Search results for: probabilistic safety assessment

Authors: Evangelos Kaisar, Anika Tabassum, Taraneh Ardalan, Majed Al-Ghandour

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The economy of any country is dependent on its ability to accommodate the movement and delivery of goods. The demand for goods movement and services increases truck traffic on highways and inside the cities. The livability of most cities is directly affected by the congestion and environmental impacts of trucks, which are the backbone of the urban freight system. Better operation of heavy vehicles on highways and arterials could lead to the network’s efficiency and reliability. In many cases, roundabouts can respond better than at-level intersections to enable traffic operations with increased safety for both cars and heavy vehicles. Recently emerged, the concept of turbo-roundabout is a viable alternative to the two-lane roundabout aiming to improve traffic efficiency. The primary objective of this study is to evaluate the operation and performance level of an at-grade intersection, a conventional two-lane roundabout, and a basic turbo roundabout for freight movements. To analyze and evaluate the performances of the signalized intersections and the roundabouts, micro simulation models were developed PTV VISSIM. The networks chosen for this analysis in this study are to experiment and evaluate changes in the performance of the movement of vehicles with different geometric and flow scenarios. There are several scenarios that were examined when attempting to assess the impacts of various geometric designs on vehicle movements. The overall traffic efficiency depends on the geometric layout of the intersections, which consists of traffic congestion rate, hourly volume, frequency of heavy vehicles, type of road, and the ratio of major-street versus side-street traffic. The traffic performance was determined by evaluating the delay time, number of stops, and queue length of each intersection for varying truck percentages. The results indicate that turbo-roundabouts can replace signalized intersections and two-lane roundabouts only when the traffic demand is low, even with high truck volume. More specifically, it is clear that two-lane roundabouts are seen to have shorter queue lengths compared to signalized intersections and turbo-roundabouts. For instance, considering the scenario where the volume is highest, and the truck movement and left turn movement are maximum, the signalized intersection has 3 times, and the turbo-roundabout has 5 times longer queue length than a two-lane roundabout in major roads. Similarly, on minor roads, signalized intersections and turbo-roundabouts have 11 times longer queue lengths than two-lane roundabouts for the same scenario. As explained from all the developed scenarios, while the traffic demand lowers, the queue lengths of turbo-roundabouts shorten. This proves that turbo roundabouts perform well for low and medium traffic demand. The results indicate that turbo-roundabouts can replace signalized intersections and two-lane roundabouts only when the traffic demand is low, even with high truck volume. Finally, this study provides recommendations on the conditions under which different intersections perform better than each other.

Keywords: At-grade intersection, simulation, turbo-roundabout, two-lane roundabout

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Authors: Adebayo-Victoria Tobi Dada, Dada Emmanuel

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This study assessed households’ food security and hunger levels among different communities with varying educational and economic background in Ile-Ife, Nigeria, and its environment. It also examined the impacts of varying demography on the household food security level in the area. This was with a view to providing information on the food security status of the subjects within the study area. Ten different communities with varying demography (Parakin, Mokuro, Ilare, Obafemi Awolowo University (OAU) Staff Quarters, Ibadan Road, Aba-Iya Gani, Eleweran, Iraye, Boosa, and Eku-Isobo) were identified within the study area. Fieldwork was then carried out from 7th to 14th of March, 2016 in each of these communities through survey of market prices of food stuff, diet, and nutrition, social well-being, food accessibility and affordability as well as price fluctuation and variation in household’s social background. Selection of households for the survey was done using stratified random sampling method. Key informants included community heads, landlords, tenants, and household heads. Similarly, information on food security levels with respect to demographic backgrounds was obtained from the use of modified Food and Hunger Insecurity Module (FHIM) structured questionnaire. The questionnaire was administered to one percent of the households’ population per community. The results showed that communities such as Parakin and OAU Senior Staff Quarters were dominated by civil servants, while community such as Boosa was dominated by artisans. Respondents earning between ₦11,000 and ₦20,000 per month, during the study period, had the highest percentage across the selected communities. The household food security indices showed that about 41% of the investigated respondents could not guarantee their household food for a month, while 18% reduced or skipped meals. There were positive significant relationships between monthly income (F-value = 132.04), educational status (F-value = 102.30), occupation (F-value = 104.05) and food budget (F-value = 122.09), all at p < 0.05. However, there was no significant relationship between the monthly food budget and household sizes (t-value = -1.4074, p > 0.05). Food secured households’ had the household heads with a higher level of educational attainment. The study concluded that large variations which existed between socio-economic and educational background among the communities had significant effects on households’ food security level in the study area.

Keywords: food security, households, hunger level, market prices

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Authors: Stephanie Duval

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The concept of educational success, combined with the overall development of the child in kindergarten, is at the center of current interests, both in research and in the environments responsible for the education of young children. In order to promote it, researchers emphasize the importance of studying the executive functions [EF] of children in preschool education. More precisely, the EFs, which refers to working memory [WM], inhibition, mental flexibility and planning, would be the pivotal element of the child’s educational success. In order to support the EFs of the child, and even his educational success, the quality of the environments is beginning to be explored more and more. The question that arises now is how to promote EFs for young children in the educational environment, in order to support their educational success? The objective of this study is to investigate the link between the quality of interactions in 5-year-old kindergarten and child’s EFs. The sample consists of 118 children (70 girls, 48 boys) in 12 classes. The quality of the interactions is observed from the Classroom Assessment Scoring System [CLASS], and the EFs (i.e., working memory, inhibition, cognitive flexibility, and planning) are measured with administered tests. The hypothesis of this study was that the quality of teacher-child interactions in preschool education, as measured by the CLASS, was associated with the child’s EFs. The results revealed that the quality of emotional support offered by adults in kindergarten, included in the CLASS tool, was positively and significantly related to WM and inhibition skills. The results also suggest that WM is a key skill in the development of EFs, which may be associated with the educational success of the child. However, this hypothesis remains to be clarified, as is the link with educational success. In addition, results showed that factors associated to the family (ex. parents’ income) moderate the relationship between the domain ‘instructional support’ of the CLASS (ex. concept development) and child’s WM skills. These data suggest a moderating effect related to family characteristics in the link between ‘quality of classroom interactions’ and ‘EFs’. This project proposes, as a future avenue, to check the distinctive effect of different environments (familial and educational) on the child’s EFs. More specifically, future study could examine the influence of the educational environment on EF skills, as well as whether or not there is a moderating effect of the family environment (ex. parents' income) on the link between the quality of the interactions in the classroom and the EFs of the children, as anticipated by this research.

Keywords: executive functions [EFs], environmental factors, quality of interactions, preschool education

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Authors: Getahun Nigusie Demise

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Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: The aim of this study is to assess the incidence and predictors of mortality among HIV positive children on antiretroviral therapy (ART) in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, treatment, Ethiopia

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Authors: Awadh O. Al-Anazi

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As part of the organizational needs toward successful maintaining activities, a proper management system need to be put in place, ensuring the effectiveness of maintenance activities. The management system shall clearly describes the process of identifying, prioritizing, planning, scheduling, execution, and providing valuable feedback for all maintenance activities. Completion and accuracy of the system with proper implementation shall provide the organization with a strong platform for effective maintenance activities that are resulted in efficient outcomes toward business success. The purpose of this research was to introduce a practical tool for measuring the maintenance efficiency level within Saudi organizations. A comprehensive study was launched across many maintenance professionals throughout Saudi leading organizations. The study covered five main categories: work process, identification, planning and scheduling, execution, and performance monitoring. Each category was evaluated across many dimensions to determine its current effectiveness through a five-level scale from 'process is not there' to 'mature implementation'. Wide participation was received, responses were analyzed, and the study was concluded by highlighting major gaps and improvement opportunities within Saudi organizations. One effective implementation of the efficiency enhancement efforts was deployed in Saudi Kayan (one of Sabic affiliates). Below details describes the project outcomes: SK overall maintenance wrench time was measured at 20% (on average) from the total daily working time. The assessment indicates the appearance of several organizational gaps, such as a high amount of reactive work, poor coordination and teamwork, Unclear roles and responsibilities, as well as underutilization of resources. Multidiscipline team was assigned to design and implement an appropriate work process that is capable to govern the execution process, improve the maintenance workforce efficiency, and maximize wrench time (targeting > 50%). The enhanced work process was introduced through brainstorming and wide benchmarking, incorporated with a proper change management plan and leadership sponsorship. The project was completed in 2018. Achieved Results: SK WT was improved to 50%, which resulted in 1) reducing the Average Notification completion time. 2) reducing maintenance expenses on OT and manpower support (3.6 MSAR Actual Saving from Budget within 6 months).

Keywords: efficiency, enhancement, maintenance, work force, wrench time

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Authors: Fatma Refaat Ahmed, Sally Mohamed Farghaly

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Context: Intensive care unit (ICU) nurses often face pressure and constraints in their work, leading to the rationing of care when demands exceed available time and resources. Observations suggest that ICU nurses are frequently distracted from their core nursing roles by non-core tasks. This study aims to provide evidence on ICU nurses' multitasking activities and explore the association between nurses' personal and clinical characteristics and their time allocation. Research Aim: The aim of this study is to quantify the time spent by ICU nurses on multitasking activities and investigate the relationship between their personal and clinical characteristics and time allocation. Methodology: A self-observation form utilizing the "Diary" recording method was used to record the number of tasks performed by ICU nurses and the time allocated to each task category. Nurses also reported on the distractions encountered during their nursing activities. A convenience sample of 60 ICU nurses participated in the study, with each nurse observed for one nursing shift (6 hours), amounting to a total of 360 hours. The study was conducted in two ICUs within a university teaching hospital in Alexandria, Egypt. Findings: The results showed that ICU nurses completed 2,730 direct patient-related tasks and 1,037 indirect tasks during the 360-hour observation period. Nurses spent an average of 33.65 minutes on ventilator care-related tasks, 14.88 minutes on tube care-related tasks, and 10.77 minutes on inpatient care-related tasks. Additionally, nurses spent an average of 17.70 minutes on indirect care tasks per hour. The study identified correlations between nursing time and nurses' personal and clinical characteristics. Theoretical Importance: This study contributes to the existing research on ICU nurses' multitasking activities and their relationship with personal and clinical characteristics. The findings shed light on the significant time spent by ICU nurses on direct care for mechanically ventilated patients and the distractions that require attention from ICU managers. Data Collection: Data were collected using self-observation forms completed by participating ICU nurses. The forms recorded the number of tasks performed, the time allocated to each task category, and any distractions encountered during nursing activities. Analysis Procedures: The collected data were analyzed to quantify the time spent on different tasks by ICU nurses. Correlations were also examined between nursing time and nurses' personal and clinical characteristics. Question Addressed: This study addressed the question of how ICU nurses allocate their time across multitasking activities and whether there is an association between nurses' personal and clinical characteristics and time allocation. Conclusion: The findings of this study emphasize the need for a lean evaluation of ICU nurses' activities to identify and address potential gaps in patient care and distractions. Implementing lean techniques can improve efficiency, safety, clinical outcomes, and satisfaction for both patients and nurses, ultimately enhancing the quality of care and organizational performance in the ICU setting.

Keywords: motion study, ICU nurse, lean, nursing time, multitasking activities

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Authors: C. M. Choi, H. C. Tsang, W. K. Fong, Y. K. Cheng, T. K. Chui, L. Y. Chan, K. W. Lee, C. K. Yuen, P. W. Lau, Y. L. To, K. C. Chow

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Six-minute walk test (6MWT) is a sub-maximal exercise test to assess aerobic capacity and exercise tolerance of patients with chronic respiratory disease and heart failure. This has been proven to be a reliable and valid tool and commonly used in clinical situations. Traditional 6MWT is labour-intensive and time-consuming especially for patients who require assistance in ambulation and oxygen use. When performing the test with these patients, one staff will assist the patient in walking (with or without aids) while another staff will need to manually record patient’s oxygen saturation, heart rate and walking distance at every minute and/or carry oxygen cylinder at the same time. Physiotherapist will then have to document the test results in bed notes in details. With the use of electronic 6MWT (E-6MWT), patients wear a wireless oximeter that transfers data to a tablet PC via Bluetooth. Real-time recording of oxygen saturation, heart rate, and distance are displayed. No manual work on recording is needed. The tablet will generate a comprehensive report which can be directly attached to the patient’s bed notes for documentation. Data can also be saved for later patient follow up. This study was carried out in North District Hospital. Patients who followed commands and required 6MWT assessment were included. Patients were assigned to study or control groups. In the study group, patients adopted the E-6MWT while those in control group adopted the traditional 6MWT. Manpower and time consumed were recorded. Physiotherapists also completed a questionnaire about the use of E-6MWT. Total 12 subjects (Study=6; Control=6) were recruited during 11-12/2017. An average number of staff required and time consumed in traditional 6MWT were 1.67 and 949.33 seconds respectively; while in E-6MWT, the figures were 1.00 and 630.00 seconds respectively. Compared to traditional 6MWT, E-6MWT required 67.00% less manpower and 50.10% less in time spent. Physiotherapists (n=7) found E-6MWT is convenient to use (mean=5.14; satisfied to very satisfied), requires less manpower and time to complete the test (mean=4.71; rather satisfied to satisfied), has better data management (mean=5.86; satisfied to very satisfied) and is recommended to be used clinically (mean=5.29; satisfied to very satisfied). It is proven that E-6MWT requires less manpower input with higher efficiency and better data management. It is welcomed by the clinical frontline staff.

Keywords: electronic, physiotherapy, six-minute walk test, 6MWT

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Authors: Oli Sophie Meredith, Jacquelyn Osborne, Sarah Verdon, Jane Frawley

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PROJECT OVERVIEW AND BACKGROUND: Over one million Australians are affected by ADHD at an economic and social cost of over $20 billion per annum. Despite health outcomes being significantly worse compared with men, women have historically been overlooked in ADHD diagnosis and treatment. While research suggests physical activity and other non-prescription options can help with ADHD symptoms, the frontline response to ADHD remains expensive stimulant medications that can have adverse side effects. By interviewing women with ADHD, this research will examine women’s self-directed approaches to managing symptoms, including alternatives to prescription medications. It will investigate barriers and affordances to potentially helpful approaches and identify any concerning strategies pursued in lieu of diagnosis. SIGNIFICANCE AND INNOVATION: Despite the economic and societal impact of ADHD on women, research investigating how women manage their symptoms is scant. This project is significant because although women’s ADHD symptoms are markedly different to those of men, mainstream treatment has been based on the experiences of men. Further, it is thought that in developing nuanced coping strategies, women may have masked their symptoms. Thus, this project will highlight strategies which women deem effective in ‘thriving’ rather than just ‘hiding’. By investigating the health service use, self-care and physical activity of women with ADHD, this research aligns with a priority research areas as identified by the November 2023 senate ADHD inquiry report. APPROACH AND METHODS: Semi-structured interviews will be conducted with up to 20 women with ADHD. Interviews will be conducted in person and online to capture experience across rural and metropolitan Australia. Participants will be recruited in partnership with the peak representative body, ADHD Australia. The research will use an intersectional framework, and data will be analysed thematically. This project is led by an interdisciplinary and cross-institutional team of women with ADHD. Reflexive interviewing skills will be employed to help interviewees feel more comfortable disclosing their experiences, especially where they share common ground ENGAGEMENT, IMPACT AND BENEFIT: This research will benefit women with ADHD by increasing knowledge of strategies and alternative treatments to prescription medications, reducing the social and economic burden of ADHD on Australia and on individuals. It will also benefit women by identifying risks involved with some self-directed approaches in lieu of medical advice. The project has an accessible impact plan to directly benefit end-users, which includes the development of a podcast and a PDF resource translating findings. The resources will reach a wide audience through ADHD Australia’s extensive national networks. We will collaborate with Charles Sturt’s Accessibility and Inclusion Division of Safety, Security and Well-being to create a targeted resource for students with ADHD.

Keywords: ADHD, women's health, self-directed strategies, health service use, physical activity, public health

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Authors: Atara Shriki, Ilana Lavy

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Teaching for the first time an online course dealing with the history of mathematics, we were struggling with questions related to the design of a proper learning environment (LE). Thirteen high school mathematics teachers, M.Ed. students, attended the course. The teachers were engaged in independent reading of mathematical texts, a task that is recognized as complex due to the unique characteristics of such texts. In order to support the learning processes and develop skills that are essential for succeeding in learning online (e.g. self-regulated learning skills, meta-cognitive skills, reflective ability, and self-assessment skills), the LE comprised of three components aimed at “scaffolding” the learning: (1) An online "self-feedback" questionnaires that included drill-and-practice questions. Subsequent to responding the questions the online system provided a grade and the teachers were entitled to correct their answers; (2) Open-ended questions aimed at stimulating critical thinking about the mathematical contents; (3) Reflective questionnaires designed to assist the teachers in steering their learning. Using a mixed-method methodology, an inquiry study examined the learning processes, the learners' difficulties in reading the mathematical texts and on the unique contribution of each component of the LE to the ability of teachers to comprehend the mathematical contents, and support the development of their learning skills. The results indicate that the teachers found the online feedback as most helpful in developing self-regulated learning skills and ability to reflect on deficiencies in knowledge. Lacking previous experience in expressing opinion on mathematical ideas, the teachers had troubles in responding open-ended questions; however, they perceived this assignment as nurturing cognitive and meta-cognitive skills. The teachers also attested that the reflective questionnaires were useful for steering the learning. Although in general the teachers found the LE as supportive, most of them indicated the need to strengthen instructor-learners and learners-learners interactions. They suggested to generate an online forum to enable them receive direct feedback from the instructor, share ideas with other learners, and consult with them about solutions. Apparently, within online LE, supporting learning merely with respect to cognitive aspects is not sufficient. Leaners also need an emotional support and sense a social presence.

Keywords: cognitive and meta-cognitive skills, independent reading of mathematical texts, online learning environment, self-regulated learning skills

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Authors: Monika Konieczyńska, Joanna Fajfer, Olga Lipińska

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In Poland works related to the exploration and prospection of unconventional hydrocarbons (natural gas accumulated in the Silurian shale formations) started in 2007, based on the experience of the other countries that have created new possibilities for the use of existing hydrocarbons resources. The highly water-consuming process of hydraulic fracturing is required for the exploitation of shale gas which implies a need to ensure large volume of water available. As a result considerable amount of mining waste is generated, particularly liquid waste, i.e. flowback fluid with variable chemical composition. The chemical composition of the flowback fluid depends on the composition of the fracturing fluid and the chemistry of the fractured geological formations. Typically, flowback fluid is highly salinated, can be enriched in heavy metals, including rare earth elements, naturally occurring radioactive materials and organic compounds. The generated fluids considered as the extractive waste should be properly managed in the recovery or disposal facility. Problematic issue is both high hydration of waste as well as their variable chemical composition. Also the limited capacity of currently operating facilities is a growing problem. Based on the estimates, currently operating facilities will not be sufficient for the need of waste disposal when extraction of unconventional hydrocarbons starts. Further more, the content of metals in flowback fluids including rare earth elements is a considerable incentive to develop technology of metals recovery. Also recycling is a key factor in terms of selection of treatment process, which should provide that the thresholds required for reuse are met. The paper will present the study of the flowback fluids chemical composition, based on samples from hydraulic fracturing processes performed in Poland. The scheme of flowback fluid cleaning and recovering technology will be reviewed along with a discussion of the results and an assessment of environmental impact, including all generated by-products. The presented technology is innovative due to the metal recovery, as well as purified water supply for hydraulic fracturing process, which is significant contribution to reducing water consumption.

Keywords: environmental impact, flowback fluid, management of special waste streams, metals recovery, shale gas

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Authors: A. Giani

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The current pedagogical culture recognizes an educational scope within the sports practices. It is widely accepted, in the pedagogical culture, that thanks to the acquisition and development of motor skills, it is also possible to exercise abilities that concern the way of facing and managing the difficulties of everyday life. Sport is a peculiar educational environment: the children have the opportunity to discover the possibilities of their body, to correlate with their peers, and to learn how to manage the rules and the relationship with authorities, such as coaches. Educational aspects of the sport concern both non-formal and formal educational environments. Coaches play a critical role in an agonistic sphere: exactly like the competencies developed by the children, coaches have to work on their skills to properly set up the educational scene. Facing these new educational tasks - which are not new per se, but new because they are brought back to awareness - a few questions arise: does the coach have adequate preparation? Is the training of the coach in this specific area appropriate? This contribution aims to explore the issue in depth by focusing on the reality of the Football School. Starting from a possible sense of pedagogical inadequacy detected during a series of meetings with several football clubs in Piedmont (Italy), there have been highlighted some important educational needs within the professional training of sports coaches. It is indeed necessary for the coach to know the processes underlying the educational relationship in order to better understand the centrality of the assessment during the educational intervention and to be able to manage the asymmetry in the coach-athlete relationship. In order to provide a response to these pedagogical needs, a formative plan has been designed to allow both an in-depth study of educational issues and a correct self-evaluation of certain pedagogical skills’ control levels, led by the coach. This plan has been based on particular practices, the Educational Practices of Pre-test (EPP), a specific version of community practices designed for the extracurricular activities. The above-mentioned practices realized through the use of texts meant as pre-tests, promoted a reflection within the group of coaches: they set up real and plausible sports experiences - in particular football, triggering a reflection about the relationship’s object, spaces, and methods. The characteristic aspect of pre-tests is that it is impossible to anticipate the reflection as it is necessarily connected to the personal experience and sensitivity, requiring a strong interest and involvement by participants: situations must be considered by the coaches as possible settings in which they could be found on the field.

Keywords: relational needs, values, responsibility, self-evaluation

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Authors: Abdulwhab Alotaibi, Abdullah Alzahrani, Ziyad Bokhari, Abdulelah Alghamdi

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First described in 1975 by Dr. Miller, Medical dressings are uncommon but possible cause of hand digital ischemia due the tourniquet-like effect. The incident of this complication has been reported across wide range of age-groups, yet it seems like that the pediatric population are specifically vulnerable. Multiple dressing types were reported to have caused ischemic injury, such as elastic wrap, tubular gauze, and self-adherent dressings. We present a case of medical dressing induced digital ischemia in patient with Congenital insensitivity to pain and anhidrosis (CIPA), which further challenge the discovery of the condition. An 8-year-old girl known case of CIPA. Brought by her mother to the ER after nail bed injury, which she managed by application of elastic wrap that was left for 24 hours. When the mother found out she immediately removed the elastic band, and noticed the fingertip was black and cold with tense bullae. The color then changed later when she arrived to the ER to dark purple with bluish discoloration on the tip. On examination there was well demarcated tense bullae on the distal right fifth finger. Neurovascular intact, pulse oximetry on distal digit 100%, capillary refill time was delayed. She was seen under Plastic surgery and conservative management recommended, and patient was discharged with safety netting. Two days later the patient came as follow-up visit at which her condition demonstrated significant improvement, the bullae has since ruptured leaving behind sloughed skin, capillary refill and pulse oximetry were both within normal limits, sensory function couldn’t be assessed but her motor function and ROM were normal, topical bacitracin and bandage dressings were applied for the eroded skin. Patient was scheduled for a follow-up in 2 weeks. Preventatively it’s advisable to avoid the commonly implicated dressings such as elastic, tubular gauze or self-adherent wraps in hand or digital injuries when possible, but in cases where the use of these dressings is of necessity the appropriate precautions must be taken, Dr. Makarewich proposed the following 5 measures to help minimize the incidence of the injury: 1-Unwrapping 12 inches of the dressing before rolling the injured finger. 2-Wrapping from distal to proximal with minimal tension to avoid vascular embarrassment. 3-The use of 5-25 inch to overlap the entire wrap. 4-Maintaining light pressure over the wrap to allow adherence of the dressing. 5-Minimization of the number of layers used to wrap the affected digit. Also assessing the capillary refill after the application can help in determining the patency of the supplying blood vessels. It’s also important to selectively determine if the patient is a candidate for conservative management, as tailored approach can help in maximizing the positive outcomes for our patients.

Keywords: congenital insensitivity to pain, digital ischemia, medical dressing, conservative management

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Authors: Dalia El Hadi, Alaa Bou Ghannam, Hala Mostafa, Hana Mansour, Ibrahim Hashim, Soubhi Tahhan, Tharwat El Zahran

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Introduction: Neuro-ophthalmological emergencies require prompt assessment and management to avoid vision or life-threatening sequelae. Some would require neuroimaging. Most commonly used are the CT and MRI of the Brain. They can be over-used when not indicated. Their yield remains dependent on multiple factors relating to the clinical scenario. Methods: A retrospective cross-sectional study was conducted by reviewing the electronic medical records of patients presenting to the Emergency Department (ED) with isolated neuro-ophthalmologic complaints. For each patient, data were collected on the clinical presentation, whether neuroimaging was performed (and which type), and the result of neuroimaging. Analysis of the performed neuroimaging was made, and its yield was determined. Results: A total of 211 patients were reviewed. The complaints or symptoms at presentation were: blurry vision, change in the visual field, transient vision loss, floaters, double vision, eye pain, eyelid droop, headache, dizziness and others such as nausea or vomiting. In the ED, a total of 126 neuroimaging procedures were performed. Ninety-four imagings (74.6%) were normal, while 32 (25.4%) had relevant abnormal findings. Only 2 symptoms were significant for abnormal imaging: blurry vision (p-value= 0.038) and visual field change (p-value= 0.014). While 4 physical exam findings had significant abnormal imaging: visual field defect (p-value= 0.016), abnormal pupil reactivity (p-value= 0.028), afferent pupillary defect (p-value= 0.018), and abnormal optic disc exam (p-value= 0.009). Conclusion: Risk indicators for abnormal neuroimaging in the setting of neuro-ophthalmological emergencies are blurred vision or changes in the visual field on history taking. While visual field irregularities, abnormal pupil reactivity with or without afferent pupillary defect, or abnormal optic discs, are risk factors related to physical testing. These findings, when present, should sway the ED physician towards neuroimaging but still individualizing each case is of utmost importance to prevent time-consuming, resource-draining, and sometimes unnecessary workup. In the end, it suggests a well-structured patient-centered algorithm to be followed by ED physicians.

Keywords: emergency department, neuro-ophthalmology, neuroimaging, risk indicators

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Authors: Qian Chen, Lin Xu, Ping Ju, Zhuoran Li, Yiping Yu, Yuqing Jin

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The operation of power grid is becoming more and more complex and difficult due to its rapid development towards high voltage, long distance, and large capacity. For instance, many large-scale wind farms have connected to power grid, where their fluctuation and randomness is very likely to affect the stability and safety of the grid. Fortunately, many new-type equipments based on power electronics have been applied to power grid, such as UPFC (Unified Power Flow Controller), TCSC (Thyristor Controlled Series Compensation), STATCOM (Static Synchronous Compensator) and so on, which can help to deal with the problem above. Compared with traditional equipment such as generator, new-type controllable devices, represented by the FACTS (Flexible AC Transmission System), have more accurate control ability and respond faster. But they are too expensive to use widely. Therefore, on the basis of the comparison and analysis of the controlling characteristics between traditional control equipment and new-type controllable equipment in both time and space scale, a coordinated optimizing control method within mutil-time-space frame is proposed in this paper to bring both kinds of advantages into play, which can better both control ability and economical efficiency. Firstly, the coordination of different space sizes of grid is studied focused on the fluctuation caused by large-scale wind farms connected to power grid. With generator, FSC (Fixed Series Compensation) and TCSC, the coordination method on two-layer regional power grid vs. its sub grid is studied in detail. The coordination control model is built, the corresponding scheme is promoted, and the conclusion is verified by simulation. By analysis, interface power flow can be controlled by generator and the specific line power flow between two-layer regions can be adjusted by FSC and TCSC. The smaller the interface power flow adjusted by generator, the bigger the control margin of TCSC, instead, the total consumption of generator is much higher. Secondly, the coordination of different time sizes is studied to further the amount of the total consumption of generator and the control margin of TCSC, where the minimum control cost can be acquired. The coordination method on two-layer ultra short-term correction vs. AGC (Automatic Generation Control) is studied with generator, FSC and TCSC. The optimal control model is founded, genetic algorithm is selected to solve the problem, and the conclusion is verified by simulation. Finally, the aforementioned method within multi-time-space scale is analyzed with practical cases, and simulated on PSASP (Power System Analysis Software Package) platform. The correctness and effectiveness are verified by the simulation result. Moreover, this coordinated optimizing control method can contribute to the decrease of control cost and will provide reference to the following studies in this field.

Keywords: FACTS, multi-space-time frame, optimal control, TCSC

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Authors: Anila Naz, Arusa Lakhani, Kiran Mubeen, Yasmeen Amarsi

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Pakistan's neonatal mortality rate has the highest proportion in the South Asian region and it is higher in the rural areas as compared to the urban areas. Poor resuscitation techniques and lack of basic newborn resuscitation skills in birth attendants, are contributing factors towards neonatal deaths. Based on the significant outcomes of the Helping Baby Breath (HBB) training, a similar training was implemented for Community Midwives (CMWs) in a low resource setting in Gujrat, Pakistan, to improve their knowledge and skills. The training evaluation was conducted and participant feedback was obtained through both qualitative and quantitative methods. The findings of the quantitative assessment of the training evaluation will be published elsewhere. This paper presents the qualitative evaluation of the training. Objective: The objective of the study was to determine the perceptions of HBB trained CMWs about the effectiveness of the HBB training, and the challenges faced in the implementation of HBB skills for newborn resuscitation, at their work settings. The qualitative descriptive design was used in this study. The purposive sampling technique was chosen to recruit midwives and key informants as participants of the training. Interviews were conducted by using a semi-structured interview guide. The study included a total of five interviews: two focus group interviews for CMWs (10 in each group), and three individual interviews of key informants. The content analysis of the qualitative data yielded three themes: the effectiveness of training, challenges, and suggestions. The findings revealed that the HBB training was effective for the CMWs in terms of its usability, regarding improvement in newborn resuscitation knowledge and skills. Moreover, it enhanced confidence and satisfaction in CMWs. However, less volume of patients was a challenge for a few CMWs with regards to practicing their skills. Due to the inadequate number of patients and less opportunities of practice for several CMWs, they required such trainings frequently, in order to maintain their competency. The CMWs also recommended that HBB training should be part of the Midwifery program curriculum. Moreover, similar trainings were also recommended for other healthcare providers working in low resource settings, including doctors and nurses.

Keywords: neonatal resuscitation technique, helping baby breathe, community midwives, training evaluation

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Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

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Authors: László Schmidt

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“Post hoc ergo propter hoc” means after it, therefore because of it. In other words: If event Y followed event X, then event Y must have been caused by event X. The question of causation has long been a central theme in philosophical thought, and many different theories have been put forward. However, causality is an essentially contested concept (ECC), as it has no universally accepted definition and is used differently in everyday, scientific, and legal thinking. In the field of law, the question of causality arises mainly in the context of establishing legal liability: in criminal law and in the rules of civil law on liability for damages arising either from breach of contract or from tort. In the study some philosophical theories of causality will be presented and how these theories correlate with legal causality. It’s quite interesting when philosophical abstractions meet the pragmatic demands of jurisprudence. In Hungarian criminal judicial practice the principle of equivalence of conditions is the generally accepted and applicable standard of causation, where all necessary conditions are considered equivalent and thus a cause. The idea is that without the trigger, the subsequent outcome would not have occurred; all the conditions that led to the subsequent outcome are equivalent. In the case where the trigger that led to the result is accompanied by an additional intervening cause, including an accidental one, independent of the perpetrator, the causal link is not broken, but at most the causal link becomes looser. The importance of the intervening causes in the outcome should be given due weight in the imposition of the sentence. According to court practice if the conduct of the offender sets in motion the causal process which led to the result, it does not exclude his criminal liability and does not interrupt the causal process if other factors, such as the victim's illness, may have contributed to it. The concausa does not break the chain of causation, i.e. the existence of a causal link establish the criminal liability of the offender. Courts also adjudicates that if an act is a cause of the result if the act cannot be omitted without the result being omitted. This essentially assumes a hypothetical elimination procedure, i.e. the act must be omitted in thought and then examined to see whether the result would still occur or whether it would be omitted. On the substantive side, the essential condition for establishing the offence is that the result must be demonstrably connected with the activity committed. The provision on the assessment of the facts beyond reasonable doubt must also apply to the causal link: that is to say, the uncertainty of the causal link between the conduct and the result of the offence precludes the perpetrator from being held liable for the result. Sometimes, however, the courts do not specify in the reasons for their judgments what standard of causation they apply, i.e. on what basis they establish the existence of (legal) causation.

Keywords: causation, Hungarian criminal law, responsibility, philosophy of law

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Authors: Therese Besnard

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Internationally in early childhood education (ECE), the great majority of teachers are women. Some groups believe that a greater male teacher presence in ECE would be beneficial for children, specifically for boys as it could offer a positive male model. It is a common belief that children would benefit from being exposed to both male and female models. Some believe that women are naturally better suited to offer quality care to young children comparatively to men. Some authors bring forth that after equivalent training, differences in the educational practices are purely individual and do not depend on the teacher’s gender. Others believe that a greater male presence in ECE would increase the risk of pedophilia or child abuse. The few scientific studies in this area suggest that differences could exist between male and female ECE teacher, in particular when it comes to play which is the mainstay of the ECE educational program. Male teachers describe themselves as being more playful and having a greater tendency to initiate physical and turbulent play comparatively to female teachers, who describe themselves as favoring games that are calmer and focused on social interaction. Observed directly, male teachers appear more actively engaged in play with children and propose more motor play than female teachers. Furthermore children who have both male and female teachers for one year show less behavior difficulties when compared to children with only female teachers. Despite a variety of viewpoints we don’t know if the educational practices of male ECE teachers, (emotional support, classroom organization or instructional support) are different than the educational practices of female teachers and if these practices are linked with children’s adaptation. This study compares the educational practices of 37 ECE teachers (57 % male) and analyses the link with children' social adaptation (n=221). Educational practices were assessed through observational measurements with the Classroom Assessment Scoring System (CLASS) in a natural class environment. Child social adaptation was assessed with the Social Competence and Behavior Evaluation (SCBE). Observational data reveals no differences between men's and women's scale of the CLASS. Results using Multilevel models analyses suggest that the ability to propose good classroom organization and give good instructional support are linked with better child' social adaptation, and that is always true for men and women teachers. The results are discussed on the basis of their potential impact on future educational interventions.

Keywords: child social adaptation, early childhood education, educational practices, men teacher

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Authors: Ekin Esen, Mohammad Alipour, Riza Kizilel

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Rechargeable lithium-ion batteries have been replacing lead-acid batteries for the last decade due to their outstanding properties such as high energy density, long shelf life, and almost no memory effect. Besides these, being very light compared to lead acid batteries has gained them their dominant place in the portable electronics market, and they are now the leading candidate for electric vehicles (EVs) and hybrid electric vehicles (HEVs). However, their performance strongly depends on temperature, and this causes some inconveniences for their utilization in extreme temperatures. Since weather conditions vary across the globe, this situation limits their utilization for EVs and HEVs and makes a thermal management system obligatory for the battery units. The objective of this study is to understand thermal characteristics of Li-ion battery modules for various operation conditions and design a thermal management system to enhance battery performance in EVs and HEVs. In the first part of our study, we investigated thermal behavior of commercially available pouch type 20Ah LiFePO₄ (LFP) cells under various conditions. Main parameters were chosen as ambient temperature and discharge current rate. Each cell was charged and discharged at temperatures of 0°C, 10°C, 20°C, 30°C, 40°C, and 50°C. The current rate of charging process was 1C while it was 1C, 2C, 3C, 4C, and 5C for discharge process. Temperatures of 7 different points on the cells were measured throughout charging and discharging with N-type thermocouples, and a detailed temperature profile was obtained. In the second part of our study, we connected 4 cells in series by clinching and prepared 4S1P battery modules similar to ones in EVs and HEVs. Three reference points were determined according to the findings of the first part of the study, and a thermocouple is placed on each reference point on the cells composing the 4S1P battery modules. In the end, temperatures of 6 points in the module and 3 points on the top surface were measured and changes in the surface temperatures were recorded for different discharge rates (0.2C, 0.5C, 0.7C, and 1C) at various ambient temperatures (0°C – 50°C). Afterwards, aluminum plates with channels were placed between the cells in the 4S1P battery modules, and temperatures were controlled with airflow. Airflow was provided with a regular compressor, and the effect of flow rate on cell temperature was analyzed. Diameters of the channels were in mm range, and shapes of the channels were determined in order to make the cell temperatures uniform. Results showed that the designed thermal management system could help keeping the cell temperatures in the modules uniform throughout charge and discharge processes. Other than temperature uniformity, the system was also beneficial to keep cell temperature close to the optimum working temperature of Li-ion batteries. It is known that keeping the temperature at an optimum degree and maintaining uniform temperature throughout utilization can help obtaining maximum power from the cells in battery modules for a longer time. Furthermore, it will increase safety by decreasing the risk of thermal runaways. Therefore, the current study is believed to be beneficial for wider use of Li batteries for battery modules of EVs and HEVs globally.

Keywords: lithium ion batteries, thermal management system, electric vehicles, hybrid electric vehicles

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Authors: Svetlana Kostrubina, Anastasia Prokopeva

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This research presents a comprehensive study of the word formation processes in computer terminology within English and Russian languages and provides listeners with a system of exercises for training these skills. The originality is that this study focuses on a comparative approach, which shows both general patterns and specific features of English and Russian computer terms word formation. The key point is the system of exercises development for training computer terminology based on Bloom’s taxonomy. Data contain 486 units (228 English terms from the Glossary of Computer Terms and 258 Russian terms from the Terminological Dictionary-Reference Book). The objective is to identify the main affixation models in the English and Russian computer terms formation and to develop exercises. To achieve this goal, the authors employed Bloom’s Taxonomy as a methodological framework to create a systematic exercise program aimed at enhancing students’ cognitive skills in analyzing, applying, and evaluating computer terms. The exercises are appropriate for various levels of learning, from basic recall of definitions to higher-order thinking skills, such as synthesizing new terms and critically assessing their usage in different contexts. Methodology also includes: a method of scientific and theoretical analysis for systematization of linguistic concepts and clarification of the conceptual and terminological apparatus; a method of nominative and derivative analysis for identifying word-formation types; a method of word-formation analysis for organizing linguistic units; a classification method for determining structural types of abbreviations applicable to the field of computer communication; a quantitative analysis technique for determining the productivity of methods for forming abbreviations of computer vocabulary based on the English and Russian computer terms, as well as a technique of tabular data processing for a visual presentation of the results obtained. a technique of interlingua comparison for identifying common and different features of abbreviations of computer terms in the Russian and English languages. The research shows that affixation retains its productivity in the English and Russian computer terms formation. Bloom’s taxonomy allows us to plan a training program and predict the effectiveness of the compiled program based on the assessment of the teaching methods used.

Keywords: word formation, affixation, computer terms, Bloom's taxonomy

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Authors: Noor Taleb Ismael, Areej Abd Al Kareem Al Titi, Ala'a Fayez Jaber

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Objectives: To investigate self-perceived functional performance among adults with IDD who are Jordanian residential care and rehabilitation centers residents. Also, to investigate their functional abilities (i.e., motor, and cognitive). In addition, to determine the motor and cognitive predictors of their functional performance. Methods: The study utilized a cross-sectional descriptive design; the sample included 180 individuals with IDD (90 males and 90 females) aged 18 to 75 years. The inclusion criteria encompassed: 1) Adults with a confirmed IDD by their physician’s professional and 2) residents in Jordanian Residential Care and Rehabilitation Centers affiliated with the Jordanian Ministry of Social Development. The exclusion criteria were: 1) bedridden or totally dependent on their care providers; 2) who had an accident or acquired neurological conditions. Researchers conducted semi-structured interviews to complete the outcome measures that include the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), the Montreal Cognitive Assessment (MoCA), the Mini-Mental Status Examination (MMSE), and the sociodemographic questionnaire. Data analyses consisted of descriptive statistics, analysis of frequencies, correlation, and regression analyses. Result: Individuals with IDD showed low functional performance in all daily life areas, including self-care, productivity, and leisure; there was severe cognitive impairment and poor independence and functional performance. (COPM Performance M= 1.433, SD±.57021, COPM Satisfaction M= 1.31, SD±.54, FIM M= 3.673, SD± 1.7918). Two predictive models were validated for the COPM performance and FIM total scores. First, significant predictors of high self-perceived functional performance on COPM were high scores on FIM Motor sub scores, FIM cognitive sub scores, young age, and having a high school educational level (R2=0.603, p=0.012). Second, significant predictors of high functional capacity on FIM were a high score on the COPM performance subscale, a high MMSE score, and having a cerebral palsy (CP) diagnosis (R2=0.671, p<0.001). Conclusions: Evaluating functional performance and associated factors is important in rehabilitation to provide better services and improve health and QoL for individuals with IDD. This study suggested conducting future studies targeting integrated individuals with IDD who live with their families in the communities.

Keywords: functional performance, intellectual and developmental disabilty, cognitive abilities, motor abilities

Procedia PDF Downloads 48

Authors: Jo Angouri, Charlotte Kennedy, Shawnea Ting, David Rawlinson, Matthew Booker, Nigel Rees

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Ambulance services need to balance the large volume of emergency (999 in the UK) calls they receive (e.g., West Midlands Ambulance Service reports per day about 4,000 999 calls; about 679,000 calls per year are received in Wales), with dispatching limited resource for on-site intervention to the most critical cases. The process by which Emergency Medical Dispatch (EMD) decisions are made is related to risk assessment and involves the caller and call-taker as well as clinical teams negotiating risk levels on a case-by-case basis. Medical Priority Dispatch System (MPDS – also referred to as Advanced Medical Priority Dispatch System AMPDS) are used in the UK by NHS Trusts (e.,g WAST) to process and prioritise 999 calls. MPDS / AMPDS provide structured protocols for call prioritisation and call management. Protocols/policy frameworks have not been examined before in the way we propose in our project. In more detail, the risk factors that play a role in the EMD negotiation between the caller and call-taker have been analysed in both medical and social science research. Research has focused on the structural, morphological and phonological aspects that could improve, and train, human-to-human interaction or automate risk detection, as well as the medical factors that need to be captured from the caller to inform the dispatch decision. There are two significant gaps in our knowledge that we address in our work: 1. the role of backstage clinical teams in translating the caller/call-taker interaction in their internal risk negotiation and, 2. the role of policy frameworks, protocols and regulations in the framing of institutional priorities and resource allocation. We take a multi method approach and combine the analysis of 999 calls with the analysis of policy documents. We draw on interaction analysis, corpus methodologies and thematic analysis. In this paper, we report on our preliminary findings and focus in particular on the risk factors we have identified and the relationship with the regulations that create the frame within which teams operate. We close the paper with implications of our study for providing evidence-based policy intervention and recommendations for further research.

Keywords: emergency (999) call, interaction analysis, discourse analysis, ambulance dispatch, medical discourse

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Authors: Namasivayam Navaranjan, Eric Dimla

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The world needs more quality food, shelter and transportation to meet the demands of growing population and improving living standard of those who currently live below the poverty line. Materials are essential commodities for various applications including food and pharmaceutical packaging, building and automobile. Petroleum based plastics are widely used materials amongst others for these applications and their demand is expected to increase. Use of plastics has environment related issues because considerable amount of plastic used worldwide is disposed in landfills, where its resources are wasted, the material takes up valuable space and blights communities. Some countries have been implementing regulations and/or legislations to increase reuse, recycle, renew and remanufacture materials as well as to minimise the use of non-environmentally friendly materials such as petroleum plastics. However, issue of material waste is still a concern in the countries who have low environmental regulations. Development of materials, mostly bioplastics from renewable biomass resources has become popular in the last decade. It is widely believed that the potential for up to 90% substitution of total plastics consumption by bioplastics is technically possible. The global demand for bioplastics is estimated to be approximately six times larger than in 2010. Recently, standard polymers like polyethylene (PE), polypropylene (PP), Polyvinyl Chloride (PVC) or Polyethylene terephthalate (PET), but also high-performance polymers such as polyamides or polyesters have been totally or partially substituted by their renewable equivalents. An example is Polylactide (PLA) being used as a substitute in films and injection moulded products made of petroleum plastics, e.g. PET. The starting raw materials for bio-based materials are usually sugars or starches that are mostly derived from food resources, partially also recycled materials from food or wood processing. The risk in lower food availability by increasing price of basic grains as a result of competition with biomass-based product sectors for feedstock also needs to be considered for the future bioplastic production. Manufacturing of bioplastic materials is often still reliant upon petroleum as an energy and materials source. Life Cycle Assessment (LCA) of bioplastic products has being conducted to determine the sustainability of a production route. However, the accuracy of LCA depends on several factors and needs improvement. Low oil price and high production cost may also limit the technically possible growth of these plastics in the coming years.

Keywords: bioplastics, plastics, renewable resources, biomass

Procedia PDF Downloads 308

Authors: Niyongabo Elyse

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Prefabricated building construction is a pioneering approach that combines design, production, and assembly to attain energy efficiency, environmental sustainability, and economic feasibility. Despite continuous development in the industry in China, the low technical maturity of standardized design, factory production, and construction assembly introduces uncertainties affecting prefabricated component production and on-site assembly processes. This research focuses on enhancing project management performance under uncertainty to help enterprises navigate these challenges and optimize project resources. The study introduces a perspective on how uncertain factors influence the implementation of prefabricated building construction projects. It proposes a theoretical model considering project process management ability, adaptability to uncertain environments, and collaboration ability of project participants. The impact of uncertain factors is demonstrated through case studies and quantitative analysis, revealing constraints on implementation time, cost, quality, and safety. To address uncertainties in prefabricated component production scheduling, a fuzzy model is presented, expressing processing times in interval values. The model utilizes a cooperative co-evolution evolution algorithm (CCEA) to optimize scheduling, demonstrated through a real case study showcasing reduced project duration and minimized effects of processing time disturbances. Additionally, the research addresses on-site assembly construction scheduling, considering the relationship between task processing times and assigned resources. A multi-objective model with fuzzy activity durations is proposed, employing a hybrid cooperative co-evolution evolution algorithm (HCCEA) to optimize project scheduling. Results from real case studies indicate improved project performance in terms of duration, cost, and resilience to processing time delays and resource changes. The study also introduces a multistage dynamic process control model, utilizing IoT technology for real-time monitoring during component production and construction assembly. This approach dynamically adjusts schedules when constraints arise, leading to enhanced project management performance, as demonstrated in a real prefabricated housing project. Key contributions include a fuzzy prefabricated components production scheduling model, a multi-objective multi-mode resource-constrained construction project scheduling model with fuzzy activity durations, a multi-stage dynamic process control model, and a cooperative co-evolution evolution algorithm. The integrated mathematical model addresses the complexity of prefabricated building construction project management, providing a theoretical foundation for practical decision-making in the field.

Keywords: prefabricated construction, project management performance, uncertainty, fuzzy scheduling

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Authors: Sweta Pandey, Samridhi Dhyani, Susmita Chaudhuri

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Klebsiella pneumoniae bacteria is a global threat to human health due to an increase in multi-drug resistance among strains. The hypervirulent strains of Klebsiella pneumoniae is a major trouble due to their association with life-threatening infections in a healthy population. One of the major virulence factors of hyper virulent strains of Klebsiella pneumoniae is the T6SS (Type six secretary system) which is majorly involved in microbial antagonism and causes interaction with the host eukaryotic cells during infections. T6SS mediates some of the crucial factors for establishing infection by the bacteria, such as cell adherence, invasion, and subsequent in vivo colonisation. The antibacterial activity and the cell invasion property of the T6SS system is a major requirement for the establishment of K. pneumoniae infections within the gut. The T6SS can be an appropriate target for developing therapeutics. The T6SS consists of an inner tube comprising hexamers of Hcp (Haemolysin -regulated protein) protein, and at the top of this tube sits VgrG (Valine glycine repeat protein G); the tip of the machinery consists of PAAR domain containing proteins which act as a delivery system for bacterial effectors. For this study, immune response to recombinant VgrG protein was generated to establish this protein as a potential immunogen for the development of therapeutic leads. The immunogenicity of the selected protein was determined by predicting the B cell epitopes by the BCEP analysis tool. The gene sequence for multiple domains of VgrG protein (phage_base_V, T6SS_Vgr, DUF2345) was selected and cloned in pMAL vector in E. coli. The construct was subcloned and expressed as a fusion protein of 203 residue protein with mannose binding protein tag (MBP) to enhance solubility and purification of this protein. The purified recombinant VgrG fusion protein was used for mice immunisation. The antiserum showed reactivity with the recombinant VgrG in ELISA and western blot. The immunised mice were challenged with K. pneumoniae bacteria and showed bacterial clearance in immunised mice. The recombinant VgrG protein can further be used for studying downstream signalling of VgrG protein in mice during infection and for therapeutic MAb development to eradicate K. pneumoniae infections.

Keywords: immune response, Klebsiella pneumoniae, multi-drug resistance, recombinant protein expression, T6SS, VgrG

Procedia PDF Downloads 103

Authors: Shivani Thakur, Jasmin Dominguez Cervantes, Ahmed Zabiba, Fatima Zabiba, Sandhini Agarwal, Kamalpreet Kaur, Hussein Maatouk, Shae Chand, Omar Madriz, Tiffany Huang, Saloni Bansal

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The prevalence of lymphedema in women in rural communities highlights the importance of developing effective treatment and prevention methods. Subjects with secondary lymphedema in California’s Central Valley were surveyed at 6 surgical clinics to assess demographics and symptoms of lymphedema. Additionally, subjects on semaglutide treatment for obesity and/or T2DM were monitored for their diabetes management, weight loss progress, and lymphedema symptoms compared to subjects who were not treated with semaglutide. The subjects were followed for 12 months. Subjects who were treated with semaglutide completed pre-treatment questionnaires and follow-up post-treatment questionnaires at 3, 6, 9, 12 months, along with medical assessment. The untreated subjects completed similar questionnaires. The questionnaires investigated subjective feelings regarding lymphedema symptoms and management using a Likert-scale; quantitative leg measurements were collected, and blood work reviewed at these appointments. Paired difference t-tests, chi-squared tests, and independent sample t-tests were performed. 50 subjects, aged 18-75 years, completed the surveys evaluating secondary lymphedema: 90% female, 69% Hispanic, 45% Spanish speaking, 42% disabled, 57 % employed, 54% income range below 30 thousand dollars, and average BMI of 40. Both treatment and non-treatment groups noted the most common symptoms were leg swelling (x̄=3.2, ▁d= 1.3), leg pain (x̄=3.2, ▁d=1.6 ), loss of daily function (x̄=3, ▁d=1.4 ), and negative body image (x̄=4.4, ▁d=0.54). Subjects in the semaglutide treatment group >3 months of treatment compared to the untreated group demonstrated: 55% subject in the treated group had a 10% weight loss vs 3% in the untreated group (average BMI reduction by 11% vs untreated by 2.5%, p<0.05) and improved subjective feelings about their lymphedema symptoms: leg swelling (x̄=2.4, ▁d=0.45 vs x̄=3.2, ▁d=1.3, p<0.05), leg pain (x̄=2.2, ▁d=0.45 vs x̄= 3.2, ▁d= 1.6, p<0.05), and heaviness (x̄=2.2, ▁d=0.45 vs x̄=3, ▁d=1.56, p<0.05). Improvement in diabetes management was demonstrated by an average of 0.9 % decrease in A1C values compared to untreated 0.1 %, p<0.05. In comparison to untreated subjects, treatment subjects on semaglutide noted 6 cm decrease in the circumference of the leg, knee, calf, and ankle compared to 2 cm in untreated subjects, p<0.05. Semaglutide was shown to significantly improve weight loss, T2DM management, leg circumference, and secondary lymphedema functional, physical and psychosocial symptoms.

Keywords: diabetes, secondary lymphedema, semaglutide, obesity

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Authors: Shayma Mohammed, Adel Trabelsi

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Radiopharmacy is the art of preparing high-quality, radioactive, medicinal products for use in diagnosis and therapy. Radiopharmaceuticals unlike normal medicines, this dual aspect (radioactive, medical) makes their management highly critical. One of the most convincing applications of modern technologies is the ability to delegate the execution of repetitive tasks to programming scripts. Automation has found its way to the most skilled jobs, to improve the company's overall performance by allowing human workers to focus on more important tasks than document filling. This project aims to contribute to implement a comprehensive system to insure rigorous management of radiopharmaceuticals through the use of a platform that links the Nuclear Medicine Service Management System to the Nuclear Radio-pharmacy Management System in accordance with the recommendations of World Health Organization (WHO) and International Atomic Energy Agency (IAEA). In this project we attempt to build a web application that targets radiopharmacies, the platform is built atop the inherently compatible web stack which allows it to work in virtually any environment. Different technologies are used in this project (PHP, Symfony, MySQL Workbench, Bootstrap, Angular 7, Visual Studio Code and TypeScript). The operating principle of the platform is mainly based on two parts: Radiopharmaceutical Backoffice for the Radiopharmacian, who is responsible for the realization of radiopharmaceutical preparations and their delivery and Medical Backoffice for the Doctor, who holds the authorization for the possession and use of radionuclides and he/she is responsible for ordering radioactive products. The application consists of sven modules: Production, Quality Control/Quality Assurance, Release, General Management, References, Transport and Stock Management. It allows 8 classes of users: The Production Manager (PM), Quality Control Manager (QCM), Stock Manager (SM), General Manager (GM), Client (Doctor), Parking and Transport Manager (PTM), Qualified Person (QP) and Technical and Production Staff. Digital platform bringing together all players involved in the use of radiopharmaceuticals and integrating the stages of preparation, production and distribution, Web technologies, in particular, promise to offer all the benefits of automation while requiring no more than a web browser to act as a user client, which is a strength because the web stack is by nature multi-platform. This platform will provide a traceability system for radiopharmaceuticals products to ensure the safety and radioprotection of actors and of patients. The new integrated platform is an alternative to write all the boilerplate paperwork manually, which is a tedious and error-prone task. It would minimize manual human manipulation, which has proven to be the main source of error in nuclear medicine. A codified electronic transfer of information from radiopharmaceutical preparation to delivery will further reduce the risk of maladministration.

Keywords: automated system, management, radiopharmacy, technical papers

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Authors: Maryam Tabrizi, Shahrzad Aarup

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Objectives- Understanding the close association between oral health and overall health for older adults at the right time and right place, a person, focus treatment through Project ECHO telementoring. Methodology- Data from monthly ECHO telementoring sessions were provided for three years. Sessions including case presentations, overall health conditions, considering medications, organ functions limitations, including the level of cognition. Contributions- Providing the specialist level of providing care to all elderly regardless of their location and other health conditions and decreasing oral health inequity by increasing workforce via Project ECHO telementoring program worldwide. By 2030, the number of adults in the USA over the age of 65 will increase more than 60% (approx.46 million) and over 22 million (30%) of 74 million older Americans will need specialized geriatrician care. In 2025, a national shortage of medical geriatricians will be close to 27,000. Most individuals 65 and older do not receive oral health care due to lack of access, availability, or affordability. One of the main reasons is a significant shortage of Oral Health (OH) education and resources for the elderly, particularly in rural areas. Poor OH is a social stigma, a thread to quality and safety of overall health of the elderly with physical and cognitive decline. Poor OH conditions may be costly and sometimes life-threatening. Non-traumatic dental-related emergency department use in Texas alone was over $250 M in 2016. Most elderly over the age of 65 present with at least one or multiple chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are at higher risk to develop gum (periodontal) disease, yet they are less likely to get dental care. In addition, most older adults take both prescription and over-the-counter drugs; according to scientific studies, many of these medications cause dry mouth. Reduced saliva flow due to aging and medications may increase the risk of cavities and other oral conditions. Most dental schools have already increased geriatrics OH in their educational curriculums, but the aging population growth worldwide is faster than growing geriatrics dentists. However, without the use of advanced technology and creating a network between specialists and primary care providers, it is impossible to increase the workforce, provide equitable oral health to the elderly. Project ECHO is a guided practice model that revolutionizes health education and increases the workforce to provide best-practice specialty care and reduce health disparities. Training oral health providers for utilizing the Project ECHO model is a logical response to the shortage and increases oral health access to the elderly. Project ECHO trains general dentists & hygienists to provide specialty care services. This means more elderly can get the care they need, in the right place, at the right time, with better treatment outcomes and reduces costs.

Keywords: geriatric, oral health, project echo, chronic disease, oral health

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Authors: Noel Smith

Abstract:

To achieve professional registration, UK social workers need to complete a programme of education and training which meets standards set down by central government. When it comes to practice, social work in local authorities must fulfil requirements of national legislation but there is considerable local variation in the organisation and delivery of services. This presentation discusses the on-going reform of social work education by central government in the context of research of social work services in a local authority. In doing so it highlights that the ‘direction of travel’ of the national reform of social work education seems at odds with the trajectory of development of local social work services. In terms of education reform, the presentation cites key government initiatives including the knowledge and skills requirements which have been published separately for, respectively, child and family social work and adult social work. Also relevant is the Government’s new ‘teaching partnership’ pilot which focuses exclusively on social work in local government, in isolation from social work in NGOs. In terms of research, the presentation discusses two studies undertaken by Professor Smith in Suffolk County Council, a local authority in the east of England. The first is an equality impact analysis of the introduction of a new model for the delivery of adult and community services in Suffolk. This is based on qualitative research with local government representatives and NGOs involved in social work with older people and people with disabilities. The second study is an on-going, mixed method evaluation of the introduction of a new model of social care for children and young people in Suffolk. This new model is based on the international ‘Signs of Safety’ approach, which is applied in this model to a wide range of services from early intervention to child protection. While both studies are localised, the service models they examine are good illustrations of the way services are developing nationally. Analysis of these studies suggest that, if services continue to develop as they currently are, then social workers will require particular skills which are not be adequately addressed in the Government’s plans for social work education. Two issues arise. First, education reform concentrates on social work within local government while increasingly local authorities are outsourcing service provision to NGOs, expecting greater community involvement in providing care, and integrating social care with health care services. Second, education reform focuses on the different skills required for working with older and disabled adults and working with children and families, to the point where potentially the profession would be fragmented into two different classes of social worker. In contrast, the development of adult and children’s services in local authorities re-asserts the importance of common social work skills relating to personalisation, prevention and community development. The presentation highlights the importance for social work education in the UK to be forward looking, in terms of the changing design of service delivery, and outward looking, in terms of lessons to be drawn from international social work.

Keywords: adult social work, children and families social work, European social work, social work education

Procedia PDF Downloads 300

Authors: Jifeng Zhang , Yongpeng Lei

Abstract:

Continuous carbon fiber reinforced polyamide 6 (CF/PA6) composites are potential for application in the automotive industry due to their high specific strength and stiffness. However, PA6 resin is sensitive to the moisture in the hydrothermal environment and CF/PA6 composites might undergo several physical and chemical changes, such as plasticization, swelling, and hydrolysis, which induces a reduction of mechanical properties. So far, little research has been reported on the assessment of the effects of hydrothermal aging on the mechanical properties of continuous CF/PA6 composite. This study deals with the effects of hydrothermal aging on moisture absorption and mechanical properties of polyamide 6 (PA6) and polyamide 6 reinforced with continuous carbon fibers composites (CF/PA6) by immersion in distilled water at 30 ℃, 50 ℃, 70 ℃, and 90 ℃. Degradation of mechanical performance has been monitored, depending on the water absorption content and the aging temperature. The experimental results reveal that under the same aging condition, the PA6 resin absorbs more water than the CF/PA6 composite, while the water diffusion coefficient of CF/PA6 composite is higher than that of PA6 resin because of interfacial diffusion channel. In mechanical properties degradation process, an exponential reduction in tensile strength and elastic modulus are observed in PA6 resin as aging temperature and water absorption content increases. The degradation trend of flexural properties of CF/PA6 is the same as that of tensile properties of PA6 resin. Moreover, the water content plays a decisive role in mechanical degradation compared with aging temperature. In contrast, hydrothermal environment has mild effect on the tensile properties of CF/PA6 composites. The elongation at breakage of PA6 resin and CF/PA6 reaches the highest value when their water content reaches 6% and 4%, respectively. Dynamic mechanical analysis (DMA) and scanning electron microscope (SEM) were also used to explain the mechanism of mechanical properties alteration. After exposed to the hydrothermal environment, the Tg (glass transition temperature) of samples decreases dramatically with water content increase. This reduction can be ascribed to the plasticization effect of water. For the unaged specimens, the fibers surface is coated with resin and the main fracture mode is fiber breakage, indicating that a good adhesion between fiber and matrix. However, with absorbed water content increasing, the fracture mode transforms to fiber pullout. Finally, based on Arrhenius methodology, a predictive model with relate to the temperature and water content has been presented to estimate the retention of mechanical properties for PA6 and CF/PA6.

Keywords: continuous carbon fiber reinforced polyamide 6 composite, hydrothermal aging, Arrhenius methodology, interface

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