Search results for: loss of slab support

Authors: K. Amanzoui, A. Erragh, M. Elharit, A. Afif, K. Elfakhr, S. Kalouch, A. Chlilek

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Orthopedic surgery is a provider of pre and postoperative bleeding; patients are exposed to several risks, and different measures are proposed to reduce bleeding during surgery, called the transfusion-sparing method, including tranexamic acid, which has shown its effectiveness in numerous studies. A prospective analytical study in 50 children was carried out in the orthopedic traumatology operating room of the EL HAROUCHI hospital of the CHU IBN ROCHD in Casablanca over a period of six months (April to October 2022). Two groups were randomized: one receiving tranexamic acid (Group A) and a non-receiving control group (Group B). The average age was 10.3 years, of which 58.8% were female. The first type of surgery was thoracolumbar scoliosis (52%). The average preoperative hemoglobin was 12.28 g/dl in group A, against 12.67 g/dl in the control group. There was no significant difference between the two groups (p=0.148). Mean intraoperative bleeding was 396.29 ml in group A versus 412 ml in the control group. No significant difference was observed for this parameter (p=0.632). The average hemoglobin level in the immediate postoperative period in our patients is 10.2 g/dl. In group A, it was 10.95 g/dl versus 10.93 g/dl in group B. At H24 postoperative, the mean hemoglobin value was 10.29 g/dl in group A against 9.5 g/dl in group B. For group A, the blood loss recorded during the first 24 hours was 209.43 ml, against 372 ml in group B, with a significant difference between the two groups (p=0.001). There is no statistically significant difference between the 2 groups in terms of the use of fillers, ephedrine or intraoperative transfusion. While for postoperative transfusion, we note the existence of a statistically significant difference between group A and group B. It is suggested that the use of tranexamic acid is an effective, simple, and low-cost way to limit postoperative blood loss and the need for transfusion.

Keywords: tranexamic acid, blood loss, orthopedic surgery, children

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Authors: A. Capodieci, G. Del Fiore, L. Mainetti

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Recently, the use of web 2.0 tools has increased in companies and public administration organizations. This phenomenon, known as "Enterprise 2.0", has, de facto, modified common organizational and operative practices. This has led “knowledge workers” to change their working practices through the use of Web 2.0 communication tools. Unfortunately, these tools have not been integrated with existing enterprise information systems, a situation that could potentially lead to a loss of information. This is an important problem in an organizational context, because knowledge of information exchanged within the organization is needed to increase the efficiency and competitiveness of the organization. In this article we demonstrate that it is possible to capture this knowledge using collaboration processes, which are processes of abstraction created in accordance with design patterns and applied to new organizational operative practices.

Keywords: business practices, business process patterns, collaboration tools, enterprise 2.0, knowledge workers

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Authors: Pachawo Bisani, Goodall Nyirenda

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The Malawi National Antiretroviral Therapy (NART) Electronic Medical Record (EMR) system was designed and developed with guidance from the Ministry of Health through the Department of HIV and AIDS (DHA) with the aim of supporting the management of HIV patient data and reporting in high prevalence ART clinics. As of 2021, the system has been scaled up to over 206 facilities across the country. The system is integrated with the clinical decision support system (CDSS) to assist healthcare providers in making a decision about an individual patient at a particular point in time. Despite NART EMR undergoing several evaluations and assessments, little has been done to evaluate the clinical decision support system in the NART EMR system. Hence, the study aimed to evaluate the use of CDSS in the NART EMR system in Malawi. The study adopted a mixed-method approach, and data was collected through interviews, observations, and questionnaires. The study has revealed that the CDSS tools were integrated into the ART clinic workflow, making it easy for the user to use it. The study has also revealed challenges in system reliability and information accuracy. Despite the challenges, the study further revealed that the system is effective and efficient, and overall, users are satisfied with the system. The study recommends that the implementers focus more on the logic behind the clinical decision-support intervention in order to address some of the concerns and enhance the accuracy of the information supplied. The study further suggests consulting the system's actual users throughout implementation.

Keywords: clinical decision support system, electronic medical record system, usability, antiretroviral therapy

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Authors: Stela Doncheva

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Postpartum distress, encompassing depressive symptoms, obsessions, and anxiety, remains a subject of significant scientific interest due to its prevalence among individuals giving birth. This critical and transformative period presents a multitude of factors that impact women's health. On the one hand, variables such as social support, satisfaction in romantic relationships, shared newborn care, and birth satisfaction directly affect the mental well-being of new mothers. On the other hand, the interplay of hormonal changes, personality characteristics, emotional difficulties, and the profound life adjustments experienced by mothers can profoundly influence their self-esteem and overall physical and emotional well-being. This paper extensively explores the factors of alexithymia, social support, partners' support, and birth satisfaction to gain deeper insights into their impact on postpartum distress. Utilizing a qualitative survey consisting of six self-reflective questionnaires, this study collects valuable data regarding the individual postpartum experiences of Bulgarian mothers. The primary objective is to enrich our understanding of the complex factors involved in the development of postpartum distress during this crucial period. The results shed light on the intricate nature of the problem and highlight the significant influence of bio-psycho-social elements. By contributing to the existing knowledge in the field, this research provides valuable implications for the development of interventions and support systems tailored to the unique needs of mothers in the postpartum period. Ultimately, this study aims to improve the overall well-being of new mothers and promote optimal maternal health during the postpartum journey.

Keywords: maternal mental health, postpartum distress, postpartum depression, postnatal mothers

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Authors: Lina Ismail Jassim, Robiah Yunus

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To successfully drill oil or gas well, two main characteristics of numerous other tasks of an efficient drilling fluid are required, which are suspended and carrying cuttings from the beneath wellbore to the surface and managed between pore (formation) and hydrostatic pressure (mud pressure). Several factors like mud composition and its rheology, wellbore design, drilled cuttings characteristics and drilling string rotation contribute to drill wellbore successfully. Simulation model can support an appropriate indication on the drilling fluid performance in the real field as Genting Timur field, located in Pahang in Malaysia on 4295 m depth, held the world record in Sempah Muda 1 (Vertical). A detailed 3 dimensional CFD analysis of vertical, concentric annular two phase flow was developed to study and asses Herschel Bulkley drilling fluid. The effect of Hematite, Barite and calcium carbonates types and size of cutting rock particles on such flow is analyzed. The vertical flows are also associated with a good amount of temperature variation along the depth. This causes a good amount of change in viscosity of the fluid, which is non-Newtonian in nature. Good understanding of the nature of such flows is imperative in developing and maintaining successful vertical well systems. A detailed analysis of flow characteristics due to the drill pipe rotation is done in this work. The inner cylinder of the annulus gets different rotational speed, depending upon the operating conditions. This speed induces a good swirl on the particles and primary fluids which interpret in Ester based drilling fluid cleaning well ability, which in turn determines energy loss along the pipe. Energy loss is assessed in this work in terms of wall shear stress and pressure drop along the pipe. The flow is under an adverse pressure gradient condition, which causes chance of reversed flow and transfers the rock cuttings to the surface.

Keywords: concentric annulus, non-Newtonian, two phase, Herschel Bulkley

Procedia PDF Downloads 306

Authors: Fenni Sim

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Background: The application of systemic family therapy approaches to community health cases have not gathered traction. In National Kidney Foundation, Singapore, the belief is that community support has great potential in helping End Stage Renal Failure (ESRF) patients manage the demands of their treatment regime, whether Hemodialysis (HD) or Peritoneal Dialysis(PD) and sustain them on the treatment. However, the current community support does not include family interventions and is largely nursing based. Although nursing support is well provided to patients, and their family members in issues related to treatment and compliance, complex family issues and dynamics arising from caregiver strain or pre-dialysis relationship strain might deter efforts in managing the challenges of the treatment. Objective: The objective of the study is to understand the potential scope of work provided by a social worker who is trained in systemic family therapy and the effects of these interventions. Methodology: 3 families on HD and 3 families on PD who have been receiving family intervention for the past 6 months would be chosen for the study. A qualitative interview would be conducted to review the effectiveness for the family. Scales such as SCORE-15, PHQ-9, and Zarit Burden were used to measure family functioning, depression, and caregiver’s burden for the families. Results: The research is still in preliminary phase. Conclusion: The study highlights the importance of family intervention for families with multiple stressors on different treatment modalities who might have different needs and challenges. Nursing support needs to be complemented with family-based support to manage complex family issues in order to achieve better health outcomes and improved family coping.

Keywords: complementing nursing support, end stage renal failure, healthcare, systemic approaches

Procedia PDF Downloads 203

Authors: Rim Frikha, Nouha Bouayed, Afifa Sellami, Nozha Chakroun, Salima Daoud, Leila Keskes, Tarek Rebai

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Introduction: Recurrent pregnancy loss (RPL) defined as two or more pregnancy losses, is a serious clinical problem. Methylene-tetrahydro-folate-reductase (MTHFR) polymorphisms, commonly the variant C677T is recognized as an inherited thrombophilia which might affect embryonic development and pregnancy success and cause pregnancy complications as RPL. Material and Methods DNA was extracted from peripheral blood samples and PCR-RFLP was performed for the molecular diagnosis of the C677T MTHFR polymorphism among 70 patients (35 couples) with more than 2 fetal losses. Aims and Objective: The aim of this study is to determine the frequency of MTHFR C677T among Tunisian couples with RPL and to critically analyze the available literature on the importance of MTHFR polymorphism testing in the management of RPL. Result and comments: No C677T mutation was detected in the carriers of RPL. This result would be related to sample size and to different criteria (number of abortion), - The association between MTHFR polymorphisms and pregnancy complications has been reported but with controversial results. - A lack of evidence for MTHFR polymorphism testing previously recommended by ACMG (American College of Medical medicine). Our study highlights the importance of screening of MTHFR polymorphism since the real impact of such thrombotic molecular defect on the pregnancy outcome is evident. - Folic supplementation of these patients during pregnancy can prevent such complications and lead to a successful pregnancy outcome.

Keywords: methylenetetrahydrofolate reductase, C677T, recurrent pregnancy loss, genetic testing

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Authors: M. Hirani, M. Devine, O. Obisesan, C. Bryant

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Introduction: The use of four or more implants to support a fixed prosthesis in the edentulous mandible is well documented, with high levels of clinical outcomes recorded. Despite this, the use of three implant-supported fixed prostheses offers the potential to deliver a more cost-effective method of oral rehabilitation in the lower arch, an important consideration given that edentulism is most prevalent in low-income subpopulations. The purpose of this study aimed to evaluate the implant and prosthetic survival rate, changes in marginal bone level, and patient satisfaction associated with a three-implant-supported fixed prosthesis for rehabilitation of the edentulous mandible over a follow-up period of at least one year. Methods: A comprehensive literature search was performed to evaluate studies that met the selection criteria. The information extracted included the study design and population, participant demographics, observation period, loading protocol, and the number of implants placed together with the required outcome measures. Mean values and standard deviations (SD) were calculated using SPSS® (IBM Corporation, New York, USA), and the level of statistical significance across all comparative studies described was set at P < 0.05. Results: The eligible studies included a total of 1968 implants that were placed in 652 patients. The subjects ranged in age from 33-89 years, with a mean of 63.2 years. The mean cumulative implant and prosthetic survival rates were 95.5% and 96.2%, respectively, over a mean follow-up period of 3.25 years. The mean marginal bone loss recorded was 1.04 mm, and high patient satisfaction rates were reported across the studies. Conclusion: Current evidence suggests that a three implant-supported fixed prosthesis for the edentulous mandible is a successful treatment strategy presenting high implant and prosthetic survival rates over the short-to-medium term. Further well-designed controlled clinical trials are required to evaluate longer-term outcomes, with supplemental data correlating implant dimensions and prosthetic design.

Keywords: implants, mandible, fixed, prosthesis

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Authors: Magdy I. A. Alshourbagi

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Background: The National Institute for Deafness and Communication Disorders defines idiopathic sudden sensorineural hearing loss as the idiopathic loss of hearing of at least 30 dB across 3 contiguous frequencies occurring within 3 days.The most common clinical presentation involves an individual experiencing a sudden unilateral hearing loss, tinnitus, a sensation of aural fullness and vertigo. The etiologies and pathologies of ISSNHL remain unclear. Several pathophysiological mechanisms have been described including: vascular occlusion, viral infections, labyrinthine membrane breaks, immune associated disease, abnormal cochlear stress response, trauma, abnormal tissue growth, toxins, ototoxic drugs and cochlear membrane damage. The rationale for the use of hyperbaric oxygen to treat ISSHL is supported by an understanding of the high metabolism and paucity of vascularity to the cochlea. The cochlea and the structures within it require a high oxygen supply. The direct vascular supply, particularly to the organ of Corti, is minimal. Tissue oxygenation to the structures within the cochlea occurs via oxygen diffusion from cochlear capillary networks into the perilymph and the cortilymph. . The perilymph is the primary oxygen source for these intracochlear structures. Unfortunately, perilymph oxygen tension is decreased significantly in patients with ISSHL. To achieve a consistent rise of perilymph oxygen content, the arterial-perilymphatic oxygen concentration difference must be extremely high. This can be restored with hyperbaric oxygen therapy. Subject and Methods: A 37 year old man was presented at the clinic with a five days history of muffled hearing and tinnitus of the right ear. Symptoms were sudden onset, with no associated pain, dizziness or otorrhea and no past history of hearing problems or medical illness. Family history was negative. Physical examination was normal. Otologic examination revealed normal tympanic membranes bilaterally, with no evidence of cerumen or middle ear effusion. Tuning fork examination showed positive Rinne test bilaterally but with lateralization of Weber test to the left side, indicating right ear sensorineural hearing loss. Audiometric analysis confirmed sensorineural hearing loss across all frequencies of about 70- dB in the right ear. Routine lab work were all within normal limits. Clinical diagnosis of idiopathic sudden sensorineural hearing loss of the right ear was made and the patient began a medical treatment (corticosteroid, vasodilator and HBO therapy). The recommended treatment profile consists of 100% O2 at 2.5 atmospheres absolute for 60 minutes daily (six days per week) for 40 treatments .The optimal number of HBOT treatments will vary, depending on the severity and duration of symptomatology and the response to treatment. Results: As HBOT is not yet a standard for idiopathic sudden sensorineural hearing loss, it was introduced to this patient as an adjuvant therapy. The HBOT program was scheduled for 40 sessions, we used a 12-seat multi place chamber for the HBOT, which was started at day seven after the hearing loss onset. After the tenth session of HBOT, improvement of both hearing (by audiogram) and tinnitus was obtained in the affected ear (right). Conclusions: In conclusion, HBOT may be used for idiopathic sudden sensorineural hearing loss as an adjuvant therapy. It may promote oxygenation to the inner ear apparatus and revive hearing ability. Patients who fail to respond to oral and intratympanic steroids may benefit from this treatment. Further investigation is warranted, including animal studies to understand the molecular and histopathological aspects of HBOT and randomized control clinical studies.

Keywords: idiopathic sudden sensorineural hearing loss (issnhl), hyperbaric oxygen therapy (hbot), the decibel (db), oxygen (o2)

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Authors: Mohammad A. Khasawneh

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The design of high pressure water jet based polishing equipment and its fabrication conducted in this study is reported herein, together with some preliminary test results for assessing its applicability for HMA surface polishing. This study also provides preliminary findings concerning the test variables, such as the rotational speed, the water jet pressure, the abrasive agent used, and the impact angel that were experimentally investigated in this study. The preliminary findings based on four trial tests (two on large slab specimens and two on small size gyratory compacted specimens), however, indicate that both friction and texture values tend to increase with the polishing durations for two combinations of pressure and rotation speed of the rotary deck. It seems that the more polishing action the specimen is subjected to; the aggregate edges are created such that the surface texture values are increased with the accompanied increase in friction values. It may be of interest (but which is outside the scope of this study) to investigate if the similar trend exist for HMA prepared with aggregate source that is sand and gravel.

Keywords: high-pressure, water jet, friction, texture, polishing, statistical analysis

Procedia PDF Downloads 482

Authors: F. Christie, M. Staber

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Malnutrition is a predictor of poor clinical outcome in the elderly. Up to 60% of hip fracture patients are clinically malnourished on admission. This study assessed the perioperative nutritional state of patients admitted with a proximal femoral fracture and examined if adequate nutritional support was achieved. Methods: Prospective, the observational audit of 30 patients, admitted with a proximal femoral fracture, over a one-month period. We recorded: patient demographics; surgical delay; nutritional state on admission; documentation of Malnutrition Universal Screening Tool (MUST) score; dietician input and daily calorie intake through food charts. The nutritional state was re-assessed weekly and at discharge. The outcome was measured by the length of hospital stay and thirty-day mortality. Results: Mean age 87, M:F 1:2 and all patients were ASA three or four. Five patients (17%) had a prolonged ( >24 hours) fasting period. All patients had a MUST score completed on admission, 27% were underweight and 30% were high risk for malnutrition. Twenty-six patients (87%) were appropriately assessed for dietician referral. Thirteen patients had food charts; on average, hospital meals provided 1500kcal daily. No patient achieved > 75% of the provided calories with 69% of patients achieving 50% or less. Only three patients were started on nutritional supplements. Twenty-three patients (77%) lost weight, averaging 6% weight loss during admission. Mean length of stay (LOS) was 23 days and 30-day mortality 9%. Four patients (13%) gained weight, their mean LOS was 17 days and 30-day mortality 0%. Discussion: Malnutrition in the elderly originates in the community. Following major trauma it’s difficult to reverse nutritional deficits in hospitals. It’s therefore concerning that no high-risk patient achieved their recommended calorie intake. Perioperative optimisation needs to include early nutritional intervention, early anaesthetic review and adjusted anaesthetic techniques to support feeding.

Keywords: trauma, nutrition, neck of femur fracture

Procedia PDF Downloads 322

Authors: Katejarinporn Chaiya, Jarumon Nookong, Nutthapat Kaewrattanapat

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The purposes of this research were to develop and find users’ satisfaction after using the Decision Support System for Examination Selection. This research presents the design of information systems. In order to find the necessary examination of the statistics. Based on the examination of the candidate and then taking the easy difficulty setting statistics applied to the test. In addition, research has also made performance appraisals from experts and user satisfaction. By results of analysis showed that the performance appraisals from experts on the system as a whole and at a good level. mean was 3.44 and S.D. was 0.55 and user satisfaction per system as a whole and the good level mean was 3.37 and S.D. was 0.42 can conclude that effective systems are in a good level. Work has been completed in accordance with the scope of work. The website used developing this project is PHP, MySQL.5.0.45 for database.

Keywords: secision support system, examination, PHP, information systems

Procedia PDF Downloads 443

Authors: G. Kabir, A. M. Mohammed, M. A. Bawa

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The paper presents corrosion behaviors of Naval Brass, aluminum alloy and carbon steel in simulated seawater under stagnant conditions. The behaviors were characterized on the variation of chloride ions concentration in the range of 3.0wt% and 3.5wt% and exposure time. The weight loss coupon-method immersion technique was employed. The weight loss for the various alloys was measured. Based on the obtained results, the corrosion rate was determined. It was found that the corrosion rates of the various alloys are related to the chloride ions concentrations, exposure time and kinetics of passive film formation of the various alloys. Carbon steel, suffers corrosion many folds more than Naval Brass. This indicated that the alloy exhibited relatively strong resistance to corrosion in the exposure environment of the seawater. Whereas, the aluminum alloy exhibited an excellent and beneficial resistance to corrosion more than the Naval Brass studied. Despite the prohibitive cost, Naval Brass and aluminum alloy, indicated to have beneficial corrosion behavior that can offer wide range of application in seashore operations. The corrosion kinetics parameters indicated that the corrosion reaction is limited by diffusion mass transfer of the corrosion reaction elements and not by reaction controlled.

Keywords: alloys, chloride ions concentration, corrosion kinetics, corrosion rate, diffusion mass transfer, exposure time, seawater, weight loss

Procedia PDF Downloads 300

Authors: Savita Tangwongkit, Chittur S Srinivasan, Philip J. Jones

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Thailand has become the world’s fourth largest sugarcane producer and second largest sugar exporter. While there have been a number of drivers of this growth, the primary driver has been wide-ranging government support measures. Recently, the Thai government has emphasized the need for policy reform as part of a broader industry restructuring to bring the sector up-to-date with the current and future developments in the international sugar market. Because of the sectors historical dependence on government support, any such reform is likely to have a very significant impact on the fortunes of Thai cane farmers. This study explores the impact of three policy scenarios, representing a spectrum of policy approaches, on Thai cane producers. These reform scenarios were designed in consultation with policy makers and academics working in the cane sector. Scenario 1 captures the current ‘government proposal’ for policy reform. This scenario removes certain domestic production subsidies but seeks to maintain as much support as is permissible under current WTO rules. The second scenario, ‘protectionism’, maintains the current internal market producer supports, but otherwise complies with international (WTO) commitments. Third, the ‘libertarian scenario’ removes all production support and market interventions, trade and domestic consumption distortions. Most important driver of producer behaviour in all of the scenarios is the producer price of cane. Cane price is obviously highest under the protectionism scenario, followed by government proposal and libertarian scenarios, respectively. Likely producer responses to these three policy scenarios was determined by means of a large-scale survey of cane farmers. The sample was stratified by size group and quotas filled by size group and region. One scenario was presented to each of three sub-samples, consisting of approx.150 farmers. Total sample size was 462 farms. Data was collected by face-to-face interview between June and August 2019. There was a marked difference in farmer response to the three scenarios. Farmers in the ‘Protectionism’ scenario, which maintains the highest cane price and those who farm larger cane areas are more likely to continue cane farming. The libertarian scenario is likely to result in the greatest losses in terms of cane production volume broadly double that of the ‘protectionism’ scenario, primarily due to farmers quitting cane production altogether. Over half of loss cane production volume comes from medium-size farm, i.e. the largest and smallest producers are the most resilient. This result is likely due to the fact that the medium size group are large enough to require hired labour but lack the economies of scale of the largest farms. Over all size groups the farms most heavily specialized in cane production, i.e. those devoting 26-50% of arable land to cane, are also the most vulnerable, with 70% of all farmers quitting cane production coming from this group. This investigation suggests that cane price is the most significant determinant of farmer behaviour. Also, that where scenarios drive significantly lower cane price, policy makers should target support towards mid-sized producers, with policies that encourage efficiency gains and diversification into alternative agricultural crops.

Keywords: farmer intentions, farm survey, policy reform, Thai cane production

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Authors: Yeliz Yazıcı, Alev Erenler

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School is an institution designed to provide learning, teaching places and environments under guidance of selected teachers. School is not just a place or institution but it is a place where complex and living structures are alive and always changing. It is also an undeniable fact that schools have shaped the ideas, future, society as well as the students and their lives. While this is the situation, schools having academic excellence is considered as successful ones. Academic excellence is a composition of excellence in teachers, management and physical environment, also. This is the general perception of the authorities and parents when the excellence is the point but the school is a developing and supporting organism. In this concept, the main aim of this study is to compare student and teacher perceptions of school as a ‘positive support factor’. The study is designed as a quantitative and qualitative design and a questionnaire is applied to both teachers and students via online and face to face meetings. It is aimed to define the perceptions of the participants related to the school as a positive support factor. It means the role of school in establishing self-efficacy, shaping and acquiring the behavior etc. Gathered data is analyzed via SPSS program and the detailed discussion is carried in the frame of the related literature.

Keywords: positive support factor, education, school, student teacher perception

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Authors: Y. Galerkin, A. Rekstin, K. Soldatova

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Universal modeling method well proven for industrial compressors was applied for design of the high flow rate supersonic stage. Results were checked by ANSYS CFX and NUMECA Fine Turbo calculations. The impeller appeared to be very effective at transonic flow velocities. Stator elements efficiency is acceptable at design Mach numbers too. Their loss coefficient versus inlet flow angle performances correlates well with Universal modeling prediction. The impeller demonstrated ability of satisfactory operation at design flow rate. Supersonic flow behavior in the impeller inducer at the shroud blade to blade surface Φdes deserves additional study.

Keywords: centrifugal compressor stage, supersonic impeller, inlet flow angle, loss coefficient, return channel, shock wave, vane diffuser

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Authors: Amr Hamdy

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Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Many methods have been developed to decrease its rate. The aim of this study was to evaluate the applicability of a new non-pharmacologic maneuver in decreasing its rate. Methods: This case series study was conducted in one centre in Cairo, Egypt, from January-2010 to June-2013. 400 pregnant–women aged 18 years or more and candidate for normal labour; were enrolled to this study. High-risk subjects for PPH were excluded. After placental delivery, the new maneuver was done by sustained traction of the anterior and posterior lips of the cervix by two ovum forceps for duration of 90 seconds. The amount of blood loss was estimated by standardized visual estimation after removal of the forceps. All subjects were followed up for 6 hours. Results: The rate of PPH, defined as more than 500 ml, was 8 cases (2%) with 95% CI (0.63-3.37%). The rate of PPH was not affected by parity, gestational age, episiotomy or the presence of tears. PPH is more in cases with anemia (p 0.032). It occurred in all cases with uterine atony (p <0.001). The range of estimated blood loss was 550-600ml in cases with PPH and 150-450ml in cases without PPH. Severe PPH more than 1000 ml, did not occur. Conclusion: This pilot study introduced a novel maneuver that can be helpful in decreasing the rate of PPH and reducing the amount of post partum blood loss.Despite the low rate of PPH showed in this study, the need for conducting a randomized controlled study is at its highest level before further inclusion of such manoeuvre to be a part of the current medical practice and before considering it as an evident tool to decrease the burden of PPH.

Keywords: maternal mortality, new manoeuvre, post-partum haemorrhage, uterine atony

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Authors: Ji Sun Kim, Jae Ho Baek, Kyeong Ho Kim, Ji Hae Ha, Seong Soo Hong, Jung-Wook Park, Man Sig Lee

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Carbon supported palladium catalysts have been used in many industrial reactions, especially for hydrogenation in the fine chemical industry. Porous carbons had been widely used as catalyst supports due to its higher surface area and larger pore volume. The specific surface area, pore structure and surface chemical functional groups of porous carbon affects metal dispersion and particle size. In this paper, we confirm the effect of support texture on the dispersion of Pd. Pd catalyst supported on activated carbon having various specific surface area were characterized by BET, XRD and FE-TEM. Catalyst activity and dispersion of prepared catalyst were evaluated on the basis of the CO adsorption capacity by CO-chemisorption. As concluding remark to this part of our study, let us note that specific area of carbon play important role on the synthesis of Pd/C catalyst/.

Keywords: carbon, dispersion, Pd/C, specific are, support

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Authors: Bahloul Amel

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This study is an attempt to raise the awareness of the stakeholders and the authorities on the sensitivity of Algerian secondary school teachers of English as a Foreign Language about the students’ loss of English language skills learned during formal schooling with effort and at expense and the supposed measures to arrest that loss. Data was collected from secondary school teachers of EFL and analyzed quantitatively using a questionnaire containing open-ended and close-ended questions. The results advocate a consensus about the need for actions to be adopted to make assessment techniques outcome-oriented. Most of the participants were in favor of including curricular activities involving contextualized learning, problem-solving learning critical self-awareness, self and peer-assisted learning, use of computers and internet so as to make learners autonomous.

Keywords: lifelong learning, EFL, contextualized learning, Algeria

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Authors: Yin Ma, Xun Wang, Kelsey Austin

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Purpose – Building upon career construction theory and the conservation of resources theory, we developed a moderated mediation model to examine how the perceived university support impact students’ career adapting responses, namely, crystallization, exploration, decision and preparation, via the mediator career adaptability and moderator perceived parental support. Design/methodology/approach – The multi-stage sampling strategy was employed and survey data were collected. Structural equation modeling was used to perform the analysis. Findings – Perceived university support could directly promote students’ career adaptability, and promote three career adapting responses, namely, exploration, decision and preparation. It could also impact four career adapting responses via mediation effect of career adaptability. Its impact on students’ career adaptability can greatly increase when students’ receive parental related career support. Research limitations/implications – The cross-sectional design limits causal inference. Conducted in China, our findings should be cautiously interpreted in other countries due to cultural differences. Practical implications – University support is vital to students’ career adaptability and supports from parents can enhance this process. University-home collaboration is necessary to promote students’ career adapting responses. For students, seeking and utilizing as much supporting resources as possible is vital for their human resources development. On an organizational level, universities could benefit from our findings by introducing the practices which ask students to rate the career-related courses and encourage them to chat with parents regularly. Originality/ value – Using recently developed scale, current work contributes to the literature by investigating the impact of multiple contextual factors on students’ career adapting response. It also provide the empirical support for the role of human intervention in fostering career adapting responses.

Keywords: career adapability, university and parental support, China studies, sociology of education

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Authors: Maria Pratt, Lynn Martin

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Context: In nursing education, clinical instructors are crucial in assessing and evaluating students' performance in clinical courses. However, instructors often struggle when assigning failing grades to students at risk of failing. Research Aim: This qualitative study aims to understand clinical instructors' experiences evaluating students with unsatisfactory performance, including how reflection and collegial support impact this evaluation process. Methodology, Data Collection, and Analysis Procedures: This study employs Gadamer's Hermeneutic Inquiry as the research methodology. A purposive maximum variation sampling technique was used to recruit eight clinical instructors from a collaborative undergraduate nursing program in Southwestern Ontario. Semi-structured, open-ended, and audio-taped interviews were conducted with the participants. The hermeneutic analysis was applied to interpret the interview data to allow for a thorough exploration and interpretation of the instructors' experiences evaluating failing students. Findings: The main findings of this qualitative research indicate that evaluating failing students was emotionally draining for the clinical instructors who experienced multiple challenges, uncertainties, and negative feelings associated with assigning failing grades. However, the analysis revealed that ongoing reflection and collegial support played a crucial role in mitigating the challenges they experienced. Conclusion: This study contributes to the theoretical understanding of nursing education by shedding light on clinical instructors' challenges in evaluating failing students. It emphasizes the emotional toll associated with this process and the role that reflection and collegial support play in alleviating those challenges. The findings underscore the need for ongoing professional development and support for instructors in nursing education. By understanding and addressing clinical instructors' experiences, nursing education programs can better equip them to effectively evaluate struggling students and provide the necessary support for their professional growth.

Keywords: clinical instructor, student evaluation, nursing, reflection, support

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Authors: P. Vosynek, T. Návrat, M. Peč, J. Pořízka, P. Diviš

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Changes of mechanical properties and response behavior of bones is an important external sign of medical problems like osteoporosis, bone remodeling after fracture or surgery, osteointegration, or bone tissue loss of astronauts in space. Measuring of mechanical behavior of bones in physiological and osteoporotic states, quantified by different degrees of protein (collagen) and mineral loss, is thus an important topic in biomechanical research. This contribution deals with the relation between mechanical properties of the turkey long bone–tibia in physiological, demineralized, and deproteinized state. Three methods for comparison were used: densitometry, three point bending and harmonic response analysis. The results help to find correlations between the methods and estimate their possible application in medical practice.

Keywords: bone properties, long bone, osteoporosis, response behavior

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Authors: Vinita Choudhary

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The solidly mounted resonator (SMR) is a bulk acoustic wave-based device consisting of a piezoelectric layer sandwiched between two electrodes upon Bragg reflectors, which then are attached to a substrate. To transform the effective acoustic impedance of the substrate to a near zero value, the Bragg reflectors are composed of alternating high and low acoustic impedance layers of quarter-wavelength thickness. In this work presents the design and investigation of acoustic Bragg reflectors (ABRs) for solidly mounted bulk acoustic wave resonators through analysis and simulation. This performance of the resonator is analyzed using 1D Mason modeling. The performance parameters are the effect of Bragg pairs number on transmissivity, reflectivity, insertion loss, the electromechanical and quality factor of the 5GHz operating resonator.

Keywords: bragg reflectors, SMR, insertion loss, quality factor

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Authors: Robert Pellerin, Michel Gamache, Remi Trudeau, Nathalie Perrier

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The context of large engineering projects is particularly favorable to the appearance of engineering changes and contractual modifications. These elements are potential causes for claims. In this paper, we investigate one of the critical components of the claim management process: the calculation of the impacts of changes in terms of losses of productivity due to the need to accelerate some project activities. When project changes are initiated, delays can arise. Indeed, project activities are often executed in fast-tracking in an attempt to respect the completion date. But the acceleration of project execution and the resulting rework can entail important costs as well as induce productivity losses. In the past, numerous methods have been proposed to quantify the duration of delays, the gains achieved by project acceleration, and the loss of productivity. The calculation related to those changes can be divided into two categories: direct cost and indirect cost. The direct cost is easily quantifiable as opposed to indirect costs which are rarely taken into account during the calculation of the cost of an engineering change or contract modification despite several research projects have been made on this subject. However, proposed models have not been accepted by companies yet, nor they have been accepted in court. Those models require extensive data and are often seen as too specific to be used for all projects. These techniques are also ignoring the resource constraints and the interdependencies between the causes of delays and the delays themselves. To resolve this issue, this research proposes a simulation model that mimics how major engineering changes or contract modifications are handled in large construction projects. The model replicates the use of overtime in a reactive scheduling mode in order to simulate the loss of productivity present when a project change occurs. Multiple tests were conducted to compare the results of the proposed simulation model with statistical analysis conducted by other researchers. Different scenarios were also conducted in order to determine the impact the number of activities, the time of occurrence of the change, the availability of resources, and the type of project changes on productivity loss. Our results demonstrate that the number of activities in the project is a critical variable influencing the productivity of a project. When changes occur, the presence of a large number of activities leads to a much lower productivity loss than a small number of activities. The speed of reducing productivity for 30-job projects is about 25 percent faster than the reduction speed for 120-job projects. The moment of occurrence of a change also shows a significant impact on productivity. Indeed, the sooner the change occurs, the lower the productivity of the labor force. The availability of resources also impacts the productivity of a project when a change is implemented. There is a higher loss of productivity when the amount of resources is restricted.

Keywords: engineering changes, indirect costs overtime, productivity, scheduling, simulation

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Authors: Lorenzo Ciletti, Ed Baines, Matt Somerville

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Internationally, supporting staff with limited training (Teaching Assistants (TA)) has played a critical role in the education of children with special educational needs and/or disabilities (SEND). Researchers have notably illustrated that TAs support the children’s classroom tasks while teachers manage the whole class. Rarely have researchers investigated the TAs’ support for children’s participation in whole-class or peer-group talk, despite this type of “social support” playing a significant role in children’s whole-class integration and engagement with the classroom curriculum and learning. Social support seems particularly crucial for a large proportion of children with SEND, namely those with communication and interaction difficulties (e.g., autism spectrum conditions and speech impairments). This study explored TA practice and, particularly, TA social support in a rarely examined context (Italy). The Italian case was also selected as it provides TAs, known nationally as “support teachers,” with the most comprehensive training worldwide, thus potentially echoing (effective) nuanced practice internationally. Twelve hours of video recordings of a single TA and a child with communication and interaction difficulties (CID) were made. Video data was converted into frequencies of TA multidimensional support strategies, including TA social support and pedagogical assistance. TA-pupil talk oriented to children’s participation in classroom talk was also analysed into thematic patterns. These multi-method analyses were informed by social scaffolding principles: in particular, the extent to which the TA designs instruction contingently to the child’s communication and interaction difficulties and how their social support fosters the child’s highest responsibility in dealing with whole-class or peer-group talk by supplying the least help. The findings showed that the TA rarely supported the group or whole class participation of the child with CID. When doing so, the TA seemed to highly control the content and the timing of the child’s contributions to the classroom talk by a) interrupting the teacher’s whole class or group conversation to start an interaction between themselves and the child and b) reassuring the child about the correctness of their talk in private conversations and prompting them to raise their hand and intervene in the whole-class talk or c) stopping the child from contributing to the whole-class or peer-group talk when incorrect. The findings are interpreted in terms of their theoretical relation to scaffolding. They have significant implications for promoting social scaffolding in TA training in Italy and elsewhere.

Keywords: children with communication and interaction difficulties, children with special educational needs and/or disabilities, social scaffolding, teaching assistants, teaching practice, whole-class talk participation

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Authors: Sabina Ampon-Wireko

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Purpose: The study explores the influence of the organizational climate of silence on job performance through the mediating effects of work engagement (WE). Further, the degree to which supervisor support (SS) and work engagement moderate job performance are examined. Method: Using a questionnaire, the study collected 565 valid responses from frontline nurses in Ghana. The hierarchical regression technique was employed in estimating the relationship between the variables. Findings: The results showed a significant negative influence of top managers' and supervisors' attitudes to silence on both contextual and task performance. Communication opportunities, however, revealed positive and significant effects on contextual and task performance. Work engagement had no role in mediating top managers' and supervisors’ attitudes toward silence, communication opportunities, and task performance. Supervisor support acted as a moderating factor in the relationship between job engagement and task performance. In contrast, despite the direct positive relationship between supervisor support and contextual performance, it failed to moderate the relationship between work engagement and contextual performance. Practical implications: The study's findings demonstrate the need for health managers and supervisors to become more conscious of silence. The findings offer diverse recommendations for encouraging the sharing of relevant ideas, facts, and opinions within the health sector.

Keywords: organizational climate of silence, job performance, work engagement, supervisor support, frontline nurses

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Authors: Shahram Payandeh

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This paper presents an overview of a model which can be used as a part of a decision support system when fusing information from multiple sensing environment. Data fusion has been widely studied in the past few decades and numerous frameworks have been proposed to facilitate decision making process under uncertainties. Multi-sensor data fusion technology plays an increasingly significant role during people tracking and activity recognition. This paper presents an overview of a quantum model as a part of a decision-making process in the context of multi-sensor data fusion. The paper presents basic definitions and relationships associating the decision-making process and quantum model formulation in the presence of uncertainties.

Keywords: quantum model, sensor space, sensor network, decision support

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Authors: Noha Seddik, Sherine Youssef, Mohamed Kholeif

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The automated epileptic seizure detection research field has emerged in the recent years; this involves analyzing the Electroencephalogram (EEG) signals instead of the traditional visual inspection performed by expert neurologists. In this study, a Support Vector Machine (SVM) that uses Weighted Permutation Entropy (WPE) as the input feature is proposed for classifying normal and seizure EEG records. WPE is a modified statistical parameter of the permutation entropy (PE) that measures the complexity and irregularity of a time series. It incorporates both the mapped ordinal pattern of the time series and the information contained in the amplitude of its sample points. The proposed system utilizes the fact that entropy based measures for the EEG segments during epileptic seizure are lower than in normal EEG.

Keywords: electroencephalogram (EEG), epileptic seizure detection, weighted permutation entropy (WPE), support vector machine (SVM)

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Authors: Cailyn Green

Abstract:

Substance use counselors have a variety of fast-paced tasks and responsibilities. Professional resources are designed to support professionals in making their job duties easier and less stressful. The purpose of this research was to identify what types of resources would support addiction counselors in performing their job duties. Counselors often must jump in and facilitate a group counseling session with little to no time for prep. This causes stress and creates pressure to come up with a clinical group activity in little time. The researcher utilized qualitative interviews focused on identifying what types of resources would support addiction counselors in doing their jobs easier and effectively. The researcher visited 23 different addiction counseling facilities seeking participants for the interviews. Altogether 15 interviews were collected across six different substance-use counseling facilities. The interviews guided the researcher toward creating an open education resource (OER) of group activities for addiction counselors to utilize.

Keywords: addiction, counseling, resources, OER, treatment

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Authors: Muhammad Ali, Aamir Sohail, Umair Malik

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Research in entrepreneurship has gained much attention in current academic environment. Youngsters are taking interest to start their own business in spite of risk matter. The objective of the study is to explain how various personality traits (personal attitude, locus of control, instrumental readiness and perceived behavioral control) are affecting entrepreneurial intention of students. The theory of planned behavior supports out study which explains that personal attractiveness, social norms and feasibility are the main factors that affect intentions of an individual. The sample data of 120 is collected from graduating batch of three reputed universities of Islamabad through questionnaires. Our results support the hypothesis that personality traits positively influence the entrepreneurial intention. We conclude from the study that many graduating students are willing to start a new venture, but most of them are likely to do a job in their respective fields. Risk factor also exists in their minds because in our country most people are risk-averse and they do not want to lose their money in case of loss.

Keywords: entrepreneurship, instrumental readiness, locus of control, personal attitude

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