Search results for: online practical training

Authors: Ahmed Elsayed, Andrew Shea, Nicolas Kelly, John Allison

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In northern European climates, domestic space heating and hot water represents a significant proportion of total primary total primary energy use and meeting these demands from a national electricity grid network supplied by renewable energy sources provides an opportunity for a significant reduction in EU CO₂ emissions. However, in order to adapt to the intermittent nature of renewable energy generation and to avoid co-incident peak electricity usage from consumers that may exceed current capacity, the demand for heat must be decoupled from its generation. Storage of heat within the fabric of dwellings for use some hours, or days, later provides a route to complete decoupling of demand from supply and facilitates the greatly increased use of renewable energy generation into a local or national electricity network. The integration of thermal energy storage into the building fabric for retrieval at a later time requires much evaluation of the many competing thermal, physical, and practical considerations such as the profile and magnitude of heat demand, the duration of storage, charging and discharging rate, storage media, space allocation, etc. In this paper, the authors report investigations of thermal storage in building fabric using concrete material and present an evaluation of several factors that impact upon performance including heating pipe layout, heating fluid flow velocity, storage geometry, thermo-physical material properties, and also present an investigation of alternative storage materials and alternative heat transfer fluids. Reducing the heating pipe spacing from 200 mm to 100 mm enhances the stored energy by 25% and high-performance Vacuum Insulation results in heat loss flux of less than 3 W/m², compared to 22 W/m² for the more conventional EPS insulation. Dense concrete achieved the greatest storage capacity, relative to medium and light-weight alternatives, although a material thickness of 100 mm required more than 5 hours to charge fully. Layers of 25 mm and 50 mm thickness can be charged in 2 hours, or less, facilitating a fast response that could, aggregated across multiple dwellings, provide significant and valuable reduction in demand from grid-generated electricity in expected periods of high demand and potentially eliminate the need for additional new generating capacity from conventional sources such as gas, coal, or nuclear.

Keywords: fabric integrated thermal storage, FITS, demand side management, energy storage, load shifting, renewable energy integration

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Authors: Peter Kutis, Vladimir Littva

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Nowadays, it is necessary to ensure that this reduction in costs is not at the expense of the quality of health care and future medical success. In general, physiotherapy for total hip joint arthroplasty is considered to be a routine matter that deals mainly with mobility training, increased muscular strength, and basic day-to-day activities such as bed-to-chair transition, standing, and walking. Within the KEGA project no. 003KU-4-2021, we decided to investigate preoperative physiotherapy care in Slovakia and Austria in total hip arthroplasty patients to shortened overall recovery. Research Sample and Methods: The sample comprised 498 respondents –patients who were indicated to total hip arthroplasty on the territory of Slovakia and Austria. There were 130 women in Slovakia and 135 women in Austria. The numbers of men were 120 in Slovakia and 113 men in Austria. The age of respondents was between 40 and 85 years of age. As a method of our research, we chose a non-standardized questionnaire, which consisted of three parts. The first part for the initial examination of the patient contained the identification of the patient according to the assigned number and subsequently 19 questions conditioned by the physical examination and evaluation of the patients. The second part of our questionnaire was completed after the patient's hospitalization and contained 10 questions that were conditioned by the patient's examination. The last third part for the overall assessment of the patient's state of health consisted of 12 questions conditioned by the patient's examination. This part was performed at the last meeting with the patient at the end of the treatment. All data were statistically processed by SPSS 25. Results: All data were evaluated at a significance level of p = 0.05. From the comparison of patients who underwent preoperative preparation, we can clearly state that the total duration of treatment is significantly shorter. A t-test of two mean values with uneven variance was used to verify the validity of the assumption. The total duration of treatment in patients with preoperative preparation was on average 92,635 days and without preoperative preparation was on average 135,884 days (t-Stat = 44,52784, t Critical one-tail = 1,648187415, t Critical two-tail = 1,965157). Conclusion: The results obtained during the research show the importance of adequate preoperative physiotherapeutic preparation of the patient. The results of total hip joint arthroplasty studies showed a significant reduction in a hospital stay as well as shortened total treatment time.

Keywords: THA, physiotherapy, recovery, preoperative physiotherapy care

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Authors: Devika Nair, Sean Bellairs, Ken Evans

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Flow and erosion modeling provides an avenue for simulating the fine suspended sediment in surface water systems like streams and creeks. Fine suspended sediment is highly mobile, and many contaminants that may have been released by any sort of catchment disturbance attach themselves to these sediments. Therefore, a knowledge of fine suspended sediment transport is important in assessing contaminant transport. The CAESAR-Lisflood Landform Evolution Model, which includes a hydrologic model (TOPMODEL) and a hydraulic model (Lisflood), is being used to assess the sediment movement in tropical streams on account of a disturbance in the catchment of the creek and to determine the dynamics of sediment quantity in the creek through the years by simulating the model for future years. The accuracy of future simulations depends on the calibration and validation of the model to the past and present events. Calibration and validation of the model involve finding a combination of parameters of the model, which, when applied and simulated, gives model outputs similar to those observed for the real site scenario for corresponding input data. Calibrating the sediment output of the CAESAR-Lisflood model at the catchment level and using it for studying the equilibrium conditions of the landform is an area yet to be explored. Therefore, the aim of the study was to calibrate the CAESAR-Lisflood model and then validate it so that it could be run for future simulations to study how the landform evolves over time. To achieve this, the model was run for a rainfall event with a set of parameters, plus discharge and sediment data for the input point of the catchment, to analyze how similar the model output would behave when compared with the discharge and sediment data for the output point of the catchment. The model parameters were then adjusted until the model closely approximated the real site values of the catchment. It was then validated by running the model for a different set of events and checking that the model gave similar results to the real site values. The outcomes demonstrated that while the model can be calibrated to a greater extent for hydrology (discharge output) throughout the year, the sediment output calibration may be slightly improved by having the ability to change parameters to take into account the seasonal vegetation growth during the start and end of the wet season. This study is important to assess hydrology and sediment movement in seasonal biomes. The understanding of sediment-associated metal dispersion processes in rivers can be used in a practical way to help river basin managers more effectively control and remediate catchments affected by present and historical metal mining.

Keywords: erosion modelling, fine suspended sediments, hydrology, surface water systems

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Authors: M. François, L. Sigot, C. Vallières

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Volatile Organic Compounds (VOCs) are a real health issue, particularly in domestic indoor environments. Among these VOCs, acetaldehyde is frequently monitored in dwellings ‘air, especially due to smoking and spontaneous emissions from the new wall and soil coverings. It is responsible for respiratory complaints and is classified as possibly carcinogenic to humans. Adsorption processes are commonly used to remove VOCs from the air. Metal-Organic Frameworks (MOFs) are a promising type of material for high adsorption performance. These hybrid porous materials composed of metal inorganic clusters and organic ligands are interesting thanks to their high porosity and surface area. The HKUST-1 (also referred to as MOF-199) is a copper-based MOF with the formula [Cu₃(BTC)₂(H₂O)₃]n (BTC = benzene-1,3,5-tricarboxylate) and exhibits unsaturated metal sites that can be attractive sites for adsorption. The objective of this study is to investigate the impact of HKUST-1 pretreatment on acetaldehyde adsorption. Thus, dynamic adsorption experiments were conducted in 1 cm diameter glass column packed with 2 cm MOF bed height. MOF were sieved to 630 µm - 1 mm. The feed gas (Co = 460 ppmv ± 5 ppmv) was obtained by diluting a 1000 ppmv acetaldehyde gas cylinder in air. The gas flow rate was set to 0.7 L/min (to guarantee a suitable linear velocity). Acetaldehyde concentration was monitored online by gas chromatography coupled with a flame ionization detector (GC-FID). Breakthrough curves must allow to understand the interactions between the MOF and the pollutant as well as the impact of the HKUST-1 humidity in the adsorption process. Consequently, different MOF water content conditions were tested, from a dry material with 7 % water content (dark blue color) to water saturated state with approximately 35 % water content (turquoise color). The rough material – without any pretreatment – containing 30 % water serves as a reference. First, conclusions can be drawn from the comparison of the evolution of the ratio of the column outlet concentration (C) on the inlet concentration (Co) as a function of time for different HKUST-1 pretreatments. The shape of the breakthrough curves is significantly different. The saturation of the rough material is slower (20 h to reach saturation) than that of the dried material (2 h). However, the breakthrough time defined for C/Co = 10 % appears earlier in the case of the rough material (0.75 h) compared to the dried HKUST-1 (1.4 h). Another notable difference is the shape of the curve before the breakthrough at 10 %. An abrupt increase of the outlet concentration is observed for the material with the lower humidity in comparison to a smooth increase for the rough material. Thus, the water content plays a significant role on the breakthrough kinetics. This study aims to understand what can explain the shape of the breakthrough curves associated to the pretreatments of HKUST-1 and which mechanisms take place in the adsorption process between the MOF, the pollutant, and the water.

Keywords: acetaldehyde, dynamic adsorption, HKUST-1, pretreatment influence

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Authors: Elisabetta Cianfanelli, Margherita Tufarelli, Paolo Pupparo

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The dialectical mediation between desires and objects or between mass production and consumption continues to evolve over time. This relationship is influenced both by variable geometries of contexts that are distant from the mere design of product form and by aspects rooted in the very definition of industrial design. In particular, the overcoming of macro-areas of innovation in the technological, social, cultural, formal, and morphological spheres, supported by recent theories in critical and speculative design, seems to be moving further and further away from the design of the formal dimension of advanced products. The articulated fabric of theories and practices that feed the definition of “hyperobjects”, and no longer objects describes a common tension in all areas of design and production of industrial products. The latter are increasingly detached from the design of the form and meaning of the same in mass productions, thus losing the quality of products capable of social transformation. For years we have been living in a transformative moment as regards the design process in the definition of the industrial product. We are faced with a dichotomy in which there is, on the one hand, a reactionary aversion to the new techniques of industrial production and, on the other hand, a sterile adoption of the techniques of mass production that we can now consider traditional. This ambiguity becomes even more evident when we talk about industrial products, and we realize that we are moving further and further away from the concepts of "form" as a synthesis of a design thought aimed at the aesthetic-emotional component as well as the functional one. The design of forms and their contents, as statutes of social acts, allows us to investigate the tension on mass production that crosses seasons, trends, technicalities, and sterile determinisms. The design culture has always determined the formal qualities of objects as a sum of aesthetic characteristics functional and structural relationships that define a product as a coherent unit. The contribution proposes a reflection and a series of practical experiences of research on the form of advanced products. This form is understood as a kaleidoscope of relationships through the search for an identity, the desire for democratization, and between these two, the exploration of the aesthetic factor. The study of form also corresponds to the study of production processes, technological innovations, the definition of standards, distribution, advertising, the vicissitudes of taste and lifestyles. Specifically, we will investigate how the genesis of new forms for new meanings introduces a change in the relative innovative production techniques. It becomes, therefore, fundamental to investigate, through the reflections and the case studies exposed inside the contribution, also the new techniques of production and elaboration of the forms of the products, as new immanent and determining element inside the planning process.

Keywords: industrial design, product advanced design, mass productions, new meanings

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Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

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Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

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Authors: G. Zakharov, Z. Aslamazashvili, M. Chikhradze, D. Kvaskhvadze, N. Khidasheli, S. Gvazava

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Traditional technologies for processing iron-containing industrial waste, including steel-rolling production, are associated with significant energy costs, the long duration of processes, and the need to use complex and expensive equipment. Waste generated during the industrial process negatively affects the environment, but at the same time, it is a valuable raw material and can be used to produce new marketable products. The study of the effectiveness of self-propagating high-temperature synthesis (SHS) methods, which are characterized by the simplicity of the necessary equipment, the purity of the final product, and the high processing speed, is under the wide scientific and practical interest to solve the set problem. The work presents technological aspects of the production of Ferro boron by the method of SHS - metallurgy from iron-containing wastes of rolled production for alloying of cast iron and results of the effect of alloying element on the degree of boron assimilation with liquid cast iron. Features of Fe-B system combustion have been investigated, and the main parameters to control the phase composition of synthesis products have been experimentally established. Effect of overloads on patterns of cast ligatures formation and mechanisms structure formation of SHS products was studied. It has been shown that an increase in the content of hematite Fe₂O₃ in iron-containing waste leads to an increase in the content of phase FeB and, accordingly, the amount of boron in the ligature. Boron content in ligature is within 3-14%, and the phase composition of obtained ligatures consists of Fe₂B and FeB phases. Depending on the initial composition of the wastes, the yield of the end product reaches 91 - 94%, and the extraction of boron is 70 - 88%. Combustion processes of high exothermic mixtures allow to obtain a wide range of boron-containing ligatures from industrial wastes. In view of the relatively low melting point of the obtained SHS-ligature, the positive dynamics of boron absorption by liquid iron is established. According to the obtained data, the degree of absorption of the ligature by alloying gray cast iron at 1450°C is 80-85%. When combined with the treatment of liquid cast iron with magnesium, followed by alloying with the developed ligature, boron losses are reduced by 5-7%. At that, uniform distribution of boron micro-additives in the volume of treated liquid metal is provided. Acknowledgment: This work was supported by Shota Rustaveli Georgian National Science Foundation of Georgia (SRGNSFG) under the GENIE project (grant number № CARYS-19-802).

Keywords: self-propagating high-temperature synthesis, cast iron, industrial waste, ductile iron, structure formation

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Authors: Maik Kschischo, Dominik Kahl, Philipp Wendland, Andreas Weber

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Understanding and modelling of real-world complex dynamic systems in biology, engineering and other fields is often made difficult by incomplete knowledge about the interactions between systems states and by unknown disturbances to the system. In fact, most real-world dynamic networks are open systems receiving unknown inputs from their environment. To understand a system and to estimate the state dynamics, these inputs need to be reconstructed from output measurements. Reconstructing the input of a dynamic system from its measured outputs is an ill-posed problem if only a limited number of states is directly measurable. A first requirement for solving this problem is the invertibility of the input-output map. In our work, we exploit the fact that invertibility of a dynamic system is a structural property, which depends only on the network topology. Therefore, it is possible to check for invertibility using a structural invertibility algorithm which counts the number of node disjoint paths linking inputs and outputs. The algorithm is efficient enough, even for large networks up to a million nodes. To understand structural features influencing the invertibility of a complex dynamic network, we analyze synthetic and real networks using the structural invertibility algorithm. We find that invertibility largely depends on the degree distribution and that dense random networks are easier to invert than sparse inhomogeneous networks. We show that real networks are often very difficult to invert unless the sensor nodes are carefully chosen. To overcome this problem, we present a sensor node placement algorithm to achieve invertibility with a minimum set of measured states. This greedy algorithm is very fast and also guaranteed to find an optimal sensor node-set if it exists. Our results provide a practical approach to experimental design for open, dynamic systems. Since invertibility is a necessary condition for unknown input observers and data assimilation filters to work, it can be used as a preprocessing step to check, whether these input reconstruction algorithms can be successful. If not, we can suggest additional measurements providing sufficient information for input reconstruction. Invertibility is also important for systems design and model building. Dynamic models are always incomplete, and synthetic systems act in an environment, where they receive inputs or even attack signals from their exterior. Being able to monitor these inputs is an important design requirement, which can be achieved by our algorithms for invertibility analysis and sensor node placement.

Keywords: data-driven dynamic systems, inversion of dynamic systems, observability, experimental design, sensor node placement

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Authors: S. Ithai, A. Oloo

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The emergence of globalization has cultivated an international consensus that without economic development; it is very unlikely that a country may realize social or political development. It is equally important to note that the economic effect on social development automatically influence the country healthcare services as healthcare systems are improved and adopted. For decades and before 1980's, the colonial and the Governments of Kenya had pursued a goal to provide free healthcare services to its citizen with minimal success; but as population increased, this endeavor became almost a mirage. The challenge called for a change of strategy with introduction of cost sharing which also could not guarantee sustainability of healthcare services in the country due to increased number of poor people and poverty. An involvement of multisectral approach to provision of health individual, collaboration and adoption of all dimensions through globalization provides a ray of hope to not only economic, political and social development but also guaranteed equitable and reliable healthcare systems in Kenya and specifically referral healthcare services at KNH. With the advent of globalization, KNH has made positive strides that have guaranteed patients with reliable healthcare services. These include increased donor funding, collaboration levels, training and research as well as enhanced the hospital relations with international partners. During this period, the hospital has increased number of local doctors and nurses, enhanced transfer of skills, innovations and technologies which are driving forces to quality and efficient healthcare services. The period has also brought in challenges for the hospital which include increased competition, attraction of qualified nurses and doctors to international are some the issues that have made the hospital to spend more resources in research and development in order to stay afloat. This paper reveals the link between globalization and healthcare and its influence on institution policy choice. However, the process is not expected to take place automatically without institutional initiatives if KNH is to reap the benefits of globalization. KNH need to make use of the existing infrastructure, human resources and donor confidence, the opportunities that are indeed important in propelling KNH toward Vision 2030 and achieving the desired Millennium Development Goals (MDGs).

Keywords: globalization, Kenyatta National Hospital, native, healthcare

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Authors: Thomas Folegot, Arnaud Levaufre, Léna Bourven, Nicolas Kermagoret, Alexis Caillard, Roger Gallou

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Concern for negative impacts of anthropogenic noise on the ocean’s ecosystems has increased over the recent decades. This concern leads to a similar increased willingness to regulate noise-generating activities, of which shipping is one of the most significant. Dealing with ship noise requires not only knowledge about the noise from individual ships, but also how the ship noise is distributed in time and space within the habitats of concern. Marine mammals, but also fish, sea turtles, larvae and invertebrates are mostly dependent on the sounds they use to hunt, feed, avoid predators, during reproduction to socialize and communicate, or to defend a territory. In the marine environment, sight is only useful up to a few tens of meters, whereas sound can propagate over hundreds or even thousands of kilometers. Directive 2008/56/EC of the European Parliament and of the Council of June 17, 2008 called the Marine Strategy Framework Directive (MSFD) require the Member States of the European Union to take the necessary measures to reduce the impacts of maritime activities to achieve and maintain a good environmental status of the marine environment. The Ocean-Planner is a web-based platform that provides to regulators, managers of protected or sensitive areas, etc. with a decision support tool that enable to anticipate and quantify the effectiveness of management measures in terms of reduction or modification the distribution of underwater noise, in response to Descriptor 11 of the MSFD and to the Marine Spatial Planning Directive. Based on the operational sound modelling tool Quonops Online Service, Ocean-Planner allows the user via an intuitive geographical interface to define management measures at local (Marine Protected Area, Natura 2000 sites, Harbors, etc.) or global (Particularly Sensitive Sea Area) scales, seasonal (regulation over a period of time) or permanent, partial (focused to some maritime activities) or complete (all maritime activities), etc. Speed limit, exclusion area, traffic separation scheme (TSS), and vessel sound level limitation are among the measures supported be the tool. Ocean Planner help to decide on the most effective measure to apply to maintain or restore the biodiversity and the functioning of the ecosystems of the coastal seabed, maintain a good state of conservation of sensitive areas and maintain or restore the populations of marine species.

Keywords: underwater noise, marine biodiversity, marine spatial planning, mitigation measures, prediction

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Authors: Caitlin Bailey, Marian Frattarola Saulino, Beth Steinberg

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Today, virtually all programs offered to people with intellectual and developmental disabilities tout themselves as person-centered, community-based and inclusive, yet there is a vast range in type and quality of services that use these similar descriptors. The issue is exacerbated by the fields’ measurement practices around quality, inclusion, independent living, choice and person-centered outcomes. For instance, community inclusion for people with disabilities is often measured by the number of times person steps into his or her community. These measurement approaches set standards for quality too low so that agencies supporting group home residents to go bowling every week can report the same outcomes as an agency that supports one person to join a book club that includes people based on their literary interests rather than disability labels. Ultimately, lack of delineation in measurement contributes to the confusion between face value “quality” and true quality services and supports for many people with disabilities and their families. This exploratory study adopts alternative approaches to quality measurement including co-production methods and systems theoretical framework in order to identify the factors that 1) lead to high-quality supports and, 2) differentiate high-quality services. Project researchers have partnered with community practitioners who are all committed to providing quality services and supports but vary in the degree to which they are actually able to provide them. The study includes two parts; first, an online survey distributed to more than 500 agencies that have demonstrated commitment to providing high-quality services; and second, four in-depth case studies with agencies in three United States and Israel providing a variety of supports to children and adults with disabilities. Results from both the survey and in-depth case studies were thematically analyzed and coded. Results show that there are specific factors that differentiate service quality; however meaningful quality measurement practices also require that researchers explore the contextual factors that contribute to quality. These not only include direct services and interactions, but also characteristics of service users, their environments as well as organizations providing services, such as management and funding structures, culture and leadership. Findings from this study challenge researchers, policy makers and practitioners to examine existing quality service standards and measurements and to adopt alternate methodologies and solutions to differentiate and scale up evidence-based quality practices so that all people with disabilities have access to services that support them to live, work, and enjoy where and with whom they choose.

Keywords: co-production, inclusion, independent living, quality measurement, quality supports

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Authors: Priyanka Sharma, Manoj Jais, Poonam Gupta, Suraiya K. Ansari, Ravinder Kaur

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Introduction: As much as the Health Care is necessary for the population, so is the management of the Biomedical waste produced. Biomedical waste is a wide terminology used for the waste material produced during the diagnosis, treatment or immunization of human beings and animals, in research or in the production or testing of biological products. Biomedical waste management is a chain of processes from the point of generation of Biomedical waste to its final disposal in the correct and proper way, assigned for that particular type of waste. Any deviation from the said processes leads to improper disposal of Biomedical waste which itself is a major health hazard. Proper segregation of Biomedical waste is the key for Biomedical Waste management. Improper disposal of BMW can cause sharp injuries which may lead to HIV, Hepatitis-B virus, Hepatitis-C virus infections. Therefore, proper disposal of BMW is of upmost importance. Health care establishments segregate the Biomedical waste and dispose it as per the Biomedical waste management rules in India. Objectives: This study was done to observe the current trends of Biomedical waste generated in a tertiary care Hospital in Delhi. Methodology: Biomedical waste management rounds were conducted in the hospital wards. Relevant details were collected and analysed and sites with maximum Biomedical waste generation were identified. All the data was cross checked with the commons collection site. Results: The total amount of waste generated in the hospital during January 2014 till December 2014 was 6,39,547 kg, of which 70.5% was General (non-hazardous) waste and the rest 29.5% was BMW which consisted highly infectious waste (12.2%), disposable plastic waste (16.3%) and sharps (1%). The maximum quantity of Biomedical waste producing sites were Obstetrics and Gynaecology wards with a total Biomedical waste production of 45.8%, followed by Paediatrics, Surgery and Medicine wards with 21.2 %, 4.6% and 4.3% respectively. The maximum average Biomedical waste generated was by Obstetrics and Gynaecology ward with 0.7 kg/bed/day, followed by Paediatrics, Surgery and Medicine wards with 0.29, 0.28 and 0.18 kg/bed/day respectively. Conclusions: Hospitals should pay attention to the sites which produce a large amount of BMW to avoid improper segregation of Biomedical waste. Also, induction and refresher training Program of Biomedical waste management should be conducted to avoid improper management of Biomedical waste. Healthcare workers should be made aware of risks of poor Biomedical waste management.

Keywords: biomedical waste, biomedical waste management, hospital-tertiary care, New Delhi

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Authors: André Melo Franco Lorena De Barros, Elida Geralda Campos

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The bilingual education has just started in Brazils public schools. This paper is a didactic sequence of biology bilingual lessons about biologic control in the Brazilian Savana. This sequence has been applied in the first year of a bilingual education program in the only public English and Portuguese bilingual high school in Brazil. The aim of this work is to develop and apply a didactic sequence capable of developing the scientific literacy through the bilingual education associated with Problem Based Learning. This didactic sequence was applied in a class of 30 students. It was divided in three lessons. In the first lesson the students were divided in groups and received a fiction Letter from a mayor explaining the problem and asking students for help. The organic soy plantation of the mayor’s is been attacked by caterpillars. The students read the text then raised hypothesis of how they could solve the problem. In the second lesson the students searched online to verify if theirs hypothesis were correct and to find answers for the question proposed. In the third lesson the groups got together and discussed about their results and wrote a final essay with the answers for the problem proposed. The tools used to acquire information about the didactic sequence were: researcher’s diary, survey, interview and essay developed by the students. Most of the initial hypothesis couldn’t answer the problem properly. By the second lesson most of the students could answer properly. During the third lesson all the groups figured out suitable answers. The forms of biological control, birds habits and transgenic were deeply studied by the students. This methodology was successful for developing the scientific literacy with most of the students and also concluded that the quality of learning is directly associated with the effort of each student during the process. [ARAÚJO, Denise Lino de. O que é (e como se faz) sequência didática. Entrepalavras, Fortaleza, v. 3, n. 3, p.322-334, jul. 2013.] [FRANCO, Aline Aparecida et al. Preferência alimentar de Anticarsia gemmatalis Hübner (Lepidoptera: Noctuidae) por cultivares de soja. Científica: Revista de Ciências Agrárias, Jaboticabal, v. 1, n. 42, p.32-38, 29 jan. 2014.] [RIBEIRO, Luis Roberto de Camargo. Aprendizagem baseada em problemas (PBL): Uma experiência no ensino superior. São Carlos: Editora da Universidade Federal de São Carlos Ribeiro, 2008. 151 p.] [TRIVELATO, Sílvia L. Frateschi; TONIDANDEL, Sandra M. Rudella. Ensino Por Investigação: Eixos Organizadores Para Sequências De Ensino De Biologia. Ensaio Pesquisa em Educação em Ciências, Belo Horizonte, v. 17, n. especial, p.97-114, nov. 2015.].

Keywords: Bilingual Education, Environmental Education, Problem Based Learning, Science education

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Authors: Payel Saha

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Social media is playing an important role for dissemination of information in society. In 21st century most people have a smart phone and used different social media tools like Facebook, Twitter, Instagram, WhatsApp, Skype etc. in day to day life. It is rapidly growing web-based tool for everyone to share thoughts, ideas and knowledge globally using internet. The study highlights the current use of social media tools for promoting library and information services of Library and Information Professionals of India, which are working in Library. The study was conducted during November, 2017. A structured questionnaire was prepared using google docs and shared using different mailing list, sent to individual email IDs and sharing with other social media tools. Only 90 responses received from the different states of India and analyzed via MS-Excel. The data receive from 17 states and 3 union territories of India; however most of the respondents has come from the states Odisha 23, Himachal Pradesh 14 and Assam 10. The results revealed that out 90 respondents 37 Female and 53 male categories and also majority of respondents 71 have come from academic library followed by special library 15, Public library 3 and corporate library 1 respondent. The study indicates that, out of 90 respondent’s majority of 53 of respondents said that their Library have a social media account while 39 of respondents have not their Library social media account. The study also inform that Facebook, YouTube, Google+, LinkedIn, Twitter and Instagram are using by the LIS professional of India and Facebook 86 was popular social media tool among the other social media tools. Furthermore, respondent reported that they are using social media tools for sharing photos of events and programs of library 72, followed by tips for using different services 64, posting of new arrivals 56, tutorials of database 35 and send brief updates to patrons 32, announcement of library holidays 22. It was also reported by respondents that they are sharing information about scholarships training programs and marketing of library events etc. The study furthermore identify that lack of time is the major problem while using social media with 53 of respondents followed by low speed of internet 35, too many social media tools to learn 17 and some 3 respondents reported that there is no problem while using social media tools. The results also revealed that, majority of the respondents reported that they are using social media tools in daily basis 71 followed by weekly basis 16. It was followed by monthly 1 respondent and other 2 of the respondents. In summary, this study is expected to be useful in further promoting the social media for dissemination of library and information services to the general public.

Keywords: application of social media, India, promoting library services, library professionals

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Authors: Angeliki Gkiouzeli, Christine Rotonda, Elise Eby, Claire Touchet, Marie-Jo Brennstuhl, Cyril Tarquinio

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Resilience is a psychological concept of possible relevance to the development and maintenance of chronic pain (CP). It refers to the ability of individuals to maintain reasonably healthy levels of physical and psychological functioning when exposed to an isolated and potentially highly disruptive event. Extensive research in recent years has supported the importance of this concept in the CP literature. Increased levels of resilience were associated with lower levels of perceived pain intensity and better mental health outcomes in adults with persistent pain. The ongoing project seeks to include the concept of pain-specific resilience in the French literature in order to provide more appropriate measures for assessing and understanding the complexities of CP in the near future. To the best of our knowledge, there is currently no validated version of the pain-specific resilience measure, the Pain Resilience scale (PRS), for French-speaking populations. Therefore, the present work aims to address this gap, firstly by performing a linguistic and cultural translation of the scale into French and secondly by studying the internal validity and reliability of the PRS for French CP populations. The forward-translation-back translation methodology was used to achieve as perfect a cultural and linguistic translation as possible according to the recommendations of the COSMIN (Consensus-based Standards for the selection of health Measurement Instruments) group, and an online survey is currently conducted among a representative sample of the French population suffering from CP. To date, the survey has involved one hundred respondents, with a total target of around three hundred participants at its completion. We further seek to study the metric properties of the French version of the PRS, ''L’Echelle de Résilience à la Douleur spécifique pour les Douleurs Chroniques'' (ERD-DC), in French patients suffering from CP, assessing the level of pain resilience in the context of CP. Finally, we will explore the relationship between the level of pain resilience in the context of CP and other variables of interest commonly assessed in pain research and treatment (i.e., general resilience, self-efficacy, pain catastrophising, and quality of life). This study will provide an overview of the methodology used to address our research objectives. We will also present for the first time the main findings and further discuss the validity of the scale in the field of CP research and pain management. We hope that this tool will provide a better understanding of how CP-specific resilience processes can influence the development and maintenance of this disease. This could ultimately result in better treatment strategies specifically tailored to individual needs, thus leading to reduced healthcare costs and improved patient well-being.

Keywords: chronic pain, pain measure, pain resilience, questionnaire adaptation

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Authors: Mahmoud Reza Hosseini

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The universe is in a continuous expansion process, resulting in the reduction of its density and temperature. Also, by extrapolating back from its current state, the universe at its early times is studied, known as the big bang theory. According to this theory, moments after creation, the universe was an extremely hot and dense environment. However, its rapid expansion due to nuclear fusion led to a reduction in its temperature and density. This is evidenced through the cosmic microwave background and the universe structure at a large scale. However, extrapolating back further from this early state reaches singularity, which cannot be explained by modern physics, and the big bang theory is no longer valid. In addition, one can expect a nonuniform energy distribution across the universe from a sudden expansion. However, highly accurate measurements reveal an equal temperature mapping across the universe, which is contradictory to the big bang principles. To resolve this issue, it is believed that cosmic inflation occurred at the very early stages of the birth of the universe. According to the cosmic inflation theory, the elements which formed the universe underwent a phase of exponential growth due to the existence of a large cosmological constant. The inflation phase allows the uniform distribution of energy so that an equal maximum temperature can be achieved across the early universe. Also, the evidence of quantum fluctuations of this stage provides a means for studying the types of imperfections the universe would begin with. Although well-established theories such as cosmic inflation and the big bang together provide a comprehensive picture of the early universe and how it evolved into its current state, they are unable to address the singularity paradox at the time of universe creation. Therefore, a practical model capable of describing how the universe was initiated is needed. This research series aims at addressing the singularity issue by introducing a state of energy called a "neutral state," possessing an energy level that is referred to as the "base energy." The governing principles of base energy are discussed in detail in our second paper in the series "A Conceptual Study for Addressing the Singularity of the Emerging Universe," which is discussed in detail. To establish a complete picture, the origin of the base energy should be identified and studied. In this research paper, the mechanism which led to the emergence of this natural state and its corresponding base energy is proposed. In addition, the effect of the base energy in the space-time fabric is discussed. Finally, the possible role of the base energy in quantization and energy exchange is investigated. Therefore, the proposed concept in this research series provides a road map for enhancing our understating of the universe's creation from nothing and its evolution and discusses the possibility of base energy as one of the main building blocks of this universe.

Keywords: big bang, cosmic inflation, birth of universe, energy creation, universe evolution

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Authors: Pronab Ganguly, Ahmed A. Moustafa

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Holistic management of schizophrenia involves mainstream pharmacological intervention, complimentary medicine intervention, therapeutic intervention and other psychosocial factors such as accommodation, education, job training, employment, relationship, friendship, exercise, overall well-being, smoking, substance abuse, suicide prevention, stigmatisation, recreation, entertainment, violent behaviour, arrangement of public trusteeship and guardianship, day-day-living skill, integration with community, and management of overweight due to medications and other health complications related to medications amongst others. Our review shows that there is no integrated survey by combining all these factors. An international web-based survey was conducted to evaluate the significance of all these factors and present them in a unified manner. It is believed this investigation will contribute positively towards holistic management of schizophrenia. There will be two surveys. In the pharmacological intervention survey, five popular drugs for schizophrenia will be chosen and their efficacy as well as harmful side effects will be evaluated on a scale of 0 -10. This survey will be done by psychiatrists. In the second survey, each element of therapeutic intervention and psychosocial factors will be evaluated according to their significance on a scale of 0 - 10. This survey will be done by care givers, psychologists, case managers and case workers. For the first survey, professional bodies of psychiatrists in English speaking countries will be contacted to request them to ask their members to participate in the survey. For the second survey, professional bodies of clinical psychologist and care givers in English speaking countries will be contacted to request them to ask their members to participate in the survey. Additionally, for both the surveys, relevant professionals will be contacted through personal contact networks. For both the surveys, mean, mode, median, standard deviation and net promoter score will be calculated for each factor and then presented in a statistically significant manner. Subsequently each factor will be ranked according to their statistical significance. Additionally, country specific variation will be highlighted to identify the variation pattern. The results of these surveys will identify the relative significance of each type of pharmacological intervention, each type of therapeutic intervention and each type of psychosocial factor. The determination of this relative importance will definitely contribute to the improvement in quality of life for individuals with schizophrenia.

Keywords: schizophrenia, holistic management, antipsychotics, quality of life

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Authors: Samira Mehrabi

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Geriatric depression is a common late-life mental health disorder that increases morbidity and mortality. It has been shown that exercise is effective in alleviating symptoms of geriatric depression. However, inconsistencies across studies and lack of optimal dose-response of exercise for improving geriatric depression have made it challenging to draw solid conclusions on the effectiveness of exercise in late-life depression. Purpose: To further investigate the moderators of the effectiveness of exercise on geriatric depression across the current body of evidence. Methods: Based on the Arksey and O’Malley framework, an extensive search strategy was performed by exploring PubMed, Scopus, Sport Discus, PsycInfo, ERIC, and IBSS without limitations in the time frame. Eight systematic reviews with empirical results that evaluated the effect of exercise on depression among people aged ≥ 60 years were identified and their individual studies were screened for inclusion. One additional study was found through the hand searching of reference lists. After full-text screening and applying inclusion and exclusion criteria, 21 studies were retained for inclusion. Results: The review revealed high variability in characteristics of the exercise interventions and outcome measures. Sample characteristics, nature of comparators, main outcome assessment, and baseline severity of depression also varied notably. Mind-body and aerobic exercises were found to significantly reduce geriatric depression. However, results on the relationship between resistance training and improvements in geriatric depression were inconsistent, and results of the intensity-related antidepressant effects of exercise interventions were mixed. Extensive use of self-reported questionnaires for the main outcome assessment and lack of evidence on the relationship between depression severity and observed effects were of the other important highlights of the review. Conclusion: Several literature gaps were found regarding the potential effect modifiers of exercise and geriatric depression. While acknowledging the complexity of establishing recommendations on the exercise variables and geriatric depression, future studies are required to understand the interplay and threshold effect of exercise for treating geriatric depression.

Keywords: exercise, geriatric depression, healthy aging, older adults, physical activity intervention, scoping review

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Authors: Ellen Dahl Gundersen, Berit Johannessen

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Introduction: Dementia and depression are common mental disorders of nursing home residents. The care of these residents consists of providing both physical, social and mental care. Too often, the physical needs are given priority, and municipal health services are urged to focus more on the patients mental and social needs. The presence of dogs may have positive impact on the mental health of nursing home residents by improving mood, social interaction and enjoyment of the visits. The voluntary organization Red Cross, has given priority to this subject by training and certifying dogs and owners (equipages), committed for regular visits at local nursing homes. Focus of this study: How do the dog owners and employees experience the presence of a dog equipage concerning the mental health of nursing home residents? Method: Individual interviews with 8-10 certified dog owners who are volunteers from Red Cross, contributing with regular visits at local nursing homes. Focus group interviews with 10 employees working in two different nursing homes. Preliminary results: Five to seven residents and one or two employees attended weekly dog equipage visits during a period of six months. The presence of an equipage seems to have made the residents calm and more social orientated with a lighter mood and better verbal expression. Some of the residents with dementia remembered the name of the dog from one week to another. The informants also reported positive outcome for the residents by their opportunity to give and get close through physical contact with a dog. Further, the presence of an equipage affected the atmosphere at the nursing home positively by promoting joy and initiating conversations about dogs. A conscious approach by the dog owners towards the residents seems to be of significance to this matter. The positive attitude and support from employees also seem to be of crucial importance for the maintenance of these visits. Conclusion: The presence of trained dog equipages in nursing homes seems to have had an overall positive impact on the mental health of residents. A conscious approach from the dog owners as well as positive support from employees seems to have a crucial impact on the success and maintenance of the visits. These findings correspond well to former research and can thereby give implications for more extended use of dogs as a mental health promoting initiative towards geriatric consumers of municipal health care services. Further research through larger studies is needed.

Keywords: animal assisted intervention, geriatric mental health, nursing home, resident

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Authors: Mihretu Erjabo

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Halaba special district is characterized by drought, soil erosion, high population pressure, poor livestock production, lack of feed for livestock, very deep water table, very low productivity of crops and food insufficiency. In order to address these problems, the woreda agricultural development office along with other management practices such as soil physical conservation measures agroforestry was introduced decades ago as a means to alleviate the problem. However, the level of agroforestry adoption remains low. Objective of this study was to identify the factors that influence adoption of agroforestry technologies by farmers in the district. Random sampling was employed to select two kebele administrations and respondents. Data collection was conducted by rural household questionnaire survey, participatory rural appraisal, questionnaires for local and woreda extension staff, secondary data resources and field observation. A sample of 12 key informants, 6 extension staffs, and 182 households, were used in the data collection. Chi square test used to determine significant relationships between adoption of agroforestry and 15 selected variables. Out of which eleven were found to be significant to affect farmers’ adoptiveness. These were frequency of visits of farmers (13.39%), participation in training (11.49%), farmers’ attitude towards agroforestry practices (10.61%), frequency of visits of extensionists (10.38%), participation in extension meeting (10.34%), participation in field day (10.28%), land holding size (9.29%), level of literacy (8.78%), awareness about the importance of agroforestry technology packages (7.06%), time taken from their residence to nearest extension (5.04%) and gender of respondents (3.34%). This study also identified various factors that result in low adoption rates of agroforestry including fear of competition, seedling, rainfall and labour shortage, free grazing, financial problem, expecting trees as soil degrader and long span of trees and lack of need ranking. To improve farmers’ adoption, the factors identified should be well addressed by launching a series and recurrent outreach extension program appropriate and suitable to farmers need.

Keywords: farmers attitude, farmers participation, soil degradation, technology packages

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Authors: Gracia V. Navarro, María C. González, María G. González, María V. González

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In Chile, since 2002, there are extracurricular enrichment programs complementary to regular education for students with high intellectual capacity. This paper describes a model for the educational inclusion of students, with special educational needs associated with high intellectual capacity, developed at the University of Concepción and its effects on its students, academics and undergraduate students that collaborate with the program. The Talentos UdeC Program was created in 2003 and is intended for 240 children and youth from 11 to 18 years old, from 15 communes of the Biobio region. The case Talentos UdeC is analyzed from a mixed qualitative study in which those participating in the educational model are considered. The sample was composed of 30 students, 30 academics, and 30 undergraduate students. In the case of students, pre and post program measurements were made to analyze their socio-emotional adaptation, academic motivation and socially responsible behavior. The mentioned variables are measured through questionnaires designed and validated by the University of Concepcion that included: The Socially Responsible Behavior Questionnaire (CCSR); the Academic Motivation Questionnaire (CMA) and the Socio-Emotional Adaptation Questionnaire (CASE). The information obtained by these questionnaires was analyzed through a quantitative analysis. Academics and undergraduate students were interviewed to learn their perception of the effects of the program on themselves, on students and on society. The information obtained is analyzed using qualitative analysis based on the identification of common themes and descriptors for the construction of conceptual categories of answers. Quantitative results show differences in the first three variables analyzed in the students, after their participation for two years in Talentos UdeC. Qualitative results demonstrate perception of effects in the vision of world, project of life and in other areas of the students’ development; perception of effects in a personal, professional and organizational plane by academics and a perception of effects in their personal-social development and training in generic competencies by undergraduates students.

Keywords: educational model, high intellectual capacity, inclusion, special educational needs

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

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

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

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Authors: Olga Maksakova

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A work with unconscious patients after acute brain damages besides special knowledge and practical skills of all the participants requires a very specific organization. A lot of said about team approach in neurorehabilitation, usually as for outpatient mode. Rehabilitologists deal with fixed patient problems or deficits (motion, speech, cognitive or emotional disorder). Team-building means superficial paradigm of management psychology. Linear mode of teamwork fits casual relationships there. Cases with deep altered states of consciousness (vegetative states, coma, and confusion) require non-linear mode of teamwork: recovery of consciousness might not be the goal due to phenomenon uncertainty. Rehabilitation team as Semi-open Complex System includes the patient as a part. Patient's response pattern becomes formed not only with brain deficits but questions-stimuli, context, and inquiring person. Teamwork is sourcing of phenomenology knowledge of patient's processes as Third-person approach is replaced with Second- and after First-person approaches. Here is a chance for real-time change. Patient’s contacts with his own body and outward things create a basement for restoration of consciousness. The most important condition is systematic feedbacks to any minimal movement or vegetative signal of the patient. Up to now, recovery work with the most severe contingent is carried out in the mode of passive physical interventions, while an effective rehabilitation team should include specially trained psychologists and psychotherapists. It is they who are able to create a network of feedbacks with the patient and inter-professional ones building up the team. Characteristics of ‘Team-Patient’ system (TPS) are energy, entropy, and complexity. Impairment of consciousness as the absence of linear contact appears together with a loss of essential functions (low energy), vegetative-visceral fits (excessive energy and low order), motor agitation (excessive energy and excessive order), etc. Techniques of teamwork are different in these cases for resulting optimization of the system condition. Directed regulation of the system complexity is one of the recovery tools. Different signs of awareness appear as a result of system self-organization. Joint meetings are an important part of teamwork. Regular or event-related discussions form the language of inter-professional communication, as well as the patient's shared mental model. Analysis of complex communication process in TPS may be useful for creation of the general theory of consciousness.

Keywords: rehabilitation team, urgent rehabilitation, severe brain damage, consciousness disorders, complex system theory

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Authors: Margarida Porfírio Tomás, Paula Pereira, José Palma Oliveira

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Robotic grasping is advancing rapidly, but transferring techniques from rigid to deformable objects remains a challenge. Deformable and flexible items, such as food containers, demand nuanced handling due to their changing shapes. Bridging this gap is crucial for applications in food processing, surgical robotics, and household assistance. AGILEHAND, a Horizon project, focuses on developing advanced technologies for sorting, handling, and packaging soft and deformable products autonomously. These technologies serve as strategic tools to enhance flexibility, agility, and reconfigurability within the production and logistics systems of European manufacturing companies. Key components include intelligent detection, self-adaptive handling, efficient sorting, and agile, rapid reconfiguration. The overarching goal is to optimize work environments and equipment, ensuring both efficiency and safety. As new technologies emerge in the food industry, there will be some implications, such as labour force, safety problems and acceptance of the new technologies. To overcome these implications, AGILEHAND emphasizes the integration of social sciences and humanities, for example, the application of the Technology Acceptance Model (TAM). The project aims to create a change management manual, that will outline strategies for developing digital skills and managing health and safety transitions. It will also provide best practices and models for organizational change. Additionally, AGILEHAND will design effective training programs to enhance employee skills and knowledge. This information will be obtained through a combination of case studies, structured interviews, questionnaires, and a comprehensive literature review. The project will explore how organizations adapt during periods of change and identify factors influencing employee motivation and job satisfaction. This project received funding from European Union’s Horizon 2020/Horizon Europe research and innovation program under grant agreement No101092043 (AGILEHAND).

Keywords: change management, technology acceptance model, organizational change, health and safety

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Authors: Chang Yu Chuan

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Background and Aim: Pressure sore is not only the consequence of any gradual damage of the skin leading to tissue defects but also an important indicator of clinical care. If hospitalized patients develop pressure sores without proper care, it would result in delayed healing, wound infection, increase patient physical pain, prolonged hospital stay and even death, which would have a negative impact on the quality of care and also increase nursing manpower and medical costs. This project is aimed at decreasing the incidence of pressure sore in one ward of internal medicine. Our data showed 53 cases (0.61%) of pressure sore in 2015, which exceeded the average (0.5%) of Taiwan Clinical Performance Indicator (TCPI) for medical centers. The purpose of this project is to reduce the incidence rate of pressure sore in the ward. After data collection and analysis from January to December 2016, the reasons of developing pressure sore were found: 1. Lack of knowledge to prevent pressure among nursing staffs; 2. No relevant courses about preventing pressure ulcers and pressure wound care being held in this unit; 3. Low complete rate of pressure sore care education that family members should receive from nursing staffs; 4. Decompression equipment is not enough; 5. Lack of standard procedures for body-turning and positioning care. After team members brainstorming, several strategies were proposed, including holding in-service education, pressure sore care seed training, purchasing decompression mattress and memory pillows, designing more elements of health education tools, such as health education pamphlet, posters and multimedia films of body-turning and positioning demonstration, formulation and promotion of standard operating procedures. In this way, nursing staffs can understand the body-turning and positioning guidelines for pressure sore prevention and enhance the quality of care. After the implementation of this project, the pressure sore density significantly decreased from 0.61%(53 cases) to 0.45%(28 cases) in this ward. The project shows good results and good example for nurses working at the ward and helps to enhance quality of care.

Keywords: body-turning and positioning, incidence density, nursing, pressure sore

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Authors: Naser Zouri

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Purpose: Measures of formulate and implementation strategy shows amount of product rate-market based strategic management category such as courtesy, competence, and compliance to reach the high loyalty of financial ecosystem. Despite, it solves the market place error intention to fair trade organization. Finding: Finding shows the ability of executives’ level of management to motivate and better decision-making to solve the treatments in business organization. However, it made ideal level of each interposition policy for a hypothetical household. Methodology/design. Style of questionnaire about the data collection was selected to survey of both pilot test and real research. Also, divide of questionnaire and using of Free Scale Semiconductor`s between the finance employee was famous of this instrument. Respondent`s nominated basic on non-probability sampling such as convenience sampling to answer the questionnaire. The way of realization costs to performed the questionnaire divide among the respondent`s approximately was suitable as a spend the expenditure to reach the answer but very difficult to collect data from hospital. However, items of research survey was formed of implement strategy, environment, supply chain, employee from impact of implementation strategy on reach to better financial consequences and also formulate strategy, comprehensiveness strategic design, organization performance from impression on formulate strategy and financial consequences. Practical Implication: Dynamic capability approach of formulate and implement strategy focuses on the firm-specific processes through which firms integrate, build, or reconfigure resources valuable for making a theoretical contribution. Originality/ value of research: Going beyond the current discussion, we show that case studies have the potential to extend and refine theory. We present new light on how dynamic capabilities can benefit from case study research by discovering the qualifications that shape the development of capabilities and determining the boundary conditions of the dynamic capabilities approach. Limitation of the study :Present study also relies on survey of methodology for data collection and the response perhaps connection by financial employee was difficult to responds the question because of limitation work place.

Keywords: financial ecosystem, loyalty, Malaysian market error, dynamic capability approach, rate-market, optimization intelligence strategy, courtesy, competence, compliance

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Authors: Laith F. Gulli, Nicole M. Mallory

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We developed a novel measurement instrument to assess Knowledge of Educational Programs in Professional Psychotherapy Programs (KEP-PPP or KEP-Triple P) within the United States. The instrument was designed by a Panel of Experts (PoE) that consisted of Licensed Psychotherapists and Medical Care Providers. Licensure track psychotherapy programs are listed in the databases of the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE); American Psychological Association (APA); Council on Social Work Education (CSWE); and the Council for Accreditation of Counseling & Related Educational Programs (CACREP). A complete list of psychotherapy programs can be obtained from these professional databases, selecting search fields of (All Programs) in (All States). Each program has a Web link that electronically and directly connects to the institutional program, which can be researched using the KEP-Triple P. The 29-item KEP Triple P was designed to consist of six categorical fields; Institutional Type: Degree: Educational Delivery: Accreditation: Coursework Competency: and Special Program Considerations. The KEP-Triple P was designed to determine whether a specific course(s) is offered in licensure track psychotherapy programs. The KEP-Triple P is designed to be modified to assess any part or the entire curriculum of licensure graduate programs. We utilized the KEP-Triple P instrument to study whether a graduate course in Addictions was offered in Marriage and Family Therapy (MFT) programs. Marriage and Family Therapists are likely to commonly encounter patients with Addiction(s) due to the broad treatment scope providing psychotherapy services to individuals, couples and families of all age groups. Our study of 124 MFT programs which concluded at the end of 2016 found that we were able to assess 61 % of programs (N = 76) since 27 % (N = 34) of programs were inaccessible due to broken Web links. From the total of all MFT programs 11 % (N = 14) did not have a published curriculum on their Institutional Web site. From the sample study, we found that 66 % (N = 50) of curricula did not offer a course in Addiction Treatment and that 34 % (N =26) of curricula did require a mandatory course in Addiction Treatment. From our study sample, we determined that 15 % (N = 11) of MFT doctorate programs did not require an Addictions Treatment course and that 1 % (N = 1) did require such a course. We found that 99 % of our study sample offered a Campus based program and 1 % offered a hybrid program with both online and residential components. From the total sample studied, we determined that 84 % of programs would be able to obtain reaccreditation within a five-year period. We recommend that MFT programs initiate procedures to revise curricula to include a required course in Addiction Treatment prior to their next accreditation cycle, to improve the escalating addiction crisis in the United States. This disparity in MFT curricula raises serious ethical and legal consideration for national and Federal stakeholders as well as for patients seeking a competently trained psychotherapist.

Keywords: addiction, competency, curriculum, psychotherapy

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Authors: Kadidiatou Toure

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Mali has started experimentation of teaching the national languages at school through the convergent pedagogy in 1987. Then, it is in 1994 that it will become widespread with eleven of the thirteen former national languages used at primary school. The aim was to improve the Malian educational system because the use of French as the only medium of instruction was considered a contributing factor to the significant number of student dropouts and the high rate of repetition. The Convergent pedagogy highlights the knowledge acquired by children at home, their vision of the world and especially the knowledge they have of their mother tongue. That pedagogy requires the use of a specific medium only during classroom practices and teachers have been trained in this sense. The specific medium depends on the learning content, which sometimes is French, other times, it is the national language. Research has shown that bilingual learners do not only use the required medium in their learning activities, but they code switch. It is part of their learning processes. Currently, many scholars agree on the importance of CS in bilingual classes, and teachers have been told about the necessity of integrating it into their classroom practices. One of the challenges of the Malian bilingual education curriculum is the question of ‘effective languages management’. Theoretically, depending on the classrooms, an average have been established for each of the involved language. Following that, teachers make use of CS differently, sometimes, it favors the learners, other times, it contributes to the development of some linguistic weaknesses. The present research tries to fill that gap through a tentative model of didactization of CS, which simply means the practical management of the languages involved in the bilingual classrooms. It is to know how to use CS for effective learning. Moreover, the didactization of CS tends to sensitize the teachers about the functional role of CS so that they may overcome their own weaknesses. The overall goal of this research is to make code switching a real tool for bilingual education. The specific objectives are: to identify the types of CS used during classroom activities to present the functional role of CS for the teachers as well as the pupils. to develop a tentative model of code-switching, which will help the teachers in transitional classes of bilingual schools to recognize the appropriate moment for making use of code switching in their classrooms. The methodology adopted is a qualitative one. The study is based on recorded videos of teachers of 3rd year of primary school during their classroom activities and interviews with the teachers in order to confirm the functional role of CS in bilingual classes. The theoretical framework adopted is the typology of CS proposed by Poplack (1980) to identify the types of CS used. The study reveals that teachers need to be trained on the types of CS and the different functions they assume and on the consequences of inappropriate use of language alternation.

Keywords: bilingual curriculum, code switching, didactization, national languages

Procedia PDF Downloads 52

Authors: Tereza Hruskova

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200 million people globally experience serious mental health problems, and only one third seek professional help, and help-seeking is described as a last resort. Adolescents and young adults have a high prevalence of mental illness. Mental stigma is a key element in the decision to seek help and is divided into (i) self-stigma (self-stigmatization), including internal beliefs, low self-esteem, and lower quality of life, and (ii) public stigma (social stigma) containing stereotypes, beliefs and society's disapproval of help-seeking having a negative effect on help-seeking and our attitudes. Previous research has mainly focused on examining the construct of help seeking, avoidance, and delaying separately and trying to find out why people do not seek help in time and what obstacles stand in the way. Barriers are not static and may change over time and the stage of help-seeking. Attitudes are closely related to self-stigma and social stigma and predict whether a person will seek help. Barriers (stigmatization, a sense of humiliation, insufficient recognition of the problem, preferences, solving it alone, and distrust of a professional) and facilitators (previous experience with mental problems, social support, and help from others) are factors influencing help-seeking. The current research on the Czech population of young adults responds to the gap between a person with mental health problems and actually seeking professional help. The aim of the study is to describe in detail the individual constructs and factors, to understand the person seeking help, and to define possible obstacles on this path of seeking help. A sample of approximately 250 participants (age 18-35) would take part in the online questionnaire, conducted in May-June 2023, and would be administered a demographic questionnaire and four scales measuring attitudes (Attitudes Toward Seeking Professional Psychological Help – Short form), barriers (Barrier to Help Seeking Scale), self-stigma (Self Stigma of Seeking Help) and stigmatization (Perceptions of Stigmatization by Others for seeking help). Firstly, all four scales would be translated into the Czech language. The aim is (I) to determine the validity and reliability of the Czech translation of the scales, (II) to examine the factors of the scales on the Czech population and compare them retrospectively with the results of reliability and validity from the original language of the scales and (III) to examine the connections between attitudes towards seeking, avoidance or delaying the search for professional psychological help due to the demographic and individual differences of the participants, barriers, self-stigmatization and social stigmatization. We expect to carry out the first study on the given topic in the Czech Republic, to identify and better understand the factors leading to the avoidance of seeking professional help and to reveal the relationships between stigmatization, attitudes and barriers leading to the avoidance or postponement of seeking professional help. The belief is to find out whether the Czech population of young adults differs from the data found on the foreign population in individual constructs, as cultural differences in individual countries were found.

Keywords: mental health, stigma, problems, seeking psychological help

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Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

Abstract:

Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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