Search results for: nursing assessment
4843 An Audit on Optimum Utilisation of Preoperative Clinic
Authors: Vidya Iyer, Suresh Babu Loganathan, Yuan Hwa Lee, Kwong Fah Koh
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Introduction: It has been recommended that every patient undergoes careful preoperative evaluation in a preoperative clinic to improve theatre utilization, reduce bed occupancy and avoid unnecessary cancellation due to inadequate optimisation, communication and administrative errors. It also gives an opportunity to counsel patients regarding different aspects of anaesthesia. Methodology: A retrospective audit of all the patients seen in preoperative assessment clinic, referral letters of all the patients postponed / referred to other sub specialities in the perioperative period from June 2012 - June 2013 was done. In our clinic, we retrieved patient records who were awaiting surgery pending clearance by other sub specialities. Those patients, who could continue with their scheduled date of surgery after having been referred, were not included in the file. We also studied details of same day cancellations from the data base, during the same study period. The reasons for cancellation were examined and defined as avoidable and unavoidable. Results: Less than 0.5% was postponed from the scheduled day of surgery. Less than 0.5% was cancelled on the day of surgery. Conclusions: Patients who undergo pre anaesthetic evaluation in a well-established clinic results in adequate preoperative patient optimisation, avoids unnecessary preoperative admission, efficient theatre utilisation and greater patient satisfaction. The benefits are the result of guidelines and timely update of them which are used by the junior doctors and trainees who run the clinic and a dedicated specialist to supervise them.Keywords: preoperative assessment, clinic, referrals, cancellation
Procedia PDF Downloads 3314842 Product Design and Development of Wearable Assistant Device
Authors: Hao-Jun Hong, Jung-Tang Huang
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The world is gradually becoming an aging society, and with the lack of laboring forces, this phenomenon is affecting the nation’s economy growth. Although nursing centers are booming in recent years, the lack of medical resources are yet to be resolved, thus creating an innovative wearable medical device could be a vital solution. This research is focused on the design and development of a wearable device which obtains a more precise heart failure measurement than products on the market. The method used by the device is based on the sensor fusion and big data algorithm. From the test result, the modified structure of wearable device can significantly decrease the MA (Motion Artifact) and provide users a more cozy and accurate physical monitor experience.Keywords: big data, heart failure, motion artifact, sensor fusion, wearable medical device
Procedia PDF Downloads 3514841 Development and Validation of the Response to Stressful Situations Scale in the General Population
Authors: Célia Barreto Carvalho, Carolina da Motta, Marina Sousa, Joana Cabral, Ana Luísa Carvalho, Ermelindo Peixoto
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The aim of the current study was to develop and validate a Response to Stressful Situations Scale (RSSS) for the Portuguese population. This scale assesses the degree of stress experienced in scenarios that can constitute positive, negative and more neutral stressors, and also describes the physiological, emotional and behavioral reactions to those events according to their intensity. These scenario include typical stressor scenarios relevant to patients with schizophrenia, which are currently absent from most scale, assessing specific risks that these stressors may bring on subjects, which may prove useful in non-clinical and clinical populations (i.e. patients with mood or anxiety disorders, schizophrenia). Results from Principal Components Analysis and Confirmatory Factor Analysis of on two adult samples from general population allowed to confirm a three-factor model with good fit indices: χ2 (144)= 370.211, p = 0.000; GFI = 0.928; CFI = 0.927; TLI = 0.914, RMSEA = 0.055, P( rmsea ≤ 0.005) = 0.096; PCFI = 0.781. Further data analysis on the scale revealed that RSSS is an adequate assessment tool of stress response in adults to be used in further research and clinical settings, with good psychometric characteristics, adequate divergent and convergent validity, good temporal stability and high internal consistency.Keywords: assessment, stress events, stress response, stress vulnerability
Procedia PDF Downloads 5204840 The Environmental Impact of Sustainability Dispersion of Chlorine Releases in Coastal Zone of Alexandra: Spatial-Ecological Modeling
Authors: Mohammed El Raey, Moustafa Osman Mohammed
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The spatial-ecological modeling is relating sustainable dispersions with social development. Sustainability with spatial-ecological model gives attention to urban environments in the design review management to comply with Earth’s System. Naturally exchange patterns of ecosystems have consistent and periodic cycles to preserve energy flows and materials in Earth’s System. The probabilistic risk assessment (PRA) technique is utilized to assess the safety of industrial complex. The other analytical approach is the Failure-Safe Mode and Effect Analysis (FMEA) for critical components. The plant safety parameters are identified for engineering topology as employed in assessment safety of industrial ecology. In particular, the most severe accidental release of hazardous gaseous is postulated, analyzed and assessment in industrial region. The IAEA- safety assessment procedure is used to account the duration and rate of discharge of liquid chlorine. The ecological model of plume dispersion width and concentration of chlorine gas in the downwind direction is determined using Gaussian Plume Model in urban and ruler areas and presented with SURFER®. The prediction of accident consequences is traced in risk contour concentration lines. The local greenhouse effect is predicted with relevant conclusions. The spatial-ecological model is also predicted the distribution schemes from the perspective of pollutants that considered multiple factors of multi-criteria analysis. The data extends input–output analysis to evaluate the spillover effect, and conducted Monte Carlo simulations and sensitivity analysis. Their unique structure is balanced within “equilibrium patterns”, such as the biosphere and collective a composite index of many distributed feedback flows. These dynamic structures are related to have their physical and chemical properties and enable a gradual and prolonged incremental pattern. While this spatial model structure argues from ecology, resource savings, static load design, financial and other pragmatic reasons, the outcomes are not decisive in artistic/ architectural perspective. The hypothesis is an attempt to unify analytic and analogical spatial structure for development urban environments using optimization software and applied as an example of integrated industrial structure where the process is based on engineering topology as optimization approach of systems ecology.Keywords: spatial-ecological modeling, spatial structure orientation impact, composite structure, industrial ecology
Procedia PDF Downloads 804839 The Relationship between Self Concept Clarity and Need for Absolute Truth and Problem Solving and Symptoms of Stress in Homosexual Male
Authors: Gizem Akcan, Erdinc Ozturk
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When it is examined as historically, it has caught attention that homosexual people try to behave as heterosexual or come out to have a place in community. Homosexual people have identity confusion during identity development, they have high levels of need for absolute truth and their psychological well being is affected negatively because of high levels of need for absolute truth and they have problems about self concept clarity. People who have problems about self concept clarity have problems on problem solving and show lots of symptoms of stress. People who have clear self concept use healthier coping strategies to solve problems. The purpose of this study is to show whether need for absolute truth predicts problem solving and symptoms of stress via mediator effect of self concept clarity or not on homosexual men. The participants of this study were 200 homosexual men. The ages of participants were 20-50. In addition, Demographic Information Form, Self Concept Clarity Scale, Need for Absolute Truth Scale, Stres Self-Assessment Checklist and Problem Solving Inventory were applied to the participants. The assessment of the data was made with confirmatory factor analysis and structural equation modeling analysis. According to the results of this study, need for absolute truth predicts problem solving and symptoms of stress via mediator effect of self concept clarity on homosexual men.Keywords: need for absolute truth, self concept clarity, symptoms of stress, problem solving
Procedia PDF Downloads 2244838 Industrial Ergonomics Improvement at a Refrigerator Manufacturing Company in Iran: An Approach on Interventional Ergonomics
Authors: Hassan S. Naeini
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Nowadays a lot of people are working in several sorts of industrial sectors in which there are some risk factors which threaten human being especially in developing countries. One of the main problems which effect on workers’ health refers to Ergonomics. Ergonomics as multidisciplinary science concerns workers’ health and safety in terms of somatic and mental concepts. Surely ergonomics interventions and improvement make a better condition for workers and change the quality of working life to better condition. In this study, one of the factories in Iran which is producing some kinds of small and medium size of refrigerators was chosen as the sample. The preliminary ergonomics observation of the mentioned factory showed that there are some risk factors in terms of ergonomics aspects, so an ergonomic intervention was defined, then some ergonomic assessment methods such as NMQ,OWAS, and Environmental Ergonomic Assessment were used. Also Anthropometric measurement was done. This study shows that there are some workstations and plants which suffer some degrees of ergonomic problems. Considering with the gathered data, illumination, noise control and workstation design in metal workstation are known as the priority actions. Some parts of the mentioned interventions are ongoing actions. it seems that the mentioned intervention and workstations design make a better condition for workers, because ergonomics make a safer and more sustainable environments for human being.Keywords: anthropometry, ergonomics, health, NMQ, OWAS
Procedia PDF Downloads 7554837 Investigating the Challenges Faced by English Language Teachers in Implementing Outcome Based Education the Outcome Based Education model in Engineering Universities of Sindh
Authors: Habibullah Pathan
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The present study aims to explore problems faced by English Language Teachers (ELT) while implementing the Outcome Based Education (OBE) model in engineering universities of Sindh. OBE is an emerging model initiative of the International Engineering Alliance. Traditional educational systems are teacher-centered or curriculum-centered, in which learners are not able to achieve desired outcomes, but the OBE model enables learners to know the outcomes before the start of the program. OBE is a circular process that begins from the needs and demands of society to stakeholders who ask the experts to produce the alumnus who can fulfill the needs and ends up getting new enrollment in the respective programs who can work according to the demands. In all engineering institutions, engineering courses besides English language courses are taught on the OBE model. English language teachers were interviewed to learn the in-depth of the problems faced by them. The study found that teachers were facing problems including pedagogical, OBE training, assessment, evaluation and administrative support. This study will be a guide for public and private English language teachers to cope with these challenges while teaching the English language on the OBE model. OBE is an emerging model by which the institutions can produce such a product that can meet the demands.Keywords: problems of ELT teachers, outcome based education (OBE), implementing, assessment
Procedia PDF Downloads 984836 Youth Health Promotion Project for Indigenous People in Canada: Together against Bullying and Cyber-Dependence
Authors: Mohamed El Fares Djellatou, Fracoise Filion
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The Ashukin program that means bridge in Naskapi or Atikamekw language, has been designed to offer a partnership between nursing students and an indigenous community. The students design a health promotion project tailored to the needs of the community. The issues of intimidation in primary school and cyber-dependence in high school were some concerns in a rural Atikamekw community. The goal of the project was to have a conversation with indigenous youths, aged 10-16 years old, on the challenges presented by intimidation and cyber dependence as well as promoting healthy relationships online and within the community. Methods: Multiple progressive inquiry questions (PIQs) were used to assess the feasibility and importance of this project for the Atikamekw nation, and to determine a plan to follow. The theoretical foundations to guide the conception of the project were the Population Health Promotion Model (PHPM), the First Nations Holistic Lifelong Learning Model, and the Medicine Wheel. A broad array of social determinants of health were addressed, including healthy childhood development, personal health practices, and coping skills, and education. The youths were encouraged to participate in interactive educational sessions, using PowerPoint presentations and pamphlets as the main effective strategies. Additional tools such as cultural artworks and physical activities were introduced to strengthen the inter-relational and team spirit within the Indigenous population. A quality assurance tool (QAT) was developed specifically to determine the appropriateness of these health promotion tools. Improvements were guided by the feedback issued by the indigenous schools’ teachers and social workers who filled the QATs. Post educational sessions, quantitative results have shown that 93.48% of primary school students were able to identify the different types of intimidation, 72.65% recognized more than two strategies, and 52.1% were able to list at least four resources to diffuse intimidation. On the other hand, around 75% of the adolescents were able to name at least three negative effects, and 50% listed three strategies to reduce cyber-dependence. This project was meant to create a bridge with the First Nation through health promotion, a population that is known to be disadvantaged due to systemic health inequity and disparities. Culturally safe care was proposed to deal with the two identified priority issues, and an educational toolkit was given to both schools to ensure the sustainability of the project. The project was self-financed through fundraising activities, and it yielded better results than expected.Keywords: indigenous, first nation, bullying, cyber-dependence, internet addiction, intimidation, youth, adolescents, school, community nursing, health promotion
Procedia PDF Downloads 984835 Self-Care and Emotional Wellbeing of Nurses Using Playback Theatre and Expressive Arts
Authors: Radhika Jain
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The nursing community in India face unique challenges ranging from lack of adequate career progression, low social status attached to the profession, poor nurse-to-patient ratio leading to heavy workload resulting in stress and burnout, lack of general recognition and the responsibility of often having to deal with the ire of the patients and their families. This study explores how a combination of Playback Theatre and Expressive Arts could be used as a very powerful tool to understand the concerns, and consequently as a self-care tool to bring about the sense of well-being and emotional awareness for the nurses. For the purpose of this study, Playback Theatre was used as an entry tool to understand the thoughts, feelings and concerns. Playback theatre is a unique improvisational form of theatre developed by Jonathan Fox and Jo Salas in 1975, in which audience share their own stories from their lives and the performers play them back through a range of improv techniques such as metaphor, poetry, music and movement. Playback Theatre helped in first warming them up to the idea of sharing and then gave them the confidence of a safe space to collectively go deeper into their emotional experiences. As the next step, structured sessions of Expressive Arts were conducted with the same set of nurses, for them to work on the issues and concerns they have (and which they shared during the Playback performance). These sessions were to enable longer engagements as many of the concerns expressed were related to perceptions and beliefs that have been ingrained over a period of time and hence it needs a longer engagement to be worked on in detail. The Expressive Art sessions helped in this regard. Expressive arts therapy combines psychology and the creative process to promote emotional growth and healing. The study was conducted at two places: one a geriatric centre and the other, a palliative care centre. The study revealed that concerns and challenges would not be identical across the nursing community or across similar types of health care organizations but would be specific to each organization or centre as the circumstances and set-up at each place would be different. At the geriatric centre, stress and burnout emerged as the main concerns while at the palliative care centre, the main concern that came up was around the difficulty the nurses faced in expressing emotions and in communicating their feelings. The objective analysis of the results of the study indicated how longer-term engagements using Expressive Arts as the modality helped the nurses have better awareness of their emotions and helped them develop tools of self-care tools while also tapping into their emotions to express and experience. The process of eliciting the main concerns from the nurses using a Playback Theatre performance and then following that with subsequent sessions of expressive arts helped the nurses in the way nurses approached their job and the reduced level of overwhelm that they felt.Keywords: palliative care, nurses, self-care, expressive arts, playback theatre
Procedia PDF Downloads 1204834 Identifying Factors of Wellbeing in Russian Orphans
Authors: Alexandra Telitsyna, Galina Semya, Elvira Garifulina
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Introduction: Starting from 2012 Russia conducts deinstitutionalization policy and now the main indicator of success is the number of children living in institutions. Active family placement process has resulted in residents of the institution now mainly consists of adolescents with behavioral and emotional problems, children with disabilities and groups of siblings. Purpose of science research: The purpose of science research is to identify factors for child’s wellbeing while temporary stay in an orphanage and the subjective assessment of children's level of well-being (psychological well-being). Methods: The data used for this project was collected by the questionnaire of 72 indicators, a tool for monitoring the behavior of children and caregivers, an additional questionnaire for children; well-being assessment questionnaire containing 10 scales for three age groups from preschool to older adolescents. In 2016-2018, the research was conducted in 1873 institution in 85 regions of Russia. In each region a team of academics, specialists from Non-profits, independent experts was created. Training was conducted for team members through a series of webinars prior to undertaking the assessment. The results: To ensure the well-being of the children, the following conditions are necessary: 1- Life of children in institution is organised according to the principles of family care (including the creation of conditions for attachment to be formed); 2- Contribution to find family-based placement for children (including reintegration into the primary family); 3- Work with parents of children, who are placed in an organization at the request of parents; 4- Children attend schools according to their needs; 5- Training of staff and volunteers; 6- Special environment and services for children with special needs and children with disabilities; 7- Cooperation with NGOs; 8 - Openness and accessibility of the organization. Conclusion: A study of the psychological well-being of children showed that the most emotionally stressful for children were questions about the presence and frequency of contact with relatives, and the level of well-being is higher in the presence of a trusted adult and respect for rights. The greatest contribution to the trouble is made by the time the child is in the orphanage, the lack of contact with parents and relatives, the uncertainty of the future.Keywords: identifying factors, orphans, Russia, wellbeing
Procedia PDF Downloads 1284833 Environmental Impacts Assessment of Power Generation via Biomass Gasification Systems: Life Cycle Analysis (LCA) Approach for Tars Release
Authors: Grâce Chidikofan, François Pinta, A. Benoist, G. Volle, J. Valette
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Statement of the Problem: biomass gasification systems may be relevant for decentralized power generation from recoverable agricultural and wood residues available in rural areas. In recent years, many systems have been implemented in all over the world as especially in Cambodgia, India. Although they have many positive effects, these systems can also affect the environment and human health. Indeed, during the process of biomass gasification, black wastewater containing tars are produced and generally discharged in the local environment either into the rivers or on soil. However, in most environmental assessment studies of biomass gasification systems, the impact of these releases are underestimated, due to the difficulty of identification of their chemical substances. This work deal with the analysis of the environmental impacts of tars from wood gasification in terms of human toxicity cancer effect, human toxicity non-cancer effect, and freshwater ecotoxicity. Methodology: A Life Cycle Assessment (LCA) approach was adopted. The inventory of tars chemicals substances was based on experimental data from a downdraft gasification system. The composition of six samples from two batches of raw materials: one batch made of tree wood species (oak+ plane tree +pine) at 25 % moisture content and the second batch made of oak at 11% moisture content. The tests were carried out for different gasifier load rates, respectively in the range 50-75% and 50-100%. To choose the environmental impacts assessment method, we compared the methods available in SIMAPRO tool (8.2.0) which are taking into account most of the chemical substances. The environmental impacts for 1kg of tars discharged were characterized by ILCD 2011+ method (V.1.08). Findings Experimental results revealed 38 important chemical substances in varying proportion from one test to another. Only 30 are characterized by ILCD 2011+ method, which is one of the best performing methods. The results show that wood species or moisture content have no significant impact on human toxicity noncancer effect (HTNCE) and freshwater ecotoxicity (FWE) for water release. For human toxicity cancer effect (HTCE), a small gap is observed between impact factors of the two batches, either 3.08E-7 CTUh/kg against 6.58E-7 CTUh/kg. On the other hand, it was found that the risk of negative effects is higher in case of tar release into water than on soil for all impact categories. Indeed, considering the set of samples, the average impact factor obtained for HTNCE varies respectively from 1.64 E-7 to 1.60E-8 CTUh/kg. For HTCE, the impact factor varies between 4.83E-07 CTUh/kg and 2.43E-08 CTUh/kg. The variability of those impact factors is relatively low for these two impact categories. Concerning FWE, the variability of impact factor is very high. It is 1.3E+03 CTUe/kg for tars release into water against 2.01E+01 CTUe/kg for tars release on soil. Statement concluding: The results of this study show that the environmental impacts of tars emission of biomass gasification systems can be consequent and it is important to investigate the ways to reduce them. For environmental research, these results represent an important step of a global environmental assessment of the studied systems. It could be used to better manage the wastewater containing tars to reduce as possible the impacts of numerous still running systems all over the world.Keywords: biomass gasification, life cycle analysis, LCA, environmental impact, tars
Procedia PDF Downloads 2814832 Life Cycle Analysis of Using Brick Waste in Road Technology
Authors: Mezhoud Samy, Toumi Youcef, Boukendekdji Otmane
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Nowadays, industrial by-products and waste are increasing along with public needs increase. The engineering sector has turned to sustainable development by emphasizing the aspects of environmental and life cycle assessment as an important objective. Among this waste, the remains of the red bricks (DBR) may be an alternative worth checking out, given their availability and abundance at the construction sites. In this context, this work aims to valorize DBR in the concrete road (BR). The incorporation of DBR is carried out by the substitution of the granular fractions of mixtures from noble quarry materials. The experimental plan aims to determine the physico-mechanical performance and environmental performance of manufactured BRs from DBR with a cement content (6.5%) and compared with a control BR without DBR. The studied characteristics are proctor, resistance to compression, resistance to flexural tensile at 7 and 28 days, modulus of elasticity, and total shrinkage. The results of this experimental study showed that the characteristics of recycled aggregates (DBR) are lower than those of natural aggregates but remain acceptable with respect to regulations. Results demonstrate the mechanical performance of BR made from less DBR than the control BR without DBR but remains appreciable and encourage their jobs in the road sector. Recycled aggregates can constitute an interesting economic and ecological alternative but require elementary precautions before any use.Keywords: life cycle assessment, brick waste, road concrete, performance
Procedia PDF Downloads 964831 Relationship between the Development of Sepsis, Systemic Inflammatory Response Syndrome and Body Mass Index among Adult Trauma Patients at University Hospital in Cairo
Authors: Mohamed Hendawy Mousa, Warda Youssef Mohamed Morsy
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Background: Sepsis is a major cause of mortality and morbidity in trauma patients. Body mass index as an indicator of nutritional status was reported as a predictor of injury pattern and complications among critically ill injured patients. Aim: The aim of this study is to investigate the relationship between body mass index and the development of sepsis, systemic inflammatory response syndrome among adult trauma patients at emergency hospital - Cairo University. Research design: Descriptive correlational research design was utilized in the current study. Research questions: Q1. What is the body mass index profile of adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, Q2. What is the frequency of systemic inflammatory response syndrome and sepsis among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?, and Q3. What is the relationship between the development of sepsis, systemic inflammatory response syndrome and body mass index among adult trauma patients admitted to the emergency hospital at Cairo University over a period of 6 months?. Sample: A purposive sample of 52 adult male and female trauma patients with revised trauma score 10 to 12. Setting: The Emergency Hospital affiliated to Cairo University. Tools: Four tools were utilized to collect data pertinent to the study: Socio demographic and medical data tool, Systemic inflammatory response syndrome assessment tool, Revised Trauma Score tool, and Sequential organ failure assessment tool. Results: The current study revealed that, (61.5 %) of the studied subjects had normal body mass index, (25 %) were overweight, and (13.5 %) were underweight. 84.6% of the studied subjects had systemic inflammatory response syndrome and 92.3% were suffering from mild sepsis. No significant statistical relationship was found between body mass index and occurrence of Systemic inflammatory response syndrome (2= 2.89 & P = 0.23). However, Sequential organ failure assessment scores were affected significantly by body mass index was found mean of initial and last Sequential organ failure assessment score for underweight, normal and obese where t= 7.24 at p = 0.000, t= 16.49 at p = 0.000 and t= 9.80 at p = 0.000 respectively. Conclusion: Underweight trauma patients showed significantly higher rate of developing sepsis as compared to patients with normal body weight and obese. Recommendations: based on finding of this study the following are recommended: replication of the study on a larger probability sample from different geographical locations in Egypt; Carrying out of further studies in order to assess the other risk factors influencing trauma outcome and incidence of its complications; Establishment of standardized guidelines for managing underweight traumatized patients with sepsis.Keywords: body mass index, sepsis, systemic inflammatory response syndrome, adult trauma
Procedia PDF Downloads 2514830 Health Risk Assessment and Source Apportionment of Elemental Particulate Contents from a South Asian Future Megacity
Authors: Afifa Aslam, Muhammad Ibrahim, Abid Mahmood, Muhammad Usman Alvi, Fariha Jabeen, Umara Tabassum
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Many factors cause air pollution in Pakistan, which poses a significant threat to human health. Diesel fuel and gasoline motor vehicles, as well as industrial companies, pollute the air in Pakistan's cities. The study's goal is to determine the level of air pollution in a Pakistani industrial city and to establish risk levels for the health of the population. We measured the intensity of air pollution by chemical characterization and examination of air samples collected at stationary remark sites. The PM10 levels observed at all sampling sites, including residential, commercial, high-traffic, and industrial areas were well above the limits imposed by Pakistan EPA, the United States EPA, and WHO. We assessed the health risk via chemical factors using a methodology approved for risk assessment. All Igeo index values greater than one were considered moderately contaminated or moderately to severely contaminated. Heavy metals have a substantial risk of acute adverse effects. In Faisalabad, Pakistan, there was an enormously high risk of chronic effects produced by a heavy metal acquaintance. Concerning specified toxic metals, intolerable levels of carcinogenic risks have been determined for the entire population. As a result, in most of the investigated areas of Faisalabad, the indices and hazard quotients for chronic and acute exposure exceeded the permissible level of 1.0. In the current study, re-suspended roadside mineral dust, anthropogenic exhaust emissions from traffic and industry, and industrial dust were identified as major emission sources of elemental particulate contents. Because of the unacceptable levels of risk in the research area, it is strongly suggested that a comprehensive study of the population's health status as a result of air pollution should be conducted for policies to be developed against these risks.Keywords: elemental composition, particulate pollution, Igeo index, health risk assessment, hazard quotient
Procedia PDF Downloads 914829 Assessment and Prediction of Vehicular Emissions in Commonwealth Avenue, Quezon City at Various Policy and Technology Scenarios Using Simple Interactive Model (SIM-Air)
Authors: Ria M. Caramoan, Analiza P. Rollon, Karl N. Vergel
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The Simple Interactive Models for Better Air Quality (SIM-air) is an integrated approach model that allows the available information to support the integrated urban air quality management. This study utilized the vehicular air pollution information system module of SIM-air for the assessment of vehicular emissions in Commonwealth Avenue, Quezon City, Philippines. The main objective of the study is to assess and predict the contribution of different types of vehicles to the vehicular emissions in terms of PM₁₀, SOₓ, and NOₓ at different policy and technology scenarios. For the base year 2017, the results show vehicular emissions of 735.46 tons of PM₁₀, 108.90 tons of SOₓ, and 2,101.11 tons of NOₓ. Motorcycle is the major source of particulates contributing about 52% of the PM₁₀ emissions. Meanwhile, Public Utility Jeepneys contribute 27% of SOₓ emissions and private cars using gasoline contribute 39% of NOₓ emissions. Ambient air quality monitoring was also conducted in the study area for the standard parameters of PM₁₀, S0₂, and NO₂. Results show an average of 88.11 µg/Ncm, 47.41 µg/Ncm and 22.54 µg/Ncm for PM₁₀, N0₂, and SO₂, respectively, all were within the DENR National Ambient Air Quality Guideline Values. Future emissions of PM₁₀, NOₓ, and SOₓ are estimated at different scenarios. Results show that in the year 2030, PM₁₀ emissions will be increased by 186.2%. NOₓ emissions and SOₓ emissions will also be increased by 38.9% and 5.5%, without the implementation of the scenarios.Keywords: ambient air quality, emissions inventory, mobile air pollution, vehicular emissions
Procedia PDF Downloads 1384828 Radiation Protection Study for the Assessment of Mixed Fields Ionizing Radiation
Authors: Avram Irina, Coiciu Eugenia-Mihaela, Popovici Mara-Georgiana, Mitu Iani Octavian
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ELI-NP stands as a cutting-edge facility globally, hosting unique radiological setups. It conducts experiments leveraging high-power lasers capable of producing extremely brief 10 PW pulses on two fronts. Moreover, it houses an exceptional gamma beam system with distinctive spectral characteristics. The facility hosts various experiments across designated experimental areas, encompassing ultra-short high-power laser tests, high-intensity gamma beam trials, and combined experiments utilizing both setups. The facility hosts a dosimetry laboratory, which recently obtained accreditation, where the radiation safety group employs a host of different types of detectors for monitoring the personnel, environment, and public exposure to ionizing radiation generated in experiments performed. ELI-NP's design was shaped by radiological protection assessments conducted through Monte Carlo simulations. The poster exemplifies an assessment conducted using the FLUKA code in an experimental area where a high-power laser system is implemented, and the future diagnostic system for variable energy gamma beams will soon be operational.Keywords: radiation protection, Monte Carlo simulation, FLUKA, dosimetry
Procedia PDF Downloads 744827 Correlative Study of Serum Interleukin-18 and Disease Activity, Functional Disability and Quality of Life in Rheumatoid Arthritis Patients
Authors: Hamdy Khamis Korayem, Manal Yehia Tayel, Abeer Shawky El Hadedy, Emmanuel Kamal Aziz Saba, Shimaa Badr Abdelnaby Badr
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The aim of the current study was to demonstrate whether serum Interleukin-18 (IL-18) is increased in rheumatoid arthritis (RA) and its correlation with disease activity, functional disability and quality of life in RA patients. The study included 30 RA patients and 20 healthy normal control subjects. The RA patients were diagnosed according to the 2010 ACR/EULAR classification criteria for RA with the exclusion of those who had diabetes mellitus, endocrine disorders, associated rheumatologic diseases, viral hepatitis B or C and other diseases with increased serum IL-18 level. All patients were subjected to clinical evaluation of the musculoskeletal system. Disease activity was assessed by disease activity score 28 with 4 variables (DAS 28). Functional disability was assessed by health assessment questionnaire disability index (HAQ-DI). The quality of life was assessed by Short form-36 (SF-36) questionnaire. Radiological assessment of both hands and feet by Sharp/van der Heijde (SvH) scoring method. Laboratory parameters including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) were assessed in patients and serum level of IL-18 in both patients and control subjects. There was no statistically significant difference between patient and control group as regards age and sex. Among patients, 29 % were females and the age range was between 25 to 55 years. Extra-articular manifestations were presented in 56.7% of the patients. The mean of DAS 28 score was 5.73±1.46 and that of HAQ-DI was 1.22±0.72 while that of SF-36 was 40.03±13.96. The level of serum IL-18 was significantly higher in patients than in the control subjects (P= 0.030). Serum IL-18 was correlated with ACPA among the patient group. There were no statistically significant correlations between serum IL-18 and DAS28, HAQ-DI, SF-36, total SvH score and the other laboratory results. In conclusion, IL-18 is significantly higher in RA patient than in healthy control subjects and positively correlated with ACPA level. IL-18 is associated with extra-articular manifestations. However, it is not correlated with other laboratory parameters, disease activity, functional disability, quality of life nor radiological severity.Keywords: disease activity score, Interleukin-18, quality of life assessment, rheumatoid arthritis
Procedia PDF Downloads 3254826 Cancer and Disability: A Psychosocial Approach in Puerto Rican Women as Cancer Survivors
Authors: Hector Jose Velazquez-Gonzalez, Norma Maldonado-Santiago, Laura Pietri-Gomez
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Cancer is one of the first cause of death in the world, most of them are women. In Puerto Rico, there is a permanent controversy on the conceptuation of what really involves a disability, also in when a chronic illness, like cancer, should be considered a disability. The aim of the research was to identify functional limitation in 50 women survivors of cancer. In turn, to know the meanings that 6 women attributed to cancer with a focus on functionality. We conducted a mix method research based on surveys and narratives. We administered the World Health Organization Disability Assessment, version 2.0, which obtained a Cronbach’s alpha of .949 on the general scale, and from .773 to .956 on the six domains. The domain that obtained the highest average was social participation (M= 33.89, SD= 20.434), but it was not significant in the disability percentage. Also, there was no significance in the disability percentage in the other five domains. In a matter of meanings, we conduct a semistructured interview to 6 participants. All of them do not refer to cancer as a disability, either they do not know that in Puerto Rico cancer is considered as a disability by the law. However, participants agree that cancer at the time of treatment and subsequent to it, has significant effects on functional limitations (fatigue, pain, cognitive limitations, and weakness, among others. Psychooncologic practice should encourage the constant assessment of the functionality to identify the needs that emerge from oncological diagnosis. So that psychosocial intervention could be considered as critical in cancer treatment to promote a better quality of life and well-being in a person with cancer.Keywords: cancer, Puerto Rico, disability, psychosocial approach
Procedia PDF Downloads 2784825 Association Between Hip Internal and External Rotation Range of Motion and Low Back Pain in Table Tennis Players
Authors: Kaili Wang, Botao Zhang, Enming Zhang
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Background: Low back pain (LBP) is a common problem affecting athletes' training and competition. Although the association between a limited hip range of motion and prevalence of low back pain has been studied extensively, it has not been studied in table tennis. Aim: The main purposes of this study in table tennis players were (1) to investigate if there is a difference in hip internal rotation (HIR) and external rotation (HER) range of motion (ROM) between players with LBP and players without LBP and (2) to analyze the association between HIR and HER ROM and LBP. Methods: Forty-six table tennis players from the Chinese table tennis team were evaluated for passive maximum HIR and HER ROM. LBP was retrospectively recorded for the last 12 months before the date of ROM assessment by a physical therapist. The data were analyzed the difference in HIR and HER ROM between players with LBP and players without LBP by Mann-Whitney U test, and the association between the difference in HIR and HER ROM and LBP was analyzed via a binary logistic regression. Results: The 54% of players had developed LBP during the retrospective study period. Significant difference between LBP group and the asymptomatic group for HIR ROM (z=4.007, p<0.001) was observed. Difference between LBP group and asymptomatic group for HER ROM (z=1.117, p=0.264) was not significant. Players who had HIR ROM deficit had an increased risk of LBP compared with players without HIR ROM deficit (OR=5.344, 95%CI: 1.006-28.395, P=0.049). Conclusion: HIR ROM of a table tennis player with LBP was less than a table tennis player without LBP. Compared with player whose HIR ROM was normal, player who had HIR ROM deficit appeared to have a higher risk for LBP.Keywords: assessment, injury prevention, low back pain, table tennis players
Procedia PDF Downloads 1114824 Spatial Analysis for Wind Risk Index Assessment
Authors: Ljiljana Seric, Vladimir Divic, Marin Bugaric
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This paper presents methodology for spatial analysis of GIS data that is used for assessing the microlocation risk index from potential damages of high winds. The analysis is performed on freely available GIS data comprising information about wind load, terrain cover and topography of the area. The methodology utilizes the legislation of Eurocode norms for determination of wind load of buildings and constructions. The core of the methodology is adoption of the wind load parameters related to location on geographical spatial grid. Presented work is a part of the Wind Risk Project, supported by the European Commission under the Civil Protection Financial Instrument of the European Union (ECHO). The partners involved in Wind Risk project performed Wind Risk assessment and proposed action plan for three European countries – Slovenia, Croatia and Germany. The proposed method is implemented in GRASS GIS open source GIS software and demonstrated for Case study area of wider area of Split, Croatia. Obtained Wind Risk Index is visualized and correlated with critical infrastructures like buildings, roads and power lines. The results show good correlation between high Wind Risk Index with recent incidents related to wind.Keywords: Eurocode norms, GIS, spatial analysis, wind distribution, wind risk
Procedia PDF Downloads 3174823 Human Health Risk Assessment of Mercury-Contaminated Soils in Alebediah Mining Community, Sudan
Authors: Ahmed Elwaleed, Huiho Jeong, Ali H. Abdelbagi, Nguyen Thi Quynh, Koji Arizono, Yasuhiro Ishibashi
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Artisanal and small-scale gold mining (ASGM) poses substantial risks to both human health and the environment, particularly through contamination of soil, water, and air. Prolonged exposure to ASGM-contaminated soils can lead to acute or chronic mercury toxicity. This study assesses the human health risks associated with mercury-contaminated soils and tailings in the Alebediah mining community in Sudan. Soil samples were collected from various locations within Alebediah, including ASGM areas, farmlands, and residential areas, along with tailings samples commonly found within ASGM sites. The evaluation of potential health risks to humans included the computation of the estimated daily intake (AvDI), the hazard quotient (HQ), and the hazard index (HI) for both adults and children. The primary exposure route identified as potentially posing a significant health risk was the volatilization of mercury from tailings samples, where mercury concentrations reached up to 25.5 mg/kg. In contrast, other samples within the ASGM area showed elevated mercury levels but did not present significant health risks, with HI values below 1. However, all areas indicated HI values above 1 for the remaining exposure routes. The study observed a decrease in mercury concentration with increasing distance from the ASGM community. Additionally, soil samples revealed elevated mercury levels exceeding background values, prompting an assessment of contamination levels using the enrichment factor (EF). The findings indicated that farmlands and residential areas exhibited depleted EF, while areas surrounding the ASGM community showed none to moderate pollution. In contrast, ASGM areas exhibited significant to extreme pollution. A GIS map was generated to visually depict the extent of mercury pollution, facilitating communication with stakeholders and decision-makers.Keywords: mercury pollution, artisanal and small-scale gold mining, health risk assessment, hazard index, soil and tailings, enrichment factor
Procedia PDF Downloads 834822 A Study on FWD Deflection Bowl Parameters for Condition Assessment of Flexible Pavement
Authors: Ujjval J. Solanki, Prof.(Dr.) P.J. Gundaliya, Prof.M.D. Barasara
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The application of Falling Weight Deflectometer is to evaluate structural performance of the flexible pavement. The exercise of back calculation is required to know the modulus of elasticity of existing in-service pavement. The process of back calculation needs in-depth field experience for the input of range of modulus of elasticity of bituminous, granular and subgrade layer, and its required number of trial to find such matching moduli with the observed FWD deflection on the field. The study carried out at Barnala-Mansa State Highway Punjab-India using FWD before and after overlay; the deflections obtained at 0 on the load cell, 300, 600, 900,1200, 1500 and 1800 mm interval from the load cell these seven deflection results used to calculate Surface Curvature Index (SCI), Base damage Index (BDI), Base curvature index (BCI). This SCI, BCI and BDI indices are useful to predict the structural performance of in-service pavement and also useful to identify homogeneous section for condition assessment. The SCI, BCI and BDI range are determined for before and after overlay the range of SCI 520 to 51 BDI 294 to 63 BCI 83 to 0.27 for old pavement and SCI 272 to 23 BDI 228 to 28, BCI 25.85 to 4.60 for new pavement. It also shows good correlation with back calculated modulus of elasticity of all the three layer.Keywords: back calculation, base damage index, base curvature index, FWD (Falling Weight Deflectometer), surface curvature index
Procedia PDF Downloads 3324821 Fifth Grade Student Skills of Reading Illustrated Drawings in Physical and Chemical Changes Included in Science Textbook
Authors: Sozan H. Omar, Lina L. Al-Rewaili
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The current study aimed to measure the fifth Grade student skills of reading illustrates in physical and chemical chapter included in science textbook, as well as identity the tasks the dispersants related to designing these illustrates which obstruct the students to read them properly. The researcher applied the test instrument of open discuss questions to measure the skill of: recognizing, description, interpretation and assessment for a sample of this research consisted of (269) students who read three illustrates, and conduct an interview with sample of them (27) students to recognize the dispersants related to designing of these illustrates. The study results showed that there are poor levels in illustrated drawing reading skills: description, interpretation, and assessment. The most important dispersants which obstruct the students to read theses illustrates properly representing: Art impacts of these illustrates, there are some elements which don’t serve these illustrates. In the light of the above results, the researcher provided some recommendations such as training the students on using the images and illustrates properly in science textbooks, as well as create simple designs of illustrates and they should be free of crowded elements and impacts which don’t serve the illustrates.Keywords: reading illustrated drawings skills, fifth grade science, physical and chemical changes
Procedia PDF Downloads 3744820 Developing Leadership and Teamwork Skills of Pre-Service Teachers through Learning Camp
Authors: Sirimanee Banjong
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This study aimed to 1) develop pre-service teachers’ leadership skills through camp-based learning, and 2) develop pre-service teachers’ teamwork skills through camp-based learning. An applied research methodology was used. The target group was derived from a purposive selection. It involved 32 fourth-year students in Early Childhood Education Program enrolling in a course entitled Seminar in Early Childhood Education provided during the second semester of the academic year 2013. The treatment was camp-based learning activities which applied a PDCA process including four stages: 1) plan, 2) do, 3) check, and 4) act. Research instruments were a learning camp program, a camp-based learning management plan, a 5-level assessment form for leadership skills and a 5-level assessment form for assessing teamwork skills. Data were analyzed using descriptive statistics. Results were: 1) pre-service teachers’ leadership skills yielded the before treatment average score at ¯("x" )=3.4, S.D.= 0.62 and the after-treatment average score at ¯("x" ) 4.29, S.D.=0.66 pre-service teachers’ teamwork skills yielded the before-treatment average score at ¯("x" )=3.31, S.D.= 0.60 and the after-treatment average score at ¯("x" )=4.42, S.D.= 0.66. Both differences were statistically significant at the .05 level. Thus, the pre-service teachers’ leadership and teamwork skills were significantly improved through the camp-based learning approach.Keywords: learning camp, leadership skills, teamwork skills, pre-service teachers
Procedia PDF Downloads 3614819 Assessment of Academic Knowledge Transfer Channels in Field of Environment
Authors: Jagul Huma Lashari, Arabella Bhutto
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Last few years have shown increased an interest of researchers in knowledge and technology transfer. However, facts show fewer types of knowledge transfer practices in the developing countries. This article focuses on assessment transfer channels of academic research produced by highly qualified academicians working in universities in Sindh offering degrees in field of an Environment in Sindh Pakistan. The academic field has been chosen because in field of the environment there is alarming need of research into practice for sustainable development. Using case study approach; in this research qualitative interviews have been conducted from PhD faculty members working in the universities offering degrees in field of environment. Obtained data is analyzed using descriptive statistics and chi-square test with the help of statistical packages for social sciences (SPSS). Research explored 31 channels of academic knowledge transfer from detailed review of literature and exploratory interviews with participants. Identified knowledge transfer channels have been grouped together in 6 groups of knowledge transfer channels; As knowledge transfer through publications, networking, mobility of researchers, joint research, intellectual property and co-operations. Results revealed that academic knowledge have been transferred through publications, networking, and co-operation. However, less number of academic knowledge has been transferred through groups of knowledge transfer channels such as Intellectual Property and joint research.Keywords: environment, research knowledge, transfer channels, universities
Procedia PDF Downloads 3364818 Assessment of the Performance of Fly Ash Based Geo-Polymer Concrete under Sulphate and Acid Attack
Authors: Talakokula Visalakshi
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Concrete is the most commonly used construction material across the globe, its usage is second only to water. It is prepared using ordinary Portland cement whose production contributes to 5-8% of total carbon emission in the world. On the other hand the fly ash by product from the power plants is produced in huge quantities is termed as waste and disposed in landfills. In order to address the above issues mentioned, it is essential that other forms of binding material must be developed in place of cement to make concrete. The geo polymer concrete is one such alternative developed by Davidovits in 1980’s. Geopolymer do not form calcium-silicate hydrates for matrix formation and strength but undergo polycondensation of silica and alumina precursors to attain structural strength. Its setting mechanism depends upon polymerization rather than hydration. As a result it is able to achieve its strength in 3-5 days whereas concrete requires about a month to do the same. The objective of this research is to assess the performance of geopolymer concrete under sulphate and acid attack. The assessment is done based on the experiments conducted on geopolymer concrete. The expected outcomes include that if geopolymer concrete is more durable than normal concrete, then it could be a competitive replacement option of concrete and can lead to significant reduction of carbon foot print and have a positive impact on the environment. Fly ash based geopolymer concrete offers an opportunity to completely remove the cement content from concrete thereby making the concrete a greener and future construction material.Keywords: fly ash, geo polymer, geopolymer concrete, construction material
Procedia PDF Downloads 4884817 Current Status of Inclusive Education for Students with Disabilities in Punjab, Pakistan
Authors: Muhammad Shahid Shah, Akram Maqbool, Samina Ashraf
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Since start of this century, world has adopted inclusion as a trend in special education. To meet the challenges of inclusion response, the Punjab government has developed a progressive policy to implement inclusive education. The objectives of this research were to analyze the administration and implementation process by consideration on the management, student’s admission process, screening and assessment, adaptations in curriculum and instruction along with an evaluation, government and nonprofit organizations support. The sample consisted of 50 schools both public and private with a total of 3000 students, 9 percent of which (270) were students with disabilities. Among all the students with disabilities, 63 percent (170) were male and 37 percent (100) were female. The concluded remarks regarding management revealed that a large number of inclusive schools was lacking in terms of developing a certain model for inclusion, including the managerial breakup of staff, the involvement of stakeholders, and conducted frequent meetings. Many of schools are not able to restructure their school organizations due to lack of financial resources, consultations, and backup. As for as student’s admission/identification/assessment was concerned, only 12 percent schools applied a selection process regarding student admission, half of which used different procedures for disable candidates. Approximately 5 percent of inclusive schools had modified their curriculum, including a variety of standards. In terms of instruction, 25 percent of inclusive schools reported that they modified their instructional process. Only a few schools, however, provided special equipment for students with visual impairment, physical impairment, speech and hearing problems, students with mild intellectual disabilities, and autism. In a student evaluation, more than 45 percent reported that test items, administration, time allocations, and students’ reports were modified. For the primary board examination conducted by the Education Department of Government of Punjab, this number decreased dramatically. Finally, government and nonprofit organizations support in the forms of funding, coaching, and facilities were mostly provided by provincial governments and by Ghazali Education Trust.Keywords: inclusion, identification, assessment, funding, facilities, evaluation
Procedia PDF Downloads 1384816 English Pronunciation Materials on TikTok
Authors: Sebastian Leal-Arenas
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TikTok’s influence on contemporary society is undeniable. The impact of the mobile app transcends entertainment, as shown by the growing presence of specialized accounts dedicated to providing educational content, particularly as it pertains to language learning. However, the prevailing trend on the platform is vocabulary and grammar acquisition, neglecting a critical component: pronunciation. This study examines English pronunciation materials available on TikTok by taking a comprehensive approach that incorporates established assessment tools, such as the Learning Object Review Instrument and the Framework for Language Learning App Evaluation. Furthermore, novel evaluation categories are introduced to provide a more holistic assessment of these educational resources. 60 English pronunciation videos were part of the analysis. The findings reveal that these audio-visual materials present clear audio bolstered by high-quality video content and automatically generated closed captions. These three components enhance the comprehensibility of the input, making these concise videos valuable assets for language learners. Nevertheless, certain deficiencies are observed, such as the lack of emphasis on specific segments and their relationship with articulators. Improvements and refinements are discussed, as well as their potential utility within the language classroom. This study contributes to the ongoing investigation of multimedia materials used for language teaching and emphasizes the need to adapt pronunciation instruction methods to today’s technology.Keywords: pronunciation, segments, teaching materials, technology
Procedia PDF Downloads 864815 Assessment of Land Use and Land Cover Change in Lake Ol Bolossat Catchment, Nyandarua County, Kenya
Authors: John Wangui, Charles Gachene, Stephen Mureithi, Boniface Kiteme
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Land use changes caused by demographic, natural variability, economic, technological and policy factors affect the goods and services derived from an ecosystem. In the past few decades, Lake Ol Bolossat catchment in Nyandarua County Kenya has been facing challenges of land cover changes threatening its capacity to perform ecosystems functions and adversely affecting communities and ecosystems downstream. This study assessed land cover changes in the catchment for a period of twenty eight years (from 1986 to 2014). Analysis of three Landsat images i.e. L5 TM 1986, L5 TM 1995 and L8 OLI/TIRS 2014 was done using ERDAS 9.2 software. The results show that dense forest, cropland and area under water increased by 27%, 29% and 3% respectively. On the other hand, open forest, dense grassland, open grassland, bushland and shrubland decreased by 3%, 3%, 11%, 26% and 1% respectively during the period under assessment. The lake was noted to have increased due to siltation caused by soil erosion causing a reduction in Lake’s depth and consequently causing temporary flooding of the wetland. The study concludes that the catchment is under high demographic pressure which would lead to resource use conflicts and therefore formulation of mitigation measures is highly recommended.Keywords: land cover, land use change, land degradation, Nyandarua, Remote sensing
Procedia PDF Downloads 3694814 Sleep Quality as Perceived by Critically Ill Patients at El Manial University Hospitals
Authors: Mohamed Adel Ahmed, Warda Youssef Morsy , Hanaa Ali El Feky
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Background: Literature review cited that sleep is absolutely essential for surviving and reclamation of the quality of life. Critically ill patients often have poor sleep quality with prolonged sleep latency, sleep fragmentation, decreased sleep efficiency and frequent arousals. Nurses have a unique role for the early diagnosis of sleep disorders, decreasing stressors levels and providing the necessary environmental regulations to create a therapeutic ambiance. The aim of the study: to assess perceived sleep quality and identify factors affecting sleep quality among adult critically ill patients At El Manial University Hospital. Research Design: A descriptive exploratory design was utilized. Research questions: a) how do adult critically ill patients perceive sleep quality in the Critical Care Department of El Manial University Hospital? b) What are the factors affecting sleep quality among adult critically ill patients at El Manial University Hospital? Setting: selected critical and cardiac care units at El Manial University Hospital. Sample: A samples of convenience consisting of 100 adult male and female patients were included in the study. Tools of data collection: tool 1: Socio-demographic and Medical Data Sheet, tool 2: Modified St Mary's Hospital Sleep Questionnaire tool 3: Factors Affecting Sleep Quality Questionnaire among ICU Patients Results: The current study revealed that 76.0% of the studied sample had lack of sleep disturbance before hospitalization. However, 84 % had sleep disturbances during ICU stay, of these more than two-thirds (67 %) had moderate sleep disturbance. Presence of strange and bad odors, noise, having pain, fear of death and a loud voice produced by the ICU personnel had the most significant negative impact on patients’ sleep in percentage of 52.4, 50, 61.9, 45.2, 52.4, respectively. Conclusion: Sleep disturbances in the ICU are multifactorial, and ICU patients’ perceived degrees of sleep disturbance as a moderate. Recommendations: Based on findings of the present study, the following are recommended to be done by ICU nurses; create a healing ICU environment that should incorporate noise, light and temperature controls; decrease stimuli during night time hours to promote regulation of the circadian rhythm, allow usage of sleeping aids such as relaxing music, eye patches and earplugs into their daily nursing practice; cluster nursing activities and eliminate non-essential treatments during night time hours to allow uninterrupted sleep periods of at least 90 minutes to complete one sleep cycle , and minimize staff conversation, alarm noise and light during the quiet night time hours.Keywords: sleep quality, critically ill, patients, perception
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