Search results for: SCBU special care baby unit

Authors: Rim Baroudi

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The notion of the context-induced metaphors refers to the role of different contextual aspects (socio-cultural, linguistic, bodily-physical, and ideological) in affecting metaphor production. This has not been investigated in visual discourse. This paper intends to extend the focus of this research interest to study context-induced metaphors in newspapers’ cartoons. It seeks to account for different contextual variables influencing the production of metaphors in cartoons placing special focus on the ideological variable. The aim is to demonstrate how different contextual aspects are conditioned by the ideological variable. The study applied critical metaphor approach to analyse contextual variables shaping the conceptualization of ‘the Islamic State’ in the cartoons of 3 newspapers (Al-Ryadh newspaper, Tehran Times, and The New York Times). Findings have revealed the decisive role of the ideological context in conditioning and priming the rest of contextual variables in the conceptualisation of ‘the Islamic State’ in political cartoons of the three newspapers. These findings bear special importance to the study of bodily-physical and socio-cultural variables inducing and shaping political cognition in political cartoons in a way consistent with the ideological framework within which newspapers operate.

Keywords: context-induced metaphors, ideological context, the Islamic State, political cartoons

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Authors: Ted Silva

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Dietrich de Velsa's Équation à un inconnu / Equation to an Unknown hybridizes art cinema style with the sexually explicit aesthetics of pornography to envision a uniquely queer world unmoored by heteronormative influence. This stylization evokes the memory of a queer history that once approximated such a prospect. With this historical and political context in mind, this paper utilizes formal analysis to assess how the film frames queer sexual encounters as tender acts of care, sometimes literally mending physical wounds. However, Equation to Unknown also highlights the transience of these sexual exchanges. By emphasizing the homogeneity of the protagonist’s sexual conquests, the film reveals that these practices have a darker meaning when the men reject the individualized connection to pursue purely visceral gratification. Given the lack of diversity or even recognizable identifying factors, the men become more anonymous to each other the more they pair up. Ultimately, Equation to an Unknown both celebrates and problematizes its vision of a queer utopia, highlighting areas in the community wherein intimacy and care flourish and locating those spots in which they are neglected.

Keywords: pornography studies, queer cinema, French cinema, history

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Authors: Nabil Hameed Al-Farsi

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This study’s main goal is to develop a model and a maintenance strategy for a cement factory called Arabian Cement Company, Rabigh Plant. The proposed work here depends on Reliability centric maintenance approach to develop a strategy and maintenance schedule that ensures increasing the reliability of the production system components, thus ensuring continuous productivity. The cost-effective maintenance of the plant’s dependability performance is the key goal of durability-based maintenance is. The cement plant consists of 7 important steps, so, developing a maintenance plan based on Reliability centric maintenance (RCM) method is made up of 10 steps accordingly starting from selecting units and data until performing and updating the model. The processing unit chosen for the analysis of this case is the calcinatory unit regarding model’s validation and the Travancore Titanium Products Ltd (TTP) using the claimed data history acquired from the maintenance department maintenance from the mentioned company. After applying the proposed model, the results of the maintenance simulation justified the plant's existing scheduled maintenance policy being reconsidered. Results represent the need for preventive maintenance for all Class A criticality equipment instead of the planned maintenance and the breakdown one for all other equipment depends on its criticality and an FMEA report. Consequently, the additional cost of preventive maintenance would be offset by the cost savings from breakdown maintenance for the remaining equipment.

Keywords: engineering, reliability, strategy, maintenance, failure modes, effects and criticality analysis (FMEA)

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Authors: Jessica Raven Gates, Gemma Wilson-Menzfeld, Professor Alison Steven

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In 2019, the Primary Care system in the UK National Health Service (NHS) was subject to reform and restructuring. Primary Care Networks (PCNs) were established, which aligned with a trend towards integrated care both within the NHS and internationally. The introduction of PCNs brought groups of GP practices in a locality together, to operate as a network, build on existing services and collaborate at a larger scale. PCNs were expected to bring a range of benefits to patients and address some of the workforce pressures in the NHS, through an expanded and collaborative workforce. The early establishment of PCNs was disrupted by the emerging COVID-19 pandemic. This study, set in the context of the pandemic, aimed to explore experiences of the PCN workforce, and their perceptions of the establishment of PCNs. Specific objectives focussed on examining factors perceived as enabling or hindering the success of a PCN, the impact on day-to-day work, the approach to implementing change, and the influence of the COVID-19 pandemic upon PCN development. This study is part of a three-phase PhD project that utilized qualitative approaches and was underpinned by social constructionist philosophy. Phase 1: a systematic narrative review explored the provision of preventative healthcare services in UK primary settings and examined facilitators and barriers to delivery as experienced by the workforce. Phase 2: informed by the findings of phase 1, semi-structured interviews were conducted with fifteen participants (PCN workforce). Phase 3: follow-up interviews were conducted with original participants to examine any changes to their experiences and perceptions of PCNs. Three main themes span across phases 2 and 3 and were generated through a Framework Analysis approach: 1) working together at scale, 2) network infrastructure, and 3) PCN leadership. Findings suggest that through efforts to work together at scale and collaborate as a network, participants have broadly accepted the concept of PCNs. However, the workforce has been hampered by system design and system complexity. Operating against such barriers has led to a negative psychological impact on some PCN leaders and others in the PCN workforce. While the pandemic undeniably increased pressure on healthcare systems around the world, it also acted as a disruptor, offering a glimpse into how collaboration in primary care can work well. Through the integration of findings from all phases, a new theoretical model has been developed, which conceptualises the findings from this Ph.D. study and demonstrates how the workforce has experienced change associated with the establishment of PCNs. The model includes a contextual component of the COVID-19 pandemic and has been informed by concepts from Complex Adaptive Systems theory. This model is the original contribution to knowledge of the PhD project, alongside recommendations for practice, policy and future research. This study is significant in the realm of health services research, and while the setting for this study is the UK NHS, the findings will be of interest to an international audience as the research provides insight into how the healthcare workforce may experience imposed policy and service changes.

Keywords: health services research, qualitative research, NHS workforce, primary care

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Authors: I. N. Nwafia, U. C. Ozumba, M. E. Ohanu, S. O. Ebede

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Antibiotic resistance is increasing globally and has become a major health challenge. Extended-spectrum beta-lactamase is clinically important because the ESBL gene are mostly plasmid encoded and these plasmids frequently carry genes encoding resistance to other classes of antimicrobials thereby limiting antibiotic options in the treatment of infections caused by these organisms. The specific objectives of this study were to determine the prevalence of ESBLs production in Escherichia coli, to determine the antibiotic susceptibility pattern of ESBLs producing Escherichia coli, to detect TEM, SHV and CTX-M genes and the risk factors to acquisition of ESBL producing Escherichia coli. The protocol of the study was approved by Health Research and Ethics committee of the University of Nigeria Teaching Hospital (UNTH), Enugu. It was a descriptive cross-sectional study that involved all hospitalized patients in UNTH from whose specimens Escherichia coli was isolated during the period of the study. The samples analysed were urine, wound swabs, blood and cerebrospinal fluid. These samples were cultured in 5% sheep Blood agar and MacConkey agar (Oxoid Laboratories, Cambridge UK) and incubated at 35-370C for 24 hours. Escherichia coli was identified with standard biochemical tests and confirmed using API 20E auxanogram (bioMerieux, Marcy 1'Etoile, France). The antibiotic susceptibility testing was done by disc diffusion method and interpreted according to the Clinical and Laboratory Standard Institute guideline. ESBL production was confirmed using ESBL Epsilometer test strips (Liofilchem srl, Italy). The ESBL bla genes were detected with polymerase chain reaction, after extraction of DNA with plasmid mini-prep kit (Jena Bioscience, Jena, Germany). Data analysis was with appropriate descriptive and inferential statistics. One hundred and six isolates (53.00%) out of the 200 were from urine, followed by isolates from different swabs specimens 53(26.50%) and the least number of the isolates 4(2.00) were from blood (P value = 0.096). Seventy (35.00%) out of the 200 isolates, were confirmed positive for ESBL production. Forty-two (60.00%) of the isolates were from female patients while 28(40.00%) were from male patients (P value = 0.13). Sixty-eight (97.14%) of the isolates were susceptible to imipenem while all of the isolates were resistant to ampicillin, chloramphenicol and tetracycline. From the 70 positive isolates the ESBL genes detected with polymerase chain reaction were blaCTX-M (n=26; 37.14%), blaTEM (n=7; 10.00%), blaSHV (n=2; 2.86%), blaCTX-M/TEM (n=7; 10.0%), blaCTX-M/SHV (n=14; 20.0%) and blaCTX-M/TEM/SHV (n=10; 14.29%). There was no gene detected in 4(5.71%) of the isolates. The most associated risk factors to infections caused by ESBL producing Escherichia coli was previous antibiotics use for the past 3 months followed by admission in the intensive care unit, recent surgery, and urinary catheterization. In conclusion, ESBLs was detected in 4 of every 10 Escherichia coli with the predominant gene detected being CTX-M. This knowledge will enable appropriate measures towards improvement of patient health care, antibiotic stewardship, research and infection control in the hospital.

Keywords: antimicrobial, Escherichia coli, extended spectrum beta lactamase, resistance

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Authors: Cinthia C. Costa, Heloisa L. Burnquist, Joaquim J. M. Guilhoto

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This study identified the impact of special agricultural safeguards (SSG) for the global market of meat and for the Brazilian economy. The tariff lines subject to SSG were selected and the period of analysis was 1995 (when the rules about the SSGs were established) to 2015 (more recent period for which there are notifications). The value of additional tariff was calculated for each of the most important tariff lines. The import volume and the price elasticities for imports were used to estimate the impacts of each additional tariff estimated on imports. Finally, the effect of Brazilian exports of meat without SSG taxes was calculated as well as its impact in the country’s economy by using an input-output matrix. The most important markets that applied SSGs were the U.S. for beef and European Union for poultry. However, the additional tariffs could be estimated in only two of the sixteen years that the U.S. applied SSGs on beef imports, suggesting that its use has been enforced when the average annual price has been higher than the trigger price level. The results indicated that the value of the bovine and poultry meat that could not be exported by Brazil due to SSGs to both markets (EU and the U.S.) was equivalent to BRL 804 million. The impact of this loss in trade was about: BRL 3.7 billion of the economy’s production value (at 2015 prices) and almost BRL 2 billion of the Brazilian Gross Domestic Product (GDP).

Keywords: beef, poultry meat, SSG tariff, input-output matrix, Brazil

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Authors: Gautam, Arjun, V. R. Sharma

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In the civil construction steel and concrete plays a different role but the same purposes dealing with the design of structures that support or resist loads. Concrete has been used in construction since long time from now. Being brittle and weak in tension, concrete is always reinforced with steel bars for the purposes in beams and columns etc. The paper deals with idea of special designed 3D materials which we named as “BUM629” to be placed/anchored in the structural member and mixed with concrete later on, so as to resist the developments of cracks due to shear failure , buckling,tension and compressive load in concrete. It had cutting edge technology through Draft, Analysis and Design the “BUM629”. The results show that “BUM629” has the great results in Mechanical application. Its material properties are design according to the need of structure; we apply the material such as Mild Steel and Magnesium Alloy. “BUM629” are divided into two parts one is applied at the middle section of concrete member where bending movements are maximum and the second part is laying parallel to vertical bars near clear cover, so we design this material and apply in Reinforcement of Civil Structures. “BUM629” is analysis and design for use in the mega structures like skyscrapers, dams and bridges.

Keywords: BUM629, magnesium alloy, cutting edge technology, mechanical application, draft, analysis and design, mega structures

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Authors: A. De Serres-Lafontaine, S. Porlier, K. Poitras

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Introduction: Placement is, without doubt, a challenging experience for both foster children and biological parents who witness their child being removed from their care. Yet, few studies have examined parenting in such a context through critical parental skills such as parental sensitivity and commitment. Sensitivity is described as the capacity of parents to respond accurately to their child’s needs in a warm, predictable and consistent way, whereas commitment is the ability of the parent to get involved physically and emotionally in an enduring relationship with his child. The research confirms the important role of parental sensitivity and parental commitment on child development following placement in foster care. Nevertheless, these studies were mainly conducted with foster parents, and few studies have examined these components of parenthood with biological parents. Method: This study evolves in two times. At first, 17 parents participated throughout a 90-minutes interview. It allowed to collect information regarding the sociodemographic situation, contacts, placement trajectory. Parental sensitivity is observed during a supervised parent-child contact. The second time occurred one to two years later and implied an at-home 90-minutes interview where we updated the information from the first interview and were able to assess the level of parental commitment. In this ongoing part of the study, five parents have already participated in implying the rest of them remain to be interviewed in the coming months - from October through December 2018. Results: Descriptive analysis from the first part of the study suggests the examination of two groups: 11 children have been reunified whereas six are still in foster care. Qualitative analysis allows to compare themes of sensitivity and commitment regarding if the reunification project occurs or not. Preliminary analysis about thematic content shows key components of parental commitment through parent’s reveal of the way they nurture a relationship with their child. Furthermore, preliminary analysis suggests that parental sensitivity is not associated with family reunification (r = 0,11, p = 0,74). Further analysis will be assessed with the date from the second part of the study to examine the potential association between commitment and reunification. Discussion: Parental sensitivity and commitment are fundamental to the well-being of the child in a placement trajectory. They need to be understood better as two different complex concepts and as two parenting skills that might have a way of echoing to one another when engaged in a specific context. Above all, a more accurate comprehension of parenting in a placement trajectory allows to sustain adequate intervention practices for birth parents and could change the way parental adequacy is assessed when reaching for reunification.

Keywords: child welfare, foster care, intervention practices, parenthood

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Authors: Wipakon Sonsnam, Kanya Napapongsa

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The quantitative aim of the study; 1) health conditions, to examine the state of health of the aging, 2) perceived of self-efficacy, self-care of aging ,3) perceived of social support of the aging, 4) to examine factors associated with self-efficacy in enhancing the health and self-care when illness. 100 samples selected from communities in Dusit, Bangkok, 2014 by random sampling. The questionnaires were used to collect data have 5-point rating scale, consisting of strongly agree, agree, undecided, disagree, and strongly disagree; approved content valid by 3 experts, reliability coefficients alpha was .784 for perceived of self-efficacy, self-care of aging and .827 for perceived of social support of the aging. ST-5, 2Q used for collect mental health. The ability to engage in a daily routine was collected by Barthel ADL index. Founding, the sample group were female (68%). (33%) of them were in the age of 60-65. Most of them were married and still live with their spouse (55%) and do not work (38%). The average annual income was less than 10,000 baht supported by child. Most people think that income was adequate (49.0%) and Satisfaction (61.0%). Most of aging caring them-self, followed by them spouse (26%). Welfare of the public had supported, living for the aging (100%), followed by Join and health volunteers in communities (23%). In terms of health, (53%) of the sample group feels health was fair, hypertension was the most common health condition among sample group (68%), following by diabetes (55%). About eyesight, (42%) have visual acuity. (59.0%) do not need hearing aids. 84% have more than 20 teeth remaining, and have no problem with chewing (61%). In terms of Ability to engage in a daily routine, most of people (84%) in sample group are in type 1. (91%) of the participants don’t have bladder incontinence. For mental condition, (82%) do not have insomnia. (87%) do not have anxiety. (96%) do not have depression. However, (77%) of the sample group is facing stress. In terms of environment in home, bathroom in the home (90.0%) and floor of bathroom was slippery (91.0%). (48%) of the sample group has the skills of how to look after themselves while being sick, and how to keep up healthy lifestyle. Besides, some other factors, such as gender, age and educational background are related to the health perception. The statistical significance was <0.05. Suggestion: The instruments available to national standards such as ST-5, 2Q and Barthel ADL index. Reliability coefficients alpha was .784 for perceived of self-efficacy, self-care of aging and .827 for perceived of social support of the aging. The instrument used to collect perceived of social support must be further developed to study level of influence of social support that affect the health of elderly.

Keywords: ้health status, perception of aging, self-efficacy, social support

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: Aanh Eduardo Dimate-Garcia, Diana Carolina Rodriguez-Romero, Edna Yuliana Gonzalez Rincon, Diana Marcela Pardo Lopez, Yessica Garibello Cubillos

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Musculoskeletal disorders (MD) are the new epidemic of chronic diseases, are multifactorial and affect the different productive sectors. Although there are multiple instruments to evaluate the static and dynamic load, the method of repetitive occupational action (OCRA) seems to be an attractive option. Objective: It is aimed to analyze the use of the OCRA method and the prevalence of MD in workers of various productive sectors according to the literature (2007-2018). Materials and Methods: A literature review (following the PRISMA statement) of studies aimed at assessing the level of biomechanical risk (OCRA) and the prevalence of MD in the databases Scielo, Science Direct, Scopus, ProQuest, Gale, PubMed, Lilacs and Ebsco was realized; 7 studies met the selection criteria; the majority are quantitative (cross section). Results: it was evidenced (gardening and flower-growers) in this review that 79% of the conditions related to the task require physical requirements and involve repetitive movements. In addition, of the high appearance of DM in the high-low back, upper and lower extremities that are produced by the frequency of the activities carried out (footwear production). Likewise, there was evidence of 'very high risks' of developing MD (salmon industry) and a medium index (OCRA) for repetitive movements that require special care (U-Assembly line). Conclusions: the review showed the limited use of the OCRA method for the detection of MD in workers from different sectors, and this method can be used for the detection of biomechanical risk and the appearance of MD.

Keywords: checklist, cumulative trauma disorders, musculoskeletal diseases, repetitive movements

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Authors: Dauda Ibrahim Adagye

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Effective internal control system in the bursary unit of tertiary educational institutions is geared toward achieving quality teaching, learning, and research environment and as well assist the management of the institutions, particularly when decisions are to be made. While internal control system exists in all institutions, the outlined objectives above are far from being achieved. The paper; therefore, assesses the effectiveness of internal control system in tertiary educational institutions in Nasarawa State, Nigeria with the specific focus on the Nasarawa state Polytechnic, Lafia. The study is survey; hence, a simple closed-ended questionnaire was developed and administered to a sample of twenty-seven (27) member staff from the Bursary and the internal audit unit of the Nasarawa State Polytechnic, Lafia to obtain data for analysis purposes and to test the study hypothesis. Responses from the questionnaire were analyzed using a simple percentage and chi-square. Findings shows that the right people are not assigned to the right job in the department, budget, and management accounting were never used in the institution’s operations and checking of subordinate by their superior officers is not regular. This renders the current internal control structure of the Polytechnic as ineffective and weak. The paper therefore, recommends that: transparency should be seen as significant, as the institution work toward meeting its objectives, therefore, it means that the right staff is assigned to the right job and regular checking of the subordinates by their ensued superiors.

Keywords: internal control, tertiary educational intuitions, efficiency

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Authors: Samaneh Sadat Fattahi Massoom, Hossein Salimi Bajestani

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The study examines loneliness and depression in students who regularly care for themselves after school (latchkey students) in Mashhad and compares them with parent supervised students using a causal-comparative research method. The 270 participants, aged 7 -13, were selected using convenience and cluster random-assignment sampling. Independent t-test results showed significant differences between loneliness (-4.32, p ≤ 0.05) and depression (-3.02, p ≤0.05) among latchkey and non-latchkey students. Using the Pearson correlation test, significant correlation between depression and loneliness among latchkey students was also discovered (r=0.59, p ≤ 0.05). However, regarding non latchkey students, no significant difference between loneliness and depression was observed (r= 0.02. p ≥ 0.05). Multiple regression results also showed that depression variance can be determined by gender (22%) and loneliness (34%). The findings of this study, specifically the significant difference between latchkey and non-latchkey children regarding feelings of loneliness and depression, carries clear implications for parents. It can be concluded that mothers who spend most of their time working out of the house and devoid their children of their presence in the home may cause some form of mental distress like loneliness and depression. Moreover, gender differences affect the degree of these psychological disorders.

Keywords: loneliness, depression, self-care students, latchkey and non-latchkey students, gender

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Authors: Liane J. Ioannou, Jonathan Serpell, Cino Bendinelli, David Walters, Jenny Gough, Dean Lisewski, Win Meyer-Rochow, Julie Miller, Duncan Topliss, Bill Fleming, Stephen Farrell, Andrew Kiu, James Kollias, Mark Sywak, Adam Aniss, Linda Fenton, Danielle Ghusn, Simon Harper, Aleksandra Popadich, Kate Stringer, David Watters, Susannah Ahern

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BACKGROUND: There are significant variations in the management, treatment and outcomes of thyroid cancer, particularly in the role of: diagnostic investigation and pre-treatment scanning; optimal extent of surgery (total or hemi-thyroidectomy); use of active surveillance for small low-risk cancers; central lymph node dissections (therapeutic or prophylactic); outcomes following surgery (e.g. recurrent laryngeal nerve palsy, hypocalcaemia, hypoparathyroidism); post-surgical hormone, calcium and vitamin D therapy; and provision and dosage of radioactive iodine treatment. A proven strategy to reduce variations in the outcome and to improve survival is to measure and compare it using high-quality clinical registry data. Clinical registries provide the most effective means of collecting high-quality data and are a tool for quality improvement. Where they have been introduced at a state or national level, registries have become one of the most clinically valued tools for quality improvement. To benchmark clinical care, clinical quality registries require systematic measurement at predefined intervals and the capacity to report back information to participating clinical units. OBJECTIVE: The aim of this study was to develop a core set clinical indicators that enable measurement and reporting of quality of care for patients with thyroid cancer. We hypothesise that measuring clinical quality indicators, developed to identify differences in quality of care across sites, will reduce variation and improve patient outcomes and survival, thereby lessening costs and healthcare burden to the Australian community. METHOD: Preparatory work and scoping was conducted to identify existing high quality, clinical guidelines and best practice for thyroid cancer both nationally and internationally, as well as relevant literature. A bi-national panel was invited to participate in a modified Delphi process. Panelists were asked to rate each proposed indicator on a Likert scale of 1–9 in a three-round iterative process. RESULTS: A total of 236 potential quality indicators were identified. One hundred and ninety-two indicators were removed to reflect the data capture by the Australian and New Zealand Thyroid Cancer Registry (ANZTCR) (from diagnosis to 90-days post-surgery). The remaining 44 indicators were presented to the panelists for voting. A further 21 indicators were later added by the panelists bringing the total potential quality indicators to 65. Of these, 21 were considered the most important and feasible indicators to measure quality of care in thyroid cancer, of which 12 were recommended for inclusion in the final set. The consensus indicator set spans the spectrum of care, including: preoperative; surgery; surgical complications; staging and post-surgical treatment planning; and post-surgical treatment. CONCLUSIONS: This study provides a core set of quality indicators to measure quality of care in thyroid cancer. This indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research. Inclusion of these quality indicators into monitoring databases such as clinical quality registries will enable opportunities for benchmarking and feedback on best practice care to clinicians involved in the management of thyroid cancer.

Keywords: clinical registry, Delphi survey, quality indicators, quality of care

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Authors: Sanjeev Singh

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Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: After the approval of the ethical committee, this single-center prospective randomized and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (after aortic cross-clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a better outcome than milrinone alone.

Keywords: inhaled nitric oxide, milrinone, pulmonary artery hypertension, total anomalous pulmonary venous connection

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Authors: Abhishek Agarwal, Manoj Sarda, Juhi Kaushik, Vatsal Sanjay, Arup Kumar Das

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Propagation of fire through a non-air conditioned railway compartment is studied by virtue of numerical simulations. Simultaneous computational fire dynamics equations, such as Navier-Stokes, lumped species continuity, overall mass and energy conservation, and heat transfer are solved using finite volume based (for radiation) and finite difference based (for all other equations) solver, Fire Dynamics Simulator (FDS). A single coupe with an eight berth occupancy is used to establish the numerical model, followed by the selection of a three coupe system as the fundamental unit of the locomotive compartment. Heat Release Rate Per Unit Area (HRRPUA) of the initial fire is varied to consider a wide range of compartmental fires. Parameters, such as air inlet velocity relative to the locomotive at the windows, the level of interaction with the ambiance and closure of middle berth are studied through a wide range of numerical simulations. Almost all the loss of lives and properties due to fire breakout can be attributed to the direct or indirect exposure to flames or to the inhalation of toxic gases and resultant suffocation due to smoke and soot. Therefore, the temporal stature of fire and smoke are reported for each of the considered cases which can be used in the present or extended form to develop guidelines to be followed in case of a fire breakout.

Keywords: fire dynamics, flame propagation, locomotive fire, soot flow pattern, non-air-conditioned coaches

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Authors: E. O. Egieyeh, N. Butler, R. Coetzee, M. Van Huyssteen, A. Bheekie

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Background: High rate of maternal and child mortality is a global concern. Nationally, it constitutes one of South Africa’s quadruple burdens of diseases. Pharmacists have a crucial role in maternal and child health care delivery and as such should be equipped with adequate knowledge and skill required to contribute to maternal and child well-being. The International Pharmaceutical Federation statement of policy (2013) outlines pharmacist-led interventions in accordance with the World Health Organisation’s interventions in maternal, new-born and child health care. The South African Pharmacy Council’s guideline on Good Pharmacy Practice (2010) also stipulates the minimum standards required to participate in reproductive, maternal and child care. Pharmacy schools are obliged to train pharmacy students to meet priority health needs of the population so that graduates are ‘fit for purpose’. The purpose of the study is to evaluate the knowledge and skill of final year pharmacy students at a university in South Africa to determine their preparedness to contribute effectively to maternal and child health care. Method: A quantitative, descriptive, non-randomized baseline study was conducted among the final year students at the School of Pharmacy. Data was collected using a questionnaire designed in sections to assess knowledge of contraception, maternal and child health directed at the primary care level and framed within the scope of practice required of an entry-level generalist pharmacist. Participants’ skill in infant growth assessment was assessed in a section of the questionnaire in a written format. Participants ticked the topics they had been exposed to on a curriculum content assessment tool which was not graded. A pilot study examined the clarity and suitability of question items, and duration to complete the questionnaire. A score of 50% in each section of the questionnaire indicated a pass. The questionnaire was delivered in campus lecture venue. Results: Of the 102 students in final year, 53 (52%) students consented to participate in the study. Only 13.2% of participants scored above 50% in each section. Forty five (85%) participants scored above 50% in the contraception section while 40 (75%) scored less than 50% in the skills assessment. Less than half (45.3%) of the participants had a total score above 50%. Being a parent or working part-time as pharmacist assistance did not have any influence on the performance of the participants. Evaluation of participants’ curriculum content exposure showed differences in exposure to the various topics. Exposure to contraception teaching received the most recognition. Conclusion: Maternal and child health curriculum content should be reviewed at the university to enhance the knowledge and skill of pharmacy graduates.

Keywords: final year pharmacy students, knowledge and skill, maternal and child health, South Africa

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Authors: Fariea Bakul, Chhanda Karmaker

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The present study was designed to investigate the effects of parental bonding on adult’s cognitive emotion regulation and also to investigate gender differences in parental bonding and cognitive emotion regulation. Data were collected by using convenience sampling technique from 100 adult students (50 males and 50 females) of different universities of Dhaka city, ages between 20 to 25 years, using Bengali version of Parental Bonding Inventory and Bengali version of Cognitive Emotion Regulation Questionnaire. The obtained data were analyzed by using multiple regression analysis and independent samples t-test. The results revealed that fathers care (β =0.317, p < 0.05) was only significantly positively associated with adult’s cognitive emotion regulation. Adjusted R² indicated that the model explained 30% of the variance in adult’s adaptive cognitive emotion regulation. No significant association was found between parental bonding and less adaptive cognitive emotion regulations. Results from independent samples t-test also revealed that there was no significant gender difference in both parental bonding and cognitive emotion regulations.

Keywords: cognitive emotion regulation, parental bonding, parental care, parental over-protection

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Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor

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Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.

Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan

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Authors: Melike Orhan

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Along with impetuous physical change, configuration and increase in the density of cities, urban public spaces have started to become a transition area rather than spaces to inhabit. The insufficiency of public spaces, one of the most significant components of a city, where communal life is maintained and the decrease in the quality of urban spaces have led to an increase in the use of semi-public spaces as urban space. Semi-public spaces are those that ensure transition between private and public spaces and can be seen, observed, reached and used by urban-dwellers. Humans are in a constant relation to their surroundings and care for integration as part of their surroundings. Semi-public spaces providing balance for the individual between private spaces (structures) and urban-public spaces make this integration easier. Spaces with a semi-public characteristic serve for a particular neighboring unit and the user (i.e. common use areas in residential spaces and dwellings, common outdoor areas situated between office buildings, and etc.) These spaces, whose density of usage is increased with distinctive functions and activities, gain different attributions according to the characteristics of the urban space they are located in (commercial, residential, touristic, and etc.) and to the functions of the structures with which they are in relation. At the same time, they begin to serve other neighboring units along with an increase in public usage. As a result, the interaction between environment-space-structure-humans changes, which directly affects the urban space quality. The aim of this study is to determine how and depending on what characteristics the public usage density of semi-public spaces change and to put forth the effects of this change on the urban environment it is located in and to designate its role in terms of 'urban space quality'. In conclusion, within the scope of this study, semi-public spaces located in urban spaces with distinctive functions will be explored through examples, and the effects of these spaces with altered public usage and density on urban space and quality of life will be put forward. Accordingly, applicable criteria will be determined by means of semi-public spaces oriented at increasing and sustaining the quality of urban space.

Keywords: semi-public spaces, urban public spaces, urban space quality, public usage

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Authors: Muhadam Labolo, Mughny Ibtisyam Mukhlis, Zulkarnaen, Safira Maulida Rahman Soulisa

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This research is motivated by one of the functions of government is a regulatory function. Aceh Province, especially in Banda Aceh City has special autonomy, one of them is in the application of Islamic law, but when the law implemented to the citizen, there are many problems happens. One of the problems faced by the Government and people of Banda Aceh was Seclusion. Seclusion/nasty silent act between two people mukallafor more of the opposite sex who is not mahram or without marriage. This study aims to determine and analyze how the effectiveness of the policy as well as enabling and inhibiting factors of Qanun Number 14 of 2003 On Khalwat (nasty) in sharia Islam Islamic law in the city of Banda Aceh. This type of research is qualitative research method is a descriptive and inductive approach. The source of data used is People, Problem, Phenomenon, and programs, while the data collection through field studies and literature such as interviews, observation, and documentation. The results of this study were analyzed by using data reduction, display data, conclusions, and verification. The results showed that the Qanun Number 14 of 2003 on Khalwat (nasty) in the establishment of Islamic law in Banda Aceh is still not effective. It is seen from the high number of violations seclusion committed by Banda Aceh citizen, especially among teenagers, lack of socialization, as well as a lack of budgetary support for the implementation of Islamic Law in Banda Aceh. The supporting factors are 1) Coordination and communication among agencies had been walking steadily. 2) Facilities and infrastructure Syar'iah Court of Banda Aceh and the Office of Sharia Islam Banda Aceh that very good. 3) The Cultural majority of the people of Banda Aceh that support. Inhibiting factors: 1) There are no written duties of each institution for the prosecution case Seclusion. 2) The lack of socialization programs. 3) Lack of facilities and infrastructure Municipal Police Unit and the WH less. 4) Lack of control by the family. 5) The absence of training for officials Municipal Police Units and the Wilayatul Hisbah Banda Aceh.

Keywords: effectiveness, Islamic Sharia, Khalwat, Qanun

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Authors: M. V. Rane, Tareke Tekia

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Fresh Air Dehumidifier having a capacity of 1 TR has been developed by Heat Pump Laboratory at IITB. This fresh air dehumidifier is based on potassium formate liquid desiccant. The regeneration of the liquid desiccant can be done in two stages. The first stage of liquid desiccant regeneration involves the boiling of liquid desiccant inside the evacuated glass type solar thermal collectors. Further regeneration of liquid desiccant can be achieved using Low Temperature Regenerator, LTR. The coefficient of performance of the fresh air dehumidifier greatly depends on the performance of the major components such as high temperature regenerator, low temperature regenerator, fresh air dehumidifier, and solution heat exchangers. High effectiveness solution heat exchanger has been developed and tested. The solution heat exchanger is based on a patented aluminium extrusion with special passage geometry to enhance the heat transfer rate. Effectiveness up to 90% was achieved. Before final testing of the dehumidifier, major components have been tested individually. Testing of the solar thermal collector as hot water and steam generator reveals that efficiency up to 55% can be achieved. In this paper, the development of 1 TR fresh air dehumidifier with special focus on solution heat exchangers and solar thermal collector performance is presented.

Keywords: solar, liquid desiccant, dehumidification, air conditioning, regeneration, coefficient of performance

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Authors: Jaroslav Frantík, Jan Najser

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This article deals with increasing the energy efficiency of a plant in terms of optimizing the process. The European Union is striving to achieve the climate-energy package in the area increasing of energy efficiency. The goal of energy efficiency is to reduce primary energy consumption by 20% within the EU until 2020. The objective of saving energy consumption in the Czech Republic was set at 47.84 PJ (13.29 TWh). For reducing electricity consumption, it is possible to choose: a) mandatory increasing of energy efficiency, b) alternative scheme, c) combination of both actions. The Czech Republic has chosen for reducing electricity consumption using-alternative scheme. The presentation is focused on the proposal of a technological unit dealing with the gasification process of processing of biomass with an increase of power in the output. The synthesis gas after gasification of biomass is used as fuel in a cogeneration process of reciprocating internal combustion engine with the classic production of heat and electricity. Subsequently, there is an explanation of the ORC system dealing with the conversion of waste heat to electricity with the using closed cycle of the steam process with organic medium. The arising electricity is distributed to the power grid as a further energy source, or it is used for needs of the partial coverage of the technological unit. Furthermore, there is a presented schematic description of the technology with the identification of energy flows starting from the biomass treatment by drying, through its conversion to gaseous fuel, producing of electricity and utilize of thermal energy with minimizing losses. It has been found that using of ORC system increased the efficiency of the produced electricity by 7.5%.

Keywords: biomass, efficiency, gasification, ORC system

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Authors: Kalpeshkumar L. Gupta, Shivali Rathore

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India is home to over 30 crore rural poor, aware of the criticality of the situation that has made to come with an innovative business idea. Entrepreneurship in India is on the verge of explosive growth and which is actually need of an hour for employment generation, poverty elevation at grass root through developmental intervention. India economic progress has started from the development of its small and medium scale enterprises to ensure that the sectors continues to stay competitive and achieve sustained growth in the era of global economy many incubators centers has been established with the mission to give the encouragement to many innovative ideas. If we define an Incubator, it is simply an enclosed apparatus in which premature small babies are placed and which provides a controlled and protective environment for their care this gives them a chance to adjust to outside environment, and grow stronger before they face the outside world. In a similar way the startup entrepreneur’s business idea is incubated in the incubation centers. Entrepreneurship has been conventionally rated as risky career, to break the myth and to augment the supply of new entrepreneurs through education; research training the incubation centers has been established, their goal is to help create and grow young businesses by providing them with necessary support and financial and technical services. The startup companies spend on an average two years in a business incubator during which numerous benefits like funding, office space, equipment’s etc. is provided by the incubators to the startup business. Present paper will study the background, role, objectives of different incubators set up in Indian Institute of Management (IIMs) and Indian Institute of Technology (IITs) for our study.

Keywords: incubation centres, entrepreneurship, Indian Institute of Management, Indian Institute of Technology

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Authors: Eeva Wallenius-Nareneva, Tuula Toivanen-Labiad

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Background: Oral health promotion event was organised for forty Afghanistan, Iraqi and Bangladeshi underage asylum seekers in Finland. The invitation to arrange this coaching occasion was accepted in the Degree Programme in Oral Hygiene in Metropolia. The personnel in the reception center found the need to improve oral health among the youngsters. The purpose was to strengthen the health literacy of the boys in their oral self-care and to reduce dental fears. The Finnish studies, especially the terminology of oral health was integrated to coaching with the help of interpreters. Cooperative learning was applied. Methods: Oral health was interactively discussed in four study group sessions: 1. The importance of healthy eating habits; - Good and bad diets, - Regular meals, - Acid attack o Xylitol. 2. Oral diseases − connection to general health; - Aetiology of gingivitis, periodontitis and caries, - Harmfulness of smoking 3. Tools and techniques for oral self-care; - Brushing and inter dental cleaning. 4. Sharing earlier dental care experiences; - Cultural differences, - Dental fear, - Regular check-ups. Results: During coaching deficiencies appeared in brushing and inter dental cleaning techniques. Some boys were used to wash their mouth with salt justifying it by salt’s antiseptic properties. Many brushed their teeth by vertical movements. The boys took feedback positively when a demonstration with model jaws revealed the inefficiency of the technique. The advantages of fluoride tooth paste were advised. Dental care procedures were new and frightening for many boys. Finnish dental care system was clarified. The safety and indolence of the treatments and informed consent were highlighted. Video presentations and the dialog lowered substantially the threshold to visit dental clinic. The occasion gave the students means for meeting patients from different cultural and language backgrounds. The information hidden behind the oral health problems of the asylum seekers was valuable. Conclusions: Learning dental care practices used in different cultures is essential for dental professionals. The project was a good start towards multicultural oral health care. More experiences are needed before graduation. Health education themes should be held simple regardless of the target group. The heterogeneity of the group does not pose a problem. Open discussion with questions leading to the theme works well in clarifying the target group’s knowledge level. Sharing own experiences strengthens the sense of equality among the participants and encourages them to express own opinions. Motivational interview method turned out to be successful. In the future coaching occasions must confirm active participation of everyone. This could be realized by dividing the participants to even smaller groups. The different languages impose challenges but they can be solved by using more interpreters. Their presence ensures that everyone understands the issues properly although the use of plain and sign languages are helpful. In further development, it would be crucial to arrange a rehearsal occasion to the same participants in two/three months’ time. This would strengthen the adaption of self-care practices and give the youngsters opportunity to pose more open questions. The students would gain valuable feedback regarding the effectiveness of their work.

Keywords: cooperative learning, interactive methods, motivational interviewing, oral health promotion, underage asylum seekers

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Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

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Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

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Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

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Authors: Alessandra Turini Bolsoni Silva, Nilson Rogério Da Silva

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The hospitalization process for long periods and the experience of invasive and painful clinical procedures can trigger a set of stressors in children, family members and professionals, leading to stress. Mothers are, in general, the main caregivers and, therefore, have a high degree of sadness and stress with an impact on mental health. However, the father, in the face of the mother's absence, needs to assume other responsibilities such as domestic activities and healthy children in addition to work activities. In addition, he has to deal with changes in family and work relationships during the child's hospitalization, with disagreements and changes in the relationship with the partner, changes in the relationship with the children, and finding it difficult to reconcile the new tasks as a caregiver and work. A consequence of the hospitalization process is the interruption of the routine activities of both the child and the family members responsible for the care, who can go through stressful moments due to the consequences of family breakdown, attention focused only on the child and sleepless nights. In this sense, both the mother and the father can have their health affected by their child's hospitalization. The present study aims to compare the prevalence of stress and overload in mothers and fathers of hospitalized children, as well as possible associations with activities related to care. The participants were 10 fathers and 10 mothers of children hospitalized in a hospital located in a medium-sized city in the interior of São Paulo. Three instruments were used for data collection: 1) Script to characterize the participants; 2) The Lipp Stress Symptom Inventory (ISSL, 2000) 3) Zarit Burden Interview Protocol – ZBT. Contact was made with the management of the hospital in order to present the objectives of the project, then authorization was requested for the participation of the parents; after an agreement, the time and place were convenient for the participant to carry out the interview. Thus, they signed the Free and Informed Consent Term. Data were analyzed according to the instrument application manuals and organized in Figures and Tables. The results revealed that fathers and mothers have their family and professional routine affected by the hospitalization of their children, with the consequent presence of stress and overload indicators. However, the study points to a greater presence of stress and overload in mothers due to their role as the main caregiver, often interrupting their professional life to exercise care. In the case of the father, the routine is changed due to taking on household chores and taking care of the other children, with the professional life being less affected. It is hoped that the data can guide future interventions that promote and develop strategies that favor care and, at the same time, preserve the health of caregivers and that include mothers and fathers, considering that both are affected, albeit in a different way.

Keywords: stress, overload, caregivers, parents

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Authors: Ahmed AlNouss, Salim Ahmed

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Process control refers to the techniques to control the variables in a process in order to maintain them at their desired values. Advanced process control (APC) is a broad term within the domain of control where it refers to different kinds of process control and control related tools, for example, model predictive control (MPC), statistical process control (SPC), fault detection and classification (FDC) and performance assessment. APC is often used for solving multivariable control problems and model predictive control (MPC) is one of only a few advanced control methods used successfully in industrial control applications. Advanced control is expected to bring many benefits to the plant operation; however, the extent of the benefits is plant specific and the application needs a large investment. This requires an analysis of the expected benefits before the implementation of the control. In a real plant simulation studies are carried out along with some experimentation to determine the improvement in the performance of the plant due to advanced control. In this research, such an exercise is undertaken to realize the needs of APC application. The main objectives of the paper are as follows: (1) To apply MPC to a number of simulations set up to realize the need of MPC by comparing its performance with that of proportional integral derivatives (PID) controllers. (2) To study the effect of controller parameters on control performance. (3) To develop appropriate performance index (PI) to compare the performance of different controller and develop novel idea to present tuning map of a controller. These objectives were achieved by applying PID controller and a special type of MPC which is dynamic matrix control (DMC) on the multi-tanks process simulated in loop-pro. Then the controller performance has been evaluated by changing the controller parameters. This performance was based on special indices related to the difference between set point and process variable in order to compare the both controllers. The same principle was applied for continuous stirred tank heater (CSTH) and continuous stirred tank reactor (CSTR) processes simulated in Matlab. However, in these processes some developed programs were written to evaluate the performance of the PID and MPC controllers. Finally these performance indices along with their controller parameters were plotted using special program called Sigmaplot. As a result, the improvement in the performance of the control loops was quantified using relevant indices to justify the need and importance of advanced process control. Also, it has been approved that, by using appropriate indices, predictive controller can improve the performance of the control loop significantly.

Keywords: advanced process control (APC), control loop, model predictive control (MPC), proportional integral derivatives (PID), performance indices (PI)

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Authors: Shameka Stanford

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This presentation will discuss how cognitive and communication disorders in the areas of executive functioning, receptive and expressive language can impact the problem-solving and decision making of individuals with such impairments. More specifically, this presentation will discuss approaches the legal defense team of capital case lawyers can add to their experience when servicing individuals who have a history of educational decline, special education, and limited intervention and treatment. The objective of the research is to explore and identify the correlations between impaired executive function skills and decision making and competency for individuals facing death penalty charges. To conduct this research, experimental design, randomized sampling, qualitative analysis was employed. This research contributes to the legal and criminal justice system related to how they view, defend, and characterize, and judge individuals with documented cognitive and communication disorders who are eligible for capital case charges. More importantly, this research contributes to the increased ability of death penalty lawyers to successfully defend clients with a history of academic difficulty, special education, and documented disorders that impact educational progress and academic success.

Keywords: communication disorders, cognitive disorders, capital murder, death penalty, executive function

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