Search results for: expert evaluations

Authors: Cristina-Corina Bențea, Teodora-Mihaela Iconomescu, Laurențiu-Gabriel Talaghir, Claudiu Mereuță, Anamaria Berdilă

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The study aims to examine the relationships between motor abilities, self-evaluation of athletic competence, and demographic characteristics in a sample of late-childhood participants. Defined as physical elements that enable the movements, motor skills are classified according to movement precision as gross and fine motor skills. Across their development, children enhance their ability to coordinate the limbs to produce different actions. In educational settings, they perform various instructional activities that involve the improvement of their athletic prowess and are taught how to strengthen their gross and fine motor abilities. Also, in relation to their activities, children tend to evaluate themselves differently across the various domains of their life. Starting from childhood, athletic competence is one of the area-specific evaluations of competence that refers to one’s ability to do well at sports, including outdoor games. Method: The sample consisted of fifty-eight primary school children, thirty girls, and twenty-eight boys, with ages between 8-10 years. The Bruininks-Oseretsky test of motor proficiency was used to assess both gross and fine motor skills in eight specific areas (fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance, running speed and agility, upper-limb coordination, strength). Athletic competence self-perceived was assessed with one of the six subscales of the Self-Perception Profile for Children. Results: Were examined both the relationships between each motor skills scale and subscales and between motor skills and general self-perceived athletic competence. Results indicated correlations between the athletic competence and four motor skills subscales depending on the gender and age of the children. The findings of the study were discussed related to the possibility to improve children's physical proficiency in educational settings according to the level of self-perceived athletic competence.

Keywords: gross motor skills, fine motor skills, athletic competence, self-evaluation, children, education

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Authors: Recep Kesli, Onur Turkyilmaz, Cengiz Demir

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Objective: Autoimmune collagen diseases occur with the immune reactions against the body’s own cell or tissues which cause inflammation and damage the tissues and organs. In this study, it was aimed to compare seropositivity rates and patterns of the anti-nuclear antibodies (ANA) in the diagnosis of four different autoimmune collagen tissue diseases (Rheumatoid Arthritis-RA, Systemic Lupus Erythematous-SLE, Scleroderma-SSc and Sjogren Syndrome-SS) with each other. Methods: One hundred eighty-eight patients applied to different clinics in Afyon Kocatepe University ANS Practice and Research Hospital between 11.07.2014 and 14.07.2015 that thought the different collagen disease such as RA, SLE, SSc and SS have participated in the study retrospectively. All the data obtained from the patients participated in the study were evaluated according to the included criteria. The historical archives belonging to the patients have been screened, assessed in terms of ANA positivity. The obtained data was analysed by using the descriptive statistics; chi-squared, Fischer's exact test. The evaluations were performed by SPSS 20.0 version and p < 0.05 level was considered as significant. Results: Distribution rates of the totally one hundred eighty-eight patients according to the diagnosis were found as follows: 82 (43.6%) were RA, 38 (20.2%) were SLE, 22 (11.7%) were SSc, and 46 (24.5%) were SS. Distribution of ANA positivity rates according to the collagen tissue diseases were found as follows; for RA were 54 (65,9 %), for SLE were 36 (94,7 %), for SSc were 18 (81,8 %), and for SS were 43 (93,5 %). Rheumatoid arthritis should be evaluated and classified as a different class among all the other investigated three autoimmune illnesses. ANA positivity rates were found as differently higher (91.5 %) in the SLE, SSc, and SS, from the RA (65.9 %). Differences at ANA positivity rates for RA and the other three diseases were found as statistically significant (p=0.015). Conclusions: Systemic autoimmune illnesses show broad spectrum. ANA positivity was found as an important predictor marker in the diagnosis of the rheumatologic illnesses. ANA positivity should be evaluated as more valuable and sensitive a predictor diagnostic marker in the laboratory findings of the SLE, SSc, and SS according to RA.

Keywords: antinuclear antibody (ANA), rheumatoid arthritis, scleroderma, Sjogren syndrome, systemic lupus Erythemotosus

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Authors: Susana Aragoneses Garrido

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Every day, the roads are scenery of numerous accidents involving vehicles, producing thousands of deaths and serious injuries all over the world. Investigations have revealed that Human Factors (HF) are one of the main causes of road accidents in modern societies. Distracted driving (including external or internal aspects of the vehicle), which is considered as a human factor, is a serious and emergent risk to road safety. Consequently, a further analysis regarding this issue is essential due to its transcendence on today’s society. The objectives of this investigation are the detection and assessment of the HF in order to provide solutions (including a better vehicle design), which might mitigate road accidents. The methodology of the project is divided in different phases. First, a statistical analysis of public databases is provided between Spain and The UK. Second, data is classified in order to analyse the major causes involved in road accidents. Third, a simulation between different paths and vehicles is presented. The causes related to the HF are assessed by Failure Mode and Effects Analysis (FMEA). Fourth, different car models are evaluated using the Rapid Upper Body Assessment (RULA). Additionally, the JACK SIEMENS PLM tool is used with the intention of evaluating the Human Factor causes and providing the redesign of the vehicles. Finally, improvements in the car design are proposed with the intention of reducing the implication of HF in traffic accidents. The results from the statistical analysis, the simulations and the evaluations confirm that accidents are an important issue in today’s society, especially the accidents caused by HF resembling distractions. The results explore the reduction of external and internal HF through the global analysis risk of vehicle accidents. Moreover, the evaluation of the different car models using RULA method and the JACK SIEMENS PLM prove the importance of having a good regulation of the driver’s seat in order to avoid harmful postures and therefore distractions. For this reason, a car redesign is proposed for the driver to acquire the optimum position and consequently reducing the human factors in road accidents.

Keywords: analysis vehicles, asssesment, ergonomics, car redesign

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Authors: Ahmed Abdullah Ahmed

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The task of recognizing the writer of a handwritten text has been an attractive research problem in the document analysis and recognition community with applications in handwriting forensics, paleography, document examination and handwriting recognition. This research presents an automatic method for writer recognition from digitized images of unconstrained writings. Although a great effort has been made by previous studies to come out with various methods, their performances, especially in terms of accuracy, are fallen short, and room for improvements is still wide open. The proposed technique employs optimal codebook based writer characterization where each writing sample is represented by a set of features computed from two codebooks, beginning and ending. Unlike most of the classical codebook based approaches which segment the writing into graphemes, this study is based on fragmenting a particular area of writing which are beginning and ending strokes. The proposed method starting with contour detection to extract significant information from the handwriting and the curve fragmentation is then employed to categorize the handwriting into Beginning and Ending zones into small fragments. The similar fragments of beginning strokes are grouped together to create Beginning cluster, and similarly, the ending strokes are grouped to create the ending cluster. These two clusters lead to the development of two codebooks (beginning and ending) by choosing the center of every similar fragments group. Writings under study are then represented by computing the probability of occurrence of codebook patterns. The probability distribution is used to characterize each writer. Two writings are then compared by computing distances between their respective probability distribution. The evaluations carried out on ICFHR standard dataset of 206 writers using Beginning and Ending codebooks separately. Finally, the Ending codebook achieved the highest identification rate of 98.23%, which is the best result so far on ICFHR dataset.

Keywords: off-line text-independent writer identification, feature extraction, codebook, fragments

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Authors: Paschal Arsein Mugabe

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This paper examines sustainable development planning in the context of environmental concerns in rural areas of the Tanzania. It challenges mainstream approaches to development, focusing instead upon transformative action for environmental justice. The goal is to help shape future sustainable development agendas in local government, international agencies and civil society organisations. Research methods: The approach of the study is geographical, but also involves various Trans-disciplinary elements, particularly from development studies, sociology and anthropology, management, geography, agriculture and environmental science. The research methods included thematic and questionnaire interviews, participatory tools such as focus group discussion, participatory research appraisal and expert interviews for primary data. Secondary data were gathered through the analysis of land use/cover data and official documents on climate, agriculture, marketing and health. Also several earlier studies that were made in the area provided an important reference base. Findings: The findings show that, agricultural sustainability in Tanzania appears likely to deteriorate as a consequence of climate change. Noteworthy differences in impacts across households are also present both by district and by income category. Also food security cannot be explained by climate as the only influencing factor. A combination of economic, political and socio-cultural context of the community are crucial. Conclusively, it is worthy knowing that people understand their relationship between climate change and their livelihood.

Keywords: agriculture, climate change, environment, sustainable development

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Authors: T. Delval, C. Sauvage, Q. Jullien, R. Viano, T. Diallo, B. Collignan, G. Picinbono

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In the context of the international spread of COVID-19, the Centre Scientifique et Technique du Bâtiment (CSTB) has led a joint research with the French government authorities Hauts-de-Seine department, to analyse the risk in school spaces according to their configuration, ventilation system and spatial segmentation strategy. This paper describes the main results of this joint research. A multidisciplinary team involving experts in indoor air quality/ventilation, pedestrian movements and IT domains was established to develop a COVID risk analysis tool based on Building Information Model. The work started with specific analysis on two pilot schools in order to provide for the local administration specifications to minimize the spread of the virus. Different recommendations were published to optimize/validate the use of ventilation systems and the strategy of student occupancy and student flow segmentation within the building. This COVID expertise has been digitized in order to manage a quick risk analysis on the entire building that could be used by the public administration through an easy user interface implemented in a free BIM Management software. One of the most interesting results is to enable a dynamic comparison of different ventilation system scenarios and space occupation strategy inside the BIM model. This concurrent engineering approach provides users with the optimal solution according to both ventilation and pedestrian flow expertise.

Keywords: BIM, knowledge management, system expert, risk management, indoor ventilation, pedestrian movement, integrated design

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Authors: Sujeet Poudyal

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Introduction: Renal cell carcinoma is the most common malignancy associated with Inferior vena cava (IVC) thrombosis. Radical nephrectomy with tumor thrombectomy provides durable cancer-free survival. Other renal malignancies like Wilms’ tumors are also associated with IVC thrombus. We describe our experience with the management of renal malignancies associated with IVC thrombus. Methods: This prospective study included 28 patients undergoing surgery for renal malignancies associated with IVC thrombus from February 2017 to March 2023. Demographics of patients, types of renal malignancy, level of IVC thrombus, intraoperative details, need for venovenous bypass, cardiopulmonary bypass and postoperative outcomes were all documented. Results: Out of a total of 28 patients, 24 patients had clear cell Renal Cell Carcinoma,1 had renal osteosarcoma and 3 patients had Wilms tumor. The levels. of thrombus were II in eight, III in seven, and IV in six patients. The mean age of RCC was 62.81±10.2 years, renal osteosarcoma was 26 years and Wilms tumor was 23 years. There was a need for venovenous bypass in four patients and cardiopulmonary bypass in four patients, and the Postoperative period was uneventful in most cases except for two mortalities, one in Level III due to pneumonia and one in Level IV due to sepsis. All cases followed up till now have no local recurrence and metastasis except one case of RCC with Level IV IVC thrombus, which presented with paraaortic nodal recurrence and is currently managed with sunitinib. Conclusion: The complexity in the management of renal malignancy with IVC thrombus increases with the level of IVC thrombus. As radical nephrectomy with tumor thrombectomy provides durable cancer-free survival in most cases, the surgery should be undertaken in an expert and experienced setup with a strong cardiovascular backup to minimize morbidity and mortality associated with the procedure.

Keywords: renal malignancy, IVC thrombus, radical nephrectomy with tumor thrombectomy, renal cell carcinoma

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Authors: Sabine Ambros, Ulrich Kulozik

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Berries such as blue- and raspberries belong to the most valuable fruits. To preserve the characteristic flavor and the high contents of vitamins and anthocyanins, the very sensitive berries are usually dried by lyophilization. As this method is very time- and energy-consuming, the dried fruit is extremely expensive. However, healthy snack foods are growing in popularity. Especially dried fruit free of any additives or additional sugar are more and more asked for. To make these products affordable, the fruits have to be dried by a method that is more energy-efficient than freeze drying but reveals the same high product quality. The additional insertion of microwaves to a freeze drying process was examined in this work to overcome the inconveniences of freeze drying. As microwaves penetrate the product volumetrically, sublimation takes place simultaneously all over the product and leads to a many times shorter process duration. A range of microwave and pressure settings was applied to find the optimum drying condition. The influence of the process parameters microwave power and chamber pressure on drying kinetics, product temperature and product quality was investigated to find the best condition for an energy-efficient process with high product quality. The product quality was evaluated by rehydration capacitiy, crispiness, shrinkage, color, vitamin C content and antioxidative capacity. The conclusion could be drawn that microwave freeze dried berries were almost equal to freeze dried fruit in all measured quality parameters or even could overcome it. Additionally, sensory evaluations could confirm the analytical studies. Drying time could be reduced by more than 75% at much lower energy consumption rates. Thus, an energy-efficient and cost saving method compared to the conventional freeze drying technique for the gentle production of tasty fruit or vegetable snacks has been found. This technique will make dried high-quality snacks available for many of consumers.

Keywords: blueberries, freeze drying, microwave freeze drying, process parameters, product quality

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Authors: Patrick Oehler, Nicholas Folger

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Following a new public management approach, Germany has widely reformed its higher education system around the turn of the millennium. Aimed at preparing the country’s publicly funded universities and applied science colleges for a century of glory, the reforms led to the introduction of rigid performance measurement and management practices, which disrupted the inert system on all levels. Yet, many of the new policies met significant resistance, and some of them had to be reversed over time. Ever since Germany has struggled to find a balance between its pre- and its post-millennial approach to performance measurement and management. This contribution combines insights of a joint research project, which was created and funded by the German Federal Ministry of Education and Research with the aim to better understand the effects of its performance measurement and management policies, including those the ministry had implemented over the previous decades. The research project combines researchers from 17 German research institutions who employed a wide range of theories from various disciplines and very diverse research methods to explain performance measurement and management and their consequences on the behavior of various stakeholders in higher education systems. In these projects, performance measurement and management have been researched from three angles—education, research, and third mission. The collaborative project differentiated functional and dysfunctional elements of common performance measurement and management practices, and identified key problems with these practices, such as (1) oversimplification of performance indicators, (2) ‘overmeasurement’ of performance in general, (3) excessive use of quantitative indicators, and (4), a myopic focus on research-focused indicators and a negligence of measures targeting education and third mission. To address these issues, the collaborative project developed alternative approaches to performance measurement and management, including suggestions for qualitative performance measures, improved supervision, review, and evaluations methods, and recommendations how to better balance education, research, and third mission. The authors would like to share the rich findings of the joint research project with an international audience and discuss their implications for alternative higher education systems.

Keywords: performance measurement, performance management, new public management, performance evaluation

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Authors: Longondjo Etambakonga Clement

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Local municipality responsible for solid waste management (SWM) in many developing countries is facing real challenge. This is even more critical in the country facing political instability. Few decades ago, it has emerged new urban governance including partnerships and involvement of formal and informal actors for an effective and sustainable solid waste management. This paper identifies SWM actors and analyzes their roles to sustainable development in Kinshasa. An attempt has been to examine the challenges facing the actors in managing effectively waste in the city. The study is based on the empirical data gathered in the years 2009 and 2014 in Kinshasa using expert interviews, observation and documentation. The findings indicate that solid waste in the city is poorly managed, activities not coordinated and fragmented, as consequence severe public health and environmental problems. Five group actors are involved in SWM in the city including government, private business, NGOs/CBOs/donors, household, scavengers, in which, scavengers are more visible in collection and recycling activities. The results suggest that recognition of informal collectors and recyclers (scavengers) and strengthening alliances among all SWM stakeholders can lead to greater effective SWM in the city. The key lessons learned include lack of city’s SWM culture over SWM, unwillingness to pay and lack of environmental consciences are the main obstructions to sustainable SWM, therefore there is a need for social capital approach to empower individual and group actors as to create capabilities for an sustainable SWM.

Keywords: challenges, institutions, political instability, scavengers, solid waste management, sustainable development

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Authors: Chantal Hendriks, Harry Gibson, Anna Trett, Penny Hancock, Catherine Moyes

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The use of modern inputs for crop protection, such as insecticides, is strongly underestimated in Sub-Saharan Africa. Several studies measured toxic concentrations of insecticides in fruits, vegetables and fish that were cultivated in Sub-Saharan Africa. The use of agricultural insecticides has impact on human and environmental health, but it also has the potential to impact on insecticide resistance in malaria transmitting mosquitos. To analyse associations between historic use of agricultural insecticides and the distribution of insecticide resistance through space and time, the use and environmental fate of agricultural insecticides needs to be mapped through the same time period. However, data on the use and environmental fate of agricultural insecticides in Africa are limited and therefore risk maps on the spatiotemporal occurrence of agricultural insecticides are created using environmental data. Environmental data on crop density and crop type were used to select the areas that most likely receive insecticides. These areas were verified by a literature review and expert knowledge. Pesticide fate models were compared to select most dominant processes that are involved in the environmental fate of insecticides and that can be mapped at a continental scale. The selected processes include: surface runoff, erosion, infiltration, volatilization and the storing and filtering capacity of soils. The processes indicate the risk for insecticide accumulation in soil, water, sediment and air. A compilation of all available data for traces of insecticides in the environment was used to validate the maps. The risk maps can result in space and time specific measures that reduce the risk of insecticide exposure to non-target organisms.

Keywords: crop protection, pesticide fate, tropics, insecticide resistance

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Authors: Christian Perrin, Nicholas Blagden, Louise Allen, Sarah Impey

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Social workers in the UK and professionals globally are faced with a particular challenge when dealing with allegations of child sexual abuse (CSA) in the community. In the absence of a conviction or incontestable evidence, staff can often find themselves unable to take decisive action to remove a child from harm, even though there may be a credible threat to their welfare. Conversely, practitioners may over-calculate risk through fear of being accountable for harm. This is, in part, due to the absence of a structured and evidence-based risk assessment tool which can predict the likelihood of a person committing child sexual abuse. Such assessments are often conducted by forensic professionals who utilise offence-specific data and personal history information to calculate risk. In situations where only allegations underpin a case, this mode of assessment is not viable. There are further ethical issues surrounding the assessment of risk in this area which require expert consideration and sensitive planning. This paper explores this entangled problem extant in the wider call to prevent sexual and child sexual abuse in the community. To this end, 32 qualitative interviews were undertaken with social workers dealing with CSA cases. Results were analysed using thematic analysis and operationalised to formulate a risk and protection protocol for use in case management. This paper reports on the early findings associated with the initial indications of protocol reliability. Implications for further research and practice are discussed.

Keywords: sexual offending, child sexual offence, offender rehabilitation, risk assessment, offence prevention

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Authors: Lourenço Bastos, Filipa Carneiro, Bruno Vale, Rita Marques Joana Silva, Ricardo Freitas, Ângelo Marques, Sara Cortez, Alberta Coelho, Pedro Parreira, Liliana Sousa, Anabela Salgueiro, Bruno Silva

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The process of flushing is considered to be an adequate technique to reduce the risk of infection during the clinical practice of venous catheterization. Nonetheless, there is still a lack of adhesion to this method, in part due to the complexity of this procedure. The project SeringaDuo aimed to develop an innovative double-chamber syringe for intravenous sequential administration of drugs and serums. This device served the purpose of improving the adherence to the practice, through the reduction of manipulations needed, which also improves patient safety, and though the promotion of flushing practice by health professionals, by simplifying this task. To assist on the development of this innovative syringe, a numerical methodology was developed and validated in order to predict the syringe’s mechanical and flow behavior during the fluids’ loading and administration phases, as well as to allow the material behavior evaluation during its production. For this, three commercial numerical simulation software was used, namely ABAQUS, ANSYS/FLUENT, and MOLDFLOW. This methodology aimed to evaluate the concepts feasibility and to optimize the geometries of the syringe’s components, creating this way an iterative process for product development based on numerical simulations, validated by the production of prototypes. Through this methodology, it was possible to achieve a final design that fulfils all the characteristics and specifications defined. This iterative process based on numerical simulations is a powerful tool for product development that allows obtaining fast and accurate results without the strict need for prototypes. An iterative process can be implemented, consisting of consecutive constructions and evaluations of new concepts, to obtain an optimized solution, which fulfils all the predefined specifications and requirements.

Keywords: Venous catheterization, flushing, syringe, numerical simulation

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Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand

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Introduction: Limited facility situations require allocating the most available resources for most casualties. Accordingly, Traumatic Brain Injury (TBI) is the one that may need to transport the patient as soon as possible. In a mass casualty event, deciding when the facilities are restricted is hard. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: In a multicenter cross-sectional study conducted on 144 patients with TBI admitted to trauma emergency centers. All the patients with isolated TBI who were mentally and physically healthy before the trauma entered the study. The patient’s information was evaluated, including demographic characteristics, duration of hospital stays, mechanical ventilation on admission laboratory measurements, and on-admission vital signs. We recorded the patients’ TBI-related symptoms and brain computed tomography (CT) scan findings. Results: GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30), and within three months (7.58 ± 1.21) evaluations (P < 0.001). On discharge, GOSE was positively correlated with Glasgow Coma Scale (GCS) (r = 0.729, P < 0.001) and motor GCS (r = 0.812, P < 0.001), and inversely with age (r = −0.261, P = 0.002), hospitalization period (r = −0.678, P < 0.001), pulse rate (r = −0.256, P = 0.002) and white blood cell (WBC). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) were significantly associated with GOSE at discharge in multivariable analysis. Conclusion: Our study showed some predictive factors that could help to decide which casualty should transport earlier to a trauma center. According to the current study findings, GCS, pulse rate, WBC, and among imaging signs and trauma-related symptoms, ICH, IVH, SAH, SDH, and EDH are significant independent predictors of GOSE at discharge in TBI patients.

Keywords: field, Glasgow outcome score, prediction, traumatic brain injury.

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Authors: Hamish de Nett

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On 23rd June 2018, twelve young footballers from the Wild Boar Academy and their coach went to explore the Tham Luang cave in the Doi Nang Non mountain range in Chiang Rai Province, Northern Thailand. Whilst they were inside the cave, monsoon rains hit, and the complex became partially flooded. In the following days, Thai Navy SEALs and an international team of expert divers assembled at the cave complex in order to rescue the boys. Although it was only marginally reported in the Western press, Buddhism and ritual activities played a major role in the rescue and its aftermath. This paper utilises numerous news articles and books written by reporters who covered the cave rescue to uncover what the place of Buddhism was in the Tham Luang cave rescue. This paper initially sets out the development of Thai Buddhism and the Thai nation state, paying particular note to the tension in Thai Buddhism between Buddhism as it is popularly practised and normative, state-favoured Buddhism. Secondly, this paper demonstrates that, during the Tham Luang cave rescue, Buddhism helped people cope with the disaster, provided an explanation for its occurrence, and allowed bystanders some efficacy in the process. Thirdly, this paper discusses how Buddhism helped people to give thanks after the rescue, achieve reconciliation, and gain closure. Finally, this paper analyses how the government and the political sphere utilised Buddhism during the rescue. The conclusion reached is that the Buddhism practiced during the Tham Luang cave rescue and its aftermath is representative of the wider tension between popular Buddhism and normative state-favoured Buddhism that is currently present within Thai Buddhism and has been for centuries.

Keywords: cave rescue, contemporary Buddhism, lived religion, Thai Buddhism, Tham Luang cave rescue

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Authors: Stavroula Stavropoulou-Tatla, Danyal Awal, Mohammad Ayaz Hossain

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The first wave of the COVID-19 pandemic saw several countries issue guidance postponing all non-urgent diagnostic evaluations and operations, leading to an estimated backlog of 28 million cases worldwide and over 4 million in the UK alone. In an attempt to regulate the resumption of elective surgical activity, the National Institute for Health and Care Excellence (NICE) introduced the ‘COVID-19 rapid guideline [NG179]’. This project aimed to increase healthcare staff knowledge of the aforementioned guideline to a targeted score of 100% in the disseminated questionnaire within 3 months at the Royal Free Hospital. A standardized online questionnaire was used to assess the knowledge of surgical and medical staff at baseline and following each 4-week-long Plan-Study-Do-Act (PDSA) cycle. During PDSA1, the A4 visual summary accompanying the guideline was visibly placed in all relevant clinical areas and the full guideline was distributed to the staff in charge together with a short briefing on the salient points. PDSA2 involved brief small-group teaching sessions. A total of 218 responses was collected. Mean percentage scores increased significantly from 51±19% at baseline to 81±16% after PDSA1 (t=10.32, p<0.0001) and further to 93±8% after PDSA2 (t=4.9, p<0.0001), with 54% of participants achieving a perfect score. In conclusion, the targeted distribution of guideline printouts and visual aids, combined with small-group teaching sessions, were simple and effective ways of educating healthcare staff about the new standards of elective surgical care at the time of COVID-19. This could facilitate the safe restoration of surgical activity, which is critical in order to mitigate the far-reaching consequences of surgical delays on an unprecedented scale during a time of great crisis and uncertainty.

Keywords: COVID-19, elective surgery, NICE guidelines, quality improvement

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Authors: Christine Pichler

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The German word Bildung in a comprehensive understanding can be defined as the development of the personality and as a process, which lasts from birth, or even before birth, until death. Gaining experience, acquiring abilities and knowledge as a lifelong learning process is what Bildung means. The development of the personality is intransitive because of the personality’s development itself, and transitive because of influences on the formation of a person by individuals and institutions. In public and political discussions, the term Bildung is understood with a constricted usage as education at schools. This leads to the research question, which consequences this limited comprehension of the term Bildung implies and how a comprehensive term of Bildung has to be defined. In discussions, Bildung is limited to its formal part. The limited understanding prevents from accurate analyses and discussions as well as adequate actions. This hypothesis and the research issue will be processed by theoretical analyses of the factors of Bildung, guideline-controlled expert interviews and a qualitative content analysis. The limited understanding on the term Bildung is a methodological problem. This results in inaccuracies in the analysis of the processes of Bildung and their effects on the development of personality structures. On the one hand, an individual is influenced by formal structures in the system of Bildung (e.g. schools) and on the other hand an individual is influenced by gained individual and informal personality and character attributes. In general, too little attention is given to these attributes and individual qualifications. The aim of this work is to demonstrate informative terms so the educational process with all its facets could be considered and applicable analyses can be made. If the informative terms can be defined, it´s also possible to identify and discuss the components of a comprehensive term Bildung to enable correct action.

Keywords: Bildung, development of personality, education, formative process, organized and non-organized Bildung

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Authors: Rigas Dimakopoulos, Marianna Papadopoulou, Roser Pons

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Background: Participation in family, recreational activities and self-care is an integral part of health. It is also the main outcome of rehabilitation services for children and adolescents with motor disabilities. There are currently no tools in Greek to assess participation in young children. Purpose: To culturally adapt and validate the Greek version of the Child Engagement in Daily Living (CEDL). Method: The CEDL was cross-culturally translated into Greek using forward-backward translation, review by the expert committee, pretest application and final review. Internal consistency was evaluated using the Cronbach alpha and test-retest reliability using the intra-class correlation coefficient (ICC). Parents of children aged 18 months to 5 years and with motor disabilities were recruited. Participants completed the CEDL and the children’s gross motor function was classified using the Gross Motor Function Classification System (GMFCS). Results: Eighty-three children were included, GMFCS I-V. Mean ± standard deviation of the CEDL domains “frequency of participation” “enjoyment of participation” and “self-care” were 58.4±14.0, 3.8±1.0 and 49.9±24, respectively. Internal consistency of all domains was high; Cronbach alpha for “frequency of participation” was 0.83, for “enjoyment of participation” was 0.76 and for “self-care” was 0.92. Test-retest reliability (ICC) was excellent for the “self-care” (0.95) and good for “frequency of participation” and “enjoyment of participation” domains (0.90 and 0.88, respectively). Conclusion: The Greek CEDL has good reliability. It can be used to evaluate participation in Greek young children with motor disabilities GMFCS levels I-V.

Keywords: participation, child, disabilities, child engagement in daily living

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Authors: K. Pankaj, R. K. Chaudhary, B. P. Mishra, S. Kochar

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Introduction: Consultation-Liaison psychiatry is a branch of psychiatry that includes clinical service, teaching and research. A consultation-liaison psychiatrist plays a role in having an expert opinion and linking the patients to other medical professionals and the patient’s bio-psycho-social aspects that may be leading to his/her symptoms. Consultation-Liaison psychiatry has been recognised as 'The guardian of the holistic approach to the patient', underlining its pre-eminent role in the management of patients who are admitted in a tertiary care hospital. Aims/ Objectives: The aim of the study was to analyse the utilization of psychiatric services and reasons for referrals in a tertiary care hospital. Materials and Methods: The study was done in a tertiary care hospital. The study included all the cases referred from different Inpatient wards to the psychiatry department for consultation. The study was conducted on 300 patients over a 3 month period. International classification of diseases 10 was used to diagnose the referred cases. Results: The majority of the referral was from the Medical Intensive care unit (22%) followed by general medical wards (18.66%). Majority of the referral was taken for altered sensorium (24.66%), followed by low mood or unexplained medical symptoms (21%). Majority of the referrals had a diagnosis of alcohol withdrawal syndrome (21%) as per International classification of diseases criteria, followed by unipolar Depression and Anxiety disorder (~ 14%), followed by Schizophrenia (5%) and Polysubstance abuse (2.6%). Conclusions: Our study concludes the importance of utilization of consultation-liaison psychiatric services. Also, the study signifies the need for sensitization of our colleagues regarding psychiatric sign and symptoms from time to time and seek psychiatric consult timely to decrease morbidity.

Keywords: consultation-liaison, psychiatry, referral, tertiary care hospital

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Authors: Eny Syatriana, Ardiansyah

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The purpose of recent study was to develop a learning model on writing, based on the reading texts which will be read by the students using reflection strategy. The strategy would allow the students to read the text and then they would write back the main idea and to develop the text by using their own sentences. So, the writing practice was begun by reading an interesting text, then the students would develop the text which has been read into their writing. The problem questions are (1) what kind of learning model that can develop the students writing ability? (2) what is the achievement of the students of STKIP YPUP through reflection strategy? (3) is the using of the strategy effective to develop students competence In writing? (4) in what level are the students interest toward the using of a strategy In writing subject? This development research consisted of some steps, they are (1) need analysis (2) model design (3) implementation (4) model evaluation. The need analysis was applied through discussion among the writing lecturers to create a learning model for writing subject. To see the effectiveness of the model, an experiment would be delivered for one class. The instrument and learning material would be validated by the experts. In every steps of material development, there was a learning process, where would be validated by an expert. The research used development design. These Principles and procedures or research design and development .This study, researcher would do need analysis, creating prototype, content validation, and limited empiric experiment to the sample. In each steps, there should be an assessment and revision to the drafts before continue to the next steps. The second year, the prototype would be tested empirically to four classes in STKIP YPUP for English department. Implementing the test greatly was done through the action research and followed by evaluation and validation from the experts.

Keywords: learning model, reflection, strategy, reading, writing, development

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Authors: R. Premasiri, W. A. H. A. Abeygunasekara, S. M. Hewavidana, T. Jananthan, R. M. S. Madawala, K. Vaheeshan

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Forecasting the potential for disastrous events such as landslides has become one of the major necessities in the current world. Most of all, the landslides occurred in Sri Lanka are found to be triggered mostly by intense rainfall events. The study area is the landslide near Gerandiella waterfall which is located by the 41st kilometer post on Nuwara Eliya-Gampala main road in Kotmale Division in Sri Lanka. The landslide endangers the entire Kotmale town beneath the slope. Geographic Information System (GIS) platform is very much useful when it comes to the need of emulating the real-world processes. The models are used in a wide array of applications ranging from simple evaluations to the levels of forecast future events. This project investigates the possibility of developing a dynamic model to map the spatial distribution of the slope stability. The model incorporates several theoretical models including the infinite slope model, Green Ampt infiltration model and Perched ground water flow model. A series of rainfall values can be fed to the model as the main input to simulate the dynamics of slope stability. Hydrological model developed using GIS is used to quantify the perched water table height, which is one of the most critical parameters affecting the slope stability. Infinite slope stability model is used to quantify the degree of slope stability in terms of factor of safety. DEM was built with the use of digitized contour data. Stratigraphy was modeled in Surfer using borehole data and resistivity images. Data available from rainfall gauges and piezometers were used in calibrating the model. During the calibration, the parameters were adjusted until a good fit between the simulated ground water levels and the piezometer readings was obtained. This model equipped with the predicted rainfall values can be used to forecast of the slope dynamics of the area of interest. Therefore it can be investigated the slope stability of rainfall induced landslides by adjusting temporal dimensions.

Keywords: factor of safety, geographic information system, hydrological model, slope stability

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Authors: Vedat Uyak

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Seasonal variations of trihalomethanes (THMs) and haloacetic acids (HAAs) concentrations were investigated within three distribution systems of a coastal city of Istanbul, Turkey. Moreover, total trihalomethanes and other organics concentration were also analyzed. The investigation was based on an intensive 16 month (2009-2010) sampling program, undertaken during the spring, summer, fall and winter seasons. Four THM (chloroform, dichlorobromomethane, chlorodibromomethane, bromoform), and nine HAA (the most commonly occurring one being dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA); other compounds are monochloroacetic acid (MCAA), monobromoacetic acid (MBAA), dibromoacetic acid (DBAA), tribromoacetic acid (TBAA), bromochloroacetic acid (BCAA), bromodichloroacetic acid (BDCAA) and chlorodibromoacetic acid (CDBAA)) species and other water quality and operational parameters were monitored at points along the distribution system between the treatment plant and the system’s extremity. The effects of coastal water sources, seasonal variation and spatial variation were examined. The results showed that THMs and HAAs concentrations vary significantly between treated waters and water at the distribution networks. When water temperature exceeds 26°C in summer, the THMs and HAAs levels are 0.8 – 1.1, and 0.4 – 0.9 times higher than treated water, respectively. While when water temperature is below 12°C in the winter, the measured THMs and HAAs concentrations at the system’s extremity were very rarely higher than 100 μg/L, and 60 μg/L, respectively. The highest THM concentrations occurred in the Buyukcekmece distribution system, with an average total HAA concentration of 92 μg/L. Moreover, the lowest THM levels were observed in the Omerli distribution network, with a mean concentration of 7 μg/L. For HAA levels, the maximum concentrations again were observed in the Buyukcekmece distribution system, with an average total HAA concentration of 57 μg/l. High spatial and seasonal variation of disinfection by-products in the drinking water of Istanbul was attributed of illegal wastewater discharges to water supplies of Istanbul city.

Keywords: disinfection byproducts, drinking water, trihalomethanes, haloacetic acids, seasonal variation

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Authors: Joseph George, Anne Kotteswara Roa

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Skin disease is one of the most common and popular kinds of health issues faced by people nowadays. Skin cancer (SC) is one among them, and its detection relies on the skin biopsy outputs and the expertise of the doctors, but it consumes more time and some inaccurate results. At the early stage, skin cancer detection is a challenging task, and it easily spreads to the whole body and leads to an increase in the mortality rate. Skin cancer is curable when it is detected at an early stage. In order to classify correct and accurate skin cancer, the critical task is skin cancer identification and classification, and it is more based on the cancer disease features such as shape, size, color, symmetry and etc. More similar characteristics are present in many skin diseases; hence it makes it a challenging issue to select important features from a skin cancer dataset images. Hence, the skin cancer diagnostic accuracy is improved by requiring an automated skin cancer detection and classification framework; thereby, the human expert’s scarcity is handled. Recently, the deep learning techniques like Convolutional neural network (CNN), Deep belief neural network (DBN), Artificial neural network (ANN), Recurrent neural network (RNN), and Long and short term memory (LSTM) have been widely used for the identification and classification of skin cancers. This survey reviews different DL techniques for skin cancer identification and classification. The performance metrics such as precision, recall, accuracy, sensitivity, specificity, and F-measures are used to evaluate the effectiveness of SC identification using DL techniques. By using these DL techniques, the classification accuracy increases along with the mitigation of computational complexities and time consumption.

Keywords: skin cancer, deep learning, performance measures, accuracy, datasets

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Authors: Saule Mussabekova

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Forensic investigation of human teeth plays an important role in detection of crime, particularly in cases of personal identification of dead bodies changed by putrefactive processes or skeletonized bodies as well as when finding bodies of unknown persons. 152 teeth have been investigated; 85 of them belonged to men and 67 belonged to women taken from alive people of different age. Teeth have been investigated after extraction. Two types of teeth have been investigated: teeth without integrity violation of dental crown and teeth with different degrees of its violation. Additionally, 517 teeth have been investigated that were collected from dead bodies, 252 of which belonged to women and 265 belonged to men, whatever the cause of death with death limitation from 1 month to 20 years. Isohemagglutinating serums and Coliclons of different series have been used for the research of tooth-group specificity by serological methods according to the AB0 system. Standard protocols of different techniques have been used for DNA purification from teeth (by reagent Chelex 100 produced by Bio-Rad using reagent kit 'DNA IQTM System' produced by Promega company (USA) and using columns 'QIAamp DNA Investigator Kit' produced by Qiagen company). Results of comparative forensic investigation of human teeth using serological and molecular genetic methods have shown that use of serological methods for forensic identification is sensible only in cases of preselection prior to the next molecular genetic investigation as well as in cases of impossibility of corresponding genetic investigation for different objective reasons. A number of advantages of methods of molecular genetics in the dental investigation have been marked, particularly in putrefactive changes, in personal identification. Key moments of modern condition of personal identification have been reflected according to dental state. Prospective directions of advance preparation of material have been emphasized for identification of teeth in forensic practice.

Keywords: dental state, forensic identification, molecular genetic analysis, teeth

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Authors: Samaneh Arasteh

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Neighbourhood satisfaction and safety are the two main components of urban life and have a substantial impact on residents’ quality of life. The relationship between these two components, especially in areas surrounding our individual private dwellings, is highly influential on many social, economic, and wellbeing activities that may benefit neighbourhood residents. Neighbourhood and urban design – which are liable to be affected by the perceived quality of local public spaces – are likely to be significant factors influencing broader residents’ feelings of safety. With this in mind, this study reviews recent normative literature on how these design processes have influenced neighbourhood satisfaction including perceived safety with a focus on different aspects of public spaces including planning, management, and design in a mix-tenure neighbourhood. Following the study aim, Riverwood in Sydney’s southwest was chosen as a case study to gain a detailed understanding of the context by engaging with community members, residents, non-government organisations, and experts. Moreover, archival studies on neighbourhood satisfaction and safety, expert interviews, and resident questionnaires are presented to shed light on the relationship between neighbourhood satisfaction and perception of safety. The study argues that for the safer neighbourhood in urban areas, social-cultural factors need to be aligned toward strengthening physical factors and since making the environments safer, it is important to understand practical and achievable mechanisms which are required to improve existing estates. Findings show that increasing the clarity of community social and physical environmental involvements can promote residents’ feelings of safety and following neighbourhood satisfaction.

Keywords: neighbourhood satisfaction, public space, Riverwood, urban safety

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Authors: Andrea Treviño Gavito, Diego Klabjan, Sanjiv J. Shah

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Echocardiograms serve as pivotal resources for clinicians in diagnosing cardiac conditions, offering non-invasive insights into a heart’s structure and function. When echocardiographic studies are conducted, no standardized labeling of the acquired views is performed. Employing machine learning algorithms for automated echocardiogram view detection has emerged as a promising solution to enhance efficiency in echocardiogram use for diagnosis. However, existing approaches predominantly rely on supervised learning, necessitating labor-intensive expert labeling. In this paper, we introduce a fully unsupervised echocardiographic view detection framework that leverages convolutional autoencoders to obtain lower dimensional representations and the K-means algorithm for clustering them into view-related groups. Our approach focuses on discriminative patches from echocardiographic frames. Additionally, we propose a trainable inverse average layer to optimize decoding of average operations. By integrating both public and proprietary datasets, we obtain a marked improvement in model performance when compared to utilizing a proprietary dataset alone. Our experiments show boosts of 15.5% in accuracy and 9.0% in the F-1 score for frame-based clustering, and 25.9% in accuracy and 19.8% in the F-1 score for view-based clustering. Our research highlights the potential of unsupervised learning methodologies and the utilization of open-sourced data in addressing the complexities of echocardiogram interpretation, paving the way for more accurate and efficient cardiac diagnoses.

Keywords: artificial intelligence, echocardiographic view detection, echocardiography, machine learning, self-supervised representation learning, unsupervised learning

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Authors: Ilana Margalith, Yaron Niv

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One of the most important factors of professional health treatment is teamwork, in which each discipline contributes its expert knowledge, thus ensuring quality and a high standard of care as well as efficient communication (one of the International Patient Safety Goals). However, in most countries, students are educated separately by each health discipline. They are exposed to teamwork only during their clinical experience, which in some cases is short and skill-oriented. In addition, health organizations in most countries are hierarchical and although changes have occurred in the hierarchy of the medical system, there are still disciplines that underrate the unique contributions of other health professionals, thus, young graduates of health professions develop and base their perception of their peers from other disciplines on insufficient knowledge. In order to establish a wide-ranging perception among nursing students as to the contribution of different health professionals to the health of their patients, students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel, participated in an interdisciplinary clinical discussion with students from several different professions, other than nursing, who were completing their clinical experience at Rabin Medical Center in medicine, health psychology, social work, audiology, physiotherapy and occupational therapy. The discussion was led by a medical-surgical nursing instructor. Their tutors received in advance, a case report enabling them to prepare the students as to how to present their professional theories and interventions regarding the case. Mutual stimulation and acknowledgment of the unique contribution of each part of the team enriched the nursing students' understanding as to how their own nursing interventions could be integrated into the entire process towards a safe and speedy recovery of the patient.

Keywords: health professions' students, interdisciplinary clinical discussion, nursing education, patient safety

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Authors: Hossein Hassani, Ali Rezaei

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In recent years, the study of soil contamination problems surrounding mines and smelting plants has attracted some serious attention of the environmental experts. These elements due to the non- chemical disintegration and nature are counted as environmental stable and durable contaminants. Variability of these contaminants in the soil and the time and financial limitation for the favorable environmental application, in order to reduce the risk of their irreparable negative consequences on environment, caused to apply the favorable grading of these contaminant for the further success of the risk management processes. In this study, we use the contaminants factor risk indices, average concentration, enrichment factor and geoaccumulation indices for evaluating the metal contaminant of including Pb, Ni, Se, Mo and Zn in the soil of Sarcheshmeh copper mine area. For this purpose, 120 surface soil samples up to the depth of 30 cm have been provided from the study area. And the metals have been analyzed using ICP-MS method. Comparison of the heavy and potentially toxic elements concentration in the soil samples with the world average value of the uncontaminated soil and shale average indicates that the value of Zn, Pb, Ni, Se and Mo is higher than the world average value and only the Ni element shows the lower value than the shale average. Expert opinions on the relative importance of each indicators were used to assign a final weighting of the metals and the heavy metals were ranked using the TOPSIS approach. This allows us to carry out efficient environmental proceedings, leading to the reduction of environmental ricks form the contaminants. According to the results, Ni, Pb, Mo, Zn, and Se have the highest rate of risk contamination in the soil samples of the study area.

Keywords: contamination coefficient, geoaccumulation factor, TOPSIS techniques, Sarcheshmeh copper complex

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Authors: Afshin Zahedi, Keivan Jamshidi

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This study was conducted to determine the neurotoxic effects of different doses of ACR on the thoracic axons of the spinal cord of rat. To evaluate this hypothesis in the thoracic axons, amino-cupric silver staining technique of the de Olmos was conducted to define the histopathologic characteristic (argyrophilia) of axonal damage following ACR exposure. For this purpose 60 adult male rats (Wistar, approximately 250 g) were selected. Rats were hosed in polycarbonate boxes as two per each. Randomly assigned groups of rats (10 rats per exposure group, total 5 exposure groups as A, B, C, D and E) were exposed to 0.5, 5, 50, 100 and 500 mg/kg per day×11days intraperitoneal injection (IP injection) respectively. The remaining 10 rats were housed in group (F) as control group. Control rats received daily injections of 0.9% saline (3ml/kg). As indices of developing neurotoxicity, weight gain, gait scores and landing hindlimb foot splay (LHF) were determined. Weight gains were measured daily prior to injection. Gait scoring involved observation of spontaneous open field locomotion, included evaluations of ataxia, hopping, rearing and hind foot placement, and hindlimb foot splay were determined 3-4 times per week. Gait score was assigned from 1-4. After 11 days, two rats for silver stain, were randomly selected, dissected and proper samples were collected from thoracic portion of the spinal cord of rat. Results did show no neurological behavior in groups A, B and F, whereas severe neurotoxicity was observed in groups C and D. Rats in groups E died within 1-2 hours due to severe toxemia. In histopathological studies based on the de Olmos technique no argyrophilic neurons or processes were observed in stained sections obtained from the thoracic portion of the spinal cord of rats belong to groups A, B and F, while moderate to severe argyrophilic changes were observed in different stained sections obtained from the thoracic portion of the spinal cord of rats belong to groups C and D.

Keywords: acrylamide, rat, axonopathy, argyrophily, de Olmos

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Authors: Goutom K. Pall

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At the very heart of the power system, power transmission (PT) acts as an essential link between power generation and distribution. Timely completion of PT infrastructures is therefore crucial to support the development of power system as a whole. Yet despite the importance, studies on PT infrastructure development projects are embryonic and, hence, PT projects undergoing widespread delays worldwide. These delay factors are idiosyncratic and identifying the critical delay factors is essential if the PT industry professionals are to complete their projects efficiently and within the expected timeframes. This study identifies and categorizes 46 causes of PT project delay under ten major groups using six sector expert’s recommendations studied by a preliminary questionnaire survey. Based on the experts’ strong recommendations, two new groups are introduced in the final questionnaire survey: sector specific factors (SSF) and general factors (GF). SSF pertain to delay factors applicable only to the PT projects, while GF represents less biased samples with shared responsibilities of all project parties involved in a project. The study then uses 112 data samples from the contractors to rank the delay factors using relative importance index (RII). The results reveal that SSF, GF and external factors are the most critical groups, while the highest ranked delay factors include the right of way (RoW) problems of transmission lines (TL), delay in payments, frequent changes in TL routes, poor communication and coordination among the project parties and accessibility to TL tower locations. Finally, recommendations are made to minimize the identified delay. The findings are expected to be of substantial benefit to professionals in minimizing time overrun in PT projects implementation, as well as power generation, power distribution, and non-power linear construction projects worldwide.

Keywords: delay, project delay, power transmission projects, time-overruns

Procedia PDF Downloads 174