Search results for: electronic medical record

Authors: Larissa Burruano, Sergey Grabovyj, Irina Nguen

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The study aimed to assess the level of adherence to anti retroviral therapy (ART) and to examine the relationship between adherence and risk behavior factor (drug use) among patients infected with HIV. The patients with newly diagnosed or established HIV infection under follow-up at the Sumskij Regional Centre for AIDS Prevention in Ukraine were eligible for this study. Medical records were used to measure the patient’s adherence to medication. Measurements were obtained at month 6 and at month 12 to calculate the number of medication omission during the past 30 days: (on a 2-point scale – once until three in a month – were considered adherent, three and more in a month – were considered non-adherent). Of the 50 study participants, 27 (54.0%) were men and 23 (46.0%) women. The mean age is 35.2 years (SD= 5.1). A majority of the patients (82.0%) is in the age group of 25-30 years. The main level of adherence was 74.0% and 66.0% at 6 and 12 months, respectively. The main routes of HIV transmission were drug injection among men 12 (44.4%) and sexual contact among women 11 (47.8%). Univariate analyses indicated that patients who had lower level of education were more likely to have been non-adherent at month 6- (X2 =5.1, n=50, p < .05) and at month 12 (X2 = 4.34, n=50, p < .05). Multivariate tests showed that only age (OR= 1.163 [95% CI 0.98–1.370]) was significant independent predictor of treatment adherence, while gender, education, employment status were not predictive for the risk of developing non-compliance. There was not a significant interaction between non-adherence and intravenous drug use. Consistent with these findings, younger people were more likely to have missed a dose of their medication because they had a greater sense of invulnerability than older patients. The study indicates that the socio demographic characteristic should be taken into an account in the future research regarding adherence in the case of HIV infection. If the patient anti retroviral adherence can be improved by qualitatively better medical care in all regions of the Ukraine, behavioral changes in the population can to be expected in the long term.

Keywords: HIV, antiretroviral therapy, adherence, Ukraine, Eastern Europe

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Authors: Elizabeth Russo, Angelica Terepka

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The present paper reviews literature examining trends among suicide, suicidal ideation, and mental illness rates in ethnic and racial minority student-athletes. While the rates of suicide amongst student athlete populations is lower than rates of suicide seen in the general student populations, there is a discrepancy amongst rates of suicide in student athletes; specifically, those identifying with racial and ethnic minority backgrounds endorse higher rates of suicidal ideation. The samples from the existing literature consisted of White, Black, Hispanic/Latinx, Asian/ Pacific Islander, Multiracial, and Native American student-athletes. Studies suggest that ethnic and racial minority students are more susceptible to suicide, depression, and other mental health concerns compared to their white counterparts. Across the literature, White student athletes appeared to have more social and academic support from fellow classmates, university administration and professors, and staff within their athletic departments. Student athletes who did not identify as White endorsed higher rates of loneliness, felt ethnically and racially underrepresented within their athletic department, and endorsed lack of appropriate medical treatment for injuries by athletic department medical staff. Additionally, non-White student athletes receive less peer support and must balance additional stressors such as discrimination in contrast to their White/non-Latinx peers. Recommendations for athletic departments and mental health providers supporting student athletes who identify as racial and ethnic minorities are discussed.

Keywords: racial and ethnic minority, suicide, student-athlete, suicidal ideation

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Authors: Molly Pui Man Wong

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In this study, a blended and interactive e-learning Courseware that our team developed will be introduced, and our team’s experiences on how the e-learning Courseware and the flipped classroom benefit student learning in bioethics in the medical program will be shared. This study is a continuation of the previously established study, which provides a summary of the well-developed e-learning Courseware in a blended learning approach and an update on its efficiency and efficacy. First, a collection of animated videos capturing selected topics of bioethics and related ethical issues and dilemma will be introduced. Next, a selection of problem-based learning videos (“simulated doctor-patient role play”) with pop-up questions and discussions will be further discussed. Our recent findings demonstrated that these activities launched by the Courseware strongly engaged students in bioethics education and enhanced students’ critical thinking and creativity, which were consistent with the previous data in the preliminary studies. Moreover, the educational benefits of the online art exhibition, art jamming, and competition will be discussed, through which students could express bioethics through arts and enrich their learning in medical research in an interactive, fun, and entertaining way, strengthening their interests in bioethics. Furthermore, online survey questionnaires and focus group interviews were conducted. Consistent with the preliminary studies, our results indicated that implementing the e-learning Courseware with a flipped classroom in bioethics education enhanced both active learning and student engagement. In conclusion, our Courseware not only reinforces education in art, bioethics, and medicine but also benefits students in understanding and critical thinking in socio-ethical issues and serves as a valuable learning tool in bioethics teaching and learning.

Keywords: bioethics, courseware, e-learning, flipped classroom

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Authors: Samuel Pimpong

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In most liberal and constitutional democracies, the media serves as a dominant power in the construction of the fundamental building blocks for the consolidation of democratic governance. However, the extent to which the media can enhance democratic consolidation in a country depends to a large extent on the independence of the media, the robustness of legislative frameworks and the safety of journalists in discharging their duties without fear or favor. This study sought to examine pertinent issues, practices and challenges facing the media in Ghana’s Fourth Republic and attempts to make recommendations regarding the way forward. The work adopted a qualitative study approach. A total of sixteen (16) participants were purposively selected for face-to-face interviews. The study hinges on the democratic participant media theory and the development media theory. Primary data was analyzed via thematic analysis procedure. The study revealed that although Ghana has repealed its criminal libel laws, nonetheless other statutory Acts, such as the Electronic Communications Act 2008 (ACT 775) and the Criminal and other offences Act 1960 (Act 29), among others continue to stifle freedom of expression. On the other hand, press freedom is being abused by the use of fake content publication. Further, the study revealed that the absence of a comprehensive regulatory structure impedes the activities carried out by the media. Consequently, the study recommends a regulatory structure to oversee media activities and content, as the National Media Commission (NMC) lacks the authority to do so. In this direction, the study recommends a limitation on the role of the National Communications Authority (NCA) to administer broadcasting signals and transfer its licensing and sanctioning powers to the NMC in order to create one sole and completely independent media regulatory authority that deals with all media related issues.

Keywords: media, constitutional democracy, democratic consolidation, fourth republic

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Authors: Ateba Benedict Belobo, Faan Pelser, Ambe Marcus

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Aims: This study arise from repeated complaints from both electronic mails about the underperformance of Mafikeng Small and Medium-Size enterprises after the global financial crisis. The authors were on the view that, this poor performance experienced could be as a result of the negative effects on the cash flow of these businesses due to volatilities in the business environment in general prior to the global crisis. Thus, the paper was mainly aimed at determining the shortcomings experienced by these SMEs with regards to cash flow management. It was also aimed at suggesting possible measures to improve cash flow management of these SMEs in this tough time. Methods: A case study was conducted on 3 beverage suppliers, 27 bottle stores, 3 largest fast consumer goods super markets and 7 automobiles enterprises in the Mafikeng local municipality. A mixed method research design was employed and a purposive sampling was used in selecting SMEs that participated. Views and experiences of participants of the paper were captured through in-depth interviews. Data from the empirical investigation were interpreted using open coding and a simple percentage formula. Results: Findings from the empirical research reflected that majority of Mafikeng SMEs suffer poor operational performance prior to the global financial crisis primarily as a result of poor cash flow management. However, the empirical outcome also indicted other secondary factors contributing to this poor operational performance. Conclusion: Finally, the authorsproposed possible measures that could be used to improve cash flow management and to solve other factors affecting operational performance of SMEs in the Mafikeng local municipality in other to achieve a better business performance.

Keywords: cash flow, business performance, global financial crisis, SMEs

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Authors: Thaminda Liyanage, Anuga Liyanage, Chamila Kurukulasuriya, Sidath Bandara

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Background: The burden of chronic kidney disease (CKD) is growing rapidly around the world, particularly in Asia. Over the last two decades Sri Lanka has experienced an epidemic of CKD with ever growing number of patients pursuing medical care due to CKD and its complications, specially in the “Mahaweli” river basin in north central region of the island nation. This was apparently a new form of CKD which was not attributable to conventional risk factors such as diabetes mellitus, hypertension or infection and widely termed as “CKD-unknown” or “CKDu”. In the past decade a number of small scale studies were conducted to determine the aetiology, prevalence and complications of CKDu in North Central region. These hospital-based studies did not provide an accurate estimate of the problem as merely 10% or less of the people with CKD are aware of their diagnosis even in developed countries with better access to medical care. Interestingly, similar observations were made on the changing epidemiology of obesity in the region but no formal study was conducted to date to determine the magnitude of obesity burden. Moreover, if increasing obesity in the region is associated with CKD epidemic is yet to be explored. Methods: We will conduct an area wide cross sectional survey among all adult residents of the “Mahaweli” development project area 5, in the North Central Province of Sri Lanka. We will collect relevant medical history, anthropometric measurements, blood and urine for hematological and biochemical analysis. We expect a participation rate of 75%-85% of all eligible participants. Participation in the study is voluntary, there will be no incentives provided for participation. Every analysis will be conducted in a central laboratory and data will be stored securely. We will calculate the prevalence of obesity and chronic kidney disease, overall and by stage using total number of participants as the denominator and report per 1000 population. The association of obesity and CKD will be assessed with regression models and will be adjusted for potential confounding factors and stratified by potential effect modifiers where appropriate. Results: This study will provide accurate information on the prevalence of obesity and CKD in the region. Furthermore, this will explore the association between obesity and CKD, although causation may not be confirmed. Conclusion: Obesity and CKD are increasingly recognized as major public health problems in Sri Lanka. Clearly, documenting the magnitude of the problem is the essential first step. Our study will provide this vital information enabling the government to plan a coordinated response to tackle both obesity and CKD in the region.

Keywords: BMI, Chronic Kidney Disease, obesity, Sri Lanka

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Authors: Freya Harding, Anne Gatuguta, Chi Eziefula

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Introduction Research shows the quality of experiences of pregnancy, birth, and postpartum impacts the health and well-being of the mother and baby. This is recognised by the WHO in their recommendations ‘Intrapartum care for a positive childbirth experience’. The COVID-19 pandemic saw the transformation of the NHS Maternity services to prevent the transmission of COVID-19. Physical and social isolation may have affected women’s experiences of pregnancy, birth and postpartum; especially those of healthcare. Examples of such changes made to the NHS include both the reduction in volume of face-to-face consultations and restrictions to visitor time in hospitals. One notable detriment due to these changes was the absence of a partner during certain stages of birth. The aim of this study was to explore women’s experiences of pregnancy, birth, and postnatal period during the COVID-19 pandemic in the UK. Methods We collected qualitative data from women who had given birth during the COVID-19 pandemic. In-depth, semi-structured interviews were conducted with twelve participants recruited from mother and baby groups in Southeast England. Data were audio-recorded, transcribed verbatim, and analysed thematically using both inductive and deductive approaches. Ethics permission was granted from Brighton and Sussex Medical School (ER/BSMS9A83/1). Results Interviews were conducted with 12 women who gave birth between May 2020 and February 2021. Ages of the participants ranged between 28 and 42 years, most of which were white British, with one being Asian British. All participants were heterosexual and either married or co-habiting with their partner. Five participants worked in the NHS, and all participants had professional occupations. Women felt inadequately supported both socially and medically. An appropriate sense of control over their own birthing experience was lacking. Safety mechanisms, such as in-person visits from the midwife, had no suitable alternatives in place. Serious health issues were able to “slip through the net.” Mental health conditions in some of those interviewed worsened or developed. Similarly, reduced support from partners during birth and during the immediate postpartum period at the hospital, coupled with reduced ward staffing, resulted in some traumatic experiences; particularly for women who had undergone caesarean section. However, some unexpected positive effects were reported; one example being that partners were able to spend more time with their baby due to furlough schemes and working from home. Similarly, emergency care was not felt to have been compromised. Overall, six themes emerged: (1) Self-reported traumatic experiences, (2) Challenges of caring for a baby with reduced medical and social support, (3) Unexpected benefits to the parenting experience, (4) The effects of a sudden change in medical management (5) Poor communication from healthcare professionals (6) Social change; with subthemes of support accessing medical care, the workplace, family and friends, and antenatal & baby groups. Conclusions The results indicate that the healthcare system was unable to adequately deliver maternity care to facilitate positive pregnancy, birth, and postnatal experiences during the heights of the pandemic. The poor quality of such experiences has been linked an increased risk of long-term health complications in both the mother and child.

Keywords: pregnancy, birth, postpartum, postnatal, COVID-19, maternity, social support, qualitative, pandemic

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Authors: Ma. Cecilia D. Licuan

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The pandemic situation continues to affect the lives of many people, including children with disabilities and their families, globally, especially in developing countries like the Philippines. The operations of health programs, industries, and economic sectors, as well as academic training institutions, are still challenged in terms of operations and delivery of services. The academic community of the Physical Therapy program is not spared by this circumstance. The restriction posted by the quarantine policies nearly terminated the onsite delivery of training programs for the senior internship level, which challenged the academic institutions to implement flexible learning programs to ensure the continuity of the instructional and learning processes with full consideration of safety and compliance to health protocols. This study aimed to develop a benchmark model that can be used by tertiary-level health institutions in the implementation of the Pediatric Senior Clinical Internship Training Program using Telerehabilitation. It is a descriptive-qualitative paper that utilized documentary analysis and focused on explaining the design, development, and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences (DLSMHSI-CRS) Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program covering the pandemic years spanning from the academic year 2020- 2021 to present anchored on needs analysis based on documentary reviews. Results of the study yielded the determination of the Pediatric Telerehabilitation Model; declaration of developed training program outcomes and thrusts and content; explanation of the process integral to the training program’s pedagogy in implementation; and the evaluation procedures conducted for the program. Since the study did not involve human participants, ethical considerations on the use of documents for review were done upon the endorsement of the management of the DLSMHSI-CRS to conduct the study. This paper presents the big picture of how a tertiary-level health sciences institution in the Philippines embraced the senior clinical internship challenges through the operations of its telerehabilitation program. It specifically presents the design, development and implementation processes used by De La Salle Medical and Health Sciences Institute – College of Rehabilitation Sciences Physical Therapy Department in its Pediatric Cluster Senior Clinical Internship Training Program, which can serve as a benchmark model for other institutions as they continue to serve their stakeholders amidst the pandemic.

Keywords: pediatric physical therapy, telerehabilitation, clinical internship, pandemic

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Authors: Carlos Rios Llamas

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Urban health challenges, like the obesity epidemic, need to be studied from a dialogue between different disciplines and geographical conditions. Public health uses quantitative analysis and local samples, but qualitative data and multisite analysis would help to better understand how obesity has become a health problem. In the last decades, obesity rates have increased in most of the countries, especially in the Western World. Concerned about the problem, the American Medical Association has recently voted obesity as a disease. Suddenly, a ‘war on obesity’ attracted scientists from different disciplines to explore various ways to control and even reverse the trends. Medical sciences have taken the advance with quantitative methodologies focused on individual behaviors. Only a few scientist have extended their studies to the environment where obesity is produced as social risk, and less of them have taken into consideration the political and cultural aspects. This paper presents a multisite ethnography in South Bronx, USA, La Courneuve, France, and Lomas del Sur, Mexico, where obesity rates are as relevant as urban degradation. The comparative ethnography offers a possibility to unveil the mechanisms producing health risks from the urban tissue. The analysis considers three main categories: 1) built environment and access to food and physical activity, 2) biocultural construction of the healthy body, 3) urban inequalities related to health and body size. Major findings from a comparative ethnography on obesogenic environments, refer to the anthropological values related to food and body image, as well as the multidimensional oppression expressed in fat people who live in stigmatized urban zones. At the end, obesity, like many other diseases, is the result of political and cultural constructions structured in urbanization processes.

Keywords: comparative ethnography, urban health, obesogenic cities, biopolitics

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Authors: Gianluca Castelnuovo, Gian Mauro Manzoni, Giada Pietrabissa, Stefania Corti, Emanuele Giusti, Roberto Cattivelli, Enrico Molinari, Susan Simpson

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Obesity is currently an important public health problem of epidemic proportions (globesity). Moreover Binge Eating Disorder (BED) is typically connected with obesity, even if not occurring exclusively in conjunction with overweight conditions. Typically obesity with BED requires a longer term treatment in comparison with simple obesity. Rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation, due to the growing costs of a limited inpatient approach. Internet-based technologies can improve long-term obesity rehabilitation within a collaborative approach. The new m health (m-health, mobile health) paradigm, defined as clinical practices supported by up to date mobile communication devices, could increase compliance- engagement and contribute to a significant cost reduction in BED and obesity rehabilitation. Five psychological components need to be considered for successful m Health-based obesity rehabilitation in order to facilitate weight-loss.1) Self-monitoring. Portable body monitors, pedometers and smartphones are mobile and, therefore, can be easily used, resulting in continuous self-monitoring. 2) Counselor feedback and communication. A functional approach is to provide online weight-loss interventions with brief weekly or monthly counselor or psychologist visits. 3) Social support. A group treatment format is typically preferred for behavioral weight-loss interventions. 4) Structured program. Technology-based weight-loss programs incorporate principles of behavior therapy and change with structured weekly protocolos including nutrition, exercise, stimulus control, self-regulation strategies, goal-setting. 5) Individually tailored program. Interventions specifically designed around individual’s goals typically record higher rates of adherence and weight loss. Opportunities and limitations of m health approach in clinical psychology for obesity and BED are discussed, taking into account future research directions in this promising area.

Keywords: obesity, rehabilitation, out-patient, new technologies, tele medicine, tele care, m health, clinical psychology, psychotherapy, chronic care management

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Authors: Samson Mil'shtein, Dhawal Asthana, Benjamin Sullivan

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The wide energy gap of GaN is the major parameter justifying the design and fabrication of high-power electronic components made of this material. However, the existence of a piezo-electrics in nature sheet charge at the AlGaN/GaN interface complicates the control of carrier injection into the intrinsic channel of GaN HEMTs (High Electron Mobility Transistors). As a result, most of the transistors created as R&D prototypes and all of the designs used for mass production are D-mode devices which introduce challenges in the design of integrated circuits. This research presents the design and modeling of an E-mode GaN HEMT with a very low turn-on voltage. The proposed device includes two critical elements allowing the transistor to achieve zero conductance across the channel when Vg = 0V. This is accomplished through the inclusion of an extremely thin, 2.5nm intrinsic Ga₀.₇₄Al₀.₂₆N spacer layer. The added spacer layer does not create piezoelectric strain but rather elastically follows the variations of the crystal structure of the adjacent GaN channel. The second important factor is the design of a gate metal with a high work function. The use of a metal gate with a work function (Ni in this research) greater than 5.3eV positioned on top of n-type doped (Nd=10¹⁷cm⁻³) Ga₀.₇₄Al₀.₂₆N creates the necessary built-in potential, which controls the injection of electrons into the intrinsic channel as the gate voltage is increased. The 5µm long transistor with a 0.18µm long gate and a channel width of 30µm operate at Vd=10V. At Vg =1V, the device reaches the maximum drain current of 0.6mA, which indicates a high current density. The presented device is operational at frequencies greater than 10GHz and exhibits a stable transconductance over the full range of operational gate voltages.

Keywords: compound semiconductors, device modeling, enhancement mode HEMT, gallium nitride

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Authors: Rithika Sriram, Kiran M. Bhojwani

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Introduction : Tuberculosis of the head and neck has proved to be a diagnostic challenge for otorhinolarynologists around the world. These lesions are often misdiagnosed as cancer. So in order to contribute to a better understanding of these lesions, we have conducted our study among patients affected by TB in the head and neck region with the objective of assessing the various manifestations, presentations, diagnostic techniques, risk factors such as smoking and alcohol consumption, coexisting illnesses and treatment modalities. Materials and Methods: This was a retrospective study conducted over a three year period (2012-2014) in 2 hospitals affliated to Kasturba Medical College in Mangalore, South India. A semi structured proforma was used to capture information from the medical records pertaining to the various objectives of the study such as clinical features and history of smoking. Data was analysed using SPSS version 16.0 and results obtained were depicted as percentages. Chi square test was used to find association between the variables and p<0.05 was considered statistically significant. Results: 104 patients were found to have TB of the head and neck and among them,the most common manifestation was found to be Tubercular Lymphadenitis (86.53%), followed by laryngeal TB (4.8%), submandibular gland TB (3.8%), deep neck space abscess(3.8%) and adenotonsillar TB. FNAC was found to be the gold standard for the diagnosis of TB disease of the lymph node.26% of the patients had coexisting HIV infection and 16.3% of the patients had associated pulmonary TB. More than 20% of the patients were smokers. Most patients were treated using ATT. Conclusion: Tuberculosis affecting regions of head and neck is no longer uncommon. Sufficient knowledge and appropriate diagnostic means is required while dealing with these lesions and must be included in the differential diagnosis of pathological lesions of head and neck.

Keywords: FNAC, Mangalore, smoking, tuberculosis

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Authors: Adriana Stefan, Cristina-Elisabeta Pelin, George Pelin, Maria Daniela Stelescu, Elena Manaila

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Elastomeric composites have been known for a long time, but, to our knowledge, space and the aeronautic community has been directing a special attention to them only in the last decade. The required properties of advanced elastomeric materials used in space applications (such as O-rings) are sealing, abrasion, low-temperature flexibility, the long-term compression set properties, impact resistance and low-temperature thermal stability in different environments, such as ionized radiations. Basically, the elastomeric nanocomposites are composed of a rubber matrix and a wide and varied range of nanofillers, added with the aim of improving the physico-mechanical and elasticity modulus properties of the materials as well as their stability in different environments. The paper presents a partial synthesis of the research regarding the use of silicon carbide in nanometric form and/or organophylized montmorillonite as fillers in butyl rubber matrix. The need of composite materials arose from the fact that stand-alone polymers are ineffective in providing all the superior properties required by different applications. These drawbacks can be diminished or even eliminated by incorporating a new range of additives into the organic matrix, fillers that have important roles in modifying properties of various polymers. A composite material can provide superior and unique mechanical and physical properties because it combines the most desirable properties of its constituents while suppressing their least desirable properties. The commercial importance of polymers and the continuous increase of their use results in the continuous demand for improvement in their properties to meet the necessary conditions. To study the performance of the elastomeric nanocomposites were mechanically tested, it will be tested the qualities of tensile at low temperatures and RT and the behavior at the compression at cryogenic to room temperatures and under different environments. The morphology of specimens will be investigated by optical and scanning electronic microscopy.

Keywords: elastomeric nanocomposites, O-rings, space applications, mechanical properties

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Authors: P. Moskal, T. Bednarski, P. Bialas, E. Czerwinski, A. Gajos, A. Gruntowski, D. Kaminska, L. Kaplon, G. Korcyl, P. Kowalski, T. Kozik, W. Krzemien, E. Kubicz, Sz. Niedzwiecki, M. Palka, L. Raczynski, Z. Rudy, P. Salabura, N. G. Sharma, M. Silarski, A. Slomski, J. Smyrski, A. Strzelecki, A. Wieczorek, W. Wislicki, M. Zielinski, N. Zon

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A new concept and results of the performance tests of the TOF-PET detection system developed at the Jagiellonian University will be presented. The novelty of the concept lies in employing long strips of polymer scintillators instead of crystals as detectors of annihilation quanta, and in using predominantly the timing of signals instead of their amplitudes for the reconstruction of Lines-of-Response. The diagnostic chamber consists of plastic scintillator strips readout by pairs of photo multipliers arranged axially around a cylindrical surface. To take advantage of the superior timing properties of plastic scintillators the signals are probed in the voltage domain with the accuracy of 20 ps by a newly developed electronics, and the data are collected by the novel trigger-less and reconfigurable data acquisition system. The hit-position and hit-time are reconstructed by the dedicated reconstruction methods based on the compressing sensing theory and the library of synchronized model signals. The solutions are subject to twelve patent applications. So far a time-of-flight resolution of ~120 ps (sigma) was achieved for a double-strip prototype with 30 cm field-of-view (FOV). It is by more than a factor of two better than TOF resolution achievable in current TOF-PET modalities and at the same time the FOV of 30 cm long prototype is significantly larger with respect to typical commercial PET devices. The Jagiellonian PET (J-PET) detector with plastic scintillators arranged axially possesses also another advantage. Its diagnostic chamber is free of any electronic devices and magnetic materials thus giving unique possibilities of combining J-PET with CT and J-PET with MRI for scanning the same part of a patient at the same time with both methods.

Keywords: PET-CT, PET-MRI, TOF-PET, scintillator

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Authors: Changyeop Lee, Sewon Kim, Jongho Lee

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Reburning technology has been developed to adopt various commercial combustion systems. Fuel lean reburning is an advanced reburning method to reduce NOx economically without using burnout air, however it is not easy to get high NOx reduction efficiency. In the fuel lean reburning system, the localized fuel rich eddies are used to establish partial fuel rich regions so that the NOx can react with hydrocarbon radical restrictively. In this paper, a new advanced reburning method which supplies reburn fuel with oscillatory motion is introduced to increase NOx reduction rate effectively. To clarify whether forced oscillating injection of reburn fuel can effectively reduce NOx emission, experimental tests were conducted in vertical combustion furnace. Experiments were performed in flames stabilized by a gas burner, which was mounted at the bottom of the furnace. The natural gas is used as both main and reburn fuel and total thermal input is about 40kW. The forced oscillating injection of reburn fuel is realized by electronic solenoid valve, so that fuel rich region and fuel lean region is established alternately. In the fuel rich region, NOx is converted to N2 by reburning reaction, however unburned hydrocarbon and CO is oxidized in fuel lean zone and mixing zone at downstream where slightly fuel lean region is formed by mixing of two regions. This paper reports data on flue gas emissions and temperature distribution in the furnace for a wide range of experimental conditions. All experimental data has been measured at steady state. The NOx reduction rate increases up to 41% by forced oscillating reburn motion. The CO emissions were shown to be kept at very low level. And this paper makes clear that in order to decrease NOx concentration in the exhaust when oscillating reburn fuel injection system is adopted, the control of factors such as frequency and duty ratio is very important.

Keywords: NOx, CO, reburning, pollutant

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Authors: Judith Partouche-Sebban, Saeedeh Rezaee Vessal

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Because of the rising number of new cases of cancer, especially among women, it is more than essential to better understand how women experience cancer in order to bring them adapted to support and care and enhance their well-being and patient experience. Cancer stands for a traumatic experience in which the diagnosis, its medical treatments, and the related side effects lead to deep physical and psychological changes that may arouse considerable stress and anxiety. In order to reduce these negative emotions, women tend to use various defense mechanisms, among which denial has been defined as the most frequent mechanism used by breast cancer patients. This study aims to better understand the consequences of the experience of cancer and their link with the adoption of a denial strategy. The empirical research was done among female cancer survivors in France. Since the topic of this study is relatively unexplored, a qualitative methodology and open-ended interviews were employed. In total, 25 semi-directive interviews were conducted with a female with different cancers, different stages of treatment, and different ages. A systematic inductive method was performed to analyze data. The content analysis enabled to highlight three different denial-related behaviors among women with cancer, which serve a self-protective function. First, women who expressed high levels of anxiety confessed they tended to completely deny the existence of their cancer immediately after the diagnosis of their illness. These women mainly exhibit many fears and a deep distrust toward the medical context and professionals. This coping mechanism is defined by the patient as being unconscious. Second, other women deliberately decided to deny partial information about their cancer, whether this information is related to the stages of the illness, the emotional consequences, or the behavioral consequences of the illness. These women use this strategy as a way to avoid the reality of the illness and its impact on the different aspects of their life as if cancer does not exist. Third, some women tend to reinterpret and give meaning to their cancer as a way to reduce its impact on their life. To this end, they may use magical thinking or positive reframing, or reinterpretation. Because denial may lead to delays in medical treatments, this topic deserves a deep investigation, especially in the context of oncology. As denial is defined as a specific defense mechanism, this study contributes to the existing literature in service marketing which focuses on emotions and emotional regulation in healthcare services which is a crucial issue. Moreover, this study has several managerial implications for healthcare professionals who interact with patients in order to implement better care and support for the patients.

Keywords: cancer, coping mechanisms, denial, healthcare services

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Authors: Rahaf Alasiri, Tarek Alghamdi, Abdullah Zarkan

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Background: Due to measures such as school closure, social distancing, and virtual teaching during the pandemic, primary school children's psychological well-being is greatly affected. These measures have short and long-term consequences on the children's well-being and mental health. Identifying these consequences is important. Aim: This study aimed to evaluate mood and behavior changes in children who attended school virtually. Subjects and methods: This is a cross-sectional study conducted among children and their parents who visited the outpatient clinic. A self-administered questionnaire was given to the parents of children aged between 6 to 14 years. The questionnaire includes socio-demographic characteristics, Conor's modifies scale to assess the attention deficit hyperactivity disorder (ADHD) of children, and the parental stress scale (PSS) to assess the stress symptoms of the parents. Results: Of the 66 surveyed children, 60.6% were aged between 10 to 14 years old, with the female being dominant (77.3%). The most common medical condition was asthma (7.6%), and nearly two-thirds (63.6%) indicated good health conditions during the pandemic. There was a significant inverse correlation observed between ADHD score and PSS score (r=-0.387). No significant differences are in ADHD and PSS scores in relation to the socio-demographic characteristics of the children, including age, gender, and having an associated medical condition (p>0.05). Conclusion: During the pandemic, children who attended virtual classes did not seem to affect even with restrictions. Most children indicated good health conditions during the pandemic. However, it is surprising to know that in spite of children’s high spirits during the pandemic, their parents were seen to have an increased level of stress. Strategies to address parents’ psychological disorders during the pandemic are warranted.

Keywords: children's mood, COVID-19, ADHD, parental stress

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Authors: Latha Krishnan, Andrew Cobley

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Epoxy resin is most widely used as matrices for composites of aerospace, automotive and electronic applications due to its outstanding mechanical properties. These properties are chiefly predetermined by the chemical structure of the prepolymer and type of hardener but can also be varied by the processing conditions such as prepolymer and hardener mixing, degassing and curing conditions. In this research, the effect of degassing on the curing behaviour and the void occurrence is experimentally evaluated for epoxy /anhydride resin system. The epoxy prepolymer was mixed with an anhydride hardener and accelerator in an appropriate quantity. In order to investigate the effect of degassing on the curing behaviour and void content of the resin, the uncured resin samples were prepared using three different methods: 1) no degassing 2) degassing on prepolymer and 3) degassing on mixed solution of prepolymer and hardener with an accelerator. The uncured resins were tested in differential scanning calorimeter (DSC) to observe the changes in curing behaviour of the above three resin samples by analysing factors such as gel temperature, peak cure temperature and heat of reaction/heat flow in curing. Additionally, the completely cured samples were tested in DSC to identify the changes in the glass transition temperature (Tg) between the three samples. In order to evaluate the effect of degassing on the void content and morphology changes in the cured epoxy resin, the fractured surfaces of cured epoxy resin were examined under the scanning electron microscope (SEM). Also, the changes in the mechanical properties of the cured resin were studied by three-point bending test. It was found that degassing at different stages of resin mixing had significant effects on properties such as glass transition temperature, the void content and void size of the epoxy/anhydride resin system. For example, degassing (vacuum applied on the mixed resin) has shown higher glass transition temperature (Tg) with lower void content.

Keywords: anhydride epoxy, curing behaviour, degassing, void occurrence

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Authors: Ali Albadri

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The logistics equation has never been used or studied in scientific fields outside the field of ecology. It has never been used to understand the behavior of a dynamic system of mechanical machines, like an escalator. We have studied the compatibility of the logistic map against real measurements from an escalator. This study has proven that there is good compatibility between the logistics equation and the experimental measurements. It has discovered the potential of a relationship between the fractal dimension and the non-linearity parameter, R, in the logistics equation. The fractal dimension increases as the R parameter (non-linear parameter) increases. It implies that the fractal dimension increases as the phase of the life span of the machine move from the steady/stable phase to the periodic double phase to a chaotic phase. The fractal dimension and the parameter R can be used as a tool to verify and check the health of machines. We have come up with a theory that there are three areas of behaviors, which they can be classified during the life span of a machine, a steady/stable stage, a periodic double stage, and a chaotic stage. The level of attention to the machine differs depending on the stage that the machine is in. The rate of faults in a machine increases as the machine moves through these three stages. During the double period and the chaotic stages, the number of faults starts to increase and become less predictable. The rate of predictability improves as our monitoring of the changes in the fractal dimension and the parameter R improves. The principles and foundations of our theory in this work have and will have a profound impact on the design of systems, on the way of operation of systems, and on the maintenance schedules of the systems. The systems can be mechanical, electrical, or electronic. The discussed methodology in this paper will give businesses the chance to be more careful at the design stage and planning for maintenance to control costs. The findings in this paper can be implied and used to correlate the three stages of a mechanical system to more in-depth mechanical parameters like wear and fatigue life.

Keywords: logistcs map, bifurcation map, fractal dimension, logistics equation

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Authors: Zarah M. Bello, Nathan Baddoo, Mariana Lilley, Paul Wernick

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In this paper, we present findings from a multi-part study to evaluate candidate elements reflecting the level of digital capability maturity (DCM) in higher education and the relationship between these elements. We will use these findings to propose a model of DCM for educational institutions. We suggest that the success of learning in higher education is dependent in part on the level of maturity of digital capabilities of institutions as well as the abilities of learners and those who support the learning process. It is therefore important to have a good understanding of the elements that underpin this maturity as well as their impact and interactions in order to better exploit the benefits that technology presents to the modern learning environment and support its continued improvement. Having identified ten candidate elements of digital capability that we believe support the level of a University’s maturity in this area as well as a number of relevant stakeholder roles, we conducted two studies utilizing both quantitative and qualitative research methods. In the first of these studies, 85 electronic questionnaires were completed by various stakeholders in a UK university, with a 100% response rate. We also undertook five in-depth interviews with management stakeholders in the same university. We then utilized statistical analysis to process the survey data and conducted a textual analysis of the interview transcripts. Our findings support our initial identification of candidate elements and support our contention that these elements interact in a multidimensional manner. This multidimensional dynamic suggests that any proposal for improvement in digital capability must reflect the interdependency and cross-sectional relationship of the elements that contribute to DCM. Our results also indicate that the notion of DCM is strongly data-centric and that any proposed maturity model must reflect the role of data in driving maturity and improvement. We present these findings as a key step towards the design of an operationalisable DCM maturity model for universities.

Keywords: digital capability, elements, maturity, maturity framework, university

Procedia PDF Downloads 146

Authors: Nir Nissim, Ran Yahalom, Tomer Lancewiki, Yuval Elovici, Boaz Lerner

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Background: Attackers increasingly take advantage of innocent users who tend to use USB devices casually, assuming these devices benign when in fact they may carry an embedded malicious behavior or hidden malware. USB devices have many properties and capabilities that have become the subject of malicious operations. Many of the recent attacks targeting individuals, and especially organizations, utilize popular and widely used USB devices, such as mice, keyboards, flash drives, printers, and smartphones. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched via USB devices. Significance: We propose USBWARE, a project that focuses on the vulnerabilities of USB devices and centers on the development of a comprehensive detection framework that relies upon a crucial attack repository. USBWARE will allow researchers and companies to better understand the vulnerabilities and attacks associated with USB devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The framework of USBWARE is aimed at accurate detection of both known and unknown USB-based attacks by a process that efficiently enhances the framework's detection capabilities over time. The framework will integrate two main security approaches in order to enhance the detection of USB-based attacks associated with a variety of USB devices. The first approach is aimed at the detection of known attacks and their variants, whereas the second approach focuses on the detection of unknown attacks. USBWARE will consist of six independent but complimentary detection modules, each detecting attacks based on a different approach or discipline. These modules include novel ideas and algorithms inspired from or already developed within our team's domains of expertise, including cyber security, electrical and signal processing, machine learning, and computational biology. The establishment and maintenance of the USBWARE’s dynamic and up-to-date attack repository will strengthen the capabilities of the USBWARE detection framework. The attack repository’s infrastructure will enable researchers to record, document, create, and simulate existing and new USB-based attacks. This data will be used to maintain the detection framework’s updatability by incorporating knowledge regarding new attacks. Based on our experience in the cyber security domain, we aim to design the USBWARE framework so that it will have several characteristics that are crucial for this type of cyber-security detection solution. Specifically, the USBWARE framework should be: Novel, Multidisciplinary, Trusted, Lightweight, Extendable, Modular and Updatable and Adaptable. Major Findings: Based on our initial survey, we have already found more than 23 types of USB-based attacks, divided into six major categories. Our preliminary evaluation and proof of concepts showed that our detection modules can be used for efficient detection of several basic known USB attacks. Further research, development, and enhancements are required so that USBWARE will be capable to cover all of the major known USB attacks and to detect unknown attacks. Conclusion: USBWARE is a crucial detection framework that must be further enhanced and developed.

Keywords: USB, device, cyber security, attack, detection

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Authors: Sohni Siddiqui, Anja Schultze-Krumbholz

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Our lives now revolve more around online-related tasks, as the internet has become a necessity. One of the disturbance concerns with high internet usage is the multiplication of cyber-associated risky behaviors such as cyber aggression and/or cyberbullying. Cyber Bullying is an emerging issue that needs immediate attention from many stakeholders such as parents, doctors, school administrators, policymakers, researchers, and others, especially in the COVID-19 pandemic when online learning has been adopted as an instructional strategy, and there is a continuous rise in cyberbullying cases. The aim of the article is to review existing successful and emerging interventions designed to control bullying and cyberbullying by engaging individuals through teachers’ professional development and adopting a whole-school approach. The study identified the strengths and limitations of the programs and suggested improvements to existing interventions. Preparing interventions with a strong theoretical framework, integrating applications of emerging theories in interventions, promoting proactive and reactive strategies in combination, beginning with the baseline needs assessment surveys, reducing digital time and digital divide among parents and children, promoting the concept of lead trainer, peer trainer, and hot spots, focusing on physical activities, use of landmarks are some of the recommendations proposed by authors. In addition to face-to-face intervention, the researchers recommend updating and improving previous intervention programs with games and apps. Especially in the time of pandemic crises, when face-to-face interactions are limited and cyberbullying is triggered, the use of apps, web-based interventions, and games can be an effective way to control electronic perpetration and victimization.

Keywords: anti bullying programs, cyber bullying, individualized trainings, teachers’ professional development, whole school interventions

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Authors: Wei-Chia Huang, Jane Wang

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Damage to nerves is considered one of the most irreversible injuries. The regeneration of nerves has always been an important topic in regenerative medicine. In general, damage to human tissue will naturally repair overtime. However, when the nerves are damaged, healed flesh wound cannot guarantee full restoration to its original function, as truncated nerves are often irreversible. Therefore, the development of treatment methods to successfully guide and accelerate the regeneration of nerves has been highly sought after. In order to induce nerve tissue growth, nerve conduits are commonly used to help reconnect broken nerve bundles to provide protection to the location of the fracture while guiding the growth of the nerve bundles. To prevent the protected tissue from becoming necrotic and to ensure the growth rate, the conduits used are often modified with microstructures or blended with neuron growth factors that may facilitate nerve regeneration. Electrical stimulation is another attempted treatment for medical rehabilitation. With appropriate range of voltages and stimulation frequencies, it has been demonstrated to promote cell proliferation and migration. Biodegradability are critical for medical devices like nerve conduits, while conductive polymers pose great potential toward the differentiation and growth of nerve cells. In this work, biodegradability and conductivity were combined into a novel biodegradable, photocurable, conductive polymer composite materials by embedding conductive nanoparticles in poly(glycerol sebacate) acrylate (PGSA) and 3D-printed into nerve conduits. Rat pheochromocytoma cells and rat neuronal Schwann cells were chosen for the in vitro tests of the conduits and had demonstrate selective growth upon culture in the conductive conduits with built-in microchannels and electrical stimulation.

Keywords: biodegradable polymer, 3d printing, neural regeneration, electrical stimulation

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Authors: S. Chuenchooklin, S. Taweepong, U. Pangnakorn

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This research was conducted in the Mae Sot Watershed whereas located in the Moei River Basin at the Upper Salween River Basin in Tak Province, Thailand. The Mae Sot Municipality is the largest urbanized in Tak Province and situated in the midstream of the Mae Sot Watershed. It usually faces flash flood problem after heavy rain due to poor flood management has been reported since economic rapidly bloom up in recently years. Its catchment can be classified as ungauged basin with lack of rainfall data and no any stream gaging station was reported. It was attached by most severely flood event in 2013 as the worst studied case for those all communities in this municipality. Moreover, other problems are also faced in this watershed such shortage water supply for domestic consumption and agriculture utilizations including deterioration of water quality and landslide as well. The research aimed to increase capability building and strengthening the participation of those local community leaders and related agencies to conduct better water management in urban area was started by mean of the data collection and illustration of appropriated application of some short period rainfall forecasting model as the aim for better flood relief plan and management through the hydrologic model system and river analysis system programs. The authors intended to apply the global rainfall data via the integrated data viewer (IDV) program from the Unidata with the aim for rainfall forecasting in short period of 7 - 10 days in advance during rainy season instead of real time record. The IDV product can be present in advance period of rainfall with time step of 3 - 6 hours was introduced to the communities. The result can be used to input to either the hydrologic modeling system model (HEC-HMS) or the soil water assessment tool model (SWAT) for synthesizing flood hydrographs and use for flood forecasting as well. The authors applied the river analysis system model (HEC-RAS) to present flood flow behaviors in the reach of the Mae Sot stream via the downtown of the Mae Sot City as flood extents as water surface level at every cross-sectional profiles of the stream. Both models of HMS and RAS were tested in 2013 with observed rainfall and inflow-outflow data from the Mae Sot Dam. The result of HMS showed fit to the observed data at dam and applied at upstream boundary discharge to RAS in order to simulate flood extents and tested in the field, and the result found satisfied. The result of IDV’s rainfall forecast data was compared to observed data and found fair. However, it is an appropriate tool to use in the ungauged catchment to use with flood hydrograph and river analysis models for future efficient flood relief plan and management.

Keywords: global rainfall, flood forecast, hydrologic modeling system, river analysis system

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Authors: Priscilla Marcus

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The mass media was a force to reckon with in the struggle and attainment of Nigeria’s independence in 1960 and since then, the Nigerian media has carved a niche for itself in performing its traditional role of education, information, entertainment, shaping of opinions and swinging of views of the society on knotty national issues. Boko Haram insurgency in Nigeria which emerged from an unnoticed, negligible and quiet beginning, has turned out daring, monstrous and unstoppable. This paper examines The Media and Reportage of Boko Haram Insurgency in Nigeria and to suggest strategies the mass media could adopt in combating this form of terrorism. Data for the study were collected from a variety of sources including the print and electronic media. The major observation of this study is that the mass media have an enormous role to play if Boko Haram’s activities are to be combated. It argued that even though the media houses are just doing their job – reporting the incident(s) as they occur, thus keeping the citizens abreast of facts; the rate at which news keeps coming regarding the activities of the sect has portrayed the media as information dissemination and terror campaign spread. It also argued that the ceaseless reporting has not translated to a decrease in the activities of the sect or increase in the level of government actions to check the insurgency. However, the information being disseminated is enlightening the populace and also creating an atmosphere of panic and insecurity. It further argued that the media should move beyond mere recitation of events to providing the public with knowledge needed to make things better. This is because the sect has been accorded too much undeserved and unnecessary publicity while the government on the other hand has been portrayed, albeit indirectly as a weak organization incapable of handling the ‘more organized’ Boko Haram. The study, concluded that, to effectively address the problem of this form of terrorism in Nigeria, the media have to brace up to the task of uncovering activities of the sect in appreciation of their watch-dog role.

Keywords: Boko Haram, insurgency, mass media, Nigeria

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Authors: Nur Ilya Farhana Md Noh, Zakiah Ahmad

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Heat treatment on timbers is a process of applying heat to modify and equip the timbers with new improvised characteristics. It is environmental friendly compared to the common practice of treating timber by chemical preservatives. Malaysian hardwood timbers; Pauh Kijang and Kapur in green condition were heat treated at 150°C, 170°C, 190°C and 210°C in a specially design electronic furnace in one hour duration. The objectives were to determine the effect of heat treatment on bending strength properties of heat treated Pauh Kijang and Kapur in term of Modulus of Elasticity (MOE) and Modulus of Rupture (MOR) and to examine the significance changes at each temperature levels applied. Untreated samples for each species were used as a control sample. The results indicated that the bending strength properties for both species of timbers were affected by the heat exposure. Both MOE and MOR values for heat treated Pauh Kijang were increased when subjected to the specified temperature levels except at 210°C. The values were dropped compared to the control sample and sample treated at 190°C. Heat treated Kapur shows the same pattern of increment on its MOE and MOR values after exposure to heat at three temperature levels used and the values dropped at 210°C. However, differ to Pauh Kijang, even though there were decrement occurred at 210°C but the value is still higher compared to the control sample. The increments of MOE and MOR values are an indicator that heat treatment had successfully improvised the bending strength properties of these two species of hardwood timber. As the good strength of Malaysian timbers used as structural material is limited in numbers and expensive, heat treating timber with low strength properties is an alternative way to overcome this issue. Heat treatment is an alternative method need to be explored and made available in Malaysia as this country is still practicing chemical preservative treatment on the timbers.

Keywords: bending strength, hardwood timber, heat treatment, modulus of elasticity (MOE), modulus of rupture (MOR)

Procedia PDF Downloads 268

Authors: Perizat Aitmaganbet, Kerbez Kimatova, Gulmira Umarova

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As a result of medical check-up conducted in the framework of this research study an evaluation of the health status of the population living in the oil-producing regions, namely Sarkul and Kenkiyak villages in Aktobe was examined. With the help of the Spearman correlation, the connection between the level of hazard chemical elements in the atmosphere and the health of population living in the regions of oil and gas industry was estimated. Background & Objective. The oil and gas resource-extraction industries play an important role in improving the economic conditions of the Republic of Kazakhstan, especially for the oil-producing administrative regions. However, environmental problems may adversely affect the health of people living in that area. Thus, the aim of the study is to evaluate the exposure to negative environmental factors of the adult population living in Sarkul and Kenkiyak villages, the oil and gas producing areas in the Aktobe region. Methods. After conducting medical check-up among the population of Sarkul and Kenkiyak villages. A single cross-sectional study was conducted. The population consisted of randomly sampled 372 adults (181 males and 191 females). Also, atmospheric air probes were taken to measure the level of hazardous chemical elements in the air. The nonparametric method of the Spearman correlation analysis was performed between the mean concentration of substances exceeding the Maximum Permissible Concentration and the classes of newly diagnosed diseases. Selection and analysis of air samples were carried out according to the developed research protocol; the qualitative-quantitative analysis was carried out on the Gas analyzer HANK-4 apparatus. Findings. The medical examination of the population identified the following diseases: the first two dominant were diseases of the circulatory and digestive systems, in the 3rd place - diseases of the genitourinary system, and the nervous system and diseases of the ear and mastoid process were on the fourth and fifth places. Moreover, significant pollution of atmospheric air by carbon monoxide (MPC-5,0 mg/m3), benzapyrene (MPC-1mg/m3), dust (MPC-0,5 mg/m3) and phenol (МРС-0,035mg/m3) were identified in places. Correlation dependencies between these pollutants of air and the diseases of the population were established, as a result of diseases of the circulatory system (r = 0,7), ear and mastoid process (r = 0,7), nervous system (r = 0,6) and digestive organs(r = 0,6 ); between the concentration of carbon monoxide and diseases of the circulatory system (r = 0.6), the digestive system(r = 0.6), the genitourinary system (r = 0.6) and the musculoskeletal system; between nitric oxide and diseases of the digestive system (r = 0,7) and the circulatory system (r = 0,6); between benzopyrene and diseases of the digestive system (r = 0,6), the genitourinary system (r = 0,6) and the nervous system (r = 0,4). Conclusion. The positive correlation was found between air pollution and the health of the population living in Sarkul and Kenkiyak villages. To enhance the reliability of the results we are going to continue this study further.

Keywords: atmospheric air, chemical substances, oil and gas, public health

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Authors: Professor Jo Angouri, Polina Mesinioti, Chris Turner

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In order for a group of ad-hoc professional to perform as a team, a shared understanding of the problem at hand and an agreed action plan are necessary components. This is particularly significant in complex, time sensitive professional settings such as in trauma emergencies. In this context, team briefings prior to the patient arrival (pre-briefings) constitute a critical event for the performance of the team; they provide the necessary space for co-constructing a shared understanding of the situation through summarising information available to the team: yet the act of summarising is widely assumed in medical practice but not systematically researched. In the vast teamwork literature, terms such as ‘shared mental model’, ‘mental space’ and ‘cognate labelling’ are used extensively, and loosely, to denote the outcome of the summarising process, but how exactly this is done interactionally remains under researched. This paper reports on the forms and functions of pre-briefings in a major trauma centre in the UK. Taking an interactional approach, we draw on 30 simulated and real-life trauma emergencies (15 from each dataset) and zoom in on the use of pre-briefings, which we consider focal points in the management of trauma emergencies. We show how ad hoc teams negotiate sharedness of future orientation through summarising, synthesising information, and establishing common understanding of the situation. We illustrate the role, characteristics, and structure of pre-briefing sequences that have been evaluated as ‘efficient’ in our data and the impact (in)effective pre-briefings have on teamwork. Our work shows that the key roles in the event own the act of summarising and we problematise the implications for leadership in trauma emergencies. We close the paper with a model for pre-briefing and provide recommendations for clinical practice, arguing that effective pre-briefing practice is teachable.

Keywords: summarising, medical emergencies, interaction analysis, shared/mental models

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Authors: Nisa Mohan

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Adverse drug event (ADE) related hospital admissions are common among older people. The first step in prevention is accurately estimating the prevalence of ADE admissions. Clinical coding is an efficient method to estimate the prevalence of ADE admissions. The objective of the study is to estimate the rate of under-coding of ADE admissions in older people in New Zealand and to explore how clinical coders decide whether or not to code an admission as an ADE. There has not been any research in New Zealand to explore these areas. This study is done using a mixed-methods approach. Two common and serious ADEs in older people, namely bleeding and hypoglycaemia were selected for the study. In study 1, eight hundred medical records of people aged 65 years and above who are admitted to hospital due to bleeding and hypoglycemia during the years 2015 – 2016 were selected for quantitative retrospective medical records review. This selection was made to estimate the proportion of ADE-related bleeding and hypoglycemia admissions that are not coded as ADEs. These files were reviewed and recorded as to whether the admission was caused by an ADE. The hospital discharge data were reviewed to check whether all the ADE admissions identified in the records review were coded as ADEs, and the proportion of under-coding of ADE admissions was estimated. In study 2, thirteen clinical coders were selected to conduct qualitative semi-structured interviews using a general inductive approach. Participants were selected purposively based on their experience in clinical coding. Interview questions were designed in a way to investigate the reasons for the under-coding of ADE admissions. The records review study showed that 35% (Cl 28% - 44%) of the ADE-related bleeding admissions and 22% of the ADE-related hypoglycemia admissions were not coded as ADEs. Although the quality of clinical coding is high across New Zealand, a substantial proportion of ADE admissions were under-coded. This shows that clinical coding might under-estimate the actual prevalence of ADE related hospital admissions in New Zealand. The interviews with the clinical coders added that lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing might be the potential reasons for the under-coding of the ADE admissions. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. These results highlight that further work is needed on interventions to improve the clinical coding of ADE admissions, such as providing education to coders about the importance of ADEs, education to clinicians about the importance of clear and confirmed medical records entries, availing pharmacist service to improve the detection and clear documentation of ADE admissions and including a mandatory field in the discharge summary about external causes of diseases.

Keywords: adverse drug events, bleeding, clinical coders, clinical coding, hypoglycemia

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Authors: K. Drabczyk, Z. Starowicz, S. Maleczek, P. Zieba

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The army, police and fire brigade commonly use dedicated equipment based on special textile materials. The properties of these textiles should ensure human life and health protection. Equally important is the ability to use electronic equipment and this requires access to the source of electricity. Photovoltaic cells integrated with such textiles can be solution for this problem in the most of outdoor circumstances. One idea may be to laminate the cells to textile without changing their properties. The main goal of this work was analyzed lamination quality of special designed semi-flexible solar module with special textile materials as a backsheet. In the first step of investigation, the quality of lamination was determined using device equipped with dynamometer. In this work, the crystalline silicon solar cells 50 x 50 mm and thin chemical tempered glass - 62 x 62 mm and 0.8 mm thick - were used. The obtained results showed the correlation between breaking force and type of textile weave and fiber. The breaking force was in the ranges: 4.5-5.5 N, 15-20 N and 30-33 N depending on the type of wave and fiber type. To verify these observations the microscopic and FTIR analysis of fibers was performed. The studies showed the special textile can be used as a backsheet of semi-flexible solar modules. This work presents a new composition of solar module with special textile layer which, to our best knowledge, has not been published so far. Moreover, the work presents original investigations on adhesion of EVA (ethylene-vinyl acetate) polymer to textile with respect to fiber structure of laminated substrate. This work is realized for the GEKON project (No. GEKON2/O4/268473/23/2016) sponsored by The National Centre for Research and Development and The National Fund for Environmental Protection and Water Management.

Keywords: flexible solar modules, lamination process, solar cells, textile for photovoltaics

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