Search results for: intensive care unit

Authors: Shu-Ling Wang

Abstract:

Background: Multiple studies showed early skin-to-skin contact (SSC) with mothers was beneficial to newborns such as breastfeeding and maternal childcare. In cases of newborns unable to have early SSC with mothers, fathers’ involvement could let early SSC continue without interruption. However, few studies had explored the effects of early SSC by fathers in comparison to early SSC with mothers. Paternal involvement of early SSC should be equally important in term of childcare and breastfeeding. The purpose of this study was to evaluate the efficacy of early SSC by fathers in particular in their support of breastfeeding. Methods: A quasi-experimental design was employed by the study. One hundred and forty-four father-infant pairs had participated the study, in which infants were assigned either to SSC with their fathers (n = 72) or to routine care (n = 72) as the control group. The study was conducted at a regional hospital in northern Taiwan. Participants included parents of both vaginal delivery (VD) and caesarean section birth (CS) infants. To be eligible for inclusion, infants must be over 37-week gestational ages. Data were collected twice: as pretest upon admission and as posttest with online questionnaire during first, second, and third postpartum months. The questionnaire included items for Breastfeeding Social Support, methods of feeding, and the mother-infant 24-hour rooming-in rate. The efficacy of early SSC with fathers was evaluated using the generalized estimating equation (GEE) modeling. Research Result: The primary finding was that SSC with fathers had positive impact on fathers’ support of breastfeeding. Analysis of the online questionnaire indicated that early SSC with fathers improved the support of breastfeeding than the control group (VD: t = -4.98, p < .001; CS: t = -2.37, p = .02). Analysis of mother-infant 24-hour rooming-in rate showed that SSC with fathers after CS had a positive impact on the rooming-in rate (χ² = 5.79, p = .02); however, with VD the difference between early SSC with fathers and the control group was insignificant (χ² = .23, p = .63). Analysis of the rate of exclusive breastfeeding indicated that early SSC with fathers had a higher rate than the control group during first three postpartum months for both delivery methods (VD: χ² = 12.51, p < .001 on 1st postpartum month, χ² = 8.13, p < .05 on 2nd postpartum month, χ² = 4.43, p < .05 on 3rd postpartum month; CS: χ² = 6.92, p < .05 on 1st postpartum month, χ² = 7.41, p < .05 on 2nd postpartum month, χ² = 6.24, p < .05 on 3rd postpartum month). No significant difference was found on the rate of exclusive breastfeeding with both methods of delivery between two groups during hospitalization. (VD: χ² =2 .00, p = .16; CS: χ² = .73, p = .39). Conclusion: Implementing early SSC with fathers has many benefits to both parents. The result of this study showed increasing fathers’ support of breastfeeding. This encourages our nursing personnel to focus the needs of father during breastfeeding, therefore further enhancing the quality of parental care, the rate and duration of breastfeeding.

Keywords: breastfeeding, skin-to-skin contact, support of breastfeeding, rooming-in

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Authors: Zheng Miao, Dennis Fernandez

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CRISPR research has the potential to completely transform life science, agriculture, live-stock and the health care industry. The Intellectual Property derived from its research has raised significant attention in the academic as well as the biopharmaceutical industry culminating an urgent need for strategic IP protection. We review the rudimentary concepts and key competitors of CRISPR technologies as well as the paramount strategies for intellectual property protection. Further, we elaborate on prosecution issues related to CRISPR patents as well as possible solutions to various patent laws, interferences and litigation. Finally, we address how the bioinformatics of the CRISPR technology begs an inquiry into issues of privacy and a host of ethical concerns.

Keywords: bioinformatics, CRISPR, biotechnology, intellectual property

Procedia PDF Downloads 245

Authors: Angelica Alvarez-Lee, Sergio Martinez-Diaz, Jose Luis Garcia-Corona, Humberto Lanz-Mendoza

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World aquaculture is always looking for improvements to achieve productions with high yields avoiding the infection by pathogenic agents. The best way to achieve this is to know the biological model to create alternative treatments that could be applied in the hatcheries, which results in greater economic gains and improvements in human public health. In the last decade, immunomodulation in shrimp culture with probiotics, organic acids and different carbon sources has gained great interest, mainly in larval and juvenile stages. Immune priming is associated with a strong protective effect against a later pathogen challenge. This work provides another perspective about immunostimulation from spawning until hatching. The stimulation happens during development embryos and generates resistance to infection by pathogenic bacteria. Massive spawnings of white shrimp L. vannamei were obtained and placed in experimental units with 700 mL of sterile seawater at 30 °C, salinity of 28 ppm and continuous aeration at a density of 8 embryos.mL⁻¹. The immunostimulating effect of three death strains of non-pathogenic bacterial (Escherichia coli, Staphylococcus aureus and Bacillus subtilis) and a pathogenic strain for white shrimp (Vibrio parahaemolyticus) was evaluated. The strains killed by heat were adjusted to O.D. 0.5, at A 600 nm, and directly added to the seawater of each unit at a ratio of 1/100 (v/v). A control group of embryos without inoculum of dead bacteria was kept under the same physicochemical conditions as the rest of the treatments throughout the experiment and used as reference. The duration of the stimulus was 12 hours, then, the larvae that hatched were collected, counted and transferred to a new experimental unit (same physicochemical conditions but at a salinity of 28 ppm) to carry out a challenge of infection against the pathogen V. parahaemolyticus, adding directly to seawater an amount 1/100 (v/v) of the live strain adjusted to an OD 0.5; at A 600 nm. Subsequently, 24 hrs after infection, nauplii survival was evaluated. The results of this work shows that, after 24 hrs, the hatching rates of immunostimulated shrimp embryos with the dead strains of B. subtillis and V. parahaemolyticus are significantly higher compared to the rest of the treatments and the control. Furthermore, survival of L. vanammei after a challenge of infection of 24 hrs against the live strain of V. parahaemolyticus is greater (P < 0.05) in the larvae immunostimulated during the embryonic development with the dead strains B. subtillis and V. parahaemolyticus, followed by those that were treated with E. coli. In summary superficial antigens can stimulate the development cells to promote hatching and can have normal development in agreeing with the optical observations, plus exist a differential response effect between each treatment post-infection. This research provides evidence of the immunostimulant effect of death pathogenic and non-pathogenic bacterial strains in the rate of hatching and oversight of shrimp L. vannamei during embryonic and larval development. This research continues evaluating the effect of these death strains on the expression of genes related to the defense priming in larvae of L. vannamei that come from massive spawning in hatcheries before and after the infection challenge against V. parahaemolyticus.

Keywords: immunostimulation, L. vannamei, hatching, survival

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Authors: Nkiru I. Ibeakuzie, Paul D. J. Watson, John F. Pescatore

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In roadway construction, the cost of soil-cement stabilization per unit area is significantly influenced by the binder content, hence the need to optimise cement usage. This research work will characterize the influence of soil fractal geometry on properties of cement-stabilized soil, and strive to determine a correlation between mechanical proprieties of cement-stabilized soil and the mass fractal dimension Dₘ indicated by particle size distribution (PSD) of aggregate mixtures. Since strength development in cemented soil relies not only on cement content but also on soil PSD, this study will investigate the possibility of reducing cement content by changing the PSD of soil, without compromising on strength, reduced permeability, and compressibility. A series of soil aggregate mixes will be prepared in the laboratory. The mass fractal dimension Dₘ of each mix will be determined from sieve analysis data prior to stabilization with cement. Stabilized soil samples will be tested for strength, permeability, and compressibility.

Keywords: fractal dimension, particle size distribution, cement stabilization, cement content

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Authors: A. E. Kurtoglu, A. Cevik, M. Bilgehan

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In this parametric study, effect of soil and material characteristics on safety of structures is investigated. The soil parameters such as shear strength, unit weight; geometrical parameters of the structure such as foundation depth and height of building; and material properties such as weight of concrete were selected as input parameters. A real accelerogram of 1989 El-Centro earthquake recorded by the USGS in Imperial Valley is used for this study. It is contained in the standard Strong Motion CD-ROM (SMC) format, which can be recognized and interpreted by FEM software used. The soil-structure interaction model subjected to above-mentioned earthquake was analyzed for 729 cases. Effect of input parameters on safety factor of the soil-structure system was then investigated and the interaction between the input and output parameters is presented in graphical form. Findings showed that all input parameters have significant effects on factor of safety results.

Keywords: factor of safety, finite element method, safety of structures, soil structure interaction

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Authors: T. B. Anil Kumar, Mallikarjun Hiremath, V. Ramachandra

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The present experimental investigation deals with the quality performance analysis of cement concrete with 0, 15 and 25% fly ash and 0, 0.2, 0.4 and 0.6% of polypropylene fibers by weight of cement. The various test parameters like workability, unit weight, compressive strength, flexural strength, split tensile strength and abrasion resistance are detailed in the analysis. The compressive strength of M40 grade concrete attains higher value by the replacement of cement by 15% fly ash and at 0.4% PP after 28 and 56 days of curing. Higher flexural strength of concrete was observed by the replacement of cement by 15% fly ash with 0.2% PP after 28 and 56 days of curing. Similarly, split tensile strength value also increases and attains higher value by the replacement of cement by 15% fly ash with 0.4% PP after 28 and 56 days of curing. The percentage of wear gets reduced to 30 to 33% by the addition of fibers at 0.2%, 0.4% and 0.6% in cement concrete replaced by 15 and 25% fly ash. Hence, it is found that the pavement thickness gets reduced up to 20% when compared with plain concrete slab by the 15% fly ash treated with 0.2% PP fibers and also reduced up to 27% of surface course cost.

Keywords: cement, fly ash, polypropylene fiber, pavement design, cost analysis

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Authors: Antoine Villa, Moustapha Mohamedou, Florence Pilliere, Catherine Verdun-Esquer, Mathieu Molimard, Mohamed Sidatt Cheikh El Moustaph, Mireille Canal-Raffin

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Context: In Mauritania, the activity of the National Center of Oncology (NCO) has steadily risen leading to an increase in the handling of antineoplastic drugs (AD) by healthcare professionals. In this context, the AD contamination of those professionals is a major concern for occupational physicians. It has been evaluated using biological monitoring of occupational exposure (BMOE). Methods: The intervention took place in 2015, in 2 care units, and evaluated nurses preparing and/or infusing AD and agents in charge of hygiene. Participants provided a single urine sample, at the end of the week, at the end of their shift. Five molecules were sought using specific high sensitivity methods (UHPLC-MS/MS) with very low limits of quantification (LOQ) (cyclophosphamide (CP), Ifosfamide (IF), methotrexate (MTX): 2.5ng/L; doxorubicin (Doxo): 10ng/L; α-fluoro-β-alanine (FBAL, 5-FU metabolite): 20ng/L). A healthcare worker was considered as 'contaminated' when an AD was detected at a urine concentration equal to or greater than the LOQ of the analytical method or at trace concentration. Results: Twelve persons participated (6 nurses, 6 agents in charge of hygiene). Twelve urine samples were collected and analyzed. The percentage of contamination was 66.6% for all participants (n=8/12), 100% for nurses (6/6) and 33% for agents in charge of hygiene (2/6). In 62.5% (n=5/8) of the contaminated workers, two to four of the AD were detected in the urine. CP was found in the urine of all contaminated workers. FBAL was found in four, MTX in three and Doxo in one. Only IF was not detected. Urinary concentrations (all drugs combined) ranged from 3 to 844 ng/L for nurses and from 3 to 44 ng/L for agents in charge of hygiene. The median urinary concentrations were 87 ng/L, 15.1 ng/L and 4.4 ng/L for FBAL, CP and MTX, respectively. The Doxo urinary concentration was found 218ng/L. Discussion: There is no current biological exposure index for the interpretation of AD contamination. The contamination of these healthcare professionals is therefore established by the detection of one or more AD in urine. These urinary contaminations are higher than the LOQ of the analytical methods, which must be as low as possible. Given the danger of AD, the implementation of corrective measures is essential for the staff. Biological monitoring of occupational exposure is the most reliable process to identify groups at risk, tracing insufficiently controlled exposures and as an alarm signal. These results show the necessity to educate professionals about the risks of handling AD and/or to care for treated patients.

Keywords: antineoplastic drugs, Mauritania, biological monitoring of occupational exposure, contamination

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Authors: Uttam Neupane, Narendra Budha, Subash Kumar Bhattarai

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Material management is an essential part in construction project management. There are a number of material management problems in the Nepalese construction industry, which contribute to an inefficient material management system. Ineffective material management can cause waste of time and money thus increasing the problem of time and cost overrun. An assessment of material management system with gap and solution was carried out on 20 construction projects implemented by the Federal Level Project Implementation Unit (FPIU); Kaski district of Nepal. To improve the material management process, the respondents have provided possible solutions to overcome the gaps seen in the current material management process. The possible solutions are preparation of material schedule in line with the construction schedule for material requirement planning, verifications of material and locating of source, purchasing of the required material in advance before commencement of work, classifying the materials, and managing the inventory based on their usage value and eliminating and reduction in wastages during the overall material management process.

Keywords: material management, construction site, inventory, construction project

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Authors: Syed Mahbubuz Zaman, A. B. M. Abrar Haque, Mehedi Hassan Nayeem, Misbah Uddin Sagor

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Everyday e-mails are being used by millions of people as an effective form of communication over the Internet. Although e-mails allow high-speed communication, there is a constant threat known as spam. Spam e-mail is often called junk e-mails which are unsolicited and sent in bulk. These unsolicited emails cause security concerns among internet users because they are being exposed to inappropriate content. There is no guaranteed way to stop spammers who use static filters as they are bypassed very easily. In this paper, a smart system is proposed that will be using neural networks to approach spam in a different way, and meanwhile, this will also detect the most relevant features that will help to design the spam filter. Also, a comparison of different parameters for different neural network models has been shown to determine which model works best within suitable parameters.

Keywords: long short-term memory, bidirectional long short-term memory, gated recurrent unit, natural language processing, natural language processing

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Authors: Balázs Kulcsár

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Today, there is no part of the world that does not bear the mark of man in some way. This process seems unstoppable. So perhaps the best thing we can do is to touch that handprint gently and with the utmost care. There are multiple uses for the same piece of land, the coordination of which requires careful and sustainable spatial planning. The case study of the Rétközlake in north-eastern Hungary illustrates a habitat rehabilitation project in which a number of human uses were coordinated with the conservation and restoration of the natural environment. Today, the good condition of the habitat can only be maintained artificially, but the project has paid particular attention to finding a sustainable solution. The rehabilitation of Lake Rétköz is considered good practice in resolving land-use conflicts.

Keywords: sustainability, ecosystem service, land use conflict, landscape utilization

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Authors: N. K. Bhute, B. B. Bhosle, D. G. More, B. V. Bhede

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The field experiments were conducted during kharif season of the year 2007-08 at the experimental farm of the Department of Agricultural Entomology, Vasantrao Naik Marathwada Krishi Vidyapeeth, Studies on evaluation of different IPM modules for Bt cotton in relation to yield economics and ICBR revealed that MAU and CICR IPM modules proved superior. It was, however, on par with chemical control. Considering the ICBR and safety to natural enemies, an inference can be drawn that Bt cotton with IPM module is the most ideal combination. Besides reduction in insecticide use, it is also expected to ensure favourable ecological and economic returns in contrast to the adverse effects due to conventional insecticides. The IPM approach, which takes care of varying pest situation, appears to be essential for gaining higher advantage from Bt cotton.

Keywords: yield, economics, ICBR, IPM Modules, Bt cotton

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Authors: N. R. Harris, J. Curry

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This paper describes the construction and operation of an experimental LoRaWAN network surrounding the University of Southampton in the United Kingdom. Following successful installation, an experimental node design is built and characterised, with particular emphasis on radio range. Several configurations are investigated, including different data rates, and varying heights of node. It is concluded that although range can be great (over 8 km in this case), environmental topology is critical. However, shorter range implementations, up to about 2 km in an urban environment, are relatively insensitive although care is still needed. The example node and the relatively simple base station reported demonstrate that LoraWan can be a very low cost and practical solution to Internet of Things type applications for distributed monitoring systems with sensors spread over distances of several km.

Keywords: long-range, wireless, sensor, network

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Authors: J. Valach, S. Pospisil, S. Kuznecov

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The paper deals with experimental estimation of future environmental load on medieval mosaic of Last Judgement on entrance to St. Vitus cathedral on Prague castle. The mosaic suffers from seasonal changes of weather pattern, as well as rains, their acidity, deposition of dust and sooth particles from polluted air and also from freeze-thaw cycles. These phenomena influence state of the mosaic. The mosaic elements, tesserae are mostly made from glass prone to weathering. To estimate future procedure of the best maintenance, relation between various weather scenarios and their effect on the mosaic was investigated. At the same time local method for evaluation of protective coating was developed. Together both methods will contribute to better care for the mosaic and also visitors aesthetical experience.

Keywords: environmental load, cultural heritage, glass mosaic, protection

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Authors: Shilpa Sondkar, Maithili Patil, Atharva Potnis

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The current health care landscape desires efficiency and patient satisfaction for optimal performance. Medical appointment booking apps have increased the overall efficiency of clinics, hospitals, and e-health marketplaces while simplifying processes. These apps allow patients to connect with doctors online. Not only are mobile doctor appointment apps a reliable and efficient solution, but they are also the future of clinical progression and a distinct new stage in the patient-doctor relationship. Compared to the usual queuing method, the web-based appointment system could significantly increase patients' satisfaction with registration and reduce total waiting time effectively.

Keywords: appointment, patient, scheduling, design and development, Figma

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Authors: A. Kourou, A. Ioakeimidou, A. Gakou

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Greece due to its location in the Eastern Mediterranean region is characterized by a high degree of seismicity and occurrence of severe earthquakes. It is generally accepted that preventive planning is vital in mitigating impacts, protecting those who are the most vulnerable namely children and increasing the degree of resilience of local communities. Worldwide, States have highlighted the need to ensure the safety of early childhood environments in case of disaster. A great number of children are enrolled in daycare facilities, so building and improving the preparedness of pre-primary schools to prevent injuries and fatalities in case of an earthquake becomes an important policy issue. It is more than evident that preparedness in early preschool level will be increased through awareness and education of the people who work to pre-primary classes and provide early childhood care. The aim of the present study is to assess the level of awareness and preparedness of the Greek pre-primary schools staff concerning earthquake protection issues, as well as their risk mitigation behaviors and earthquake management in case of a strong event. In this framework, specific questionnaire was developed and filled by the abovementioned target group at 30 different municipalities of Greece (2014-2016). Also in the framework of this study it is presented the Pre-Primary Schools’ Earthquake Safety Initiative that has been undertaken by Earthquake Planning and Protection Organization (EPPO) the last years. This initiative aims to develop disaster-resilient day care centers through awareness, self-help, cooperation and education. Recognizing the necessity of integration of the disaster safety concept at pre-primary environments, EPPO published practical guidelines that focused on earthquake planning of these workspaces. Furthermore, dozens of seminars are implemented in municipality or prefecture-level every year by EPPO, in order the early childhood schools’ staff to be appropriately educated and adequately trained to face the earthquake risk. Great progress has been made towards building awareness and increasing preschool preparedness in Greece but significant gaps still remain. Anyway, it is extremely important that the implementation of effective programs and practices and the broad collaboration of all involved parties have been recognized as essential in order to develop a comprehensive disaster management system at preschool environment.

Keywords: awareness, earthquake, education, emergency plans, preparedness, pre-primary schools

Procedia PDF Downloads 191

Authors: Andrés I. Ávila, Patricia Aros, César San Martín, Elizabeth Kehr, Yovana Leal

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Planning models for fresh products is a very useful tool for improving the net profits. To get an efficient supply chain model, several functions should be considered to get a complete simulation of several operational units. We consider a linear programming model to help farmers to decide if it is convenient to choose what area should be planted for three kinds of export fruits considering their future investment. We consider area, investment, water, productivity minimal unit, and harvest restrictions to develop a monthly based model to compute the average income in five years. Also, conditions on the field as area, water availability, and initial investment are required. Using the Chilean costs and dollar-peso exchange rate, we can simulate several scenarios to understand the possible risks associated to this market. Also, this tool help to support decisions for government and individual farmers.

Keywords: mixed integer problem, fresh fruit production, support decision model, agricultural and biosystems engineering

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Authors: Xinwen Zhu, Xingguang Li, Sun Yi

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Crack is one of the most common damages in buildings, bridges, roads and so on, which may pose safety hazards. However, cracks frequently happen in structures of various materials. Traditional methods of manual detection and measurement, which are known as subjective, time-consuming, and labor-intensive, are gradually unable to meet the needs of modern development. In addition, crack detection and measurement need be safe considering space limitations and danger. Intelligent crack detection has become necessary research. In this paper, an efficient method for crack detection and quantification using a 3D sensor, LiDAR, and depth camera is proposed. This method works even in a dark environment, which is usual in real-world applications. The LiDAR rapidly spins to scan the surrounding environment and discover cracks through lasers thousands of times per second, providing a rich, 3D point cloud in real-time. The LiDAR provides quite accurate depth information. The precision of the distance of each point can be determined within around  ±3 cm accuracy, and not only it is good for getting a precise distance, but it also allows us to see far of over 100m going with the top range models. But the accuracy is still large for some high precision structures of material. To make the depth of crack is much more accurate, the depth camera is in need. The cracks are scanned by the depth camera at the same time. Finally, all data from LiDAR and Depth cameras are analyzed, and the size of the cracks can be quantified successfully. The comparison shows that the minimum and mean absolute percentage error between measured and calculated width are about 2.22% and 6.27%, respectively. The experiments and results are presented in this paper.

Keywords: LiDAR, depth camera, real-time, detection and measurement

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Authors: O. M. Omar, A. M. Heniegal, G. D. Abd Elhameed, H. A. Mohamadien

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Local steel slag is produced as a by-product during the oxidation of steel pellets in an electric arc furnace. Using local steel slag waste as a hundred substitute of crushed stone in construction materials would resolve the environmental problems caused by the large-scale depletion of the natural sources of dolomite. This paper reports the experimental study to investigate the influence of a hundred replacement of dolomite as a coarse aggregate with local steel slag, on the fresh and hardened geopolymer concrete properties. The investigation includes traditional testing of hardening concrete, for selected mixes of cement and geopolymer concrete. It was found that local steel slag as a coarse aggregate enhanced the slump test of the fresh state of cement and geopolymer concretes. Nevertheless the unit weight of concretes was affected. Meanwhile, the good performance was observed when fly ash used as geopolymer concrete based.

Keywords: geopolymer, molarity, steel slag, sodium hydroxide, sodium silicate

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Authors: Mohamed A. Deyab, Ahmed E. Awadallah

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Under various conditions, we present a promising method for producing pure hydrogen energy from the electrochemical reaction of Mg metal in waste oilfield water (WOW). Mg metal and WOW are primarily consumed in this process. The results show that the hydrogen gas output is highly dependent on temperature and solution pH. The best conditions for hydrogen production were found to be a low pH (2.5) and a high temperature (338 K). For the first time, the Allyl methylimidazolium bis-trifluoromethyl sulfonyl imide) (IL) ionic liquid is used to regulate the rate of hydrogen generation. It has been confirmed that increasing the solution temperature and decreasing the solution pH accelerates Mg dissolution and produces more hydrogen per unit of time. The adsorption of IL on the active sites of the Mg surface is unrestricted by mixing physical and chemical orientation. Inspections using scanning electron microscopy (SEM), energy dispersive X-ray (EDX), and FT-IR spectroscopy were used to identify and characterise surface corrosion of Mg in WOW. This process is also completely safe and can create energy on demand.

Keywords: hydrogen production, Mg, wastewater, ionic liquid

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Authors: Prasanti Widyasih Sarli, Prayatni Soewondo

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Greater access to sanitation in developing countries is urgent. However even though sanitation is crucial, overall budget for sanitation is limited. With this budget limitation, it is important to (1) allocate resources strategically to maximize impact and (2) take into account communal agency to potentially be a source for sanitation improvements. The Jodipan and Kesatrian Project in Malang, Indonesia is an interesting alternative for solving the sanitation problem in which resources were allocated strategically and communal agency was also observed. Although the projects initial goal was only to improve visually the situation in the slums, it became a new tourist destination, and the economic benefit that came with it had an effect also on the change of behavior of the residents and the government towards sanitation. It also grew from only including the Kesatrian Village to expanding to the Jodipan Village in the course of less than a year. To investigate the success of this project, in this paper a descriptive model will be used and data will be drawn from intensive interviews with the initiators of the project, residents affected by the project and government officials. In this research it is argued that three points mark the success of the project: (1) the strategic initial impact due to choice of location, (2) the influx of tourists that triggered behavioral change among residents and, (3) the direct economic impact which ensured its sustainability and growth by gaining government officials support and attention for more public spending in the area for slum development and sanitation improvement.

Keywords: behaviour change, sanitation, slum, strategic thinking

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Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli

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Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.

Keywords: assessment, education, nurse, triage

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Authors: Ali Ben Abbes, ImedRiadh Farah, Vincent Barra

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Remotely sensed data are a significant source for monitoring and updating databases for land use/cover. Nowadays, changes detection of urban area has been a subject of intensive researches. Timely and accurate data on spatio-temporal changes of urban areas are therefore required. The data extracted from multi-temporal satellite images are usually non-stationary. In fact, the changes evolve in time and space. This paper is an attempt to propose a methodology for changes detection in urban area by combining a non-stationary decomposition method and stochastic modeling. We consider as input of our methodology a sequence of satellite images I₁, I₂, … I_n at different periods (t = 1, 2, ..., n). Firstly, a preprocessing of multi-temporal satellite images is applied. (e.g. radiometric, atmospheric and geometric). The systematic study of global urban expansion in our methodology can be approached in two ways: The first considers the urban area as one same object as opposed to non-urban areas (e.g. vegetation, bare soil and water). The objective is to extract the urban mask. The second one aims to obtain a more knowledge of urban area, distinguishing different types of tissue within the urban area. In order to validate our approach, we used a database of Tres Cantos-Madrid in Spain, which is derived from Landsat for a period (from January 2004 to July 2013) by collecting two frames per year at a spatial resolution of 25 meters. The obtained results show the effectiveness of our method.

Keywords: multi-temporal satellite image, urban growth, non-stationary, stochastic model

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Authors: Deepak Jugran, Rajesh Gill

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Purpose: To study the demographic, sociological, gender and clinical profile of the children presented for childhood cataract at a public sector tertiary eye care centre in India. Methodology: The design of the study is retrospective, and hospital-based data is available with the Central Registration Department of the PGIMER, Chandigarh. The majority of the childhood cataract cases are being reported in this hospital, yet not each and every case of childhood cataract approaches PGI, Chandigarh. Nevertheless, this study is going to be pioneering research in India, covering five-year data of the childhood cataract patients who visited the Advanced Eye Centre, PGIMER, Chandigarh, from 1.1.2015 to 31.12.2019. The SPSS version 23 was used for all statistical calculations. Results: A Total of 354 children were presented for childhood cataract from 1.1.2015 to 31.12.2019. Out of 354 children, 248 (70%) were male, and 106 (30%) were female. In-spite of 2 flagship programmes, namely the National Programme for Control of Blindness (NPCB) and Aayushman Bharat (PM JAY) for eradication of cataract, no children received any financial assistance from these two programmes. A whopping 99% of these children belong to the poor families. In most of these families, the mothers were house-wives and did not employ anywhere. These interim results will soon be conveyed to the Govt. of India so that a suitable mechanism can be evolved to address this pertinent issue. Further, the disproportionate ratio of male and female children in this study is an area of concern as we don’t know whether the prevalence of childhood cataract is lower in female children or they are not being presented on time in the hospital by the families. Conclusion: The World Health Organization (WHO) has categorized Childhood blindness resulting from cataract as a priority area and urged all member countries to develop institutionalized mechanisms for its early detection, diagnosis and management. The childhood cataract is an emerging and major cause of preventable and avoidable childhood blindness, especially in low and middle-income countries. In the formative years, the children require a sound physical, mental and emotional state, and in the absence of either one of them, it can severely dent their future growth. The recent estimate suggests that India could suffer an economic loss of US$12 billion (Rs. 88,000 Crores) due to blindness, and almost 35% of cases of blindness are preventable and avoidable if detected at an early age. Besides reporting these results to the policy makers, synchronized efforts are needed for early detection and management of avoidable causes of childhood blindness such as childhood cataract.

Keywords: childhood blindness, cataract, Who, Npcb

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Authors: Jonathan Bolduc

Abstract:

Studies have demonstrated the effectiveness of music training approaches to help children with language disabilities. Because music is closely associated with a number of cognitive functions, including language, it has been hypothesized that musical skills transfer to other domains. Research suggests that music training strengthens basic auditory processing skills in dyslexic children and may ameliorate phonological deficits. Furthermore, music instruction has the particular advantage of being non-literacy-based, thus removing the frustrations that can be associated with reading and writing activities among children with specific learning disabilities. In this study, we assessed the effect of implementing an intensive music program on the development of language skills (phonological and reading) in 4- to 9-year-old children. Seventeen children (N=17) participated in the study. The experiment took place over 6 weeks in a controlled environment. Eighteen lessons of 40 minutes were offered during this period by two music specialists. The Dalcroze, Orff, and Kodaly approaches were used. A series of qualitative measures were implemented to document the contribution of music training to this population. Currently, the data is being analyzed. The first results show that learning music seems to significantly improve verbal memory. We already know that language disabilities are considered one of the main causes of school dropout as well as later professional and social failure. We aim to corroborate that an integrated music education program can provide children with language disabilities with the same opportunities to develop and succeed in school as their classmates. Scientifically, the results will contribute to advance the knowledge by identifying the more effective music education strategies to improve the overall development of children worldwide.

Keywords: music education, music, art education, language diasabilities

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Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

Abstract:

Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

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Authors: Amberly Brigden, Ali Heawood, Emma C. Anderson, Richard Morris, Esther Crawley

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Background: Paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is characterised by persistent, disabling fatigue. Health services see patients below the age of 12. This age group experience high levels of disability, with low levels of school attendance, high levels of fatigue, anxiety, functional disability and pain. CFS/ME interventions have been developed for adolescents, but the developmental needs of younger children suggest treatment should be tailored to this age group. Little is known about how intervention should be delivered to this age group, and further work is needed to explore this. Qualitative research aids patient-centered design of health intervention. Methods: Five to 11-year-olds and their parents were recruited from a specialist CFS/ME service. Semi-structured interviews explored the families’ experience of the condition and perspectives on treatment. Interactive and arts-based methods were used. Interviews were audio-recorded, transcribed and analysed thematically. Qualitative Results: 14 parents and 7 children were interviewed. Early analysis of the interviews revealed the importance of the social-ecological setting of the child, which led to themes being developed in the context of Systems Theory. Theme one relates to the level of the child, theme two the family system, theme three the organisational and societal systems, and theme four cuts-across all levels. Theme1: The child’s capacity to describe, understand and manage their condition. Younger children struggled to describe their internal experiences, such as physical symptoms. Parents felt younger children did not understand some concepts of CFS/ME and did not have the capabilities to monitor and self-regulate their behaviour, as required by treatment. A spectrum of abilities was described; older children (10-11-year-olds) were more involved in clinical sessions and had more responsibility for self-management. Theme2: Parents’ responsibility for managing their child’s condition. Parents took responsibility for regulating their child’s behaviour in accordance with the treatment programme. They structured their child’s environment, gave direct instructions to their child, and communicated the needs of their child to others involved in care. Parents wanted their child to experience a 'normal' childhood and took steps to shield their child from medicalization, including diagnostic labels and clinical discussions. Theme3: Parental isolation and the role of organisational and societal systems. Parents felt unsupported in their role of managing the condition and felt negative responses from primary care health services and schools were underpinned by a lack of awareness and knowledge about CFS/ME in younger children. This sometimes led to a protracted time to diagnosis. Parents felt that schools have the potential important role in managing the child’s condition. Theme4: Complexity and uncertainty. Many parents valued specialist treatment (which included activity management, physiotherapy, sleep management, dietary advice, medical management and psychological support), but felt it needed to account for the complexity of the condition in younger children. Some parents expressed uncertainty about the diagnosis and the treatment programme. Conclusions: Interventions for younger children need to consider the 'systems' (family, organisational and societal) involved in the child’s care. Future research will include interviews with clinicians and schools supporting younger children with CFS/ME.

Keywords: chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), pediatric, qualitative, treatment

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Authors: Festus Epetimehin

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Agriculture remains the dominant sector in the rural areas where over 70% of Nigerian reside and it’s still the backbone of our economy. The observed poor performance of farmers in agricultural productivity is due to the nature of risks and uncertainties in agriculture.Agricultural insurance is one of the mechanisms by which farmers can stabilize farm income and investment. The study examined the relationship between agricultural insurance scheme (AIS) and performance of agribusiness in Nigeria. The study adopted exploratory research design which is an ex-ante research approach. One hundred copies of structured questionnaire were administered for the purpose of the study. Correlation analysis and regression analysis were employed for the study. The correlation analysis of the finding revealed that the independent variable; agricultural insurance scheme (AIS) is positively and significantly correlated with the set of dependent variables; where turnover (ABT)=0.582**, profitability (ABP)=0.321**, solvency (ABS)=0.418**and cost of production (ABC)=0.23** respectively. The regression analysis result also revealed the degree of relationship between the independent variable (AIS) and set of dependent variables where one(1%) percent increase in independent variable will lead to 33.9% (ABT), 9.7% (ABP), 17.5%(ABS) and 1.5%(ABC).The study recommended that the Federal Government in collaboration with the participating Agricultural insurers embark on awareness campaign through to the length and breadth of Nigeria on government support and insurance scheme for farmers. Government should also ensure that the loan and insurance scheme should extend beyond the mechanized farmers and include the intensive subsistence farmers in view of the fact that they are the dominants in most of the farm produce markets.

Keywords: agribusiness, agricultural insurance, performance, turnover, solvency, agricultural risks

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Authors: Reina Kawase

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World GHG emissions should be reduced 50% by 2050 compared with 1990 level. CO2 emission reduction from steel sector, an energy-intensive sector, is essential. To estimate CO2 emission from steel sector in the world, estimation of steel production is required. The world steel production by process is estimated during the period of 2005-2050. The world is divided into aggregated 35 regions. For a steel making process, two kinds of processes are considered; basic oxygen furnace (BOF) and electric arc furnace (EAF). Steel production by process in each region is decided based on a current production capacity, supply-demand balance of steel and scrap, technology innovation of steel making, steel consumption projection, and goods trade. World steel production under moderate countermeasure scenario in 2050 increases by 1.3 times compared with that in 2012. When domestic scrap recycling is promoted, steel production in developed regions increases about 1.5 times. The share in developed regions changes from 34 %(2012) to about 40%(2050). This is because developed regions are main suppliers of scrap. 48-57% of world steel production is produced by EAF. Under the scenario which thinks much of supply-demand balance of steel, steel production in developing regions increases is 1.4 times and is larger than that in developed regions. The share in developing regions, however, is not so different from current level. The increase in steel production by EAF is the largest under the scenario in which supply-demand balance of steel is an important factor. The share reaches 65%.

Keywords: global steel production, production distribution scenario, steel making process, supply-demand balance

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Authors: Manal Alosaimi

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Many rehabilitation strategies exist to aid persons with neurological disorders relearn motor skills through intensive training. Evidence supporting the theory that cortical areas involved in motor execution can be triggered by observing actions performed by others is attributed to the function of the mirror neuron system (MNS) indicates that activation of the MNS is associated with improvements in physical action and motor learning. Therefore, it is important to investigate the relationship between motor training (in this case, playing the drums) and the activation of the MNS. To achieve this, 15 healthy right-handed participants received drum-kit training for 21 weeks, during which time blood oxygen level-dependent (BOLD) signals were monitored in the brain using functional magnetic resonance imaging (fMRI). Participants were required to perform action–observation and action–execution fMRI tasks. The main results are that BOLD signals in classical regions of the MNS such as supramarginal gyri, inferior parietal lobule, and supplementary motor area increase significantly over the training period. Activation of these areas indicates that passive-observation of others performing these same skills may facilitate recovery of persons suffering from neurological disorders, and complement conventional rehabilitation programs that focus on action execution or intense training.

Keywords: fMRI, mirror neuron system, magnetic resonance imaging, neuroplasticity, drumming, learning, music, action observation, action execution

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Authors: Margareta Simina Stanc, Aurel Mototolea, Tiberiu Potarniche

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Sacidava archeological site is located in Dobrudja region, Romania, on a hill on the right bank of the Danube - the Musait point, located at about 5 km north-east from Dunareni village. The place-name documents the fact that, prior to the Roman conquest, in the area, there was a Getic settlement. The location of the Sacidava was made possible by corroborating the data provided by the ancient sources with the epigraphic documents (the milial pillar during the time of Emperor Decius). The tegular findings attest that an infantry unit, cohors I Cilicum milliaria equitata, as well as detachments from Legio V Macedonica and Legio XI Claudia, were confined to Sacidava. During the period of the Dominion, the garrison of the fortification is the host of a cavalry unit: cuneus equitum scutariorum. In the immediate vicinity to the Roman fortress, to the east, were identified two other fortifications: a Getic settlement (4th-1st century B.C.) and an Early Medieval settlement (9th-10th century A.C.). The archaeological material recovered during the research is represented by ceramic forms such as amphoras, jugs, pots, cups, plates, to which are added oil lamps, some of them typologically new at the time of discovery. Local ceramic shapes were also founded, worked by hand or by wheel, considered un-Romanized or in the course of Romanization. During the time of the Principality, Sacidava it represented an important military outpost serving mainly the city of Tropaeum Traiani, controlling also the supply and transport on the Danube limes in the Moesic sector. This role will determine the development of the fortress and the appearance of extramuros civil structures, thus becoming an important landmark during the 5th-6th centuries A.C., becoming a representation of power of the Roman empire in an area of continuous conflict. During recent archaeological researches, faunal remains were recovered, and their analysis allowed to estimate the animal resources and subsistence practices (animal husbandry, hunting, fishing) in the settlement. The methodology was specific to archaeozoology, mainly consisting of anatomical, taxonomical, and taphonomical identifications, recording, and quantification of the data. The remains of domestic mammals have the highest proportion indicating the importance of animal husbandry; the predominant species are Bos taurus, Ovis aries/Capra hircus, and Sus domesticus. Fishing and hunting were of secondary importance in the subsistence economy of the community. Wild boar and the red deer were the most frequently hunted species. Just a few fish bones were recovered. Thus, the ancient city of Sacidava is proving to be an important element of cultural heritage of the south-eastern part of Romania, for whose conservation and enhancement efforts must be made, especially by landscape reconstruction.

Keywords: archaeozoology, landscape reconstruction, limes, military outpost

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