Search results for: hospital site suitability
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4975

Search results for: hospital site suitability

3535 Microbial Contamination of Cell Phones of Health Care Workers: Case Study in Mampong Municipal Government Hospital, Ghana

Authors: Francis Gyapong, Denis Yar

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The use of cell phones has become an indispensable tool in the hospital's settings. Cell phones are used in hospitals without restrictions regardless of their unknown microbial load. However, the indiscriminate use of mobile devices, especially at health facilities, can act as a vehicle for transmitting pathogenic bacteria and other microorganisms. These potential pathogens become exogenous sources of infection for the patients and are also a potential health hazard for self and as well as family members. These are a growing problem in many health care institutions. Innovations in mobile communication have led to better patient care in diabetes, asthma, and increased in vaccine uptake via SMS. Notwithstanding, the use of cell phones can be a great potential source for nosocomial infections. Many studies reported heavy microbial contamination of cell phones among healthcare workers and communities. However, limited studies have been reported in our region on bacterial contamination on cell phones among healthcare workers. This study assessed microbial contamination of cell phones of health care workers (HCWs) at the Mampong Municipal Government Hospital (MMGH), Ghana. A cross-sectional design was used to characterize bacterial microflora on cell phones of HCWs at the MMGH. A total of thirty-five (35) swab samples of cell phones of HCWs at the Laboratory, Dental Unit, Children’s Ward, Theater and Male ward were randomly collected for laboratory examinations. A suspension of the swab samples was each streak on blood and MacConkey agar and incubated at 37℃ for 48 hours. Bacterial isolates were identified using appropriate laboratory and biochemical tests. Kirby-Bauer disc diffusion method was used to determine the antimicrobial sensitivity tests of the isolates. Data analysis was performed using SPSS version 16. All mobile phones sampled were contaminated with one or more bacterial isolates. Cell phones from the Male ward, Dental Unit, Laboratory, Theatre and Children’s ward had at least three different bacterial isolates; 85.7%, 71.4%, 57.1% and 28.6% for both Theater and Children’s ward respectively. Bacterial contaminants identified were Staphylococcus epidermidis (37%), Staphylococcus aureus (26%), E. coli (20%), Bacillus spp. (11%) and Klebsiella spp. (6 %). Except for the Children ward, E. coli was isolated at all study sites and predominant (42.9%) at the Dental Unit while Klebsiella spp. (28.6%) was only isolated at the Children’s ward. Antibiotic sensitivity testing of Staphylococcus aureus indicated that they were highly sensitive to cephalexin (89%) tetracycline (80%), gentamycin (75%), lincomycin (70%), ciprofloxacin (67%) and highly resistant to ampicillin (75%). Some of these bacteria isolated are potential pathogens and their presence on cell phones of HCWs could be transmitted to patients and their families. Hence strict hand washing before and after every contact with patient and phone be enforced to reduce the risk of nosocomial infections.

Keywords: mobile phones, bacterial contamination, patients, MMGH

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3534 Urban Regeneration of Unplanned Settlements in Al-Ruwais

Authors: Rama Ajineh

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Neighborhoods are defined as local zones within settlements and cities recognized by individuals who live there, with their identities and given boundaries. Neighborhoods mainly structure individual’s lives, the small box which various social groups interact with each other, develop and become one strong entity. Also, it is a platform for more activities, providing many of the social services to enhance the connections between the people, giving a sense of community. However, some of these neighborhoods were unplanned and caused many social, economical and architectural problems to its residents in the first place, and to the city. A great example of such case is in Saudi Arabia, Jeddah, Al-Ruwais neighborhood, where the authority is planning to regenerate the area and make it a landmark for the city. Urban Regeneration of Unplanned Settlements is a process to make people live and work, now and in the future, and meet the various needs of the current and coming inhabitants, with a high-quality life for all. Through research, it was discovered that Urban regeneration plans on Al-Ruwais were planned regardless to the collective agreement of the inhabitants, giving themselves the absolute right to demolish and reconstruct the desired locations with a low compensation. Consequently, a deep research will be done on integrating the residents with the process, by showcasing examples of successful Urban Regenerations of Unplanned settlements in different cities. The research aims to understand the sustainable, and well-planned regeneration strategies used to enhance people’s living without harming them, and give sustainable urban solutions. Moreover, the research explores the definition of Sustainable Communities. The used methods in this paper are secondary research on site analysis and the relationship between the human and the neighborhood. The conclusion reveals the most successful fashion of Urban regeneration of Unplanned settlements and applies it to Al-Ruwais neighborhood considering the human factor as a primary element.

Keywords: architecture, human integration, original residents, site analysis, sustainable communities, urban sustainable solutions, urban regeneration

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3533 Radiofrequency Ablation: A Technique in the Management of Low Anal Fistula

Authors: R. Suresh, C. B. Singh, A. K. Sarda

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Background: Over the decades, several surgical techniques have been developed to treat anal fistulas with variable success rates and complications. Large amount of work has been done in radiofrequency excision of the fistula for several years but no work has been done for ablating the tract. Therefore one can consider for obliteration ofanal fistula by Radiofrequency ablation (RFA). Material and Methods: A randomized controlled clinical trial was conducted at Lok Nayak Hospital, where a total of 40 patients were enrolled in the study and they were randomly assigned to Group I (fistulectomy)(n=20) and Group II (RFA) (n=20). Aim of the study was to compare the efficacy of RFA of fistula versus fistulectomy in the treatment of a low anal fistula and to evaluate RFA as an effective alternative to fistulectomy with respect to time taken for wound healing as primary outcome and post-operative pain, time taken to return to work as secondary outcomes. Patients with simple low anal fistulas, single internal and external opening, not more than two secondary tracts were included. Patients with high complex fistula, fistulas communicating with cavity, fistula due to condition like tuberculosis, Crohn's, malignancy were excluded from the study. Results: Both groups were comparable with respect to age, sex ratio, type of fistula. Themean healing time was significantly shorter in group II (41.02 days) than in group I(62.68 days).The mean operative time was significantly shorter in groupII (21.40 min) than in group I(28.50 min). The mean time taken to return to work was significantly shorter in group II(8.30 days)than in group I(12.01 days).There was no significant difference in the post operative hospital stay, mean postoperative pain score, wound infection and recurrence between the two groups. Conclusion: The patients who underwent RFA of fistula had shorter wound healing time, operative time and time taken to return to work when compared to those who underwent fistulectomy and therefore RFA shows outcome comparable to fistulectomy in the treatment of low anal fistula.

Keywords: fistulectomy, low anal fistula, radio frequency ablation, wound healing

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3532 Mistuning in Radial Inflow Turbines

Authors: Valentina Futoryanova, Hugh Hunt

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One of the common failure modes of the diesel engine turbochargers is high cycle fatigue of the turbine wheel blades. Mistuning of the blades due to the casting process is believed to contribute to the failure mode. Laser vibrometer is used to characterize mistuning for a population of turbine wheels through the analysis of the blade response to piezo speaker induced noise. The turbine wheel design under investigation is radial and is typically used in 6-12 L diesel engine applications. Amplitudes and resonance frequencies are reviewed and summarized. The study also includes test results for a paddle wheel that represents a perfectly tuned system and acts as a reference. Mass spring model is developed for the paddle wheel and the model suitability is tested against the actual data. Randomization is applied to the stiffness matrix to model the mistuning effect in the turbine wheels. Experimental data is shown to have good agreement with the model.

Keywords: vibration, radial turbines, mistuning, turbine blades, modal analysis, periodic structures, finite element

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3531 Localized Detection of ᴅ-Serine by Using an Enzymatic Amperometric Biosensor and Scanning Electrochemical Microscopy

Authors: David Polcari, Samuel C. Perry, Loredano Pollegioni, Matthias Geissler, Janine Mauzeroll

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ᴅ-serine acts as an endogenous co-agonist for N-methyl-ᴅ-aspartate receptors in neuronal synapses. This makes it a key component in the development and function of a healthy brain, especially given its role in several neurodegenerative diseases such as Alzheimer’s disease and dementia. Despite such clear research motivations, the primary site and mechanism of ᴅ-serine release is still currently unclear. For this reason, we are developing a biosensor for the detection of ᴅ-serine utilizing a microelectrode in combination with a ᴅ-amino acid oxidase enzyme, which produces stoichiometric quantities of hydrogen peroxide in response to ᴅ-serine. For the fabrication of a biosensor with good selectivity, we use a permselective poly(meta-phenylenediamine) film to ensure only the target molecule is reacted, according to the size exclusion principle. In this work, we investigated the effect of the electrodeposition conditions used on the biosensor’s response time and selectivity. Careful optimization of the fabrication process allowed for enhanced biosensor response time. This allowed for the real time sensing of ᴅ-serine in a bulk solution, and also provided in means to map the efflux of ᴅ-serine in real time. This was done using scanning electrochemical microscopy (SECM) with the optimized biosensor to measure localized release of ᴅ-serine from an agar filled glass capillary sealed in an epoxy puck, which acted as a model system. The SECM area scan simultaneously provided information regarding the rate of ᴅ-serine flux from the model substrate, as well as the size of the substrate itself. This SECM methodology, which provides high spatial and temporal resolution, could be useful to investigate the primary site and mechanism of ᴅ-serine release in other biological samples.

Keywords: ᴅ-serine, enzymatic biosensor, microelectrode, scanning electrochemical microscopy

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3530 Applying Resilience Engineering to improve Safety Management in a Construction Site: Design and Validation of a Questionnaire

Authors: M. C. Pardo-Ferreira, J. C. Rubio-Romero, M. Martínez-Rojas

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Resilience Engineering is a new paradigm of safety management that proposes to change the way of managing the safety to focus on the things that go well instead of the things that go wrong. Many complex and high-risk sectors such as air traffic control, health care, nuclear power plants, railways or emergencies, have applied this new vision of safety and have obtained very positive results. In the construction sector, safety management continues to be a problem as indicated by the statistics of occupational injuries worldwide. Therefore, it is important to improve safety management in this sector. For this reason, it is proposed to apply Resilience Engineering to the construction sector. The Construction Phase Health and Safety Plan emerges as a key element for the planning of safety management. One of the key tools of Resilience Engineering is the Resilience Assessment Grid that allows measuring the four essential abilities (respond, monitor, learn and anticipate) for resilient performance. The purpose of this paper is to develop a questionnaire based on the Resilience Assessment Grid, specifically on the ability to learn, to assess whether a Construction Phase Health and Safety Plans helps companies in a construction site to implement this ability. The research process was divided into four stages: (i) initial design of a questionnaire, (ii) validation of the content of the questionnaire, (iii) redesign of the questionnaire and (iii) application of the Delphi method. The questionnaire obtained could be used as a tool to help construction companies to evolve from Safety-I to Safety-II. In this way, companies could begin to develop the ability to learn, which will serve as a basis for the development of the other abilities necessary for resilient performance. The following steps in this research are intended to develop other questions that allow evaluating the rest of abilities for resilient performance such as monitoring, learning and anticipating.

Keywords: resilience engineering, construction sector, resilience assessment grid, construction phase health and safety plan

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3529 The Magnitude and Associated Factors of Coagulation Abnormalities Among Liver Disease Patients at the University of Gondar Comprehensive Specialized Hospital Northwest, Ethiopia

Authors: Melkamu A., Woldu B., Sitotaw C., Seyoum M., Aynalem M.

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Background: Liver disease is any condition that affects the liver cells and their function. It is directly linked to coagulation disorders since most coagulation factors are produced by the liver. Therefore, this study aimed to assess the magnitude and associated factors of coagulation abnormalities among liver disease patients. Methods: A cross-sectional study was conducted from August to October 2022 among 307 consecutively selected study participants at the University of Gondar Comprehensive Specialized Hospital. Sociodemographic and clinical data were collected using a structured questionnaire and data extraction sheet, respectively. About 2.7 mL of venous blood was collected and analyzed by the Genrui CA51 coagulation analyzer. Data was entered into Epi-data and exported to STATA version 14 software for analysis. The finding was described in terms of frequencies and proportions. Factors associated with coagulation abnormalities were analyzed by bivariable and multivariable logistic regression. Result: In this study, a total of 307 study participants were included. Of them, the magnitude of prolonged Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) were 68.08% and 63.51%, respectively. The presence of anemia (AOR = 2.97, 95% CI: 1.26, 7.03), a lack of a vegetable feeding habit (AOR = 2.98, 95% CI: 1.42, 6.24), no history of blood transfusion (AOR = 3.72, 95% CI: 1.78, 7.78), and lack of physical exercise (AOR = 3.23, 95% CI: 1.60, 6.52) were significantly associated with prolonged PT. While the presence of anaemia (AOR = 3.02; 95% CI: 1.34, 6.76), lack of vegetable feeding habit (AOR = 2.64; 95% CI: 1.34, 5.20), no history of blood transfusion (AOR = 2.28; 95% CI: 1.09, 4.79), and a lack of physical exercise (AOR = 2.35; 95% CI: 1.16, 4.78) were significantly associated with abnormal APTT. Conclusion: Patients with liver disease had substantial coagulation problems. Being anemic, having a transfusion history, lack of physical activity, and lack of vegetables showed significant association with coagulopathy. Therefore, early detection and management of coagulation abnormalities in liver disease patients are critical.

Keywords: coagulation, liver disease, PT, Aptt

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3528 Hyponatremia in Community-Acquired Pneumonia

Authors: Emna Ketata, Wafa Farhat

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Introduction: Hyponatremia is defined by a blood sodium level of ≤ 136 mmol/L; it is associated with a high risk of morbidity and mortality in the emergency room. This was explained by transit disorders, including diarrhea and inappropriate antidiuretic hormone secretion (Syndrome of inappropriate antidiuretic hormone secretion). Pneumonia can cause dyspnea, stress-causing SIADH and digestive symptoms (diarrhea and vomiting). Aim: The purpose of this study was to determine the link between pneumonia and hyponatremia as a predictor of patient’s prognosis and intra-hospital mortality. Methodology: This is a prospective observational study over a period of 3 years in the emergency department. Inclusion :patients (age > 14 years), with clinical signs in favor of pneumonia. Natremia was measured. Natremia was classified as mild to moderate with a blood sodium level between 121 and 135 mmol/L and as severe with a blood sodium level ≤ 120 mmol/L. Results: This study showed an average serum sodium value of 135 mmol/L (range 114–159 mmol/L) in these patients. Hyponatremia was observed in 123 patients (43.6%), 115 patients (97,8%) had mild to moderate hyponatremia and 2,8% had severe hyponatremia. The mean age was 65±17 years with a sex ratio of 1.05. The main reason for consultation in patients with hyponatremia was cough in 58 patients (47.2%), and digestive symptoms were present in 25 patients (20.3. An altered state of consciousness was observed in 11 patients (3%). Patients with hyponatremia had greater heart rate (p=0.02),white blood cell count (p=0.009) , plasmatic lactate (p=0.002) and higher rate of pneumonia recurrence (p=0.001) .In addition, 80% of them have a positive CURB65 score (>=2). hyponatremia had higher rates of use of oxygen therapy compared to patients with normo-natremia (54% vs. 45%). The analytical study showed that hyponatremia is significantly associated with intra-hospital mortality with( p=0.01), severe hyponatremia p=0.04. Conclusion: Hyponatremia is a predictor of mortality and worse prognosis. Recognition of the pathophysiological mechanisms of hyponatremia in pneumonia will probably allow better management of it.

Keywords: oxygenotherapy, mortality, recurrence, positif curb65

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3527 The Journey of a Malicious HTTP Request

Authors: M. Mansouri, P. Jaklitsch, E. Teiniker

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SQL injection on web applications is a very popular kind of attack. There are mechanisms such as intrusion detection systems in order to detect this attack. These strategies often rely on techniques implemented at high layers of the application but do not consider the low level of system calls. The problem of only considering the high level perspective is that an attacker can circumvent the detection tools using certain techniques such as URL encoding. One technique currently used for detecting low-level attacks on privileged processes is the tracing of system calls. System calls act as a single gate to the Operating System (OS) kernel; they allow catching the critical data at an appropriate level of detail. Our basic assumption is that any type of application, be it a system service, utility program or Web application, “speaks” the language of system calls when having a conversation with the OS kernel. At this level we can see the actual attack while it is happening. We conduct an experiment in order to demonstrate the suitability of system call analysis for detecting SQL injection. We are able to detect the attack. Therefore we conclude that system calls are not only powerful in detecting low-level attacks but that they also enable us to detect high-level attacks such as SQL injection.

Keywords: Linux system calls, web attack detection, interception, SQL

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3526 Impact of Maternal Nationality on Caesarean Section Rate Variation in a High-income Country

Authors: Saheed Shittu, Lolwa Alansari, Fahed Nattouf, Tawa Olukade, Naji Abdallah, Tamara Alshdafat, Sarra Amdouni

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Cesarean sections (CS), a highly regarded surgical intervention for improving fetal-maternal outcomes and serving as an integral part of emergency obstetric services, are not without complications. Although CS has many advantages, it poses significant risks to both mother and child and increases healthcare expenditures in the long run. The escalating global prevalence of CS, coupled with variations in rates among immigrant populations, has prompted an inquiry into the correlation between CS rates and the nationalities of women undergoing deliveries at Al-Wakra Hospital (AWH), Qatar's second-largest public maternity hospital. This inquiry is motivated by the notable CS rate of 36%, deemed high in comparison to the 34% recorded across other Hamad Medical Corporation (HMC) maternity divisions This is Qatar's first comprehensive investigation of Caesarean section rates and nationalities. A retrospective cross-sectional study was conducted, and data for all births delivered in 2019 were retrieved from the hospital's electronic medical records. The CS rate, the crude rate, and adjusted risks of Caesarean delivery for mothers from each nationality were determined. The common indications for CS were analysed based on nationality. The association between nationality and Caesarean rates was examined using binomial logistic regression analysis considering Qatari women as a standard reference group. The correlation between the CS rate in the country of nationality and the observed CS rate in Qatar was also examined using Pearson's correlation. This study included 4,816 births from 69 different nationalities. CS was performed in 1767 women, equating to 36.5%. The nationalities with the highest CS rates were Egyptian (49.6%), Lebanese (45.5%), Filipino and Indian (both 42.2%). Qatari women recorded a CS rate of 33.4%. The major indication for elective CS was previous multiple CS (39.9%) and one prior CS, where the patient declined vaginal birth after the cesarean (VBAC) option (26.8%). A distinct pattern was noticed: elective CS was predominantly performed on Arab women, whereas emergency CS was common among women of Asian and Sub-Saharan African nationalities. Moreover, a significant correlation was found between the CS rates in Qatar and the women's countries of origin. Also, a high CS rate was linked to instances of previous CS. As a result of these insights, strategic interventions were successfully implemented at the facility to mitigate unwarranted CS, resulting in a notable reduction in CS rate from 36.5% in 2019 to 34% in 2022. This proves the efficacy of the meticulously researched approach. The focus has now shifted to reducing primary CS rates and facilitating well-informed decisions regarding childbirth methods.

Keywords: maternal nationality, caesarean section rate variation, migrants, high-income country

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3525 Phage Therapy of Staphylococcal Pyoderma in Dogs

Authors: Jiri Nepereny, Vladimir Vrzal

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Staphylococcus intermedius/pseudintermedius bacteria are commonly found on the skin of healthy dogs and can cause pruritic skin diseases under certain circumstances (trauma, allergy, immunodeficiency, ectoparasitosis, endocrinological diseases, glucocorticoid therapy, etc.). These can develop into complicated superficial or deep pyoderma, which represent a large group of problematic skin diseases in dogs. These are predominantly inflammations of a secondary nature, associated with the occurrence of coagulase-positive Staphylococcus spp. A major problem is increased itching, which greatly complicates the healing process. The aim of this work is to verify the efficacy of the developed preparation Bacteriophage SI (Staphylococcus intermedius). The tested preparation contains a lysate of bacterial cells of S. intermedius host culture including culture medium and live virions of specific phage. Sodium Merthiolate is added as a preservative in a safe concentration. Validation of the efficacy of the product was demonstrated by monitoring the therapeutic effect after application to indicated cases from clinical practice. The indication for inclusion of the patient into the trial was an adequate history and clinical examination accompanied by sample collection for bacteriological examination and isolation of the specific causative agent. Isolate identification was performed by API BioMérieux identification system (API ID 32 STAPH) and rep-PCR typing. The suitability of therapy for a specific case was confirmed by in vitro testing of the lytic ability of the bacteriophage to lyse the specific isolate = formation of specific plaques on the culture isolate on the surface of the solid culture medium. So far, a total of 32 dogs of different sexes, ages and breed affiliations with different symptoms of staphylococcal dermatitis have been included in the testing. Their previous therapy consisted of more or less successful systemic or local application of broad-spectrum antibiotics. The presence of S. intermedius/pseudintermedius has been demonstrated in 26 cases. The isolates were identified as a S. pseudintermedius, in all cases. Contaminant bacterial microflora was always present in the examined samples. The test product was applied subcutaneously in gradually increasing doses over a period of 1 month. After improvement in health status, maintenance therapy was followed by application of the product once a week for 3 months. Adverse effects associated with the administration of the product (swelling at the site of application) occurred in only 2 cases. In all cases, there was a significant reduction in clinical signs (healing of skin lesions and reduction of inflammation) after therapy and an improvement in the well-being of the treated animals. A major problem in the treatment of pyoderma is the frequent resistance of the causative agents to antibiotics, especially the increasing frequency of multidrug-resistant and methicillin-resistant S. pseudintermedius (MRSP) strains. Specific phagolysate using for the therapy of these diseases could solve this problem and to some extent replace or reduce the use of antibiotics, whose frequent and widespread application often leads to the emergence of resistance. The advantage of the therapeutic use of bacteriophages is their bactericidal effect, high specificity and safety. This work was supported by Project FV40213 from Ministry of Industry and Trade, Czech Republic.

Keywords: bacteriophage, pyoderma, staphylococcus spp, therapy

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3524 Studies on the Physico-Chemical Parameters of Jebba Lake, Niger State, Nigeria

Authors: M. B. Mshelia, J. K. Balogun, J. Auta, N. O. Bankole

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Studies on some aspects of the physico-chemical parameters of Jebba Lake, Niger State, Nigeria was carried out from January to December, 2011. The aim was to investigate some of the physico-chemical parameters relevant to life and health of fish in the water body. Six (6) sampling sites were selected at random which covered Northern (Faku and Awuru), middle (Old Gbajibo and Shankade) and southern zones (New Gbajibo and Jebba dam} of Jebba Lake. Sampling was carried out for the period of 12 Months. The Physico-chemical parameters that were considered were water temperature, pH, dissolved oxygen, electrical conductivity, water transparency, phosphate and nitrate. They were all measured using standard methods. The results showed that water temperature values ranged between 26.06 ± 0.15a in Jebba lake site to 27.34 ± 0.12b in Shankade sampling site, depth varied from 8.08m to 31.64m, water current was between 20.10.62 cm/sec and 26.46 cm/sec, Secchi disc transparency ranged from0.46±0.01 m in New Gbajibo, while the highest mean value was 0.53 ± 0.04 m in Jebba dam., pH varied from 6.49 ± 0.01 and 7.59,5.35±0.03a mg/l in New Gbajibo and 6.75 ± 0.03 mg/l in Faku.The dissolved oxygen varied between 5.35±0.03a mg/l in New Gbajibo and 6.75 ± 0.03 mg/l in Faku.,The mean conductivity value was highest in Faku and Jebba with 128.8 ± 0.32 and 128.8 ± 0.42homs/cm) respectively, Alkalinity ranged 43.00±0.02 to33.30±0.32 mg/l., The nitrate-nitrogen range (2.37 ± 0.08 – 6.40 ± 0.50mg/l)., The mean values of phosphate-phosphorus (PO4-P) recorded varied between 0.18 ± 0.00 mg/l in Faku to 0.47 + 0.10 mg/l in Old Gbajibo.The highest mean value for total dissolved solids was 57.88 ± 0.28 mg/l in Shankade, while the lowest mean value of 39.17 ± 0.42 mg/l was recorded in Faku. Free CO2 ranged from 1.75 mg/l to 2.94 mg/l, Biochemical oxygen demand (BOD) was between 4.25 mg/l and 5.41 mg/l and nitrate-nitrogen concentration was between 2.37 mg/l and 6.40 mg/l. There were significant differences (P < 0.05) between these parameters in relation to stations. Generally, the physico-chemical characteristics of Lake Jebba were within the productive values for aquatic systems, and strongly indicate that the lake is unpolluted.

Keywords: Jebba Lake, water quality, secchi disc, DO meter, sampling sites, physico-chemical parameters

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3523 Redefining "Dedhee" in Terms of Knowledge Gathering and Conserving Hazara Literature

Authors: Urooj Shafique, Salman Jamil

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In the context of an urban human life, city requires to meeting some standards which, at a glance are called the standards of a quality life. Measuring the quality of life according to particular social, economic and cultural conditions of a country and also the emphasis of a country twenty years visions on this issue has special importance. Cultural gathering spaces improve social and economic vitality on one side and on the other side provide favorable conditions for citizen leisure. But unfortunately these cultural gathering spaces in our society are losing their meaning and importance with time. Like coffee houses and libraries. Dedhee was the most prominent place among the cultural gathering spaces in Hazara division. People used to visit them in order to get something out of these spaces. At present they lie in our cities as places of no interest. Libraries are converted into storage houses where books lie untouched for years and years. The aim of my project is to create unique space that engage community members in the learning and creation process, where people can share their knowledge with others as well as enjoy their personal space. The spaces are flexible enough to accommodate people of different moods and interests, with the purpose of helping communities to become aware of their own cultures and to be socially engaged. The site for this specific project has been selected near Cantonment Park Abbottabad, Pakistan. The city of Abbottabad is famous for its writers, poets and storytellers. The site is selected next to the Cantonment Park, at a central location in the whole city so that it can attract users from almost every point of the city. The project provides a cultural gathering space for the people of the city where they can sit and discuss their ideas within a creative and expressive environment, which can represent the cultures of a community.

Keywords: cultural gathering space, Dedhee, Hazara literature, intellectuals’ hub

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3522 Spatial Assessment of Creek Habitats of Marine Fish Stock in Sindh Province

Authors: Syed Jamil H. Kazmi, Faiza Sarwar

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The Indus delta of Sindh Province forms the largest creeks zone of Pakistan. The Sindh coast starts from the mouth of Hab River and terminates at Sir Creek area. In this paper, we have considered the major creeks from the site of Bin Qasim Port in Karachi to Jetty of Keti Bunder in Thatta District. A general decline in the mangrove forest has been observed that within a span of last 25 years. The unprecedented human interventions damage the creeks habitat badly which includes haphazard urban development, industrial and sewage disposal, illegal cutting of mangroves forest, reduced and inconsistent fresh water flow mainly from Jhang and Indus rivers. These activities not only harm the creeks habitat but affected the fish stock substantially. Fishing is the main livelihood of coastal people but with the above-mentioned threats, it is also under enormous pressure by fish catches resulted in unchecked overutilization of the fish resources. This pressure is almost unbearable when it joins with deleterious fishing methods, uncontrolled fleet size, increase trash and by-catch of juvenile and illegal mesh size. Along with these anthropogenic interventions study area is under the red zone of tropical cyclones and active seismicity causing floods, sea intrusion, damage mangroves forests and devastation of fish stock. In order to sustain the natural resources of the Indus Creeks, this study was initiated with the support of FAO, WWF and NIO, the main purpose was to develop a Geo-Spatial dataset for fish stock assessment. The study has been spread over a year (2013-14) on monthly basis which mainly includes detailed fish stock survey, water analysis and few other environmental analyses. Environmental analysis also includes the habitat classification of study area which has done through remote sensing techniques for 22 years’ time series (1992-2014). Furthermore, out of 252 species collected, fifteen species from estuarine and marine groups were short-listed to measure the weight, health and growth of fish species at each creek under GIS data through SPSS system. Furthermore, habitat suitability analysis has been conducted by assessing the surface topographic and aspect derivation through different GIS techniques. The output variables then overlaid in GIS system to measure the creeks productivity. Which provided the results in terms of subsequent classes: extremely productive, highly productive, productive, moderately productive and less productive. This study has revealed the Geospatial tools utilization along with the evaluation of the fisheries resources and creeks habitat risk zone mapping. It has also been identified that the geo-spatial technologies are highly beneficial to identify the areas of high environmental risk in Sindh Creeks. This has been clearly discovered from this study that creeks with high rugosity are more productive than the creeks with low levels of rugosity. The study area has the immense potential to boost the economy of Pakistan in terms of fish export, if geo-spatial techniques are implemented instead of conventional techniques.

Keywords: fish stock, geo-spatial, productivity analysis, risk

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3521 Use and Appreciation of a Type of Mathematics Textbook for Secondary Education

Authors: Verónica Díaz Quezada

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Despite the wide variety of educational resources on the market and the advances produced in the technological field, the practice of teaching continues to be supported mainly by textbooks. This article reports on descriptive research with qualitative methodology carried out on secondary school mathematics teachers in a region of Chile, in order to describe the use and the indicators of appreciation that teachers have on the textbooks distributed by the official body to public educational establishments. Data were collected through an open response opinion questionnaire. According to the results, among the texts available for the annual performance of their teaching work, the expository and technological books predominate, to the detriment of comprehensive books. The exhibition structure favors master expositions and repetitive exercises, while, with the technological structure, a productive exercise is attempted, proposing numerous applications with the intention of giving meaning to the different mathematical rules and procedures. In relation to the indicators of appreciation that teachers have regarding the use of mathematics textbooks, the suitability and quality of the teaching resources are verified as the most satisfying characteristic.

Keywords: mathematics, secondary school, teachers, textbooks

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3520 A Serious Game to Upgrade the Learning of Organizational Skills in Nursing Schools

Authors: Benoit Landi, Hervé Pingaud, Jean-Benoit Culie, Michel Galaup

Abstract:

Serious games have been widely disseminated in the field of digital learning. They have proved their utility in improving skills through virtual environments that simulate the field where new competencies have to be improved and assessed. This paper describes how we created CLONE, a serious game whose purpose is to help nurses create an efficient work plan in a hospital care unit. In CLONE, the number of patients to take care of is similar to the reality of their job, going far beyond what is currently practiced in nurse school classrooms. This similarity with the operational field increases proportionally the number of activities to be scheduled. Moreover, very often, the team of nurses is composed of regular nurses and nurse assistants that must share the work with respect to the regulatory obligations. Therefore, on the one hand, building a short-term planning is a complex task with a large amount of data to deal with, and on the other, good clinical practices have to be systematically applied. We present how reference planning has been defined by addressing an optimization problem formulation using the expertise of teachers. This formulation ensures the gameplay feasibility for the scenario that has been produced and enhanced throughout the game design process. It was also crucial to steer a player toward a specific gaming strategy. As one of our most important learning outcomes is a clear understanding of the workload concept, its factual calculation for each caregiver along time and its inclusion in the nurse reasoning during planning elaboration are focal points. We will demonstrate how to modify the game scenario to create a digital environment in which these somewhat abstract principles can be understood and applied. Finally, we give input on an experience we had on a pilot of a thousand undergraduate nursing students.

Keywords: care planning, workload, game design, hospital nurse, organizational skills, digital learning, serious game

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3519 Tree Dress and the Internet of Living Things

Authors: Vibeke Sorensen, Nagaraju Thummanapalli, J. Stephen Lansing

Abstract:

Inspired by the indigenous people of Borneo, Indonesia and their traditional bark cloth, artist and professor Vibeke Sorensen executed a “digital unwrapping” of several trees in Southeast Asia using a digital panorama camera and digitally “stitched” them together for printing onto sustainable silk and fashioning into the “Tree Dress”. This dress is a symbolic “un-wrapping” and “re-wrapping” of the tree’s bark onto a person as a second skin. The “digital bark” is directly responsive to the real tree through embedded and networked electronics that connect in real-time to sensors at the physical site of the living tree. LEDs and circuits inserted into the dress display the continuous measurement of the O2 / CO2, temperature, humidity, and light conditions at the tree. It is an “Internet of Living Things” (IOLT) textile that can be worn to track and interact with it. The computer system connecting the dress and the tree converts the gas emission data at the site of the real tree into sound and music as sonification. This communicates not only the scientific data but also translates it into a poetic representation. The wearer of the garment can symbolically identify with the tree, or “become one” with it by adorning its “skin.” In this way, the wearer also becomes a human agent for the tree, bringing its actual condition to direct perception of the wearer and others who may engage it. This project is an attempt to bring greater awareness to issues of deforestation by providing a direct access to living things separated by physical distance, and hopefully, to increase empathy for them by providing a way to sense individual trees and their daily existential condition through remote monitoring of data. Further extensions to this project and related issues of sustainability include the use of recycled and alternative plant materials such as bamboo and air plants, among others.

Keywords: IOLT, sonification, sustainability, tree, wearable technology

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3518 Seismic Performance of Isolated Bridge Configurations with Soil Structure Interaction

Authors: Davide Forcellini

Abstract:

The most recent development of earthquake engineering is based on concept of design consisting in prescribed performance rather than the more traditional prescriptive approaches. The paper aims to assess the effects of isolation devices and soil structure interaction on a benchmark bridge adopting a Performance-Based Earthquake Engineering methodology. Several isolated configurations of abutments and pier connections are compared performing the most representative isolation devices. Isolation systems suitability depends on many factors, mainly connected with ground effects. In this regard, the second purpose of this paper is to assess the effects of soil-structure interaction (SSI) on the studied bridge configurations. Contributions of isolation technique and soil structure interaction are assessed evaluating the resistance effects applied to Peak Ground Acceleration (PGA) levels in terms of cost and time repair quantities.

Keywords: base isolation, bridge, earthquake engineering, non linearity, PBEE methodology, seismic assessment, soil structure interaction

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3517 Heritage Tourism and the Changing Rural Landscape: Case Study of Cultural Landscape of Honghe Hani Rice Terraces

Authors: Yan Wang; Mathis Stock

Abstract:

The World Heritage Site of Honghe Hani rice terrace, also a marginal rural region in Southern China, is undergoing rapid change because of urbanization and heritage tourism. Influenced by out-migration and changing ways of living in the urbanization process, the place sees a tendency of losing its rice terrace landscape, traditional housings and other forms of cultural traditions. However, heritage tourism tends to keep the past, valorize them for tourism purposes and diversifies rural livelihood strategies. The place stands at this development trajectories, where the same resources are subjected to different uses by different actors. The research seeks to answer the questions of how the site is transformed and co-constructed by different institutions, practices and actors, and the how heritage tourism affects local livelihood. The research aims to describe the transformation of villages, rice terraces, and cultural traditions, analyze the place-making process, and assess the role of heritage tourism in local livelihood transition. The research uses a mixed of methods including direct observation, participant observation, interviews; collects various data of images, words, narratives, and statistics, and analyze them qualitatively and qualitatively. Theoretically, it is hoped that the research would reexamine the concept of heritage, the world heritage practice from UNESCO, reveal the conflicts it entails in development and brings more thoughts from a functional perspective on heritage in relation to rural development. Practically, it is also anticipated that the research could access the linkage between heritage tourism and local livelihood, and generate concrete suggestions on how tourism could engage locals and improve their livelihood.

Keywords: cultural landscape, Hani rice terraces, heritage tourism, livelihood strategy, place making, rural development, transformation

Procedia PDF Downloads 215
3516 The Effect of Antibiotic Use on Blood Cultures: Implications for Future Policy

Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor

Abstract:

Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.

Keywords: antibiotics, blood culture, efficacy, inpatient

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3515 Analyzing Doctors’ Knowledge of the United Kingdom Chief Medical Officer's Guidelines for Physical Activity: Survey of Secondary Care Doctors in a District General Hospital

Authors: Alexandra Von Guionneau, William Sloper, Charlotte Burford

Abstract:

The benefits of exercise for the prevention and management of chronic disease are well established and the importance of primary care practitioners in promoting exercise is becoming increasingly recognized. However, those with severe manifestations of the chronic disease are managed in a secondary care setting. Secondary care practitioners, therefore, have a role to play in promoting physical activity. Methods: In order to assess secondary care doctors’ knowledge of the Chief Medical Officer’s guidelines for physical activity, a 12-question survey was administered to staff working in a district general hospital in South England during team and unit meetings. Questions related to knowledge of the current guidelines for both 19 - 64 year olds and older adults (65 years and above), barriers to exercise discussion or prescription and doctors’ own exercise habits. Responses were collected anonymously and analyzed using SPSS Version 24.0. Results: 96 responses were collected. Doctors taking part in the survey ranged from foundation years (26%) to consultants (40%). 17.7% of participants knew the guidelines for moderate intensity activity for 19 - 64 year olds. Only one participant knew all of the guidance for both 19 - 64 year olds and older adults. While 71.6% of doctors felt they were adequately informed about how to exercise, only 45.6% met the minimum recommended guidance for moderate intensity activity. Conclusion: More work is needed to promote the physical activity guidelines and exercise prescription to doctors working within a secondary care setting. In addition, doctors require more support to personally meet the recommended minimum level of physical activity.

Keywords: exercise is medicine, exercise prescription, physical activity guidelines, exercise habits

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3514 Subsurface Exploration for Soil Geotechnical Properties and its Implications for Infrastructure Design and Construction in Victoria Island, Lagos, Nigeria

Authors: Sunday Oladele, Joseph Oluwagbeja Simeon

Abstract:

Subsurface exploration, integrating methods of geotechnics and geophysics, of a planned construction site in the coastal city of Lagos, Nigeria has been carried out with the aim of characterizing the soil properties and their implication for the proposed infrastructural development. Six Standard Penetration Tests (SPT), fourteen Dutch Cone Penetrometer Tests (DCPT) and 2D Electrical Resistivity Imaging employing Dipole-dipole and Pole-dipole arrays were implemented on the site. The topsoil (0 - 4m) consists of highly compacted sandy lateritic clay(10 to 5595Ωm) to 1.25m in some parts and dense sand in other parts to 5.50m depth. This topsoil was characterized as a material of very high shear strength (≤ 150kg/m2) and allowable bearing pressure value of 54kN/m2 to 85kN/m2 and a safety factor of 2.5. Soft amorphous peat/peaty clay (0.1 to 11.4Ωm), 3-6m thick, underlays the lateritic clay to about 18m depth. Grey, medium dense to very dense sand (0.37 to 2387Ωm) with occasional gravels underlies the peaty clay down to 30m depth. Within this layer, the freshwater bearing zones are characterized by high resistivity response (83 to 2387Ωm), while the clayey sand/saline water intruded sand produced subdued resistivity output (0.37 to 40Ωm). The overall ground-bearing pressure for the proposed structure would be 225kN/m2. Bored/cast-in-place pile at 18.00m depth with any of these diameters and respective safe working loads 600mm/1,140KN, 800mm/2,010KN and 1000mm/3,150KN is recommended for the proposed multi-story structure.

Keywords: subsurface exploration, Geotechnical properties, resistivity imaging, pile

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3513 Implementation of an Induction Programme to Help the International Medical Graduates in the NHS

Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

Abstract:

Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

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3512 Outcomes of Using Guidelines for Caring and Referring ST Elevation Myocardial Infarction (STEMI) Patients at the Accident and Emergency Department of Songkhla Hospital, Thailand

Authors: Thanom Kaeniam

Abstract:

ST-Elevation Myocardial Infarction (STEMI) is a state of sudden death of the heart muscle due to sudden blockage of the artery. STEMI patients are usually in critical condition and with a potential opportunity for sudden death. Therefore, management guidelines for safety in caring and referring STEMI patients are needed. The objective of this developmental research was to assess the effectiveness of using the guidelines for caring and referring STEMI patients at the Accident and Emergency Department of Songkhla Hospital. The subjects of the study were 22 nurses in the emergency room, and doctors on duty in the accident and emergency room selected using purposive sampling with inclusion criteria. The research instruments were the guidelines for caring and referring STEMI patients, and record forms for the effectiveness of using the guidelines for caring and referring STEMI patients (a general record form for STEMI patients, a record form for SK administering, a referring record form for PCI, and a record form for dead patient in the accident and emergency room and during referring). The instruments were tested for content validity by three experts, and the reliability was tested using Kuder-Richardson 20 (KR20). The descriptive statistic employed was the percentage. The outcomes of using the guidelines for caring and referring ST Elevation Myocardial Infarction (STEMI) Patients at the Accident and Emergency Department revealed that before using the guidelines in 2009, 2010, and 2011, there were 84, 73, and 138 STEMI patients receiving services at the accident and emergency room, of which, only 9, 32, and 48 patients were referred for PCI/SK medications, or 10.74; 43.84; and 34.78 percent, and the death rates were 10.71; 10.95; and 11.59 percent, respectively. However, after the use of the guidelines in 2012, 2013, and 2014, there were 97, 77, and 57 patients, of which, the increases to 77, 72, and 55 patients were referred for PCI /SK medications or 79.37; 93.51; and 96.49 percent, and the death rates were reduced to 10.30; 6.49; and 1.76 percent, respectively. The results of the study revealed that the use of the guidelines for caring and referring STEMI patients at the Accident and Emergency Department increased the effectiveness and quality of nursing, especially in terms of SK medication, caring and referring patients for PCI to reduce the death rate.

Keywords: outcomes, guidelines for caring, referring, myocardial infarction, STEMI

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3511 Analysis of Criteria for Determining the Location of Hilal Observation in the Tropical Regions: Study of Hilal Observation Location in Bengkulu City

Authors: Badrun Taman

Abstract:

This study aims to review the use of the Bengkulu Provincial Government Mess as the location of rukyatul hilal because its determination has not been carried out scientifically. There are three things that will be analyzed, namely geographical-astronomical conditions, the suitability of the location with ideal criteria, and the determination of the location of rukyatul hilal in accordance with regional conditions based on the results of the study. The research method used is qualitative with an astronomical geographical approach. The results showed that the factor that strengthened the disturbance from the weather aspect was the western sky horizon in the form of the Indian Ocean sea level. The potential for geographical disturbances on this horizon is high sea waves, relatively high sea breezes, and more seawater vapor due to sea surface temperatures and high air humidity. This study found new criteria for determining the location of the observation crescent. The criteria is the western horizon is not sea level (especially the Indian Ocean).

Keywords: criteria, location, Rukyatul Hilal, tropics, Indian ocean

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3510 Study on the Knowledge, Attitude and Practice (KAP) of Patients with Hypertension in Aseer Hospital, Asir Region, Saudi Arabia

Authors: Ayesha Siddiqua

Abstract:

Background: Hypertension is a silent killer disease and a common risk factor for considerable morbidity and mortality. Its effects can be seen on the organs like Heart; Brain; Kidneys. In Saudi Arabia, hypertension affects a sizeable enough proportion of the population, with a prevalence of 27.9% in urban and 22.4 in rural population. Despite these features, the magnitude and epidemiological characteristics of this disease have been rarely studied in Saudi Arabia. To fill this gap, we conducted a survey in Abha to study the KAP of hypertension. KAP study shows what people know about certain things, their feelings and behavior towards the disease management. An improvement in the Knowledge and Attitudes towards disease management can reform the kinds of practices which are followed. Objectives: To assess the level of Knowledge, Attitude and Practice of patients who suffer from Hypertension. To improve the Quality of life of patients. Methods: A prospective cross-sectional survey was conducted on a sample size of 130 Hypertensive patients of both the genders enrolled by simple random sampling technique admitted in the Aseer Central Hospital of Abha during the period from October 2016 to December 2016. Results: Altogether 130 hypertensive patients were enrolled in this study with equal no. of Males and Females. Most of the respondents were aged between 18-40 years (45%). On assessing the KAP of the patients, we found that the Knowledge and Attitude score was good but the Practice scores were moderate in both the genders. Conclusion: Our study concludes that a significant proportion of hypertensive patients show less Practice towards the disease management which can lead to severe complications in time being and also result in damage of other vital organs. So there is a need of intense educational intervention for the patients which can be done by Patient counselling by the clinical pharmacist. Strategies to modify lifestyle which help in control of hypertension can include providing leaflets as well as direct educational programs.

Keywords: Attitude, hypertension, Knowledge, practices

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3509 Extent of Knowledge, Preparedness and Perception on Telemedicine among Family Medicine Resident Physicians in Different Training Institutions in Cebu City, PH during COVID-19 Pandemic

Authors: Kristine Joy Y. Sumanga, Clarissa Mae D. Derecho

Abstract:

Telemedicine is providing health care services using electronic means at a distance, including the diagnosis, treatment, and prevention of diseases as well as the research and evaluation and education of health care providers. The role of telemedicine in this time of the COVID-19 pandemic is vital, especially in the practice of medicine. General Objective: To determine the extent of knowledge, preparedness and perception of telemedicine among Family Medicine Resident Physicians in different training institutions in Cebu City during the Coronavirus Disease 19 pandemic. Methods: A descriptive, cross-sectional survey research study was conducted in four hospital training institutions in Cebu City. A total of 41 respondents gave their consent and were given the online survey questionnaire pertaining to the extent of knowledge, preparedness and perceptions on telemedicine, including respondents’ demographic data and problems encountered in Telemedicine. Results: Out of the 41 respondents, 56.10% were young adults (26 to 30 years old), mostly females (70.73%), single (68.29%), first-year residents (43.90%), employed at a government hospital (70.73%) and are in the traditional residency pathway (82.93%). On relevant experience, 82.93% experienced telemedicine during residency, with 100% on follow-up consultations, and 95% were consulted due to infections. Respondents’ extent of knowledge was average, while the extent of preparedness and perception were great. Problems with low connectivity (80.48%) were noted by most of the respondents. Conclusion: Resident physicians moderately understood the information about telemedicine but with a great extent of preparedness and perception. They are always prepared for telemedicine modality because they are fully aware of its existence and need in the delivery of health care services among their patients at the time of the pandemic. Challenges to low connectivity and handling patients’ data privacy were the major concerns met by the resident physicians in the use of telemedicine.

Keywords: telemedicine, knowledge, preparedness, perception, family medicine, residents, COVID 19

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3508 Effect of Carbon Nanotube Reinforcement in Polymer Composite Plates under Static Loading

Authors: S. Madhu, V. V. Subba Rao

Abstract:

In the implementation of carbon nanotube reinforced polymer matrix composites in structural applications, deflection and stress analysis are important considerations. In the present study, a multi scale analysis of deflection and stress analysis of carbon nanotube (CNT) reinforced polymer composite plates is presented. A micromechanics model based on the Mori-Tanaka method is developed by introducing straight CNTs aligned in one direction. The effect of volume fraction and diameter of CNTs on plate deflection and the stresses are investigated using Classical Laminate Plate Theory (CLPT). The study is primarily conducted with the intention of observing the suitability of CNT reinforced polymer composite plates under static loading for structural applications.

Keywords: carbon nanotube, micromechanics, composite plate, multi-scale analysis, classical laminate plate theory

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3507 Physical-Chemical Parameters of Latvian Apple Juices and Their Suitability for Cider Production

Authors: Rita Riekstina-Dolge, Zanda Kruma, Daina Karklina, Fredijs Dimins

Abstract:

Apple juice is the main raw material for cider production. In this study apple juices obtained from 14 dessert and crab variety apples grown in Latvia were investigated. For all samples soluble solids, titratable acidity, pH and sugar content were determined. Crab apples produce more dry matter, total sugar and acid content compared to the dessert apples but it depends on the apple variety. Total sugar content of crab apple juices was 1.3 to 1.8 times larger than in dessert apple juices. Titratable acidity of dessert apple juices is in the range of 4.1g L-1 to 10.83g L-1 and in crab apple juices titratable acidity is from 7.87g L-1 to 19.6g L-1. Fructose was detected as the main sugar whereas glucose level varied depending on the variety. The highest titratable acidity and content of sugars was detected in ‘Cornelia’ apples juice.

Keywords: apple juice, hierarchical cluster analysis, sugars, titratable acidity

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3506 The Sustainability of Health and Safety on Construction Sites in Zamfara State

Authors: Ismaila Oladunni Muhammed, Adegbenga Raphael Ashiru

Abstract:

Construction industry has been attributed to be the engine growth of Nigerian economic and infrastructural development. It promotes infrastructural development and grows an average output of Nigerian Gross Domestic Profit. However, from this great prospect, yearly reports show that consistent accidents on construction sites in Zamfara State has affected a substantial number of workers as they become temporarily or permanently disabled, thereby making many construction sites a death trap. This posed a great threat to the industry’s sustainability, de- motivate workers from working in the industry, and further have negative impact on the economy as well. It is as a result of high construction site accident currently experiencing in Zamfara state that this research was carried out to appraise the sustainability of health and safety of construction workers on sites. The proper practice and compliance to Construction Health and safety laws are very vital to the output and growth of Zamfara State construction sector. However, a quantitative approach was adopted to justify the aforesaid statement which will provide a broader understanding of the study. Descriptive statistical analysis was obtained through Statistical Package for the Social Sciences (SPSS Version 20). Furthermore, the findings from the research highlighted that the performance and output of construction workers on construction sites depends on the proper practice of health and safety. The research findings also recommended ways to enhance employers and employee’s compliance with existing laws guiding health and safety on Zamfara State construction sites. Nevertheless, the purpose of the paper is to appraise the sustainability of Health and Safety on Zamfara State construction sites. This study further provided thorough information for resolving challenges of construction sites accidents to improve construction firm productivity and also ensured construction worker’s safety on site.

Keywords: construction industry, health and safety regulations, causes of accident, construction safety practices

Procedia PDF Downloads 200