Search results for: intensive listening
1286 Efficiency of Treatment in Patients with Newly Diagnosed Destructive Pulmonary Tuberculosis Using Intravenous Chemotherapy
Authors: M. Kuzhko, M. Gumeniuk, D. Butov, T. Tlustova, O. Denysov, T. Sprynsian
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Background: The aim of the research was to determine the effectiveness of chemotherapy using intravenous antituberculosis drugs compared with their oral administration during the intensive phase of treatment. Methods: 152 tuberculosis patients were randomized into 2 groups: Main (n=65) who received isoniazid, ethambutol and sodium rifamycin intravenous + pyrazinamide per os and control (n=87) who received all the drugs (isoniazid, rifampicin, ethambutol, pyrazinamide) orally. Results: After 2 weeks of treatment symptoms of intoxication disappeared in 59 (90.7±3.59 %) of patients of the main group and 60 (68.9±4.9 %) patients in the control group, p<0.05. The mean duration of symptoms of intoxication in patients main group was 9.6±0.7 days, in control group – 13.7±0.9 days. After completing intensive phase sputum conversion was found in all the patients main group and 71 (81.6±4.1 %) patients control group p < 0.05. The average time of sputum conversion in main group was 1.6±0.1 months and 1.9±0.1 months in control group, p > 0.05. In patients with destructive pulmonary tuberculosis time to sputum conversion was 1.7±0.1 months in main group and 2.2±0.2 months in control group, p < 0.05. The average time of cavities healing in main group was 2.9±0.2 months and 3.9±0.2 months in the control group, p < 0.05. Conclusions: In patients with newly diagnosed destructive pulmonary tuberculosis use of isoniazid, ethambutol and sodium rifamycin intravenous in the intensive phase of chemotherapy resulted in a significant reduction in terms of the disappearance of symptoms of intoxication and sputum conversion.Keywords: intravenous chemotherapy, tuberculosis, treatment efficiency, tuberculosis drugs
Procedia PDF Downloads 2021285 Assessment of Delirium, It's Possible Risk Factors and Outcome in Patient Admitted in Medical Intensive Care Unit
Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda
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Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.Keywords: delirium, risk factors, outcome, intervention
Procedia PDF Downloads 1631284 Determining the Factors Affecting Social Media Addiction (Virtual Tolerance, Virtual Communication), Phubbing, and Perception of Addiction in Nurses
Authors: Fatima Zehra Allahverdi, Nukhet Bayer
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Objective: Three questions were formulated to examine stressful working units (intensive care units, emergency unit nurses) utilizing the self-perception theory and social support theory. This study provides a distinctive input by inspecting the combination of variables regarding stressful working environments. Method: The descriptive research was conducted with the participation of 400 nurses working at Ankara City Hospital. The study used Multivariate Analysis of Variance (MANOVA), regression analysis, and a mediation model. Hypothesis one used MANOVA followed by a Scheffe post hoc test. Hypothesis two utilized regression analysis using a hierarchical linear regression model. Hypothesis three used a mediation model. Result: The study utilized mediation analyses. Findings supported the hypotheses that intensive care units have significantly high scores in virtual communication and virtual tolerance. The number of years on the job, virtual communication, virtual tolerance, and phubbing significantly predicted 51% of the variance of perception of addiction. Interestingly, the number of years on the job, while significant, was negatively related to perception of addiction. Conclusion: The reasoning behind these findings and the lack of significance in the emergency unit is discussed. Around 7% of the variance of phubbing was accounted for through working in intensive care units. The model accounted for 26.80 % of the differences in the perception of addiction.Keywords: phubbing, social media, working units, years on the job, stress
Procedia PDF Downloads 531283 Effect of Lullabies on Babies Growth and Development, Vital Signs and Hospitalization Times in the Neonatal Intensive Care Units
Authors: Işın Alkan, Meltem Kürtüncü
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Objective: This study was carried out with an experimental design in order to determine whether the lullaby, which was listened from mother’s voice and a stranger’s voice to the babies born at term and hospitalized in neonatal intensive care unit, had an effect on saturation values (SpO2), peak heart rate (PHR), respiration, fever, growth and development and hospitalization times of the infants. Method: Data from the study were obtained from 90 newborn babies who were hospitalized in Neonatal Intensive Care Unit of Zonguldak Maternity And Children Hospital between September 2015-January 2016 and who met the eligibility criteria. Lullaby concert was performed by choosing one of the suitable care hours. SpO2, PHR, respiration, fever, growth and development and hospitalization times of the infants were recorded by the researcher on “Newborn response follow-up form” at pre-care and post-care. Vital signs of babies every day, weight, height and head circumference measurements at admission, weakly rated at an output. Results: In the experimental and control groups, like weight, height and head circumference anthropometric measurements were not found statistically significant difference intensive care units admission and output times. Hospitalization times on babies who listen to lullaby mother’s voice revealed statistically significant difference according to babies who listen to lullaby stranger’s voice. Before care and after care were examined, SpO2 rates of babies who listen to lullaby mother’s voice revealed statistically significant higher difference according to babies who listen to lullaby stranger’s voice and control group babies. Before care on PHR of babies in three groups were not found the statistical difference, but aftercare, it was found that statistically lower (normal range) on babies who listen to lullaby mother’s voice according to babies who listen to lullaby stranger’s voice. Before care in three groups were not found the statistical difference on respiration values of babies, but aftercare, it was found that statistically lower (normal range) on babies who listen to lullaby stranger’s voice according to babies who listen to mother’s voice and control groups. Before care and after care were examined, fever signs did not reveal statistically significant difference in three groups. Conclusion: Lullaby concerts as being normal ranges of vital signs of infants and also helping to shorten hospitalization times should be preferred in the neonatal intensive care units.Keywords: growth and development, lullaby, mother voice, vital signs
Procedia PDF Downloads 2141282 Architecture - Performance Relationship in GPU Computing - Composite Process Flow Modeling and Simulations
Authors: Ram Mohan, Richard Haney, Ajit Kelkar
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Current developments in computing have shown the advantage of using one or more Graphic Processing Units (GPU) to boost the performance of many computationally intensive applications but there are still limits to these GPU-enhanced systems. The major factors that contribute to the limitations of GPU(s) for High Performance Computing (HPC) can be categorized as hardware and software oriented in nature. Understanding how these factors affect performance is essential to develop efficient and robust applications codes that employ one or more GPU devices as powerful co-processors for HPC computational modeling. This research and technical presentation will focus on the analysis and understanding of the intrinsic interrelationship of both hardware and software categories on computational performance for single and multiple GPU-enhanced systems using a computationally intensive application that is representative of a large portion of challenges confronting modern HPC. The representative application uses unstructured finite element computations for transient composite resin infusion process flow modeling as the computational core, characteristics and results of which reflect many other HPC applications via the sparse matrix system used for the solution of linear system of equations. This work describes these various software and hardware factors and how they interact to affect performance of computationally intensive applications enabling more efficient development and porting of High Performance Computing applications that includes current, legacy, and future large scale computational modeling applications in various engineering and scientific disciplines.Keywords: graphical processing unit, software development and engineering, performance analysis, system architecture and software performance
Procedia PDF Downloads 3631281 The Relationship between Fluctuation of Biological Signal: Finger Plethysmogram in Conversation and Anthropophobic Tendency
Authors: Haruo Okabayashi
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Human biological signals (pulse wave and brain wave, etc.) have a rhythm which shows fluctuations. This study investigates the relationship between fluctuations of biological signals which are shown by a finger plethysmogram (i.e., finger pulse wave) in conversation and anthropophobic tendency, and identifies whether the fluctuation could be an index of mental health. 32 college students participated in the experiment. The finger plethysmogram of each subject was measured in the following conversation situations: Fun memory talking/listening situation and regrettable memory talking/ listening situation for three minutes each. Lyspect 3.5 was used to collect the data of the finger plethysmogram. Since Lyspect calculates the Lyapunov spectrum, it is possible to obtain the largest Lyapunov exponent (LLE). LLE is an indicator of the fluctuation and shows the degree to which a measure is going away from close proximity to the track in a dynamical system. Before the finger plethysmogram experiment, each participant took the psychological test questionnaire “Anthropophobic Scale.” The scale measures the social phobia trend close to the consciousness of social phobia. It is revealed that there is a remarkable relationship between the fluctuation of the finger plethysmography and anthropophobic tendency scale in talking about a regrettable story in conversation: The participants (N=15) who have a low anthropophobic tendency show significantly more fluctuation of finger pulse waves than the participants (N=17) who have a high anthropophobic tendency (F (1, 31) =5.66, p<0.05). That is, the participants who have a low anthropophobic tendency make conversation flexibly using large fluctuation of biological signal; on the other hand, the participants who have a high anthropophobic tendency constrain a conversation because of small fluctuation. Therefore, fluctuation is not an error but an important drive to make better relationships with others and go towards the development of interaction. In considering mental health, the fluctuation of biological signals would be an important indicator.Keywords: anthropophobic tendency, finger plethymogram, fluctuation of biological signal, LLE
Procedia PDF Downloads 2381280 Shortening Distances: The Link between Logistics and International Trade
Authors: Felipe Bedoya Maya, Agustina Calatayud, Vileydy Gonzalez Mejia
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Encompassing inventory, warehousing, and transportation management, logistics is a crucial predictor of firm performance. This has been extensively proven by extant literature in business and operations management. Logistics is also a fundamental determinant of a country's ability to access international markets. Available studies in international and transport economics have shown that limited transport infrastructure and underperforming transport services can severely affect international competitiveness. However, the evidence lacks the overall impact of logistics performance-encompassing all inventory, warehousing, and transport components- on global trade. In order to fill this knowledge gap, the paper uses a gravitational trade model with 155 countries from all geographical regions between 2007 and 2018. Data on logistics performance is obtained from the World Bank's Logistics Performance Index (LPI). First, the relationship between logistics performance and a country’s total trade is estimated, followed by a breakdown by the economic sector. Then, the analysis is disaggregated according to the level of technological intensity of traded goods. Finally, after evaluating the intensive margin of trade, the relevance of logistics infrastructure and services for the extensive trade margin is assessed. Results suggest that: (i) improvements in both logistics infrastructure and services are associated with export growth; (ii) manufactured goods can significantly benefit from these improvements, especially when both exporting and importing countries increase their logistics performance; (iii) the quality of logistics infrastructure and services becomes more important as traded goods are technology-intensive; and (iv) improving the exporting country's logistics performance is essential in the intensive margin of trade while enhancing the importing country's logistics performance is more relevant in the extensive margin.Keywords: gravity models, infrastructure, international trade, logistics
Procedia PDF Downloads 2081279 Linking Milk Price and Production Costs with Greenhouse Gas Emissions of Luxembourgish Dairy Farms
Authors: Rocco Lioy, Tom Dusseldorf, Aline Lehnen, Romain Reding
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A study concerning both the rentability and ecological performance of dairy production in Luxembourg was carried out for the years 2017, 2018 and 2019. The data of 100 dairy farms, referring to the Greenhouse gas emissions (ecology) and the profitability (economy) of dairy production, were evaluated, and the average was compared to the corresponding figures of 80 Luxembourgish dairy farms evaluated in the years 2014, 2015 and 2016. The ecological evaluation could confirm that farm efficiency (especially defined as the lowest ratio between used feedstuff and produced milk) is the key driver for significantly reducing the level of emissions in dairy farms. In both farm groups and in the two periods, the efficient farms show almost the same level of emissions per kg ECM (1,17 kg CO2-eq) in comparison with intensive farms (1,13 kg CO2-eq), and at the same time a by far lowest level of emissions related to the production surface (9,9 vs. 13,9 t CO2-eq/ha). Concerning the economic performances, it could be observed that in the years 2017, 2018 and 2019, the intensive farms (we define intensity in the first place in terms of produced milk pro ha) reached a higher profit (incomes minus costs, only consideration for subsidies) than the efficient farms (4,8 vs. 2,6 €-cent/kg ECM), in contradiction with the observation of the years 2014, 2015 and 2015 (1,5 vs. 3,7 €-cent/kg ECM). The most important reason for this divergent behavior was a change in income and cost structure in the considered periods. In the last period (2017, 2018 and 2019), the milk price was considerably higher than in the previous period, and the production costs were lower. This was of advantage for intensive farms, which produce the highest quantity of milk with a high amount of production means. In the period 2014, 2015 and 2016, with lower milk prices but comparable production costs, the advantage was with efficient farms. In conclusion, we expect that in the next future, when especially the production costs will presumably be much higher than in the last years, the profitableness of dairy farming will decrease. In this case, we assume that efficient farms will provide not only an ecologically but also an economically better performance than production-intensive farms. High milk prices and low production costs are no good incentives for carbon-smart farming.Keywords: efficiency, intensity, dairy, emissions, prices, costs
Procedia PDF Downloads 971278 Improvement plan for Integrity of Intensive Care Unit Patients Withdrawn from Life-Sustaining Medical Care
Authors: Shang-Sin Shiu, Shu-I Chin, Hsiu-Ju Chen, Ru-Yu Lien
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The Hospice and Palliative Care Act has undergone three revisions, making it less challenging for terminal patients to withdraw life support systems. However, the adequacy of care before withdraw is a crucial factor in end-of-life medical treatment. The author observed that intensive care unit (ICU) nursing staff often rely on simple flowcharts or word of mouth, leading to inadequate preparation and failure to meet patient needs before withdraw. This results in confusion or hesitation among those executing the process. Therefore, there is a motivation to improve the withdraw of patient care processes, establish standardized procedures, ensure the accuracy of removal execution, enhance end-of-life care self-efficacy for nursing staff, and improve the overall quality of care. The investigation identified key issues: the lack of applicable guidelines for ICU care for withdraw from life-sustaining, insufficient education and training on withdraw and end-of-life care, scattered locations of withdraw-related tools, and inadequate self-efficacy in withdraw from life-sustaining care. Solutions proposed include revising withdraw care processes and guidelines, integrating tools and locations, conducting educational courses, and forming support groups. After the project implementation, the accuracy of removal cognition improved from 78% to 96.5%, self-efficacy in end-of-life care after removal increased from 54.7% to 93.1%, and the correctness of care behavior progressed from 27.7% to 97.8%. It is recommended to regularly conduct courses on removing life support system care and grief consolation to enhance the quality of end-of-life care.Keywords: the intensive care unit (ICU) patients, nursing staff, withdraw life support systems, self-efficacy
Procedia PDF Downloads 511277 Exploring the Development of Communicative Skills in English Teaching Students: A Phenomenological Study During Online Instruction
Authors: Estephanie S. López Contreras, Vicente Aranda Palacios, Daniela Flores Silva, Felipe Oliveros Olivares, Romina Riquelme Escobedo, Iñaki Westerhout Usabiaga
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This research explored whether the context of online instruction has influenced the development of first-year English-teaching students' communication skills, being these speaking and listening. The theoretical basis finds its niche in the need to bridge the gap in knowledge about the Chilean online educational context and the development of English communicative skills. An interpretative paradigm and a phenomenological design were implemented in this study. Twenty- two first-year students and two teachers from an English teaching training program participated in the study. The students' ages ranged from 18 to 26 years of age, and the teachers' years of experience ranged from 5 to 13 years in the program. For data collection purposes, semi- structured interviews were applied to both students and teachers. Interview questions were based on the initial conceptualization of the central phenomenon. Observations, field notes, and focus groups with the students are also part of the data collection process. Data analysis considered two-cycle methods. The first included descriptive coding for field notes, initial coding for interviews, and creating a codebook. The second cycle included axial coding for both field notes and interviews. After data analysis, the findings show that students perceived online classes as instances in which active communication cannot always occur. In addition, changes made to the curricula as a consequence of the COVID-19 pandemic have affected students' speaking and listening skills.Keywords: attitudes, communicative skills, EFL teaching training program, online instruction, and perceptions
Procedia PDF Downloads 1201276 Application of a Compact Wastewater Treatment Unit in a Rural Area
Authors: Mohamed El-Khateeb
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Encompassing inventory, warehousing, and transportation management, logistics is a crucial predictor of firm performance. This has been extensively proven by extant literature in business and operations management. Logistics is also a fundamental determinant of a country's ability to access international markets. Available studies in international and transport economics have shown that limited transport infrastructure and underperforming transport services can severely affect international competitiveness. However, the evidence lacks the overall impact of logistics performance-encompassing all inventory, warehousing, and transport components- on global trade. In order to fill this knowledge gap, the paper uses a gravitational trade model with 155 countries from all geographical regions between 2007 and 2018. Data on logistics performance is obtained from the World Bank's Logistics Performance Index (LPI). First, the relationship between logistics performance and a country’s total trade is estimated, followed by a breakdown by the economic sector. Then, the analysis is disaggregated according to the level of technological intensity of traded goods. Finally, after evaluating the intensive margin of trade, the relevance of logistics infrastructure and services for the extensive trade margin is assessed. Results suggest that: (i) improvements in both logistics infrastructure and services are associated with export growth; (ii) manufactured goods can significantly benefit from these improvements, especially when both exporting and importing countries increase their logistics performance; (iii) the quality of logistics infrastructure and services becomes more important as traded goods are technology-intensive; and (iv) improving the exporting country's logistics performance is essential in the intensive margin of trade while enhancing the importing country's logistics performance is more relevant in the extensive margin.Keywords: low-cost, recycling, reuse, solid waste, wastewater treatment
Procedia PDF Downloads 1971275 Effects of Clinical Practice Guidelines for Central Venous Catheter to Infection Rate and Nurse’s Satisfaction in Medicine Intensive Care Unit 240 Hat Yai Hospital, Thailand
Authors: Jiranun Sreecharit, Anongnat Boonrut, Kunvadee Munvaradee, Phechnoy Singchungchai
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Hatyai Hospital as center of hospital with a capacity of 670 beds. Medicine intensive care units (MICU240) provide care for critically ill patients who are at high risk need to be monitored closely. Intravenous catheter is vital to help assess the level of water in the body fluids and medications. Potential complications such as infection. We need to have guidelines for the care of patients who received intravenous catheter used to achieve good results. The operations research in this study was intended 1) To study the effects of practice for nurses in caring for patients with central venous catheter to infection rate and 2) To assess the satisfaction of nurses and patient care practices in central venous catheterization patients in the MICU 240. The sample of the patient's central venous catheter crisis that everyone who admitted in MICU 240 during the period from October 2013 to May 2014. Samples prior to practice and 148 samples with 249 case of practice. A systematic review of the research NSWHealth Statewide Guideline for Intensive Care. Data were analyzed by statistics, percentages and frequency NON-PARAMETRICS with Mann-Whitney U. The finding revealed that: 1. Results of the practice patient care central venous catheter infection rates were found to be reduced from 35.14 percent to 25.3 percent. 2. The results of the evaluation of nurses and patients in the patient care practices central venous catheter found to be satisfied and happy to work 85 percent.Keywords: clinical practice guidelines, central venous catheter, infection satisfaction
Procedia PDF Downloads 4751274 Identification and Antibiotic Resistance Rates of Acinetobacter baumannii Strains Isolated from the Respiratory Tract Samples, Obtained from the Different Intensive Care Units
Authors: Recep Kesli, Gulşah Asik, Cengiz Demir, Onur Turkyilmaz
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Objective: Acinetobacter baumannii (A. baumannii) can cause health-care associated infections, such as bacteremia, urinary tract and wound infections, endocarditis, meningitis, and pneumonia, particularly in intensive care unit patients. In this study, we aimed to evaluate A. baumannii production in sputum and bronchoalveolar lavage and susceptibilities for antibiotics in a 24 months period. Methods: Between October 2013 and September 2015, Acinetobacter baumannii isolated from respiratory tract speciments were evaluated retrospectively. The strains were isolated from the different intensive care units patients. A. baumannii strains were identified by both the conventional methods and aoutomated identification system -VITEK 2 (bio-Merieux, Marcy l’etoile, France). Antibiotic resistance testing was performed by Kirby-Bauer disc diffusion method according to CLSI criteria. Results: All the ninety isolates included in the study were from respiratory tract specimens. While of all the isolated 90 Acinetobacter baumannii strains were found to be resistant (100%), against ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam, resistance rates against other tested antibiotics found as follows; meropenem 77, 86%, imipenem 75, 83%, trimethoprim-sulfamethoxazole (TMP-STX) 69, 76,6%, gentamicin 51, 56,6% and amikacin 48, 53,3%. Colistin was found as the most effective antibiotic against Acinetobacter baumannii, and there were not found any resistant (0%) strain against colistin. Conclusion: This study demonstrated that the no resistance was found in Acinetobacter baumannii against to colistin. High rates of resistance to carbapenems (imipenem and meropenem) and other tested antibiotics (ceftiaxone, ceftazidime, ciprofloxacine, piperacilline-tazobactam, TMP-STX gentamicin and amikacin) also have remarkable resistance rates. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay with resistance rates. High resistance rates against antibiotics require implementation of the infection control program and rational use of antibiotics. In the present study, while there were not found colistin resistance, panresistance were found against to ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam.Keywords: acinetobacter baumannii, antibiotic resistance, multi drug resistance, intensive care unit
Procedia PDF Downloads 2821273 Functional Decomposition Based Effort Estimation Model for Software-Intensive Systems
Authors: Nermin Sökmen
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An effort estimation model is needed for software-intensive projects that consist of hardware, embedded software or some combination of the two, as well as high level software solutions. This paper first focuses on functional decomposition techniques to measure functional complexity of a computer system and investigates its impact on system development effort. Later, it examines effects of technical difficulty and design team capability factors in order to construct the best effort estimation model. With using traditional regression analysis technique, the study develops a system development effort estimation model which takes functional complexity, technical difficulty and design team capability factors as input parameters. Finally, the assumptions of the model are tested.Keywords: functional complexity, functional decomposition, development effort, technical difficulty, design team capability, regression analysis
Procedia PDF Downloads 2931272 Thixomixing as Novel Method for Fabrication Aluminum Composite with Carbon and Alumina Fibers
Authors: Ebrahim Akbarzadeh, Josep A. Picas Barrachina, Maite Baile Puig
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This study focuses on a novel method for dispersion and distribution of reinforcement under high intensive shear stress to produce metal composites. The polyacrylonitrile (PAN)-based short carbon fiber (Csf) and Nextel 610 alumina fiber were dispersed under high intensive shearing at mushy zone in semi-solid of A356 by a novel method. The bundles and clusters were embedded by infiltration of slurry into the clusters, thus leading to a uniform microstructure. The fibers were embedded homogenously into the aluminum around 576-580°C with around 46% of solid fraction. Other experiments at 615°C and 568°C which are contained 0% and 90% solid respectively were not successful for dispersion and infiltration of aluminum into bundles of Csf. The alumina fiber has been cracked by high shearing load. The morphologies and crystalline phase were evaluated by SEM and XRD. The adopted thixo-process effectively improved the adherence and distribution of Csf into Al that can be developed to produce various composites by thixomixing.Keywords: aluminum, carbon fiber, alumina fiber, thixomixing, adhesion
Procedia PDF Downloads 5581271 A Quality Improvement Project on Eye Care in the Intensive Care Unit
Authors: Julius Lenaerts, Ahmed Elsaadawy, Mohammed Bashir
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Background Sedated and paralyzed patients have an impaired blink reflex leading to ophthalmic complications such as conjunctivitis, epithelial defects, bacterial keratitis, and more. These are entirely preventable complications through regular eye care. Methods Patients at level 3 or above (intubated/paralyzed) care in the Intensive Care Unit (ICU) were reviewed between February and April. Data was pulled from Metavision and adherence was compared to Royal College of Ophthalmology (RCOphth) recommendations[4]. Using a multi-pronged approach through posters, individual teaching sessions and faculty teaching, we aimed to educate staff about eye care in the ICU. Patients were reaudited in the period July to August. Results Out of 40 patients, only 23% were assessed for eye care needs on admission compared to 77% after teaching; eye care was only delivered 59% of the time it was due, compared to 61%; 2.5% of patients had eyedrops prescribed compared to 41%. This shows an overall increase in meeting RCOphth standards. Key messages Eye care is an overlooked aspect of patient care in the ICU, associated with avoidable ocular complications. Healthcare staff need further rigorous education on the provision and importance of eye care to reduce avoidable complications.Keywords: ICU, eye care, risk, QIP
Procedia PDF Downloads 831270 Carbon Footprint and Exergy Destruction Footprint in White Wine Production Line
Authors: Mahmut Genc, Seda Genc
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Wine is the most popular alcoholic drink in the World with 274.4 million of hectoliter annual production in the year of 2015. The wine industry is very important for some regions as well as creating significant value in their economies. This industry is very sensitive to the global warming since viticulture highly depends on climate and geographical region. Sustainability concept is a crucial issue for the wine industry and sustainability performances of wine production processes should be determined. Although wine production industry is an energy intensive sector as a whole, the most energy intensive products are widely used both in the viti and vinicultural process. In this study, gate-to-gate LCA approach in energy resource utilization and global warming potential impacts for white wine production line were attempted and carbon footprint and exergy destruction footprint were calculated, accordingly. As a result, carbon footprint and exergy destruction footprint values were calculated to be 1.75 kg CO2eq and 365.3kW, respectively.Keywords: carbon footprint, exergy analysis, exergy destruction footprint, white wine
Procedia PDF Downloads 2711269 A Similar Image Retrieval System for Auroral All-Sky Images Based on Local Features and Color Filtering
Authors: Takanori Tanaka, Daisuke Kitao, Daisuke Ikeda
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The aurora is an attractive phenomenon but it is difficult to understand the whole mechanism of it. An approach of data-intensive science might be an effective approach to elucidate such a difficult phenomenon. To do that we need labeled data, which shows when and what types of auroras, have appeared. In this paper, we propose an image retrieval system for auroral all-sky images, some of which include discrete and diffuse aurora, and the other do not any aurora. The proposed system retrieves images which are similar to the query image by using a popular image recognition method. Using 300 all-sky images obtained at Tromso Norway, we evaluate two methods of image recognition methods with or without our original color filtering method. The best performance is achieved when SIFT with the color filtering is used and its accuracy is 81.7% for discrete auroras and 86.7% for diffuse auroras.Keywords: data-intensive science, image classification, content-based image retrieval, aurora
Procedia PDF Downloads 4491268 Effect of Inorganic Fertilization on Soil N Dynamics in Agricultural Plots in Central Mexico
Authors: Karla Sanchez-Ortiz, Yunuen Tapia-Torres, John Larsen, Felipe Garcia-Oliva
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Due to food demand production, the use of synthetic nitrogenous fertilizer has increased in agricultural soils to replace the N losses. Nevertheless, the intensive use of synthetic nitrogenous fertilizer in conventional agriculture negatively affects the soil and therefore the environment, so alternatives such as organic agriculture have been proposed for being more environmentally friendly. However, further research in soil is needed to see how agricultural management affects the dynamics of C and N. The objective of this research was to evaluate the C and N dynamics in the soil with three different agricultural management: an agricultural plot with intensive inorganic fertilization, a plot with semi-organic management and an agricultural plot with recent abandonment (2 years). For each plot, the soil C and N dynamics and the enzymatic activity of NAG and β-Glucosidase were characterized. Total C and N concentration of the plant biomass of each site was measured as well. Dissolved organic carbon (DOC) and dissolved organic nitrogen (DON) was higher in abandoned plot, as well as this plot had higher total carbon (TC) and total nitrogen (TN), besides microbial N and microbial C. While the enzymatic activity of NAG and β-Glucosidase was greater in the agricultural plot with inorganic fertilization, as well as nitrate (NO₃) was higher in fertilized plot, in comparison with the other two plots. The aboveground biomass (AB) of maize in the plot with inorganic fertilization presented higher TC and TN concentrations than the maize AB growing in the semiorganic plot, but the C:N ratio was highest in the grass AB in the abandoned plot. The C:N ration in the maize grain was greater in the semi-organic agricultural plot. These results show that the plot under intensive agricultural management favors the loss of soil organic matter and N, degrading the dynamics of soil organic compounds, promoting its fertility depletion.Keywords: mineralization, nitrogen cycle, soil degradation, soil nutrients
Procedia PDF Downloads 1821267 Importance of Different Spatial Parameters in Water Quality Analysis within Intensive Agricultural Area
Authors: Marina Bubalo, Davor Romić, Stjepan Husnjak, Helena Bakić
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Even though European Council Directive 91/676/EEC known as Nitrates Directive was adopted in 1991, the issue of water quality preservation in areas of intensive agricultural production still persist all over Europe. High nitrate nitrogen concentrations in surface and groundwater originating from diffuse sources are one of the most important environmental problems in modern intensive agriculture. The fate of nitrogen in soil, surface and groundwater in agricultural area is mostly affected by anthropogenic activity (i.e. agricultural practice) and hydrological and climatological conditions. The aim of this study was to identify impact of land use, soil type, soil vulnerability to pollutant percolation, and natural aquifer vulnerability to nitrate occurrence in surface and groundwater within an intensive agricultural area. The study was set in Varaždin County (northern Croatia), which is under significant influence of the large rivers Drava and Mura and due to that entire area is dominated by alluvial soil with shallow active profile mainly on gravel base. Negative agricultural impact on water quality in this area is evident therefore the half of selected county is a part of delineated nitrate vulnerable zones (NVZ). Data on water quality were collected from 7 surface and 8 groundwater monitoring stations in the County. Also, recent study of the area implied detailed inventory of agricultural production and fertilizers use with the aim to produce new agricultural land use database as one of dominant parameters. The analysis of this database done using ArcGIS 10.1 showed that 52,7% of total County area is agricultural land and 59,2% of agricultural land is used for intensive agricultural production. On the other hand, 56% of soil within the county is classified as soil vulnerable to pollutant percolation. The situation is similar with natural aquifer vulnerability; northern part of the county ranges from high to very high aquifer vulnerability. Statistical analysis of water quality data is done using SPSS 13.0. Cluster analysis group both surface and groundwater stations in two groups according to nitrate nitrogen concentrations. Mean nitrate nitrogen concentration in surface water – group 1 ranges from 4,2 to 5,5 mg/l and in surface water – group 2 from 24 to 42 mg/l. The results are similar, but evidently higher, in groundwater samples; mean nitrate nitrogen concentration in group 1 ranges from 3,9 to 17 mg/l and in group 2 from 36 to 96 mg/l. ANOVA analysis confirmed statistical significance between stations that are classified in the same group. The previously listed parameters (land use, soil type, etc.) were used in factorial correspondence analysis (FCA) to detect importance of each stated parameter in local water quality. Since stated parameters mostly cannot be altered, there is obvious necessity for more precise and more adapted land management in such conditions.Keywords: agricultural area, nitrate, factorial correspondence analysis, water quality
Procedia PDF Downloads 2591266 Production of Cement-Free Construction Materials via Fly Ash Carbonation
Authors: Zhenhua Wei, Gabriel Falzone, Bu Wang, Laurent Pilon, Gaurav Sant
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The production of ordinary Portland cement (OPC) is a CO₂ intensive process. Specifically, cement clinkering reactions require not only substantial energy in the form of heat, but also result in the release of CO₂, from limestone decarbonation and the combustion of fuel. To overcome this CO₂ intensive process, clinkering-free cementation is demonstrated by the carbonation of fly ash; i.e., a by-product of coal combustion. It is shown that in moist environments and at sub-boiling temperatures, calcium-rich fly ashes readily react with gas-phase CO₂ to provide cementation. After seven days of CO₂ exposure at 75°C, such formulations achieve a compressive strength on the order of 35 MPa and take-up 9% CO₂ (by mass of the solid). On the other hand, calcium-deficient fly ashes, due to their lack of alkalinity (i.e., abundance of mobile Ca or Mg), show little if any potential for CO₂ uptake and strength gain. The role of the CO₂ concentration and processing temperature are discussed and linked to the progress of reactions, and the development of microstructure. The outcomes demonstrate a means for enabling clinkering-free cementation while enabling beneficial utilization of CO₂ and fly ash; i.e., two abundant but underutilized industrial by-products.Keywords: fly ash, carbonation, concrete, strength
Procedia PDF Downloads 2511265 Assessment of Al/Fe Humus, pH, and P Retention to Differentiate Andisols under Different Cultivation, Karanganyar, Central Java, Indonesia
Authors: Miseri Roeslan Afany, Nur Ainun Pulungan
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The unique characteristics of Andisol differentiate them from other soils. These characteristics become a guideline in determining management and usage with regards to agriculture. Especially in the tropical area, Andisols may have fast mineral alteration due to intensive water movement in the soils. Four soil chemical tests were conducted for evaluating soils in the study area. Al/Fe humus, allophane, pH, and P retention were used to differentiate Andisols under different practices. Non-cultivation practice (e.g. natural forest) and cultivation practices (e.g. horticulture systems and intensive farming systems) are compared in this study. We applied Blackmore method for P retention analysis. The aims of this study are: (i) to analyze the specific behavior of Al/Fe humus, pH, and allophane towards P retention in order (ii) to evaluate the effect of cultivation practices on their behavior changes among Andisols, and (iii) to gain the sustainable agriculture through proposing an appropriate soil managements in the study area. 5 observation sites were selected, and 75 soil sampling were analyzed in this study. The results show that the cultivation decreases P retention in all sampling sites. There is a declining from ±90% to ±50% of P retention in the natural forest where shifts into cultivated land. The average of P retention under 15 years of cultivation down into 63%, whereas, the average of P retention more than 15 years of cultivation down into 54%. Many factors affect the retention of P in the soil such as: (1) type and amount of clay, (2) allophone and/or imogolit, (3) Al/Fe humus, (4) soil pH, (5) type and amount of organic material, (6) Exchangeable bases (Ca, Mg, Na, K), (7) forms and solubility of Al/Fe. To achieve the sustainable agriculture in the study area, conventional agriculture practices should be preserved and intensive fertilizing practices should be applied in order to increase the soil pH, to maintain the organic matter of andisols, to maintain microba activities, and to release Al/Fe humus complex, and thus increase available P in the soils.Keywords: Andisols, cultivation, P retention, sustainable agriculture
Procedia PDF Downloads 2801264 Growth and Development Parameters of Saanen Kids Raised under Intensive Conditions in Konya/Turkey
Authors: Vahdetti̇n Sariyel, Bi̇rol Dağ
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In this research, growth and development parameters in Konya, a private company in Saanen kids reared in intensive conditions in the province were examined. Average birth weights were 3.42, 2.96, 3.57, 3.23 and 2.77 kg for male, female, single, twins and triplets kids. Average weaning weights (three months of age) were 12.65, 12.09, 12.80, 12.65 and 11.68 kg for male, female, single, twins and triplets kids. Average body weights at seven months of age were 20.55, 18.98, 20.12, 20.12 and 19.05 kg for male, female, single, twins and triplets kids respectively. Considering the gender of the live weight factors birth control and rule in favor of the first en ( P <0.01), the second control finally it disappeared statistically significant ( P> 0.05). Main age and the effect of birth weight in the first month, while significant (P < 0.01); The effect of the second month following the live weight of the kid was not significant.Keywords: Saanen kids, growth, development, body weight
Procedia PDF Downloads 2721263 Value-Added Tax Exemptions and Farm-Level Productivity: The Case of Rice, Millet, and Maize in Senegal
Authors: Awa Diouf
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Since 2004, inputs specific to the agricultural sector have been exempt from VAT in Senegal. This paper measures, using the Naatal Mbay survey, the impact of this reform on agricultural productivity. The survey covers a sample of 3,122 rice, millet and maize farms for the 2016 crop year. The regressions show that tax incentives are ineffective in improving partial productivity of the land factor: the higher the share of the value of exemptions in the higher the production costs, the less productive the operation. The negative effect of the exemptions on productivity is accentuated for the most intensive agricultural area: the Senegal River Delta, and the most intensive crop: irrigated rice. This relationship could stem from a decrease in allocative efficiency: farmers have overinvested in the most accessible inputs. The loose budget constraint syndrome, therefore, explains this result: farmers who benefit more from exemptions reduce their managerial effort. The results suggest a removal of the VAT exemptions applied to finished products and agricultural inputs for a better efficiency of this tax, which typically taxes final consumption and should be neutral for the producer.Keywords: agricultural productivity, agricultural taxation, Senegal, tax incentives
Procedia PDF Downloads 1301262 Using the Synchronous Online Flipped Learning Approach to Facilitate Student Podcasting
Authors: Yasmeen Coaxum
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The year 2020 became synonymous with the words “Emergency Remote Teaching,” which was imposed upon educators during the COVID-19 pandemic. Consequently, teachers were compelled to find new and engaging ways to educate their students outside of the face-to-face classroom setting. Now online instruction has become more of the norm rather than a way to manage educational expectations during a crisis. Therefore, implementing a strategic way to create online environments for students to thrive, create, and fully engage in their learning process is essential. The Synchronous Online Flipped Learning Approach or SOFLA® is a distance learning model that most closely replicates actual classroom teaching. SOFLA® includes structured, interactive, multimodal activities in an eight-step learning cycle with both asynchronous and synchronous components that foster autonomous and interactive learning among today’s online learners. The results of a pilot study in an Intensive English Program at a university, using SOFLA® methodology to facilitate podcasting in an online learning environment will be shared. Previous findings on student-produced podcasting projects have shown that students felt they improved their pronunciation, vocabulary, and speaking skills. However, few if any studies have been conducted on using a structured online flipped learning approach to facilitate such projects. Therefore, the purpose of this study is to assess the effect of using the SOFLA® framework to enhance optimum engagement in the online environment while using podcasts as the primary tool of instruction. Through data from interviews, questionnaires, and the results of formative and summative assessments, this study also investigates the affective and academic impact this flipped learning method combined with podcasting has on the students in terms of speaking confidence and vocabulary retention, and production. The steps of SOFLA will be illustrated, a video demonstration of the Anchor podcasting app will be shown, and final student projects and questionnaire responses will be shared. The specific context is a 14-week advanced level conversation and listening class. Participants vary in age but are all adult language learners representing a diverse array of countries.Keywords: mall online flipped learning, podcasting, productive vocabulary
Procedia PDF Downloads 1761261 Comparison of Bactec plus Blood Culture Media to BacT/Alert FAN plus Blood Culture Media for Identification of Bacterial Pathogens in Clinical Samples Containing Antibiotics
Authors: Recep Kesli, Huseyin Bilgin, Ela Tasdogan, Ercan Kurtipek
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Aim: The aim of this study was to compare resin based Bactec plus aerobic/anaerobic blood culture bottles (Becton Dickinson, MD, USA) and polymeric beads based BacT/Alert FA/FN plus blood culture bottles (bioMerieux, NC, USA) in terms of microorganisms recovery rates and time to detection (TTD) in the patients receiving antibiotic treatment. Method: Blood culture samples were taken from the patients who admitted to the intensive care unit and received antibiotic treatment. Forty milliliters of blood from patients were equally distributed into four types of bottles: Bactec Plus aerobic, Bactec Plus anaerobic, BacT/Alert FA Plus, BacT/Alert FN Plus. Bactec Plus and BacT/Alert Plus media were compared to culture recovery rates and TTD. Results: Blood culture samples were collected from 382 patients hospitalized in the intensive care unit and 245 patients who were diagnosed as having bloodstream infections were included in the study. A total of 1528 Bactec Plus aerobic, Bactec Plus anaerobic, BacT/Alert FA Plus, BacT/Alert FN Plus blood culture bottles analyzed and 176, 144, 154, 126 bacteria or fungi were isolated, respectively. Gram-negative and gram-positive bacteria were significantly more frequently isolated in the resin-based Bactec Plus bottles than in the polymeric beads based BacT/Alert Plus bottles. The Bactec Plus and BacT/Alert Plus media recovery rates were similar for fungi and anaerobic bacteria. The mean TTDs in the Bactec Plus bottles were shorter than those in the BacT/Alert Plus bottles regardless of the microorganisms. Conclusion: The results of this study showed that resin-containing media is a reliable and time-saving tool for patients who are receiving antibiotic treatment due to sepsis in the intensive care unit.Keywords: Bactec Plus, BacT/Alert Plus, blood culture, antibiotic
Procedia PDF Downloads 1461260 Examining the Usefulness of an ESP Textbook for Information Technology: Learner Perspectives
Authors: Yun-Husan Huang
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Many English for Specific Purposes (ESP) textbooks are distributed globally as the content development is often obliged to compromises between commercial and pedagogical demands. Therefore, the issue of regional application and usefulness of globally published ESP textbooks has received much debate. For ESP instructors, textbook selection is definitely a priority consideration for curriculum design. An appropriate ESP textbook can facilitate teaching and learning, while an inappropriate one may cause a disaster for both teachers and students. This study aims to investigate the regional application and usefulness of an ESP textbook for information technology (IT). Participants were 51 sophomores majoring in Applied Informatics and Multimedia at a university in Taiwan. As they were non-English majors, their English proficiency was mostly at elementary and elementary-to-intermediate levels. This course was offered for two semesters. The textbook selected was Oxford English for Information Technology. At class end, the students were required to complete a survey comprising five choices of Very Easy, Easy, Neutral, Difficult, and Very Difficult for each item. Based on the content design of the textbook, the survey investigated how the students viewed the difficulty of grammar, listening, speaking, reading, and writing materials of the textbook. In terms of difficulty, results reveal that only 22% of them found the grammar section difficult and very difficult. For listening, 71% responded difficult and very difficult. For general reading, 55% responded difficult and very difficult. For speaking, 56% responded difficult and very difficult. For writing, 78% responded difficult and very difficult. For advanced reading, 90% reported difficult and very difficult. These results indicate that, except the grammar section, more than half of the students found the textbook contents difficult in terms of listening, speaking, reading, and writing materials. Such contradictory results between the easy grammar section and the difficult four language skills sections imply that the textbook designers do not well understand the English learning background of regional ESP learners. For the participants, the learning contents of the grammar section were the general grammar level of junior high school, while the learning contents of the four language skills sections were more of the levels of college English majors. Implications from the findings are obtained for instructors and textbook designers. First of all, existing ESP textbooks for IT are few and thus textbook selections for instructors are insufficient. Second, existing globally published textbooks for IT cannot be applied to learners of all English proficiency levels, especially the low level. With limited textbook selections, third, instructors should modify the selected textbook contents or supplement extra ESP materials to meet the proficiency level of target learners. Fourth, local ESP publishers should collaborate with local ESP instructors who understand best the learning background of their students in order to develop appropriate ESP textbooks for local learners. Even though the instructor reduced learning contents and simplified tests in curriculum design, in conclusion, the students still found difficult. This implies that in addition to the instructor’s professional experience, there is a need to understand the usefulness of the textbook from learner perspectives.Keywords: ESP textbooks, ESP materials, ESP textbook design, learner perspectives on ESP textbooks
Procedia PDF Downloads 3401259 Haematological Alterations in Anemic Bali Cattle Raised in Semi-Intensive Husbandry System
Authors: Jully Handoko, B. Kuntoro, E. Saleh, Sadarman
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Most farmers in Bangkinang Seberang sub district raise Bali cattle in semi-intensive husbandry system. The farmers believe that raising such a way is economical and quite effective. The farmers do not need to provide forage and plant feed crops. Furthermore, the raising method is considered not to interfere with the main job. Screening for anemia in Bali cattle of Bangkinang Seberang subdistrict, Kampar regency, Riau, Indonesia, had been conducted. The aim of the study was to analyze hematological alterations in the anemic Bali cattle. A number of 75 Bali cattle were screened for anemia on the basis of Hemoglobin (Hb) concentration. The other hematological parameters that were measured including packed cell volume (PCV), total erythrocyte count (TEC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC). The screening showed that 18 (24.00%) of Bali cattle were anemic. Levels of Hb, PCV, TEC, MCV, MCH and MCHC in anemic Bali cattle were 7.15±1.61 g/dl, 21.15±4.16%, 3.72±1.10x106/µl, 52.75±4.13 fl, 17.31±1.86 pg and 32.77±1.69 g/dl respectively. Hematological values of Hb, PCV, TEC, MCV, MCH and MCHC were significantly (p < 0.05) lower in anemic Bali cattle compared to non-anemic Bali cattle.Keywords: anemia, Bali cattle, alterations, hematology
Procedia PDF Downloads 4521258 Intensive Multidisciplinary Feeding Intervention for a Toddler with In-Utero Drug Exposure
Authors: Leandra Prempeh, Emily Malugen
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Prenatal drug exposure can have a molecular impact on the hypothalamic and reward genes that regulate feeding behavior. This can impact feeding regulation, resulting in feeding difficulties and growth failure. This was potentially seen in “McKayla,” a 19- month old girl with a history of in-utero drug exposure, patent ductus arteriosus, and gastroesophageal reflux disease who presented for intensive day treatment feeding therapy. She was diagnosed with Avoidant Restrictive Food Intake Disorder, described as total food refusal and meeting 100% of her caloric needs from a gastrostomy tube. The primary goals during intensive feeding therapy were to increase her oral intake and decrease her reliance on supplementation with formula. Several behavioral antecedent manipulations were implemented to establish consistent responding and make progress towards treatment goals. This included multiple modified bolus placements (using underloaded and Nuk brush), reinforcement contingencies, and variety fading before stability was finally achieved. Following, increasing retention of bites then increasing volume and variety were goals targeted. From treatment onset to the last 3 days of treatment, McKayla's rate of rapid acceptance of bite presentations increased significantly from 33.33% to 93.13%, rapid swallowing went from 0.00% to 92.32%, and her percentage of inappropriate mealtime behavior and expels decreased from 58.33% and 100% to 2.31% and 7.68%, respectively. Overall, the treatment team successfully introduced and increased the bite size of 7 pureed foods, generalize the treatment to caregivers with high integrity, and began facilitating tube weaning. She was receiving about 33.42% of her needs by mouth at the time of discharge. Other nutritional concerns addressed during treatment included drinking a nutritionally complete drink out of an open cup and age appropriate growth. McKayla continued to have emesis almost daily, as was her baseline before starting treatment; however, the frequency during mealtime decreased. Overall, McKayla responded well to treatment. She had a very slow response to treatment and required a lot of antecedent manipulations to establish consistent responding. As the literature suggests, [drug]-exposed neonates, like McKayla, may be at increased risk for nutritional and growth challenges that may persist throughout development. This supports the need for longterm follow-up of infant growth.Keywords: behavioral intervention, feeding problems, in-utero drug exposure, intensive multidisciplinary intervention
Procedia PDF Downloads 661257 Definition, Barriers to and Facilitators of Moral Distress as Perceived by Neonatal Intensive Care Physicians
Authors: M. Deligianni, P. Voultsos, E. Tsamadou
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Background/Introduction: Moral distress is a common occurrence for health professionals working in neonatal critical care. Despite a growing number of critically ill neonatal and pediatric patients, only a few articles related to moral distress as experienced by neonatal physicians have been published over the last years. Objectives/Aims: The aim of this study was to define and identify barriers to and facilitators of moral distress based on the perceptions and experiences of neonatal physicians working in neonatal intensive care units (NICUs). This pilot study is a part of a larger nationwide project. Methods: A multicenter qualitative descriptive study using focus group methodology was conducted. In-depth interviews lasting 45 to 60 minutes were audio-recorded. Once data were transcribed, conventional content analysis was used to develop the definition and categories, as well as to identify the barriers to and facilitators of moral distress. Results: Participants defined moral distress broadly in the context of neonatal critical care. A wide variation of definitions was displayed. The physicians' responses to moral distress included different feelings and other situations. The overarching categories that emerged from the data were patient-related, family-related, and physician-related factors. Moreover, organizational factors may constitute major facilitators of moral distress among neonatal physicians in NICUs. Note, however, that moral distress may be regarded as an essential component to caring for neonates in critical care. The present study provides further insight into the moral distress experienced by physicians working in Greek NICUs. Discussion/Conclusions: Understanding how neonatal and pediatric critical care nurses define moral distress and what contributes to its development is foundational to developing targeted strategies for mitigating the prevalence of moral distress among neonate physicians in the context of NICUs.Keywords: critical care, moral distress, neonatal physician, neonatal intensive care unit, NICU
Procedia PDF Downloads 151