Search results for: bioclimatic charts

Authors: Redvan Ghasemlounia, Elham Ansari, Hikmet Kerem Cigizoglu

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Hydrological modeling in arid and semi-arid regions is very important. Iran has many regions with these climate conditions such as Chaharmahal and Bakhtiari province that needs lots of attention with an appropriate management. Forecasting of hydrological parameters and estimation of hydrological events of catchments, provide important information that used for design, management and operation of water resources such as river systems, and dams, widely. Discharge in rivers is one of these parameters. This study presents the application and comparison of some estimation methods such as Feed-Forward Back Propagation Neural Network (FFBPNN), Multi Linear Regression (MLR), Gene Expression Programming (GEP) and Bayesian Network (BN) to predict the daily flow discharge of the Soolegan River, located at Chaharmahal and Bakhtiari province, in Iran. In this study, Soolegan, station was considered. This Station is located in Soolegan River at 51° 14՜ Latitude 31° 38՜ longitude at North Karoon basin. The Soolegan station is 2086 meters higher than sea level. The data used in this study are daily discharge and daily precipitation of Soolegan station. Feed Forward Back Propagation Neural Network(FFBPNN), Multi Linear Regression (MLR), Gene Expression Programming (GEP) and Bayesian Network (BN) models were developed using the same input parameters for Soolegan's daily discharge estimation. The results of estimation models were compared with observed discharge values to evaluate performance of the developed models. Results of all methods were compared and shown in tables and charts.

Keywords: ANN, multi linear regression, Bayesian network, forecasting, discharge, gene expression programming

Procedia PDF Downloads 533

Authors: Tahra AlMahmoud, Sameeha Mohamed Al Hadhrami, Mohamed Elhanan, Hanan Naser Alshamsi, Fikri Abu-Zidan

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Background: To the best of the author(s)’ knowledge there are no epidemiological studies for traumatic eye injuries in UAE, neither data on groups at risk or mechanisms for ocular trauma. Purpose: To report the epidemiology of eye injuries that required hospital admission and surgery at a referral center at the eastern part of Abu Dhabi. Method: Retrospective charts review of all patients who had suffered an eye injury that required surgical intervention between 2012 and 2017 at Al Ain Hospital. Demographic data, place of occurrence, the cause of injury, visual acuity (VA) before and after treatment, number of admission days and follow up were extracted. Data were tabulated and presented as number (%), mean (SD), or median (range) as appropriate. Wilcoxon signed rank test was used for VA outcome. Results: One hundred forty-one patients were identified, 96 eyes with open-globe and 48 other types of injuries. The mean age of the patients was 26±15.5 years, and 89% were male. Majority of injuries occurred at the workplace (50.4%) followed by home (31.2%). Trauma with a sharp object (24.1%), blunt object (16.3%), nail (11.3%), and hammer on metal (7.8%) were the most common etiologies of injury. Corneas injuries (48.2%) was the most frequent cause for visual acuity limitation followed by lens/cataract (23.4%). Among the traumatized eyes, 30 eyes (21.3%) retained intraocular foreign body, Mean admission days was 3.16± 2.81days (1-16) and a number of follow up visit was 3.17± 4.11times (0-26). Conclusion: Ocular trauma requiring surgical intervention is an area of concern in particular for occupations involving work with metals. This work may give insight into the value and necessity of implementing preventive measures.

Keywords: epidemiology, Middle Eastern area, occupational injury, ocular traumas

Procedia PDF Downloads 105

Authors: H. A. Algahtani, A. S. Khan, O. Alzahrani, N. Hussein, M. A. Khan, Loudhi Y. I. Soliman

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Objective: To report on the Saudi experience (developing country) of neurological complications from bariatric surgery. The literature on the subject is reviewed. Method: This is a cross sectional study done in King Abdul Aziz Medical City Jeddah, WR, where we reviewed all charts of the patients who underwent bariatric surgery between January 1st, 2009 to December 31st , 2014. Personal and clinical data including age, sex, BMI, comorbidities, type of procedure, duration of stay in hospital, complications and postoperative follow up were collected. In addition follow up visit and remote complication if present were collected. All patients with neurological complications were reviewed in details including their clinical examination, laboratory and imaging results, treatment and prognosis. This report is essentially descriptive with no statistical analysis performed. Results: Fifteen cases were collected in this study (3%). Axonal polyneuropathy was the most frequent neurological complica¬tion, but cases of Wernicke syndrome, vitamin B12 deficiency, Guillain-Barre syndrome and cupper deficiency were also identified. Fourteen patients (93.3%) had full recovery from the neurological signs and symptoms but unfortunately one patient died. Conclusion: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications. A clear education, guidelines and follow-up program should be planned and practiced. Facts should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.

Keywords: bariatric surgery, neurological complications, neuropathy, Wenicke syndrome

Procedia PDF Downloads 300

Authors: Londeka Ntuli, Frasia Oosthuizen

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Background: Tenefovir disiproxil fumarate (TDF) is a nephrotoxic drug and has been proven to contribute to renal insufficiency necessitating intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. TDF is one of the preferred first-line drugs used in combination therapy in most regions. There are estimated 300 000 patients being initiated on the Efavirenz/TDF/Emtricitabine first-line regimen annually in South Africa. It is against this background that this study aims to investigate the effects of TDF on renal sufficiency of HIV positive patients. Methodology: A retrospective quantitative study was conducted, analysing clinical charts of HIV positive patient’s older than 18 years of age and on a TDF-containing regimen for more than 1 year. Data were obtained from the analysis of patient files and was transcribed into Microsoft® Excel® spreadsheet. Extracted data were coded, categorised and analysed using STATA®. Results: A total of 275 patient files were included in this study. Renal function started decreasing after 3 months of treatment (with 93.5% patients having a normal EGFR), and kept on decreasing as time progressed with only 39.6% normal renal function at year 4. Additional risk factors for renal insufficiency included age below 25, female gender, and additional medication. Conclusion: It is clear from this study that the use of TDF necessitates intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. The findings from this study generated pertinent information on the safety profile of the drug TDF in a resource-limited setting of a public health institution. The appropriate management is of tremendous importance in the South African context where the majority of HIV positive individuals are on the TDF containing regimen; thus it is beneficial to ascertain the possible level of toxicities these patients may be experiencing.

Keywords: renal insufficiency, tenefovir, HIV, risk factors

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Authors: Yoshitaka Ooya, Daishuke Furuya, Manabu Nemoto

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Some countries such as Canada and Australia have mandatory bicycle helmet laws for all citizens and age groups. As of 2008 Japan has also adopted a helmet law but it is restricted to people 13 years old and under. People over 13 years of age are not required to wear helmets in Japan. Currently, the rate that people 0-13 years old actually wear helmets is low. In 2013 a number of patients came to Saitama University Hospital International Medical Center for treatment due to bicycle-related trauma. The total number of patients was 89 (55 male and 34 female). The average age of the patients was 40.9 years old (eldest; 83 y/o, median; 40 y/o, youngest; 1 y/o with a standard deviation ± 2.8). 54 of these patients (61%) experienced head trauma as well as some experiencing multiple injuries associated with their accident. 13 patients were wearing helmets, 50 patients were not wearing helmets and it is unknown if the remaining 26 patients were wearing helmets. This information was acquired from the patient`s medical charts. Only one patient who was wearing a helmet had a severe head injury, and this patient also experienced other multiple injuries. 17 patients who were not wearing helmets had severe head injuries and out of the 17, two had multiple injuries. The mechanism for injury varied. 12 patients were injured in an accident with a vehicle, only one of which was wearing a helmet. This patient also had multiple injuries. Of the other 11 patients, two had multiple injuries. The remaining patient`s injuries were caused by other accidents (3; fell over while riding, 2; crashed into an inanimate object, 1; collided with a motorcycle). The ladder of which had a severe head injury. All of these patients had light energy accidents and were all over 13 years of age. In Japan it is not mandatory for people over the age of 13 years to wear a bicycle helmet. Research shows that light energy accidents were mostly present in people over the age of 13, to which the law does not require the wearing of helmets. It is important that all people in all age groups be required to wear helmets when operating a bicycle to reduce the rate of light energy severe head injuries.

Keywords: bicycle helmet, head trauma, hospital, traumatic situation

Procedia PDF Downloads 335

Authors: M. Towhidur Rahman, Nasim Zaman Piyas, M. Sadiqul Baree, Shahnewaz Ahmed

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The design of high-speed craft has recently become one of the most active areas of naval architecture. Speed increase makes these vehicles more efficient and useful for military, economic or leisure purpose. The planing hull is designed specifically to achieve relatively high speed on the surface of the water. Speed on the water surface is closely related to the size of the vessel and the installed power. The Savitsky method was first presented in 1964 for application to non-monohedric hulls and for application to stepped hulls. This method is well known as a reliable comparative to CFD analysis of hull resistance. A computer program based on Savitsky’s method has been developed using MATLAB. The power of high-speed vessels has been computed in this research. At first, the program reads some principal parameters such as displacement, LCG, Speed, Deadrise angle, inclination of thrust line with respect to keel line etc. and calculates the resistance of the hull using empirical planning equations of Savitsky. However, some functions used in the empirical equations are available only in the graphical form, which is not suitable for the automatic computation. We use digital plotting system to extract data from nomogram. As a result, value of wetted length-beam ratio and trim angle can be determined directly from the input of initial variables, which makes the power calculation automated without manually plotting of secondary variables such as p/b and other coefficients and the regression equations of those functions are derived by using data from different charts. Finally, the trim angle, mean wetted length-beam ratio, frictional coefficient, resistance, and power are computed and compared with the results of Savitsky and good agreement has been observed.

Keywords: nomogram, planing hull, principal parameters, regression

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Authors: Adinarayana S., Sudhakar I.

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Energy conversion is one of the inevitable parts of any industries. It involves either conversion of mechanical energy in to electrical or vice versa. The later conversion of energy i.e. electrical to mechanical emphasizes the need of motor. Statistics reveals, about 8 % of industries’ annual turnover met on maintenance. Thus substantial numbers of efforts are required to minimize in incurring expenditure met towards break down maintenance. Condition monitoring is one of such techniques based on vibration widely used to recognize premature failures and paves a way to minimize cumbersome involved during breakdown of machinery. The present investigation involves a case study of squirrel cage induction motor (frequently in the electro machines) has been chosen for the conditional monitoring to predict its soundness on the basis of results of FFT analyser. Accelerometer which measures the acceleration converts in to impulses by FFT analyser generates vibration spectrum and time spectrum has been located at various positions on motor under different conditions. Results obtained from the FFT analyser are compared to that of ISO standard vibration severity charts are taken to predict the preventative condition of considered machinery. Initial inspection of motor revealed that stator faults, broken end rings in rotor, eccentricity faults and misalignment between bearings are trouble shootings areas for present investigation. From the results of the shaft frequencies, it can be perceived that there is a misalignment between the bearings at both the ends. The higher order harmonics of FTF shows the presence of cracks on the race of the bearings at both the ends which are in the incipient stage. Replacement of the bearings at both the drive end (6306) and non drive end (6206) and the alignment check between the bearings in the shaft are suggested as the constructive measures towards preventive maintenance of considered squirrel cage induction motor.

Keywords: FFT analyser, condition monitoring, vibration spectrum, time wave form

Procedia PDF Downloads 358

Authors: Adi Narayana S Sudhakar. I

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Energy conversion is one of the inevitable parts of any industries. It involves either conversion of mechanical energy in to electrical or vice versa. The later conversion of energy i.e. electrical to mechanical emphasizes the need of motor .Statistics reveals, about 8 % of industries’ annual turnover met on maintenance. Thus substantial numbers of efforts are required to minimize in incurring expenditure met towards break down maintenance. Condition monitoring is one of such techniques based on vibration widely used to recognize premature failures and paves a way to minimize cumbersome involved during breakdown of machinery. The present investigation involves a case study of squirrel cage induction motor (frequently in the electro machines) has been chosen for the conditional monitoring to predict its soundness on the basis of results of FFT analyser. Accelerometer which measures the acceleration converts in to impulses by FFT analyser generates vibration spectrum and time spectrum has been located at various positions on motor under different conditions. Results obtained from the FFT analyzer are compared to that of ISO standard vibration severity charts are taken to predict the preventative condition of considered machinery. Initial inspection of motor revealed that stator faults, broken end rings in rotor, eccentricity faults and misalignment between bearings are trouble shootings areas for present investigation. From the results of the shaft frequencies, it can be perceived that there is a misalignment between the bearings at both the ends. The higher order harmonics of FTF shows the presence of cracks on the race of the bearings at both the ends which are in the incipient stage. Replacement of the bearings at both the drive end (6306) and non-drive end (6206) and the alignment check between the bearings in the shaft are suggested as the constructive measures towards preventive maintenance of considered squirrel cage induction motor.

Keywords: FFT analyser, condition monitoring, vibration spectrum, time spectrum accelerometer

Procedia PDF Downloads 417

Authors: Adelson G. Guillarte, M. D., Noel J. Belonguel, Jarungchai Anton S. Vatanagul

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Patients with malignant middle cerebral infarction (MCA) (with massive brain swelling and herniation) were reported to have a mortality rate of 80% even with the appropriate conservative medical therapy. European Trials (DECIMAL, DESTINY I, and II, HAMLET) showed significant improvement in mortality and functional outcome with hemicraniectomy. No known published local studies in the region, thus a local study is vital. This is a single center, retrospective, descriptive, cross-sectional, chart review study which includes ≥18 year-old patients with malignant MCA infarction, who underwent hemicraniectomy, and those who were given conservative medical therapy alone, from January 2008 to December 2012 at Perpetual Succour Hospital. Excluded were patients whose charts are with insufficient data, prior MCA stroke, with concomitant intracerebral hemorrhage and with other serious medical conditions or terminal illnesses. Minimum of 32 populations were needed. Data were presented in mean, standard deviation, frequency and percentage distribution. Man n Whitney U test and Chi Square test were used. P-values lesser than 0.05 alpha were considered statistically significant. A total of 672 stroke patients were admitted. 34 patients pass the inclusion criteria. 9 underwent hemicraniectomy and 25 were treated by conservative medical therapy alone. Although not statistically significant (64% vs 33%, p=0.112) there were more patients noted improved in the conservative treatment group. Meanwhile, the Hemicraniectomy group have increased percentage of mortality (67%) (p=0.112). There was a decreasing trend in the average NIHSS score in both groups from admission to post-op 7 days (p=0.198, p=0.78). A bigger multicenter prospective study is recommended to control inherent biases and limitations of a retrospective and smaller study.

Keywords: cerebral infarct, hemicraniectomy, ischemic stroke, malignant middle cerebral artery (MCA) infarct

Procedia PDF Downloads 297

Authors: Dyna Ann C. Sevilles, Noel J. Belonguel, Jarungchai Anton S. Vatanagul, Mary Jeanne O. Flordelis, Grace G. Anota

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Guillain Barre syndrome is an acute inflammatory polyradiculoneuropathy causing progressive symmetrical weakness which can be debilitating to the patient. Early diagnosis is important especially in the acute phase when treatment favors good outcome and reduces the incidence of the need for mechanical ventilation. Electrodiagnostic studies aid in the evaluation of patients suspected with GBS. However, the characteristic electrical changes may not be evident until after several weeks. Thus, studies performed early in the course may give unclear results. The aim of this study is to associate the symptom onset of patients diagnosed with Guillain Barre syndrome with the EMG NCV results and determine the earliest time when there is evident findings supporting the diagnosis. This is a retrospective descriptive chart review study involving patients of >/= 18 years of age with GBS written on their charts in a Tertiaty hospital in Cebu City, Philippines from January 2000 to July 2014. Twenty patients showed electrodiagnostic findings suggestive of GBS. The mean day of illness when EMG NCV was carried out was 7 days. The earliest with suggestive findings was done on day 2 (10%) of illness. Moreover, the highest frequency with positive results was done on day 3 (20%) of illness. Based on the Dutch Guillain Barre Study group criteria, the most frequent variables noted were: prolonged distal motor latency in both median and ulnar nerves(65%) and both peroneal and tibial nerves (71%); and reduced CMAP in both median and ulnar nerves (65%) and both tibial and peroneal nerves (71%). The EMG NCV findings showed majority of demyelinating type (59%). Electrodiagnostic studies are helpful in aiding the physician in the diagnosis and treatment of the disease in the early stage. Based on this study, neurophysiologic evidence of GBS can be seen in as early as day 2 of clinical illness.

Keywords: Acute Inflammatory Demyelinating Polyneuropathy, electrophysiologic study, EMG NCV, Guillain Barre Syndrome

Procedia PDF Downloads 264

Authors: Mohamed Moheyeldin Mahmoud

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Egypt suffers from a severe shortage of data and charts concerning the physical dimensions, measurements, qualities and consumer behavior. The shortage of needed information and appropriate methods has forced the Egyptian designer to use any other foreign standard when designing a product for the Egyptian consumer which has led to many problems. The urgently needed database concerning the physical specifications, measurements of the Egyptian consumers, as well as the need to support the Ergonomics given courses in many colleges and institutes with the latest technologies, is stated as the research problem. Descriptive analytical method relying on the compiling, comparing and analyzing of information and facts in order to get acceptable perceptions, ideas and considerations is the used methodology by the researcher. The research concludes that: 1. Good interaction relationship between users and products shows the success of that product. 2. An integration linkage between the most prominent fields of science specially Ergonomics, Interaction Design and Ethnography should be encouraged to provide an ultimately updated database concerning the nature, specifications and environment of the Egyptian consumer, in order to achieve a higher benefit for both user and product. 3. Chinese economic policy based on the study of market requirements long before any market activities should be emulated. 4. Using Ethnography supports the design activities creating new products or updating existent ones through measuring the compatibility of products with their environment and user expectations, While contracting a joint cooperation between military colleges, sports education institutes from one side, and design institutes from the other side to provide an ultimately updated (annually updated) database concerning some specifications about students of both sexes applying in those institutes (height, weight, etc.) to provide the Industrial designer with the needed information when creating a new product or updating an existing one concerning that category is recommended by the researcher.

Keywords: adapt, ergonomics, ethnography, interaction design

Procedia PDF Downloads 196

Authors: Azize Serap Tuncer

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Turkey is one of the most outstanding figures among the Mediterranean countries from the natural and historical point at view. It is relatively rich country as regards the flora and vegetation. But at the same time as a result of improper and unplanned usage of the land for centuries, its forests and fertile soils have been exposed to great damages. While rapid and uncontrolled urbanization has important effects on the environment, urban development legislations, have become very unsufficient for the protection of these areas. Some of them have been completely eradicated, and some others have lost their fertility. Besides Turkey has a high main land with a rough surface and its soils areas exposed to heavy erosion. On the other hand as a developing country, it is not willing to endanger the goals of industrialization and avoid foreign direct investment by implementing strict environmental policies. Although this kind of pressure on forestland resources threatens the stability of forest land and land use management, in recent years, there has been an obvious increase in public concern about environmental problems like over global warming, environmental pollution, deforestation and their potential effects on natural resources. To protect the ecological balance and prevention of naturel resources from the unplanned intervention of human-beıng is only possible establishing conservation areas wıth co-operation at the national and the internatıonal levels. This study was carried out to evaluate the relation between urbanization and forestry policies in Turkey. While it elaborates the normative arrangements resulting in power conflicts, it also addresses which shortages and discrepancies are responsible for the said conflicts. The present urban reconstruction and transformation practices and their aesthetic and functional aspects were studied with some examples in a country level and evaluated within the assistance of literature researches, analyses, and observations. Atatürk Forest Farm and ODTU Forest examples were negotiated as two famous cases. Obtained findings were supported by charts and photos.

Keywords: deforestration, environmental policies, metropolitan, pollution, urbanization

Procedia PDF Downloads 132

Authors: Rhodine Hickman, Craig Wylie, Michael G. McCaul

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Introduction: The World Health Organisation has called on governments around the world to recognise emergency conditions as a global public health problem and respond with appropriate steps for effective preventative strategies. However, to understand the magnitude of the problem, good quality epidemiological data is required. This is especially challenging in low and middle-income countries, where routine data is scarce, specifically within the prehospital setting. Methods: We conducted a retrospective cross-sectional study of a national prehospital private sector EMS database. The database being the property of ER24 (private Emergency Medical Services (EMS) company in South Africa) contains claims submitted by the majority of ambulance services in South Africa during the period between 1 January 2008 to 28 March 2017. We used descriptive statistics and control charts to describe the data using STATA 14. Results: 299,257 calls were included in the analysis. The top clinical conditions requiring ambulance transport were transport accidents (10% of total call volume) and ischaemic heart disease (4.4%). The number of transport accidents consistently increased between 2009 and 2014 and reached beyond the limit for normal variation in 2015. Victims of transport accidents required basic life support services 60% of the time with 80% of injuries being minor to moderate. The frequency of ischaemic heart disease had a steady incline from 2011 to 2016. Advanced life support services were required about 50% of the time, with 60% of patients needing urgent care. Conclusion: Transport accidents, followed by ischaemic heart disease, are the most prevalent conditions in South African private EMS. There is a potential to address these conditions by developing the capacity of low and mid-level providers in trauma and advanced EMS providers in ischaemic heart disease.

Keywords: emergency care, emergency medicine, prehospital providers, South Africa

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Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole

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Musculoskeletal disorders (MSDs) such as low back pain (LBP), cervical spondylosis (CSPD), sprain, osteoarthritis (OA), and post immobilization stiffness (PIS) have a major impact on individuals, health systems and society in terms of morbidity, long-term disability, and economics. This study estimated the direct and indirect costs of common MSDs in Osun State, Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out. The occupational class of the patients was determined using the International Labour Classification (ILO). The direct and indirect costs were estimated using a cost-of-illness approach. Physiotherapy related health resource use, and costs of the common MSDs, including consultation fee, total fee charge per session, costs of consumables were estimated. Data were summarised using descriptive statistics mean and standard deviation (SD). Overall, 1582 (Male = 47.5%, Female = 52.5%) patients with MSDs population with a mean age of 47.8 ± 25.7 years participated in this study. The mean (SD) direct costs estimate for LBP, CSPD, PIS, sprain, OA, and other conditions were $18.35 ($17.33), $34.76 ($17.33), $32.13 ($28.37), $35.14 ($44.16), $37.19 ($41.68), and $15.74 ($13.96), respectively. The mean (SD) indirect costs estimate of LBP, CSPD, PIS, sprain, OA, and other MSD conditions were $73.42 ($43.54), $140.57 ($69.31), $128.52 ($113.46), sprain $140.57 ($69.31), $148.77 ($166.71), and $62.98 ($55.84), respectively. Musculoskeletal disorders contribute a substantial economic burden to individuals with the condition and society. The unacceptable economic loss of MSDs should be reduced using appropriate strategies. Further research is required to determine the clinical and cost effectiveness of strategies to improve health outcomes of patients with MSDs. The findings of the present study may assist health policy and decision makers to understand the economic burden of MSDs and facilitate efficient allocation of healthcare resources to alleviate the burden associated with these conditions in Nigeria.

Keywords: economic burden, low back pain, musculoskeletal disorders, real-world

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Authors: Abdulrahman M. Alajlan, Saichao Dang, Qiaoqiang Gan

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Photovoltaic (PV) cells, while pivotal for solar energy harnessing, confront a challenge due to the presence of persistent residual heat. This thermal energy poses significant obstacles to the performance and longevity of PV cells. Mitigating this thermal issue is imperative, particularly in tropical regions where solar abundance coexists with elevated ambient temperatures. In response, a sustainable and economically viable solution has been devised, incorporating water-passive cooling within a Photovoltaic-Thermoelectric (PV-TEG) hybrid system to address PV cell overheating. The implemented system has significantly reduced the operating temperatures of PV cells, achieving a notable reduction of up to 15 °C below the temperature observed in standalone PV systems. In addition, a thermoelectric generator (TEG) integrated into the system significantly enhances power generation, particularly during nighttime operation. The developed hybrid system demonstrates its capability to generate power at a density of 0.5 Wm⁻² during nighttime, which is sufficient to concurrently power multiple light-emitting diodes, demonstrating practical applications for nighttime power generation. Key findings from this research include a consistent temperature reduction exceeding 10 °C for PV cells, translating to a 5% average enhancement in PV output power compared to standalone PV systems. Experimental demonstrations underscore nighttime power generation of 0.5 Wm⁻², with the potential to achieve 0.8 Wm⁻² through simple geometric optimizations. The optimal cooling of PV cells is determined by the volume of water in the heat storage unit, exhibiting an inverse relationship with the optimal performance for nighttime power generation. Furthermore, the TEG output effectively powers a lighting system with up to 5 LEDs during the night. This research not only proposes a practical solution for maximizing solar radiation utilization but also charts a course for future advancements in energy harvesting technologies.

Keywords: photovoltaic-thermoelectric systems, nighttime power generation, PV thermal management, PV cooling

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Authors: Habtamu Wolde Engudai

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Background: Sedation can be provided to facilitate a procedure or to stabilize patients admitted in pediatric intensive care unit (PICU). Sedation is often necessary to maintain optimal care for critically ill children requiring mechanical ventilation. However, if sedation is too deep or too light, it has its own adverse effects, and hence, it is important to monitor the level of sedation and maintain an optimal level. Objectives: The objective is to assess the level of sedation and associated factors among intubated critically ill children admitted to PICU of JUMC, Jimma. Methods: A prospective observation study was conducted in the PICU of JUMC in September 2021 in 105 patients who were going to be admitted to the PICU aged less than 14 and with GCS >8. Data was collected by residents and nurses working in PICU. Data entry was done by Epi data manager (version 4.6.0.2). Statistical analysis and the creation of charts is going to be performed using SPSS version 26. Data was presented as mean, percentage and standard deviation. The assumption of logistic regression and the result of the assumption will be checked. To find potential predictors, bi-variable logistic regression was used for each predictor and outcome variable. A p value of <0.05 was considered as statistically significant. Finally, findings have been presented using figures, AOR, percentages, and a summary table. Result: in this study, 105 critically ill children had been involved who were started on continuous or intermittent forms of sedative drugs. Sedation level was assessed using a comfort scale three times per day. Based on this observation, we got a 44.8% level of suboptimal sedation at the baseline, a 36.2% level of suboptimal sedation at eight hours, and a 24.8% level of suboptimal sedation at sixteen hours. There is a significant association between suboptimal sedation and duration of stay with mechanical ventilation and the rate of unplanned extubation, which was shown by P < 0.05 using the Hosmer-Lemeshow test of goodness of fit (p> 0.44).

Keywords: level of sedation, critically ill children, Pediatric intensive care unit, Jimma university

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Authors: James Beringer

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Switzerland’s ability to forge a strong national identity across linguistic barriers has long been of interest to nationalism scholars. This begs the question of how this has been achieved, given that traditional explanations of luck or exceptionalism appear highly reductionist. This paper evaluates the theory that successful Swiss management of linguistic diversity stems from the strong integration of multilingualism into Swiss national identity. Using archival analysis of Swiss government records, historical accounts of prominent Swiss citizens, as well as secondary literature concerning the fundamental aspects of Swiss national identity, this paper charts the historical evolution of Swiss national identity. It explains how multilingualism was deliberately and successfully integrated into Swiss national identity as a response to political fragmentation along linguistic lines during the First World War. Its primary conclusions are the following. Firstly, the earliest foundations of Swiss national identity were purposefully removed from any association with a single national language. This produced symbols, myths, and values -such as a strong commitment to communalism, the imagery of the Swiss natural landscape, and the use of Latin expressions, which can be adopted across Swiss linguistic groups. Secondly, the First World War triggered a turning point in the evolution of Swiss national identity. The fundamental building blocks proved insufficient in preventing political fractures amongst linguistic lines, as each Swiss linguistic group gravitated towards its linguistic neighbours within Europe. To avoid a repeat of such fragmentation, a deliberate effort was made to fully integrate multilingualism as a fundamental aspect of Swiss national identity. Existing natural symbols, such as the St Gotthard Mountains, were recontextualized in order to become associated with multilingualism. The education system was similarly reformed to reflect the unique multilingual nature of the Swiss nation. The successful result of this process can be readily observed in polls and surveys, with large segments of the Swiss population highlighting multilingualism as a uniquely Swiss characteristic, indicating the symbiotic connection between multilingualism and the Swiss nation.

Keywords: language's role in identity formation, multilingualism in nationalism, national identity formation, Swiss national identity history

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Authors: Brigita Mieziene, Arunas Emeljanovas, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen

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Background. Health-related physical fitness refers to the favorable health status, i.e. ability to perform daily activities with vigor, as well as capacities that are associated with a low risk for development of chronic diseases and premature death. However, in school-aged children it is constantly declining, while some aspects of fitness declined as much as 50 percent during the last two decades, which prognosticates increasingly earlier onset of health problems, decreasing the quality of life of the population and financial burden for the society. Therefore, the goal of the current study was to indicate nationally representative age- and gender-specific reference values of anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children from 6 to 10 years. Methods. The study included 3556 students in total, from 73 randomly selected schools. Ethics approval for research by the Kaunas Regional Ethics Committee (No. BE-2-42) was obtained. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues. Height and weight were measured and body mass index calculated. Smoothed centile charts were derived using the LMS method. Results. The numerical age- and gender-specific percentile values (3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile) for anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness were provided. The equivalent smoothed LMS curves were performed. The study indicated 12.5 percent of overweight and 5 percent of obese children in accordance with international gender and age specific norms of body mass index. This data could be used in clinical and educational settings in order to identify the level of individual physical fitness within its different components.

Keywords: fitness, overweight, primary school children, reference values, smoothed percentile curves

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Authors: R. Alramyan, S. Alsalamah, R. Alrashed, R. Alakel, F. Altheyeb, M. Alessa

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Background: Nutritional support with total parenteral nutrition (TPN) is usually commenced with hematopoietic stem cell transplantation (HSCT) patients. However, it has its benefits and risks. Complications related to central venous catheter such as infections, and metabolic disturbances, including abnormal liver function, is usually of concern in such patients. Methods: A retrospective charts review of all pediatric patients who underwent HSCT between the period 2015-2018 in a tertiary hospital in Riyadh, Saudi Arabia. Patients' demographics, types of conditioning, type of nutrition, and patients' outcomes were collected. Statistical analysis was conducted using SPSS version 22. Frequencies and percentages were used to describe categorical variables. Mean, and standard deviation were used for continuous variables. A P value of less than 0.05 was considered as statically significant. Results: a total of 162 HSCTs were identified during the period mentioned. Indication of allogenic transplant included hemoglobinopathy in 50 patients (31%), acute lymphoblastic leukemia in 21 patients (13%). TPN was used in 96 patients (59.30%) for a median of 14 days, nasogastric tube feeding (NGT) in 16 (9.90%) patients for a median of 11 days, and 71 of patients (43.80%) were able to tolerate oral feeding. Out of the 96 patients (59.30%) who were dependent on TPN, 64 patients (66.7%) had severe mucositis in comparison to 17 patients (25.8%) who were either on NGT or tolerated oral intake. (P-value= 0.00). Sinusoidal obstruction syndrome (SOS) was seen in 14 patients (14.6%) who were receiving TPN compared to none in non-TPN patients (P=value 0.001). Moreover, majority of patients who had SOS received myeloablative conditioning therapy for non-malignant disease (hemoglobinopathy). However, there were no statistically significant differences in Graft-vs-Host Disease (both acute and chronic), bacteremia, and patient outcome between both groups. Conclusions: Nutritional support using TPN is used in majority of patients, especially post-myeloablative conditioning associated with severe mucositis. TPN was associated with VOD, especially in hemoglobinopathy patients who received myeloablative therapy. This may emphasize on use of preventative measures such as fluid restriction, use of diuretics, or defibrotide in high-risk patients.

Keywords: hematopoeitic stem cell transplant, HSCT, stem cell transplant, sinusoidal obstruction syndrome, total parenteral nutrition

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Authors: Ademola Ibukunolu Atanda

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Research undertakings are meant to proffer solutions to issues and challenges in society. This justifies the need for research in ivory towers. Multinational and non-governmental organisations, as well as foundations, commit financial resources to support research endeavours. In recent times, the direction and dimension of research undertaking encourage collaborations, whereby experts from different disciplines or specializations would bring their expertise in addressing any identified problem, whether in humanities or sciences. However, the extent to which collaborative research undertakings are perceived and embraced by academic staff would determine the impact collaborative research would have on society. To this end, this study investigated academic staff’s perception and willingness to be involved in collaborative research for the purpose of proffering solutions to societal problems. The study adopted a descriptive research design. The population comprised academic staff in southern Nigeria. The sample was drawn through a convenient sampling technique. The data were collected using a questionnaire titled “Perception and Willingness to Participate in Collaborative Research Questionnaire (PWPCRQ)’ using Google Forms. Data collected were analyzed using descriptive statistics of simple percentages, mean and charts. The findings showed that Academic Staff’s readiness to participate in collaborative research is to a great extent (89%) and they participate in collaborative research very often (51%). The Academic Staff was involved more in collaboration research among their colleagues within their universities (1.98) than participation in inter-disciplines collaboration (1.47) with their colleagues outside Nigeria. Collaborative research was perceived to impact on development (2.5). Collaborative research offers the following benefits to members’ aggregation of views, the building of an extensive network of contacts, enhancement of sharing of skills, facilitation of tackling complex problems, increased visibility of research network and citations and promotion of funding opportunities. The study concluded that Academic staff in universities in the South-West of Nigeria participate in collaborative research but with their colleagues within Nigeria rather than outside the country. Based on the findings, it was recommended that the management of universities in South-West Nigeria should encourage collaborative research with some incentives.

Keywords: collaboration, research, development, participation

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Authors: Justina Jor, Mahmud Pinga

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Climate change has become a significant worldwide environmental challenge with extensive implications, compelling both governments and non-governmental organizations to remain vigilant, as it seemingly impacts various sectors of the global economy, including education. The study investigates the implementation of smart climate change measures for effective primary school management in Benue State, Nigeria. Theorized by the diffusion of innovations, the study was guided by two research questions, and two null hypotheses were formulated and tested. The study used a descriptive survey design. The population comprised 12,364 teachers from 2,721 primary schools, with a sample of 618 teachers from 136 schools selected through a multistage sampling procedure. Smart climate change measures questionnaire (SCCMQ) and key informant interview (KII) were used for data collection. The data collected were analyzed using mean and standard deviation to answer the research questions, while the Chi-square (χ2) test of goodness-of-fit was used to test the hypotheses at a 0.05 level of significance, with qualitative data analyzed using simple percentages, tables, and bar charts. The findings highlight the significant positive impact of green building practices on the efficient administration of primary schools in Benue State, Nigeria. The crucial integration of environmentally sustainable construction methods is emphasized for enhancing overall management in these educational institutions. In addition, the research demonstrates a favorable impact on the adoption of renewable energy solutions and effective school management. The utilization of renewable energy not only aligns with eco-friendly practices but also contributes to the overall operational efficiency and sustainability of primary schools in the region. The study recommends that educational authorities and policymakers prioritize integrating green building practices and renewable energy solutions, pointing towards the prospect of improved governance and functionality for primary education facilities not only in Benue but throughout Nigeria.

Keywords: smart, climate change, effective management, green building, renewable energy

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Authors: Obadiah Nwabueze

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Bodija market is classified as Central Business District (CBD) of Ibadan North Local Government Area of Oyo State (Nigeria) because of socio economic activities, so Crime is a peculiar social issue that causes insecurity. The law enforcement agencies tasked with crime prevention and control such as the Nigerian Police have insufficient manpower, and a resultant effect is the emergence of Vigilante groups as citizen’s response to crime control and prevention (self-help). The research design adopted for this study is a case study design exploring Vigilante activities in Bodija Market. The study utilizes both quantitative and qualitative approach, sources of data includes primary and secondary sources. A sample of 127 respondents randomly picked from the 4 sections of Bodija Market through questionnaire, comprising of 50 male and 77 females which alienates issues of gender bias in addition to the 4 in-depth interview, making a total of 131 respondents. Statistical package for Social Sciences (SPSS) was used. The descriptive statistics of simple frequency, percentage, charts and graphs were computed for the analysis. Finding in the study shows that the market vigilante is able to deter and disrupt criminal activities through strategic spiritual intelligence (SSI), use of charm and juju, physical presence in strategic locations vulnerable to crime occurrence. Findings in the study also show that vigilantes collaborate with the police by assisting them in surveillance, tracking down criminals, identifying black spots, acting as informants to the police, arrest and handover criminal to police. Their challenges include poor equipment, motivation, unhealthy rivalry between the vigilante and the police. The study recommends that the government should support vigilantes with logistics and training, including patrol vehicle and radio communication. The study also recommends the integration of the informal mechanism (juju and charm) of crime detection and prevention into the formal policing strategy, an office should be created in the force commands for use of SSI.

Keywords: central business district, CBD, charm, Juju, strategic spiritual intelligence, SSI

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Authors: A. Y. Purnama, N. Yasufuku

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The bridge structure is a building that has to be maintained, especially for the elastomeric bearing. The girder of the bridge needs to be lifted upward to maintain this elastomeric bearing, that needs high cost. Nowadays, integral abutment bridges are becoming popular. The integral abutment bridge is less costly because the elastomeric bearings are eliminated, which reduces the construction cost and maintenance costs. However, when this elastomeric bearing removed, the girder movement due to environmental thermal forces directly support by pile foundation, and it needs to be considered in the design. In case of pile foundation in a stiff soil, in the top area of the pile cannot move freely due to the fixed condition by soil stiffness. Pre-bored pile system can be used to increase the flexibility of pile foundation using a pre-bored hole that filled with elastic materials, but the behavior of soil-pile interaction and soil response due to this system is still rarely explained. In this paper, an experimental study using small-scale laboratory model test conducted in a half size model. Single flexible pile model embedded in sandy soil with the pre-bored ring, which filled with the filler material. The testing box made from an acrylic glass panel as observation area of the pile shaft to monitor the displacement of the pile during the lateral loading. The failure behavior of the soil inside the pre-bored ring and around the pile shaft was investigated to determine the point of pile rotation and the movement of this point due to the pre-bored ring system along the pile shaft. Digital images were used to capture the deformations of the soil and pile foundation during the loading from the acrylic glass on the side of the testing box. The results were presented in the form of lateral load resistance charts against the pile shaft displacement. The failure pattern result also established due to the cyclic lateral loading. The movement of the rotational point was measured due to the pre-bored system filled with appropriate filler material. Based on the findings, design considerations for pre-bored pile system due to cyclic lateral loading can be introduced.

Keywords: failure behavior, pre-bored pile system, cyclic lateral loading, sandy soil

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Authors: P. Mambanga, T. G. Tshitangano, H. Akinsola

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Background: Unintended pregnancies constitute a most serious public health challenge to women to an extent that they sometimes end in illegal abortions resulting in adverse consequences. However, the introduction of emergency contraception has served as the last chance for women to avoid unintended pregnancies, though, in countries like Zimbabwe the cause for underutilisation of emergency contraception has been hardly investigated. Purpose: The main purpose of this study was to assess the knowledge, attitude and practice of female students regarding emergency contraception among in preventing unintended pregnancy. Methodology: A quantitative approach using descriptive cross-sectional survey design was conducted among 319 stratified random sampled female university students of Midland State University, Zimbabwe. Self-administered close-ended questionnaire was used to collect the data. To ensure validity, the development of the instrument was guided by a wide range of literature and the inputs of experts. The instrument was retested for reliability and the responses will be comparing using Cronbach’s alpha which yielded high reliability alpha (α) value of 0.84. Data was coded and entered into a computer using Microsoft Excel 2010 and analysed using Statistical Package for Social Scientists (SPSS) version 22.0. Descriptive statistics were used to analyse data in the form of cross tabulation and the results were presented in table, graphs and pie charts. Results: The results indicated that apart from all sources of information about EC, mass media has shown to be the most famous. Although female students knows about EC, the knowledge about effective level and correct use of EC poor. The attitudes of female students at MSU are unfavourable for EC as they gave reasons like EC promotes promiscuity and it can pose risk. The practice of EC at MSU is low with only 47% of respondents said they have once use EC. Conclusion and recommendation: The study concluded the lack of actual knowledge about EC which has directly influenced attitudes and practices. The study concluded that there MSU female students has fair knowledge about EC which has resulted in negative and attitudes towards EC with few EC practices. The study, therefore, recommends the adoption and use of Health Belief Model approach in promoting the young to use EC to prevent unwanted pregnancies.

Keywords: emergency contraception, knowledge, attitude, practice, female students

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Authors: Aneena Suresh, C. S. Sidharth

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Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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Authors: Peter Akayuure

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Geometry is considered an important strand in mathematics due to its wide-ranging utilitarian value and because it serves as a building block for understanding other aspects of undergraduate mathematics, including algebra and calculus. Matters regarding students’ geometric thinking have therefore long been pursued by mathematics researchers and educators globally via different theoretical lenses, curriculum reform efforts, and innovative instructional practices. However, so far, studies remain inconclusive about the instructional platforms that effectively promote geometric thinking. At the University of Education, Winneba, an undergraduate geometry course was designed and delivered on UEW Learning Management System (LMS) using Moodle platform. This study utilizes van Hiele’s theoretical lens to examine the entry and exit’s geometric thinking behaviours of prospective teachers who took the undergraduate geometry course in the LMS platform. The study was a descriptive survey that involved an intact class of 280 first-year students enrolled to pursue a bachelor's in mathematics education at the university. The van Hiele’s Geometric thinking test was used to assess participants’ entry and exit behaviours, while semi-structured interviews were used to obtain data for triangulation. Data were analysed descriptively and displayed in tables and charts. An Independent t-test was used to test for significant differences in geometric thinking behaviours between those who entered the university with a diploma certificate and with senior high certificate. The results show that on entry, more than 70% of the prospective teachers operated within the visualization level of van Hiele’s geometric thinking. Less than 20% reached analysis and abstraction levels, and no participant reached deduction and rigor levels. On exit, participants’ geometric thinking levels increased markedly across levels, but the difference from entry was not significant and might have occurred by chance. The geometric thinking behaviours of those enrolled with diploma certificates did not differ significant from those enrolled directly from senior high school. The study recommends that the design principles and delivery of undergraduate geometry course via LMS should be structured and tackled using van Hiele’s geometric thinking levels to serve as means of bridging the existing learning gaps of undergraduate students.

Keywords: geometric thinking, van Hiele’s, UEW learning management system, undergraduate geometry

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Authors: Awole Seid, Yosef Zenebe, Hadgu Gerensea, Kebede Haile Misgina

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Background: Clinical competence is one of the ultimate goals of nursing education. Clinical skills are more than successfully performing tasks; it incorporates client assessment, identification of deficits and the ability to critically think to provide solutions. Assessment of clinical competence, particularly identifying gaps that need improvement and determining the educational needs of nursing students have great importance in nursing education. Thus this study aims determining clinical self-efficacy of final year school of nursing students in three universities of Tigray Region. Methods: A cross-sectional study was conducted on 224 final year school of nursing students from department of nursing, psychiatric nursing, and midwifery on three universities of Tigray region. Anonymous self-administered questionnaire was administered to generate data collected on June, 2017. The data were analyzed using SPSS version 20. The result is described using tables and charts as required. Logistic regression was employed to test associations. Result: The mean age of students was 22.94 + 1.44. Generally, 21% of students have been graduated in the department in which they are not interested. The study demonstrated 28.6% had poor and 71.4% had good perceived clinical self-efficacy. Beside this, 43.8% of psychiatric nursing and 32.6% of comprehensive nursing students have poor clinical self-efficacy. Among the four domains, 39.3% and 37.9% have poor clinical self- efficacy with regard to ‘Professional development’ and ‘Management of care’. Place of the institution [AOR=3.480 (1.333 - 9.088), p=0.011], interest during department selection [AOR=2.202 (1.045 - 4.642), p=.038], and theory-practice gap [AOR=0.224 (0.110 - 0.457), p=0.000] were significantly associated with perceived clinical self-efficacy. Conclusion: The magnitude of students with poor clinically self efficacy was high. Place of institution, theory-practice gap, students interest to the discipline were the significant predictors of clinical self-efficacy. Students from youngest universities have good clinical self-efficacy. During department selection, student’s interest should be respected. The universities and other stakeholders should improve the capacity of surrounding affiliate teaching hospitals to set and improve care standards in order to narrow the theory-practice gap. School faculties should provide trainings to hospital staffs and monitor standards of clinical procedures.

Keywords: clinical self-efficacy, nursing students, Tigray, northern Ethiopia

Procedia PDF Downloads 138

Authors: Nikkey Keshri

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Arctic is a polar region located at the north of the earth. This consists of the Arctic Ocean and other parts of Canada, Russia, the United States, Denmark, Norway, Sweden, Finland, and Iceland. Arctic has vast natural resources which are exploited with modern technology, and the economic opening up of Russia has given new opportunities. All these states have connected with the Arctic region for economic activities and this effect the region ecology. The pollution problem is a serious threat to the people health living around pollution sources. Due to the prevailing worldwide sea and air currents, the Arctic area is the fallout region for long-range transport pollutants, and in some places the concentrations exceed the levels of densely populated urban areas. The Arctic is especially vulnerable to the effects of global warming, as has become apparent in the melting sea ice in recent years. Climate models predict much greater warming in the Arctic than the global average, resulting in significant international attention to the region. The global warming has an adverse impact on the climate, indigenous people, wildlife, and infrastructure. However, there are several opportunities that have emerged in the form of shipping routes, resources, and new territories. The shipping route through the Arctic is a reality and is currently navigable for a few weeks during summers. There are large deposits of oil and gas, minerals and fish and the surrounding countries with Arctic coastlines are becoming quite assertive about exercising their sovereignty over the newfound wealth. The main part of the research is that how the opening of Northern Sea Route is providing opportunities or problem in the Arctic and it is becoming geopolitically important. It focuses on the interest Arctic and non Arctic states, their present and anticipated global geopolitical aims. The Northern Sea Route might open up due to climate changes and that Iceland might benefit or has an impact from the situation. Efforts will be made to answer the research question: ‘Whether Opening of North Sea Route is providing opportunities or becoming a risk for Arctic region?’ Every research has a structure which usually called design. In this research, both Qualitative and Quantitative method is used in terms of various literature, maps, pie- charts, etc to find out the answer for the research question. The aim of this research is to find out the impact of Opening of North Sea Route over Arctic region and how this make arctic geopolitically important. The aim behind this research is to find out the impact of climate change and how the particular geographical area is being affected.

Keywords: climate change, geopolitics, international relation, Northern Sea Route

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Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

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The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

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Authors: Siyamak Sarafraz, Reza Esmaeil Pour, Saeed Jamshidi, Asghar Molaei Dehkordi

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Cutting transport is one of the major problems in directional and extended reach oil and gas wells. Lack of sufficient attention to this issue may bring some troubles such as casing running, stuck pipe, excessive torque and drag, hole pack off, bit wear, decreased the rate of penetration (ROP), increased equivalent circulation density (ECD) and logging. Since it is practically impossible to directly observe the behavior of deep wells, a test setup was designed to investigate cutting transport phenomena. This experimental work carried out to scrutiny behavior of the effective variables in cutting transport. The test setup contained a test section with 17 feet long that made of a 3.28 feet long transparent glass pipe with 3 inch diameter, a storage tank with 100 liters capacity, drill pipe rotation which made of stainless steel with 1.25 inches diameter, pump to circulate drilling fluid, valve to adjust flow rate, bit and a camera to record all events which then converted to RGB images via the Image Processing Toolbox. After preparation of test process, each test performed separately, and weights of the output particles were measured and compared with each other. Observation charts were plotted to assess the behavior of viscosity, flow rate and RPM in inclinations of 0°, 30°, 60° and 90°. RPM was explored with other variables such as flow rate and viscosity in different angles. Also, effect of different flow rate was investigated in directional conditions. To access the precise results, captured image were analyzed to find out bed thickening and particles behave in the annulus. The results of this experimental study demonstrate that drill string rotation helps particles to be suspension and reduce the particle deposition cutting movement increased significantly. By raising fluid velocity, laminar flow converted to turbulence flow in the annulus. Increases in flow rate in horizontal section by considering a lower range of viscosity is more effective and improved cuttings transport performance.

Keywords: cutting transport, directional drilling, flow rate, hole cleaning, pipe rotation

Procedia PDF Downloads 257