Search results for: emergency department admission

Authors: Adnan Sahin, Ufuk Uylas, Ercument Pasaoglu, Tarik Caga, Enver Ihtiyar, Serdar Erkasap, Ersin Ates, Fatih Yasar

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Background: In this study, it was evaluated the demographic features, etiological factors and the management of acute pancreatitis. Methods: 106 patient hospitalized due to acute pancreatitis were retrospectively examined from 1 January 2015 to 31 December 2015 in Department of General Surgery of ESOGUMF. The data of gender, signs and symptoms, etiological factors, WBC, AST, ALT, Amilase, USG and CT findings treatment options ERCP, and complications, mortality rate were analysed. Results: The mean age of patients were 58.8 (53 men and 53 women). The causes of acute pancreatitis were as follows: gallbladder stone was 89, hyperlipidemia was 5 and idiopathic were 16 patients. Severe pancreatitis was developed in 16 patients in the biliary pancreatitis group and ERCP was performed. Cholecystectomy was performed to all biliary pancreatitis group patients after acute pancreatitis subside. The mean hospital stay period was 9.33 (2-37) day. Discussion and conclusion: Severe acute pancreatitis is a mortal disease. The most common etiological cause of acute pancreatitis is biliary origin. The first line treatment modality of acute pancreatitis is medical. Cholecystectomy should be planned to the all-biliary caused acute pancreatitis patients after the attack subside. ERCP is a useful treatment modality in the case of clinical worsening and suspicion of acute cholangitis. ERCP procedure used 16 patients in our series and these patients have a good morbidity and mean hospital period is lower than the others. We suppose that ERCP procedure should be planned selectively and conservatively.

Keywords: acute pancreatitis, ERCP, morbidity, treatment

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Authors: Shutchapol Chopvitayakun

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Nowadays, especially for the last 5 years, mobile devices, mobile applications and mobile users, through the deployment of wireless communication and mobile phone cellular network, all these components are growing significantly bigger and stronger. They are being integrated into each other to create multiple purposes and pervasive deployments into every business and non-business sector such as education, medicine, traveling, finance, real estate and many more. Objective of this study was to develop a mobile application for seniors or last-year students who enroll the internship program at each tertiary school (undergraduate school) and do onsite practice at real field sties, real organizations and real workspaces. During the internship session, all students as the interns are required to exercise, drilling and training onsite with specific locations and specific tasks or may be some assignments from their supervisor. Their work spaces are both private and government corporates and enterprises. This mobile application is developed under schema of a transactional processing system that enables users to keep daily work or practice log, monitor true working locations and ability to follow daily tasks of each trainee. Moreover, it provides useful guidance from each intern’s advisor, in case of emergency. Finally, it can summarize all transactional data then calculate each internship cumulated hours from the field practice session for each individual intern.

Keywords: internship, mobile application, Android OS, smart phone devices, mobile transactional processing system, guidance and monitoring, tertiary education, senior students, model view controller (MVC)

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Authors: Selina Doncevic, Lisa Perla, Angela Kindvall

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The Global War on Terror which began after September 11, 2011, increased survivability of severe injuries requiring varying trajectories of rehabilitation and recovery. The costs encompass physiologic, functional, social, emotional, psychological, vocational and scholastic domains of life. The purpose of this poster is to inform private sector health care practitioners and clinicians at various levels of the unique and long term dynamics of healthcare recovery for polytrauma, and traumatic brain injured service members and veterans in the United States of America. Challenges include care delivery between the private sector, the department of defense, and veterans affairs healthcare systems while simultaneously supporting the dynamics of acute as well as latent complications associated with severe injury and illness. Clinical relevance, subtleties of protracted recovery, and overwhelmed systems of care are discussed in the context of lessons learned and in reflection on previous wars. Additional concerns for consideration and discussion include: the cost of protracted healthcare, various U.S. healthcare payer systems, lingering community reintegration challenges, ongoing care giver support, the rise of veterans support groups and the development of private sector clinical partnerships.

Keywords: brain injury, future, polytrauma, rehabilitation

Procedia PDF Downloads 183

Authors: Sadie Khorramnia, Asha Bonney, Kate Galloway, Andrew Kyoong

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Sleep plays a pivotal role in the registration and consolidation of memory. Multiple observational studies have demonstrated that self-reported sleep duration and sleep quality are associated with cognitive performance. Montreal Cognitive Assessment questionnaire is a screening tool to assess mild cognitive (MCI) impairment with a 90% diagnostic sensitivity. In our current study, we used MOCA to identify MCI in patients who underwent sleep study in our sleep department. We then looked at the clinical risk factors and sleep-related parameters in subjects found to have mild cognitive impairment but without a diagnosis of sleep-disordered breathing. Clinical risk factors, including physician, diagnosed hypertension, diabetes, and depression and sleep-related parameters, measured during sleep study, including percentage time of each sleep stage, total sleep time, awakenings, sleep efficiency, apnoea hypopnoea index, and oxygen saturation, were evaluated. A total of 90 subjects who underwent sleep study between March 2019 and October 2019 were included. Currently, there is no pharmacotherapy available for MCI; therefore, identifying the risk factors and attempting to reverse or mitigate their effect is pivotal in slowing down the rate of cognitive deterioration. Further characterization of sleep parameters in this group of patients could open up opportunities for potentially beneficial interventions.

Keywords: apnoea hypopnea index, mild cognitive impairment, sleep architecture, sleep study

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Authors: Ana Paula Melchiors Stahlschmidt

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This paper discusses the role of music as a ludic activity and constituent element of voice in the construction and consolidation of the relationship of the baby and his/her mother or caretaker, evaluating its implications in his/her psychic structure and constitution as a subject. The work was based on the research developed as part of the author’s doctoral activities carried out from her insertion in a project of the Music Department of Federal University of Rio Grande do Sul - UFRGS, which objective was the development of musical activities with groups of babies from 0 to 24 months old and their caretakers. Observations, video recordings of the meetings, audio testemonies, and evaluation tools applied to group participants were used as instruments for this research. Information was collected on the participation of 195 babies, among which 8 were more focused on through interviews with their mothers or caretakers. These interviews were analyzed based on the referential of French Discourse Analysis, Psychoanalysis, Psychology of Development and Musical Education. The results of the research were complemented by other posterior experiences that the author developed with similar groups, in a context of a private clinic. The information collected allowed the observation of the ludic and structural functions of musical activities, when developed in a structured environment, as well as the importance of the musicality of the mother’s voice to the psychical structuring of the baby, allowing his/her insertion in the language and his/her constituition as a subject.

Keywords: music and babies, maternal voice, Psychoanalysis and music, psychology and music

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Authors: Vinay Gupta, Seema Malhotra

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Background: Patients who usually consume tobacco are unaware of its ill effects completely therefore it becomes necessary to educate and counselling them after obtaining their knowledge about tobacco. Aim: To measure prevalence of tobacco use among dental outpatients and to evaluation of tobacco user attending dental outpatients (OPD) prepared to quit. Methods: A cross-sectional survey, which was carried out on patients attending Outside Patient Department (OPD) of dental college of King Georges Medical University, Lucknow, India. All the patients who consumed tobacco attending the Dental College were asked to participate in the study. The questionnaire was written in English/ Hindi (local language). Participation in this study was voluntary and the questionnaire was anonymous and self-administered. The proposal of this survey had been approved by the ethical committee of institution. Informed consent was obtained from all the participants. Results: Prevalence of tobacco user attending the Dental OPD was 46.4%. Male tobacco user represented 85.9%. Smokeless tobacco (57%) user were more than smoking (1.4%) and 18.9% were using both smokeless and smoking tobacco. 40.7% start using tobacco since less than 5 years. 55.3% uses tobacco after get up in the morning. 87.1% tobacco user knows that it cause cancer. 54.8% respond that warning sign on packet/pouch effect on mind but due to addiction, it would not work out. 54.8% attempted for quitting but not successful. 90.0% willing to quit in future if facility provide. Conclusion: Higher prevalence of tobacco usage among study population and will to quit in future shows need of cessation clinic in every dental institution in India.

Keywords: tobacco, knowledge, practice, counselling

Procedia PDF Downloads 324

Authors: Anh Duong

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The three-phase reading lesson has been put forth around the world as the new and innovative framework which is corresponding to the learner-centered trend in English language teaching and learning. Among three stages, pre-reading attracts many teachers’ and researchers’ attention for its vital role in preparing students with knowledge and interest in reading class. The researcher’s desire to exemplify effectiveness of activities prior to text reading has provoked the current study. Three main aspects were investigated in this paper, i.e. teachers’ and student’s perception of pre-reading stage, teachers’ exploitation of pre-reading techniques and teachers’ recommendation of effective pre-reading activities. Aiming at pre-reading techniques for first-year students at English Department, this study involved 200 fresh-men and 10 teachers from Division 1 to participate in the questionnaire survey. Interviews with the teachers and classroom observation were employed as a tool to take an insight into the responses gained from the early instrument. After a detailed procedure of analyzing data, the researcher discovered that thanks to the participants’ acclamation of pre-reading stage, this phase was frequently conducted by the surveyed teachers. Despite the fact that pre-reading activities apparently put a hand in motivating students to read and creating a joyful learning atmosphere, they did not fulfill another function as supporting students’ reading comprehension. Therefore, a range of techniques and notices when preparing and conducting pre-reading phase was detected from the interviewed teachers. The findings assisted the researcher to propose some related pedagogical implications concerning teachers’ source of pre-reading techniques, variations of suggested activities and first-year reading syllabus.

Keywords: pre-reading stage, pre-reading techniques, teaching reading, language teaching

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Authors: Girma Y. Iyassu Menelik

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“The world is now like a global village!” so goes the saying that shows that due to development and technology the countries of the world are now closely linked. In the field of Human rights there is a close relationship in the way that rights are recognised and enforced. This paper will show that human rights have evolved from ancient times through important landmarks such as the Magna Carta, the French Declaration of Rights of Man and of the Citizen and the American Bill of Rights. The formation of the United Nations after the Second World War resulted in the need to codify and protect human rights. There are some rights which are so fundamental that they are found in international and continental instruments, national constitutions and domestic legislation. In the civil and political sphere they include the right to vote, to freedom of association, speech and assembly, right to life, privacy and fair trial. In the economic and social sphere you have the right to work, protection of the family, social security and rights to education, health and shelter. In some instance some rights can be suspended in times of public emergency but such derogations shall be circumscribed by the law and in most constitutions such limitations are subject to judicial review. However, some rights are so crucial that they cannot be derogated from under any circumstances and these include the right to life, recognition before the law, freedom from torture and slavery and of thought, conscience and religion. International jurisprudence has been developed to protect fundamental rights and avoid discrimination on the grounds of race, colour, sex, language or social origin. The elaborate protection system go to show that these rights have become part of the international order and they have universal application. We have now got to a stage where UDHR, ICCPR and ICESCR and have come to be regarded as part of an international bill of rights with horizontal and vertical enforcement mechanisms involving state parties, NGO’s , international bodies and other organs.

Keywords: rights, international, constitutional, state, judiciary

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Authors: Mostosi C., Stéphenne J., Kempeneers E.

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Introduction: Refuellers from Brussels South Charleroi Airport (BSCA) expressed concerns about the risks involved in handling JET-A1 fuel. The HSE Manager of BSCA, in collaboration with the occupational physician and the industrial hygiene unit of the External Service of Occupational Medicine, decided to assess the toxicological exposure of these workers. Materials and methods: Two measurement methods were used. The first was to assay three types of metabolites in urine to highlight the exposure to xylenes, toluene, and benzene in aircraft fuels. Out of 32 refuellers in the department, 26 participated in the sampling, and 23 samples were exploited. The second method targeted the assessment of environmental exposure to certain potentially hazardous substances that refuellers are likely to breathe in work areas at the airport. It was decided to carry out two ambient air measurement campaigns, using static systems on the one hand and, on the other hand, using individual sensors worn by the refuellers at the level of the respiratory tract. Volatile organic compounds and diesel particles were analyzed. Results: Despite the fears that motivated these analyzes, the overall results showed low levels of exposure, far below the existing limit values, both in air quality and in urinary measurements. Conclusion: These results are comparable to a study carried out in several French airports. The staff could be reassured, and then the medical surveillance was modified by the occupational physician. With the aviation development at BSCA, equipment and methods are evolving. Their exposure will have to be reassessed.

Keywords: refuelling, airport, exposure, fuel, occupational health, air quality

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Authors: Martha Wilson

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With the peak of Computer-Assisted Language Learning slowly coming to pass and Mobile-Assisted Language Learning, at times, a bit lacking in the communicative department, we are now faced with a challenging question: How can we engage the interest of our digital native students and, most importantly, sustain it? As previously mentioned, our classrooms are now experiencing an influx of “digital natives” – people who have grown up using and having unlimited access to technology. While modernizing our curriculum and digitalizing our classrooms are necessary in order to accommodate this new learning style, it is a huge financial burden and a massive undertaking for language institutes. Instead, opting for a more compact, simple, yet multidimensional pedagogical tool may be the solution to the issue at hand. This paper aims to give a brief overview into an existing device referred to as Student Response Systems (SRS) and to expand on this notion to include a new prototype of response system that will be designed as a mobile application to eliminate the need for costly hardware and software. Additionally, an analysis into recent attempts by other institutes to develop the Mobile Response System (MRS) and customer reviews of the existing MRSs will be provided, as well as the lessons learned from those projects. Finally, while the new model of MRS is still in its infancy stage, this paper will discuss the implications of incorporating such an application as a tool to support and to enrich traditional techniques and also offer practical classroom applications with the existing response systems that are immediately available on the market.

Keywords: app, clickers, mobile app, mobile response system, student response system

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Authors: Menglim Hoy, Suksun Horpibulsuk, Arul Arulrajah

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The results of laboratory investigation of recycled asphalt pavement (RAP) – fly ash (FA) based geopolymer as a base material is presented in this paper. An alkaline activator, the mixture of NaOH and Na₂SiO₃, is used to synthesis RAP-FA based geopolymer. RAP-FA with water (RAP-FA blend) prepared as a control material. The strength develops and the strength against wet-dry was determined by the unconfined compression strength (UCS) test, then the microstructural properties were examined by scanning electron microscopy (SEM) and X-ray Diffraction (XRD) analysis. The toxicity characteristic leaching procedure (TCLP) test is conducted to measure its leachability of heavy metal. The results show both the RAP-FA blend and geopolymer can be used as a base course as its UCS values meet the minimum strength requirement specified by the Department of Highway, Thailand. The durability test results show the UCS of these materials increases with increasing the number of wet-dry cycles, reaching its peak at six wet-dry cycles. The XRD and SEM analyses indicate strength development of the RAP-FA blend occurs due to chemical reaction between a high Calcium in RAP with a high Silica and Alumina in FA led to producing calcium aluminate hydrate formation. The strength development of the RAP-FA geopolymer occurred resulted from the polymerization reaction. The TCLP results demonstrate there is no environmental risk of these stabilized materials. Furthermore, FA based geopolymer can reduce the leachability of heavy metal in the RAP-FA blend.

Keywords: recycled asphalt pavement, geopolymer, heavy metal, microstructure

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Authors: Maria Zinnia Bardas Hoffmann

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Contrastive Analysis (CA) is the systematic comparison between two languages. It stems from the notion that errors are caused by interference of the L1 system in the acquisition process of an L2. CA represents a useful tool to understand the nature of learning and acquisition. Also, this particular method promises a path to un-derstand the nature of underlying cognitive processes, even when other factors such as intrinsic motivation and teaching strategies were found to best explain student’s problems in acquisition. CA study is justified not only from the need to get a deeper understanding of the nature of SLA, but as an invaluable source to provide clues, at a cognitive level, for those general processes involved in rule formation and abstract thought. It is relevant for cross disciplinary studies and the fields of Computational Thought, Natural Language processing, Applied Linguistics, Cognitive Linguistics and Math Theory. That being said, this paper intends to address here as well its own set of constraints and limitations. Finally, this paper: (a) aims at identifying some of the difficulties students may find in their learning process due to the nature of their specific variety of L1, Rio de la Plata Spanish (RPS), (b) represents an attempt to discuss the necessity for specific models to approach CA.

Keywords: second language acquisition, applied linguistics, contrastive analysis, applied contrastive analysis English language department, meta-linguistic rules, cross-linguistics studies, computational thought, natural language processing

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Authors: R. Geetha, J. Arunkumar, P. Gopal, D. Loganathan, K. Pavithra, C. Vikashini

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Mobile Number Portability is an attempt to switch over from one network to another network facility for mobile based on applications. This facility is currently not available for mobile handsets. This application is intended to assist the mobile network and its service customers in understanding the criteria; this will serve as a universal set of requirements which must be met by the customers. This application helps the user's network portability. Accessing permission from the network provider to enable services to the user and utilizing the available network signals. It is enabling the user to make a temporary switch over to other network. The main aim of this research work is to adapt multiple networks at the time of no network coverage. It can be accessed at rural and geographical areas. This can be achieved by this mobile application. The application is capable of temporary switch over between various networks. With this application both the service provider and the network user are benefited. The service provider is benefited by charging a minimum cost for utilizing other network. It provides security in terms of password that is unique to avoid unauthorized users and to prevent loss of balance. The goal intended to be attained is a complete utilization of available network at significant situations and to provide feature that satisfy the customer needs. The temporary switch over is done to manage emergency calls when user is in rural or geographical area, where there will be a very low network coverage. Since people find it trend in using Android mobile, this application is designed as an Android applications, which can be freely downloaded and installed from Play store. In the current scenario, the service provider enables the user to change their network without shifting their mobile network. This application affords a clarification for users while they are jammed in a critical situation. This application is designed by using Android 4.2 and SQLite Version3.

Keywords: mobile number, random number, alarm, imei number, call

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Authors: Mohsin Javed

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School Education department is usually criticized for utilizing quite low or fewer academic days due to many reasons like extreme weather conditions, sudden holidays, summer vocations, pandemics and, terrorism etc. The purpose of the experimental study was to determine the efficacy of online cooperative learning (OCL) integrated in the rotation model of blended learning. The effects on academic achievement of students and students' attitude about OCL embedded learning were assessed. By using a posttest only control group design, sixty-two first-year students were randomly allocated to either the experimental (30) or control (32) group. The control group received face to face classes for six sessions per week, while the experimental group had three OCL and three formal sessions per week under rotation model. Students' perceptions of OCL were evaluated using a survey questionnaire. Data was analyzed by independent sample t test and one sample t test. According to findings, the intervention greatly improved the state of the dependent variables. The results demonstrate that OCL can be successfully implemented in formal education using a blended learning rotation approach. Higher secondary institutions are advised to use this model in situations like Covid 19, smog, unexpected holidays, instructor absence from class due to increased responsibilities, and summer vacations.

Keywords: blended learning, online cooperative learning, rotation model of blended learning, supplementing

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Authors: Ekta Pandey

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The Indian Pharmaceutical Industry is ranked third largest by volume and fourteenth by value. It thus accounts for 10% of world’s production by volume and 1.5% by value according to Department of Pharmaceuticals, Government of India. The industry has shown phenomenal growth over past few years, moving from US $ 1 billion turnover in 1990 to a turnover of around US $30 billion in 2015. The Indian pharmaceutical sector is ranked seventeenth in terms of export value of active pharmaceutical ingredients and dosage forms to more than 200 countries around the globe. It has shown tremendous changes especially after Trade Related Aspects of Intellectual Property Rights (TRIPS) agreement. Recognizing the immense potential for growth and its direct impact on Indian economy, it is important to look up the industrial policies adopted since Indian independence which turnaround the Indian pharmaceutical industry. A systematic review of changes in market structure of Indian pharmaceutical industry due to shift in policy regimes is done from 1850 to 2015 using secondary peer reviewed published research work. The aim is to understand the impact of anti-trust laws, intellectual property rights, industry competition acts and regulations are quite crucial in determining effective economic policy and have overall lasting effects on international trade and ties. The proposed paper examines the position of Indian domestic firms relative to multinational pharmaceutical firms tries to throw some light on the growth curve of Indian pharmaceutical sector.

Keywords: active pharmaceutical ingredients, competition act, pharmaceutical industry, TRIPS

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Authors: Mya Achike

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Background and Significance: Perinatal mental illness covers a wide range of conditions and has a huge influence on maternal-child health. Issues and challenges with perinatal mental health have been associated with poor pregnancy, birth, and postpartum outcomes. It is estimated that one out of five new and expectant mothers experience some degree of perinatal mental illness, which makes this a hugely significant health outcome. Certain factors increase the maternal risk for mental illness. Challenges related to poverty, migration, extreme stress, exposure to violence, emergency and conflict situations, natural disasters, and pandemics can exacerbate mental health disorders. It is widely expected that perinatal mental health is being negatively affected during the present COVID-19 pandemic. Methods: A review of studies that reported a measurement tool to assess perinatal mental health outcomes during the COVID-19 pandemic was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, CINAHL, and Google Scholar were used to search for peer-reviewed studies published after late 2019, in accordance with the emergence of the virus. The search resulted in the inclusion of ten studies. Approach to measure health outcome: The main approach to measure perinatal mental illness is the use of self-administered, validated questionnaires, usually in the clinical setting. Summary: Widespread use of these tools has afforded the clinical and research communities the ability to identify and support women who may be suffering from mental illness disorders during a pandemic. More research is needed to validate tools in other vulnerable, perinatal populations.

Keywords: mental health during covid, perinatal mental health, perinatal mental health measurement tools, perinatal mental health tools

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Authors: Atikah Binti Azudin, Nurin Nazlah Binti Muhamad Yani, Nur Alya Nadhirah Binti Naaidith, Nur Amylia Wahida Binti Mat Ayob, Nurshamimi Shakirah Binti Suboh, Nur Auni Batrisyia Binti Md. Zaini, Nur Aziemah Binti Mohamad, Nurul Suffiyah Binti Sa’Dun, Sabrina Sasha Izzati Binti Zubaile, Umi Huwaina Binti Ahmiruddin, Wan Nur Shafawati Binti Wan Ghazali

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A hazard alert is intended to provide brief information about significant incidents or existing difficulties in Department workplaces. The alert gives guidelines for proper processes, practices, and controls to be applied. When operated in accordance with the manufacturer's instructions, any machine or tool utilized at work provides a safe and dependable platform for workers to accomplish job duties. However, when not utilized appropriately, the machine might pose a major hazard to employees. Employers have a duty to keep employees safe in this scenario. This Hazard Alert outlines specific occupational dangers and the controls that employers must apply to prevent injury or fatal accidents. There have been several cases of hazard alerts in Malaysia, which have had a negative impact on a few workers. Looking on the bright side, we can overcome every incident in a variety of ways. One of these is that only qualified individuals operate mobile machinery and equipment. In addition, employees may also perform frequent pre-use inspections of machinery to discover and fix flaws. Hazard alert is very important, and this study would cover a variety of subjects, including the methods employed.

Keywords: safe, hazard, impacts, duties.

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Authors: Jiří F. Urbánek, David Král

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Small and Middle Enterprises (SME) have a specific mission, characteristics, and behavior in global business competitive environments. They must respect policy, rules, requirements and standards in all their inherent and outer processes of supply - customer chains and networks. Paper aims and purposes are to introduce computational assistance, which enables us the using of prevailing operation system MS Office (SmartArt...) for mathematical models, using DYVELOP (Dynamic Vector Logistics of Processes) method. It is providing for SMS´s global environment the capability and profit to achieve its commitment regarding the effectiveness of the quality management system in customer requirements meeting and also the continual improvement of the organization’s and SME´s processes overall performance and efficiency, as well as its societal security via continual planning improvement. DYVELOP model´s maps - the Blazons are able mathematically - graphically express the relationships among entities, actors, and processes, including the discovering and modeling of the cycling cases and their phases. The blazons need live PowerPoint presentation for better comprehension of this paper mission – added value analysis. The crisis management of SMEs is obliged to use the cycles for successful coping of crisis situations.  Several times cycling of these cases is a necessary condition for the encompassment of the both the emergency event and the mitigation of organization´s damages. Uninterrupted and continuous cycling process is a good indicator and controlling actor of SME continuity and its sustainable development advanced possibilities.

Keywords: blazons, computational assistance, DYVELOP method, small and middle enterprises

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Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

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Authors: S. Mantzoukis, M. Gerasimou, P. Christodoulou, N. Varsamis, G. Kolliopoulou, N. Zotos

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Purpose: Patients in Intensive Care Units (ICU) are exposed to a different spectrum of microorganisms relative to the hospital. Due to the fact that the majority of these patients are intubated, bronchial secretions should be examined. Material and Method: Bronchial secretions should be taken with care so as not to be mixed with sputum or saliva. The bronchial secretions are placed in a sterile container and then inoculated into blood, Mac Conkey No2, Chocolate, Mueller Hinton, Chapman and Saboureaud agar. After this period, if any number of microbial colonies are detected, gram staining is performed and then the isolated organisms are identified by biochemical techniques in the automated Microscan system (Siemens) followed by a sensitivity test in the same system using the minimum inhibitory concentration MIC technique. The sensitivity test is verified by a Kirby Bauer test. Results: In 2017 the Laboratory of Microbiology received 365 samples of bronchial secretions from the Intensive Care Unit. 237 were found positive. S. epidermidis was identified in 1 specimen, A. baumannii in 60, K. pneumoniae in 42, P. aeruginosa in 50, C. albicans in 40, P. mirabilis in 4, E. coli in 4, S. maltophilia in 6, S. marcescens in 6, S. aureus in 12, S. pneumoniae in 1, S. haemolyticus in 4, P. fluorescens in 1, E. aerogenes in 1, E. cloacae in 5. Conclusions: The majority of ICU patients appear to be a fertile ground for the development of infections. The nature of the findings suggests that a significant part of the bacteria found comes from the unit (nosocomial infection).

Keywords: bronchial secretions, cultures, infections, intensive care units

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Authors: Derya Duran, Christine Jacknick

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This study explores post-task reflections in an English as a Medium of Instruction (EMI) setting, and it specifically focuses on how a teacher performs pedagogical practices such as reformulating, extending and evaluating following students’ spontaneous experience tellings in EMI classrooms. The data consist of 30 hours of video recordings from two EMI content classes, which were recorded for an academic term at a university in Turkey. The course, Guidance, is offered to fourth year undergraduate students as a compulsory course in the Department of Educational Sciences. The participants (n=78) study at the Faculty of Education, majoring in different educational departments (i.e., Computer Education and Instructional Technology, Elementary Education, Foreign Language Education). Using conversation analysis, we demonstrate that the teacher employs a variety of interactional resources to elicit (i.e., asking specific questions) and also provides (i.e., giving scientific information) as much content as possible, which also sheds light on the institutional fingerprints of the current research context. The study contributes to the existing research by unpacking articulation of personal experiences and cultivation of collaborativeness in classroom interaction. Moreover, describing the dialogic nature of these specific occasions, the study demonstrates how teacher and students address learning tasks together (collectivity), how they orient to each other turns interactionally (reciprocity), and how they keep the pedagogical focus in mind (purposefulness).

Keywords: conversation analysis, English as a medium of instruction, higher education, post-task reflections

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Authors: Silvia Maria Moya

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After the Great Depression, the number of admissions to psychiatric facilities saw a significant increase. This increase, coupled with the arrival of new antipsychotic drugs, prepared the ground to the psychiatric deinstitutionalization movement in North America. Community services became an essential part of care where the role of the nurse also became crucial in the management of patients. Looking through the archives of the Department of Psychiatry at the Ottawa Montfort Hospital, this project aims to assess the role of the nurse in a multidisciplinary team in a period of psychiatric deinstitutionalization. This research focuses on the different roles of the mental health nurse during the second half of the twentieth century. The case study, used as a methodological approach allows in-depth analysis of the journey of a female patient with long hospital course. The analysis of the document ‘psychiatric evaluation’ on the medical records of outpatient Montfort Hospital – where, on a regular basis, different health professionals of the multidisciplinary team write their notes – allow us to better understand the difficulties of the patient, their problems, their family and work relationships and the evolution of their self-esteem, but most importantly, it allows us to identify the importance of the different nurse`s roles in the team and in the mental health setting. This project therefore reveals that the nurse occupies a larger professional space than the other professionals in the multidisciplinary team and highlights the role of mental health nurses with patients and their families and their leadership role within a multidisciplinary team.

Keywords: mental health, nursing, deinstitutionalization, professional space

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Authors: Joshua N. Edokpayi, John O. Odiyo, Patience P. Shikwambana

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Water is a very rare natural resource in South Africa. Ga-Selati River is used for both domestic and industrial purposes. This study was carried out in order to assess the quality of Ga-Selati River in a mining area of Limpopo Province-Phalaborwa. The pH, Electrical Conductivity (EC) and Total Dissolved Solids (TDS) were determined using a Crinson multimeter while turbidity was measured using a Labcon Turbidimeter. The concentrations of Al, Ca, Cd, Cr, Fe, K, Mg, Mn, Na and Pb were analysed in triplicate using a Varian 520 flame atomic absorption spectrometer (AAS) supplied by PerkinElmer, after acid digestion with nitric acid in a fume cupboard. The average pH of the river from eight different sampling sites was 8.00 and 9.38 in wet and dry season respectively. Higher EC values were determined in the dry season (138.7 mS/m) than in the wet season (96.93 mS/m). Similarly, TDS values were higher in dry (929.29 mg/L) than in the wet season (640.72 mg/L) season. These values exceeded the recommended guideline of South Africa Department of Water Affairs and Forestry (DWAF) for domestic water use (70 mS/m) and that of the World Health Organization (WHO) (600 mS/m), respectively. Turbidity varied between 1.78-5.20 and 0.95-2.37 NTU in both wet and dry seasons. Total hardness of 312.50 mg/L and 297.75 mg/L as the concentration of CaCO3 was computed for the river in both the wet and the dry seasons and the river water was categorised as very hard. Mean concentration of the metals studied in both the wet and the dry seasons are: Na (94.06 mg/L and 196.3 mg/L), K (11.79 mg/L and 13.62 mg/L), Ca (45.60 mg/L and 41.30 mg/L), Mg (48.41 mg/L and 44.71 mg/L), Al (0.31 mg/L and 0.38 mg/L), Cd (0.01 mg/L and 0.01 mg/L), Cr (0.02 mg/L and 0.09 mg/L), Pb (0.05 mg/L and 0.06 mg/L), Mn (0.31 mg/L and 0.11 mg/L) and Fe (0.76 mg/L and 0.69 mg/L). Results from this study reveal that most of the metals were present in concentrations higher than the recommended guidelines of DWAF and WHO for domestic use and the protection of aquatic life.

Keywords: contamination, mining activities, surface water, trace metals

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Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

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This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: TPO antibody, subclinical hypothyroidism, anti nuclear antibody, thyroxin

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Authors: Ojetunde Ojewola, Mark Morgan, Sonja Wilhelm-Stanis

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State parks and historic sites are vulnerable to extreme weather events which can affect visitor experiences, management priorities, and legislative requests for disaster relief funds. Recently, global attention has been focused on the perceptions of global warming and how the presence of extreme weather events might impact protected areas, both now and in the future. The effects of climate change are not equally distributed across the United States, leading to varied perceptions based on personal experience with extreme weather events. This study describes employee perceptions of vulnerability and resilience in Missouri State Parks & Historic Sites due to extreme weather events that occur across the state but grouped according to physiographic provinces. Using a four-point rating scale, perceptions of vulnerability and resilience were divided into high and low sub-groups, thus allowing researchers to construct a two by two typology of employee responses. Subsequently, this data was used to develop a three-point continuum of environmental concern (higher scores meant more concern). Employee scores were then compared against a statewide assessment which combined social, economic, infrastructural and environmental indicators of vulnerability and resilience. State park employees thought the system was less vulnerable and more resilient to climate change than data found in statewide assessment This result was also consistent in three out of five physiographic regions across Missouri. Implications suggest that Missouri state park should develop a climate change adaptation strategy for emergency preparedness.

Keywords: extreme weather events, resilience, state parks, vulnerability

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Authors: Enjia Zhang

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During the prevention and control of the COVID-19 pandemic, all communities in China were gated and under strict management, which was highly effective in preventing the spread of the epidemic from spreading. Based on the TRIZ theory, this paper intends to propose green design strategies of community control in response to public health emergencies and to optimize community control facilities according to the principle of minimum transformation. Through the questionnaire method, this paper investigates and summarizes the situation and problems of community control during the COVID-19 pandemic. Based on these problems, the TRIZ theory is introduced to figure out the problems and associates them with prefabricated facilities. Afterward, the innovation points and solutions of prefabricated community control measures are proposed by using the contradiction matrix. This paper summarizes the current situation of community control under public health emergencies and concludes the problems such as simple forms of temporary roadblocks, sudden increase of community traffic pressure, and difficulties to access public spaces. The importance of entrance and exit control in community control is emphasized. Therefore, the community control measures are supposed to focus on traffic control, and the external access control measures, including motor vehicles, non-motor vehicles, residents and non-residents access control, and internal public space access control measures, including public space control shared with the society or adjacent communities, are proposed in order to make the community keep the open characteristics and have the flexibility to deal with sudden public health emergencies in the future.

Keywords: green design, community control, prefabricated structure, public health emergency

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Authors: Saveria Capecchi

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The aim of the quali-quantitative research conducted in the spring of 2021 (still in the midst of the Covid-19 emergency) was to analyze the relationship between the imaginary of 142 girls aged 10-12 from two Italian cities in the Emilia-Romagna region (the capital, Bologna, and Parma) and the influence that various socialization agents can have on it, with particular attention to social media. In order to investigate the relationship between imagination and media, two tools were used: first, the girls wrote an essay in class about their future lives, imagining waking up one morning as a thirty-year-old adults. Six types of "dreams" reflecting the values and lifestyles characteristic of contemporary Italian society emerged. Additionally, the girls completed a questionnaire on their leisure time and, in particular, media consumption aimed at identifying their favorite characters. The results provided insights into understanding the reference values and lifestyles that define their subculture (they belong to the so-called Generation Z). Another interesting aspect of this research is the possibility of comparing the results with those of a similar study on preadolescent imaginary conducted in 1995, involving 292 girls from Milan and Bologna, belonging to the Millennial generation. The narratives about the imagined adult life reflect some crucial changes undergone by Italian society in a quarter of a century: there are advancements towards gender equality, and the imagined family is increasingly detached from tradition. There is a more persistent dream of a life marked by beauty, wealth, and fame, while at the same time, there is a greater social commitment, from solidarity with marginalized people to environmentalism. Furthermore, the mentioned new digital and robotic professions will project us into the near future.

Keywords: gender equality, gender stereotypes, imaginary, preadolescents, social media

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Authors: Saimir Heta, Kastriot Haxhirexha, Virtut Velmishi, Nevila Alliu, Ilma Robo

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Background: Testicular rotation can occur at any age. The possibility to save the testicle is the fastest possible surgical intervention which is indicated by the presence of acute pain even at rest. The time element is more important to diagnose and proceed further with surgical intervention. Testicular damage is a consequence which mainly depends on the moment of onset of symptoms, at the time when the symptoms are diagnosed, the earliest action to be performed is surgical intervention. Sometimes medical tests are needed to confirm a diagnosis, or to help identify another cause for symptoms; for example, the urine test, that is used to check for infection, associated with the scrotal ultrasound test. Control of blood flow to the longitudinal supply vessels of the testicles is indicated. The sign that indicates testicular rotation is a reduction in blood flow. This is the element which is distinguished from ultrasound examination. Surgery may be needed to determine if the patient’s symptoms are caused by the rotation of the testis or any other condition. Discussion: As a surgical intervention of the emergency, the torsion of the test depends very much on the duration of the torsion, as the success in the life of the testicle depends on the fastest surgical intervention. From the previous clinic, it is noted that in any case presented to the pediatric patient diagnosed with testicular rotation, there is always a link with personal history that the patient refers to the presence of a previous episode of testicular trauma. Literature supports this fact very logically. Conclusions: Salvation without testicular atrophy depends closely on establishing the diagnosis of testicular rotation as soon as possible. Following the logic above, it can be said that the diagnosis for rotation should be performed as soon as possible, to avoid consequences that will not be favorable for the patient.

Keywords: acute scrotum, test torsion, newborns, clinical presentation

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Authors: Shima Behzadi

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Background: In many human malignant tumors, microRNA expression is aberrant. This study investigates miR-141 as a prognostic marker in colorectal cancer with K-Ras mutation. Materials and methods: In this case-control study, 100 patients, mostly over the age of 50, who were diagnosed with colorectal cancer were selected. The pathology department of the Mostoufi Pathobiology and Genetics Laboratory in Tehran confirmed the presence of colorectal cancer in samples of paraffin-embedded colon tissue. The case group was composed of patients with codon 12 and 13 mutations in exon 2 of the K-Ras gene, while tumor samples of individuals without these mutations in exon 2 of the K-Ras gene were selected as the control group, with patient consent. The changes in the expression of miR-141 were examined in both groups. Results: The study found that 20% of the patients tested positive for codon 12 mutation, and 10% of patients had codon 13 mutation. As a result, in 30 cases, there was a higher level of miR-141 expression. The miR-141 gene expression level in K-Ras positive tumor samples was 1.5 times higher than its expression level in K-Ras negative samples. This increase in expression was statistically significant, with a p-value of less than 0.001, indicating that the observed results are highly statistically significant. Conclusion: The study revealed that the incidence of typical K-Ras gene mutations among the colorectal cancer patients in the sample matches the national average in Iran. Additionally, the expression of miR-141 can serve as a useful biomarker to aid in the prognosis of colorectal cancer.

Keywords: colorectal cancer, K-Ras gene, miR-141 marker, real time PCR, electrophoresis

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Authors: Anochao Phetcharat

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This research aims to study problems of translation basic knowledge, particularly from English into Thai. The researcher used 38 2nd-year non-English speaking students of Suratthani Rajabhat University as samples. The samples were required to translate an A4-sized article from English into Thai assigned as a part of BEN0202 Translation for Business, a requirement subject for Business English Department, which was also taught by the researcher. After completion of the translation, numerous problems were found and the research grouped them into 4 major types. The normally occurred problems in English-Thai translation works are the lack of knowledge in terms of parts of speech, word-by-word translation employment, misspellings as well as the poor knowledge in English language structure. However, this research is currently under the process of data analysis and shall be completed by the beginning of August. The researcher, nevertheless, predicts that all the above-mentioned problems, will support the researcher’s hypothesizes, that are; 1) the lack of knowledge in terms of parts of speech causes the mistranslation problem; 2) employing word-by-word translation technique hugely results in the mistranslation problem; 3) misspellings yields the mistranslation problem; and 4) the poor knowledge in English language structure also brings about translation errors. The research also predicts that, of all the aforementioned problems, the following ones are found the most, respectively: the poor knowledge in English language structure, word-by-word translation employment, the lack of knowledge in terms of parts of speech, and misspellings.

Keywords: problem, student, Thai, translation

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