Search results for: post combustion CO2 capture

Authors: Ismail Cengiz, Faruk Elaldi

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Within the scope of the study presented in this paper, load carrying capacity and buckling behavior of a stiffened aluminum panel designed by adopting current ‘buckle-resistant’ design application and ‘Post –Buckling’ design approach were investigated experimentally and numerically. The test specimen that is stabilized by Z-type stiffeners and manufactured from aluminum 2024 T3 Clad material was test under compression load. Buckling behavior was observed by means of 3 – dimensional digital image correlation (DIC) and strain gauge pairs. The experimental study was followed by developing an efficient and reliable finite element model whose ability to predict behavior of the stiffened panel used for compression test is verified by compering experimental and numerical results in terms of load – shortening curve, strain-load curves and buckling mode shapes. While finite element model was being constructed, non-linear behaviors associated with material and geometry was considered. Finally, applicability of aluminum stiffened panel in airframe design against to composite structures was evaluated thorough the concept of ‘Structural Efficiency’. This study reveals that considerable amount of weight saving could be gained if the concept of ‘post-buckling design’ is preferred to the already conventionally used ‘buckle resistant design’ concept in aircraft industry without scarifying any of structural integrity under load spectrum.

Keywords: post-buckling, stiffened panel, non-linear finite element method, aluminum, structural efficiency

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Authors: Fred N. H. Parker, Nicola T. Fear, S. A. M. Stevelink, L. Rafferty

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Purpose Auditory problems, such as hearing loss and tinnitus, have been associated with mental health problems and alcohol misuse in the UK general population and in the US Armed Forces; however, few studies have examined these associations within the UK Armed Forces. The present study examined the association between auditory problems and probable common mental disorders, post-traumatic stress disorder and alcohol misuse. Methods 5474 serving and ex-service personnel from the UK Armed Forces were examined, selected from those who responded to phase two (data collection 2007–09) and phase three (2014–16) of a military cohort study. Multivariable logistic regression was used to examine the association between auditory problems at phase two and mental health problems at phase three. Results 9.7% of participants reported ever experiencing hearing problems alone, 7.9% reported tinnitus within the last month alone, and 7.8% reported hearing problems with tinnitus. After adjustment, hearing problems with tinnitus at phase two was associated with increased odds of probable common mental disorders (AOR = 1.50, 95% CI 1.09–2.08), post-traumatic stress disorder (AOR = 2.30, 95% CI 1.41–3.76), and alcohol misuse (AOR = 1.94, 95% CI 1.28–2.96) at phase three. Tinnitus alone was associated with probable post-traumatic stress disorder (AOR = 1.80, 95% CI 1.03–3.15); however, hearing problems alone were not associated with any outcomes of interest. Conclusions The association between auditory problems and mental health problems emphasizes the importance of the prevention of auditory problems in the Armed Forces: through enhanced audiometric screening, improved hearing protection equipment, and greater levels of utilization of such equipment.

Keywords: armed forces, hearing problems, tinnitus, mental health, alcohol misuse

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Authors: Kay-Anne Haykal, Issack Biyong

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The post-traumatic stress disorder (PTSD) rises from exposure to a traumatic event and appears by a persistent experience of this event. Several psychiatric co-morbidities are associated with PTSD and include mood disorders, anxiety disorders, and substance abuse. The main objective was to compare the criteria for PTSD according to the literature to those used to diagnose a patient in a francophone hospital and to check the correspondence of these two criteria. 700 medical charts of admitted patients on the medicine or psychiatric unit at the Montfort Hospital were identified with the following diagnoses: major depressive disorder, bipolar disorder, anxiety disorder, substance abuse, and PTSD for the period of time between April 2005 and March 2006. Multiple demographic criteria were assembled. Also, for every chart analyzed, the PTSD criteria, according to the Manual of Mental Disorders (DSM) IV were found, identified, and grouped according to pre-established codes. An analysis using the receiver operating characteristic (ROC) method was elaborated for the study of data. A sample of 57 women and 50 men was studied. Age was varying between 18 and 88 years with a median age of 48. According to the PTSD criteria in the DSM IV, 12 patients should have the diagnosis of PTSD in opposition to only two identified in the medical charts. The ROC method establishes that with the combination of data from PTSD and depression, the sensitivity varies between 0,127 and 0,282, and the specificity varies between 0,889 and 0,917. Otherwise, if we examine the PTSD data alone, the sensibility jumps to 0.50, and the specificity varies between 0,781 and 0,895. This study confirms the presence of an underdiagnosed and treated PTSD that causes severe perturbations for the affected individual.

Keywords: post-traumatic stress disorder, co-morbidities, diagnosis, mental health disorders

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Authors: Scott Cavinder

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Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

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Authors: Nacira Mecheri, N. Boussid

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A new chemical mechanism designed to study the process of forming the first aromatic ring (benzene) and polycyclic aromatic hydrocarbons (PAH) from a flame of acetylene (C2H2) has been developed. The mechanism developed, contains 50 chemical species involved in 268 reversible elementary reactions. The comparison between the results from modelling and experimental measurements allowed us to test the validity of the postulated mechanism in specific experimental conditions. Kinetic analysis of the flame by calculating the maximum rates for each elementary reaction, allowed us to identify key reactions pathways of consumption and formation of main precursors of soot.

Keywords: benzene, PAH, acetylene, modeling, flame, soot

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Authors: Mirza Obaid Baig, MaimoonaYaqub

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A 51 year old lady; known case of diabetes mellitus, post wound debridement i.e. 4 open wounds of grade III presented to us with foot drop, with prominent sensory deficit over right lower leg/foot i.e. 0 on Nottingham scale for impaired sensation, marked pedal edema and 5/10 – 6/10 pain on VAS during day and night respectively, Wounds were poorly granulated and foul smelling. Physiotherapy sessions were planned including twice a day electrical muscle stimulation sessions, strategies to decrease edema and improve muscle action which resulted in noticeable improvement in motor and sensory ability, pain levels, edema and psychological status of patient. Thus, this study gives evidence of the effect of Electrical muscle stimulation in grade III open wounds associated with motor/sensory weakness post-surgery.

Keywords: EMS, foot drop, grade III wound, diabetes mellitus

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Authors: Hanee Ryu

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The former president Lee Myung-bak's administration of Korea presented “green growth” as a catchphrase from 2008. He declared “low-carbon, green growth” the nation's vision for the next decade according to United Nation Framework on Climate Change. The government designed omnidirectional policy for low-carbon and green growth with concentrating all effort of departments. The structural change was expected because this slogan is the identity of the government, which is strongly driven with the whole department. After his administration ends, the purpose of this paper is to quantify the policy effect and to compare with the value of the other OECD countries. The major target values under direct policy objectives were suggested, but it could not capture the entire landscape on which the policy makes changes. This paper figures out the policy impacts through comparing the value of ex-ante between the one of ex-post. Furthermore, each index level of Korea’s low-carbon and green growth comparing with the value of the other OECD countries. To measure the policy effect, indicators international organizations have developed are considered. Environmental Sustainable Index (ESI) and Environmental Performance Index (EPI) have been developed by Yale University’s Center for Environmental Law and Policy and Columbia University’s Center for International Earth Science Information Network in collaboration with the World Economic Forum and Joint Research Center of European Commission. It has been widely used to assess the level of natural resource endowments, pollution level, environmental management efforts and society’s capacity to improve its environmental performance over time. Recently OCED publish the Green Growth Indicator for monitoring progress towards green growth based on internationally comparable data. They build up the conceptual framework and select indicators according to well specified criteria: economic activities, natural asset base, environmental dimension of quality of life and economic opportunities and policy response. It considers the socio-economic context and reflects the characteristic of growth. Some selected indicators are used for measuring the level of changes the green growth policies have induced in this paper. As results, the CO2 productivity and energy productivity show trends of declination. It means that policy intended industry structure shift for achieving carbon emission target affects weakly in the short-term. Increasing green technologies patents might result from the investment of previous period. The increasing of official development aids which can be immediately embarked by political decision with no time lag present only in 2008-2009. It means international collaboration and investment to developing countries via ODA has not succeeded since the initial stage of his administration. The green growth framework makes the public expect structural change, but it shows sporadic effect. It needs organization to manage it in terms of the long-range perspectives. Energy, climate change and green growth are not the issue to be handled in the one period of the administration. The policy mechanism to transfer cost problem to value creation should be developed consistently.

Keywords: comparing ex-ante between ex-post indicator, green growth indicator, implication for green growth policy, measuring policy effect

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Authors: Waqas Mehdi, Muhammad Umar Hassan, Khadeeja Mustafa

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Objective: Post-concussion syndrome (PCS) is a medical term used to point out the complicated combination of physical, emotional, cognitive and behavioral signs and symptoms associated with Mild Traumatic Brain Injury(mTBI). This study was conducted to assess the improvement or debilitating effect of behavioral therapy in addition to the conventional treatment and to document these results for increasing the efficiency of treatment provided to such cases. Method: This was primarily an interventional prospective cohort study which was conducted in the Department of Neurosurgery, Mayo Hospital Lahore. The sample size was 200 patients who were randomly distributed into two groups. The interventional group with Cognitive behavioral therapy was added in addition to the conventional treatment regimen and the Control group receiving only conventional treatment. Results were noted initially as well as after two weeks of the follow-up period. Data were subsequently analyzed by Statistical Package for Social Sciences (SPSS) software and associations worked out. Result and conclusion: Among the patients that were given therapy sessions along with conventional medicine, there was a significant improvement in the symptoms and their overall quality of life. It is also important to notice that the time period taken for these effects to wane is cut down by psychiatric solutions too. So we can conclude that CBT sessions not only speed up recovery in patients with post-concussion syndrome they also aid in the efficiency improvement in functional capability and quality of life.

Keywords: neurosurgery, CBT, PCS, mTBI

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Authors: Florian Mach, Eric Hund, Malte Stonis

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The dismantling of disused industrial facilities such as nuclear power plants or refineries is an enormous challenge for the planning and control of the logistic processes. Existing control models do not meet the requirements for a proper dismantling of industrial plants. Therefore, the paper presents an approach for the control of dismantling and post-processing processes (e.g. decontamination) in plant decommissioning. In contrast to existing approaches, the dismantling sequence and depth are selected depending on the capacity utilization of required post-processing processes by also considering individual characteristics of respective dismantling tasks (e.g. decontamination success rate, uncertainties regarding the process times). The results can be used in the dismantling of industrial plants (e.g. nuclear power plants) to reduce dismantling time and costs by avoiding bottlenecks such as capacity constraints.

Keywords: dismantling management, logistics planning and control models, nuclear power plant dismantling, reverse logistics

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Authors: Yea-Pyng Lin

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Dignity is a core element of nursing care. Maintaining the dignity of patients is an important issue because the health and recovery of patients can be adversely affected by a lack of dignity in their care. The aim of this study was to explore the effects of a nursing dignity care program upon patients’ dignity in care. A quasi-experimental research design was implemented. Nurses were recruited by purposive sampling, and their patients were recruited by simple random sampling. Nurses in the experimental group received the nursing educational program on dignity care, while nurses in the control group received in-service education as usual. Data were collected via two instruments: the dignity in care scale for nurses and the dignity in care scale to patients, both of which were developed by the researcher. Both questionnaires consisted of three domains: agreement, importance, and frequencies of providing dignity care. A total of 178 nurses in the experimental group and 193 nurses in the control group completed the pretest and the follow-up evaluations at the first month, the third month, and the sixth month. The number of patients who were cared for by the nurses in the experimental group was 94 in the pretest. The number of patients in the post-test at the first, third, and sixth months were 91, 85, and 77, respectively. In the control group, 88 patients completed the II pretest, and 80 filled out the post-test at the first month, 77 at the third, and 74 at the sixth month. The major findings revealed the scores of agreement domain among nurses in the experimental group were found significantly different from those who in the control group at each point of time. The scores of importance domain between these two groups also displayed significant differences at pretest and the first month of post-test. Moreover, the frequencies of proving dignity care to patients were significant at pretest, the third month and sixth month of post-test. However, the experimental group had only significantly different from those who in the control group on the frequencies of receiving dignity care especially in the items of ‘privacy care,’ ‘communication care,’ and ‘emotional care’ for the patients. The results show that the nursing program on dignity care could increase nurses’ dignity care for patients in three domains of agreement, importance, and frequencies of providing dignity care. For patients, only the frequencies of receiving dignity care were significantly increased. Therefore, the nursing program on dignity care could be applicable for nurses’ in-service education and practice to enhance the ability of nurses to care for patient’s dignity.

Keywords: nurses, patients, dignity care, quasi-experimental, nursing education

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Authors: Xuefan Li, Donghua Li, Juanjuan Li

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This study explores the changes in policies toward Chinese students studying abroad in different countries during the pre-pandemic, pandemic, and post-pandemic periods. Interviews and questionnaire surveys were conducted with participating institutions at the China International Education Exhibition. The results indicate that institutions were impacted by the pandemic differently, with a gradual recovery in the two years following the initial outbreak. Institutions encourage and support Chinese students to resume offline studies during the post-pandemic period. The impact of the pandemic on the recruitment of Chinese students by international institutions varied, with different measures being adopted by different institutions. Compared with universities, colleges were more affected in terms of student employment rates. Some institutions were able to respond quickly and effectively to the pandemic due to their online teaching platforms. Overall, this study is expected to provide insights into the changes in policies toward Chinese students studying abroad during the pandemic and highlights the diverse responses of international institutions.

Keywords: international education, Chinese international education, COVID-19 pandemic, international institutions

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Authors: Steven D. Capener

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The 1997 Asian financial crisis was a watershed event in Korea as it necessitated changes that begin an unravelling of many of the norms and traditions that had served to underpin society. Divorce skyrocketed; the era of lifetime employment was over; women came out the home to become, in many cases, the main breadwinners; competitive forces were exacerbated; and traditional sources of authority began to crumble. All of these changes weekend the power to structure human relations of the Confucian Three Bonds and Five Relationships (삼강오륜). Since then, this “de-confucianization” has only become more pronounced with women increasingly refusing to marry, partly in protest to what they perceive as entrenched gender inequality, married couples eschewing childbirth resulting in the lowest birthrate in the world, and diminishing inheritances eroding the traditionally strong sense of filial piety (효) of children toward parents. The result of all this can be seen in the continued weakening or outright crumbling of the hierarchies codified in the Three Bonds and Five Relationship, which have served as a social template in Korea for centuries. In his 2004 work “Oppa Came Back,” writer Kim Yong Ha depicts what he apparently sees as the “post-Confucian” family in a wickedly funny portrayal of what Korean society could look like if traditional bulwarks of prescriptive values suddenly collapse and are not replaced with tenable alternatives. In the short story, Kim subverts all the traditional hierarchies while leaving the desire to dominate these hierarchies intact. This produces the picture of a Korean family governed by the new values of money and physical power. After lying out what can be identified as major cultural changes in what could be called “traditional” society,” the article uses a close reading of Kim’s story for its implications regarding a possible new, dysfunctional version of Korean society. It seems apparent that Kim’s story is a cautionary tale of the pitfalls that lie athwart the late-modern Korean landscape. These changes have important implications in the areas of education and socio-political philosophy. The conclusion focuses on possible alternatives to this post-Confucian conundrum.

Keywords: post-confucian, three bonds and five relationships, traditional society, hierarchies

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Authors: Kerri Alderson

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There is pervasive awareness by post secondary faculty that written feedback on course assignments is inconsistently reviewed by students. In order to support student success and growth, a novel method of providing feedback was sought, and screen casting - short, narrated “movies” of audio visual instructor feedback on students’ scholarly papers - was provided as an alternative to traditional means. An overview of the teaching and learning experience as well as the user-friendly software utilized will be presented. This study covers an overview of this more direct, student-centered medium for providing feedback using technology familiar to post secondary students. Reminiscent of direct personal contact, the personalized video feedback is positively evaluated by students as a formative medium for student growth in scholarly writing.

Keywords: education, pedagogy, screen casting, student feedback, teaching and learning

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Authors: Titin Handayani, Adi Mulyanto, Fajar Eko Priyanto

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It is generally recognized, that algae could be an interesting option for reducing CO₂ emissions. Based on light and CO₂, algae can be used for the production various economically interesting products. Current algae cultivation techniques, however, still present a number of limitations. Efficient feeding of CO₂, especially on a large scale, is one of them. Current methods for CO₂ feeding to algae cultures rely on the sparging pure CO₂ or directly from flue gas. The limiting factor in this system is the solubility of CO₂ in water, which demands a considerable amount of energy for an effective gas to liquid transfer and leads to losses to the atmosphere. Due to the current ineffective methods for CO₂ introduction into algae ponds very large surface areas would be required for enough ponds to capture a considerable amount of the CO₂. The purpose of this study is to assess technology to capture carbon dioxide (CO₂) emissions generated by industry by utilizing of microalgae Chlorella sp. The microalgae were cultivated in a bioreactor culture pond raceway type. The result is expected to be useful in mitigating the effects of greenhouse gases in reducing the CO₂ emissions. The research activities include: (1) Characterization of boiler flue gas, (2) Operation of culture pond, (3) Sampling and sample analysis. The results of this study showed that the initial assessment absorption of the flue gas by microalgae using 1000 L raceway pond completed by heat exchanger were quite promising. The transfer of CO₂ into the pond culture system was run well. This identified from the success of cooling the boiler flue gas from the temperature of about 200 °C to below ambient temperature. Except for the temperature, the gas bubbles into the culture media were quite fine. Therefore, the contact between the gas and the media was well performed. The efficiency of CO₂ absorption by Chlorella sp reached 6.68 % with an average CO₂ loading of 0.29 g/L/day.

Keywords: Chlorella sp., CO2 emission, heat exchange, microalgae, milk industry, raceway pond

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Authors: Romella C. Lina, Matthew Daniel V. Leysa, Zarah D. F. Libozada, Maria Francesca I. Lirio, Angelo A. Liwag, Gabriel D. Ramos, Margaret M. Natividad

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This study aimed to determine the effectiveness of Buteyko Method in asthma control and quality of life of school-age children wherein a pretest-posttest design was utilized to measure the changes after the administration of Buteyko Method. Fourteen (14) subjects with bronchial asthma, aged 7-11 participated in the study. They were equally divided into two groups: the control group received no intervention while the experimental group was asked to attend sessions of Buteyko Method lecture and demonstration. The experimental group was visited for three (3) consecutive weeks to monitor their progress and compliance. Both groups were asked to answer ACQ pre- and post-intervention and PAQLQ before the start of the intervention phase and every week during the follow-up visits. In comparing the asthma control pre-test and post-test mean scores of the control group, no significant difference was noted (p=0.177) while the experimental group showed a significant difference after the administration of Buteyko Method (p=0.002). Moreover, the quality of life pre-test and post-test mean scores of the control group showed no significant difference in any week within one month of follow-up (p=0.736, 0.604, 0.689) while the experimental group showed a significant difference on the third week (p = 0.035) and fourth week (p=0.002) but no significant difference on the second week (p=0.111). Therefore, the use of Buteyko Method within 3-4 weeks as an adjunct to conventional management of asthma helps in improving asthma control and quality of life of school-age children.

Keywords: Buteyko Method, asthma, school-age children, asthma control, quality of life

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Authors: Kamal Tolani, Sandeep Kumar, Rohit Luthra, Ankit Dadhania, Krishnaprasad K., Ram Gupta, Deepa Joshi

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Background: Post-operative analgesia remains a clinical challenge, with central and peripheral sensitization playing a pivotal role in treatment-related complications and impaired quality of life. Centrally acting opioids offer poor risk benefit profile with increased intensity of gastrointestinal or central side effects and slow onset of clinical analgesia. The objective of this study was to assess the clinical feasibility of induction and maintenance therapy with Tapentadol Nasal Spray (NS) in moderate to severe acute post-operative pain. Methods: Phase III, randomized, active-controlled, non-inferiority clinical trial involving 294 cases who had undergone surgical procedures under general anesthesia or regional anesthesia. Post-surgery patients were randomized to receive either Tapentadol NS 45 mg or Tramadol 100mg IV as a bolus and subsequent 50 mg or 100 mg dose over 2-3 minutes. The frequency of administration of NS was at every 4-6 hours. At the end of 24 hrs, patients in the tramadol group who had a pain intensity score of ≥4 were switched to oral tramadol immediate release 100mg capsule until the pain intensity score reduced to <4. All patients who had achieved pain intensity ≤ 4 were shifted to a lower dose of either Tapentadol NS 22.5 mg or oral Tramadol immediate release 50mg capsule. The statistical analysis plan was envisaged as a non-inferiority trial involving comparison with Tramadol for Pain intensity difference at 60 minutes (PID60min), Sum of Pain intensity difference at 60 minutes (SPID60min), and Physician Global Assessment at 24 hrs (PGA24 hrs). Results: The per-protocol analyses involved 255 hospitalized cases undergoing surgical procedures. The median age of patients was 38.0 years. For the primary efficacy variables, Tapentadol NS was non-inferior to Inj/Oral Tramadol in relief of moderate to severe post-operative pain. On the basis of SPID60min, no clinically significant difference was observed between Tapentadol NS and Tramadol IV (1.73±2.24 vs. 1.64± 1.92, -0.09 [95% CI, -0.43, 0.60]). In the co-primary endpoint PGA24hrs, Tapentadol NS was non–inferior to Tramadol IV (2.12 ± 0.707 vs. 2.02 ±0.704, - 0.11[95% CI, -0.07, 0.28). However, on further assessment at 48hr, 72 hrs, and 120hrs, clinically superior pain relief was observed with the Tapentadol NS formulation that was statistically significant (p <0.05) at each of the time intervals. Secondary efficacy measures, including the onset of clinical analgesia and TOTPAR, showed non-inferiority to Tramadol. The safety profile and need for rescue medication were also similar in both the groups during the treatment period. The most common concomitant medications were anti-bacterial (98.3%). Conclusion: Tapentadol NS is a clinically feasible option for improved compliance as induction and maintenance therapy while offering a sustained and persistent patient response that is clinically meaningful in post-surgical settings.

Keywords: tapentadol nasal spray, acute pain, tramadol, post-operative pain

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Authors: Radhika Jagtap

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Contemporary scholarship in international legal theory is investigating new avenues of providing alternatives to dominant concepts. Indigenous peoples’ philosophies and perspectives developed through them provide a fertile ground to explore similar alternative ideas. This review paper evaluates the theorized accounts of indigenous scholarships which have contributed towards a rich body of knowledge generating alternative visions on dominant notions of ‘post coloniality’, ‘resistance’ and ‘globalization’. Further, it shall assess the relevance of such a project in shaping contemporary international legal thought. Traditional or classical international law has been opined to be highly influenced by the colonial and imperialist history which also left a mark on the way dominant discourses of resistance and globalization are read in mainstream international law. The paper shall first define what do we mean by indigenous philosophy and what kind of indigeneity is that inclusive of. Second, the paper defines the dominant discourse and then counters the same with the alternative indigenous perspective in the case of each concept that is in question. Finally, the paper shall conclude with certain theoretical findings – that the post coloniality, from indigenous perspective, lead to the further marginalization of indigeneity, especially in the third world; that human rights as the sole means of representing resistance in international law ends up making it a very state-centric discipline and last, that globalization from an indigenous, marginalised perspective is not as celebrated as it is in mainstream international law. Major scholarly works that shall be central to the discussion are those of Linda Tuiwahi Smith, Ella Shohat and David Harvey. The nature of the research shall be inductive and involve mostly theoretical review of scholarly works.

Keywords: indigenous, post colonial, globalization, perspectives

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Authors: Armin Bodaghkhani, Bruce Colbourne, Yuri S. Muzychka

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The process of spray-cloud formation and flow kinematics produced from breaking wave impact on vertical and slant lab-scale bow-shaped models were experimentally investigated. Bubble Image Velocimetry (BIV) and Image Processing (IP) techniques were applied to study the various types of wave-model impacts. Different wave characteristics were generated in a tow tank to investigate the effects of wave characteristics, such as wave phase velocity, wave steepness on droplet velocities, and behavior of the process of spray cloud formation. The phase ensemble-averaged vertical velocity and turbulent intensity were computed. A high-speed camera and diffused LED backlights were utilized to capture images for further post processing. Various pressure sensors and capacitive wave probes were used to measure the wave impact pressure and the free surface profile at different locations of the model and wave-tank, respectively. Droplet sizes and velocities were measured using BIV and IP techniques to trace bubbles and droplets in order to measure their velocities and sizes by correlating the texture in these images. The impact pressure and droplet size distributions were compared to several previously experimental models, and satisfactory agreements were achieved. The distribution of droplets in front of both models are demonstrated. Due to the highly transient process of spray formation, the drag coefficient for several stages of this transient displacement for various droplet size ranges and different Reynolds number were calculated based on the ensemble average method. From the experimental results, the slant model produces less spray in comparison with the vertical model, and the droplet velocities generated from the wave impact with the slant model have a lower velocity as compared with the vertical model.

Keywords: spray charachteristics, droplet size and velocity, wave-body interactions, bubble image velocimetry, image processing

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Authors: Rida Pervaiz, Bushra Allah Rakha, Muhammad Sajjad Ansari, Shamim Akhter, Kainat Waseem, Sumiyyah Zuha, Tooba Javed

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Ring-necked pheasant (Phasianus colchicus) belongs to order Galliformes and family Phasianidae. It has been recognized as the most hunted bird due to its attractive colorful appearance and meat. Loss of habitat and hunting pressure has caused population fluctuations in the native range. Under these circumstances, this species can be conserved by employing ex-situ in vitro conservation techniques. Captive breeding, in combination with semen cryobanking is the most appropriate option to conserve/propagate this species without deteriorating the genetic diversity. Cryopreservation protocols of adequate efficiency are necessary to establish semen cryobanking for a species. Therefore, present study was designed to devise an efficient extender for cryopreservation of ring-necked pheasant semen. For this purpose, a range of extenders (Beltsville Poultry, red fowl, Lake, EK, Tselutin Poultry and Chicken semen extenders) were evaluated for cryopreservation of ring-necked pheasant semen. Semen collected from 10 cocks, diluted in the Beltsville Poultry (BPSE), Red Fowl (RFE), Lake (LE), EK (EKE), Tselutin Poultry (TPE) and Chicken Semen (CSE) extenders and cryopreserved. Glycerol (10%) was added to semen at 4°C, equilibrated for 10 min, filled in 0.5 mL French straws, kept over liquid nitrogen vapors for 10 min, cryopreserved in LN2 and stored. Sperm motility (%), viability (%), live/dead ratio (%), plasma membrane (%) and DNA Integrity (%) were evaluated at post-dilution, post-cooling, post-equilibration and post-thawing stage of cryopreservation. Sperm motility (83.8 ± 3.1; 81.3 ± 3.8; 73.8 ± 2.4; 62.5 ± 1.4), viability (79.0 ± 1.7; 75.5 ± 1.6; 69.5 ± 2.3; 65.5 ± 2.4), live/dead ratio (80.5 ± 5.7; 77.3 ± 4.9; 76.0 ± 2.7; 68.3 ± 2.3), plasma membrane (74.5 ± 2.9; 73.8 ± 3.4; 71.3 ± 2.3; 75.0 ± 3.4) and DNA integrity (78.3 ± 1.7; 73.0 ± 1.2; 68.0 ± 2.0; 63.0 ± 2.5) at all four stages of cryopreservation were recorded higher (P < 0.05) in red fowl extender compared to all experimental extenders. It is concluded that red fowl extender is the best extender for cryopreservation of ring-necked pheasant semen and can be used in establishing cryobank for ex situ conservation.

Keywords: ring-necked pheasant; extenders; cryopreservation; semen quality; DNA integrity

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Authors: Nicholus M. Warstadt, Andres D. Mallipudi, Oluwadamilola Idowu, Joshua Rodriguez, Madison M. Hunt, Soma Pathak, Laura P. Weber

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Endotracheal intubation is a core procedure performed by emergency physicians. This procedure is a high risk, and failure results in substantial morbidity and mortality. Fiberoptic intubation (FOI) is the standard of care in difficult airway protocols, yet no widespread practice exists for training emergency medicine (EM) residents in the technical acquisition of FOI skills. Simulation on mannequins is commonly utilized to teach advanced airway techniques. As part of a program to introduce FOI into our ED, residents received hands-on training in FOI as part of our weekly resident education conference. We hypothesized that prior to the hands-on training, residents had little experience with FOI and were uncomfortable with using fiberoptic as a modality. We further hypothesized that resident comfort with FOI would increase following the training. The education intervention consisted of two hours of focused airway teaching and skills acquisition for PGY 1-4 residents. One hour was dedicated to four case-based learning stations focusing on standard, pediatric, facial trauma, and burn airways. Direct, video, and fiberoptic airway equipment were available to use at the residents’ discretion to intubate mannequins at each station. The second hour involved direct instructor supervision and immediate feedback during deliberate practice for FOI of a mannequin. Prior to the hands-on training, a pre-survey was sent via email to all EM residents at NYU Grossman School of Medicine. The pre-survey asked how many FOI residents have performed in the ED, OR, and on a mannequin. The pre-survey and a post-survey asked residents to rate their comfort with FOI on a 5-point Likert scale ("extremely uncomfortable", "somewhat uncomfortable", "neither comfortable nor uncomfortable", "somewhat comfortable", and "extremely comfortable"). The post-survey was administered on site immediately following the training. A two-sample chi-square test of independence was calculated comparing self-reported resident comfort on the pre- and post-survey (α ≤ 0.05). Thirty-six of a total of 70 residents (51.4%) completed the pre-survey. Of pre-survey respondents, 34 residents (94.4%) had performed 0, 1 resident (2.8%) had performed 1, and 1 resident (2.8%) had performed 2 FOI in the ED. Twenty-five residents (69.4%) had performed 0, 6 residents (16.7%) had performed 1, 2 residents (5.6%) had performed 2, 1 resident (2.8%) had performed 3, and 2 residents (5.6%) had performed 4 FOI in the OR. Seven residents (19.4%) had performed 0, and 16 residents (44.4%) had performed 5 or greater FOI on a mannequin. 29 residents (41.4%) attended the hands-on training, and 27 out of 29 residents (93.1%) completed the post-survey. Self-reported resident comfort with FOI significantly increased in post-survey compared to pre-survey questionnaire responses (p = 0.00034). Twenty-one of 27 residents (77.8%) report being “somewhat comfortable” or “extremely comfortable” with FOI on the post-survey, compared to 9 of 35 residents (25.8%) on the pre-survey. We show that dedicated FOI training is associated with increased learner comfort with such techniques. Further direction includes studying technical competency, skill retention, translation to direct patient care, and optimal frequency and methodology of future FOI education.

Keywords: airway, emergency medicine, fiberoptic intubation, medical simulation, skill acquisition

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Authors: Sajia Islam, T. Tahsina, S. Raihana, M. M. Rahman, Q. S. Rahman, T. M. Huda, S. E. Arifeen, M. J. Dibley

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Early neonatal sepsis accounts for more than two-thirds of all deaths in the first year of life. This study assessed the counseling during antenatal, perinatal, post natal periods and its association with possible sepsis in rural Bangladesh. Method: Data were collected from a large community-based trial in Bangladesh where pregnant women were enrolled from 2013-2015 covering 29,497 newborns. Sepsis was defined using neonatal danger signs reported by 'The Young-Infants Clinical Science Study Group. 'Result: Signs of sepsis was found among 15% of the neonates. Neonatal sepsis was higher among those who did not receive advice on TT vaccinations (15.4% vs. 11%, p < 0.05) and danger signs (14.8% vs. 12.8%, p < 0.05) during pregnancy. Advice on delivering in well-lit place was significantly associated with lower incidence of sepsis (12.7% vs. 14.8% p < 0.05). Sepsis was lower among neonates whose mothers were counseled on immediate newborn care for bathing after 3 days of delivery (13.4% vs. 15.2% p=0), breastfeeding within 1hr of birth (13.82 % vs. 15.28% p=0), apply nothing on the cord (11.54 vs. 15.06 p=0), immediate drying of child (12.62% vs. 14.89%, p=0). Neonatal sepsis was lower among children whose mothers received 2-4 advice [OR=0.91(95% CI: 0.85-0.97)] compared to neonates whose mothers received only 1 or none. Overall, children to mothers who received ≥ 5 advice had lowest incidence of sepsis [OR=0.83 (95% CI: 0.71-0.97)] Conclusion: Advice on antenatal, prenatal and post natal is significantly reduced with early newborn sepsis. Further research is required to identify specific type of counseling messages that translate into practices and reduce pathways towards early-newborn morbidities.

Keywords: ante natal care, counseling, neonatal sepsis, post natal care

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Authors: João Costa, Francisco Albuquerque, Ricardo J. Santos, Madalena M. Dias, José Carlos B. Lopes, Marcelo Costa

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Nowadays, it is well recognized that carbon dioxide emissions, together with other greenhouse gases, are responsible for the dramatic climate changes that have been occurring over the past decades. Gas hydrates are currently seen as a promising and disruptive set of materials that can be used as a basis for developing new technologies for CO₂ capture and storage. Its potential as a clean and safe pathway for CCS is tremendous since it requires only water and gas to be mixed under favorable temperatures and mild high pressures. However, the hydrates formation process is highly exothermic; it releases about 2 MJ per kilogram of CO₂, and it only occurs in a narrow window of operational temperatures (0 - 10 °C) and pressures (15 to 40 bar). Efficient continuous hydrate production at a specific temperature range necessitates high heat transfer rates in mixing processes. Past technologies often struggled to meet this requirement, resulting in low productivity or extended mixing/contact times due to inadequate heat transfer rates, which consistently posed a limitation. Consequently, there is a need for more effective continuous hydrate production technologies in industrial applications. In this work, a network mixing continuous production technology has been shown to be viable for producing CO₂ hydrates. The structured mixer used throughout this work consists of a network of unit cells comprising mixing chambers interconnected by transport channels. These mixing features result in enhanced heat and mass transfer rates and high interfacial surface area. The mixer capacity emerges from the fact that, under proper hydrodynamic conditions, the flow inside the mixing chambers becomes fully chaotic and self-sustained oscillatory flow, inducing intense local laminar mixing. The device presents specific heat transfer rates ranging from 107 to 108 W⋅m⁻³⋅K⁻¹. A laboratory scale pilot installation was built using a device capable of continuously capturing 1 kg⋅h⁻¹ of CO₂, in an aqueous slurry of up to 20% in mass. The strong mixing intensity has proven to be sufficient to enhance dissolution and initiate hydrate crystallization without the need for external seeding mechanisms and to achieve, at the device outlet, conversions of 99% in CO₂. CO₂ dissolution experiments revealed that the overall liquid mass transfer coefficient is orders of magnitude larger than in similar devices with the same purpose, ranging from 1 000 to 12 000 h⁻¹. The present technology has shown itself to be capable of continuously producing CO₂ hydrates. Furthermore, the modular characteristics of the technology, where scalability is straightforward, underline the potential development of a modular hydrate-based CO₂ capture process for large-scale applications.

Keywords: network, mixing, hydrates, continuous process, carbon dioxide

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Authors: William Michael Short

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Semantic Web’ technologies such as the Unified Medical Language System Metathesaurus, SNOMED-CT, and MeSH have been touted as transformational for the way users access online medical and health information, enabling both the automated analysis of natural-language data and the integration of heterogeneous healthrelated resources distributed across the Internet through the use of standardized terminologies that capture concepts and relationships between concepts that are expressed differently across datasets. However, the approaches that have so far characterized ‘semantic bioinformatics’ have not yet fulfilled the promise of the Semantic Web for medical and health information retrieval applications. This paper argues within the perspective of cognitive linguistics and cognitive anthropology that four features of human meaning-making must be taken into account before the potential of semantic technologies can be realized for this domain. First, many semantic technologies operate exclusively at the level of the word. However, texts convey meanings in ways beyond lexical semantics. For example, transitivity patterns (distributions of active or passive voice) and modality patterns (configurations of modal constituents like may, might, could, would, should) convey experiential and epistemic meanings that are not captured by single words. Language users also naturally associate stretches of text with discrete meanings, so that whole sentences can be ascribed senses similar to the senses of words (so-called ‘discourse topics’). Second, natural language processing systems tend to operate according to the principle of ‘one token, one tag’. For instance, occurrences of the word sound must be disambiguated for part of speech: in context, is sound a noun or a verb or an adjective? In syntactic analysis, deterministic annotation methods may be acceptable. But because natural language utterances are typically characterized by polyvalency and ambiguities of all kinds (including intentional ambiguities), such methods leave the meanings of texts highly impoverished. Third, ontologies tend to be disconnected from everyday language use and so struggle in cases where single concepts are captured through complex lexicalizations that involve profile shifts or other embodied representations. More problematically, concept graphs tend to capture ‘expert’ technical models rather than ‘folk’ models of knowledge and so may not match users’ common-sense intuitions about the organization of concepts in prototypical structures rather than Aristotelian categories. Fourth, and finally, most ontologies do not recognize the pervasively figurative character of human language. However, since the time of Galen the widespread use of metaphor in the linguistic usage of both medical professionals and lay persons has been recognized. In particular, metaphor is a well-documented linguistic tool for communicating experiences of pain. Because semantic medical knowledge-bases are designed to help capture variations within technical vocabularies – rather than the kinds of conventionalized figurative semantics that practitioners as well as patients actually utilize in clinical description and diagnosis – they fail to capture this dimension of linguistic usage. The failure of semantic technologies in these respects degrades the efficiency and efficacy not only of medical research, where information retrieval inefficiencies can lead to direct financial costs to organizations, but also of care provision, especially in contexts of patients’ self-management of complex medical conditions.

Keywords: ambiguity, bioinformatics, language, meaning, metaphor, ontology, semantic web, semantics

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Authors: Merav Alush Levron, Sivan Rajuan Shtang

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From as early as their emergence in Europe and the US, postmodern and post-colonial paradigm have formed the backbone of the visual culture field of study. The self-representation project of political minorities is studied, described and explained within the premises and perspectives drawn from these paradigms, addressing the key issues they had raised: modernism’s crisis of representation. The struggle for self-representation, agency and multicultural visibility sought to challenge the liberal pretense of universality and equality, hitting at its different blind spots, on issues such as class, gender, race, sex, and nationality. This struggle yielded subversive identity and hybrid performances, including reclaiming, mimicry and masquerading. These performances sought to defy the uniform, universal self, which forms the basis for the liberal, rational, enlightened subject. The argument of this research runs that this politics of representation itself is confined within liberal thought. Alongside post-colonialism and multiculturalism’s contribution in undermining oppressive structures of power, generating diversity in cultural visibility, and exposing the failure of liberal colorblindness, this subversion is constituted in the visual field by way of confrontation, flying in the face of the universal law and relying on its ongoing comparison and attribution to this law. Relying on Deleuze and Guattari, this research set out to draw theoretic and empiric attention to an alternative, post-liberal occurrence which has been taking place in the visual field in parallel to the contra-hegemonic phase and as a product of political reality in the aftermath of the crisis of representation. It is no longer a counter-representation; rather, it is a motion of organic minor desire, progressing in the form of flows and generating what Deleuze and Guattari termed deterritorialization of social structures. This discussion shall have its focus on current post-liberal performances of ‘Mizrahim’ (Jewish Israelis of Arab and Muslim extraction) in the visual field in Israel. In television, video art and photography, these performances challenge the issue of representation and generate concrete peripheral Mizrahiness, realized in the visual organization of the photographic frame. Mizrahiness then transforms from ‘confrontational’ representation into a 'presence', flooding the visual sphere in our plain sight, in a process of 'becoming'. The Mizrahi desire is exerted on the plains of sound, spoken language, the body and the space where they appear. It removes from these plains the coding and stratification engendered by European dominance and rational, liberal enlightenment. This stratification, adhering to the hegemonic surface, is flooded not by way of resisting false consciousness or employing hybridity, but by way of the Mizrahi identity’s own productive, material immanent yearning. The Mizrahi desire reverberates with Mizrahi peripheral 'worlds of meaning', where post-colonial interpretation almost invariably identifies a product of internalized oppression, and a recurrence thereof, rather than a source in itself - an ‘offshoot, never a wellspring’, as Nissim Mizrachi clarifies in his recent pioneering work. The peripheral Mizrahi performance ‘unhook itself’, in Deleuze and Guattari words, from the point of subjectification and interpretation and does not correspond with the partialness, absence, and split that mark post-colonial identities.

Keywords: desire, minority, Mizrahi Jews, post-colonialism, post-liberalism, visibility, Deleuze and Guattari

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Authors: Qianqian He, Naian Liu, Xiaodong Xie, Linhe Zhang, Yang Zhang, Weidong Yan

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In the wild, the vegetation layer with exceptionally complex fuel composition and heterogeneous spatial distribution strongly affects the rate of fire spread (ROS) and fire intensity. Clarifying the influence of fuel bed structure on fire spread behavior is of great significance to wildland fire management and prediction. The packing ratio is one of the key physical parameters describing the property of the fuel bed. There is a threshold value of the packing ratio for ROS, but little is known about the controlling mechanism. In this study, to address this deficiency, a series of fire spread experiments were performed across a discrete fuel bed composed of some regularly arranged laser-cut cardboards, with constant wind speed and different packing ratios (0.0125-0.0375). The experiment aims to explore the relative importance of the internal and surface heat transfer with packing ratio. The dependence of the measured ROS on the packing ratio was almost consistent with the previous researches. The data of the radiative and total heat fluxes show that the internal heat transfer and surface heat transfer are both enhanced with increasing packing ratio (referred to as ‘Stage 1’). The trend agrees well with the variation of the flame length. The results extracted from the video show that the flame length markedly increases with increasing packing ratio in Stage 1. Combustion intensity is suggested to be increased, which, in turn, enhances the heat radiation. The heat flux data shows that the surface heat transfer appears to be more important than the internal heat transfer (fuel preheating inside the fuel bed) in Stage 1. On the contrary, the internal heat transfer dominates the fuel preheating mechanism when the packing ratio further increases (referred to as ‘Stage 2’) because the surface heat flux keeps almost stable with the packing ratio in Stage 2. As for the heat convection, the flow velocity was measured using Pitot tubes both inside and on the upper surface of the fuel bed during the fire spread. Based on the gas velocity distribution ahead of the flame front, it is found that the airflow inside the fuel bed is restricted in Stage 2, which can reduce the internal heat convection in theory. However, the analysis indicates not the influence of inside flow on convection and combustion, but the decreased internal radiation of per unit fuel is responsible for the decrease of ROS.

Keywords: discrete fuel bed, fire spread, packing ratio, wildfire

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Authors: Weiliang Wen, Xinyu Guo, Ying Zhang, Jianjun Du, Boxiang Xiao

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Reconstructing and analyzing three-dimensional (3D) models from situ measured data is important for a number of researches and applications in plant science, including plant phenotyping, functional-structural plant modeling (FSPM), plant germplasm resources protection, agricultural technology popularization. It has many scales like cell, tissue, organ, plant and canopy from micro to macroscopic. The techniques currently used for data capture, feature analysis, and 3D reconstruction are quite different of different scales. In this context, morphological data acquisition, 3D analysis and modeling of plants on different scales are introduced systematically. The commonly used data capture equipment for these multiscale is introduced. Then hot issues and difficulties of different scales are described respectively. Some examples are also given, such as Micron-scale phenotyping quantification and 3D microstructure reconstruction of vascular bundles within maize stalks based on micro-CT scanning, 3D reconstruction of leaf surfaces and feature extraction from point cloud acquired by using 3D handheld scanner, plant modeling by combining parameter driven 3D organ templates. Several application examples by using the 3D models and analysis results of plants are also introduced. A 3D maize canopy was constructed, and light distribution was simulated within the canopy, which was used for the designation of ideal plant type. A grape tree model was constructed from 3D digital and point cloud data, which was used for the production of science content of 11th international conference on grapevine breeding and genetics. By using the tissue models of plants, a Google glass was used to look around visually inside the plant to understand the internal structure of plants. With the development of information technology, 3D data acquisition, and data processing techniques will play a greater role in plant science.

Keywords: plant, three dimensional modeling, multi-scale, plant phenotyping, three dimensional data acquisition

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Authors: Esra Güney, Tuba Uçar

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Aim: This study has been conducted for the purpose of determining the effects of fetal movement counting on antenatal maternal attachment. Material and Method: This research was conducted on the basis of the real test model with the pre-test /post-test control groups. The study population consists of pregnant women registered in the six different Family Health Centers located in the central Malatya districts of Yeşilyurt and Battalgazi. When power analysis is done, the sample size was calculated for each group of at least 55 pregnant women (55 tests, 55 controls). The data were collected by using Personal Information Form and MAAS (Maternal Antenatal Attachment Scale) between July 2015-June 2016. Fetal movement counting training was given to pregnant women by researchers in the experimental group after the pre-test data collection. No intervention was applied to the control group. Post-test data for both groups were collected after four weeks. Data were evaluated with percentage, chi-square arithmetic average, chi-square test and as for the dependent and independent group’s t test. Result: In the MAAS, the pre-test average of total scores in the experimental group is 70.78±6.78, control group is also 71.58±7.54 and so there was no significant difference in mean scores between the two groups (p>0.05). MAAS post-test average of total scores in the experimental group is 78.41±6.65, control group is also is 72.25±7.16 and so the mean scores between groups were found to have statistically significant difference (p<0.05). Conclusion: It was determined that fetal movement counting increases the maternal antenatal attachments.

Keywords: antenatal maternal attachment, fetal movement counting, pregnancy, midwifery

Procedia PDF Downloads 273

Authors: Khaled A. shady, Fagr B. Bazeed, Nashwa K. Abousamra, Ihab H. Elberawe, Ashraf E. shaalan, Mohamed A. Sobh

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Physical activity activates a variety of adult stem cells which might be released into the circulation or might be activated in their organ-resident state. A variety of stimuli such as metabolic, mechanical, and hormonal stimuli might by responsible for the mobilization. This study was done to know the changes in hematopoietic stem cells and endothelial progenitor in athletes in the 24 hours following 30 min of aerobic exercise. Methods: Ten healthy male's athlete's (age 20.7± 0.61 y) performed moderate running with 30 min at 80% of velocity of The IAT. Blood samples taken pre-, and immediately, 30 min, 2h, 6h and 24h post-exercise were analyzed for hematopoietic stem cells (HSCs ), endothelial progenitor cells (EPCs(, vascular endothelial growth factor (VEGF), nitric oxide (NO), lactic acid (LA), and white blood cells . HSCs and EPCs were quantified by flow cytometry. Results: After 30min of aerobic exercise significant increases in HSCs, EPC, VEGF, NO, LA and WBCs (p ˂ 0.05). This increase will be at different rates according to the timing of taking blood sample and was in the maximum rate of increase after 30 min of aerobic exercise. HSCs, EPC, NO and WBCs were in the maximum rate of increase 2h post exercise. In addition, VEGF was in the maximum rate of increase immediately post exercise and LA concentration not affected after exercise. Conclusion: These data suggest that HSCs and EPCs increased after aerobic exercise due to increase of VEGF which play an important role in mobilization of stem cells and promotes NO increase which contributes to increase EPCs.

Keywords: physical activity, hematopoietic stem cells, mobilization, athletes

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Authors: Daniel Y. Abebe, Sijeong Jeong, Jaehyouk Choi

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The use of eccentrically braced frame (EBF) is increasing day by day as EBF possesses high elastic stiffness, stable inelastic response under cyclic lateral loading, and excellent ductility and energy dissipation capacity. The ductility and energy dissipation capacity of EBF depends on the active link beams. Recently, there are two types EBFs; these are conventional EBFs and EBFs with replaceable links. The conventional EBF has a disadvantage during maintenance in post-earthquake. The concept of removable active link beam in EBF is developed to overcome the limitation of the conventional EBF in post-earthquake. In this study, a replaceable link with reduced web section is introduced and design equations are suggested. In addition, nonlinear finite element analysis was conducted in order to evaluate the proposed links.

Keywords: EBFs, replaceable link, earthquake disaster, reduced section

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Authors: Jawaad Saleem, Hannah Wright, Peter Sommerville, Adrian Hopper

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Introduction: Inpatient falls are the most commonly reported patient safety incidents, and carry a significant burden on resources, morbidity, and mortality. Ensuring adequate post falls management of patients by staff is therefore paramount to maintaining patient safety especially in out of hours and resource stretched settings. Aims: This quality improvement project aims to improve the current practice of falls management at Guys St Thomas Hospital, London as compared to our 2016 Quality Improvement Project findings. Furthermore, it looks to increase current junior doctors confidence in managing falls and their use of new guidance protocols. Methods: Multifaceted Interventions implemented included: the development of new trust wide guidelines detailing management pathways for patients post falls, available for intranet access. Furthermore, the production of 2000 lanyard cards distributed amongst junior doctors and staff which summarised these guidelines. Additionally, a ‘safety signal’ email was sent from the Trust chief medical officer to all staff raising awareness of falls and the guidelines. Formal falls teaching was also implemented for new doctors at induction. Using an established incident database, 189 consecutive falls in 2017were retrospectively analysed electronically to assess and compared to the variables measured in 2016 post interventions. A separate serious incident database was used to analyse 50 falls from May 2015 to March 2018 to ascertain the statistical significance of the impact of our interventions on serious incidents. A similar questionnaire for the 2017 cohort of foundation year one (FY1) doctors was performed and compared to 2016 results. Results: Questionnaire data demonstrated improved awareness and utility of guidelines and increased confidence as well as an increase in training. 97% of FY1 trainees felt that the interventions had increased their awareness of the impact of falls on patients in the trust. Data from the incident database demonstrated the time to review patients post fall had decreased from an average of 130 to 86 minutes. Improvement was also demonstrated in the reduced time to order and schedule X-ray and CT imaging, 3 and 5 hours respectively. Data from the serious incident database show that ‘the time from fall until harm was detected’ was statistically significantly lower (P = 0.044) post intervention. We also showed the incidence of significant delays in detecting harm ( > 10 hours) reduced post intervention. Conclusions: Our interventions have helped to significantly reduce the average time to assess, order and schedule appropriate imaging post falls. Delays of over ten hours to detect serious injuries after falls were commonplace; since the intervention, their frequency has markedly reduced. We suggest this will lead to identifying patient harm sooner, reduced clinical incidents relating to falls and thus improve overall patient safety. Our interventions have also helped increase clinical staff confidence, management, and awareness of falls in the trust. Next steps include expanding teaching sessions, improving multidisciplinary team involvement to aid this improvement.

Keywords: patient safety, quality improvement, serious incidents, falls, clinical care

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