Search results for: grade point average

Authors: G. Çetinkaya, M. Yıldız, P. Çetinkaya

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Tourism is one of the world’s largest industries and its total contribution to the global economy in 2014 was US$7.6 trillion, which equates to 9.8% of total economy GDP in 2014. Mountains are important regions for tourism industry and its second most popular tourist destinations after coastal regions. Hiking and trekking are most popular activity in mountains region and it is estimated that more than 50 million people visit mountains each year. So that hiking was come out to individual activity and it’s to be a massive event. Nowadays hiking is commercialized and mostly it’s become organized by travel agency and tour operators. Travel agency which is offering hiking activities to know the demands of the individuals involved in these activities and is required to submit to it for services. The aim of this study to determined hiking participant expectation from hiking by travel agency perspective. 34 travel agency officials participated in the study. Data were collected by questionnaire developed by the researchers. Results show that according to travel agency officials “visual quality” is the most important expectation factor for hikers. And other expectation factors are “safety”, “accessibility”, “unspoiled local service”, “walking grade”, “expert guidance service”, “popularity of trail”, “uncrowded trail”, “substructure facilities”, “relevant cost”, “guidebook” and “suitable climatic conditions”.

Keywords: expectation, hikers, travel agency, mountain tourism

Procedia PDF Downloads 279

Authors: Jerome Dalphinis, Vishal Patel

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The Bailiwick of Jersey is an island British crown dependency situated off the coast of France. Jersey General Hospital’s emergency department sees approximately 40,000 patients a year. It’s outside the NHS, with secondary care being free at the point of care. Sedation is a continuum which extends from a normal conscious level to being fully unresponsive. Procedural sedation produces a minimally depressed level of consciousness in which the patient retains the ability to maintain an airway, and they respond appropriately to physical stimulation. The goals of it are to improve patient comfort and tolerance of the procedure and alleviate associated anxiety. Indications can be stratified by acuity, emergency (cardioversion for life-threatening dysrhythmia), and urgency (joint reduction). In the emergency department, this is most often achieved using a combination of opioids and benzodiazepines. Some departments also use ketamine to produce dissociative sedation, a cataleptic state of profound analgesia and amnesia. The response to pharmacological agents is highly individual, and the drugs used occasionally have unpredictable pharmacokinetics and pharmacodynamics, which can always result in progression between levels of sedation irrespective of the intention. Therefore, practitioners must be able to ‘rescue’ patients from deeper sedation. These practitioners need to be senior clinicians with advanced airway skills (AAS) training. It can lead to adverse effects such as dangerous hypoxia and unintended loss of consciousness if incorrectly undertaken; studies by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) have reported avoidable deaths. The Royal College of Emergency Medicine, UK (RCEM) released an updated ‘Safe Sedation of Adults in the Emergency Department’ guidance in 2017 detailing a series of standards for staff competencies, and the required environment and equipment, which are required for each target sedation depth. The emergency department in Jersey undertook audit research in 2018 to assess their current practice. It showed gaps in clinical competency, the need for uniform care, and improved documentation. This spurred the development of a checklist incorporating the above RCEM standards, including contraindication for procedural sedation and difficult airway assessment. This was approved following discussion with the relevant heads of departments and the patient safety directorates. Following this, a second audit research was carried out in 2019 with 17 completed checklists (11 relocation of joints, 6 cardioversions). Data was obtained from looking at the controlled resuscitation drugs book containing documented use of ketamine, alfentanil, and fentanyl. TrakCare, which is the patient electronic record system, was then referenced to obtain further information. The results showed dramatic improvement compared to 2018, and they have been subdivided into six categories; pre-procedure assessment recording of significant medical history and ASA grade (2 fold increase), informed consent (100% documentation), pre-oxygenation (88%), staff (90% were AAS practitioners) and monitoring (92% use of non-invasive blood pressure, pulse oximetry, capnography, and cardiac rhythm monitoring) during procedure, and discharge instructions including the documented return of normal vitals and consciousness (82%). This procedural sedation checklist is a safe intervention that identifies pertinent information about the patient and provides a standardised checklist for the delivery of gold standard of care.

Keywords: advanced airway skills, checklist, procedural sedation, resuscitation

Procedia PDF Downloads 117

Authors: Marlone D. Severo

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A pre- and post-test quasi-experimental design was used to test the intervention of Trachtenberg Speed Math on the mathematical competency of sixty (60) matched-paired students with a poor performing grade in Mathematics from one of the biggest public national high school at the South of Metro Manila. Both control and experimental group were administered with the Attitude Towards Mathematics Inventory (ATMI) before the pretest were given and both group showed high dislike for Mathematics. Pretest showed a 53 percent accuracy for the control group and 51 percent for the experimental group using a 15-item long multiplication test without any aid of a computing device. The experimental group were taught how to use the Trachtenberg number-keys and techniques in multiplication between October 2014 to March 2015. Post-test showed an improvement in the experimental group with 96 percent accuracy for the control group and a dismal 57 percent for the control group in long-multiplication. Post-test ATMI were administered. The control group showed a great dislike towards Mathematics, while the experimental group showed a positive attitude towards the subject.

Keywords: attitude towards mathematics, mathematical competency, number-keys, trachtenberg speed math

Procedia PDF Downloads 367

Authors: Muhammad Arsalan Khan Sherwani

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The use of Volatile Corrosion Inhibitors (VCI) to protect Aboveground Storage Tank (AST) bottom plates against soil-side corrosion is one of the emerging corrosion prevention methods, specifically for tanks constructed on oily sand pad. Oily sand pad and the presence of air gaps underneath the bottom plates lead to severe corrosion and high metal thickness loss. In such cases, the cathodic protection cannot be fully considered as effective due to Cathodic Protection (CP) current shielding. These situations sometimes result in serious failures on multiple fronts, such as; containment losses, system shutdowns, extensive repairs, environmental impact and safety concerns in case of flammable fluids. Recently, East West Pipeline Department (EWPD) of Saudi Aramco has deployed this technology to one of the crude oil storage tanks, which showed high metal thickness loss during its out of service inspection. Soil-side corrosion rustled in major repairs of bottom plates and ultimately caused enormous unplanned activities in term of time as well as cost. This paper mainly focuses on the methodology of VCI installation, corrosion monitoring system and the expected results of protection.

Keywords: Vapor Corrosion Inhibitor, Soil Side Corrosion, External Corrosion, Above Grade Storage Tank

Procedia PDF Downloads 73

Authors: Iwuchukwu J. C., Ekeh G. Madukwe, M. C., Asadu A. N.

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Melon has significant importance of easy to plant, early maturing, low nutrient requirement and high yielding. Yet many melon farmers in the study area are either diversifying or abandoning this enterprise probably because of lack of agricultural knowledge/information and consequent reduction in output and income. The study was therefore carried out to asses effects of agricultural information on income of melon farmers in Enugu-Ezike Agricultural zone of Enugu state, Nigeria. Three blocks, nine circles and ninety melon farmers who were purposively selected constituted the sample for the study..Data were collected with interview schedule. Percentage and chart were used to present some of the data while some were analysed with mean score and correlation. The findings reveal that. average annual income of these respondents from melon was about seven thousand and five hundred Naira (approximately forty five Dollars). while their total average monthly income (income from melon and other sources) was about one thousand and two hundred Naira (approximately seven Dollars). About 42.% and 62% of the respondents in their respective order did not receive information on agricultural matters and melon production. Among the minority that received information on melon production, most of them sourced it from neighbours/friends/relatives. Majority of the respondents needed information on how to plant melon through interpersonal contact (face to face) using Igbo language as medium of communication and extension agent as teacher or resource person. The study also reveal a significant and positive relationship between number of times respondents received information on agriculture and their total monthly income. There was also a strong, positive and significant relationship between number of times respondents received information on melon and their annual income on melon production. The study therefore recommends that governmental and non-governmental organizations/ institutions should strengthen these farmers access to information on agriculture and melon specifically so as to boost their output and income.

Keywords: farmers, income, information, melon

Procedia PDF Downloads 246

Authors: Parimalakrishnan Sundararjan, Madheswaran Murugan, Dhanya Dharman, Yatindra Kumar, Sudhir Singh Gangwar, Guru Prasad Mohanta

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Antibiotic resistance AR is a global issue, India started to redress the issues of antibiotic resistance late and it plans to have: active surveillance of microbial resistance and promote appropriate use of antibiotics. The present study attempted to achieve appropriate use of antibiotics through pharmacists’ intervention at practice point. In a quasi-experimental prospective cohort study, the cases with bacteremia from four hospitals were identified during 2015 and 2016 for intervention. The pharmacists centered intervention: active screening of each prescription and comparing with the selection of antibiotics with susceptibility of the bacteria. Wherever irrationality noticed, it was brought to the notice of the treating physician for making changes. There were two groups: intervention group and control group without intervention. The active screening and intervention in 915 patients has reduced therapeutic regimen time in patients with bacteremia. The intervention group showed the decreased duration of hospital stay 3.4 days from 5.1 days. Further, multivariate modeling of patients who were in control group showed that patients in the intervention group had a significant decrease in both duration of hospital stay and infection-related mortality. Unlike developed countries, pharmacists are not active partners in patient care in India. This unique attempt of pharmacist’ invention was planned in consultation with hospital authorities which proved beneficial in terms of reducing the duration of treatment, hospital stay, and infection-related mortality. This establishes the need for a collaborative decision making among the health workforce in patient care at least for promoting rational use of antibiotics, an attempt to combat resistance.

Keywords: antibiotics resistance, intervention, bacteremia, multivariate modeling

Procedia PDF Downloads 182

Authors: Dimitri Bacco, Arianna Trentini, Fabiana Scotto, Flavio Rovere, Daniele Foscoli, Cinzia Para, Paolo Veronesi, Silvia Sandrini, Claudia Zigola, Michela Comandini, Marilena Montalti, Marco Zamagni, Vanes Poluzzi

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The Po Valley, in the north of Italy, is one of the most polluted areas in Europe. The air quality of the area is linked not only to anthropic activities but also to its geographical characteristics and stagnant weather conditions with frequent inversions, especially in the cold season. Even the coastal areas present high values of particulate matter (PM10 and PM2.5) because the area closed between the Adriatic Sea and the Apennines does not favor the dispersion of air pollutants. The aim of the present work was to identify the main sources of particulate matter in Rimini, a tourist city in northern Italy. Two sampling campaigns were carried out in 2018, one in winter (60 days) and one in summer (30 days), in 4 sites: an urban background, a city hotspot, a suburban background, and a rural background. The samples are characterized by the concentration of the ionic composition of the particulates and of the main a hydro-sugars, in particular levoglucosan, a marker of the biomass burning, because one of the most important anthropogenic sources in the area, both in the winter and surprisingly even in the summer, is the biomass burning. Furthermore, three sampling points were chosen in order to maximize the contribution of a specific biomass source: a point in a residential area (domestic cooking and domestic heating), a point in the agricultural area (weed fires), and a point in the tourist area (restaurant cooking). In these sites, the analyzes were enriched with the quantification of the carbonaceous component (organic and elemental carbon) and with measurement of the particle number concentration and aerosol size distribution (6 - 600 nm). The results showed a very significant impact of the combustion of biomass due to domestic heating in the winter period, even though many intense peaks were found attributable to episodic wood fires. In the summer season, however, an appreciable signal was measured linked to the combustion of biomass, although much less intense than in winter, attributable to domestic cooking activities. Further interesting results were the verification of the total absence of sea salt's contribution in the particulate with the lower diameter (PM2.5), and while in the PM10, the contribution becomes appreciable only in particular wind conditions (high wind from north, north-east). Finally, it is interesting to note that in a small town, like Rimini, in summer, the traffic source seems to be even more relevant than that measured in a much larger city (Bologna) due to tourism.

Keywords: aerosol, biomass burning, seacoast, urban area

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Authors: Suvorov Vasyl, Filipchuk Viktor

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Developmental Dysplasia of the Hip (DDH) is a frequent pathology in pediatric orthopedist’s practice. Neglected or residual cases of DDH in walking patients are usually treated using pelvic osteotomies. Plastic changes take place in hinge points due to acetabulum reorientation during surgery. Classically described hinge points and a traditional division of pelvic osteotomies on reshaping and reorientation are currently debated. The purpose of this article was to evaluate biomechanical changes during the most commonly used pelvic osteotomies (Salter, Dega, Pemberton) for DDH treatment in pediatric patients. Methods: virtual pelvic models of 2- and 6-years old patients were created, material properties were assigned, pelvic osteotomies were simulated and biomechanical changes were evaluated using finite element analysis (FEA). Results: it was revealed that the patient's age has an impact on pelvic bones and cartilages density (in younger patients the pelvic elements are more pliable - p<0.05). Stress distribution after each of the abovementioned pelvic osteotomy was assessed in 2- and 6-years old patients’ pelvic models; hinge points were evaluated. The new term "restriction point" was introduced, which means a place where restriction of acetabular deformity correction occurs. Pelvic ligaments attachment points were mainly these restriction points. Conclusions: it was found out that there are no purely reshaping and reorientation pelvic osteotomies as previously believed; the pelvic ring acts as a unit in carrying out the applied load. Biomechanical overload of triradiate cartilage during Salter osteotomy in 2-years old patient and in 2- and 6-years old patients during Pemberton osteotomy was revealed; overload of the posterior cortical layer in the greater sciatic notch in 2-years old patient during Dega osteotomy was revealed. Level of Evidence – Level IV, prognostic.

Keywords: developmental dysplasia of the hip, pelvic osteotomy, finite element analysis, hinge point, biomechanics

Procedia PDF Downloads 98

Authors: Andra Vidyarini

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Adolescence is a transition period in which various changes occur, both biologically, intellectually and psychosocially. Changes in adolescents, one of which is a change in food consumption patterns that make adolescents vulnerable to nutritional problems that can affect their growth and health in the future. Nutritional problems in adolescents have increased from year to year and one of the causes is the low diversity and quality of consumption. The diversity and quality of consumption can be seen through the Individual Dietary Diversity Score and the Healthy Eating Index. Currently, in Indonesia, data on the diversity and quality of food consumption, especially among adolescents, are still scarce. In general, the purpose of this study is to describe the diversity and quality of adolescent food consumption and the relationship between the diversity and quality of food consumption with nutritional status. This study is a cross-sectional study by looking at the diversity and quality of consumption of adolescents aged 15-17 years. The total number of subjects in this study amounted to 70 teenagers. This research was conducted online via a google form. Data analysis in this study was univariate and bivariate. The results showed that the diversity of the subject's food consumption was in the diverse and very diverse category with an average of 6. However, the quality was still not good, whereas it was still in the bad and moderate categories with an average of 12.93. The nutritional status of the majority of the subjects was in the normal category and overweight to obese. The implementation of blended learning where there are still limited face-to-face meetings at school can be the reason why teenagers' food consumption is more diverse than when they are face-to-face schools. In addition, changes in people's diet during the pandemic also influenced the results of the study. The change in pattern is a change in eating habits to three times a day with menu choices ranging from rice, meat, fish, bean and vegetables. Analysis of the relationship between the diversity and quality of food consumption shows that the diversity of consumption has a significant relationship with the quality of food consumption with a p-value of 0.002 (p<0.05). Meanwhile, the diversity and quality of food consumption have no significant relationship with nutritional status, with p values 0.777 and 0.251 (>0.05), respectively. This shows that the diversity of food consumption is directly proportional to the quality of consumption, where if you have a variety of food consumption, the quality or in terms of portions and weight are also sufficient in accordance with the recommendations of PGRS.

Keywords: healthy eating index (HEI), food diversity, quality of consumption, adolescent

Procedia PDF Downloads 175

Authors: Javad Sarvestan, Zdenek Svoboda

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Force-time (F-T) curvature characteristics are globally referenced as the main indicators of athletic jump performance. Nevertheless, to the best of authors’ knowledge, no investigation tried to deeply study the relationship between F-T curve variables and real-game jump performance among elite volleyball players. To this end, this study was designated to investigate the association between F-T curve variables, including movement timings, force, velocity, power, rate of force development (RFD), modified reactive strength index (RSImod), and net impulse with spike jump height during real-game circumstances. Twelve young elite volleyball players performed 3 countermovement jump (CMJ) and 3 spike jump in real-game circumstances with 1-minute rest intervals to prevent fatigue. Shapiro-Wilk statistical test illustrated the normality of data distribution, and Pearson’s product correlation test portrayed a significant correlation between CMJ height and peak RFD (0.85), average RFD (r=0.81), RSImod (r=0.88) and concentric net impulse (r=0.98), and also significant correlation between spike jump height and peak RFD (0.73), average RFD (r=0.80), RSImod (r=0.62) and concentric net impulse (r=0.71). Multiple regression analysis also reported that these factors have a strong contribution in predicting of CMJ (98%) and spike jump (77%) heights. Outcomes of this study confirm that the RFD, concentric net impulse, and RSImod values could precisely monitor and track the volleyball attackers’ explosive strength, muscular stretch-shortening cycle function efficiency, and ultimate spike jump height. To this effect, volleyball coaches and trainers are advised to have an in-depth focus on their athletes’ progression or the impacts of strength trainings by observing and chasing the F-T curve variables such as RFD, net impulse, and RSImod.

Keywords: net impulse, reactive strength index, rate of force development, stretch-shortening cycle

Procedia PDF Downloads 135

Authors: Masoud Abedini, Azrul A. Mutalib

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A study of the used of additives which mixed with concrete in order to increase the strength and durability of concrete was examined to improve the quality of many aspects in the concrete. This paper presents a polypropylene (PP) fibre was added into concrete to study the dynamic response under impact load. References related to dynamic impact test for sample polypropylene fibre reinforced concrete (PPFRC) is very limited and there is no specific research and information related to this research. Therefore, the study on the dynamic impact of PPFRC using a Split Hopkinson Pressure Bar (SHPB) was done in this study. Provided samples for this study was composed of 1.0 kg/m³ PP fibres, 2.0 kg/m³ PP fibres and plain concrete as a control samples. This PP fibre contains twisted bundle non-fibrillating monofilament and fibrillating network fibres. Samples were prepared by cylindrical mould with three samples of each mix proportion, 28 days curing period and concrete grade 35 Mpa. These samples are then tested for dynamic impact by SHPB at 2 Mpa pressure under the strain rate of 10 s-1. Dynamic compressive strength results showed an increase of SC1 and SC2 samples than the control sample which is 13.22 % and 76.9 % respectively with the dynamic compressive strength of 74.5 MPa and 116.4 MPa compared to 65.8 MPa. Dynamic increased factor (DIF) shows that, sample SC2 gives higher value with 4.15 than others samples SC1 and SC3 that gives the value of 2.14 and 1.97 respectively.

Keywords: polypropylene fiber, Split Hopkinson Pressure Bar, impact load, dynamic compressive strength

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Authors: Eoin Kirwan, Christopher Nulty, Declan Browne

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The professional ice hockey season consists of approximately 60 regular season games with periods of fixture congestion occurring several times in the average season. These periods of congestion provide limited time for recovery, exposing the athletes to the risk of competing whilst not fully recovered. Although a body of research is growing with respect to monitoring fatigue, particularly during periods of congested fixtures in team sports such as rugby and soccer, it has received little to no attention thus far in ice hockey athletes. Consequently, there is limited knowledge on monitoring tools that might effectively detect a fatigue response and the magnitude of fatigue that can accumulate when recovery is limited by competitive fixtures. The benefit of quantifying and establishing fatigue status is the ability to optimise training and provide pertinent information on player health, injury risk, availability and readiness. Some commonly used methods to assess fatigue and recovery status of athletes include the use of perceived fatigue and wellbeing questionnaires, tests of muscular force and ratings of perceive exertion (RPE). These measures are widely used in popular team sports such as soccer and rugby and show promise as assessments of fatigue and recovery status for ice hockey athletes. As part of a larger study, this study explored the magnitude of changes in adductor muscle strength after game play and throughout a period of fixture congestion and examined the relationship between internal game load and perceived wellbeing with adductor muscle strength. Methods 8 professional ice hockey players from a British Elite League club volunteered to participate (age = 29.3 ± 2.49 years, height = 186.15 ± 6.75 cm, body mass = 90.85 ± 8.64 kg). Prior to and after competitive games each player performed trials of the adductor squeeze test at 0˚ hip flexion with the lead investigator using hand-held dynamometry. Rate of perceived exertion was recorded for each game and from data of total ice time individual session RPE was calculated. After each game players completed a 5- point questionnaire to assess perceived wellbeing. Data was collected from six competitive games, 1 practice and 36 hours post the final game, over a 10 – day period. Results Pending final data collection in February Conclusions Pending final data collection in February.

Keywords: Conjested fixtures, fatigue monitoring, ice hockey, readiness

Procedia PDF Downloads 142

Authors: Jaejun Jong

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Many teachers in South Korea conduct research to improve the quality of their instruction. Unfortunately, many researchers generalize the results of measurements based on one subgroup to other students or to the entire population, which can cause problems. This study aims to determine examples of possible problems resulting from generalizing measurements based on one subgroup to an entire population or another group. This study is needed, as teachers’ instruction and class quality significantly affect the overall quality of education, but the quality of research conducted by teachers can become questionable due to overgeneralization. Thus, finding potential problems of overgeneralization can improve the overall quality of education. The data in this study were gathered from 145 sixth-grade elementary school students in South Korea. The result showed that students in different classes could differ significantly in various ways; thus, generalizing the results of subgroups to an entire population can engender erroneous student predictions and evaluations, which can lead to inappropriate instruction plans. This result shows that finding the reasons for such overgeneralization can significantly improve the quality of education.

Keywords: generalization, measurement, research methodology, teacher education

Procedia PDF Downloads 93

Authors: Arturo Maldonado

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In the iron ore mining industry, the intact strength of rock units is defined using the uniaxial compressive strength (UCS). This parameter is very important for the classification of shale materials, allowing the split between rock and cohesive soils based on the magnitude of UCS. For this research, it is assumed that UCS less than or equal to 1 MPa is representative of soils. Several researchers have anticipated that the magnitude of UCS reduces with weathering progression, also since UCS is a directional property, its magnitude depends upon the rock fabric orientation. Thus, the paper presents how the UCS of shales is affected by both weathering grade and bedding orientation. The mineralogy of shales has been defined using Hyper-spectral and chemical assays to define the mineral constituents of shale and other non-shale materials. Geological classification tools have been used to define distinct lithological types, and in this manner, the author uses mineralogical datasets to recognize and isolate shales from other rock types and develop tertiary plots for fresh and weathered shales. The mineralogical classification of shales has reduced the contamination of lithology types and facilitated the study of the physical factors affecting the intact strength of shales, like anisotropic strength due to bedding orientation. The analysis of mineralogical characteristics of shales is perhaps the most important contribution of this paper to other researchers who may wish to explore similar methods.

Keywords: rock mechanics, mineralogy, shales, weathering, anisotropy

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Authors: S. L. Tulasi Devi, Shivam Azad

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The primary objective of this study is to analyze the impact of green bond issuance on the stock prices of respective Indian companies. An event study methodology has been employed to study the effect of green bond issuance. For in-depth study and analysis, this paper used different window frames, including 15-15 days, 10-10 days, 7-7days, 6-6 days, and 5-5 days. Further, for better clarity, this paper also used an uneven window period of 7-5 days. The period of study covered all the companies which issued green bonds during the period of 2017-2022; Adani Green Energy, State Bank of India, Power Finance Corporation, Jain Irrigation, and Rural Electrification Corporation, except Indian Renewable Energy Development Agency and Indian Railway Finance Corporation, because of data unavailability. The paper used all three event study methods as discussed in earlier literature; 1) constant return model, 2) market-adjusted model, and 3) capital asset pricing model. For the fruitful comparison between results, the study considered cumulative average return (CAR) and buy and hold average return (BHAR) methodology. For checking the statistical significance, a two-tailed t-statistic has been used. All the statistical calculations have been performed in Microsoft Excel 2016. The study found that all other companies have shown positive returns on the event day except for the State Bank of India. The results demonstrated that constant return model outperformed compared to the market-adjusted model and CAPM. The p-value derived from all the methods has shown an almost insignificant impact of the issuance of green bonds on the stock prices of respective companies. The overall analysis states that there’s not much improvement in the market efficiency of the Indian Stock Markets.

Keywords: green bonds, event study methodology, constant return model, market-adjusted model, CAPM

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Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

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Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

Procedia PDF Downloads 130

Authors: Ayodeji Motunrayo Omoare

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Economically fish provides an important source of food and income for both men and women especially many households in the developing world and fishing has an important social and cultural position in river-rine communities. However, fish is highly susceptible to deterioration. Consequently, this study was carried out to correlate income generation of small-scale women fish processors in Abeokuta metropolis, Ogun State, Nigeria. Eighty small-scale women fish processors were randomly selected from five communities as the sample size for this study. Collected data were analyzed using both descriptive and inferential statistics. The results showed that the mean age of the respondents was 31.75 years with average household size of 4 people while 47.5% of the respondents had primary education. Most (86.3%) of the respondents were married and had spent more than 11 years in fish processing. The respondents were predominantly Yoruba tribe (91.2%). Majority (71.3%) of the respondents used traditional kiln for processing their fish while 23.7% of the respondents used hot vegetable oil to fry their fish. Also, the result revealed that respondents sourced capital from Personal Savings (48.8%), Cooperatives (27.5%), Friends and Family (17.5%) and Microfinance Banks (6.2%) for fish processing activities. The respondents generated an average income of ₦7,000.00 from roasted fish, ₦3,500.00 from dried fish, and ₦5,200.00 from fried fish daily. However, inadequate processing equipment (95.0%), non-availability of credit facility from microfinance banks (85.0%), poor electricity supply (77.5%), inadequate extension service support (70.0%), and fuel scarcity (68.7%) were major constraints to fish processing in the study area. Results of chi-square analysis showed that there was a significant relationship between personal characteristics (χ2 = 36.83, df = 9), processing methods (χ2 = 15.88, df = 3) and income generated at p < 0.05 level of significance. It can be concluded that significant relationship existed between processing methods and income generated. The study, therefore, recommends that modern processing equipment should be made available to the respondents at a subsidized price by the agro-allied companies.

Keywords: correlates, income, fish processors, women, small-scale

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Authors: Daniela Gradinaru, Iuliana Georgescu, Loredana Hutanu (Toma), Mihai-Bogdan Afrasinei

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This article aims to analyze the situation of Romanian companies from an environmental point of view. Environmental issues are addressed very often nowadays, and they reach and affect every domain, including the economical one. Implementing an environmental management system will not only help the companies to comply with laws and regulations, but, above all, will offer them an important competitive advantage.

Keywords: environmental management system, environmental reporting, environmental expenses, sustainable development

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Authors: Kanika Sharma, Shaila Bahl, Birendra Singh, Pratik Kumar, S. P. Lochab, A. Pandey

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In the present investigation, initially nano-particles of CaF2 were prepared by the chemical co-precipitation method and later the prepared salt was activated by thulium (0.1 mol%) using the combustion technique. The final product was characterized and confirmed by X-Ray diffraction (XRD) and transmission electron microscopy (TEM). Further, the thermoluminescence (TL) properties of the nanophosphor were studied by irradiating it with 1.25 MeV of gamma radiation and 65 MeV of carbon (C6+) ion beam. For gamma rays, two prominent TL peaks were observed with a low temperature peak at around 1070C and a high temperature peak at around 1570C. Furthermore, the nanophosphor maintained a linear TL response for the entire range of studied doses i.e. 10 Gy to 2000 Gy for both the temperature peaks. Moreover, when the nanophosphor was irradiated with 65 MeV of C6+ ion beam the shape and structure of the glow curves remained spectacularly similar and the nanophosphor displayed a linear TL response for the full range of studied fluences i.e. 5*1010 ions/cm2 to 1 *1012 ions/ cm2. Finally, various tests like reproducibility test and batch homogeneity were also carried out to define the final product. Thus, co-precipitation method followed by combustion technique was successful in effectively producing dosimetric grade CaF2:Tm for dosimetry of gamma as well as carbon (C6+) beam.

Keywords: gamma radiation, ion beam, nanocrystalline, radiation dosimetry

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Authors: Nadjet Mekaouche, Hanane Zitouni, Fatma Boudia, Habiba Fetati, A. Saleh, A. Lardjam, H. Geniaux, A. Coubret, H. Toumi

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Medicines have undeniably played a major role in prolonging shelf life and improving quality. The absolute efficacy of the drug remains a lever for innovation, its benefit/risk balance is not always assured and it does not always have the expected effects. Prior to marketing, knowledge about adverse drug reactions is incomplete. Once on the market, phase IV drug studies begin. For years, the drug was prescribed with less care to a large number of very heterogeneous patients and often in combination with other drugs. It is at this point that previously unknown adverse effects may appear, hence the need for the implementation of a pharmacovigilance system. Pharmacovigilance represents all methods for detecting, evaluating, informing and preventing the risks of adverse drug reactions. The most severe adverse events occur frequently in hospital and that a significant proportion of adverse events result in hospitalizations. In addition, the consequences of hospital adverse events in terms of length of stay, mortality and costs are considerable. It, therefore, appears necessary to develop ‘hospital pharmacovigilance’ aimed at reducing the incidence of adverse reactions in hospitals. The most widely used monitoring method in pharmacovigilance is spontaneous notification. However, underreporting of adverse drug reactions is common in many countries and is a major obstacle to pharmacovigilance assessment. It is in this context that this study aims to describe the experience of the pharmacovigilance service at the University Hospital of Oran (EHUO). This is a retrospective study extending from 2011 to 2017, carried out on archived records of declarations collected at the level of the EHUO Pharmacovigilance Department. Reporting was collected by two methods: ‘spontaneous notification’ and ‘active pharmacovigilance’ targeting certain clinical services. We counted 217 statements. It involved 56% female patients and 46% male patients. Age ranged from 5 to 78 years with an average of 46 years. The most common adverse reaction was drug toxidermy. For the drugs in question, they were essentially according to the ATC classification of anti-infectives followed by anticancer drugs. As regards the evolution of declarations by year, a low rate of notification was noted in 2011. That is why we decided to set up an active approach at the level of some services where a resident of reference attended the staffs every week. This has resulted in an increase in the number of reports. The declarations came essentially from the services where the active approach was installed. This highlights the need for ongoing communication between all relevant health actors to stimulate reporting and secure drug treatments.

Keywords: adverse drug reactions, hospital, pharmacovigilance, spontaneous notification

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Authors: U. Pangnakorn, S. Chuenchooklin

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Acute and chronic effects of biopesticide from entomopathogenic nematode (Steinernema thailandensis n. sp.), bacteria ISR (Pseudomonas fluorescens), wood vinegar and fermented organic substances from plants: (neem Azadirachta indica + citronella grass Cymbopogon nardus Rendle + bitter bush Chromolaena odorata L.) were tested on culantro (Eryngium foetidum L.). The biopesticide was investigated for infestation reduction of the major insect pest whitefly (Bemisia tabaci (Gennadius)). The experimental plots were located at a farm in Nakhon Sawan Province, Thailand. This study was undertaken during the drought season (late November to May). Effectiveness of the treatment was evaluated in terms of acute and chronic effect. The populations of whitefly were observed and recorded every hour up to 3 hours with insect nets and yellow sticky traps after the treatments were applied for the acute effect. The results showed that bacteria ISR had the highest effectiveness for controlling whitefly infestation on culantro; the whitefly numbers on insect nets were 12.5, 10.0 and 7.5 after 1 hr, 2 hr, and 3 hr, respectively while the whitefly on yellow sticky traps showed 15.0, 10.0 and 10.0 after 1 hr, 2 hr, and 3 hr, respectively. For chronic effect, the whitefly was continuously collected and recorded at weekly intervals; the result showed that treatment of bacteria ISR found the average whitefly numbers only 8.06 and 11.0 on insect nets and sticky traps respectively, followed by treatment of nematode where the average whitefly was 9.87 and 11.43 on the insect nets and sticky traps, respectively. In addition, the minor insect pests were also observed and collected. The biopesticide influenced the reduction number of minor insect pests (red spider mites, beet armyworm, short-horned grasshopper, pygmy locusts, etc.) with only a few found on the culantro cultivation.

Keywords: whitefly (Bemisia tabaci Gennadius), culantro (Eryngium foetidum L.), acute and chronic effect, entomopathogenic nematode (Steinernema thailandensis n. sp.), bacteria ISR (Pseudomonas fluorescens)

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Authors: S. Rashmi, Devashish Das, N. Spoorthi, H. V. Manasa

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Energy is essential and plays an important role for overall development of a nation. The global economy literally runs on energy. The use of fossil fuels as energy is now widely accepted as unsustainable due to depleting resources and also due to the accumulation of greenhouse gases in the environment, renewable and carbon neutral biodiesel are necessary for environment and economic sustainability. Unfortunately biodiesel produced from oil crop, waste cooking oil and animal fats are not able to replace fossil fuel. Fossil fuels remain the dominant source of primary energy, accounting for 84% of the overall increase in demand. Today biodiesel has come to mean a very specific chemical modification of natural oils. Objectives: To produce biodiesel from yellow oleander seed oil, to test the yield of biodiesel using different types of catalyst (KOH & NaOH). Methodology: Oil is extracted from dried yellow oleander seeds using Soxhlet extractor and oil expeller (bulk). The FFA content of the oil is checked and depending on the FFA value either two steps or single step process is followed to produce biodiesel. Two step processes includes esterfication and transesterification, single step includes only transesterification. The properties of biodiesel are checked. Engine test is done for biodiesel produced. Result: It is concluded that biodiesel quality parameters such as yield(85% & 90%), flash point(1710C & 1760C),fire point(1950C & 1980C), viscosity(4.9991 and 5.21 mm2/s) for the biodiesel from seed oil of Thevetiaperuviana produced by using KOH & NaOH respectively. Thus the seed oil of Thevetiaperuviana is a viable feedstock for good quality fuel.The outcomes of our project are a substitute for conventional fuel, to reduce petro diesel requirement,improved performance in terms of emissions. Future prospects: Optimization of biodiesel production using response surface method.

Keywords: yellow oleander seeds, biodiesel, quality parameters, renewable sources

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Authors: Galina Portnova, Kseniya Gladun

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In our EEG experiment participated 27 children with ASD with the average age of 6.13 years and the average score for CARS 32.41 and 25 healthy children (of 6.35 years). Six types of musical stimulation were presented, included Gluck, Javier-Naida, Kenny G, Chopin and other classic musical compositions. Children with autism showed orientation reaction to the music and give behavioral responses to different types of music, some of them might assess stimulation by scales. The participants were instructed to remain calm. Brain electrical activity was recorded using a 19-channel EEG recording device, 'Encephalan' (Russia, Taganrog). EEG epochs lasting 150 s were analyzed using EEGLab plugin for MatLab (Mathwork Inc.). For EEG analysis we used Fast Fourier Transform (FFT), analyzed Peak alpha frequency (PAF), correlation dimension D2 and Stability of rhythms. To express the dynamics of desynchronizing of different rhythms we've calculated the envelope of the EEG signal, using the whole frequency range and a set of small narrowband filters using Hilbert transformation. Our data showed that healthy children showed similar EEG spectral changes during musical stimulation as well as described the feelings induced by musical fragments. The exception was the ‘Chopin. Prelude’ fragment (no.6). This musical fragment induced different subjective feeling, behavioral reactions and EEG spectral changes in children with ASD and healthy children. The correlation dimension D2 was significantly lower in autists compared to healthy children during musical stimulation. Hilbert envelope frequency was reduced in all group of subjects during musical compositions 1,3,5,6 compositions compared to the background. During musical fragments 2 and 4 (terrible) lower Hilbert envelope frequency was observed only in children with ASD and correlated with the severity of the disease. Alfa peak frequency was lower compared to the background during this musical composition in healthy children and conversely higher in children with ASD.

Keywords: electroencephalogram (EEG), emotional perception, ASD, musical perception, childhood Autism rating scale (CARS)

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Authors: Shu Hwang Ang, Choo Yee Yu, Geik Yong Ang, Yean Yean Chan, Yatimah Binti Alias, And Sook Mei Khor

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With the high prevalence of Type 2 diabetes mellitus across the world, the morbidities and mortalities associated with Type 2 diabetes have significant impact on the production line for a nation. With routine scheduled clinical visits to manage Type 2 diabetes, diabetic patients with hectic lifestyles can have low clinical compliance. Hence, it often decreases the effectiveness of diabetic management personalized for each diabetic patient. Here, we report a useful developed point-of-care (POC) device that detect glycated hemoglobin (HbA1c, biomarker for long-term Type 2 diabetic management). In fact, the established POC devices certified to be used in clinical setting are not only expensive ($ 8 to $10 per test), they also require skillful practitioners to perform sampling and interpretation. As a paper-based biosensor, the developed HbA1c biosensor utilized lateral flow principle to offer an alternative for cost-effective (approximately $2 per test) and end-user friendly device for household testing. Requiring as little as 2 L of finger-picked blood, the test can be performed at the household with just simple dilution and washings. With visual interpretation of numbers of test lines shown on the developed biosensor, it can be interpreted as easy as a urine pregnancy test, aided with scale of intensity provided. In summary, the developed HbA1c immunosensor has been tested to have high selectivity towards HbA1c, and is stable with reasonably good performance in clinical testing. Therefore, our developed HbA1c immunosensor has high potential to be an effective diabetic management tool to increase patient compliance and thus contain the progression of the diabetes.

Keywords: blood, glycated hemoglobin (HbA1c), lateral flow, type 2 diabetes mellitus

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Authors: Mitsuhiro Okayasu, Lele Yang, Koji Shimotsu

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The effects of microstructural characteristics on the mechanical and hydrogen embrittlement properties of 1,800MPa grade hot stamping carbon steel were investigated experimentally. The tensile strength increased with increasing the hot stamping temperature until around 921°C, but that decreased with increasing the temperature in more than 921°C due to the increment of the size of lath martensite and prior austenite. With the hot stamping process, internal strain was slightly created in the sample, which led to the slight increment of the hardness value although no clear change of the microstructural formation was detected. Severity of hydrogen embrittlement was investigated using the hot stamped carbon steels after the immersion in a hydrogen gas, and that was directly attributed to the infiltration of the hydrogen into their grain boundaries. The high strength carbon steel with tiny lath martensite microstructure could make severe hydrogen brittleness as the hydrogen was strongly penetrated in the grain boundaries in the hydrogen gas for a month. Because of weak embrittlement for the as-received carbon (ferrite and pearlite), hydrogen embrittlement is caused by the high internal strain and high dislocation density. The hydrogen embrittlement for carbon steel is attributed to amount of the hydrogen immersed in-between grain boundaries, which is caused by the dislocation density and internal strain.

Keywords: hydrogen embrittlement, hot stamping process, carbon steel, mechanical property

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Authors: Zahra Alikhani Koopaei

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In the fifth lesson of the third-grade mathematics book, students are introduced to the concept of multiplication. However, some students showed a lack of interest in learning this topic. To address this, a simple electronic multiplication table was designed with the aim of making the concept of multiplication entertaining and engaging for students. It provides them with moments of excitement during the learning process. To achieve this goal, a device was created that produced a bell sound when two wire ends were connected. Each wire end was connected to a specific number in the multiplication table, and the other end was linked to the corresponding answer. Consequently, if the answer is correct, the bell will ring. This study employs interactive and engaging methods to teach mathematics, particularly to students who have previously shown little interest in the subject. By integrating game-based learning and critical thinking, we observed an increase in understanding and interest in learning multiplication compared to before using this method. This further motivated the students. As a result, the intelligent multiplication table was successfully designed. Students, under the instructor's supervision, could easily construct the device during the lesson. Through the implementation of these operations, the concept of multiplication was firmly established in the students' minds. Engaging multiple intelligences in each student enhances a more stable and improved understanding of the concept of multiplication.

Keywords: intelligent multiplication table, design, construction, education, increased interest, students

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Authors: Susanne Fridsten, Kristina Hellman, Anders Sundin, Lennart Blomqvist

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Background: Patients diagnosed with locally advanced cervical carcinoma are treated with definitive concomitant chemo-radiotherapy. Treatment failure occurs in 30-50% of patients with very poor prognoses. The treatment is standardized with risk for both over-and undertreatment. Consequently, there is a great need for biomarkers able to predict therapy outcomes to allow for individualized treatment. Aim: To explore the role of T2- and diffusion-weighted magnetic resonance imaging (MRI) for early prediction of therapy outcome and the optimal time point for assessment. Methods: A pilot study including 15 patients with cervical carcinoma stage IIB-IIIB (FIGO 2009) undergoing definitive chemoradiotherapy. All patients underwent MRI four times, at baseline, 3 weeks, 5 weeks, and 12 weeks after treatment started. Tumour size, size change (∆size), visibility on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and change of ADC (∆ADC) at the different time points were recorded. Results: 7/15 patients relapsed during the study period, referred to as "poor prognosis", PP, and the remaining eight patients are referred to "good prognosis", GP. The tumor size was larger at all time points for PP than for GP. The ∆size between any of the four-time points was the same for PP and GP patients. The sensitivity and specificity to predict prognostic group depending on a remaining tumor on DWI were highest at 5 weeks and 83% (5/6) and 63% (5/8), respectively. The combination of tumor size at baseline and remaining tumor on DWI at 5 weeks in ROC analysis reached an area under the curve (AUC) of 0.83. After 12 weeks, no remaining tumor was seen on DWI among patients with GP, as opposed to 2/7 PP patients. Adding ADC to the tumor size measurements did not improve the predictive value at any time point. Conclusion: A large tumor at baseline MRI combined with a remaining tumor on DWI at 5 weeks predicted a poor prognosis.

Keywords: chemoradiotherapy, diffusion-weighted imaging, magnetic resonance imaging, uterine cervical carcinoma

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Authors: Joel Santhosh, N. Bhavani Shankar Rao

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Problems associated with construction site have been known for many years. Construction industry has to support a world of continuing population growth and economic development. The rising costs of construction materials and the need to adhere to sustainability, alternative construction techniques and materials are being sought. To increase the applications of concrete paving blocks, greater understanding of products produced with locally available materials and indigenously produced mineral admixtures is essential. In the present investigation, concrete paving blocks may be produced with locally available aggregates, cement, fly ash and waste glass powder as the mineral admixture. The ultimate aim of this work is to ascertain the performance of concrete paving blocks containing fly ash and glass powder and compare it with the performance of conventional concrete paving blocks. Mix design is carried out to form M40 grade of concrete by using IS: 10262: 2009 and specification given by IRC: SP: 63: 2004. The paving blocks are tested in accordance to IS: 15658: 2006. It showed that the partial replacement of cement by fly ash and waste glass powder satisfies the minimum requirement as specified by the Indian standard IS: 15658: 2006 for concrete paving blocks to be used in non traffic, light traffic and medium-heavy traffic areas. The study indicated that fly ash and waste glass powder can effectively be used as cement replacement without substantial change in strength.

Keywords: paving block, fly ash, glass powder, strength, abrasion resistance, durability

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Authors: Ahmad AlAbdullah, Ali AlQallaf, Mahdi Hussain, Mohammed AlAttar, Salman Ashknani, Magdy Helal

Abstract:

We study the effectiveness of the parking service provided at Kuwaiti commercial malls and explore potential problems and feasible improvements. Commercial malls are important to Kuwaitis as the entertainment and shopping centers due to the lack of other alternatives. The difficulty and relatively long times wasted in finding a parking spot at the mall are real annoyances. We applied queuing analysis to one of the major malls that offer paid-parking (1040 parking spots) in addition to free parking. Patrons of the mall usually complained of the traffic jams and delays at entering the paid parking (average delay to park exceeds 15 min for about 62% of the patrons, while average time spent in the mall is about 2.6 hours). However, the analysis showed acceptable service levels at the check-in gates of the parking garage. Detailed review of the vehicle movement at the gateways indicated that arriving and departing cars both had to share parts of the gateway to the garage, which caused the traffic jams and delays. A simple comparison we made indicated that the largest commercial mall in Kuwait does not suffer such parking issues, while other smaller, yet important malls do, including the one we studied. It was suggested that well-designed inlets and outlets of that gigantic mall permitted smooth parking despite being totally free and mall is the first choice for most people for entertainment and shopping. A simulation model is being developed for further analysis and verification. Simulation can overcome the mathematical difficulty in using non-Poisson queuing models. The simulation model is used to explore potential changes to the parking garage entrance layout. And with the inclusion of the drivers’ behavior inside the parking, effectiveness indicators can be derived to address the economic feasibility of extending the parking capacity and increasing service levels. Outcomes of the study are planned to be generalized as appropriate to other commercial malls in Kuwait

Keywords: commercial malls, parking service, queuing analysis, simulation modeling

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Authors: Dua Masarwa, Yulia Niazov, Merav Ben Natan, Dina Mostovoy

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Background: the aimed to explore the role of parental health beliefs in parent seeking of eye examinations for their children, using the Health Belief Model. Methods: In this quantitative correlational survey study, 100 parents who presented to Barzilai University Medical Center in July 2021 to perform an eye examination to their child completed a questionnaire. Results: Only 29.6% of the parents knew that a vision screening is performed in first grade, and 10% of the parents were unsure about where to find local eye care for their kids. Moreover, 19% of the parents indicated that they were concerned that their child would be prescribed glasses unnecessarily, and 10% believed that wearing glasses would weaken their child's eyes. Various parental health beliefs regarding children's eye examinations were found associated with parent seeking of eye examinations for their child. Thus, perceived susceptibility (r = 0.52, p < 0.01), perceived benefits (r = 0.39, p < 0.01), and perceived barriers (r=-0.31, p < 0.01) are associated with parent seeking of eye examinations for their child. Also, parents' level of knowledge was associated with seeking eye examinations for their child (r = 0.20, p < 0.01). Conclusion: Parent perceptions of the child's susceptibility to vision problems and perceived barriers to seeking eye examinations predicted parents seeking of eye examinations for their child. Interventions aimed at increasing timely eye examinations among children should focus on raising parent awareness of vision problems in childhood, dispelling misconceptions, and providing parents with practical information regarding available services.

Keywords: children, parents, eye examination, health beliefs, vision problems

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