Search results for: rehabilitation team

Authors: Siti Rajaah Binti Sayed Sultan

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Managing the code blue event is stressful for nurses, the patient, and the patient's families. The rapid response from the first and second responders in the code blue event will improve patient outcomes and prevent tissue hypoxia that leads to brain injury and other organ failures. Providing 1 minute for the cardiac massage and 2 minutes for defibrillation will significantly improve patient outcomes. As we know, the American Heart Association came out with guidelines for managing cardiac arrest patients. The hospital must provide competent staff to manage this situation. It can be achieved when the staff is well equipped with the skill, attitude, and knowledge to manage this situation with well-planned strategies, i.e., clear guidelines for managing the code blue event, competent staff, and functional equipment. The code blue simulation (CBS) was chosen in the training program for code blue management because it can mimic real scenarios. Having the code blue simulation module will allow the staff to appreciate what they will face during the code blue event, especially since it rarely happens in that area. This CBS module training will help the staff familiarize themselves with the activities that happened during actual events and be able to operate the equipment accordingly. Being challenged and independent in managing the code blue in the early phase gives the patient a better outcome. The CBS module will help the assessor and the hospital management team with the proper tools and guidelines for managing the code blue drill accordingly. As we know, prompt action will benefit the patient and their family. It also indirectly increases the confidence and job satisfaction among the nurses, increasing the standard of care, reducing the complication and hospital burden, and enhancing cost-effective care.

Keywords: code blue simulation module, development of code blue simulation module, code blue response time, code blue drill, cardiorespiratory arrest, managing code blue

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Authors: Siobhan Laird

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Under article 12 of the Convention on the Rights of the Child, which extends human rights in their application to those under the age of 18 years, children must be consulted ‘in all matters affecting the child’. The Office of the Children’s Commissioner for England is responsible for improving the welfare of children and young people by ensuring that their Convention rights are respected and realised and their views taken seriously. In 2014 the Children’s Commissioner engaged a team of researchers at the Centre for Social Work, University of Nottingham to develop and roll out an online survey to gather information from children and young people about their exercise of choice within the public care system. Approximately 3,000 children responded to this survey, which comprised both closed and open-ended questions. SPSS was used to analyse the numerical data and a thematic analysis of textual data was conducted on answers to open-ended questions. Findings revealed that children exercised considerable choice over personal space and their spare time, but had much less choice in relation to contact with their birth families, where they lived, or the timings of moves from one placement into another. The majority of children described how they were supported to express their opinions and believed that these were taken seriously. However, a significant number reported problems and explained how specific behaviours by professionals and carers made it difficult for them to express their opinion or to feel that they had influenced decisions which affected them. In open-ended questions eliciting information about their experiences, children and young people were asked to describe how they could be better supported to make choices and what changes would assist for these to be better acknowledged and acted upon by professionals and carers. This paper concludes by presenting the ideas and suggestions of children and young people for improving the public care system in Britain in relation to their exercise of choice.

Keywords: children, choice, participation, public care

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring

Procedia PDF Downloads 183

Authors: Radhwane Boudjelthia

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The most recent earthquakes that occurred in the world and particularly in Algeria, have killed thousands of people and severe damage. The example that is etched in our memory is the last earthquake in the regions of Boumerdes and Algiers (Boumerdes earthquake of May 21, 2003). For all the actors involved in the building process, the earthquake is the litmus test for construction. The goal we set ourselves is to contribute to the implementation of a thoughtful approach to the seismic protection of structures. For many engineers, the most conventional approach protection works (buildings and bridges) the effects of earthquakes is to increase rigidity. This approach is not always effective, especially when there is a context that favors the phenomenon of resonance and amplification of seismic forces. Therefore, the field of earthquake engineering has made significant inroads among others catalyzed by the development of computational techniques in computer form and the use of powerful test facilities. This has led to the emergence of several innovative technologies, such as the introduction of special devices insulation between infrastructure and superstructure. This approach, commonly known as "seismic isolation" to absorb the significant efforts without the structure is damaged and thus ensuring the protection of lives and property. In addition, the restraints to the construction by the ground shaking are located mainly at the supports. With these moves, the natural period of construction is increasing, and seismic loads are reduced. Thus, there is an attenuation of the seismic movement. Likewise, the insulation of the base mechanism may be used in combination with earthquake dampers in order to control the deformation of the insulation system and the absolute displacement of the superstructure located above the isolation interface. On the other hand, only can use these earthquake dampers to reduce the oscillation amplitudes and thus reduce seismic loads. The use of damping devices represents an effective solution for the rehabilitation of existing structures. Given all these acceleration reducing means considered passive, much research has been conducted for several years to develop an active control system of the response of buildings to earthquakes.

Keywords: earthquake, building, seismic forces, displacement, resonance, response

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Authors: Oliveira M., Gonçalves L., Francisco I., Caramelo F., Vale F., Sanz D., Domingues M., Lopes M., Moreia D., Lopes T., Santos T., Cardoso H.

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The ARTHUR project consists of a platform that allows the virtual performance of maxillofacial surgeries, offering, in a photorealistic concept, the possibility for the patient to have an idea of the surgical changes before they are performed on their face. For this, the system brings together several image formats, dicoms and objs that, after loading, will generate the bone volume, soft tissues and hard tissues. The system also incorporates the patient's stereophotogrammetry, in addition to their data and clinical history. After loading and inserting data, the clinician can virtually perform the surgical operation and present the final result to the patient, generating a new facial surface that contemplates the changes made in the bone and tissues of the maxillary area. This tool acts in different situations that require facial reconstruction, however this project focuses specifically on two types of use cases: bone congenital disfigurement and acquired disfiguration such as oral cancer with bone attainment. Being developed a cloud based solution, with mobile support, the tool aims to reduce the decision time window of patient. Because the current simulations are not realistic or, if realistic, need time due to the need of building plaster models, patient rates on decision, rely on a long time window (1,2 months), because they don’t identify themselves with the presented surgical outcome. On the other hand, this planning was performed time based on average estimated values of the position of the maxilla and mandible. The team was based on averages of the facial measurements of the population, without specifying racial variability, so the proposed solution was not adjusted to the real individual physiognomic needs.

Keywords: 3D computing, image processing, image registry, image reconstruction

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Authors: Zakir H. Shaik, Punam L. Vartak

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Management By Objectives (MBO) is a management technique in which objectives of an organisation are conveyed to the employees to establish the individual goals. These objectives and goals are then monitored and assessed jointly by management and the employee time to time. This tool can be used for planning, monitoring as well as for performance appraisal. The success of an organisation is largely dependent on its’s Vision. Thus, it is of paramount importance to achieve the realm of vision through a mission which is well crafted within the organisation to address the objectives. The success of the mission depends upon how realistic and action oriented philosophical approach, an organisation caters to; and how the individual goals are set to track and meet the objectives. Thus, focused and passionate efforts of the team, assigned for the mission, are an absolute obligation for achieving the vision of any organisation. Any construction site is generally a controlled disorder having huge investments, resources and logistics involved. The Construction progression is time-consuming with many isolated as well as interconnected activities. Traditional MBO approach can be unsuccessful if planning and control is non-realistic and inflexible. Moreover, the Construction Industry is far behind understanding these concepts. It is important to address the employee engagement in defining and creating awareness to achieve the targets. Besides, current economic environment and competitive world demands refined management tools to achieve profit, growth and survival of the business. Therefore, the necessity of rational MBO becomes vital part towards the success of an organisation. This paper details about the philosophical assumptions to develop the grounded theory in lieu of achieving objectives through RATIONAL MBO approach in Construction Contracting Organisations. The goals and objectives of the Construction Contracting Organisations can be achieved efficiently by adopting this RATIONAL MBO approach, as those are based on realistic, logical and balanced assumptions.

Keywords: growth, leadership, management by objectives, Management By Objectives (MBO), profit, rational

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Authors: Lennon Furtado, Sandro Oliveira

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The importance of an effective measurement program lies in the ability to control and predict what can be measured. Thus, the measurement program has the capacity to provide bases in decision-making to support the interests of an organization. Therefore, it is only possible to apply for an effective measurement program with a team of software engineers well trained in the measurement area. However, the literature indicates that are few computer science courses that have in their program the teaching of the software measurement process. And even these, generally present only basic theoretical concepts of said process and little or no measurement in practice, which results in the student's lack of motivation to learn the measurement process. In this context, according to some experts in software process improvements, one of the most used approaches to maintaining the motivation and commitment to software process improvements program is the use of the gamification. Therefore, this paper aims to present a proposal of teaching the measurement process by gamification. Which seeks to improve student motivation and performance in the assimilation of tasks related to software measurement, by incorporating elements of games into the practice of measurement process, making it more attractive for learning. And as a way of validating the proposal will be made a comparison between two distinct groups of 20 students of Software Quality class, a control group, and an experiment group. The control group will be the students that will not make use of the gamification proposal to learn software measurement process, while the experiment group, will be the students that will make use of the gamification proposal to learn software measurement process. Thus, this paper will analyze the objective and subjective results of each group. And as objective result will be analyzed the student grade reached at the end of the course, and as subjective results will be analyzed a post-course questionnaire with the opinion of each student about the teaching method. Finally, this paper aims to prove or refute the following hypothesis: If the gamification proposal to teach software measurement process does appropriate motivate the student, in order to attribute the necessary competence to the practical application of the measurement process.

Keywords: education, gamification, software measurement process, software engineering

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Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

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Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

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Authors: Amna I. Shibeika, Batoul Y. Hittini, Tasneem B. Abd Bakri

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Regulation and integration of public policy, economy, insurance industry, education, and construction stakeholders are the main contributors to achieve sustainable development. Building environmental assessment methods were introduced in the field to address issues such as global warming and conservation of natural resources. In the UAE, Estidama framework with its associated Pearl Building Rating System (PBRS) has been introduced in 2010 to address and spread sustainability practices within the country’s fast-growing built environment. Based on literature review of relevant studies investigating different project characteristics that influence sustainability outcomes, this paper presents a conceptual framework for understanding the adoption of PBRS in UAE projects. The framework also draws on Diffusion of Innovations theory to address the questions of how the assessment method is chosen in the first place and what is the impact of PBRS on the multi-disciplinary design and construction processes. The study highlights the mandatory nature of the adoption of PBRS for government buildings as well as imbedding Estidama principles within Abu Dhabi building codes as key factors for raising awareness about sustainable practices. Moreover, several project-related elements are addressed to understand their relationship with the adoption process, including project team collaboration; communication and coordination; levels of commitment and engagement; and the involvement of key actors as sustainability champions. This conceptualization of the adoption of PBRS in UAE projects contributes to the growing literature on the adoption of energy assessment tools and addresses the UAE vision is to be at the forefront of innovative sustainable development by 2021.

Keywords: adoption, building assessment, design management, innovation, sustainability

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Authors: Jared Cheves, Amanda DeChent, Joyce Pan

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Total knee replacements (TKAs) are one of the most common but painful surgical procedures performed in the United States. Currently, the gold standard for postoperative pain management is the utilization of opioids. However, in the wake of the opioid epidemic, the healthcare system is attempting to reduce opioid consumption by trialing innovative opioid sparing analgesic techniques such as continuous peripheral nerve blocks (CPNB) and continuous periarticular infiltration (CPAI). The alleviation of pain, particularly during the first 72 hours postoperatively, is of utmost importance due to its association with delayed recovery, impaired rehabilitation, immunosuppression, the development of chronic pain, the development of rebound pain, and decreased patient satisfaction. While both CPNB and CPAI are being used today, there is limited evidence comparing the two to the current standard of care or to each other. An extensive literature review was performed to explore the safety profiles and effectiveness of CPNB and CPAI in reducing reported pain scores and decreasing opioid consumption. The literature revealed the usage of CPNB contributed to lower pain scores and decreased opioid use when compared to opioid-only control groups. Additionally, CPAI did not improve pain scores or decrease opioid consumption when combined with a multimodal analgesic (MMA) regimen. When comparing CPNB and CPAI to each other, neither unanimously lowered pain scores to a greater degree, but the literature indicates that CPNB decreased opioid consumption more than CPAI. More research is needed to further cement the efficacy of CPNB and CPAI as standard components of MMA in TKA procedures. In addition, future research can also focus on novel catheter-free applications to reduce the complications of continuous catheter analgesics.

Keywords: total knee arthroplasty, continuous peripheral nerve blocks, continuous periarticular infiltration, opioid, multimodal analgesia

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Authors: Hilal Keklicek, Baris Cetin, Yeliz Salci, Ayla Fil, Umut Altinkaynak, Kadriye Armutlu

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Objectives and Goals: Spasticity is a common symptom characterized with a velocity dependent increase in tonic stretch reflexes (muscle tone) in patient with multiple sclerosis (MS). Hypertonic muscles affect the normal plantigrade contact by disturbing accommodation of foot to the ground while walking. It is important to know the differences between healthy and neurologic foot features for management of spasticity related deformities and/or determination of rehabilitation purposes and contents. This study was planned with the aim of investigating the dynamic plantar pressure distribution in individuals with MS and determining the differences between healthy individuals (HI). Methods: Fifty-five individuals with MS (108 foot with spasticity according to Modified Ashworth Scale) and 20 HI (40 foot) were the participants of the study. The dynamic pedobarograph was utilized for evaluation of dynamic loading parameters. Participants were informed to walk at their self-selected speed for seven times to eliminate learning effect. The parameters were divided into 2 categories including; maximum loading pressure (N/cm2) and time of maximum pressure (ms) were collected from heal medial, heal lateral, mid foot, heads of first, second, third, fourth and fifth metatarsal bones. Results: There were differences between the groups in maximum loading pressure of heal medial (p < .001), heal lateral (p < .001), midfoot (p=.041) and 5th metatarsal areas (p=.036). Also, there were differences between the groups the time of maximum pressure of all metatarsal areas, midfoot, heal medial and heal lateral (p < .001) in favor of HI. Conclusions: The study provided basic data about foot pressure distribution in individuals with MS. Results of the study primarily showed that spasticity of lower extremity muscle disrupted the posteromedial foot loading. Secondarily, according to the study result, spasticity lead to inappropriate timing during load transfer from hind foot to forefoot.

Keywords: multiple sclerosis, plantar pressure distribution, gait, norm values

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Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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Authors: Aly Ahmed, Aber Kay Obwona, Mokrzecka Martyna, Piotrowska Małgorzata, Richardson Stephen

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Frankfurt am Main, the fifth largest city in Germany, ranked at 15th place by the Global Financial Centers Index in 2014, and a finalist of European Green Capital, 214 is a crucial player in German Environmental Policy. Since 2012 the city Authorities have been working on implementing the plan, which assumed to reduce the energy consumption by 50%, and fully switch to renewable energy by the year 2050. To achieve this goal, the Municipality of Frankfurt has begun preparing the Master plan, which will be introduced to public by the end of 2015. A significant question when facing the starting of Master Plan public’s introduction was deciding which method should be used to increase the public engagement. In order to answer this question, the city and region authorities in the cooperation with Frankfurt’s Universities and Climate KIC, organized a two-week PhD scientific workshops, in which participated more than 30 students from numerous countries. The paper presented the outcome of the research and solution proposal of the winning team. Transitions theory tells, that to address challenges as complex as Climate Change and the Energiewende, using of new technologies and system to the public is not sufficient. Transition –by definition is a process, and in such a large scale (city and region transition) can be fulfilled only, when operates within a broad socio – technical system. Authors believe that only by close cooperation with city dwellers, as well as different stakeholders, the Transition in Frankfurt can be successful. The vital part is the strategy which will ensure the engagement, sense of ownership and broad support within Frankfurt society. Author proposal based therefore, on fostering the citizens engagement through a comprehensive, innovative communication strategy.

Keywords: city development, communication strategies, social transition, sustainability

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Authors: Salam Alzubaidi, G. Fantoni, F. Failli, M. Frosolini

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The dynamic facility layout problem is a really critical issue in the competitive industrial market; thus, solving this problem requires robust design and effective simulation systems. The sustainable simulation requires inputting reliable and accurate data into the system. So this paper describes an automated system integrated into the real environment to measure the duration of the material handling operations, collect the data in real-time, and determine the variances between the actual and estimated time schedule of the operations in order to update the simulation software and redesign the facility layout periodically. The automated method- time measurement system collects the real data through using Radio Frequency-Identification (RFID) and Internet of Things (IoT) technologies. Hence, attaching RFID- antenna reader and RFID tags enables the system to identify the location of the objects and gathering the time data. The real duration gathered will be manipulated by calculating the moving average duration of the material handling operations, choosing the shortest material handling path, and then updating the simulation software to redesign the facility layout accommodating with the shortest/real operation schedule. The periodic simulation in real-time is more sustainable and reliable than the simulation system relying on an analysis of historical data. The case study of this methodology is in cooperation with a workshop team for producing mechanical parts. Although there are some technical limitations, this methodology is promising, and it can be significantly useful in the redesigning of the manufacturing layout.

Keywords: dynamic facility layout problem, internet of things, method time measurement, radio frequency identification, simulation

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Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

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Oropharyngeal dysphagia is prevalent in children with cerebral palsy (CP). There are many studies concerning this problem, however, studies examining long term outcomes of dysphagia using videofluoroscopic study (VFSS) are very rare. The Aim of this study is to investigate long-term outcomes of dysphagia in children with severe CP using initial VFSS. It was a retrospective study and chart review was done from January 2000 to December 2013. Thirty one patients under 18 years who have been diagnosed as CP in outpatient clinic of Rehabilitation Medicine, and who did VFSS were included. Long-term outcomes such as feeding method, height percentile, weight percentile, and body mass index (BMI) were tracked up for at least 3 years by medical records. Significant differences between initial and follow-up datas were investigated. The patients consisted of 18 males and 13 females, and the mean age was 31.0±18.0 months old. 64.5% of patients were doing oral diet, and 25.8% of patients were doing non-oral diet. When comparing VFSS findings among oral feeding patients, oral and non-oral feeding patients, and non-oral feeding patients at initial period, dysphagia severity, supraglottic penetration, and subglottic aspiration showed significant differences. Most of the patients who could feed orally at initial period were found to have the same feeding method at follow-up. But among eight patients who required non-oral feeding initially, three patients became possible to feed orally, and one patient was doing oral and non-oral feeding method together at follow-up. Follow up feeding method showed correlation with dysphagia severity by initial VFSS. Weight percentile was decreased in patients with GMFCS level V at follow up, which may represent poor nutritional status due to severe dysphagia compared to other patients. Initial VFSS severity would play a significant role in making an assumption about future diet in children with severe CP. Patients with GMFCS level V seem to have serious dysphagia at follow up and have nutritional deficiency over time, therefore, more careful nutritional support is needed in children with severe CP are suggested.

Keywords: cerebral palsy, child, dysphagia, videofluoroscopic study

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Authors: Saniye Çeşmecioğlu

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The importance of project sustainability and success has become increasingly significant due to the proliferation of external environmental factors that have decreased project resistance in contemporary times. The primary approach to forestall the failure of projects is to ensure their long-term viability through the strategic selection of projects as creating judicious project selection framework within the organization. Decision-makers require precise decision contexts (models) that conform to the company's business objectives and sustainability expectations during the project selection process. The establishment of a rational model for project selection enables organizations to create a distinctive and objective framework for the selection process. Additionally, for the optimal implementation of this decision-making model, it is crucial to establish a Project Management Office (PMO) team and Project Steering Committee within the organizational structure to oversee the framework. These teams enable updating project selection criteria and weights in response to changing conditions, ensuring alignment with the company's business goals, and facilitating the selection of potentially viable projects. This paper presents a multi-criteria decision model for selecting project sustainability and project success criteria that ensures timely project completion and retention. The model was developed using MACBETH (Measuring Attractiveness by a Categorical Based Evaluation Technique) and was based on broadcaster companies’ expectations. The ultimate results of this study provide a model that endorses the process of selecting the appropriate project objectively by utilizing project selection and sustainability criteria along with their respective weights for organizations. Additionally, the study offers suggestions that may ascertain helpful in future endeavors.

Keywords: project portfolio management, project selection, multi-criteria decision making, project sustainability and success criteria, MACBETH

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Authors: Bergun Meric Bingul, Cigdem Bulgan, Ozlem Tore, Mensure Aydin, Erdal Bal

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The aim of the study was to compare the effects of impact forces and some kinematic parameters with two different straight punch stance positions in boxing. 9 elite boxing athletes from the Turkish National Team (mean age± SD 19.33±2.11 years, mean height 174.22±3.79 cm, mean weight 66.0±6.62 kg) participated in this study as voluntarily. Boxing athletes performed one trial in straight punch technique for each two different stance positions (orthodox and southpaw stances) at sandbag. The trials were recorded at a frequency of 120Hz using eight synchronized high-speed cameras (Oqus 7+), which were placed, approximately at right- angles to one another. The three-dimensional motion analysis was performed with a Motion Capture System (Qualisys, Sweden). Data was transferred to Windows-based data acquisition software, which was QTM (Qualisys Track Manager). 11 segment models were used for determination of the kinematic variables (Calf, leg, punch, upperarm, lowerarm, trunk). Also, the sandbag was markered for calculation of the impact forces. Wand calibration method (with T stick) was used for field calibration. The mean velocity and acceleration of the punch; mean acceleration of the sandbag and angles of the trunk, shoulder, hip and knee were calculated. Stance differences’ data were compared with Wilcoxon test for using SPSS 20.0 program. According to the results, there were statistically significant differences found in trunk angle on the sagittal plane (yz) (p<0.05). There was a significant difference also found in sandbag acceleration and impact forces between stance positions (p < 0.05). Boxing athletes achieved more impact forces and accelerations in orthodox stance position. It is recommended that to use an orthodox stance instead of southpaw stance in straight punch technique especially for creating more impact forces.

Keywords: boxing, impact force, kinematics, straight punch, orthodox, southpaw

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Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Pedro Henrique Tertuliano Leoni, Carla Aparecida Arena Ventura, Ana Cristina de Oliveira e Silva, Renata Karina Reis

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Context and significance: Resilience is a protective agent for the physical and mental well-being of nursing professionals. Team members are constantly subjected to high levels of work stress that can negatively impact care performance and users of health services. Stress levels have been exacerbated with the COVID-19 pandemic. Objective: The aim of this study was to analyze the resilience of nursing professionals in Brazil during the COVID-19 pandemic. Method: Cross-sectional study with a quantitative approach carried out with professionals from nursing teams from all regions of Brazil. Data collection took place in the first year of the pandemic between October and December 2020. Data were obtained through an online questionnaire posted on social networks. The information collected included the sociodemographic characterization of the nursing professionals and the Brief Resilient Coping Scale was applied. Student's t-test for independent samples and analysis of variance (ANOVA) were used to compare resilience scores with sociodemographic variables. Results: 8,792 nursing professionals participated in the study, 5,767 (65.6%) were nurses, 7,437 (84.6%) were female and 2,643 (30.1%) were from the Northeast region of Brazil, 5,124 (58.8% ) had low levels of resilience. The results showed a statistically significant difference between the resilience score and the variables: professional category (p<0.001); sex (p = 0.003); age range (p<0.001); region of Brazil (p<0.001); marital status (p=0.029) and providing assistance in a field hospital (p<0.001). Conclusion: Participants in this study had, in general, low levels of resilience. There is an urgent need for actions aimed at promoting the psychological health of nursing professionals inserted in pandemic contexts. Descriptors: Psychological Resilience; Nursing professionals; COVID-19; SARSCoV-2.

Keywords: psychological resilience, nursing professionals, COVID-19, SARS-CoV-2

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Authors: Szu-Yi Chang, Jiin-Ru Rong

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This paper discussed a case involving a young female patient with schizophrenia. The patient's condition was deteriorating, and she was becoming increasingly reliant on her family to take care of her, and as her father did not understand the illness well and was afraid that others will learn about the presence of a mentally ill individual in their family, he and the patient's mother were thus unable to cope with the patient's deteriorating condition, which in turn caused her to suffer from a lack of self-confidence and low self-esteem. The patient received nursing care from July 26th to October 25th, 2017, during which counseling, family visits, and phone interviews were carried out, and her condition was monitored. By referring to the practical ability indicators for community psychiatric mental health nursing that were developed by the psychiatric mental health nurses' association of the Republic of China, defining categories such as 'self-construction,' 'self-management,' 'disease management,' and 'family nursing,' and incorporating indicators for empowerment and various skills into the steps and strategies used for nursing care, we will able to help the patient to construct her own identity, raise her self-esteem, improve her ability to independently perform activities of daily living, strengthen her disease management ability, and gradually build up her life management skills. The patient's family was also encouraged to communicate more among themselves, so as to align them with the nursing care objectives of improving the patient's ability to adapt to community life and her disease. The results indicated that the patient was able to maintain her mental stability within her community. By implementing effective self-management and maintaining a routine life, the patient was able to continue her active participation in community work and rehabilitation activities. Improvements were also achieved with respect to family role issues by establishing mutual understanding among the patient's family members and gaining their support. It is recommended that mental health nurses can leverage their community mental health nursing skills and the related strategies to promote adaptation to community life among mental life patients.

Keywords: community psychiatric mental health nursing, family nursing, schizophrenia, self-management

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Authors: Bassem Saleh, Hussam Nusair, Nariman Al Zubadi, Shams Al Shloul, Usama Saleh

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The nursing round system (NRS) means checking patients on an hourly basis during the A (0700–2200 h) shift and once every 2 h during the B (2200–0700 h) by the assigned nursing staff. The overall goal of this prospective study is to implement an NRS in a major rehabilitation centre—Sultan Bin Abdulaziz Humanitarian City—in the Riyadh area of the Kingdom of Saudi Arabia. The purposes of this study are to measure the effect of the NRS on: (i) the use of patient call light; (ii) the number of incidences of patients’ fall; (iii) the number of incidences of hospital-acquired bed sores; and (iv) the level of patients’ satisfaction. All patients hospitalized in the male stroke unit will be involved in this study. For the period of 8 weeks (17 December 2009–17 February 2010) All Nursing staff on the unit will record each call light and the patient’s need. Implementation of the NRS would start on 18 February 2010 and last for 8 weeks, until 18 April 2010. Data collected throughout this period will be compared with data collected during the 8 weeks period immediately preceding the implementation of the NRS (17 December 2009–17 February 2010) in order to measure the impact of the call light use. The following information were collected on all subjects involved in the study: (i) the Demographic Information Form; (ii) authors’ developed NRS Audit Form; (iii) Patient Call Light Audit Form; (iv) Patient Fall Audit Record; (v) Hospital-Acquired Bed Sores Audit Form; and (vi) hospital developed Patient Satisfaction Records. The findings suggested that a significant reduction on the use of call bell (P < 0.001), a significant reduction of fall incidence (P < 0.01) while pressure ulcer reduced by 50% before and after the implementation of NRS. In addition, the implementation of NRS increased patient satisfaction by 7/5 (P < 0.05).

Keywords: call light, patient-care management, patient safety, patient satisfaction, rounds

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Authors: Ayo Osisanya, Promise Ebuka Okonkwo

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Reduced hearing sensitivity among the elderly has been attributed to some risk factors and influence of age-related degenerative conditions such as diabetes, cardiovascular disease, Alzheimer’s disease, bipolar disorder, and hypertension. Hearing loss; especially the age-related type (presbycusis), has been reported as one of the global burden affecting the general well-being and quality of life of the elderly with hypertension. Thus, hearing loss has been observed to be associated with hypertension and functional decline in elderly, as this condition makes them experience poor communication, fatigue, reduced social functions, mood-swing, and withdrawal syndrome. Emerging research outcomes indicate a strong relationship between hypertension and reduced auditory performance among the elderly. Therefore, this study determined the prevalence, types, and patterns of hearing loss associated with hypertension, with a bid to suggesting comprehensive management strategies and a model of creating awareness towards promoting good healthy living among the elderly in Nigeria. One hundred and seventy-two elderly, aged 65–85 with hypertension were purposively selected from patients undergoing treatment for hypertension in some tertiary hospitals in southwest Nigeria for the study. Participants were suggested to Pure-Tone Audiometry (PTA) through the use of Maico 53 Diagnostic Audiometer to determine the degree, types ad patterns of hearing loss among the elderly with hypertension. Results showed that 148 (86.05%) elderly with hypertension presented with different degrees, types, and patterns of hearing loss. Out of this number, 123 (83.11%) presented with bilateral hearing loss, while 25 (16.89%) had unilateral hearing loss. Degree of hearing loss, 74 moderate hearing loss, 118 moderately severe and 50 severe hearing loss. 36% of the hearing loss appeared as flat audiometric configuration, 24% were slopping, 19% were rising, while 21% were tough-shaped audiometric configurations. The findings showed high prevalence of hearing loss among the elderly with hypertension in Southwest, Nigeria. Based on the findings, management of elderly with hypertension should include regular audiological rehabilitation and total adherence to hearing conservation principles, otological management, regulation of blood pressure and adequate counselling / follow-up services.

Keywords: auditory performance, elderly, hearing loss, hypertension

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Authors: A. Gagat-Matuła

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There is a definite lack – in Poland, as well as around the world – of empirical studies of families raising handicapped child, in which one parent migrates. In diagnostics of the functioning of such families emphasis should be placed not only on the difficulties, but most of all it should be indicated what possibilities are there for the family and how it overcomes the difficulties. Migration of a parent on the one hand is a chance to improve the family’s material situation. In certain circumstances this may only be an “escape” into work from the issues associated with the upbringing and rehabilitation of a handicapped child. The aim of the study was to learn the functioning of a temporarily single parent family system as a result of migration of a parent from the perspective of adolescents with cerebral palsy. The study was conducted in the year 2013 in the area of Eastern Poland. It involved an analysis of 70 persons (with cerebral palsy in an intellectual capacity) from families in which at least one of the parents migrates. The study incorporated the diagnostic survey method. These tools were used: Family Evaluation Scales (SOR) adapted for Poland by Andrzej Margasiński. The explorations in this study indicate, that 47% of studied temporarily single parent families are balanced models. This is evidence of the resources at the disposal of the family which, despite the disability of the child and temporary separation, is able to function properly. The conducted studies show, that 37% of temporarily single parent families are imbalanced models in the perception of adolescents with cerebral palsy. These families experience functional difficulties and require psychological and pedagogical support. There is a need for building skills related to effective coping with family stress. Especially considering, that families of an imbalanced type do not use the internal and external resources of the family system. Such a situation may deepen the disarrangement of family life. In intermediate families (16%) there are also temporary difficulties in functioning. Separation anxiety experienced by mothers may disrupt relations and introduce additional stress factors. For that reason it is important to provide support for women with difficulties coping with the emotions associated with raising handicapped adolescents and migratory separation.

Keywords: child with cerebral palsy, family, migration, parents

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Authors: Milad Pirali, Sohrab Keyhani, Mohhamad Ali Sanjari, Ali Ashraf Jamshidi

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Purpose: The effect of hamstring antagonist activity on the knee extensors torque of the Anterior Cruciate Ligament reconstruction (ACLR) is not clear and persistent muscle weakness is common after ACLR. Hamstring activation when acting as antagonist is considered very important for knee strengths. Therefore the purpose of this study was to examine hamstring antagonist coactivation during maximal effort of the isokinetic knee extension in ACLR athletes with hamstring autograft. Materials and Methods: We enrolled 20 professional athletes who underwent primary ACLR (hamstring tendon autograft)with 6-24 months postoperative and 20 healthy subjects as control group. Each subjects performed maximal effort isokinetic knee extension and flexion in 60/˚ s and 180/˚ s velocities for the involved and uninvolved limb. Synchronously, surface electromyography (EMG) was recorded of vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF) and biceps femoris (BF). The antagonist integrated EMG (IEMG) values were normalized to the IEMG of the same muscle during maximal isokinetic eccentric effort at the same velocities and ROM. Results: A one-way analysis of variance designs shows significantly greater IEMG coactivation of hamstring and decreased activation of Vm in ACLR when compared to uninvolved and control group leg in 60/˚ s and 180/˚ s velocities. Likewise peak torque to body weight was decreased in ACLR compared to uninvolved and control group during knee extension in both velocities (p < 0.05). Conclusions: Decreased extensors moment caused by decreased quadriceps inhibition and increased hamstring coactivation. In addition, these result indicated to decrease of motor unit recruitment in the VM (as a kinesiologicmonitore of the knee). It is appearing that strengthening of the quadriceps to be an important for rehabilitation program after ACLR for preparation in athletes endeavors. Therefore, we suggest that having more emphasis and focus on quadriceps strength and less emphasis on hamstring following ACLR.

Keywords: ACLR-coactivation, dynamometry, electromyography, isokinetic

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Authors: Kamil Dydek, Anna Boczkowska, Paulina Latko-Duralek, Rafal Kozera, Michal Salacinski

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In recent years there has been increasing interest in many industries, such as the aviation, automotive, and military industries, in Carbon Fibre Reinforced Polymers (CFRP). This is because of the excellent properties of CFRP, which are characterized by very high strength and stiffness in relation to their mass, low density (almost twice as low as aluminum and more than five times as low as steel), and corrosion resistance. However, they do not have sufficient electrical conductivity, which is required in some applications. Therefore, work is underway to improve their electrical conductivity, for example, by incorporating carbon nanotubes (CNTs) into the CFRP structure. CNTs possess excellent properties, such as high electrical conductivity, high aspect ratio, high Young’s modulus, and high tensile strength. An idea developed by our team is a modification of CFRP by the use of thermoplastic nonwovens containing CNTs. Nanocomposite fibers were made from three different masterbatches differing in the content of multi-wall carbon nanotubes, and then nonwovens that differed in areal weight were produced using a thermo-press. The out of autoclave method was used to fabricate the laminates from commercial carbon-epoxy prepreg dedicated to aviation applications - one without the nonwovens (reference) and five containing nonwovens placed between each prepreg layer. The volume of electrical conductivity of the manufactured laminates was measured in three directions. In order to investigate the adhesion between carbon fibers and nonwovens, the microstructure of the produced laminates was observed. The mechanical properties of the CFRP composites were measured in a short-beam shear test. In addition, the influence of thermoplastic nonwovens on the thermos-mechanical properties of laminates was analyzed by Dynamic Mechanical Analysis. The studies were carried out within grant no. DOB-1-3/1/PS/2014 financed by the National Centre for Research and Development in Poland.

Keywords: CFRP, thermoplastic nonwovens, carbon nanotubes, electrical conductivity

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Authors: Afshan Saad, Muhammad Saad, Shah Muhammad Emaduddin

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Nowadays the business condition is so quick paced that enhancing ourselves consistently has turned into a huge factor for the presence of an undertaking. We can check this for structural building and significantly more so in the quick-paced universe of data innovation and programming designing. The lithe philosophies, similar to Scrum, have a devoted advance in the process that objectives the enhancement of the improvement procedure and programming items. Pivotal to process enhancement is to pick up data that grants you to assess the condition of the procedure and its items. From the status data, you can design activities for the upgrade and furthermore assess the accomplishment of those activities. This investigation builds a model that measures the product nature of the improvement procedure. The product quality is dependent on the useful and auxiliary nature of the product items, besides the nature of the advancement procedure is likewise vital to enhance programming quality. Utilitarian quality covers the adherence to client prerequisites, while the auxiliary quality tends to the structure of the product item's source code with reference to its practicality. The procedure quality is identified with the consistency and expectedness of the improvement procedure. The product quality model is connected in a business setting by social occasion the information for the product measurements in the model. To assess the product quality model, we investigate the information and present it to the general population engaged with the light-footed programming improvement process. The outcomes from the application and the client input recommend that the model empowers a reasonable evaluation of the product quality and that it very well may be utilized to help the persistent enhancement of the advancement procedure and programming items.

Keywords: Agile SDLC Tools, Agile Software development, business value, enterprise applications, IBM, IBM Rational Team Concert, RTC, software quality, software metrics

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Authors: Meng-Na Dai, Bao-Fang Wen, Gao-Pei Zhu, Chen-Xi Zhang, Jing Sun, Chang-Hai Tang, Zhi-Qiang Feng, Wen-Qiang Yin

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Based on the analysis of literature in the health emergency management in China with recent 10 years, this paper discusses the Chinese current research hotspots, development trends and shortcomings in this field, and provides references for scholars to conduct follow-up research. CNKI(China National Knowledge Infrastructure), Weipu, and Wanfang were the databases of this literature. The key words during the database search were health, emergency, and management with the time from 2009 to 2018. The duplicate, non-academic, and unrelated documents were excluded. 901 articles were included in the literature review database. The main indicators of abstraction were, the number of articles published every year, authors, institutions, periodicals, etc. There are some research findings through the analysis of the literature. Overall, the number of literature in the health emergency management in China has shown a fluctuating downward trend in recent 10 years. Specifically, there is a lack of close cooperation between authors, which has not constituted the core team among them yet. Meanwhile, in this field, the number of high-level periodicals and quality literature is scarce. In addition, there are a lot of research hotspots, such as emergency management system, mechanism research, capacity evaluation index system research, plans and capacity-building research, etc. In the future, we should increase the scientific research funding of the health emergency management, encourage collaborative innovation among authors in multi-disciplinary fields, and create high-quality and high-impact journals in this field. The states should encourage scholars in this field to carry out more academic cooperation and communication with the whole world and improve the research in breadth and depth. Generally speaking, the research in health emergency management in China is still insufficient and needs to be improved.

Keywords: health emergency management, research situation, bibliometrics, literature

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Authors: Jean Hugé, Francisco Benitez-Capistros, Giorgia Camperio-Ciani

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Addressing conservation conflicts requires the consideration of multiple stakeholders' perspectives and knowledge claims, in order to inform complex and possibly contentious decision-making dilemmas. Hence, a better understanding of why people in particular contexts act in a particular way in a conservation conflict is needed. First, this contribution aims at providing and applying an approach to map and interpret the diversity of subjective viewpoints with regard to iconic species in conservation conflicts. Secondly, this contribution aims to feed the reflection on the possible consequences of the diversity of perspectives for the future management of wildlife (in particular iconic species), based on case studies in Galapagos and Malaysia. The use of the semi-quantitative Q methodology allowed us to identify various perspectives on conservation in different social-ecological contexts. While the presence of iconic species may lead to a more passionate and emotional debate, it may also provide more opportunities for finding common ground and for jointly developing acceptable management solutions that will depolarize emergent, long-lasting or latent conservation conflicts. Based on the research team’s experience in the field, and on the integration of ecological and social knowledge, methodological and management recommendations are made with regard to conservation conflicts involving iconic wildlife. The mere presence of iconic wildlife does not guarantee its centrality in conservation conflicts, and comparisons will be drawn between the cases of the giant tortoises (Chelonoidis spec.) in Galapagos, Ecuador and the Milky Stork (Mycteria cinerea) in western peninsular Malaysia. Acknowledging the diversity of viewpoints, reflecting how different stakeholders see, act and talk about wildlife management, highlights the need to develop pro-active and resilient strategies to deal with these issues.

Keywords: conservation conflicts, Q methodology, Galapagos, Malaysia, giant tortoise, milky stork

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Authors: Thuraya Ahmed Al Shidhani, Yahya Al Farsi, Alya Al Husni, Samir Al Adawi

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Background: Knee osteoarthritis (knee OA) represents a major public health burden worldwide, particularly among older adults. However, little has been documented from Arabian Gulf countries, which have left an information gap. Objective: This study describes the socio-demographic, clinical risk factors, and use of herbal medicine among men and women seeking consultation for knee OA at two secondary healthcare facilities in Muscat, Oman. Methods: A cross-sectional study was conducted among 213 Omani adults with knee OA attending a referral polyclinic in Muscat, Oman, over 12 months from January to December. Socio-demographic data were collected from the participants who are seeking consultation for knee OA. Results: Among the 213 study participants, 171 were females and 42 males. The females were comparatively older than the males, had lower education and lower-income, and more overweight. The majority of the participants were normal weight or underweight. About one-third of participants reported OA in other joints as well. Most participants recalled that they had knee OA for less than a year. About 12% reported a history of trauma. The majority (63%) concurrently had other chronic illnesses, and 33% reported having at least one complication. About 22% were using herbal medicines. About 77% are using herbal local applications in form of powder and creams. Conclusion: This study, to our knowledge, is the first to explore socio-demographic characteristics, clinical risk factors and use of herbal medicine among sufferers of knee OA in Oman. Knee OA tended to occur among our participants at younger ages than reported elsewhere, while obesity appeared orthogonal to the severity of knee OA. Women were more affected than men. About one quarter of Omani patients are using herbal medicine. More studies are needed to understand the causal factors and development of knee OA in Oman. Targeted health education and rehabilitation programs are needed, particularly among Omani women, to improve their physical quality of life.

Keywords: knee joint, osteoarthritis, herbal medicine, Oman

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Authors: Ivan Yudianto

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The research objectives are to analyze the factors that impede the Parking Tax and Parking Retribution collection in Bekasi City Government, analyzing the factors that can increase local own revenue from the tax sector of parking tax and parking retribution, analyze monitoring the parking retribution collection by the Bekasi City Government, analyze strategies Bekasi City Government through the preparation of a roadmap and action plan to increase parking tax and parking retribution revenues. The approach used in this research is a qualitative approach. Qualitative research is used because the problem is not yet clear and the object to be studied will be holistic, complex, and dynamic, and the relationship will be interactive symptoms. Methods of data collection and technical analysis of the data was in-depth interviews, participant observation, documentary materials, literature, and triangulation, as well as new methods such as the methods of visual materials and internet browsing. The results showed that there are several factors that become an obstacle such as the parking taxpayer does not disclose the actual parking revenue, the parking taxpayer are late or do not pay Parking Tax, many parking locations controlled by illegal organizations, shortage of human resources in charge levy and supervise the parking tax and parking retribution collection in the Bekasi City Government, surveillance parking tax and parking retribution are not scheduled on a regular basis. Several strategic priorities in order to develop the potential of the Parking Tax and Parking Retribution in the Bekasi City Government, namely through increased controling and monitoring of the Parking Taxpayer, forming a team of auditors to audit the Parking Taxpayer, seek law enforcement persuasive and educative to reduce Parking Taxpayer wayward, providing strict sanctions against the Parking Taxpayer disobedient, revised regulations mayors about locations of parking in Bekasi City, rationalize revenues target of Parking Retribution, conducting takeover attempts parking location on the roadside of the individual or specific group, and drafting regional regulations on parking subscribe.

Keywords: local own revenue, parking retribution, parking tax, parking taxpayer

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Authors: Aniekan Peter, ECS Naidu, Edidiong Akang, U. Offor, R. Kalhapure, A. A. Chuturgoon, T. Govender, O. O. Azu

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Introduction: Nano-drugs are novel innovations in the management of human immunodeficiency virus (HIV) pandemic, especially resistant strains of the virus in their sanctuary sites: testis and the brain. There are safety concerns to be addressed to achieve the full potential of this new drug delivery system. Aim of study: Our study was designed to investigate toxicity profile of Tenofovir Nanoparticle (TDF-N) synthesized by University of Kwazulu-Natal (UKZN) Nano-team for prevention and treatment of HIV infection. Methodology: Ten adult male Sprague-Dawley rats maintained at the Animal House of the Biomedical Resources Unit UKZN were used for the study. The animals were weighed and divided into two groups of 5 animal each. Control animals (A) were administered with normal saline. Therapeutic dose (4.3 mg/kg) of TDF-N was administered to group B. At the end of four weeks, animals were weighed and sacrificed. Liver and kidney were removed fixed in formal saline, processed and stained using H/E, PAS and MT stains for light microscopy. Serum was obtained for renal function test (RFT), liver function test (LFT) and full blood count (FBC) using appropriate analysers. Cellular measurements were done using ImageJ and Leica software 2.0. Data were analysed using graph pad 6, values < 0.05 were significant. Results: We reported no histological alterations in the liver, kidney, FBC, LFT and RFT between the TDF-N animals and saline control. There were no significant differences in weight, organo-somatic index and histological measurements in the treatment group when compared with saline control. Conclusion/recommendations: TDF-N is not toxic to the liver, kidney and blood cells in our study. More studies using human subjects is recommended.

Keywords: tenofovir nanoparticles, liver, kidney, blood cells

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