Search results for: don’t care conditions

Authors: Akankunda Veronicah Karuhanga

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Dementia is an age mental disorder that makes victims lose normal functionality that needs delicate attention. It has been technically defined as a clinical syndrome that presents a number of difficulties in speech and other cognitive functions that change someone’s behaviors and can also cause impairments in activities of daily living, not forgetting a range of neurological disorders that bring memory loss and cognitive impairment. Family members are the primary healthcare givers and therefore, the way how they handle the situation in its early stages determines future deterioration syndromes like total memory loss. Unfortunately, most family members are ignorant about this condition and in most cases, the patients are brought to our facilities when their condition was already mismanaged by family members and we thus cannot do much. For example, incontinence can be managed at early stages through potty training or toilet scheduling before resorting to 24/7 diapers which are also not good. Professional Elderly care should be understood and practiced as an extension of homes, not a dumping place for people considered “abnormal” on account of ignorance. Immediate relatives should therefore be sensitized concerning the normalcy of dementia in the context of old age so that they can be understanding and supportive of dementia patients rather than discriminating against them as present-day lepers. There is a need to skill home-based caregivers on how to handle dementia in its early stages. Unless this is done, many of our elderly homes shall be filled with patients who should have been treated and supported from their homes. This skilling of home-based caregivers is a vital intervention because until elderly care is appreciated as a human moral obligation, many transactional rehabilitation centers will crop up and this shall be one of the worst moral decadences of our times.

Keywords: dementia, family, Alzheimers, relevancy

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Authors: Abdulrahman M. Homadi

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This study focuses on how to control the outlet temperature of a solar air heater in a way simpler than the existing methods. In this work, five cases have been studied by using ANSYS Fluent based on a CFD numerical method. All the cases have been simulated by utilizing the same criteria and conditions like the temperature, materials, areas except the geometry. The case studies are conducted in Little Rock (LR), AR, USA during the winter time supposedly on 15^th of December. A fresh air that is flowing with a velocity of 0.5 m/s and a flow rate of 0.009 m³/s. The results prove the possibility of achieving a controlled temperature just by changing the geometric shape of the heater. This geometry guarantees that the absorber plate always has a normal component of the solar radiation at any time during the day. The heater has a sectarian shape with a radius of 150 mm where the outlet temperature remains almost constant for six hours.

Keywords: solar energy, air heater, control of temperature, CFD

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Authors: Calvin Stephen, Biswajit Basu, Aonghus McNabola

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Market liberalization in the power sector has led to the emergence of micro-hydropower schemes that are dependent on the use of pumps-as-turbines in applications that were not suitable as potential hydropower sites in earlier years. These applications include energy recovery in water supply networks, sewage systems, irrigation systems, alcohol breweries, underground mining and desalination plants. As a result, there has been an accelerated adoption of pumpsas-turbine technology due to the economic advantages it presents in comparison to the conventional turbines in the micro-hydropower space. The performance of this machines under cavitation conditions, however, is not well understood as there is a deficiency of knowledge in literature focused on their turbine mode of operation. In hydraulic machines, cavitation is a common occurrence which needs to be understood to safeguard them and prolong their operation life. The overall purpose of this study is to investigate the effects of cavitation on the performance of a pumps-as-turbine system over its entire operating range. At various operating speeds, the cavitating region is identified experimentally while monitoring the effects this has on the power produced by the machine. Initial results indicate occurrence of cavitation at higher flow rates for lower operating speeds and at lower flow rates at higher operating speeds. This implies that for cavitation free operation, low speed pumps-as-turbine must be used for low flow rate conditions whereas for sites with higher flow rate conditions high speed turbines should be adopted. Such a complete understanding of pumps-as-turbine suction performance can aid avoid cavitation induced failures hence improved reliability of the micro-hydropower plant.

Keywords: cavitation, micro-hydropower, pumps-as-turbine, system design

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Authors: Stamatis Zoras, Vasilis Evagelopoulos, Theodoros Staurakas

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The association between elevated air pollution levels and extreme climate conditions (temperature, particulate matter, ozone levels, etc.) and mental consequences has been, recently, the focus of significant number of studies. It varies depending on the time of the year it occurs either during the hot period or cold periods but, specifically, when extreme air pollution and weather events are observed, e.g. air pollution episodes and persistent heatwaves. It also varies spatially due to different effects of air quality and climate extremes to human health when considering metropolitan or rural areas. An air pollutant concentration and a climate extreme are taking a different form of impact if the focus area is countryside or in the urban environment. In the built environment the climate extreme effects are driven through the formed microclimate which must be studied more efficiently. Variables such as biological, age groups etc may be implicated by different environmental factors such as increased air pollution/noise levels and overheating of buildings in comparison to rural areas. Gridded air quality and climate variables derived from the land surface observations network of West Macedonia in Greece will be analysed against mortality data in a spatial format in the region of West Macedonia. Artificial intelligence (AI) tools will be used for data correction and prediction of health deterioration with climatic conditions and air pollution at local scale. This would reveal the built environment implications against the countryside. The air pollution and climatic data have been collected from meteorological stations and span the period from 2000 to 2009. These will be projected against the mortality rates data in daily, monthly, seasonal and annual grids. The grids will be operated as AI-based warning models for decision makers in order to map the health conditions in rural and urban areas to ensure improved awareness of the healthcare system by taken into account the predicted changing climate conditions. Gridded data of climate conditions, air quality levels against mortality rates will be presented by AI-analysed gridded indicators of the implicated variables. An Al-based gridded warning platform at local scales is then developed for future system awareness platform for regional level.

Keywords: air quality, artificial inteligence, climatic conditions, mortality

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Authors: Nassim Salmi

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This study aimed to identify the administrative, social, cultural, economic and psychological challenges facing the nursing s ector in the Tebessa Algeria. It also seeks to identify whether there are differences between the opinions of managers in public and private hospitals about these challenges. To achieve the objectives of the study, the descriptive analytical method was adopted. The study also used the questionnaire as a tool for collecting the necessary data and information, which was applied to a sample of directors of public and private hospitals in the Tebessa, which amounted to (114) individuals. The study reached a set of results, including: that there are no statistically significant differences between the opinions of managers in public and private hospitals about the administrative, social, cultural, economic and psychological challenges facing the nursing sector in the Tebessa . The results also showed agreement between the views of managers in private public hospitals that the most important administrative challenges are the lack of training programs that affect the efficiency and performance of nursing work, and that the most important social and cultural challenges are the hospital’s failure to provide suitable nurseries for Saudi female nurses, and that the most important economic challenges are the lack of Availability of medical equipment and devices, and the most important psychological challenge is the tense relationship between the administration and the hospital's nursing staff. The study recommended focusing on the importance of rehabilitation and training together, activating the role of training in the ministry and making it compulsory and a condition of renewal for practicing and continuing the nursing profession, and providing the social and economic needs of the nursing staff.

Keywords: postoperative care, gynecology, nursing documentation, database

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Authors: Miral Selim, May Haggag, Ibrahim Abotaleb

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The aging of transportation infrastructure presents significant challenges, particularly concerning the monitoring and maintenance of bridges. This study investigates the application of Random Forest algorithms for predictive modeling of bridge conditions, utilizing data from the US National Bridge Inventory (NBI). The research is significant as it aims to improve bridge management through data-driven insights that can enhance maintenance strategies and contribute to overall safety. Random Forest is chosen for its robustness, ability to handle complex, non-linear relationships among variables, and its effectiveness in feature importance evaluation. The study begins with comprehensive data collection and cleaning, followed by the identification of key variables influencing bridge condition ratings, including age, construction materials, environmental factors, and maintenance history. Random Forest is utilized to examine the relationships between these variables and the predicted bridge conditions. The dataset is divided into training and testing subsets to evaluate the model's performance. The findings demonstrate that the Random Forest model effectively enhances the understanding of factors affecting bridge conditions. By identifying bridges at greater risk of deterioration, the model facilitates proactive maintenance strategies, which can help avoid costly repairs and minimize service disruptions. Additionally, this research underscores the value of data-driven decision-making, enabling better resource allocation to prioritize maintenance efforts where they are most necessary. In summary, this study highlights the efficiency and applicability of Random Forest in predictive modeling for bridge management. Ultimately, these findings pave the way for more resilient and proactive management of bridge systems, ensuring their longevity and reliability for future use.

Keywords: data analysis, random forest, predictive modeling, bridge management

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Authors: Nuri Caglayan, H. Kursat Celik

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There are many factors that influence the health and productivity of the animals in livestock production fields, including temperature, humidity, carbon dioxide (CO2), ammonia (NH3), hydrogen sulfide (H2S), physical activity and particulate matter. High NH3 concentrations reduce feed consumption and cause daily weight gain. At high concentrations, H2S causes respiratory problems and CO2 displace oxygen, which can cause suffocation or asphyxiation. Good air quality in livestock facilities can have an impact on the health and well-being of animals and humans. Air quality assessment basically depends on strictly given limits without taking into account specific local conditions between harmful gases and other meteorological factors. The stated limitations may be eliminated. using controlling systems based on neural networks and fuzzy logic. This paper describes a fuzzy logic based ventilation algorithm, which can calculate different fan speeds under pre-defined boundary conditions, for removing harmful gases from the production environment. In the paper, a fuzzy logic model has been developed based on a Mamedani’s fuzzy method. The model has been built on MATLAB software. As the result, optimum fan speeds under pre-defined boundary conditions have been presented.

Keywords: air quality, fuzzy logic model, livestock housing, fan speed

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Authors: Desmond Wade, Alfredo Ormazabal

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Background: Ever since it commenced its registration process of pre-hospital practitioners in the year 2000 through the Irish Government Statute Instrument (SI 109 of 2000) process, the approach to education of its professionals has changed drastically. The progression from the traditional behaviouristic to the current constructivist approach has been based on experiences from other sectors and industries, nationally and internationally. Today, the delivery of a safe and efficient ambulance service heavily depends on its practitioners’ range of technical skills, academic knowledge, and overall competences. As these increase, so does the level of complexity of paramedics’ everyday practice. This has made it inevitable to consider the 'Human Factor' as a source of potential risk and made formative institutions like the National Ambulance Service College to include it in their curriculum. Methods: This paper used a mixed-method approach, where both, an online questionnaire and a set of semi-structured interviews were the source of primary data. An analysis of this data was carried out using qualitative and quantitative data analysis. Conclusions: The evidence presented leads to the conclusion that in the National Ambulance Service there is a considerable lack of education of Human Factors and the levels in understanding of how to manage Human Factors in practice vary across its spectrum. Paramedic Practitioners in Ireland seem to understand that the responsibility of patient care lies on the team, rather than on the most hierarchically senior practitioner present in the scene.

Keywords: human factors, ergonomics, stress, decision making, pre-hospital care, paramedic, education

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Authors: Scott Cavinder

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Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

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Authors: Yi-Fung Lin, Shiow-Ching Shun, Wen-Yu Hu

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Background: A skill mix model is regarded as one of the most effective methods of reducing nursing shortages, as well as easing nursing staff workloads and labor costs. Although this model shows several benefits for the health workforce, the relationship between the optimal model of skill mix and the patient mortality rate remains to be discovered. Objectives: This review aimed to explore the relationship between the skill mix model and patient mortality rate in acute care hospitals. Data Sources: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases and researchers retrieved studies published between January 1986 and March 2022. Review methods: Two independent reviewers screened the titles and abstracts based on selection criteria, extracted the data, and performed critical appraisals using the STROBE checklist of each included study. The studies focused on adult patients in acute care hospitals, and the skill mix model and patient mortality rate were included in the analysis. Results: Six included studies were conducted in the USA, Canada, Italy, Taiwan, and European countries (Belgium, England, Finland, Ireland, Spain, and Switzerland), including patients in medical, surgical, and intensive care units. There were both nurses and nursing assistants in their skill mix team. This main finding is that three studies (324,592 participants) show evidence of fewer mortality rates associated with hospitals with a higher percentage of registered nurse staff (range percentage of registered nurse staff 36.1%-100%), but three articles (1,122,270 participants) did not find the same result (range of percentage of registered nurse staff 46%-96%). However, based on appraisal findings, those showing a significant association all meet good quality standards, but only one-third of their counterparts. Conclusions: In light of the limited amount and quality of published research in this review, it is prudent to treat the findings with caution. Although the evidence is not insufficient certainty to draw conclusions about the relationship between nurse staffing level and patients' mortality, this review lights the direction of relevant studies in the future. The limitation of this article is the variation in skill mix models among countries and institutions, making it impossible to do a meta-analysis to compare them further.

Keywords: nurse staffing level, nursing assistants, mortality, skill mix

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Authors: Rahisham Abd Rahman

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In this paper, a nonlinear pollution model has been proposed to compute electric field distribution over the polymeric insulator surface under wet contaminated conditions. A 2D axial-symmetric insulator geometry, energized with 11kV was developed and analysed using Finite Element Method (FEM). A field-dependent conductivity with simplified assumptions was established to characterize the electrical properties of the pollution layer. Comparative field studies showed that simulation of dynamic pollution model results in a more realistic field profile, offering better understanding on how the electric field behaves under wet polluted conditions.

Keywords: electric field distributions, pollution layer, dynamic model, polymeric outdoor insulators, finite element method (FEM)

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Authors: Júlia Alarcon Pinto, Carlos João Schaffhausser, Gustavo Alarcon Pinto

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Introduction: The deaf people in Brazil communicate through the Brazilian Sign Language (LIBRAS), which is restricted to this minority and people that received training. However, there is a lack of prepared professionals in the health system to deal with these patients. Therefore, effective communication, health education, quality of support and assistance are compromised. It is of utmost importance to develop measures that ensure the inclusion of deaf parents and children since there are frequent doubts about sphincter training and an absence of tools to promote effective communication between doctors and their patients. Objective: Use of an efficient, rapid and cheap communication method to promote social inclusion and patient education of deaf parents and children during pediatrics appointments. Results; The application demonstrates how to express phrases and symptoms within seconds and this allows patients to fully understand the information provided during the appointment and are capable to evaluate the signs of readiness, learn the correct approaches with the child, what are the adequate instruments, possible obstacles and the importance to execute medical orientations in order to achieve success in the process. Consequently, patients feel more satisfied, secured and embraced by professionals in the health system care. Conclusion: It is of utmost importance to use efficient and cheap methods that support patient care and education in order to promote health and social inclusion.

Keywords: application, deaf patients, social inclusion, sphincter training

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Authors: Aleksandra Y. Sazonova, Valentina M. Raeva

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The aim of this work was to apply extractive distillation for acetonitrile removal from water solutions, to validate thermodynamic criterion based on excess Gibbs energy to entrainer selection process for acetonitrile – water mixture separation and show its potential efficiency at isothermal conditions as well as at isobaric (conditions of real distillation process), to simulate and analyze an extractive distillation process with chosen entrainers: optimize amount of trays and feeds, entrainer/original mixture and reflux ratios. Equimolar composition of the feed stream was chosen for the process, comparison of the energy consumptions was carried out. Glycerol was suggested as the most energetically and ecologically suitable entrainer.

Keywords: acetonitrile, entrainer, extractive distillation, water

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Authors: Tanvir Hasan, Minhaz Uddin, Anwar Sadat Anik

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A pressurizer is a safety-related reactor component that maintains the reactor operating pressure to guarantee safety. Its structure is usually made of high thermal and pressure resistive material. The mechanical structure of these components should be maintained in all working settings, including transient to severe accidents conditions. The goal of this study is to examine the structural integrity and stress of the pressurizer in order to ensure its design integrity towards transient situations. For this, the finite element method (FEM) was used to analyze the mechanical stress on pressurizer components in this research. ANSYS MECHANICAL tool was used to analyze a 3D model of the pressurizer. The material for the body and safety relief nozzle is selected as low alloy steel i.e., SA-508 Gr.3 Cl.2. The model was put into ANSYS WORKBENCH and run under the boundary conditions of (internal Pressure, -17.2 MPa, inside radius, -1348mm, the thickness of the shell, -127mm, and the ratio of the outside radius to an inside radius, - 1.059). The theoretical calculation was done using the formulas and then the results were compared with the simulated results. When stimulated at design conditions, the findings revealed that the pressurizer stress analysis completely fulfilled the ASME standards.

Keywords: pressurizer, stress analysis, finite element method, nuclear reactor

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Authors: Oustani Mabrouka, Halilat Md Tahar, Hannachi Slimane

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This study was conducted on representative and contrasting soils of arid regions. It focuses on the compared influence of two organic fertilizers: poultry manure (PM) and bovine manure (BM) on improving the microbial functioning of non-saline (SS) and saline (SSS) soils, in particularly, the process of mineralization of nitrogen and carbon. The microbiological activity was estimated by respirometric test (CO2–C emissions) and the extraction of two forms of mineral nitrogen (NH4+-N and NO3--N). Thus, after 56 days of incubation under controlled conditions (28 degrees and 80 per cent of the field capacity), the two types of manures showed that the mineralization activity varies according to type of soil and the organic substrate itself. However, the highest cumulative quantities of CO2–C, NH4+–N and NO3-–N obtained at the end of incubation were recorded in non-saline (SS) soil treated with poultry manure with 1173.4, 4.26 and 8.40 mg/100 g of dry soil, respectively. The reductions in rates of release of CO2–C and of nitrification under saline conditions were 21 and 36, 78 %, respectively. The influence of organic substratum on the microbial density shows a stimulating effect on all microbial groups studied. The whole results show the usefulness of two types of manures for the improvement of the microbiological functioning of arid soils.

Keywords: Salinity, Organic matter, Microorganisms, Mineralization, Nitrogen, Carbon, Arid regions

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Authors: Diana Gibson

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Aim: The first aim of the study was to ascertain the percentage of people who had been diagnosed with High Blood Pressure and/ or Type2 Diabetes Mellitus in Matzikama municipal district, Western Cape, South Africa. These two conditions are reportedly very high in this particular province, even though few statistics are available. A second aim was to gain insight into the understanding of these two conditions among sufferers. A third aim was to determine their allopathic use as well as indigenous medicinal plants to manage these conditions. A fourth aim was to understand how users of medicinal plants attend to their materiality and relationality as a continuum between humans and plants. The final aim was to ascertain the conservation status of medicinal plants utilised. Methods: One thousand one hundred and eighty-four (1184) respondents were interviewed. Semi-structured surveys were utilised to gather data on the percentage of people who had been medically diagnosed with High Blood Pressure and/or Type 2 Diabetes Mellitus. Local healers and knowledgeable old people were subsequently selected through a non-probability snowball sampling method. They were helped with plant collection. The plants were botanically identified. Results: The study found that people who have been diagnosed with High Blood Pressure or Type 2 Diabetes Mellitus drew on and continuously moved between biomedical and local understandings of these conditions. While they followed biomedical treatment regimens as far as possible they also drew on alternative ways of managing it through the use of medicinal plants. The most commonly used plant species overall were Lessertia frutescens, Tulbaghia violacea, Artemisia afra and Leonotus leonurus. For the users, medicinal plants were not mere material entities, they were actants in social networks where knowledge was produced through particular practices in specific places. None of the identified plants are currently threatened. Significance: Sufferers had a good understanding of the symptoms of and biomedical treatment regime for both conditions, but in everyday life they adhered to their local understandings and medicinal plants for treatment. The majority used reportedly used prescribed medication as well as plant alternatives.

Keywords: diabetes, high blood pressure, medicine, plants

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Authors: Peter R. Reuter

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Health professionals play important roles in helping patients use Complementary and Alternative Medicine (CAM) practices safely and accurately. Consequently, it is important for future health professionals to learn about CAM practices during their time in undergraduate and graduate programs. To satisfy this need for education, teaching CAM in nursing and medical schools and other health professions programs is becoming more prevalent. Our study was the first to look specifically at the knowledge of, and attitude toward CAM of undergraduate health professions students at a university in the U.S. Students were invited to participate in one of two anonymous online surveys depending on whether they were pre-health professions students or graduating health professions seniors. Of the 763 responses analyzed, 71.7% were from pre-health professions students, and 28.3% came from graduating seniors. The overall attitude of participants toward and interest in learning about CAM practices was generally fairly positive with graduating seniors being more positive than pre-health professions students. Yoga, meditation, massage therapy, aromatherapy, and chiropractic care were the practices most respondents had personal experience with. Massage therapy, yoga, chiropractic care, meditation, music therapy, and diet-based therapy received the highest ratings from respondents. Three-quarters of respondents planned on including aspects of holistic medicine in their future career as a health professional. The top five practices named were yoga, meditation, massage therapy, diet-based therapy, and music therapy. The study confirms the need to educate health professions students about CAM practices to give them the background information they need to select or recommend the best practices for their patients' needs.

Keywords: CAM education, health professions, health professions students, pre-health professions students

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Authors: Stephanie Cheng, Benjamin Poh, Vivyan Tay, Sachin Mathur

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Aim: Diabetes mellitus (DM) is a worldwide pandemic affecting 500 million people. It is known to be associated with increased susceptibility to soft tissue infections (STI). Despite being a major public health burden, the literature relating the effects of DM and the presentation, severity and healing of STIs in general surgical patients remain limited. Methods: We conducted a retrospective review of all patients admitted with STI in a tertiary teaching hospital over a 12-month period. Patient demographics and surgical outcomes were collected and analyzed. Results: During the study period, 1059 patients were admitted for STIs, of which 936 (88%) required surgical intervention. Diabetic patients were presented with a higher body-mass index (BMI) (28 vs 26), larger abscess size (24 vs 14 cm²) and a longer length of stay (LOS)(4.4 days vs 2.9 days). They also underwent a higher proportion of wide debridement as well as application of negative pressure wound therapy (NPWT) (42% vs 35%). More diabetic patients underwent subsequent re-operation within the same sitting (8 vs 4). There were no differences in re-admission rates within 30 days nor subsequent abscess formation in those followed for 6 months. Conclusion: The incidence of STIs among DM patients represents a significant disease burden; surgeons should consider intensive patient counseling and partnering with primary care providers in order to help reduce the incidence of future STI admissions based on lifestyle modification and glucose control.

Keywords: general surgery, emergency general surgery, acute care surgery, soft tissue infections, diabetes mellitus

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Authors: Anastasios Rodis

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Background: Case studies of walkers, climbers, and campers exposed to cold and wet conditions without limb water/windproof protection revealed experiences of muscle weakness and fatigue. It is reasonable to assume that a part of the fatigue could occur due to an alteration in substrate utilization, since reduction of performance in extreme cold conditions, may partially be explained by higher anaerobic glycolysis, reflecting higher carbohydrate oxidation and an increase accumulation rate of blood lactate. The aim of this study was to assess the effects of pre-exercise lower limb cooling on substrate utilization rate during sub-maximal exercise. Method: Six male university students (mean (SD): age, 21.3 (1.0) yr; maximal oxygen uptake (V0₂ max), 49.6 (3.6) ml.min⁻¹; and percentage of body fat, 13.6 (2.5) % were examined in random order after either 30min cold water (12°C) immersion utilized as the cooling strategy up to the gluteal fold, or under control conditions (no precooling), with tests separated by minimum of 7 days. Exercise consisted of 60min cycling at 50% V0₂ max, in a thermoneutral environment of 20°C. Subjects were also required to record a diet diary over the 24hrs prior to the each trial. Means (SD) for the three macronutrients during the 1 day prior to each trial (expressed as a percentage of total energy) 52 (3) % carbohydrate, 31 (4) % fat, and 17 (± 2) % protein. Results: The following responses to lower limb cooling relative to control trial during exercise were: 1) Carbohydrate (CHO) oxidation, and blood lactate (Bₗₐc) concentration were significantly higher (P < 0.05); 2) rectal temperature (Tᵣₑc) was significantly higher (P < 0.05), but skin temperature was significantly lower (P < 0.05); no significant differences were found in blood glucose (Bg), heart rate (HR) and oxygen consumption (V0₂). Discussion: These data suggested that lower limb cooling prior to submaximal exercise will shift metabolic processes from Fat oxidation to CHO oxidation. This shift from Fat to CHO oxidation will probably have important implications in the surviving scenario, since people facing accidental localized cooling of their limbs either through wading/falling in cold water or snow even if they do not perform high intensity activity, they have to rely on CHO availability.

Keywords: exercise in wet conditions, leg cooling, outdoors exercise, substrate utilization

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Authors: Erin Curtis, Avraham Schwiger

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Neuropsychological testing and evaluation is a crucial step in providing patients with effective diagnoses and treatment while in clinical care. The variety of batteries used in these evaluations can help clinicians better understand the nuanced declivities in a patient’s cognitive, behavioral, or emotional functioning, consequently equipping clinicians with the insights to make intentional choices about a patient’s care. Despite the knowledge these batteries can yield, some aspects of neuropsychological testing remain largely inaccessible to certain patient groups as a result of fundamental cultural, educational, or social differences. One such battery includes the Dot Counting Test (DCT), during which patients are required to count a series of dots on a page as rapidly and accurately as possible. As the battery progresses, the dots appear in clusters that are designed to be easily multiplied. This task evaluates a patient’s cognitive functioning, attention, and level of effort exerted on the evaluation as a whole. However, there is evidence to suggest that certain social groups, particularly Latinx groups, may perform worse on this task as a result of cultural or educational differences, not reduced cognitive functioning or effort. As such, this battery fails to account for baseline differences among patient groups, thus creating questions surrounding the accuracy, generalizability, and value of its results. Accessibility and cultural sensitivity are critical considerations in the testing and treatment of marginalized groups, yet have been largely ignored in the literature and in clinical settings to date. Implications and improvements to applications are discussed.

Keywords: culture, latino, neuropsychological assessment, neuropsychology, accessibility

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Authors: Olga C. Rodrigue

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Long-term care and skilled nursing facilities experience ebbs and flows of nursing staffing, a problem compounded by the perception of the facilities as undesirable workplaces and competition for staff from other healthcare entities. Travel nurses are contracted to fill staffing needs due to increased admissions, increased and unexpected attrition of nurses, or facility expansion of services. Prior to beginning the contracted assignment, the travel nurse must meet industry, company, and regulatory requirements (The Joint Commission and CMS) for skills and knowledge. Travel nurses, however, inconsistently receive the pre-assignment orientation needed to work at the contracted facility, if any information is given at all. When performance expectations are not met, travel nurses may subsequently choose to leave the position without completing the terms of the contract, and some facilities may choose to terminate the contract prior to the expected end date. The overarching goal of the Doctor of Nursing Practice evidence-based practice improvement project is to provide travel nurses with the basic and necessary information to prepare them to begin a long-term and skilled nursing assignment. The project involves the identification of travel nurse learning needs through a survey and the development and provision of web-based learning modules to address those needs prior to arrival for a long-term and skilled nursing assignment.

Keywords: nurse staffing, travel nurse, travel staff, contract staff, contracted assignment, long-term care, skilled nursing, onboarding, orientation, staff development, supplemental staff

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Authors: M. Pena, J. Shin, H. Park

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The main objective of any engineering activity is the development of a system that fulfills the specific economic, social or environmental needs. Green growth policies, as a system, targets to satisfy two main needs: economic and environmental growth. Cities are complex systems composed of varied characteristics such as differences in socio-environmental conditions and local affordability, among others. Thus, commissioned policies are required to address these differences and to ensure green development. A more maintainable and justifiable, resource-efficient green growth can be obtained in urban areas if multi-criteria framework of policies relevant to green buildings is designed. Reason is that, this approach fits to target the differences and unique conditions of urban areas. By following the principles of axiomatic design, this paper urges to derive a framework for the application of green buildings policies in urban areas with distinctive socio-economic and environmental characteristics. Functional requirements defined as principles to ensure green growth and design parameters are identified in each set of conditions. Design matrices are constructed for each group of urban areas. Thus, the understanding of the needs and differences for each group of urban areas and the methodology to ensure green buildings is achieved.

Keywords: axiomatic design, green growth, sustainable development, urban planning

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Authors: Kveta Olsanova, Gina Cook, Marija Zlatic

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This paper discusses the theoretical framework suggesting the dependencies between luxury brands’ CSR (Corporate Social Responsibility) variables and the purchase intention of luxury shoppers. The framework is based on a literature review and in-depth individual interviews with a sample of luxury users and buyers. The measures of the model are based on existing research and the authors' qualitative research results. The model suggests that purchase intention in the luxury segment is dependent on the luxury values (symbolic, experiential, functional and social), individual sustainable dimension (composed of societal, environmental and economic variables) and awareness of the brand’s CSR, the last two relationships being potentially moderated by certain conditions such as demographics and general attitudes towards CSR and sustainability. The model’s output is in the formulation of several hypotheses, to be tested in an upcoming quantitative study. The qualitative phase indicated that the perceived symbolic, functional and experiential value dimensions of luxury brands were stronger drivers of purchase intention compared to the sustainable dimension. The contribution of the research consists of highlighting CSR’s impact on customer purchase intent as a potential implication for luxury brand management due to two aspects: (i) consumer awareness of the existing CSR activities of luxury brands is low, and this might be challenged by the demands of Gen Z entrants into the lux industry as they are known for their positive approach to CSR; (ii) the UN’s SDGs will bring CSR to the attention of all industries, including currently 'CSR silent' segments represented by luxury. Our research should contribute to incorporation of strategic CSR into the policies and strategies of the luxury segment by providing evidence that luxury customers do care.

Keywords: CSR, luxury shoppers, purchase intention, sustainability

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Authors: Azadeh Jafari, Robert G. Owens

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In this study, a geometrical multiscale approach which means coupling together the 2-D Navier-Stokes equations, constitutive equations and 0-D lumped parameter models is investigated. A multiscale approach, suggest a natural way of coupling detailed local models (in the flow domain) with coarser models able to describe the dynamics over a large part or even the whole cardiovascular system at acceptable computational cost. In this study we introduce a new velocity correction scheme to decouple the velocity computation from the pressure one. To evaluate the capability of our new scheme, a comparison between the results obtained with Neumann outflow boundary conditions on the velocity and Dirichlet outflow boundary conditions on the pressure and those obtained using coupling with the lumped parameter model has been performed. Comprehensive studies have been done based on the sensitivity of numerical scheme to the initial conditions, elasticity and number of spectral modes. Improvement of the computational algorithm with stable convergence has been demonstrated for at least moderate Weissenberg number. We comment on mathematical properties of the reduced model, its limitations in yielding realistic and accurate numerical simulations, and its contribution to a better understanding of microvascular blood flow. We discuss the sophistication and reliability of multiscale models for computing correct boundary conditions at the outflow boundaries of a section of the cardiovascular system of interest. In this respect the geometrical multiscale approach can be regarded as a new method for solving a class of biofluids problems, whose application goes significantly beyond the one addressed in this work.

Keywords: geometrical multiscale models, haemorheology model, coupled 2-D navier-stokes 0-D lumped parameter modeling, computational fluid dynamics

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Authors: Sarah Fahad Alajmi, Tamer Ezzat Youssef

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Here, we report a simple method for the direct conversion of 6-Nitro-1H-indole into N-substituted indoles via electrochemical dehydrogenative reaction with halogenated reagents under strongly basic conditions through N–R bond formation. The N-protected indoles have been prepared under moderate and scalable electrolytic conditions. The conduct of the reactions was performed in a simple divided cell under constant current without oxidizing reagents or transition-metal catalysts. The synthesized products have been characterized via UV/Vis spectrophotometry, 1H-NMR, and FTIR spectroscopy. A possible reaction mechanism is discussed based on the N-protective products. This methodology could be applied to the synthesis of various biologically active N-substituted indole derivatives.

Keywords: green chemistry, 1H-indole, heteroaromatic, organic electrosynthesis

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Authors: Satpal Singh, Subhash Chander

Abstract:

An experimental study has been conducted to evaluate the thermal performance of the CNG/air dual flame impinging normally on to a flat surface. The stability limits for the dual flame under both impinging and free conditions have been evaluated to select experimental operating range. Dual flame shape and structure have been explained with direct flame image and schematic diagram indicating modification in recirculation zone in presence of inner flame. Effects of various operating parameters like H/Dh, Re(o), Φ(o), and θ(o) on heat transfer characteristics have been discussed. Inner non-swirling flame Reynolds number (Re(i)) and equivalence ratio (Φ(i)) were kept constant. Heating patterns in the impingement region around the stagnation point have been altered significantly with change in the values of H/Dh, Re(o), Φ(o), and θ(o). The axial flow of inner flame has been notably effected with increase in Re(o). Heating was most favorable near stoichiometeric conditions of the outer swirling flame. However, the effect of change in swirl intensity (expressed in terms of θ(o)) on overall heat transfer efficiency was not as significant as in the case of other parameters. It has been inferred that best performance (higher uniformity and efficiency) of the dual flame impinging on a flat surface can be achieved at moderate value of separation distance (H/Dh of 2-3) and outer swirling flame Reynolds number (Re(o) of 7000-9000) under stoichiometeric conditions.

Keywords: dual flame, heat transfer, impingement, swirling insert, transmission efficiency

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Authors: Gian Bhushan, Vinkel Arora, M. L. Aggarwal

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The objective of the present study is to determine better eye end design of a mono leaf spring used in light motor vehicle. A conventional 65Si7 spring steel leaf spring model with standard eye, casted and riveted eye end are considered. The CAD model of the leaf springs is prepared in CATIA and analyzed using ANSYS. The standard eye, casted, and riveted eye leaf springs are subjected to similar loading conditions. The CAE analysis of the leaf spring is performed for various parameters like deflection and Von-Mises stress. Mass reduction of 62.9% is achieved in case of riveted eye mono leaf spring as compared to standard eye mono leaf spring for the same loading conditions.

Keywords: CAE, leaf spring, standard, casted, riveted eye

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Authors: Yongsheng Guo, Mengyu Lu

Abstract:

This study investigates how Chinese SMEs manage financial risks in financing from customers from the perspectives of ethics and national culture. A grounded theory approach is adopted to identify the causal conditions, actions/interactions, and consequences. 32 interviews were conducted, and systematic coding methods were used to identify themes and categories. This study found that Chinese ethical principles, including integrity, friendship, and reciprocity, and cultural traits, including collectivism, acquaintance society, and long-term orientation, provide conditions for financing from customers. The SMEs establish trust-based relationships with customers through personal communications and social networks and reduce financial risk through diversification, frequent operations, and enterprise reputations. Both customers and SMEs can get benefits like financial resources and customer experiences. This study creates a theoretical framework that connects the causal conditions, processes, and outcomes, providing a deeper understanding of financing from customers. A resource and process capability theory of SMEs and a customer capital and customer value model are proposed to connect accounting and finance concepts. Suggestions are proposed for the authorities as more guidance and regulations are needed for this informal finance.

Keywords: CRM, culture, ethics, SME, risk management

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Authors: G. Lancellotta, G. Di Salvo, A. Rigazio, A. Davout, V. Pastore, G. Tonoli, A. Martin, P. Jullien, R. Jagow-Klaff, R. Wernecke

Abstract:

Artificial ground freezing (AGF) technique is a well-proven soil improvement approach used worldwide to construct shafts, tunnels and many other civil structures in difficult subsoil or ambient conditions. As part of the extension of Line 14 of the Paris subway, a passenger interchange tunnel between the new station at Porte de CI ichy and the new Tribunal the Grand Instance has been successfully constructed using this technique. The paper presents the successful application of AGF by Liquid Nitrogen and Brine implemented to provide structural stability and groundwater cut-off around the passenger interchange tunnel. The working conditions were considered to be rather challenging, due to the proximity of a hundred-year-old existing service tunnel of the Line 13, and subsoil conditions on site. Laboratory tests were carried out to determine the relevant soil parameters for hydro-thermal-mechanical aspects and to implement numerical analyses. Monitoring data were used in order to check and control the development and the efficiency of the freezing process as well as to back analyze the parameters assumed for the design, both during the freezing and thawing phases.

Keywords: artificial ground freezing, brine method, case history, liquid nitrogen

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Authors: Sabraoui Abdelhadi, El Bouhssini Mustapha, Lhaloui Saadia, El Fakhouri Karim, Bouchelta Aziz

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The surveys carried out in 2014, 2015 in the regions of Abda- Doukala, Chaouia- Ouardigha, Zemour- Zair and Fes- Sais have confirmed that the leaf miner was the main insect pest attacking chickpea (Cicer arietinum L.) in Morocco. The grain yield losses caused by this pest could be more than 20% for winter planting and more than 42% for spring-sown crop. To reduce the chickpea leaf miner infestations, four essential oils, as biopesticide alternatives, were tested for their insecticidal effect on L. ciccerina, adults and larvae under laboratory conditions. In addition, we assessed the efficacy of these essential oils with and without adjuvant against this pest in comparison to three insecticides under field conditions. Mentha pulegium, with a dose of 33 µl/l of air caused 100% mortality on adults and larvae, after three hours and six hours of exposure, respectively. Eucalyptus showed 100% mortality on adults and larvae, with doses of 33 and 83 µl/l, after six and three hours of exposure, respectively. In the field conditions M. pulegium and E. globulus with adjuvant showed promising results compared with Abamectin, Azadirachtin and Spinetoram respectively. Essential oils could be used as one of the IPM components for the control of chickpea leaf miner.

Keywords: Liriomyza cicerina, chickpea, essential oils, insecticidal activity, Morocco

Procedia PDF Downloads 373