups, (RR, 1.56 and 1.68; 95% CI, 1.24 - 1.83 and 1.39 - 2.04). The overall incidence of still birth, low birth weight and pre-term birth was 4.5%, 9.1% and 13.6%, respectively. The variation of these outcomes was significant across study groups (P < 0.05). Conclusion and recommendations: Dietary diversity status of pregnant mothers has significant effect on the incidence of anemia and key pregnancy outcomes in resource limited settings, like rural Ethiopia. Therefore, apart from the ongoing routine IFA supplementation, special emphasis should be given to dietary diversity of mothers to improve related outcomes of pregnancy and maternal health.

Keywords: anemia, birth weight, dietary diversity, pregnancy, pregnancy outcome

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Authors: J. J. Mathew

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Pulmonary tuberculosis is highly prevalent in the Indian subcontinent. Most cases of pulmonary tuberculosis are diagnosed with sputum examinations and the vast majority of these are undertaken by the government run establishments. However, mycobacterial cultures are not routinely done, unless drug resistance is detected based on clinical response. Modern diagnostic tests like bronchoscopy and Genexpert are not routinely employed in the government institutions for the diagnosis of pulmonary tuberculosis, but have been accepted widely by good private institutions. The utility of these investigations in the private sector is not yet well recognized. This retrospective study aims to assess the usefulness of bronchoscopy and Genexpert in the diagnosis of pulmonary tuberculosis in quaternary care private hospital in India. 30 patients with respiratory symptoms raising the possibility of tuberculosis based on clinical and radiological features, but without any significant sputum production, were subject to bronchoscopy and BAL samples taken for microbiological studies, including Genexpert. 6 out of the 30 patients were found to be Genexpert positive and none of them showed Rifampicin resistance. All the 6 cases had upper zone predominant disease. One of the 6 cases of tuberculosis had another co-existent bacterial infection according to the routine culture studies. 6 other cases were proven to be due to other bacterial infections alone, 2 had a malignant diagnosis and the remaining cases were thought to be non-infective pathologies. The Genexpert results were made available within 48 hours in the 6 positive cases. All of them were commenced on standard anti-tuberculous regimen with excellent clinical response. The other infective cases were also managed successfully based on the drug susceptibilities. The study has shown the usefulness of these investigations as early intervention enabled diagnosis facilitating treatment and prevention of any clinical deterioration. The study lends support to early bronchoscopy and Genexpert testing in suspected cases of pulmonary tuberculosis without significant sputum production, in a high prevalence country which normally relies on sputum examination for the diagnosis of pulmonary tuberculosis.

Keywords: pulmonary, tuberculosis, bronchoscopy, genexpert

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Authors: H. K. Ratre, M. Roy, S. Roy, M. S. Parmar, V. Bhagat

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Mastitis is a common problem of dairy industries. Reduction in milk production and an irreparable damage to the udder associated with the disease are common causes of culling of dairy cows. Milk from infected animals is not suitable for drinking and for making different milk products. So, it has a major economic importance in dairy cattle. The aims of this study were to investigate the bacteriological panorama in milk from udder quarters with subclinical mastitis and to carried out for the molecular characterization of the major isolated organisms, from subclinical mastitis-affected cows in and around Durg and Rajnandgaon district of Chhattisgarh. Isolation and identification of bacteria from the milk samples of subclinical mastitis-affected cows were done by standard and routine culture procedures. A total of 78 isolates were obtained from cows and among the various bacteria isolated, Staphylococcus spp. occupied prime position with occurrence rate of 51.282%. However, other bacteria isolated includeStreptococcus spp. (20.512%), Micrococcus spp. (14.102%), E. coli (8.974%), Klebsiela spp. (2.564%), Salmonella spp. (1.282%) and Proteus spp. (1.282%). Staphylococcus spp. was isolated as the major causative agent of subclinical mastitis in the studied area. Molecular characterization of Staphylococus aureusisolates was done for genetic expression of the virulence genes like ‘nuc’ encoding thermonucleaseexoenzyme, coa and spa by PCR amplification of the respective genes in 25 Staphylococcus isolates. In the present study, 15 isolates (77.27%) out of 20 coagulase positive isolates were found to be genotypically positive for ‘nuc’ where as 20 isolates (52.63%) out of 38 CNS expressed the presence of the same virulence gene. In the present study, three Staphylococcus isolates were found to be genotypically positive for coa gene. The Amplification of the coa gene yielded two different products of 627, 710 bp. The amplification of the gene segment encoding the IgG binding region of protein A (spa) revealed a size of 220 and 253bp in twostaphylococcus isolates. The X-region binding of the spa gene produced an amplicon of 315 bp in one Staphylococcal isolates. Staphylococcus aureus was found to be major isolate (51.28%) responsible for causing subclinical mastitis in cows which also showed expression of virulence genesnuc, coa and spa.

Keywords: mastitis, bacteria, characterization, expression, gene

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Authors: Sara Segura, Diego Nuñez, Miryam Villamil

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In this work, we studied the microscale interaction of foreign substances with blood inside an artificial transparent artery system that represents medium and small muscular arteries. This artery system had channels ranging from 75 μm to 930 μm and was fabricated using glass and transparent polymer blends like Phenylbis(2,4,6-trimethylbenzoyl) phosphine oxide, Poly(ethylene glycol) and PDMS in order to be monitored in real time. The setup was performed using a computer controlled precision micropump and a high resolution optical microscope capable of tracking fluids at fast capture. Observation and analysis were performed using a real time software that reconstructs the fluid dynamics determining the flux velocity, injection dependency, turbulence and rheology. All experiments were carried out with fully computer controlled equipment. Interactions between substances like water, serum (0.9% sodium chloride and electrolyte with a ratio of 4 ppm) and blood cells were studied at microscale as high as 400nm of resolution and the analysis was performed using a frame-by-frame observation and HD-video capture. These observations lead us to understand the fluid and mixing behavior of the interest substance in the blood stream and to shed a light on the use of implantable devices for drug delivery at arteries with different Endothelial dysfunction. Several substances were tested using the artificial artery system. Initially, Milli-Q water was used as a control substance for the study of the basic fluid dynamics of the artificial artery system. However, serum and other low viscous substances were pumped into the system with the presence of other liquids to study the mixing profiles and behaviors. Finally, mammal blood was used for the final test while serum was injected. Different flow conditions, pumping rates, and time rates were evaluated for the determination of the optimal mixing conditions. Our results suggested the use of a very fine controlled microinjection for better mixing profiles with and approximately rate of 135.000 μm3/s for the administration of drugs inside arteries.

Keywords: artificial artery, drug delivery, microfluidics dynamics, arteriosclerosis

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Authors: Aly Kassem, Eman Sapet, Eman Abdelbaset, Hosam Mahmoud

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Objective: Hypertension is an important public health challenge being one of the most common worldwide disease-affecting human. Our aim is to study the clinical characteristics, therapeutic regimens, treatment compliance, and risk factors in a sector of of hypertensive patients at Sohag City. Subject and Methods: A cross sectional study; conducted in Sohag city; it involved 520 patients; males (45.7 %) and females (54.3 %). Their ages ranged between 35-85 years. BP measurements, BMI, blood glucose, Serum creatinine, urine analysis, serum Lipids, blood picture and ECG were done all the studied patients. Results: Hypertension presented more between non-smokers (72.55%), females (54.3%), educated patients (50.99%) and patients with low SES (54.9%). CAD presented in (51.63%) of patients, while laboratory investigations showed hyperglycaemia in (28.7%), anemia in (18.3%), high serum creatinine level in (8.49%) and proteinuria in (10.45%) of patient. Adequate BP control was achieved in (49.67%); older patients had lower adequacy of BP control in spite of the extensive use of multiple-drug therapy. Most hypertensive patients had more than one coexistent CV risk factor. Aging, being a female (54.3%), DM (32.3%), family history of hypertension (28.7%), family history of CAD (25.4%), and obesity (10%) were the common contributing risk factors. ACE-inhibitors were prescribed in (58.16%), Beta-blockers in (34.64%) of the patients. Monotherapy was prescribed for (41.17%) of the patients. (75.81%) of patients had regular use of their drug regimens. (49.67%) only of patients had their condition under control, the number of drugs was inversely related to BP control. Conclusion: Hypertensive patients in Sohag city had a profile of high CV risks, and poor blood pressure control particularly in the elderly. A multidisciplinary approach for routine clinical check-up, follow-up, physicians and patients training, prescribing simple once-daily regimens and encouraging life style modifications are recommended. Anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance.

Keywords: anti hypertensives, hypertension, elderly patients, risk factors, treatment compliance

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Authors: T. Walczak, J. K. Grabski, P. Fritzkowski, M. Stopa

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Objectives of the study are i) to perform numerical simulations that permit an analysis of the dynamics of subretinal fluid when an implant has induced scleral intussusception and ii) assess the impact of the physical parameters of the model on the flow rate. Computer simulations were created using finite element method (FEM) based on a model that takes into account the interaction of a viscous fluid (subretinal fluid) with a hyperelastic body (retina). The purpose of the calculation was to investigate the dependence of the flow rate of subretinal fluid through a hole in the retina on different factors such as viscosity of subretinal fluid, material parameters of the retina, and the offset of the implant from the retina’s hole. These simulations were performed for different speeds of eye movement that reflect the behavior of the eye when reading, REM, and saccadic movements. Similar to other works in the field of subretinal fluid flow, it was assumed stationary, single sided, forced fluid flow in the considered area simulating the subretinal space. Additionally, a hyperelastic material model of the retina and parameterized geometry of the considered model was adopted. The calculations also examined the influence the direction of the force of gravity due to the position of the patient’s head on the trend of outflow of fluid. The simulations revealed that fluid outflow from the retina becomes significant with eyeball movement speed of 100°/sec. This speed is greater than in the case of reading but is four times less than saccadic movement. The increase of viscosity of the fluid increased beneficial effect. Further, the simulation results suggest that moderate eye movement speed is optimal and that the conventional prescription of the avoidance of routine eye movement following retinal detachment surgery should be relaxed. Additionally, to verify numerical results, some calculations were repeated with use of meshless method (method of fundamental solutions), which is relatively fast and easy to implement. The paper has been supported by 02/21/DSPB/3477 grant.

Keywords: CFD simulations, FEM analysis, meshless method, retinal detachment

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Authors: Sanan Raza, Muhammad Younus, Ahmad Yar Qamar, Tariq Abbas, Hamayun Khan, Amanullah Khan

Abstract:

Mares are considered to be seasonally polyestrous animals. The breeding season of mare ranges from March to May in Pakistan. However, fertility problems of mares have been trifling the horse breeders and stud owners since long, and it comes out that the fertility status of mares in Pakistan is relatively lower than the world average. The aim of the present study was to compare the effect of hCG and GnRH in improving pregnancy rate of mares in a transition period of month March and April. A total of n=66 mares showing normal estrus cycles with age ranging 5-12 y, weighing between 400-600 kg, BCS 6 ± 0.5 (1-9) and lactation varied from first to 5th were included in the experiment. These mares were administered PGF2α (75 μg; Dalmazine®, Fatro, Italy; 1 ml; i.m.) and divided into 3 groups. Mares of group 1 (n=22) were administered GnRH (100 μg; Dalmarelin®, Fatro, Italy; 4ml; im) while group 2 (n=22) mares were given hCG (5000 IU; IVF-C, LG Pharma; 1ml; iv). Likewise, mares of group 3 (n=22) were injected normal saline. Each treatment was given, when follicle attained the size of 35mm, keeping in view, the maturity of ovulating follicle at 35mm size and response to each treatment after routine ultrasound examination. All the mares of three groups were bred at 12 and 36 hours of treatment when the follicle reached the size of 35mm measured by ultrasound examination. Pregnancy was diagnosed by ultrasonography on day 18th and 42nd mating. On day 18th, pregnancy rate was 81.8% for hCG followed by 54.5% for GnRH and 45.5% for control. On day 42nd, pregnancy rate was (47.4%) for hCG which is significantly high (p<0.05) followed by GnRH (31.6%) and control (21.1%). Additionally the pregnancy loss was (25%, 20% respectively) in control and GnRH treated groups; whereas, hCG treated group showed no pregnancy loss (0.00%). Since no embryonic loss has been observed with hCG treatment during current study. Also hCG treated mares were 7.87 times more likely to conceive than controls. There were two times more chances of pregnancy in hCG treated mares than GnRH treated mares Therefore, it is concluded that the use of hCG in breeding season can improve pregnancy rate at a significant level when compared with GnRH hormone.

Keywords: mares, ovulation, hCG, pregnancy rate

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Authors: Rhodine Hickman, Craig Wylie, Michael G. McCaul

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Introduction: The World Health Organisation has called on governments around the world to recognise emergency conditions as a global public health problem and respond with appropriate steps for effective preventative strategies. However, to understand the magnitude of the problem, good quality epidemiological data is required. This is especially challenging in low and middle-income countries, where routine data is scarce, specifically within the prehospital setting. Methods: We conducted a retrospective cross-sectional study of a national prehospital private sector EMS database. The database being the property of ER24 (private Emergency Medical Services (EMS) company in South Africa) contains claims submitted by the majority of ambulance services in South Africa during the period between 1 January 2008 to 28 March 2017. We used descriptive statistics and control charts to describe the data using STATA 14. Results: 299,257 calls were included in the analysis. The top clinical conditions requiring ambulance transport were transport accidents (10% of total call volume) and ischaemic heart disease (4.4%). The number of transport accidents consistently increased between 2009 and 2014 and reached beyond the limit for normal variation in 2015. Victims of transport accidents required basic life support services 60% of the time with 80% of injuries being minor to moderate. The frequency of ischaemic heart disease had a steady incline from 2011 to 2016. Advanced life support services were required about 50% of the time, with 60% of patients needing urgent care. Conclusion: Transport accidents, followed by ischaemic heart disease, are the most prevalent conditions in South African private EMS. There is a potential to address these conditions by developing the capacity of low and mid-level providers in trauma and advanced EMS providers in ischaemic heart disease.

Keywords: emergency care, emergency medicine, prehospital providers, South Africa

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Authors: Afsaneh Soltani, Zahra Mohajer

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Migraine is one of the most common chronic neurological diseases. Migraines affect different aspects of life. Severe migraine headaches lead to dysfunction, a reduced presence at work, and decreased ability to think and make decisions. Non-pharmacological treatments play a very important role in controlling and preventing migraine headaches. A healthy lifestyle helps control migraine headaches. Migraine headaches can be reduced by following these steps: Avoiding stress, eating regularly and avoiding hunger and thirst, avoiding stimulants such as chocolate, caffeine, and cigarettes, following a regular bedtime routine, or avoiding sleep deprivation. Exercise a lot, and do regular exercise (and prevent obesity). Non-pharmacological treatment is especially important in pregnant women and children because in these cases, medical treatments are not preferred due to the many side effects. Exercise is one of the most effective and uncomplicated non-pharmacological alternatives in the treatment of migraine headaches. Exercising for episodic migraines is a safe, effective, and promising complementary treatment option. Numerous studies have shown that aerobic exercise reduces the severity and duration of migraine headaches. Effective aerobic exercise includes cycling and brisk walking. Exercise improves the quality of life and reduces the use of medication in people with migraines. Patients who exercise have fewer migraine days, resulting in better personal, social, and occupational performance. Several studies have shown that pain intensity and frequency in patients who exercise regularly decreased significantly after exercise compared to controls who did not exercise. According to a study, regular exercise reduces the levels of interleukins, especially IL-12P70, which reduces anxiety and reduces the number of days of migraine in patients. An article has shown that endurance exercise reduces the number of migraine days and also increases cerebrovascular health in migraine patients. According to studies, the minimum duration of exercise to achieve a positive effect of exercise in patients with migraine is 3 months (12 weeks) and 40 minutes three times a week.

Keywords: exercise, headache, migraine, physical activity

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Authors: Sataroopa Mishra, Mona Basker, Sneha Varkki, Ram Kumar Pandian, Grace Rebekah

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Background: Sleep deprivation is a matter of public health importance among adolescents. We used adolescent sleep wake scale and adolescent sleep hygiene scale to determine the sleep quality and sleep hygiene respectively of school going adolescents in Vellore city of India. The objective of the study was to do factorial analysis of the scales and validate it for use in local population. Methods: Observational questionnaire based cross sectional study. Setting: Community based school survey in a semi-urban setting in three schools in Vellore city. Data collection: Non probability sample was collected form students studying in standard 9 and 11. Students filled Adolescent Sleep Wake scale (ASWS) and Adolescent Sleep Hygiene Scale (ASHS) translated into vernacular language. Data Analysis: Exploratory Factorial Analysis was used to see the factor loading of various components of the two scales. Confirmatory factorial analysis is subsequently planned for assessing the internal validity of the scales.Results: 557 adolescents were included in the study of 12 – 17 years old. Exploratory factorial analysis of adolescent sleep hygiene scale indicated significant factor loading for 18 items from 28 items originally devised by the authors and has been reconstructed to four domains instead of 9 domains in the original scale namely sleep stability, cognitive – emotional, Physiological - bed time routine - behavioural arousal factor (activites before bedtime and during bed time), Sleep environment (lighting and bed sharing). Factorial analysis of Adolescent sleep wake scale showed factor loading of 18 items out of 28 items in original scale reconstructed into 5 aspects of sleep quality. Conclusions: The factorial analysis gives a reconstructed scale useful for the local population. Further a confirmatory factorial analysis has been subsequently planned to determine the internal consistency of the scale for local population.

Keywords: factorial analysis, sleep hygiene, sleep quality, adolescent sleep scale

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Authors: Saad Mahmud Khan, Sarah El Hajj Chehadeh, Mehera Abdulrahman, Wael Osman, Habiba Al Safar

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Obesity is a non-communicable disease that is widely prevalent with approximately 600 million people classified as obese worldwide. Its etiology is multifactorial and involves a complex interplay between genes and the environment. Over the past few decades, obesity rates among the Emirati population have been increasing. The aim of this study was to investigate the association of candidate gene single nucleotide polymorphisms (SNPs), namely the fat mass and obesity associated (FTO) gene SNP rs9939609 and Vitamin D Receptor (VDR) gene SNP rs1544410, with obesity in the UAE population. Methods: This is a case-control study in which 414 individuals were enrolled during their routine visit to endocrinology clinics in Abu Dhabi, United Arab Emirates between the period of June 2012 and December 2013. Several biochemical tests and clinical assessments along with a lifestyle questionnaire for each participant were completed at the clinic. Genomic DNA was extracted from saliva samples of 201 obese, 114 overweight and 99 normal subjects. Genotyping for the variants was performed using TaqMan assay. Results: The mean Body Mass Index (BMI) ± SD for the obese, overweight, and normal subjects was 35.76 ± 4.54, 27.53 ± 1.45 and 22.69 ± 1.84 kg/m2, respectively. Increasing BMI values were associated with an increase in values for systolic blood pressure, diastolic blood pressure, HbA1c, and triglycerides. The SNP rs9939609 in the FTO gene was found to be significantly associated with the BMI (p=0.028), with the minor allele A having a clear additive effect on BMI values. No significant association was detected between BMI and rs1544410 of the VDR gene. Conclusions: Our study findings indicate that the minor allele A of the rs9939609 has a significant association with increasing BMI values. In addition, our findings support the fact that increasing BMI is associated with increasing risks of other comorbidities such as higher blood pressure, poorer glycemic control and higher triglycerides.

Keywords: body mass index, FTO gene, obesity, rs9939609, United Arab Emirates

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Authors: Khalid Alshallash

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Small fragments of the roots of some Rumex species including R. obtusifolius and R. crispus have been found to regenerate readily, contributing to the severity of infestations by these very common, widespread and difficult to control perennial weeds of agricultural crops and grasslands. Their root fragments are usually created during routine agricultural practices. We found that fresh root fragments of both species containing 65-70 % of moisture, progressively lose their moisture content when desiccated under controlled growth room conditions matching summer weather of southeast England, with the greatest reduction occurring in the first 48 hours. Probability of shoot emergence and the time taken for emergence in glasshouse conditions were also reduced significantly by desiccation, with R. obtusifolius least affected up to 48-hour. However, the effects converged after 120 hours. In contrast, R. obtusifolius was significantly slower to emerge after up to 48 hours desiccation, again effects converging after longer periods, R. crispus entirely failed to emerge at 120 hours. The dry weight of emerged shoots was not significantly different between the species, until desiccated for 96 hours when R. obtusifolius was significantly reduced. At 120 hours, R. obtusifolius did not emerge. In outdoor trials, desiccation for 24 or 48 hours had less effect on emergence when planted at the soil surface or up to 10 cm of depth, compared to deeper plantings. In both species, emergence was significantly lower when desiccated fragments were planted at 15 or 20 cm. Time taken for emergence was not significantly different between the species until planted at 15 or 20 cm when R. obtusifolius was slower than R. crispus and reduced further by increasing desiccation. Similar variation in effects of increasing soil depth interacting with increasing desiccation was found in reductions in dry weight, the number of tillers and leaf area, with R obtusifolius generally but not exclusively better able to withstand more extreme trial conditions. Our findings suggest that infestations of these highly troublesome weeds may be partly controlled by appropriate agricultural practices, notably exposing cut fragments to drying environmental conditions followed by deep burial.

Keywords: regeneration, root fragment, rumex crispus, rumex obtusifolius

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Authors: Szu-Yi Chang, Jiin-Ru Rong

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This paper discussed a case involving a young female patient with schizophrenia. The patient's condition was deteriorating, and she was becoming increasingly reliant on her family to take care of her, and as her father did not understand the illness well and was afraid that others will learn about the presence of a mentally ill individual in their family, he and the patient's mother were thus unable to cope with the patient's deteriorating condition, which in turn caused her to suffer from a lack of self-confidence and low self-esteem. The patient received nursing care from July 26th to October 25th, 2017, during which counseling, family visits, and phone interviews were carried out, and her condition was monitored. By referring to the practical ability indicators for community psychiatric mental health nursing that were developed by the psychiatric mental health nurses' association of the Republic of China, defining categories such as 'self-construction,' 'self-management,' 'disease management,' and 'family nursing,' and incorporating indicators for empowerment and various skills into the steps and strategies used for nursing care, we will able to help the patient to construct her own identity, raise her self-esteem, improve her ability to independently perform activities of daily living, strengthen her disease management ability, and gradually build up her life management skills. The patient's family was also encouraged to communicate more among themselves, so as to align them with the nursing care objectives of improving the patient's ability to adapt to community life and her disease. The results indicated that the patient was able to maintain her mental stability within her community. By implementing effective self-management and maintaining a routine life, the patient was able to continue her active participation in community work and rehabilitation activities. Improvements were also achieved with respect to family role issues by establishing mutual understanding among the patient's family members and gaining their support. It is recommended that mental health nurses can leverage their community mental health nursing skills and the related strategies to promote adaptation to community life among mental life patients.

Keywords: community psychiatric mental health nursing, family nursing, schizophrenia, self-management

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Authors: Badriya Almutairi, Ashraf El-Hamalawi

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Wind energy technologies are considered to be among the most promising types of renewable energy sources due to the growing concerns over climate change and energy security. Kuwait is amongst the countries that began realising the consequences of climate change and the long-term economic and energy security situation, considering options when oil runs out. Added to this are the fluctuating oil prices, rapid increase in population, high electricity consumption and protection of the environment It began to make efforts in the direction of greener solutions for energy needs by looking for alternative forms of energy and assessing potential renewable energy resources, including wind and solar. The aim of this paper is to examine wind energy as an alternative renewable energy source in Kuwait, due to its availability and low cost, reducing the dependency on fossil fuels compared to other forms of renewable energy. This paper will present a life cycle assessment of onshore wind turbine systems in Kuwait, comprising 4 stages; goal and scope of the analysis, inventory analysis, impact assessment and interpretation of the results. It will also provide an assessment of potential renewable energy resources and technologies applied for power generation and the environmental benefits for Kuwait. An optimum location for a site (Shagaya) will be recommended for reasons such as high wind speeds, land availability and distance to the next grid connection, and be the focus of this study. The potential environmental impacts and resources used throughout the wind turbine system’s life-cycle are then analysed using a Life Cycle Assessment (LCA). The results show the total carbon dioxide (CO₂) emission for a turbine with steel pile foundations is greater than emissions from a turbine with concrete foundations by 18 %. The analysis also shows the average CO₂ emissions from electricity generated using crude oil is 645gCO₂/kWh and the carbon footprint per functional unit for a wind turbine ranges between 6.6 g/kWh to 10 g/kWh, an increase of 98%, thus providing cost and environmental benefits by creating a wind farm in Kuwait. Using a cost-benefit analysis, it was also found that the electricity produced from wind energy in Kuwait would cost 17.6fils/kWh (0.05834 $/kWh), which is less than the cost of electricity currently being produced using conventional methods at 22 fils/kW (0.07$/kWh), i.e., a reduction of 20%.

Keywords: CO₂ emissions, Kuwait, life cycle assessment, renewable energy, wind energy

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Authors: Smita Chaudhary

Abstract:

Traffic in India are observed uncontrolled, and are characterized by chaotic (not follows the lane discipline) traffic situation. Bus Rapid Transit (BRT) has emerged as a viable option to enhance transportation capacity and provide increased levels of mobility and accessibility. At present in Ahmadabad there are as many intersections which face the congestion and delay at signalized intersection due to transit (BRT) lanes. Most of the intersection in spite of being signalized is operated manually due to the conflict between BRT buses and heterogeneous traffic. Though BRTS in Ahmadabad has an exclusive lane of its own but with this comes certain limitations which Ahmadabad is facing right now. At many intersections in Ahmadabad due to these conflicts, interference, and congestion both heterogeneous traffic as well as transit buses suffer traffic delays of remarkable 3-4 minutes at each intersection which has a become an issue of great concern. There is no provision of BRT bus priority due to which existing signals have their least role to play in managing the traffic that ultimately call for manual operation. There is an immense decrement in the daily ridership of BRTS because people are finding this transit mode no more time saving in their routine, there is an immense fall in ridership ultimately leading to increased number of private vehicles, idling of vehicles at intersection cause air and noise pollution. In order to bring back these commuters’ transit facilities need to be improvised. Classified volume count survey, travel time delay survey was conducted and revised signal design was done for whole study stretch having three intersections and one roundabout, later one intersection was simulated in order to see the effect of giving priority to BRT on side street queue length and travel time for heterogeneous traffic. This paper aims at suggesting the recommendations in signal cycle, introduction of intermittent priority for transit buses, simulation of intersection in study stretch with proposed signal cycle using VISSIM in order to make this transit amenity feasible and attracting for commuters in Ahmadabad.

Keywords: BRT, priority, Ridership, Signal, VISSIM

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