Search results for: hospital waste

Authors: Simplejit Kaur Dhanoa, Manmohan Singh

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This study was done with the primary objective to evaluate the motor and mental developmental delays among children having neonatal Jaundice. A total sample of 300 neonates were collected; out of them, 150 were preterm neonates, and 150 were full term neonates from the hospital setting and follow up study was done with the help of the Developmental Assessment scale of the Indian Infant. The registered samples were assessed up to 2.6 years with a gap of 6 months. The outcomes of this study reveal that developmental delays were present among children who had preterm neonatal jaundice as compare to full term normal babies. Further, It was reported that both motor and mental development is affected due to neonatal hyperbilirubinemia in addition to preterm birth.

Keywords: hyperbinirubinemia, preterm neonates, developmental delays, preterm

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Authors: Mekroud Amel

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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

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Authors: N. Gharooni-Dowrani, B. Gharooni-Dowrani

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The benefits of hilotherapy following orthogonathic surgery have been explored in recent years, demonstrating reduction in patient pain and swelling post-operatively. However, hilotherapy is not always widely accessible to all patients following orthognathic surgery. In this study, 50 patients were examined at Luton and Dunstable Hospital, half (25) of which used hilotherm masks post operatively and half of which opted for traditional ice packs in order to aid recovery. This study demonstrated that the use of hilotherapy reduced patient pain when analgesia need and use were analysed, as well as shortening inpatient stay. Although no current hilotherm masks are available without rental services in our trust, this study demonstrated the positive outcomes that they may bring, which may be worth future investment for our department.

Keywords: orthognathic surgery, orthodontics, hilotherapy, OMFS

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Authors: Seng Sing Tan

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Clamping of the umbilical cord after birth is widely practiced as a part of labor management. Further improvements were proposed to produce a smaller, lighter and more comfortable clamp while still maintaining current standards of clamping. A detachable holder was also developed to facilitate the clamping process. This pilot study on the efficacy of the mini-clamp was conducted to evaluate a tightness of the seal and a firm grip of the clamp on the umbilical cord. The study was carried out at National University Hospital, using 5 sets of placental cord. 18 samples of approximate 10 cm each were harvested. The test results showed that the mini-clamp was able to stop the flow through the cord after clamping without rupturing the cord. All slip tests passed with a load of 0.2 kg. In the pressure testing, 30kPa of saline was exerted into the umbilical veins. Although there was no physical sign of fluid leaking through the end secured by the mini-clamp, the results showed the pressure was not able to sustain the pressure set during the tests. 12 out of the 18 test samples have more than 7% of pressure drop in 30 seconds. During the pressure leak test, it was observed on several samples that when pressurized, small droplets of saline were growing on the outer surface of the cord lining membrane. It was thus hypothesized that the pressure drop was likely caused by the perfusion of the injected saline through the Wharton’s jelly and the cord lining membrane. The average pressure in the umbilical vein is roughly 2.67kPa (20 mmHg), less than 10% of 30kPa (~225mmHg), set for the pressure testing. As such, the pressure set could be over-specified, leading to undesirable outcomes. The development of the mini-clamp was an attempt to increase the comfort of newly born babies while maintaining the usability and efficacy of hospital grade umbilical cord clamp. The pressure leak in this study would be unfair to fully attribute it to the design and efficacy of the mini-clamp. Considering the unexpected leakage of saline through the umbilical membrane due to over-specified pressure exerted on the umbilical veins, improvements can definitely be made to the existing experimental setup to obtain a more accurate and conclusive outcome. If proven conclusive and effective, the mini-clamp with a detachable holder could be a smaller and potentially cheaper alternative to existing umbilical cord clamps. In addition, future clinical trials could be conducted to determine the user-friendliness of the mini-clamp and evaluate its practicality in the clinical setting by labor ward clinicians. A further potential improvement could be proposed on the sustainability factor of the mini-clamp. A biodegradable clamp would revolutionise the industry in this increasingly environmentally sustainability world.

Keywords: leak test, mini-clamp, slip test, umbilical cord

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Authors: Chandra Shekhar Majumder, Orin Sultana Jamie

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Background: Dacryocystorhinostomy (DCR) has been a widely accepted surgical intervention for nasolacrimal duct obstructions. Some previous studies demonstrated the potential benefits of the peroperative application of agents like Mitomycin-C (MMC) with DCR to improve surgical outcomes. Relevant studies are rare in Bangladesh, and there are controversies about the dose, duration of MMC, and outcome. Therefore, the present study aimed to investigate the comparative efficacy of DCR with and without MMC in a tertiary hospital in Bangladesh. Objective: The study aims to determine the outcome of a dacryocystorhinostomy with preoperative local use of mitomycin–C. Methods: An analytical study was conducted in the Department of Ophthalmology, Sir Salimullah Medical College & Mitford Hospital, Dhaka, from January 2023 to September 2023. Seventy patients who were admitted for DCR operation were included according to the inclusion and exclusion criteria. Patients were divided into two groups: those who underwent DCR with peroperative administration of 0.2 mg/ml Mitomycin-C for 5 minutes (Group I) and those who underwent DCR alone (Group II). All patients were subjected to detailed history taking, clinical examination, and relevant investigations. All patients underwent DCR according to standard guidelines and ensured the highest peroperative and postoperative care. Then, patients were followed up at 7th POD, 1-month POD, 3 months POD, and 6 months POD to observe the success rate between the two groups by assessing tearing condition, irrigation, height of tear meniscus, and FDDT- test. Data was recorded using a pre-structured questionnaire, and collected data were analyzed using SPSS 23. Results: The mean age of the study patients was 42.17±6.7 (SD) years and 42.29±7.1 (SD) years in Groups I and II, respectively, with no significant difference (p=0.945). At the 6th month’s follow-up, group I patients were observed with 94.3% frequency of symptom-free, 85.6% patency of lacrimal drainage system, 68.6% had tear meniscus <0.1mm and 88.6% had positive Fluorescence Dye Disappearance Test (FDDT test). In group II, 91.4% were symptom-free, 68.6% showed patency, 57.1% had a height of tear meniscus < 0.1 mm, and 85.6% had FDDT test positive. But no statistically significant difference was observed (p<.05). Conclusion: The use of Mitomycin-C preoperatively during DCR offers better postoperative outcomes, particularly in maintaining patency and achieving symptom resolution with more FDDT test positive and improvement of tear meniscus in the MMC group than the control group. However, this study didn’t demonstrate a statistically significant difference between the two groups. Further research with larger sample sizes and longer follow-up periods would be beneficial to corroborate these findings.

Keywords: dacryocystorhinostomy, mitomycin-c, dacryocystitis, nasolacrimal duct obstruction

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Authors: Andrew Fox, Tao Zhang, Yuanhong Zhao, Qingping Yang

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The furniture manufacturing industry has been slow in general to adopt the latest manufacturing technologies, historically relying heavily upon specialised conventional machinery. This approach not only requires high levels of specialist process knowledge, training, and capital investment but also suffers from significant subtractive manufacturing waste and high logistics costs due to the requirement for centralised manufacturing, with high levels of furniture product not re-cycled or re-used. This paper aims to address the problems by introducing suitable digital manufacturing technologies to create step changes in furniture manufacturing design, as the traditional design practices have been reported as building in 80% of environmental impact. In this paper, a 3D printing robot for furniture manufacturing is reported. The 3D printing robot mainly comprises a KUKA industrial robot, an Arduino microprocessor, and a self-assembled screw fed extruder. Compared to traditional 3D printer, the 3D printing robot has larger motion range and can be easily upgraded to enlarge the maximum size of the printed object. Generative design is also investigated in this paper, aiming to establish a combined design methodology that allows assessment of goals, constraints, materials, and manufacturing processes simultaneously. ‘Matrixing’ for part amalgamation and product performance optimisation is enabled. The generative design goals of integrated waste reduction increased manufacturing efficiency, optimised product performance, and reduced environmental impact institute a truly lean and innovative future design methodology. In addition, there is massive future potential to leverage Single Minute Exchange of Die (SMED) theory through generative design post-processing of geometry for robot manufacture, resulting in ‘mass customised’ furniture with virtually no setup requirements. These generatively designed products can be manufactured using the robot based additive manufacturing. Essentially, the 3D printing robot is already functional; some initial goals have been achieved and are also presented in this paper.

Keywords: additive manufacturing, generative design, robot, sustainability

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Authors: Chao Li, Lei Zhou, Ruiqi Ren, Dan Li, Yali Wang, Daxin Ni, Zijian Feng, Qun Li

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Background: In 2016, yellow fever had been first ever discovered in China, soon after the yellow fever epidemic occurred in Angola. After the discovery, China had promptly made the national protocol of control and prevention and strengthened the surveillance on passenger and vector. In this study, a descriptive analysis was conducted to summarize China’s experiences of response towards this import epidemic, in the hope of providing experiences on prevention and control of yellow fever and other similar imported infectious diseases in the future. Methods: The imported cases were discovered and reported by General Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) and several hospitals. Each clinically diagnosed yellow fever case was confirmed by real-time reverse transcriptase polymerase chain reaction (RT–PCR). The data of the imported yellow fever cases were collected by local Centers for Disease Control and Prevention (CDC) through field investigations soon after they received the reports. Results: A total of 11 imported cases from Angola were reported in China, during Angola’s yellow fever outbreak. Six cases were discovered by the AQSIQ, among which two with mild symptom were initiative declarations at the time of entry. Except for one death, the remaining 10 cases all had recovered after timely and proper treatment. All cases are Chinese, and lived in Luanda, the capital of Angola. 73% were retailers (8/11) from Fuqing city in Fujian province, and the other three were labors send by companies. 10 cases had experiences of medical treatment in Luanda after onset, among which 8 cases visited the same local Chinese medicine hospital (China Railway four Bureau Hospital). Among the 11 cases, only one case had an effective vaccination. The result of emergency surveillance for mosquito density showed that only 14 containers of water were found positive around places of three cases, and the Breteau Index is 15. Conclusions: Effective response was taken to control and prevent the outbreak of yellow fever in China after discovering the imported cases. However, though the similar origin of Chinese in Angola has provided an easy access for disease detection, information sharing, health education and vaccination on yellow fever; these conveniences were overlooked during previous disease prevention methods. Besides, only one case having effective vaccination revealed the inadequate capacity of immunization service in China. These findings will provide suggestions to improve China’s capacity to deal with not only yellow fever but also other similar imported diseases in China.

Keywords: yellow fever, first import, China, suggestion

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Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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Authors: Ilze Dimanta, Zane Rutkovska, Vizma Nikolajeva, Janis Kleperis, Indrikis Muiznieks

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Majority of word’s steadily increasing energy consumption is provided by non-renewable fossil resources. Need to find an alternative energy resource is essential for further socio-economic development. Hydrogen is renewable, clean energy carrier with high energy density (142 MJ/kg, accordingly – oil has 42 MJ/kg). Biological hydrogen production is an alternative way to produce hydrogen from renewable resources, e.g. using organic waste material resource fermentation that facilitate recycling of sewage and are environmentally benign. Hydrogen gas is produced during the fermentation process of bacteria in anaerobic conditions. Bacteria are producing hydrogen in the liquid phase and when thermodynamic equilibrium is reached, hydrogen is diffusing from liquid to gaseous phase. Because of large quantities of available crude glycerol and the highly reduced nature of carbon in glycerol per se, microbial conversion of it seems to be economically and environmentally viable possibility. Such industrial organic waste product as crude glycerol is perspective for usage in feedstock for hydrogen producing bacteria. The process of biodiesel production results in 41% (w/w) of crude glycerol. The developed lab-scale test system (experimental bioreactor) with hydrogen micro-electrode (Unisense, Denmark) was used to determine hydrogen production yield and rate in the liquid phase. For hydrogen analysis in the gas phase the RGAPro-100 mass-spectrometer connected to the experimental test-system was used. Fermentative bacteria strains were tested for hydrogen gas production rates. The presence of hydrogen in gaseous phase was measured using mass spectrometer but registered concentrations were comparatively small. To decrease the hydrogen partial pressure in liquid phase reactor with a system for continuous bubbling with inert gas was developed. H2 production rate for the best producer in liquid phase reached 0,40 mmol H2/l, in gaseous phase - 1,32 mmol H2/l. Hydrogen production rate is time dependent – higher rate of hydrogen production is at the fermentation process beginning when concentration increases, but after three hours of fermentation, it decreases.

Keywords: bio-hydrogen, fermentation, experimental bioreactor, crude glycerol

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Authors: Keith D. Nare, Mohau J. Phiri, James Carson, Chris D. Woolard, Shanganyane P. Hlangothi

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In an energy-intensive world, minimizing energy consumption is paramount to cost saving and reducing the carbon footprint. Improving mixture procedures utilizing warm mix additive Fischer-Tropsch (FT) wax in ethylene vinyl acetate (EVA) and modified bitumen highlights a greener and sustainable approach to modified bitumen. In this study, the impact of FT wax on optimized EVA/waste crumb rubber modified bitumen is assayed with a maximum loading of 2.5%. The rationale of the FT wax loading is to maintain the original maximum loading of EVA in the optimized mixture. The phase change abilities of FT wax enable EVA co-crystallization with the support of the elastomeric backbone of crumb rubber. Less than 1% loading of FT wax worked in the EVA/crumb rubber modified bitumen energy-sustainability nexus. Response surface methodology approach to the mixture design is implemented amongst the different loadings of FT wax, EVA for a consistent amount of crumb rubber and bitumen. Rheological parameters (complex shear modulus, phase angle and rutting parameter) were the factors used as performance indicators of the different optimized mixtures. The low temperature chemistry of the optimized mixtures is analyzed using elementary beam theory and the elastic-viscoelastic correspondence principle. Master curves and black space diagrams are developed and used to predict age-induced cracking of the different long term aged mixtures. Modified binder rheology reveals that the strain response is not linear and that there is substantial re-arrangement of polymer chains as stress is increased, this is based on the age state of the mixture and the FT wax and EVA loadings. Dominance of individual effects is evident over effects of synergy in co-interaction of EVA and FT wax. All-inclusive FT wax and EVA formulations were best optimized in mixture 4 with mixture 7 reflecting increase in ease of workability. Findings show that interaction chemistry of bitumen, crumb rubber EVA, and FT wax is first and second order in all cases involving individual contributions and co-interaction amongst the components of the mixture.

Keywords: bitumen, crumb rubber, ethylene vinyl acetate, FT wax

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Authors: Elda Maraj, Shkelqim Kuka

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Coronary heart disease causes many deaths in the world. Unfortunately, this problem will continue to increase in the future. In this paper, a fuzzy logic model to predict coronary heart disease is presented. This model has been developed with seven input variables and one output variable that was implemented for 30 patients in Albania. Here fuzzy logic toolbox of MATLAB is used. Fuzzy model inputs are considered as cholesterol, blood pressure, physical activity, age, BMI, smoking, and diabetes, whereas the output is the disease classification. The fuzzy sets and membership functions are chosen in an appropriate manner. Centroid method is used for defuzzification. The database is taken from University Hospital Center "Mother Teresa" in Tirana, Albania.

Keywords: coronary heart disease, fuzzy logic toolbox, membership function, prediction model

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Authors: Ouabo Emmanuel Romaric, Amougou Armathe

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Background and aim: The study of impacts of floods and landslides at a small scale, specifically in the urban areas of developing countries is done to provide tools and actors for a better management of risks in such areas, which are now being affected by climate change. The main objective of this study is to assess the hydrometeorological vulnerabilities associated with flooding and urban landslides to propose adaptation measures. Methods: Climatic data analyses were done by calculation of indices of climate change within 50 years (1960-2012). Analyses of field data to determine causes, the level of risk and its consequences on the area of study was carried out using SPSS 18 software. The cartographic analysis and GIS were used to refine the work in space. Then, spatial and terrain analyses were carried out to determine the morphology of field in relation with floods and landslide, and the diffusion on the field. Results: The interannual changes in precipitation has highlighted the surplus years (21), the deficit years (24) and normal years (7). Barakat method bring out evolution of precipitation by jerks and jumps. Floods and landslides are correlated to high precipitation during surplus and normal years. Data field analyses show that populations are conscious (78%) of the risks with 74% of them exposed, but their capacities of adaptation is very low (51%). Floods are the main risk. The soils are classed as feralitic (80%), hydromorphic (15%) and raw mineral (5%). Slope variation (5% to 15%) of small hills and deep valley with anarchic construction favor flood and landslide during heavy precipitation. Mismanagement of waste produce blocks free circulation of river and accentuate floods. Conclusion: Vulnerability of population to hydrometeorological risks in Yaoundé VI is the combination of variation of parameters like precipitation, temperature due to climate change, and the bad planning of construction in urban areas. Because of lack of channels for water to circulate due to saturation of soils, the increase of heavy precipitation and mismanagement of waste, the result are floods and landslides which causes many damages on goods and people.

Keywords: climate change, floods, hydrometeorological, vulnerability

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Authors: N. B. Ikenweiwe, A. A. Alimi, N. A. Bamidele, A. O. Ewumi, J. Dairo, I. A. Akinnubi, S. O. Otubusin

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A study on the physical, chemical and biological parameters of the lower course of Ogun River, Isheri-Olofin was carried out between January and December 2014 in order to determine the effects of the anthropogenic activities of the Kara abattoir and domestic waste depositions on the quality of the water. Water samples were taken twice each month at three selected stations A, B and C (based on characteristic features or activity levels) along the water course. Samples were analysed using standard methods for chemical and biological parameters the same day in the laboratory while physical parameters were determined in-situ with water parameters kit. Generally, results of Transparency, Dissolved Oxygen, Nitrates, TDS and Alkalinity fall below the permissible limits of WHO and FEPA standards for drinking and fish production. Results of phosphates, lead and cadmium were also low but still within the permissible limit. Only Temperature and pH were within limit. Low plankton community, (phytoplankton, zooplankton), which ranges from 3, 5 to 40, 23 were as a result of low levels of DO, transparency and phosphate. The presence of coliform bacteria of public health importance like Escherichia coli, Proteus vulgaris, Aeromonas sp., Shigella sp, Enterobacter aerogenes as well as gram negative bacteria Proteus morganii are mainly indicators of faecal pollution. Fish and other resources obtained from this water stand the risk of being contaminated with these organisms and man is at the receiving end. The results of the physical, chemical and some biological parameters of Isheri, Ogun River, according to this study showed that the live forms of aquatic and fisheries resources there are dwelling under stress as a result of deposition of bones, horns, faecal components, slurry of suspended solids, fat and blood into the water. Government should therefore establish good monitoring system against illegal waste depositions and create education programmes that will enlighten the community on the social, ecological and economic values of the river.

Keywords: water parameters, Isheri Ogun river, anthropogenic activities, Kara abattoir

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Authors: Sajjad H. Kasanagh, Perviz Ahmedzade, Alexander Fainleib, Taylan Gunay

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Modification of asphalt is a fundamental method around the world mainly on the purpose of providing more durable pavements which lead to diminish repairing cost during the lifetime of highways. Various polymers such as styrene-butadiene-styrene (SBS) and ethylene vinyl acetate (EVA) make up the greater parts of the all-over asphalt modifiers generally providing better physical properties of asphalt by decreasing temperature dependency which eventually diminishes permanent deformation on highways such as rutting. However, some waste and low-cost materials such as recycled plastics and ground rubber tire have been attempted to utilize in asphalt as modifier instead of manufactured polymer modifiers due to decreasing the eventual highway cost. On the other hand, the usage of recycled plastics has become a worldwide requirement and awareness in order to decrease the pollution made by waste plastics. Hence, finding an area in which recycling plastics could be utilized has been targeted by many research teams so as to reduce polymer manufacturing and plastic pollution. To this end, in this paper, thermoplastic dynamic vulcanizate (TDV) obtained from recycled post-consumer polyethylene and ground tire rubber (GTR) were used to provide an efficient modifier for asphalt which decreases the production cost as well and finally might provide an ecological solution by decreasing polymer disposal problems. TDV was synthesized by the chemists in the research group by means of the abovementioned components that are considered as compatible physical characteristic of asphalt materials. TDV modified asphalt samples having different rate of proportions of 3, 4, 5, 6, 7 wt.% TDV modifier were prepared. Conventional tests, such as penetration, softening point and roll thin film oven (RTFO) tests were performed to obtain fundamental physical and aging properties of the base and modified binders. The high temperature performance grade (PG) of binders was determined by Superpave tests conducted on original and aged binders. The multiple stress creep and recovery (MSCR) test which is relatively up-to-date method for classifying asphalts taking account of their elasticity abilities was carried out to evaluate PG plus grades of binders. The results obtained from performance grading, and MSCR tests were also evaluated together so as to make a comparison between the methods both aiming to determine rheological parameters of asphalt. The test results revealed that TDV modification leads to a decrease in penetration, an increase in softening point, which proves an increasing stiffness of asphalt. DSR results indicate an improvement in PG for modified binders compared to base asphalt. On the other hand, MSCR results that are compatible with DSR results also indicate an enhancement on rheological properties of asphalt. However, according to the results, the improvement is not as distinct as observed in DSR results since elastic properties are fundamental in MSCR. At the end of the testing program, it can be concluded that TDV can be used as modifier which provides better rheological properties for asphalt and might diminish plastic waste pollution since the material is 100% recycled.

Keywords: asphalt, ground tire rubber, recycled polymer, thermoplastic dynamic vulcanizate

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Authors: Arief, Noovirman Jamarun, Benni Satria

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Background: The main problem in the development of livestock in Indonesia is feed both in terms of quality and quantity. On the other hand, conventional feed ingredients are expensive and difficult to obtain. Therefore, it is necessary to find alternative feed ingredients that have good quality, potential, and low cost. Feed ingredients that meet the above requirements are by-products of the palm oil industry, namely palm kernel cake (PKC). This study aims to obtain the best PKC composition for Etawa goat concentrate ration. Material and Methode : This research consists of 2 stages. Stage I is invitro study using Tilley and Terry method. The study used a Completely Randomized Design (CRD) with 4 treatments of rations and 4 replications. The treatment is the composition of the use of palm kernel cake (PKC) in the ration, namely, A). 10%, B). 20%, C). 30%, D). 40%. Other feed ingredients are corn, rice bran, tofu waste and minerals. The measured variables are the characteristics of the rumen fluid (pH, VFA and NH3). Stage II was done using the best ration of stage I (Ration C), followed by testing the use of Tithonia (Thitonia difersifolia) and agricultural waste of sweet potato leaves as a source of forage for livestock by in-vitro. The study used a Completely Randomized Design (CRD) with 3 treatments and 5 replications. The treatments were: Treatment A) Best Concentrate Ration Stage I + Titonia (Thitonia difersifolia), Treatment B) Best Concentrate Ration Stage I + Tithonia (Thitonia difersifolia) and Sweet potato Leaves, Treatment C) Best Concentrate Ration Stage I + Sweet potato leaves. The data obtained were analyzed using variance analysis while the differences between treatments were tested using the Duncant Multiple Range Test (DMRT) according to Steel and Torrie. Results of Stage II showed that the use of PKC in rations as concentrate feed combined with forage originating from Tithonia (Thitonia difersifolia) and sweet potato leaves produced pH, VFA and NH3-N which were still in normal conditions. The best treatment was obtained from diet B (P <0.05) with 6.9 pH, 116.29 mM VFA and 15mM NH3-N. Conclussion From the results of the study it can be concluded that PKC can be used as feed ingredients for dairy goat concentrate with a combination of forage from Tithonia (Tithonia difersifolia) and sweet potato leaves.

Keywords: palm oil by-product, palm kernel cake, concentrate, rumen fluid, Etawa goat

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Authors: Insaf Mehani, Bachir Bouchekima

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The necessary reduction and progressive consumption of fossil fuels, whose scarcity is inevitable, involves mobilizing a set of alternatives.Renewable energy, including bio energy are an alternative to fossil fuel depletion and a way to fight against the harmful effects of climate change. It is possible to develop common dates of low commercial value, and put on the local and international market a new generation of products with high added values such as bio ethanol. Besides its use in chemical synthesis, bio ethanol can be blended with gasoline to produce a clean fuel while improving the octane.

Keywords: bioenergy, dates, bioethanol, renewable energy, south Algeria

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Authors: Timine Suoware, Sylvester Edelugo, Charles Amgbari

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The susceptibility of natural fibre polymer composites to flame has necessitated research to improve and develop flame retardant (FR) to delay the escape of combustible volatiles. Previous approaches relied mostly on FR such as aluminium tri-hydroxide (ATH) and ammonium polyphosphate (APP) to improve fire performances of wood sawdust polymer composites (WSPC) with emphasis on non-structural building applications. In this paper, APP was modified with gum Arabic powder (GAP) and then hybridized with ATH at 0, 12 and 18% loading ratio to form new FR species; WSPC12%APP-GAP and WSPC18%ATH/APP-GAP. The FR species were incorporated in wood sawdust waste reinforced in polyester resin to form panels for fireproof doors. The panels were produced using hand lay compression moulding technique and cured at room temperature. Specimen cut from panels were then tested for tensile strength (TS), flexural strength (FS) and impact strength (IS) using universal testing machine and impact tester; thermal stability using (TGA/DSC 1: Metler Toledo); time-to-ignition (Tig), heat release rates (HRR); peak HRR (HRRp), average HRR (HRRavg), total HRR (THR), peak mass loss rate (MLRp), average smoke production rate (SPRavg) and carbon monoxide production (COP ) were obtained using the cone calorimeter apparatus. From the mechanical properties obtained, improvements of IS for the panels were not noticeable whereas TS and FS for WSPC12%APP-GAP respectively stood at 12.44 MPa and 85.58 MPa more than those without FR (WSPC0%). For WSC18%ATH/APP-GAP TS and FS respectively stood at 16.45 MPa and 50.49 MPa more compared to (WSPC0%). From the thermal analysis, the panels did not exhibit any significant change as early degradation was observed. At 900 OC, the char residues improved by 15% for WSPC12%APP-GAP and 19% for WSPC18%ATH/APP-GAP more than (WSC0%) at 5%, confirming the APP-GAP to be a good FR. At 50 kW/m2 heat flux (HF), WSPC12%APP-GAP improved better the fire behaviour of the panels when compared to WSC0% as follows; Tig = 46 s, HRRp = 56.1 kW/2, HRRavg = 32.8 kW/m2, THR = 66.6 MJ/m2, MLRp = 0.103 g/s, TSR = 0.04 m2/s and COP = 0.051 kg/kg. These were respectively more than WSC0%. It can be concluded that the new concept of modifying FR with GAP in WSC could meet the requirement of a fireproof door for building applications.

Keywords: composite, flame retardant, wood sawdust, fireproof doors

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Authors: Abubakar Maitama Yusuf Hotoro, Olokpo Israel Olofu, Yusuf U. Tarauni, Mudassir A. Umar, Aliyu A, Dahiru Garba Diso, Usman H. Jamoh, M. Sale

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The study assessed the impact of environmental pollution on groundwater potential at Tudun Murtala waste land fill using electrical resistivity, induced polarization and Physiochemical methods. The study area is located between latitude 12.023678N and longitude 8.573676 E. Geophysical data were collected at maximum length of 140m along twelve profiles using ABEM Terrameter SAS 1000. Results from the Geophysical analysis showed that the profiles were underlain by three lithological layers; the top layer consisting of Loamy and Sand soils, alluvium, granite, shale and sandstone. The second and third layers were predominantly made of weathered and fractured basements respectively. The potential groundwater water bearing zones of the study area occurred at VES2, VES4, VES5, VES6 and VES7. The thicknesses of the sounding points were found to be 20.8m at VES2; 25.2m at VES4; 13.2m at VES5; 50.8m at VES6 and 13.3m at VES7. The corresponding depths for the sounding points were 20.8m at VES2; 27.9m at VES4; 26.7m at VES5; 51.6m at VES6 and 24.9m at VES7 respectively. The Physiochemical study of selected groundwater samples assessed parameters such as the Electrical Conductivity, EC (288dS/m to 1365dS/m), TDS (170.8mg/L to 820mg/L) Pb (0.546mg/l to 0.629mg/l), Cu (-0.001mg/l to 0.004mg/l), and Cd (0.031mg/l to 0.092mg/l). The physiochemical results showed that the groundwater around the dumpsite may have been contaminated, especially in Dumpsite Hole 1 and Hole 2 at VES4 and VES6 respectively. There are indications for suspected leachate mitigation around the two VES points. Even though, the pH values of 6.4 and 6.2 at the two sounding points were considered to be within the permissible pH range (6.5 to 6.8). The values of other elements present in the groundwater for the samples at other VES points were found to be above permissible WHO and Nigerian Standards for Drinking Water.

Keywords: resistivity induced polarization, chargeability, landfill, leachate, contamination

Procedia PDF Downloads 62

Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

Procedia PDF Downloads 127

Authors: Tetyana Kendzerska, David T. Zhu, Michael Pugliese, Douglas Manuel, Mohsen Sadatsafavi, Marcus Povitz, Therese A. Stukel, Teresa To, Shawn D. Aaron, Sunita Mulpuru, Melanie Chin, Claire E. Kendall, Kednapa Thavorn, Rebecca Robillard, Andrea S. Gershon

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The impact of the COVID-19 pandemic on the management of ambulatory care sensitive conditions (ACSCs) remains unknown. To compare observed and expected (projected based on previous years) trends in all-cause mortality and healthcare use for ACSCs in the first year of the pandemic (March 2020 - March 2021). A population-based study using provincial health administrative data.General adult population (Ontario, Canada). Monthly all-cause mortality, and hospitalizations, emergency department (ED) and outpatient visit rates (per 100,000 people at-risk) for seven combined ACSCs (asthma, COPD, angina, congestive heart failure, hypertension, diabetes, and epilepsy) during the first year were compared with similar periods in previous years (2016-2019) by fitting monthly time series auto-regressive integrated moving-average models. Compared to previous years, all-cause mortality rates increased at the beginning of the pandemic (observed rate in March-May 2020 of 79.98 vs. projected of 71.24 [66.35-76.50]) and then returned to expected in June 2020—except among immigrants and people with mental health conditions where they remained elevated. Hospitalization and ED visit rates for ACSCs remained lower than projected throughout the first year: observed hospitalization rate of 37.29 vs. projected of 52.07 (47.84-56.68); observed ED visit rate of 92.55 vs. projected of 134.72 (124.89-145.33). ACSC outpatient visit rates decreased initially (observed rate of 4,299.57 vs. projected of 5,060.23 [4,712.64-5,433.46]) and then returned to expected in June 2020. Reductions in outpatient visits for ACSCs at the beginning of the pandemic combined with reduced hospital admissions may have been associated with temporally increased mortality—disproportionately experienced by immigrants and those with mental health conditions. The Ottawa Hospital Academic Medical Organization

Keywords: COVID-19, chronic disease, all-cause mortality, hospitalizations, emergency department visits, outpatient visits, modelling, population-based study, asthma, COPD, angina, heart failure, hypertension, diabetes, epilepsy

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Authors: Narges Solaymani

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medical training of patients. Nursing is a very important profession in the societies of the world. Although in the past, all caregivers of the sick and disabled were called nurses, nowadays, a nurse is a person who has a university education in this field. There are nurses in bachelor's, master's, and doctoral degrees in nursing. New courses have been launched in the master's degree based on duty-oriented nurses. A nurse cannot have an independent treatment center but is a member of the treatment team in established treatment centers such as hospitals, clinics, or offices. Nurses can establish counseling centers and provide nursing services at home. According to the standards, the number of nurses should be three times the number of doctors or twice the number of hospital beds, or there should be three nurses for every thousand people. Also, international standards show that in the internal and surgical department, every 4 to 6 patients should have a nurse.

Keywords: Nurse, Intensive Care, CPR, Bandage

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Authors: Mohammad Reza Dawoudi

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With the increasing rate of patients suffering from chronic pain, several methods for evaluating of chronic pain are suggested. Motion of morbid has been defined as the rate of pine and it is linked with various co-morbid conditions. This study provides a summary of procedure useful to statistics performing direct behavioral observation in hospital settings. We describe the need for and usefulness of comprehensive “morbid motions” observations; provide a primer on the identification, definition, and assessment of morbid behaviors; and outline and discuss specific statistical procedures, including formulating referral motions, describing and conducting the observation. We also provide practical devices for observing and analyzing the obtained information into a report that guides clinical intervention.

Keywords: assessing pain, DNA modeling, image matching technique, pain scale

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Authors: Obiageli Helen Ezeh, Chuks Clement Ezeh

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Background: It is estimated that more than 330 million persons are living with HIV-infection globally and in Nigeria about 3.4 persons are living with the infection, with an annual death rate of 180,000. Psychological morbidity often accompany chronic illnesses and may be associated with substance abuse, poor health seeking behavior and adherence to treatment program; it may worsen existing health problems and the overall quality of life. Until the burden is effectively identified, intervention cannot be planned. Until there is a cure, the goal is to manage and cope effectively with HIV-infection. Little if any studies have been done in this area in the North West geo-political zone of Nigeria. The study would help to identify high risk groups and prevent the progression and spread of the infection. Aim: To identify HIV-infected persons with psychological morbidity, accessing HIV- clinic at Shika Hospital, Zaria, Kaduna State; and analyze their socio-demographic profile. Methods: A cross sectional descriptive study was carried out to assess and analyze the socio-demographic characteristics of HIV-infected persons attending Shika hospital Zaria Nigeria, who screened positive for psychological morbidity. A total of 109 HIV-infected persons receiving HAART at Shika clinic, Zaria, Kaduna State, Nigeria, were administered questionnaires, the General Health Questionnaire (GHQ-12)measuring psychological morbidity and socio-demographic data. The participants ranged in age between 18 and 75 years. Results: Data were analyzed using SPSS software 15. Both descriptive and inferential Statistics were performed on the data. Results indicate a total prevalent rate of psychological morbidity of 78 percent among participants. Of this, about 16.2 percent were severely distressed, 25.1 percent moderately distressed and 36.7percent were mildly distressed. More females (65 percent of those with psychological morbidity) were found to be distressed than their male (55 percent) counterparts. It was (44 percent) for patients whose HIV-infection was of relatively shorter duration(2-4 years) than those of longer duration(5-9 years; and 10 years/above). The age group (21-30 years) was the most affected (35 percent). The rate was also 55 percent for Christians and 45 percent for Muslims. For married patients with partners it was 20 percent and for singles 30 percent; for the widowed (12 percent) and divorced (38 percent). At the level of tribal/ethnic groups, it was 13 percent for Ibos, 22 percent for Yorubas, 27 percent for Hausas and 33 percent for all the other minority tribes put together. Conclusion/Recommendation: The study has been able to identify the presence of psychological morbidity among HIV-infected persons as high and analyze the socio-demographic factors associated with it as significant. Periodic screening of HIV-infected persons for psychological morbidity and psychosocial intervention was recommended.

Keywords: socio-demographics, psychological morbidities, HIV-Infection, HAART

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Authors: F. Heyecan Giritli, Gizem Akgül

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Because of the raising population of world; the need for houses, buildings and infrastructures are increasing rapidly. Energy and water consumption, waste production continues to increase. If this situation of resources continues, there will be a significant loss for next generations. Therefore, there are a lot of researches and solutions developed in the world. Also sustainability criteria are collected together by some countries to serve construction industry with certification systems. Sustainable building production process’s scope requires different path from traditional building production process. Moreover, the key objective of sustainable buildings is that the process includes whole life cycle duration. The process approaches from the decision of the project to the end of it; so the project team is needed from the beginning of the integrated project delivery model. Further more, by defining project team at the beginning of the project provides communication among the team members and defined problem solving and decision making methods. In this research includes the certification systems among the world to comprehend the head lines and assessment criteria. Therefore, it is understand that usually all green building criteria have the same contents. The aim of this research is to assess the sustainable project stakeholder’ perceptions in Turkish construction industry from the point of occupation, job title and years of experience. Therefore, a survey is made to assess the perceptions of each attendant. In Turkey, sustainability criteria are not clearly defined; on the other hand some regulations like waste management, energy efficiency are made by legal agencies. LEED certification system is the most popular system in Turkey that has attended and certificated. From the LEED official data, it’s understood that 308 project registered in Turkey. Therefore, LEED sustainability criteria are used in the survey. Head lines of LEED certification criteria; sustainable sites, water efficiency, energy and atmosphere, material and resources, indoor environmental quality, innovation and regional priority are indicated to assess the perceptions of survey participants. Moreover, only surveying of criteria are not enough; so the equipment, methods, risks and benefits also considered.

Keywords: LEED, sustainability, perceptions, stakeholders, construction, Turkey, risk, benefit

Procedia PDF Downloads 301

Authors: Christine Lassen, Elizabeth Leonard, Matthew Oliver

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The management of trauma is often complex and outcomes dependent on clinical expertise, effective teamwork, and a supported trauma system. The implementation of a statewide trauma education program should be accessible to all clinicians who manage trauma, but this can be challenging due to diverse individual needs, trauma service needs and geography. The NSW Institute of Trauma and Injury Management (ITIM) is a government funded body, responsible for coordinating and supporting the NSW Trauma System. The aim of this presentation is to describe how education initiatives have been implemented across the state. Simulation: In 2006, ITIM developed a Trauma Team Training Course - aimed to educate clinicians on the technical and non-technical skills required to manage trauma. The course is now independently coordinated by trauma services across the state at major trauma centres as well as in regional and rural hospitals. ITIM is currently in the process of re-evaluating and updating the Trauma Team Training Course to allow for the development of new resources and simulation scenarios. Trauma Education Evenings: In 2013, ITIM supported major trauma services to develop trauma education evenings which allowed the provision of free education to staff within the area health service and local area. The success of these local events expanded to regional hospitals. A total of 75 trauma education evenings have been conducted within NSW, with over 10,000 attendees. Wed-Based Resources: Recently, ITIM commenced free live streaming of the trauma education evenings which have now had over 3000 live views. The Trauma App developed in 2015 provides trauma clinicians with a centralised portal for trauma information and works on smartphones and tablets that integrate with the ITIM website. This supports pre-hospital and bedside clinical decisions and allows for trauma care to be more standardised, evidence-based, timely, and appropriate. Online e-Learning modules have been developed to assist clinicians, reduce unwarranted clinical variation and provide up to date evidence based education. The modules incorporate clinically focused education content with summative and formative assessments. Conclusion: Since 2005, ITIM has helped to facilitate the development of trauma education programs for doctors, nurses, pre-hospital and allied health clinicians. ITIM has been actively involved in more than 100 specialized trauma education programs, seminars and clinical workshops - attended by over 12,000 staff. The provision of state-wide trauma education is a challenging task requiring collaboration amongst numerous agencies working towards a common goal – to provide easily accessible trauma education.

Keywords: education, simulation, team-training, trauma

Procedia PDF Downloads 188

Authors: Geetanjali Yadav, Arpit Mishra, Parthsarathi Ghosh, Ramkrishna Sen

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The world is facing problems of increasing global CO2 emissions, climate change and fuel crisis. Therefore, several renewable and sustainable energy alternatives should be investigated to replace non-renewable fuels in future. Algae presents itself a versatile feedstock for the production of variety of fuels (biodiesel, bioethanol, bio-hydrogen etc.) and high value compounds for food, fodder, cosmetics and pharmaceuticals. Microalgae are simple microorganisms that require water, light, CO2 and nutrients for growth by the process of photosynthesis and can grow in extreme environments, utilize waste gas (flue gas) and waste waters. Mixing, however, is a crucial parameter within the culture system for the uniform distribution of light, nutrients and gaseous exchange in addition to preventing settling/sedimentation, creation of dark zones etc. The overarching goal of the present study is to improve photobioreactor (PBR) design for enhancing dissolution of CO2 from ambient air (0.039%, v/v), pure CO2 and coal-fired flue gas (10 ± 2%) into microalgal PBRs. Computational fluid dynamics (CFD), a state-of-the-art technique has been used to solve partial differential equations with turbulence closure which represents the dynamics of fluid in a photobioreactor. In this paper, the hydrodynamic performance of the PBR has been characterized and compared with that of the conventional bubble column PBR using CFD. Parameters such as flow rate (Q), mean velocity (u), mean turbulent kinetic energy (TKE) were characterized for each experiment that was tested across different aeration schemes. The results showed that the modified PBR design had superior liquid circulation properties and gas-liquid transfer that resulted in creation of uniform environment inside PBR as compared to conventional bubble column PBR. The CFD technique has shown to be promising to successfully design and paves path for a future research in order to develop PBRs which can be commercially available for scale-up microalgal production.

Keywords: computational fluid dynamics, microalgae, bubble column photbioreactor, flue gas, simulation

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Authors: Ezman Fitriansyah, Lestari Diah Restu, Wawan

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Adaro coal mine in South Kalimantan-Indonesia maintains catchment area of approximately 15,000 Ha for its mine operation. As an open pit surface coal mine with high erosion rate, the mine water in Adaro coal mine contains high TSS that needs to be treated before being released to rivers. For the treatment process, Adaro operates 21 Settling Ponds equipped with combination of physical and chemical system to separate solids and water to ensure the discharged water complied with regional environmental quality standards. However, the sludge created from the sedimentation process reduces the settling ponds capacity gradually. Therefore regular maintenance activities are required to recover and maintain the ponds' capacity. Trucking system and direct dredging had been the most common method to handle sludge in Adaro. But the main problem in applying these two methods is excessive area required for drying pond construction. To solve this problem, Adaro implements an alternative method called Geotube®. The principle of Geotube® method is the sludge contained in the Settling Ponds is pumped into Geotube® containers which have been designed to release water and retain mud flocks. During the pumping process, an amount of flocculants chemicals are injected into the sludge to form bigger mud flocks. Due to the difference in particle size, the mud flocks are settled in the container whilst the water continues to flow out through the container’s pores. Compared to the trucking system and direct dredging method, this method provides three advantages: space required to operate, increasing of overburden waste dump volume, and increasing of water treatment process speed and quality. Based on the evaluation result, Geotube® method only needs 1:8 of space required by the other methods. From the geotechnical assessment result conducted by Adaro, the potential loss of waste dump volume capacity prior to implementation of the Geotube® method was 26.7%. The water treatment process of TSS in well maintained ponds is 16% more optimum.

Keywords: geotube, mine water, settling pond, sludge handling, wastewater treatment

Procedia PDF Downloads 200

Authors: Marzieh Moattari Mitra Abbasi, Masoud Mousavinasab, Poorahmad

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Background: Nurses in their daily practice need to communicate with patients and their families as well as health professional team members. Effective communication contributes to patients’ satisfaction which is a fundamental outcome of nursing practice. There are some evidences in support of patients' dissatisfaction with nurses’ performance in communication process. Therefore improving nurses’ communication skills is a necessity for nursing scholars and nursing administrators. Objective: The aim of the present study was to evaluate the effect of a 2-days workshop on nurses’ competencies and performances in communication in a central hospital located in the sought of Iran. Materials and Method: This is a randomized controlled trial which comprised of a convenient sample of 70 eligible nurses, working in a central hospital. They were randomly divided into 2 experimental and control groups. Nurses’ competencies was measured by an Objective Structured Clinical Examination (OSCE) and their performance was measured by asking eligible patients hospitalized in the nurses work setting during a one month period to evaluate nurses' communication skills before and 2 months after intervention. The experimental group participated in a 2 day workshop on communication skills. Content included in this workshop were: the importance of communication (verbal and non verbal), basic communication skills such as initiating the communication, active listening and questioning technique. Other subjects were patient teaching, problem solving, and decision making, cross cultural communication and breaking bad news. Appropriate teaching strategies such as brief didactic sessions, small group discussion and reflection were applied to enhance participants learning. The data was analyzed using SPSS 16. Result: A significant between group differences was found in nurses’ communication skills competencies and performances in the posttest. The mean scores of the experimental group was higher than that of the control group in the total score of OSCE as well as all stations of OSCE (p<0.003). Overall posttest mean scores of patient satisfaction with nurse's communication skills and all of its four dimensions significantly differed between the two groups of the study (p<0.001). Conclusion: This study shows that the education of nurses in communication skills, improves their competencies and performances. Measurement of Nurses’ communication skills as a central component of efficient nurse patient relationship by valid and reliable methods of evaluation is recommended. Also it is necessary to integrate teaching of communication skills in continuing nursing education programs. Trial Registration Number: IRCT201204042621N11

Keywords: communication skills, simulation, performance, competency, objective structure, clinical evaluation

Procedia PDF Downloads 218

Authors: Farajallah Adibhashemi

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A retrospective study on causes, surgery findings, results and the follow up of 30 horses with colic in Tehran, Iran. Colic is the main problem horse industry.The causes of colic are related to management like food, sport and medical care. In this study that has been done between 2012-2015 for 30 horses referred to teaching hospital of veterinary medicine faculty of the University of Tehran. Seventy percent of causes was related to management of feeding and twenty percent was for malsporting. The rest of causes was from the anti parasite in bad root. The surgery findings were as follows: 60% displacement of dorsal right and left colon, 20% in impaction of pelvic flexure,10% impaction of the cecum, and 10% impaction of the stomach.

Keywords: horse, colic, Tehran, Iran

Procedia PDF Downloads 366

Authors: Pinn Tsin Isabel Yee

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Students are increasingly turning towards online learning materials to supplement their education. One such approach would be the gamified student engagement platforms (GSEPs) to instill a new learning culture. Data was collected from closed-ended questions via content analysis techniques. About 81.8% of college students from the Monash University Foundation Year agreed that GSEPs (Quizizz) was an effective tool for learning. Approximately 85.5% of students disagreed that games were a waste of time. GSEPs were highly effective among students to facilitate the learning process.

Keywords: engagement, gamified, Quizizz, technology

Procedia PDF Downloads 107