Search results for: Italian administrative units

Authors: Cory B. Lord

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Falls among the elderly population has become an area of concern in healthcare today. The negative impacts of falls lead to increased morbidity, mortality, and financial burdens for both patients and healthcare systems. Falls in the United States is reported at an annual rate of 36 million in those aged 65 and older. Each year, one out of four people in this age group will suffer a fall, with 20% of these falls causing injury. The setting for this Doctor of Nursing Practice (DNP) project was a memory care unit in an assisted living community, as these facilities house cognitively impaired older adults. These communities lack fall prevention programs; therefore, the need exists to add to the body of knowledge to positively impact this population. The objective of this project was to reduce fall rates through the implementation of the Center for Disease Control and Prevention (CDC) STEADI (stopping elderly accidents, deaths, and injuries) program. The DNP project performed was a quality improvement pilot study with a pre and post-test design. This program was implemented in the memory care setting over 12 weeks. The project included an educational session for staff and a fall risk assessment with appropriate resident referrals. The three aims of the DNP project were to reduce fall rates among the elderly aged 65 and older who reside in the memory care unit, increase staff knowledge of STEADI fall prevention measures after an educational session, and assess the willingness of memory care unit staff to adopt an evidence-based a fall prevention program. The Donabedian model was used as a guiding conceptual framework for this quality improvement pilot study. The fall rate data for 12 months before the intervention was evaluated and compared to post-intervention fall rates. The educational session comprised of a pre and post-test to assess staff knowledge of the fall prevention program and the willingness of staff to adopt the fall prevention program. The overarching goal was to reduce falls in the elderly population who live in memory care units. The results of the study showed, on average that the fall rate during the implementation period of STEADI (μ=6.79) was significantly lower when compared to the prior 12 months (μ= 9.50) (p=0.02, α = 0.05). The mean staff knowledge scores improved from pretest (μ=77.74%) to post-test (μ=87.42%) (p=0.00, α= 0.05) after the education session. The results of the willingness to adopt a fall prevention program were scored at 100%. In summation, implementing the STEADI fall prevention program can assist in reducing fall rates for residents aged 65 and older who reside in a memory care setting.

Keywords: dementia, elderly, falls, STEADI

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Authors: Cheryl Forchuk, Sandra Fisman, Steve Cordes, Dan Catunto, Katherine Krakowski, Melissa Jeffrey, John D’Oria

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The discharge of youth aged 16-25 from hospital into homelessness is a prevalent issue despite research indicating social, safety, health and economic detriments on both the individual and community. Lack of stable housing for youth discharged into homelessness results in long-term consequences, including exacerbation of health problems and costly health care service use and hospital readmission. People experiencing homelessness are four times more likely to be readmitted within one month of discharge and hospitals must spend $2,559 more per client. Finding safe housing for these individuals is imperative to their recovery and transition back to the community. People discharged from hospital to homelessness experience challenges, including poor health outcomes and increased hospital readmissions. Youth are the fastest-growing subgroup of people experiencing homelessness in Canada. The needs of youth are unique and include supports related to education, employment opportunities, and age-related service barriers. This study aims to identify the needs of youth at risk of homelessness by evaluating the efficacy of the “Preventing Discharge to No Fixed Address – Youth” (NFA-Y) program, which aims to prevent youth from being discharged from hospital into homelessness. The program connects youth aged 16-25 who are inpatients at London Health Sciences Centre and St. Joseph’s Health Care London to housing and financial support. Supports are offered through collaboration with community partners: Youth Opportunities Unlimited, Canadian Mental Health Association Elgin Middlesex, City of London Coordinated Access, Ontario Works, and Salvation Army’s Housing Stability Bank. This study was reviewed and approved by Western University’s Research Ethics Board. A series of interviews are being conducted with approximately ninety-three youth participants at three time points: baseline (pre-discharge), six, and twelve months post-discharge. Focus groups with participants, health care providers, and community partners are being conducted at three-time points. In addition, administrative data from service providers will be collected and analyzed. Since homelessness has a detrimental effect on recovery, client and community safety, and healthcare expenditure, locating safe housing for psychiatric patients has had a positive impact on treatment, rehabilitation, and the system as a whole. If successful, the findings of this project will offer safe policy alternatives for the prevention of homelessness for at-risk youth, help set them up for success in their future years, and mitigate the rise of the homeless youth population in Canada.

Keywords: youth homelessness, no-fixed address, mental health, homelessness prevention, hospital discharge

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Authors: Merih Welay Welesilassie

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Language is a potent instrument that does not only serve the purpose of communication but also plays a pivotal role in shaping our cultural practices and identities. The right to choose one's language is a fundamental human right that helps to safeguard the integrity of both personal and communal identities. Language holds immense significance in Ethiopia, a nation with a diverse linguistic landscape that extends beyond mere communication to delineate administrative boundaries. Consequently, depriving Ethiopians of their linguistic rights represents a multifaceted punishment, more complex than food embargoes. In the aftermath of the civil war that shook Ethiopia in November 2020, displacing millions and resulting in the loss of hundreds of thousands of lives, concerns have been raised about the preservation of the indigenous Tigrayan language and culture. This is particularly true following the annexation of western Tigray into the Amhara region and the implementation of an Amharic-only language and culture education policy. This scholarly inquiry explores the intricacies surrounding the Amhara regional state's prohibition of Tigrayans' indigenous language and culture and the subsequent adoption of a monolingual and monocultural Amhara language and culture in western Tigray. The study adopts the linguistic genocide conceptual framework as an analytical tool to gain a deeper insight into the factors that contributed to and facilitated this significant linguistic and cultural shift. The research was conducted by interviewing ten teachers selected through a snowball sampling. Additionally, document analysis was performed to support the findings. The findings revealed that the push for linguistic and cultural assimilation was driven by various political and economic factors and the desire to promote a single language and culture policy. This process, often referred to as ‘Amharanization,’ aimed to homogenize the culture and language of the society. The Amhara authorities have enacted several measures in pursuit of their objectives, including the outlawing of the Tigrigna language, punishment for speaking Tigrigna, imposition of the Amhara language and culture, mandatory relocation, and even committing heinous acts that have inflicted immense physical and emotional suffering upon members of the Tigrayan community. Upon conducting a comprehensive analysis of the contextual factors, actions, intentions, and consequences, it has been posited that there may be instances of linguistic genocide taking place in the Western Tigray region. The present study sheds light on the severe consequences that could arise because of implementing monolingual and monocultural policies in multilingual areas. Through thoroughly scrutinizing the implications of such policies, this study provides insightful recommendations and directions for future research in this critical area.

Keywords: linguistic genocide, linguistic human right, mother tongue, Western Tigray

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Authors: Durri Andriani, Irsan Tahar, Lilian Sarah Hiariey

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Every institution has to develop, implement, and control its policies to ensure the effectiveness of the institution. In doing so, all related stakeholders have to be involved to maximize the benefit of the policies and minimize the potential constraints and resistances. Open and distance education (ODE) institution is no different. As an education institution, ODE institution has to focus their attention to fulfilling academic needs of their students through open and distance measures. One of them is quality learning support system. Significant stakeholders in learning support system are tutors since they are the ones who directly communicate with students. Tutors are commonly seen as objects whose main responsibility is limited to implementing policies decided by management in ODE institutions. Nonetheless, tutors’ perceptions of tutorials are believed to influence tutors’ performances in facilitating learning support. It is therefore important to analyze tutors’ perception on various aspects of learning support. This paper presents analysis of tutors’ perceptions on policies of tutoriala in ODE institution using Policy Analysis Framework (PAF) modified by King, Nugent, Russell, and Lacy. Focus of this paper is on on-line tutors, those who provide tutorials via Internet. On-line tutors were chosen to stress the increasingly important used of Internet in ODE system. The research was conducted in Universitas Terbuka (UT), Indonesia. UT is purposely selected because of its large number (1,234) of courses offered and large area coverage (6000 inhabited islands). These posed UT in a unique position where learning support system has, to some extent, to be standardized while at the same time it has to be able to cater the needs of different courses in different places for students with different backgrounds. All 598 listed on-line tutors were sent the research questionnaires. Around 20% of the email addresses could not be reached. Tutors were asked to fill out open-ended questionnaires on their perceptions on definition of on-line tutorial, roles of tutors and students in on-line tutorials, requirement for on-line tutors, learning materials, and student evaluation in on-line tutorial. Data analyzed was gathered from 40 on-line tutors who sent back filled-out questionnaires. Data were analyzed qualitatively using content analysis from all 40 tutors. The results showed that using PAF as entry point in choosing learning support services as area of policy with delivery learning materials as the issue at UT has been able to provide new insights of aspects need to be consider in formulating policies in online tutorial and in learning support services. Involving tutors as source of information could be proven to be productive. In general, tutors had clear understanding about definition of online tutorial, roles of tutors and roles of students, and requirement of tutor. Tutors just need to be more involved in the policy formulation since they could provide data on students and problem faced in online tutorial. However, tutors need an adjustment in student evaluation which according tutors too focus on administrative aspects and subjective.

Keywords: distance education, on-line tutorial, tutorial policy, tutors’ perspectives

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Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

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Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

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Authors: Jihede Haj Messaoud, Hamdi Omar, Hela Fakhfakh Ben Jemia, Chokri Yaich

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The Upper Lutetian alternating marl–limestone succession of Reineche Member was deposited over a warm shallow carbonate platform that permits Nummulites proliferation. High-resolution studies of 30 meters thick Nummulites-bearing Reineche Member, cropping out in Central Tunisia (Jebel Siouf), have been undertaken, regarding pronounced cyclical sedimentary sequences, in order to investigate the periodicity of cycles and their related orbital-scale oceanic and climatic changes. The palaeoenvironmental and palaeoclimatic data are preserved in several proxies obtainable through high-resolution sampling and laboratories measurement and analysis as magnetic susceptibility (MS) and carbonates contents in conjunction with a wireline logging tools. The time series analysis of proxies permits to establish cyclicity orders present in the studied intervals which could be linked to the orbital cycles. MS records provide high-resolution proxies for relative sea level change in Late Lutetian strata. The spectral analysis of MS fluctuations confirmed the orbital forcing by the presence of the complete suite of orbital frequencies in the precession of 23 ka, the obliquity of 41 ka, and notably the two modes of eccentricity of 100 and 405 ka. Regarding the two periodic sedimentary cycles detected by wavelet analysis of proxy fluctuations which coincide with the long-term 405 ka eccentricity cycle, the Reineche Member spanned 0,8 Myr. Wireline logging tools as gamma ray and sonic were used as a proxies to decipher cyclicity and trends in sedimentation and contribute to identifying and correlate units. There are used to constraint the highest frequency cyclicity modulated by a long term wavelength cycling apparently controlled by clay content. Interpreted as a result of variations in carbonate productivity, it has been suggested that the marl-limestone couplets, represent the sedimentary response to the orbital forcing. The calculation of cycle durations through Reineche Member, is used as a geochronometer and permit the astronomical calibration of the geologic time scale. Furthermore, MS coupled with carbonate contents, and fossil occurrences provide strong evidence for combined detrital inputs and marine surface carbonate productivity cycles. These two synchronous processes were driven by the precession index and ‘fingerprinted’ in the basic marl–limestone couplets, modulated by orbital eccentricity.

Keywords: magnetic susceptibility, cyclostratigraphy, orbital forcing, spectral analysis, Lutetian

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Authors: Antonio Martín-Pardo

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With regard to the context in which this paper is inserted, it is noteworthy that the current criminal policy model in which we find immersed, denominated by some doctrine sector as the citizen security model, is characterized by a marked tendency towards the discredit of expert knowledge. This type of technic knowledge has been displaced by the common sense and by the daily experience of the people at the time of legislative drafting, as well as by excessive attention to the short-term political effects of the law. Despite this criminal-political adverse scene, we still find valuable efforts in the side of experts to bring some rationality to the legislative development. This is the case of the proposal for a new cannabis regulation model in Spain carried out by the Cannabis Policy Studies Group (hereinafter referred as ‘GEPCA’). The GEPCA is a multidisciplinary group composed by authors with multiple/different orientations, trajectories and interests, but with a common minimum objective: the conviction that the current situation regarding cannabis is unsustainable and, that a rational legislative solution must be given to the growing social pressure for the regulation of their consumption and production. This paper details the main lines through which this technical proposal is developed with the purpose of its dissemination and discussion in the Congress. The basic methodology of the proposal is inductive-expository. In that way, firstly, we will offer a brief, but solid contextualization of the situation of cannabis in Spain. This contextualization will touch on issues such as the national regulatory situation and its relationship with the international context; the criminal, judicial and penitentiary impact of the offer and consumption of cannabis, or the therapeutic use of the substance, among others. In second place, we will get down to the business properly by detailing the minutia of the three main cannabis access channels that are proposed. Namely: the regulated market, the associations of cannabis users and personal self-cultivation. In each of these options, especially in the first two, special attention will be paid to both, the production and processing of the substance and the necessary administrative control of the activity. Finally, in a third block, some notes will be given on a series of subjects that surround the different access options just mentioned above and that give fullness and coherence to the proposal outlined. Among those related issues we find some such as consumption and tenure of the substance; the issue of advertising and promotion of cannabis; consumption in areas of special risk (work or driving v. g.); the tax regime; the need to articulate evaluation instruments for the entire process; etc. The main conclusion drawn from the analysis of the proposal is the unsustainability of the current repressive system, clearly unsuccessful, and the need to develop new access routes to cannabis that guarantee both public health and the rights of people who have freely chosen to consume it.

Keywords: cannabis regulation proposal, cannabis policies studies group, criminal policy, expertise participation

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Authors: Kever Bruno Paradelo Gomes, Rosana Carvalho Martins

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The home gardens areas are production systems, which are located near the homes and are quite common in the tropics. They consist of agricultural and forest species and may also involve the raising of small animals to produce food for subsistence as well as income generation, with a special focus on the conservation of biodiversity. Home gardens are diverse Agroforestry systems with multiple uses, among many, food security, income aid, traditional medicine. The work was carried out on rural properties of the family farmers of the Ponte Alta Rural Nucleus, Gama Administrative Region, in the city of Brasília, Federal District- Brazil. The present research is characterized methodologically as a quantitative, exploratory and descriptive nature. The instruments used in this research were: bibliographic survey and semi-structured questionnaire. The data collection was performed through the application of a semi-structured questionnaire, containing questions that referred to the perception and behavior of the interviewed producer on the subject under analysis. In each question, the respondent explained his knowledge about sustainability, agroecological practices, environmental legislation, conservation methods, forest and medicinal species, ago social and socioeconomic characteristics, use and purpose of agroforestry and technical assistance. The sample represented 55.62% of the universe of the study. We interviewed 99 people aged 18-83 years, with a mean age of 49 years. The low level of education, coupled with the lack of training and guidance for small family farmers in the Ponte Alta Rural Nucleus, is one of the limitations to the development of practices oriented towards sustainable and agroecological agriculture in the nucleus. It is observed that 50.5% of the interviewed people landed with agroforestry yards less than 20 years ago, and only 16.17% of them are older than 35 years. In identifying agriculture as the main activity of most of the rural properties studied, attention is drawn to the cultivation of medicinal plants, fruits and crops as the most extracted products. However, it is verified that the crops in the backyards have the exclusive purpose of family consumption, which could be complemented with the marketing of the surplus, as well as with the aggregation of value to the cultivated products. Initiatives such as this may contribute to the increase in family income and to the motivation and value of the crop in agroecological gardens. We conclude that home gardens of Ponte Alta are highly diverse thus contributing to local biodiversity conservation of are managed by women to ensure food security and allows income generation. The tradition of existing knowledge on the use and management of the diversity of resources used in agroforestry yards is of paramount importance for the development of sustainable alternative practices.

Keywords: agriculture, agroforestry system, rural development, sustainability

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Authors: María Luisa Gonzalez-SanJose, Mihaela Mihnea, Vicente Gomez-Miguel

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The zoning methodology currently recommended by the OIVV as official methodology to carry out viticulture zoning studies and to define and delimit the ‘terroirs’ has been applied in this study. This methodology has been successfully applied on the most significant an important Spanish Oenological D.O. regions, such as Ribera de Duero, Rioja, Rueda and Toro, but also it have been applied around the world in Portugal, different countries of South America, and so on. This is a complex methodology that uses edaphoclimatic data but also other corresponding to vineyards and other soils’ uses The methodology is useful to determine Homogeneous Soil Units (HSU) to different scale depending on the interest of each study, and has been applied from viticulture regions to particular vineyards. It seems that this methodology is an appropriate method to delimit correctly the medium in order to enhance its uses and to obtain the best viticulture and oenological products. The present work is focused on the comparison of volatile composition of wines made from grapes grown in different HSU that coexist in a particular viticulture region of Castile-Lion cited near to Burgos. Three different HSU were selected for this study. They represented around of 50% of the global area of vineyards of the studied region. Five different vineyards on each HSU under study were chosen. To reduce variability factors, other criteria were also considered as grape variety, clone, rootstocks, vineyard’s age, training systems and cultural practices. This study was carried out during three consecutive years, then wine from three different vintage were made and analysed. Different red wines were made from grapes harvested in the different vineyards under study. Grapes were harvested to ‘Technological maturity’, which are correlated with adequate levels of sugar, acidity, phenolic content (nowadays named phenolic maturity), good sanitary stages and adequate levels of aroma precursors. Results of the volatile profile of the wines produced from grapes of each HSU showed significant differences among them pointing out a direct effect of the edaphoclimatic characteristic of each UHT on the composition of the grapes and then on the volatile composition of the wines. Variability induced by HSU co-existed with the well-known inter-annual variability correlated mainly with the specific climatic conditions of each vintage, however was most intense, so the wine of each HSU were perfectly differenced. A discriminant analysis allowed to define the volatiles with discriminant capacities which were 21 of the 74 volatiles analysed. Detected discriminant volatiles were chemical different, although .most of them were esters, followed by were superior alcohols and fatty acid of short chain. Only one lactone and two aldehydes were selected as discriminant variable, and no varietal aroma compounds were selected, which agree with the fact that all the wine were made from the same grape variety.

Keywords: viticulture zoning, terroir, wine, volatile profile

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Authors: Uma Krishnamoorthy, Vivienne Beavers, Janet Marshall

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Introduction: Cervical cytology showing features raising the suspicion of non cervical glandular neoplasia are reported as code 0 under the United Kingdom National Health Service Cervical screening programme ( NHSCSP). As the suspicion is regarding non cervical neoplasia, smear is reported as normal and patient informed that cervical screening result is normal. GP receives copy of results where it states further referral is indicated in small font within text of report. Background: There were several incidents of delayed diagnosis of endometrial cancer in Lancashire which prompted this Northwest Regional review to enable an understanding of underlying pathology outcome of code zero smears to raise awareness and also to review whether further action on wording of smear results was indicated to prevent such delay. Methodology: All Smears reported at the Manchester cytology centre who process cytology for Lancashire population from March 2013 to March 2014 were reviewed and histological diagnosis outcome of women in whom smear was reported as code zero was reviewed retrospectively . Results: Total smears reported by the cytology centre during this period was approximately 109400. Reports issued with result code 0 among this during this time period was 49.Results revealed that among three fourth (37) of women with code zero smear (N=49), evidence of underlying pathology of non cervical origin was confirmed. Of this, 73 % (36) were due to endometrial pathology with 49 % (24) endometrial carcinoma, 12 % (6)polyp, 4 % atypical endometrial hyperplasia (2), 6 % endometrial hyperplasia without atypia (3), and 2 % adenomyosis (1 case) and 2 % ( 1 case) due to ovarian adenocarcinoma. Conclusion: This review demonstrated that more than half (51 %) of women with a code 0 smear report were diagnosed with underlying carcinoma and 75 % had a confirmed underlying pathology contributory to code 0 smear findings. Recommendations and Action Plan: A local rapid access referral and management pathway for this group of women was implemented as a result of this in our unit. The findings and Pathway were shared with other regional units served by the cytology centre through the Pan Lancashire cervical screening board and through the Cytology centre. Locally, the smear report wording was updated to include a rubber stamp/ print in "Red Bold letters" stating that " URGENT REFERRAL TO GYNAECOLOGY IS INDICATED". Findings were also shared through the Pan Lancashire board with National cervical screening programme board, and revisions to wording of code zero smear reports to highlight the need for Urgent referral has now been agreed at National level to be implemented.

Keywords: code zero smears, endometrial cancer, non cervical glandular neoplasia, ovarian cancer

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Authors: Jodie Lee, Lorena Chan, Esther Tong

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Hong Kong students face a unique learning environment. Starting from the 2010/2011 school year, The Education Bureau (EDB) of the Government of the Hong Kong Special Administrative Region implemented the fine-tuned Medium of Instruction (MOI) arrangements for secondary schools. Since then, secondary schools in Hong Kong have been given the flexibility to decide the most appropriate MOI arrangements for their schools and under the new academic structure for senior secondary education, particularly on the compulsory part of the mathematics curriculum. In 2019, Hong Kong Diploma of Secondary Education Examination (HKDSE), over 40% of school day candidates attempted the Mathematics Compulsory Part examination in the Chinese version while the rest took the English version. Moreover, only 14.38% of candidates sat for one of the extended Mathematics modules. This results in a serious of intricate issues to students’ learning in post-secondary education programmes. It is worth to note that when students further pursue to an higher education in Hong Kong or even oversea, they may facing substantial difficulties in transiting learning from learning mathematics in their mother tongue in Chinese-medium instruction (CMI) secondary schools to an English-medium learning environment. Some students understood the mathematics concepts were found to fail to fulfill the course requirements at college or university due to their learning experience in secondary study at CMI. They are particularly weak in comprehending the mathematics questions when they are doing their assessment or attempting the test/examination. A government funded project was conducted with the aims of providing integrated learning context and language support to students with a lower level of numeracy and/or with CMI learning experience. By introducing this “integrated concept + language mapping approach”, students can cope with the learning challenges in the compulsory English-medium mathematics and statistics subjects in their tertiary education. Ultimately, in the hope that students can enhance their mathematical ability, analytical skills, and numerical sense for their lifelong learning. The “Concept + Language Mapping “(CLM) approach was adopted and tried out in the bridging courses for students with a lower level of numeracy and/or with CMI learning experiences. At the beginning of each class, a pre-test was conducted, and class time was then devoted to introducing the concepts by CLM approach. For each concept, the key thematic items and their different semantic relations are presented using graphics and animations via the CLM approach. At the end of each class, a post-test was conducted. Quantitative data analysis was performed to study the effect on students’ learning via the CLM approach. Stakeholders' feedbacks were collected to estimate the effectiveness of the CLM approach in facilitating both content and language learning. The results based on both students’ and lecturers’ feedback indicated positive outcomes on adopting the CLM approach to enhance the mathematical ability and analytical skills of CMI students.

Keywords: mathematics, Concept+Language Mapping, level of numeracy, medium of instruction

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Authors: Jesika A. Walker, Mohammed Aswad, Guy Lacroix, Denis Cousineau

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There is a fundamental disconnect between the experience of time passing and the chronometric units by which time is quantified. Specifically, there appears to be no relationship between the passage of time judgments (PoTJs) and verbal duration estimates at short durations (e.g., < 2000 milliseconds). When a duration is longer than several minutes, however, evidence suggests that a slower feeling of time passing is predictive of overestimation. Might the length of a task moderate the relation between PoTJs and duration estimates? Similarly, the estimation paradigm (prospective vs. retrospective) and the mental effort demanded of a task (task demand) have both been found to influence duration estimates. However, only a handful of experiments have investigated these effects for tasks of long durations, and the results have been mixed. Thus, might the length of a task also moderate the effects of the estimation paradigm and task demand on duration estimates? To investigate these questions, 273 participants performed either an easy or difficult visual and memory search task for either eight or 58 minutes, under prospective or retrospective instructions. Afterward, participants provided a duration estimate in minutes, followed by a PoTJ on a Likert scale (1 = very slow, 7 = very fast). A 2 (prospective vs. retrospective) × 2 (eight minutes vs. 58 minutes) × 2 (high vs. low difficulty) between-subjects ANOVA revealed a two-way interaction between task demand and task duration on PoTJs, p = .02. Specifically, time felt faster in the more challenging task, but only in the eight-minute condition, p < .01. Duration estimates were transformed into RATIOs (estimate/actual duration) to standardize estimates across durations. An ANOVA revealed a two-way interaction between estimation paradigm and task duration, p = .03. Specifically, participants overestimated the task more if they were given prospective instructions, but only in the eight-minute task. Surprisingly, there was no effect of task difficulty on duration estimates. Thus, the demands of a task may influence ‘feeling of time’ and ‘estimation time’ differently, contributing to the existing theory that these two forms of time judgement rely on separate underlying cognitive mechanisms. Finally, a significant main effect of task duration was found for both PoTJs and duration estimates (ps < .001). Participants underestimated the 58-minute task (m = 42.5 minutes) and overestimated the eight-minute task (m = 10.7 minutes). Yet, they reported the 58-minute task as passing significantly slower on a Likert scale (m = 2.5) compared to the eight-minute task (m = 4.1). In fact, a significant correlation was found between PoTJ and duration estimation (r = .27, p <.001). This experiment thus provides evidence for a compensatory effect at longer durations, in which people underestimate a ‘slow feeling condition and overestimate a ‘fast feeling condition. The results are discussed in relation to heuristics that might alter the relationship between these two variables when conditions range from several minutes up to almost an hour.

Keywords: duration estimates, long durations, passage of time judgements, task demands

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Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

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Authors: Louise Reyntjens

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Where criminal law used to be the traditional response to cope with the terrorist threat, European governments are increasingly relying on administrative paths. The reliance on immigration law fits into this trend. Terrorism is seen as a civilization menace emanating from abroad. In this context, the expulsion of dangerous aliens, immigration law’s core task, is put forward as a key security tool. Governments all over Europe are focusing on removing dangerous individuals from their territory rather than bringing them to justice. This research reflects on the consequences for the expelled individuals’ fundamental rights. For this, the author selected four European countries for a comparative study: Belgium, France, the United Kingdom and Sweden. All these countries face similar social and security issues, igniting the recourse to immigration law as a counterterrorism tool. Yet, they adopt a very different approach on this: the United Kingdom positions itself on the repressive side of the spectrum. Sweden on the other hand, also 'securitized' its immigration policy after the recent terrorist hit in Stockholm, but remains on the tolerant side of the spectrum. Belgium and France are situated in between. This paper addresses the situation in Belgium. In 2017, the Belgian parliament introduced several legislative changes by which it considerably expanded and facilitated the possibility to expel unwanted aliens. First, the expulsion measure was subjected to new and questionably definitions: a serious attack on the nation’s safety used to be required to expel certain categories of aliens. Presently, mere suspicions suffice to fulfil the new definition of a 'serious threat to national security'. A definition which fails to respond to the principle of legality; the law, nor the prepatory works clarify what is meant by 'a threat to national security'. This creates the risk of submitting this concept’s interpretation almost entirely to the discretion of the immigration authorities. Secondly, in name of intervening more quickly and efficiently, the automatic suspensive appeal for expulsions was abolished. The European Court of Human Rights nonetheless requires such an automatic suspensive appeal under Article 13 and 3 of the Convention. Whether this procedural reform will stand to endure, is thus questionable. This contribution also raises questions regarding expulsion’s efficacy as a key security tool. In a globalized and mobilized world, particularly in a European Union with no internal boundaries, questions can be raised about the usefulness of this measure. Even more so, by simply expelling a dangerous individual, States avoid their responsibility and shift the risk to another State. Criminal law might in these instances be more capable of providing a conclusive and long term response. This contribution explores the human rights consequences of expulsion as a security tool in Belgium. It also offers a critical view on its efficacy for protecting national security.

Keywords: Belgium, counter-terrorism and human rights, expulsion, immigration law

Procedia PDF Downloads 99

Authors: A. M. Isakhanyan, F. N. Tkhruni, N. N. Yakimovich, Z. I. Kuvaeva, T. V. Khachatryan

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Introduction: At present, the simbiotics based on different genera and species of lactic acid bacteria (LAB) and yeasts are used. One of the basic properties of probiotics is presence of antimicrobial activity and therefore selection of LAB and yeast strains for their co-cultivation with the aim of increasing of the activity is topical. Since probiotic yeast and bacteria have different mechanisms of action, natural synergies between species, higher viability and increasing of antimicrobial activity might be expected from mixing both types of probiotics. Endemic strains of LAB Enterococcus faecium БТK-64, Lactobaccilus plantarum БТK-66, Pediococcus pentosus БТK-28, Lactobacillus rhamnosus БТK-109 and Kluyveromyces lactis БТX-412, Saccharomycopsis sp. БТX- 151 strains of yeast, with probiotic properties and hight antimicrobial activity, were selected. Strains are deposited in "Microbial Depository Center" (MDC) SPC "Armbiotechnology". Methods: LAB and yeast strains were isolated from different dairy products from rural households of Armenia. The genotyping by 16S rRNA sequencing for LAB and 26S RNA sequencing for yeast were used. Combined cultivation of LAB and yeast strains was carried out in the nutrient media on the basis of milk whey, in anaerobic conditions (without shaker, in a thermostat at 37oC, 48 hours). The complex preparations were obtained by purification of cell free culture broth (CFC) broth by the combination of ion-exchange chromatography and gel filtration methods. The spot-on-lawn method was applied for determination of antimicrobial activity and expressed in arbitrary units (AU/ml). Results. The obtained data showed that at the combined growth of bacteria and yeasts, the cultivation conditions (medium composition, time of growth, genera of LAB and yeasts) affected the display of antimicrobial activity. Purification of CFC broth allowed obtaining partially purified antimicrobial complex preparation which contains metabiotics from both bacteria and yeast. The complex preparation inhibited the growth of pathogenic and conditionally pathogenic bacteria, isolated from various internal organs from diseased animals and poultry with greater efficiency than the preparations derived individually alone from yeast and LAB strains. Discussion. Thus, our data shown perspectives of creation of a new class of antimicrobial preparations on the basis of combined cultivation of endemic strains of LAB and yeast. Obtained results suggest the prospect of use of the partially purified complex preparations instead antibiotics in the agriculture and for food safety. Acknowledgments: This work was supported by the RA MES State Committee of Science and Belarus National Foundation for Basic Research in the frames of the joint Armenian - Belarusian joint research project 13РБ-064.

Keywords: co-cultivation, antimicrobial activity, biosafety, metabiotics, lactic acid bacteria, yeast

Procedia PDF Downloads 313

Authors: Serap Gedikli, Hakan Çakmak, M. Buğra Güldiken, Duygu Yalnızoğlu

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Air, which is necessary for living things to survive; while it carries some useful substances in it, it can also carry foreign particles of different sizes that may be harmful to the health. All airborne organic substances of biological origin, including bacteria, fungi, fungal spores, viruses, pollen, and their components, are called "bioaerosols". Nowadays, everyone spends most of their time in closed areas such as home, workplace, school, etc. Although it is known that outdoor air pollution affects health, it is not known that indoor air pollution has harmful effects in terms of health. In this study, indoor air microbial load and SARS-CoV-2 virus cleaning efficiency of Froumann brand air cleaners were studied. This work in 300 m³, 600 m³, and 1000 m³ completely closed areas without any air circulation with Froumann N80, N90, and N100 air-cleaning devices. Analyzes were performed for both areas at 60 minutes before and after the device was operated using a particle measuring device (Particles Plus 7302) and an air sampler (Mas-100 ECO). The measurements were taken by placing the test equipment 1.5-2 m away from the air cleaner. At the same time, the efficiency of the HEPA filter was evaluated by taking samples from the air outlet point of the HEPA filter using the air sampling device (Mas-100 ECO) after the device was started. Nutrient agar and malt agar are used as total mesophilic bacteria and total fungi. The number of colony-forming units per m³ (cfu/m³) was calculated by counting colonies in Petri dishes after incubation for 48 hours at 37°C for bacteria and 72 hours at 30°C for fungi. The change in the number of colonies and the decrease in the microbial load was calculated as a percentage value. SARS-CoV-2 activity analysis studies were carried out by İnönü University Microbiology Department in accordance with the World Health Organization regulations. Finally, the HEPA filter in the devices used was taken and kept under a certain temperature and humidity, and the change in the microbial load on it was monitored over a 6-month period. At the end of the studies, a 91%-94% reduction was determined in the total mesophilic bacteria count of Frouman brand N80, N90, and N100 model air cleaners. A decrease of 94%-96% was detected in the total number of yeast/molds. HEPA filter efficiency was evaluated, and at the end of the analysis, 98% of the bacterial load and approximately 100% of yeast/mold load at the HEPA filter air outlet point were decreased. According to the SARS- CoV-2 analysis results, when the device is operating at the medium airflow level 3, it can filter virus-carrying aerosols by 99%. As a result, it was determined that the Froumann model air cleaner was effective in controlling and reducing the microbial load in the indoor air.

Keywords: HEPA filter, indoor air quality, microbial load, SARS-CoV-2

Procedia PDF Downloads 170

Authors: María Luisa Gonzalez-SanJose, Javier Garcia-Lomillo, Raquel Del Pino, Miriam Ortega-Heras, Maria Dolores Rivero-Perez, Pilar Muñiz-Rodriguez

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One of the most preoccupant problems related to the diet of the occidental societies is the high salt intake. In Spain, salt intake is almost twice as recommended by the World Health Organization (WHO). A lot of negative health effects of high sodium intake have been described being the hypertension, cardiovascular and coronary diseases ones of the most important. Due to this fact, government and other institutions are working on the gradual reduction of this consumption. Intake of meat products have been described as the main processed products that bring salt to the diet, followed by snacks and savory crackers. However, fortunately, the food industry has also raised awareness of this problem and is working intensely, and in recent years attempts to reduce the salt content in processed products, and is developing special lines with low sodium content. It is important to consider that processed food are the main source of sodium in occidental countries. One of the possible strategies to reduce the salt content in food is to find substitutes that can emulate their taste properties without adding much sodium or products that mask or substitute salty sensations with other flavors and aromas. In this sense, multiple products have been proposed and used until now. Potassium salts produce similar salty sensations without bring sodium, however their intake should be also limited, by healthy reasons. Furthermore, some potassium salts shows some better notes. Other alternatives are the use of flavor enhancers, spices, aromatic herbs, sea-plant derivate products, etc. The wine pomace is rich in potassium salts, content organic acid and other flavored substances, therefore it could be an interesting raw material to obtain derived products that could be useful as alternative ‘seasonings’. Considering previous comments, the main aim of this study was to evaluate the possible use of a natural seasoning, made from red wine pomace, in two different foods, crackers and burgers. The seasoning was made in the pilot plant of food technology of the University of Burgos, where the studied crackers and patties were also made. Different members of the University, students, docent and administrative personal, taste the products, and a trained panel evaluated salty intensity. The seasoning in addition to potassium contain significant levels of dietary fiber and phenolic compounds, which also makes it interesting as a functional ingredient. Both burgers and crackers made with the seasoning showed better taste that those without salt. Obviously, they showed lower sodium content than normal formulation, and were richer in potassium, antioxidant and fiber. Then, they showed lower values of the relation Na/K. All these facts are correlated with more ‘healthy’ products especially to that people with hypertension and other coronary dysfunctions.

Keywords: healthy foods, low salt, seasoning, wine pomace

Procedia PDF Downloads 251

Authors: Mohamed Adel Ahmed, Warda Youssef Morsy , Hanaa Ali El Feky

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Background: Literature review cited that sleep is absolutely essential for surviving and reclamation of the quality of life. Critically ill patients often have poor sleep quality with prolonged sleep latency, sleep fragmentation, decreased sleep efficiency and frequent arousals. Nurses have a unique role for the early diagnosis of sleep disorders, decreasing stressors levels and providing the necessary environmental regulations to create a therapeutic ambiance. The aim of the study: to assess perceived sleep quality and identify factors affecting sleep quality among adult critically ill patients At El Manial University Hospital. Research Design: A descriptive exploratory design was utilized. Research questions: a) how do adult critically ill patients perceive sleep quality in the Critical Care Department of El Manial University Hospital? b) What are the factors affecting sleep quality among adult critically ill patients at El Manial University Hospital? Setting: selected critical and cardiac care units at El Manial University Hospital. Sample: A samples of convenience consisting of 100 adult male and female patients were included in the study. Tools of data collection: tool 1: Socio-demographic and Medical Data Sheet, tool 2: Modified St Mary's Hospital Sleep Questionnaire tool 3: Factors Affecting Sleep Quality Questionnaire among ICU Patients Results: The current study revealed that 76.0% of the studied sample had lack of sleep disturbance before hospitalization. However, 84 % had sleep disturbances during ICU stay, of these more than two-thirds (67 %) had moderate sleep disturbance. Presence of strange and bad odors, noise, having pain, fear of death and a loud voice produced by the ICU personnel had the most significant negative impact on patients’ sleep in percentage of 52.4, 50, 61.9, 45.2, 52.4, respectively. Conclusion: Sleep disturbances in the ICU are multifactorial, and ICU patients’ perceived degrees of sleep disturbance as a moderate. Recommendations: Based on findings of the present study, the following are recommended to be done by ICU nurses; create a healing ICU environment that should incorporate noise, light and temperature controls; decrease stimuli during night time hours to promote regulation of the circadian rhythm, allow usage of sleeping aids such as relaxing music, eye patches and earplugs into their daily nursing practice; cluster nursing activities and eliminate non-essential treatments during night time hours to allow uninterrupted sleep periods of at least 90 minutes to complete one sleep cycle , and minimize staff conversation, alarm noise and light during the quiet night time hours.

Keywords: sleep quality, critically ill, patients, perception

Procedia PDF Downloads 422

Authors: Mohamed Elmeshad

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During the mid-1990's Egypt had become obliged to implement the Economic Reform and Structural Adjustment Program that included broad economic liberalization, expansion of the private sector and a contraction the size of government spending. This coincided as well with attempts to appear more democratic and open to liberalizing public space and discourse. At the same time, economic pressures and the proliferation of social media access and activism had led to increased pressure to open a mediascape and remove it from the clutches of the government, which had monopolized print and broadcast mass media for over 4 decades by that point. However, the mechanisms that governed the privatization of mass media allowed for sustained government control, even through the prism of ostensibly privately owned newspapers and television stations. These mechanisms involve barriers to entry from a financial and security perspective, as well as operational capacities of distribution and access to means of production. The power dynamics between mass media establishments and the state were moulded during this period in a novel way. Power dynamics within media establishments had also formed under such circumstances. The changes in the country's political economy itself somehow mirrored these developments. This paper will examine these dynamics and shed light on the political economy of Egypt's newly privatized mass media in the early 2000's especially. Methodology: This study will rely on semi-structured interviews from individuals involved with these changes from the perspective of the media organizations. It also will map out the process of media privatization by looking at the administrative, operative and legislative institutions and contexts in order to attempt to draw conclusions on methods of control and the role of the state during the process of privatization. Finally, a brief discourse analysis will be necessary in order to aptly convey how these factors ultimately reflected on media output. Findings and conclusion: The development of Egyptian private, “independent” mirrored the trajectory of transitions in the country’s political economy. Liberalization of the economy meant that a growing class of business owners would explore opportunities that such new markets would offer. However the regime’s attempts to control access to certain forms of capital, especially in sectors such as the media affected the structure of print and broadcast media, as well as the institutions that would govern them. Like the process of liberalisation, much of the regime’s manoeuvring with regards to privatization of media had been haphazardly used to indirectly expand the regime and its ruling party’s ability to retain influence, while creating a believable façade of openness. In this paper, we will attempt to uncover these mechanisms and analyse our findings in ways that explain how the manifestations prevalent in the context of a privatizing media space in a transitional Egypt provide evidence of both the intentions of this transition, and the ways in which it was being held back.

Keywords: business, mass media, political economy, power, privatisation

Procedia PDF Downloads 208

Authors: Senait Belay Adugna, Mirutse Giday, Tsegahun Manyazewal

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Background: The emergence and resurgence of zoonotic diseases have continued to be a major threat to global health and the economy. Developing countries are particularly vulnerable due to agricultural expansions and the domestication of animals by humans. Scientifically sound clinical trials are important to find better ways to prevent, diagnose, and treat zoonotic diseases, while there is a lack of evidence to inform the clinical trials’ capacity and practice in countries highly affected by the diseases. This study aimed to investigate researchers’ perceptions and experiences in conducting clinical trials on zoonotic diseases in Ethiopia. Methods: This study employed a descriptive, qualitative study design. It included major academic and research institutions in Ethiopia that had active engagements in veterinary and public health research. It included the National Veterinary Institute, the National Animal Health Diagnostic and Investigation Center, the College of Veterinary Medicine at Addis Ababa University, the Ethiopian Public Health Institute, the Armauer Hansen Research Institute, and the College of Health Sciences at Addis Ababa University. In-depth interviews were conducted with 14 senior researcher investigators in the institutions who hold a proven exhibit primarily leading research activities or research units. Data were collected from October 2019 to April 2020. Data analysis was undertaken using open code 4.03 for qualitative data analysis. Results: Five major themes, with 18 sub-themes, emerged from the in-depth interview in connection. These were: challenges in the prevention, control, and treatment of zoonotic diseases; One Health approach to mitigate zoonotic diseases; personal and institutional experiences in conducting clinical trials on zoonotic diseases; barriers in conducting clinical trials towards zoonotic diseases; and strategies that promote conducting clinical trials on zoonotic diseases. Conducting clinical trials on zoonotic diseases in Ethiopia is hampered by a lack of clearly articulated ethics and regulatory frameworks, trial experts, financial resources, and good governance. Conclusions: In Ethiopia, conducting clinical trials on zoonotic diseases deserves due attention. Strengthening institutional and human resources capacity is a precondition to harnessing effective implementation of clinical trials on zoonotic diseases in the country. In Ethiopia, where skilled human resource is scarce, the One Health approach has the potential to form multidisciplinary teams to systematically improve clinical trials capacity and outcomes in the country.

Keywords: Ethiopia, clinical triak, zoonoses, disease

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Authors: Veli Durmus, Mert Uydaci

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Every patient who needs to get a medical treatment should share health-related personal data with healthcare providers. Therefore, personal health data plays an important role to make health decisions and identify health threats during every encounter between a patient and caregivers. In other words, health data can be defined as privacy and sensitive information which is protected by various health laws and regulations. In many cases, the data are an outcome of the confidential relationship between patients and their healthcare providers. Globally, almost all nations have own laws, regulations or rules in order to protect personal data. There is a variety of instruments that allow authorities to use the health data or to set the barriers data sharing across international borders. For instance, Directive 95/46/EC of the European Union (EU) (also known as EU Data Protection Directive) establishes harmonized rules in European borders. In addition, the General Data Protection Regulation (GDPR) will set further common principles in 2018. Because of close policy relationship with EU, this study provides not only information on regulations, directives but also how they play a role during the legislative process in Turkey. Even if the decision is controversial, the Board has recently stated that private or public healthcare institutions are responsible for the patient call system, for doctors to call people waiting outside a consultation room, to prevent unlawful processing of personal data and unlawful access to personal data during the treatment. In Turkey, vast majority private and public health organizations provide a service that ensures personal data (i.e. patient’s name and ID number) to call the patient. According to the Board’s decision, hospital or other healthcare institutions are obliged to take all necessary administrative precautions and provide technical support to protect patient privacy. However, this application does not effectively and efficiently performing in most health services. For this reason, it is important to draw a legal framework of personal health data by stating what is the main purpose of this regulation and how to deal with complicated issues on personal health data in Turkey. The research is descriptive on data protection law for health care setting in Turkey. Primary as well as secondary data has been used for the study. The primary data includes the information collected under current national and international regulations or law. Secondary data include publications, books, journals, empirical legal studies. Consequently, privacy and data protection regimes in health law show there are some obligations, principles and procedures which shall be binding upon natural or legal persons who process health-related personal data. A comparative approach presents there are significant differences in some EU member states due to different legal competencies, policies, and cultural factors. This selected study provides theoretical and practitioner implications by highlighting the need to illustrate the relationship between privacy and confidentiality in Personal Data Protection in Health Law. Furthermore, this paper would help to define the legal framework for the health law case studies on data protection and privacy.

Keywords: data protection, personal data, privacy, healthcare, health law

Procedia PDF Downloads 187

Authors: Selin Top, Raul Marcos, M. Sinan Bilgili

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Although there have been several studies related to collection, temporary storage, handling and disposal of solid wastes generated by hospitals, there are only a few studies related to liquid wastes generated by hospitals or hospital wastewaters. There is an important amount of water consumptions in hospitals. While minimum domestic water consumption per person is 100 L/day, water consumption per bed in hospitals is generally ranged between 400-1200 L. This high amount of consumption causes high amount of wastewater. The quantity of wastewater produced in a hospital depends on different factors: bed numbers, hospital age, accessibility to water, general services present inside the structure (kitchen, laundry, laboratory, diagnosis, radiology, and air conditioning), number and type of wards and units, institution management policies and awareness in managing the structure in safeguarding the environment, climate and cultural and geographic factors. In our country, characterization of hospital wastewaters conducted by classical parameters in a very few studies. However, as mentioned above, this type of wastewaters may contain different compounds than domestic wastewaters. Hospital Wastewater (HWW) is wastewater generated from all activities of the hospital, medical and non medical. Nowadays, hospitals are considered as one of the biggest sources of wastewater along with urban sources, agricultural effluents and industrial sources. As a health-care waste, hospital wastewater has the same quality as municipal wastewater, but may also potentially contain various hazardous components due to using disinfectants, pharmaceuticals, radionuclides and solvents making not suitable the connection of hospital wastewater to the municipal sewage network. These characteristics may represent a serious health hazard and children, adults and animals all have the potential to come into contact with this water. Therefore, the treatment of hospital wastewater is an important current interest point to focus on. This paper aims to approach on the investigation of hospital wastewater treatment by membrane systems. This study aim is to determined hospital wastewater’s characterization and also evaluates the efficiency of hospital wastewater treatment by high pressure filtration systems such as ultrafiltration (UF). Hospital wastewater samples were taken directly from sewage system from Şişli Etfal Training and Research Hospital, located in the district of Şişli, in the European part of Istanbul. The hospital is a 784 bed tertiary care center with a daily outpatient department of 3850 patients. Ultrafiltration membrane is used as an experimental treatment and the influence of the pressure exerted on the membranes was examined, ranging from 1 to 3 bar. The permeate flux across the membrane was observed to define the flooding membrane points. The global COD and BOD5 removal efficiencies were 54% and 75% respectively for ultrafiltration, all the SST removal efficiencies were above 90% and a successful removal of the pathological bacteria measured was achieved.

Keywords: hospital wastewater, membrane, ultrafiltration, treatment

Procedia PDF Downloads 275

Authors: Raman Sharma, Ashok Kumar, Vipin Koushal

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Healthcare facilities are always seen as places of haven and protection for managing the external incidents, but the situation becomes more difficult and challenging when such facilities themselves are affected from internal hazards. Such internal hazards are arguably more disruptive than external incidents affecting vulnerable ones, as patients are always dependent on supportive measures and are neither in a position to respond to such crisis situation nor do they know how to respond. The situation becomes more arduous and exigent to manage if, in case critical care areas like Intensive Care Units (ICUs) and Operating Rooms (OR) are convoluted. And, due to these complexities of patients’ in-housed there, it becomes difficult to move such critically ill patients on immediate basis. Healthcare organisations use different types of electrical equipment, inflammable liquids, and medical gases often at a single point of use, hence, any sort of error can spark the fire. Even though healthcare facilities face many fire hazards, damage caused by smoke rather than flames is often more severe. Besides burns, smoke inhalation is primary cause of fatality in fire-related incidents. The greatest cause of illness and mortality in fire victims, particularly in enclosed places, appears to be the inhalation of fire smoke, which contains a complex mixture of gases in addition to carbon monoxide. Therefore, healthcare organizations are required to have a well-planned disaster mitigation strategy, proactive and well prepared manpower to cater all types of exigencies resulting from internal as well as external hazards. This case report delineates a true OR fire incident in Emergency Operation Theatre (OT) of a tertiary care multispecialty hospital and details the real life evidence of the challenges encountered by OR staff in preserving both life and property. No adverse event was reported during or after this fire commotion, yet, this case report aimed to congregate the lessons identified of the incident in a sequential and logical manner. Also, timely smoke evacuation and preventing the spread of smoke to adjoining patient care areas by opting appropriate measures, viz. compartmentation, pressurisation, dilution, ventilation, buoyancy, and airflow, helped to reduce smoke-related fatalities. Henceforth, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer healthcare environment for every worker and patient.

Keywords: healthcare, fires, smoke, management, strategies

Procedia PDF Downloads 44

Authors: Rima Abu Jaber Bransi, Rawya Jarjoura Burbara

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This study deals with two pioneering approaches in teaching Arabic as a mother tongue: first, computerization of literary and functional texts in the mother tongue; second, the pioneering model in teaching writing skills by computerization. The significance of the study lies in its treatment of a serious problem that is faced in the era of technology, which is the widening gap between the pupils and their mother tongue. The innovation in the study is that it introduces modern methods and tools and a pioneering instructional model that turns the process of mother tongue teaching into an effective, meaningful, interesting and motivating experience. In view of the Arabic language diglossia, standard Arabic and spoken Arabic, which constitutes a serious problem to the pupil in understanding unused words, and in order to bridge the gap between the pupils and their mother tongue, we resorted to computerized techniques; we took texts from the pre-Islamic period (Jahiliyya), starting with the Mu'allaqa of Imru' al-Qais and other selected functional texts and computerized them for teaching in an interesting way that saves time and effort, develops high thinking strategies, expands the literary good taste among the pupils, and gives the text added values that neither the book, the blackboard, the teacher nor the worksheets provide. On the other hand, we have developed a pioneering computerized model that aims to develop the pupil's ability to think, to provide his imagination with the elements of growth, invention and connection, and motivate him to be creative, and raise level of his scores and scholastic achievements. The model consists of four basic stages in teaching according to the following order: 1. The Preparatory stage, 2. The reading comprehension stage, 3. The writing stage, 4. The evaluation stage. Our lecture will introduce a detailed description of the model with illustrations and samples from the units that we built through highlighting some aspects of the uniqueness and innovation that are specific to this model and the different integrated tools and techniques that we developed. One of the most significant conclusions of this research is that teaching languages through the employment of new computerized strategies is very likely to get the Arabic speaking pupils out of the circle of passive reception into active and serious action and interaction. The study also emphasizes the argument that the computerized model of teaching can change the role of the pupil's mind from being a store of knowledge for a short time into a partner in producing knowledge and storing it in a coherent way that prevents its forgetfulness and keeping it in memory for a long period of time. Consequently, the learners also turn into partners in evaluation by expressing their views, giving their notes and observations, and application of the method of peer-teaching and learning.

Keywords: classical poetry, computerization, diglossia, writing skill

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Authors: Varun Agarwal

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Introduction: With the advent of personalized medicine, histopathological review of whole slide images (WSIs) for cancer diagnosis presents an exceedingly time-consuming, complex task. Specifically, detecting metastatic regions in WSIs of sentinel lymph node biopsies necessitates a full-scanned, holistic evaluation of the image. Thus, digital pathology, low-level image manipulation algorithms, and machine learning provide significant advancements in improving the efficiency and accuracy of WSI analysis. Using Camelyon16 data, this paper proposes a deep learning pipeline to automate and ameliorate breast cancer metastasis localization and WSI classification. Methodology: The model broadly follows five stages -region of interest detection, WSI partitioning into image tiles, convolutional neural network (CNN) image-segment classifications, probabilistic mapping of tumor localizations, and further processing for whole WSI classification. Transfer learning is applied to the task, with the implementation of Inception-ResNetV2 - an effective CNN classifier that uses residual connections to enhance feature representation, adding convolved outputs in the inception unit to the proceeding input data. Moreover, in order to augment the performance of the transfer learning CNN, a stack of convolutional denoising autoencoders (CDAE) is applied to produce embeddings that enrich image representation. Through a saliency-detection algorithm, visual training segments are generated, which are then processed through a denoising autoencoder -primarily consisting of convolutional, leaky rectified linear unit, and batch normalization layers- and subsequently a contrast-normalization function. A spatial pyramid pooling algorithm extracts the key features from the processed image, creating a viable feature map for the CNN that minimizes spatial resolution and noise. Results and Conclusion: The simplified and effective architecture of the fine-tuned transfer learning Inception-ResNetV2 network enhanced with the CDAE stack yields state of the art performance in WSI classification and tumor localization, achieving AUC scores of 0.947 and 0.753, respectively. The convolutional feature retention and compilation with the residual connections to inception units synergized with the input denoising algorithm enable the pipeline to serve as an effective, efficient tool in the histopathological review of WSIs.

Keywords: breast cancer, convolutional neural networks, metastasis mapping, whole slide images

Procedia PDF Downloads 107

Authors: Jaroslav Kraus

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Spatial information about demographic processes are a standard part of outputs in the Czech Republic. That was also the case of Population and Housing Census which was held on 2011. This is a starting point for a follow up study devoted to two basic types of households: single person households and households of one completed family. Single person households and one family households create more than 80 percent of all households, but the share and spatial structure is in long-term changing. The increase of single households is results of long-term fertility decrease and divorce increase, but also possibility of separate living. There are regions in the Czech Republic with traditional demographic behavior, and regions like capital Prague and some others with changing pattern. Population census is based - according to international standards - on the concept of currently living population. Three types of geospatial approaches will be used for analysis: (i) firstly measures of geographic distribution, (ii) secondly mapping clusters to identify the locations of statistically significant hot spots, cold spots, spatial outliers, and similar features and (iii) finally analyzing pattern approach as a starting point for more in-depth analyses (geospatial regression) in the future will be also applied. For analysis of this type of data, number of households by types should be distinct objects. All events in a meaningful delimited study region (e.g. municipalities) will be included in an analysis. Commonly produced measures of central tendency and spread will include: identification of the location of the center of the point set (by NUTS3 level); identification of the median center and standard distance, weighted standard distance and standard deviational ellipses will be also used. Identifying that clustering exists in census households datasets does not provide a detailed picture of the nature and pattern of clustering but will be helpful to apply simple hot-spot (and cold spot) identification techniques to such datasets. Once the spatial structure of households will be determined, any particular measure of autocorrelation can be constructed by defining a way of measuring the difference between location attribute values. The most widely used measure is Moran’s I that will be applied to municipal units where numerical ratio is calculated. Local statistics arise naturally out of any of the methods for measuring spatial autocorrelation and will be applied to development of localized variants of almost any standard summary statistic. Local Moran’s I will give an indication of household data homogeneity and diversity on a municipal level.

Keywords: census, geo-demography, households, the Czech Republic

Procedia PDF Downloads 82

Authors: Sami Alanazi

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Teamwork practices have been recognized as a significant strategy to improve patient safety, quality of care, and staff and patient satisfaction in healthcare settings, particularly within the emergency department (ED). The EDs depend heavily on teams of interdisciplinary healthcare staff to carry out their operational goals and core business of providing care to the serious illness and injured. The ED is also recognized as a high-risk area in relation to service demand and the potential for human error. Few studies have considered the perceptions and experiences of the ED staff (physicians, nurses, allied health professionals, and administration staff) about the practice of teamwork, especially in Saudi Arabia (SA), and no studies have been conducted to explore the practices of teamwork in the EDs. Aim: To explore the practices of teamwork from the perspectives and experiences of staff (physicians, nurses, allied health professionals, and administration staff) when interacting with each other in the admission areas in the ED of a public hospital in the Northern Border region of SA. Method: A qualitative case study design was utilized, drawing on two methods for the data collection, comprising of semi-structured interviews (n=22) with physicians (6), nurses (10), allied health professionals (3), and administrative members (3) working in the ED of a hospital in the Northern Border region of SA. The second method is non-participant direct observation. All data were analyzed using thematic analysis. Findings: The main themes that emerged from the analysis were as follows: the meaningful of teamwork, reasons of teamwork, the ED environmental factors, the organizational factors, the value of communication, leadership, teamwork skills in the ED, team members' behaviors, multicultural teamwork, and patients and families behaviors theme. Discussion: Working in the ED environment played a major role in affecting work performance as well as team dynamics. However, Communication, time management, fast-paced performance, multitasking, motivation, leadership, and stress management were highlighted by the participants as fundamental skills that have a major impact on team members and patients in the ED. It was found that the behaviors of the team members impacted the team dynamics as well as ED health services. Behaviors such as disputes among team members, conflict, cooperation, uncooperative members, neglect, and emotions of the members. Besides that, the behaviors of the patients and their accompanies had a direct impact on the team and the quality of the services. In addition, the differences in the cultures have separated the team members and created undesirable gaps such the gender segregation, national origin discrimination, and similarity and different in interests. Conclusion: Effective teamwork, in the context of the emergency department, was recognized as an essential element to obtain the quality of care as well as improve staff satisfaction.

Keywords: teamwork, barrier, facilitator, emergencydepartment

Procedia PDF Downloads 105

Authors: Shahid Razzaq

Abstract:

The governments around the globe have started taking into considerations the knowledge management dynamics while formulating, implementing, and evaluating the strategies, with or without the conscious realization, for the different public sector organizations and public policy developments. Health Department of Punjab province in Pakistan is striving to deliver quality healthcare services to the community through an efficient and effective service delivery system. Despite of this struggle some employee performance issues yet exists in the form of challenge to government. To overcome these issues department took several steps including HR strategies, use of technologies and focus of hard issues. Consequently, this study was attempted to highlight the importance of soft issue that is knowledge management in its true essence to tackle their performance issues. Knowledge management in public sector is quite an ignored area in the knowledge management-a growing multidisciplinary research discipline. Knowledge-based view of the firm theory asserts the knowledge is the most deliberate resource that can result in competitive advantage for an organization over the other competing organizations. In the context of our study it means for gaining employee performance, organizations have to increase the heterogeneous knowledge bases. The study uses the cross-sectional and quantitative research design. The data is collected from the knowledge workers of Health Department of Punjab, the biggest province of Pakistan. A total of 341 sample size is achieved. The SmartPLS 3 Version 2.6 is used for analyzing the data. The data examination revealed that knowledge management processes has a strong impact on knowledge worker performance. All hypotheses are accepted according to the results. Therefore, it can be summed up that to increase the employee performance knowledge management activities should be implemented. Health Department within province of Punjab introduces the knowledge management infrastructure and systems to make effective availability of knowledge for the service staff. This knowledge management infrastructure resulted in an increase in the knowledge management process in different remote hospitals, basic health units and care centers which resulted in greater service provisions to public. This study is to have theoretical and practical significances. In terms of theoretical contribution, this study is to establish the relationship between knowledge management and performance for the first time. In case of the practical contribution, this study is to give an insight to public sector organizations and government about role of knowledge management in employ performance. Therefore, public policymakers are strongly advised to implement the activities of knowledge management for enhancing the performance of knowledge workers. The current research validated the substantial role of knowledge management in persuading and creating employee arrogances and behavioral objectives. To the best of authors’ knowledge, this study contribute to the impact of knowledge management on employee performance as its originality.

Keywords: employee performance, knowledge management, public sector, soft issues

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Authors: Zakhile Somlata

Abstract:

In the context of international linguistic and cultural diversity, all languages can be used for all purposes. Africa in general and South Africa, in particular, is not an exception to multilingual and multicultural society. The multilingual and multicultural nature of South African society has a direct bearing to the heterogeneity of South African Universities in general. Universities as the centers of research, innovation, and transformation of the entire society should be at the forefront in leading multilingualism. The universities in South Africa had been using English and to a certain extent Afrikaans as the only academic languages during colonialism and apartheid regime. The democratic breakthrough of 1994 brought linguistic relief in South Africa. The Constitution of the Republic of South Africa recognizes 11 official languages that should enjoy parity of esteem for the realization of multilingualism. The elevation of the nine previously marginalized indigenous African languages as academic languages in higher education is central to multilingualism. It is high time that Afrocentric model instead of Eurocentric model should be the one which underpins education system in South Africa at all levels. Almost all South African universities have their language policies that seek to promote access and success of students through multilingualism, but the main dilemma is the implementation of language policies. This study is significant to respond to two objectives: (i) To evaluate how selected institutions use language policies for accessibility and success of students. (ii) To study how selected universities integrate African languages for both academic and administrative purposes. This paper reflects the language policy practices in one selected University of Technology (UoT) in South Africa. The UoT has its own language policy which depicts linguistic diversity of the institution and its commitment to promote multilingualism. Translanguaging pedagogy which accommodates minority languages' usage in the teaching and learning process plays a pivotal role in promoting multilingualism. This research paper employs mixed methods (quantitative and qualitative research) approach. Qualitative data has been collected from the key informants (insiders and experts), while quantitative data has been collected from a cohort of third-year students. A mixed methods approach with its convergent parallel design allows the data to be collected separately, analysed separately but with the comparison of the results. Language development initiatives have been discussed within the framework of language policy and policy implementation strategies. Theoretically, this paper is rooted in language as a problem, language as a right and language as a resource. The findings demonstrate that despite being a multilingual institution, there is a perpetuation of marginalization of African languages to be used as academic languages. Findings further display the hegemony of English. The promotion of status quo compromises the promotion of multilingualism, Africanization of Higher Education and intellectualization of indigenous African languages in South Africa under a democratic dispensation.

Keywords: afro-centric model, hegemony of English, language as a resource, translanguaging pedagogy

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Authors: Aysen Celen Ozturk, Hatice Dulger

Abstract:

University may be defined as a teaching institution consisting of faculties, institutes, colleges, and units that have undergraduate and graduate education, scientific research and publications. It has scientific autonomy and public legal personality. Today, universities are not only the institutions in which students and lecturers experience education, training and scientific work. They also offer social, cultural and artistic activities that strengthen the link with the city. This also incorporates all city users into the campus borders. Thus, universities contribute to social and individual development of the country by providing science, art, socio-cultural development, communication and socialization with people of different cultural and social backgrounds. Moreover, universities provide an active social life, where the young population is the majority. This enables the sense of belonging to the users to develop, to increase the interaction between academicians and students, and to increase the learning / producing community by continuing academic sharing environments outside the classrooms. For this reason, besides academic spaces in university campuses, the users also need closed and open spaces where they can socialize, spend time together and relax. Public open spaces are the most important social spaces that individuals meet, express themselves and share. Individuals belonging to different socio-cultural structures and ethnic groups maintain their social experiences with the physical environment they are in, the outdoors, and their actions and sharing in these spaces. While university campuses are being designed for their individual and social development roles, user needs must be determined correctly and design should be realized in this direction. While considering that requirements may change over time, user satisfaction should be questioned at certain periods and new arrangements should be made in existing applications in the direction of current demands. This study aims to determine the user requirements through the case of Eskişehir Osmangazi University, Meşelik Campus / Turkey. Post Occupancy Evaluation (POE) questionnaire, cognitive mapping and deep interview methods are used in the research process. All these methods show that the students, academicians and other officials in the Meşelik Campus of Eskişehir Osmangazi University find way finding elements insufficient and are in need of efficient landscape design and social spaces. This study is important in terms of determining the needs of the users as a design input. This will help improving the quality of common space in Eskişehir Osmangazi University and in other similar universities.

Keywords: university campuses, public open space, user requirement, post occupancy evaluation

Procedia PDF Downloads 217