Search results for: emergency frequency regulation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6149

Search results for: emergency frequency regulation

6029 Risk-Based Regulation as a Model of Control in the South African Meat Industry

Authors: R. Govender, T. C. Katsande, E. Madoroba, N. M. Thiebaut, D. Naidoo

Abstract:

South African control over meat safety is managed by the Department of Agriculture, Forestry and Fisheries (DAFF). Veterinary services department in each of the nine provinces in the country is tasked with overseeing the farm and abattoir segments of the meat supply chain. Abattoirs are privately owned. The number of abattoirs over the years has increased. This increase has placed constraints on government resources required to monitor these abattoirs. This paper presents empirical research results on the hygienic processing of meat in high and low throughout abattoirs. This paper presents a case for the adoption of risk-based regulation as a method of government control over hygiene and safe meat processing at abattoirs in South Africa. Recommendations are made to the DAFF regarding policy considerations on risk-based regulation as a model of control in South Africa.

Keywords: risk-based regulation, abattoir, food control, meat safety

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6028 Non-Standard Forms of Reporting Domestic Violence: Analysis of the Phenomenon in the Perception of Operators of the Polish Emergency Number 112 and Polish Society

Authors: Joanna Kufel-Orlowska

Abstract:

Domestic violence is a social threat to public safety and order. It poses a threat not only to the family members of the perpetrator but also disturbs the functioning of society and even the state. In a situation of danger, an individual either defends himself or/and calls for help by contacting an appropriate institution whose aim is to ensure civil security. Most often, such contact takes place through a telephone conversation, which is aimed at diagnosing the problem and prompt intervention. People in different situations and in different ways, despite the general reporting standards, try to inform about the need for help. The article aims to present the results of research on non-standard forms of reporting domestic violence in the opinion of the Polish society and operators of the Polish emergency number 112 (911). The research was conducted in the form of a survey technique on a sample of 160 operators (purposeful selection) and 300 people living in Poland (random selection). The research was conducted in the form of online surveys. The study found that in Poland: 1. emergency number operators often receive reports of domestic violence although they are not always able to diagnose whether the case is strictly about violence; 2. non-standard reports of domestic violence are received by about 30% of emergency number operators. Non-standard should be understood as reports of violence that deviate from the norm, are unusual, or are reported by a non-victim. 3. The most common forms of reporting violence not directly are: pretending to talk to a friend, calling a cab, making an appointment with a dentist/doctor, calling a store and helping with the selection of goods, asking about the bank's hotline, not speaking (in order for the emergency number operator to hear what is going on). 4. Emergency number operators in Poland are properly trained and are able to recognize the threatening situation of the reporting party and conduct the conversation in a safe manner for the reporting party. On the other hand, Polish people support the ability to report violence in a non-standard way and would do so themselves in the event of a threat to their own life, health, or property, thus expecting the emergency number operator to recognize a report and help us.

Keywords: domestic violence, operator of the emergency number 112 (911), emergency call center, reporting domestic violence

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6027 Epidemiology of Private Prehospital Calls over the Last Decade in South Africa

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

Abstract:

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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6026 Revised Tower Earthing Design in High-Voltage Transmission Network for High-Frequency Lightning Condition

Authors: Azwadi Mohamad, Pauzi Yahaya, Nadiah Hudi

Abstract:

Earthing system for high-voltage transmission tower is designed to protect the working personnel and equipments, and to maintain the quality of supply during fault. The existing earthing system for transmission towers in TNB’s system is purposely designed for normal power frequency (low-frequency) fault conditions that take into account the step and touch voltages. This earthing design is found to be inapt for lightning (transient) condition to a certain extent, which involves a high-frequency domain. The current earthing practice of laying the electrodes radially in straight 60 m horizontal lines under the ground, in order to achieve the specified impedance value of less than 10 Ω, was deemed ineffective in reducing the high-frequency impedance. This paper introduces a new earthing design that produces low impedance value at the high-frequency domain, without compromising the performance of low-frequency impedance. The performances of this new earthing design, as well as the existing design, are simulated for various soil resistivity values at varying frequency. The proposed concentrated earthing design is found to possess low TFR value at both low and high-frequency. A good earthing design should have a fine balance between compact and radial electrodes under the ground.

Keywords: earthing design, high-frequency, lightning, tower footing impedance

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6025 Signal On-Off Ratio and Output Frequency Analysis of Semiconductor Electron-Interference Device

Authors: Tomotaka Aoki, Isao Tomita

Abstract:

We examined the on-off ratio and frequency components of output signals from an electron-interference device made of GaAs/AlₓGa₁₋ₓAs by solving the time-dependent Schrödinger's equation on conducting electrons in the channel waveguide of the device. For electron-wave modulation, a periodic voltage of frequency f was applied to the channel. Furthermore, we examined the voltage-amplitude dependence of the signals in time and frequency domains and found that large applied voltage deformed the output-signal waveform and created additional side modes (frequencies) near the modulation frequency f and that there was a trade-off between on-off ratio and side-mode creation.

Keywords: electrical conduction, electron interference, frequency spectrum, on-off ratio

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6024 Quality Standards for Emergency Response: A Methodological Framework

Authors: Jennifer E. Lynette

Abstract:

This study describes the development process of a methodological framework for quality standards used to measure the efficiency and quality of response efforts of trained personnel at emergency events. This paper describes the techniques used to develop the initial framework and its potential application to professions under the broader field of emergency management. The example described in detail in this paper applies the framework specifically to fire response activities by firefighters. Within the quality standards framework, the fire response process is chronologically mapped. Individual variables within the sequence of events are identified. Through in-person data collection, questionnaires, interviews, and the expansion of the incident reporting system, this study identifies and categorizes previously unrecorded variables involved in the response phase of a fire. Following a data analysis of each variable using a quantitative or qualitative assessment, the variables are ranked pertaining to the magnitude of their impact to the event outcome. Among others, key indicators of quality performance in the analysis involve decision communication, resource utilization, response techniques, and response time. Through the application of this framework and subsequent utilization of quality standards indicators, there is potential to increase efficiency in the response phase of an emergency event; thereby saving additional lives, property, and resources.

Keywords: emergency management, fire, quality standards, response

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6023 The Effects of Emotional Working Memory Training on Trait Anxiety

Authors: Gabrielle Veloso, Welison Ty

Abstract:

Trait anxiety is a pervasive tendency to attend to and experience fears and worries to a disproportionate degree, across various situations. This study sought to determine if participants who undergo emotional working memory training will have significantly lower scores on the trait anxiety scales post-intervention. The study also sought to determine if emotional regulation mediated the relationship between working memory training and trait anxiety. Forty-nine participants underwent 20 days of computerized emotional working memory training called Emotional Dual n-back, which involves viewing a continuous stream of emotional content on a grid, and then remembering the location and color of items presented on the grid. Participants of the treatment group had significantly lower trait anxiety compared to controls post-intervention. Mediation analysis determined that working memory training had no significant relationship to anxiety as measured by the Beck’s Anxiety Inventory-Trait (BAIT), but was significantly related to anxiety as measured by form Y2 of the Spielberger State-Trait Anxiety Inventory (STAI-Y2). Emotion regulation, as measured by the Emotional Regulation Questionnaire (ERQ), was found not to mediate between working memory training and trait anxiety reduction. Results suggest that working memory training may be useful in reducing psychoemotional symptoms rather than somatic symptoms of trait anxiety. Moreover, it proposes for future research to further look into the mediating role of emotion regulation via neuroimaging and the development of more comprehensive measures of emotion regulation.

Keywords: anxiety, emotion regulation, working-memory, working-memory training

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6022 The Use of Regional Blocks Versus IV Opioid Analgesics for Acute Traumatic Pain Management in the Emergency Department

Authors: Lajeesh Jabbar, Shibu T. Varghese

Abstract:

Being under pain is a very distressing factor that it prolongs the healing of any kind of trauma and add to the post traumatic stressful state. Alleviating the pain from acute traumatic conditions like fracture, degloving injury etc will help in faster recovery and also decrease the incidence of post traumatic stress disorder. Most of the emergency departments in INDIA are using IV opioid analgesics to relieve the patient from pain in cases of acute traumatic injuries. None of the Emergency Departments practice regional blocks in the country. In this study, we are comparing the efficacy of Regional Blocks in relieving the pain in lower limb fractures versus the use of IV analgesics for the same in the emergency department. The site of study is Malabar Institute Of Medical Sciences in Calicut in Kerala in India and is a place which receives approximately 10-20 traumatic fracture cases per day. The fracture sites used for the study purpose are femur fracture and phalangeal fractures.

Keywords: regional blocks, IV analgesia, acute traumatic pain, femur fractures, phalanx fractures

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6021 State of Emergency in Turkey (July 2016-July 2018): A Case of Utilization of Law as a Political Instrument

Authors: Neslihan Cetin

Abstract:

In this study, we will aim to analyze how the period of the state of emergency in Turkey lead to gaps in law and the formation of areas in which there was a complete lack of supervision. The state of emergency that was proclaimed following the coup attempt of July 15, 2016, continued until July 18, 2018, that is to say, 2 years, without taking into account whether the initial circumstances persisted. As part of this work, we claim that the state of emergency provided the executive power with important tools for governing, which it took constant use. We can highlight how the concern for security at the center of the basic considerations of the people in a city was exploited as a foundation by the military power in Turkey to interfere in the political, legal, and social spheres. The constitutions of 1924, 1961, and 1982 entrusted the army with the role of protector of the integrity of the state. This became an instrument at the hands of the military to legitimize their interventions in the name of public security. Its interventions in the political field are indeed politically motivated. The constitution, the legislative, and regulatory systems are modified and monopolized by the military power that dominates the legislative, regulatory, and judicial power, leading to a state of exception. With the political convulsions over a decade, the government was able to usurp the instrument called the state of exception. In particular, the decree-laws of the state of emergency, which the executive makes frequent and generally abusive use, became instruments in the hands of the government to take measures that it wishes to escape from the rules and the pre-established control mechanisms. Thus the struggle against the political opposition becomes more unbalanced and destructive. To this must also be added the ineffectiveness of ex-post controls and domestic remedies. This research allows us to stress how a legal concept, such as ‘the state of emergency’ can be politically exploited to make it a legal weapon that continues to produce victims.

Keywords: constitutional law, state of emergency, rule of law, instrumentalization of law

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6020 Determination of the Thermally Comfortable Air Temperature with Consideration of Individual Clothing and Activity as Preparation for a New Smart Home Heating System

Authors: Alexander Peikos, Carole Binsfeld

Abstract:

The aim of this paper is to determine a thermally comfortable air temperature in an automated living room. This calculated temperature should serve as input for a user-specific and dynamic heating control in such a living space. In addition to the usual physical factors (air temperature, humidity, air velocity, and radiation temperature), individual clothing and activity should be taken into account. The calculation of such a temperature is based on different methods and indices which are usually used for the evaluation of the thermal comfort. The thermal insulation of the worn clothing is determined with a Radio Frequency Identification system. The activity performed is only taken into account indirectly through the generated heart rate. All these methods are ultimately very well suited for use in temperature regulation in an automated home, but still require further research and extensive evaluation.

Keywords: smart home, thermal comfort, predicted mean vote, radio frequency identification

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6019 Distributed Leadership and Emergency Response: A Study on Seafarers

Authors: Delna Shroff

Abstract:

Merchant shipping is an occupation with a high rate of fatal injuries caused by organizational accidents and maritime disasters. In most accident investigations, the leader’s actions are under scrutiny and point out the necessity to investigate the leader’s decisions in critical conditions. While several leadership studies have been carried out in the past, there is a tendency for most research to focus on holders of formal positions. The unit of analysis in most studies has been the ‘individual.’ A need is, therefore, felt to adopt a practice-based perspective of leadership, understand how leadership emerges to affect maritime safety. This paper explores the phenomenon of distributed leadership among seafarers more holistically. It further examines the role of one form of distributed leadership, that is, planfully aligned leadership in the emergency response of the team. A mixed design will be applied. In the first phase, the data gathered by way of semi-structured interviews will be used to explore the seafarer’s implicit understanding of leadership. The data will be used to develop a conceptual framework of distributed leadership, specific to the maritime context. This framework will be used to develop a simulation. Experimental design will be used to examine the relationship between planfully aligned leadership and emergency response of the team members during navigation. Findings show that planfully aligned leadership significantly and positively predicts the emergency response of team members. Planfully aligned leadership leads to a better emergency response of the team members as compared to authoritarian leadership. In the third qualitative phase, additional data will be gathered through semi-structured interviews to further validate the findings to gain a more complete understanding of distributed leadership and its relation to emergency response. Above are the predictive results; the study expects to be a cornerstone of safety leadership research and has important implications for leadership development and training within the maritime industry.

Keywords: authoritarian leadership, distributed leadership, emergency response , planfully aligned leadership

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6018 Slugging Frequency Correlation for High Viscosity Oil-Gas Flow in Horizontal Pipeline

Authors: B. Y. Danjuma, A. Archibong-Eso, Aliyu M. Aliyu, H. Yeung

Abstract:

In this experimental investigation, a new data for slugging frequency for high viscosity oil-gas flow are reported. Scale experiments were carried out using a mixture of air and mineral oil as the liquid phase in a 17 m long horizontal pipe with 0.0762 ID. The data set was acquired using two high-speed Gamma Densitometers at a data acquisition frequency of 250 Hz over a time interval of 30 seconds. For the range of flow conditions investigated, increase in liquid oil viscosity was observed to strongly influence the slug frequency. A comparison of the present data with prediction models available in the literature revealed huge discrepancies. A new correlation incorporating the effect of viscosity on slug frequency has been proposed for the horizontal flow, which represents the main contribution of this work.

Keywords: gamma densitometer, flow pattern, pressure gradient, slug frequency

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6017 Intelligent CRISPR Design for Bone Regeneration

Authors: Yu-Chen Hu

Abstract:

Gene editing by CRISPR and gene regulation by microRNA or CRISPR activation have dramatically changed the way to manipulate cellular gene expression and cell fate. In recent years, various gene editing and gene manipulation technologies have been applied to control stem cell differentiation to enhance tissue regeneration. This research will focus on how to develop CRISPR, CRISPR activation (CRISPRa), CRISPR inhibition (CRISPRi), as well as bi-directional CRISPR-AI gene regulation technologies to control cell differentiation and bone regeneration. Moreover, in this study, CRISPR/Cas13d-mediated RNA editng for miRNA editing and bone regeneration will be discussed.

Keywords: gene therapy, bone regeneration, stem cell, CRISPR, gene regulation

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6016 Examining Risk Based Approach to Financial Crime in the Charity Sector: The Challenges and Solutions, Evidence from the Regulation of Charities in England and Wales

Authors: Paschal Ohalehi

Abstract:

Purpose - The purpose of this paper, which is part of a PhD thesis is to examine the role of risk based approach in minimising financial crime in the charity sector as well as offer recommendations to improving the quality of charity regulation whilst still retaining risk based approach as a regulatory framework and also making a case for a new regulatory model. Increase in financial crimes in the charity sector has put the role of regulation in minimising financial crime up for debates amongst researchers and practitioners. Although previous research has addressed the regulation of charities, research on the role of risk based approach to minimising financial crime in the charity sector is limited. Financial crime is a concern for all organisation including charities. Design/methodology/approach - This research adopts a social constructionist’s epistemological position. This research is carried out using semi structured in-depth interviews amongst randomly selected 24 charity trustees divided into three classes: 10 small charities, 10 medium charities and 4 large charities. The researcher also interviewed 4 stakeholders (NFA, Charity Commission and two different police forces in terms of size and area of coverage) in the charity sector. Findings - The results of this research show that reliance on risk based approach to financial crime in the sector is weak and fragmented with the research pointing to a clear evidence of disconnect between the regulator and the regulated leading to little or lack of regulation of trustees’ activities, limited monitoring of charities and lack of training and awareness on financial crime in the sector. Originality – This paper shows how regulation of charities in general and risk based approach in particular can be improved in order to meet the expectations of the stakeholders, the public, the regulator and the regulated.

Keywords: risk, risk based approach, financial crime, fraud, self-regulation

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6015 A Framework for Systemically Understanding and Increasing Compliance with Water Regulation in Time Limited and Uncertain Contexts

Authors: Luisa Perez-Mujica

Abstract:

Traditionally, non-compliance in water regulation has been understood to be attributable to lack of information or knowledge of regulations. In other words, it is confusing behavioural change and education with communication or regulations. However, compliance is a complex response to water regulation factors including 1) knowledge and understanding of regulations; 2) perception that resources are overregulated; 3) presence of regulatory officers in the field; 4) accurate communication of what is being protected; 5) time lag between behavioral change projects and observation of outcomes and 6) how success of behavioral change is measured and evaluated. This paper presents a framework for designing education and behavioral change projects by understanding non-compliance in terms of the interaction of its factors, including a process for prioritizing projects, actions, evaluation and monitoring of outcomes. By taking a systemic approach to compliance, a more directed type of actions can be efficiently identified and prioritized, preventing the reactive nature of education and behavioral change projects.

Keywords: water regulation, compliance, behaviour change, systems thinking

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6014 Voltage and Frequency Regulation Using the Third-Party Mid-Size Battery

Authors: Roghieh A. Biroon, Zoleikha Abdollahi

Abstract:

The recent growth of renewables, e.g., solar panels, batteries, and electric vehicles (EVs) in residential and small commercial sectors, has potential impacts on the stability and operation of power grids. Considering approximately 50 percent share of the residential and the commercial sectors in the electricity demand market, the significance of these impacts, and the necessity of addressing them are more highlighted. Utilities and power system operators should manage the renewable electricity sources integration with power systems in such a way to extract the most possible advantages for the power systems. The most common effect of high penetration level of the renewables is the reverse power flow in the distribution feeders when the customers generate more power than their needs. The reverse power flow causes voltage rise and thermal issues in the power grids. To overcome the voltage rise issues in the distribution system, several techniques have been proposed including reducing transformers short circuit resistance and feeder impedance, installing autotransformers/voltage regulators along the line, absorbing the reactive power by distributed generators (DGs), and limiting the PV and battery sizes. In this study, we consider a medium-scale battery energy storage to manage the power energy and address the aforementioned issues on voltage deviation and power loss increase. We propose an optimization algorithm to find the optimum size and location for the battery. The optimization for the battery location and size is so that the battery maintains the feeder voltage deviation and power loss at a certain desired level. Moreover, the proposed optimization algorithm controls the charging/discharging profile of the battery to absorb the negative power flow from residential and commercial customers in the feeder during the peak time and sell the power back to the system during the off-peak time. The proposed battery regulates the voltage problem in the distribution system while it also can play frequency regulation role in islanded microgrids. This battery can be regulated and controlled by the utilities or a third-party ancillary service provider for the utilities to reduce the power system loss and regulate the distribution feeder voltage and frequency in standard level.

Keywords: ancillary services, battery, distribution system and optimization

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6013 Factors Influencing Infection Prevention and Control Practices in the Emergency Department of Mbarara Regional Referral Hospital in Mbarara District- Uganda

Authors: Baluku Nathan

Abstract:

Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients and attendants. It is, therefore, important for all EMTs and patients to adhere to them strictly. It is also imperative for administrators to ensure the implementation of the infection control program for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against Infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other Factors influencing Infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, majority16(50%) always used protective gear when doing clinical work,14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. Regarding disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5(15.6%) in yellow buckets and only5(15.6%) in black buckets and 12(37.5%) didn’t respond. However, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17(53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms,15(46.9%) said they had never had quality assurance monitoring events,14(43.8%) said monitoring was continuous while15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: infection prevention, influencing factors, emergency medical technician (EMT), emergency unit

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6012 Factors Influencing Infection Prevention and Control Practices in the Emergency Department of Mbarara Regional Referral Hospital in Mbarara District-Uganda

Authors: Baluku Nathan

Abstract:

Infection prevention and control (IPC) is a practical, evidence-based approach that prevents patients and emergency health workers from being harmed by avoidable infections as a result of antimicrobial resistance; all hospital infection control programs put together various practices which, when used appropriately, restrict the spread of infection. A breach in these control practices facilitates the transmission of infections from patients to health workers, other patients, and attendants. It is, therefore important for all emergency medical technicians (EMTs) and patients to strictly adhere to them. It is also imperative for administrators to ensure the implementation of the infection control programme for their facilities. Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in the emergency department at Mbarara hospital. Methodology: This was a descriptive cross-sectional study that employed a self-reported questionnaire that was filled out by 32 EMTs in the emergency department from 12th February to 3rd march 2022. The questionnaire consisted of items concerning the defensive environment and other factors influencing infection prevention and control practices in the accident and emergency department of Mbarara hospital. Results: From the findings, the majority 16 (50%) always used protective gear when doing clinical work, 14 (43.8%) didn’t use protective gear, citing they were only assisting those performing resuscitations, gumboots were the least used protective gear with only3(9.4%) usage. About disposal techniques of specific products like blood and sharps, results showed 10 (31.3%) said blood is disposed of in red buckets, 5 (15.6%) in yellow buckets, and only 5(15.6%) in black buckets, and 12(37.5%) didn’t respond, however, 28(87.5%) said sharps were disposed of in a sharps container. The majority, 17 (53.1%), were not aware of the infection control guidelines even though they were pinned on walls of the emergency rooms, 15(46.9%) said they have never had quality assurance monitoring events, 14(43.8%) said monitoring was continuous while 15(46.9 %) said it was discrete. Conclusions: The infection control practices at the emergency department were inadequate in view of less than 100% of the EMTs observing the five principles of infection prevention, such as the use of personal protective equipment and proper waste disposal in appropriate color-coded bins. Dysfunctional infection prevention and control committees accompanied by inadequate supervision to ensure infection control remained a big challenge.

Keywords: emergency medical technician, infection prevention, influencing factors, infection control

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6011 Forensic Nursing in the Emergency Department: The Overlooked Roles

Authors: E. Tugba Topcu

Abstract:

The emergency services are usually the first places to encounter forensic cases. Hence, it is important to consider forensics from the perspective of the emergency services staff and the physiological and psychological consequences that may arise as a result of behaviour by itself or another person. Accurate and detailed documentation of the situation in which the patient first arrives at the emergency service and preservation of the forensic findings is pivotal for the subsequent forensic investigation. The first step in determining whether or not a forensic case exists is to perform a medical examination of the patient. For each individual suspected to be part of a forensic case, police officers should be informed at the same time as the medical examination is being conducted. Violent events are increasing every year and with an increase in the number of forensic cases, emergency service workers have increasing responsibility and consequently play a key role in protecting, collecting and arranging the forensic evidence. In addition, because the emergency service workers involved in forensic events typically have information about the accused and/or victim, as well as evidence related to the events and the cause of injuries, police officers often require their testimony. However, both nurses and other health care personnel do not typically have adequate expertise in forensic medicine. Emergency nurses should take an active role for determining that whether any patient admitted to the emergency services is a clinical forensic patient the emergency service with injury and requiring possible punishment and knowing of their roles and responsibilities in this area provides legal protection as well as the protection of the judicial affair. Particularly, in emergency services, where rapid patient turnover and high workload exists, patient registration and case reporting may not exist. In such instances, the witnesses, typically the nurses, are often consulted for information. Knowledge of forensic medical matters plays a vital role in achieving justice. According to the Criminal Procedure Law, Article 75, Paragraph 3, ‘an internal body examination or the taking of blood or other biological samples from the body can be performed only by a doctor or other health professional member’. In favour of this item, the clinic nurse and doctor are mainly responsible for evaluating forensic cases in emergency departments, performing the examination, collecting evidence, and storing and reporting data. The courts place considerable importance on determining whether a suspect is the victim or accused and, thus, in terms of illuminating events, it is crucial that any evidence is gathered carefully and appropriately. All the evidence related to the forensic case including the forensic report should be handed over to the police officers. In instances where forensic evidence cannot be collected and the only way to obtain the evidence is the hospital environment, health care personnel in emergency services need to have knowledge about the diagnosis of forensic evidence, the collection of evidence, hiding evidence and provision of the evidence delivery chain.

Keywords: emergency department, emergency nursing, forensic cases, forensic nursing

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6010 Dielectric Properties in Frequency Domain of Main Insulation System of Printed Circuit Board

Authors: Xize Dai, Jian Hao, Claus Leth Bak, Gian Carlo Montanari, Huai Wang

Abstract:

Printed Circuit Board (PCB) is a critical component applicable to power electronics systems, especially for high-voltage applications involving several high-voltage and high-frequency SiC/GaN devices. The insulation system of PCB is facing more challenges from high-voltage and high-frequency stress that can alter the dielectric properties. Dielectric properties of the PCB insulation system also determine the electrical field distribution that correlates with intrinsic and extrinsic aging mechanisms. Hence, investigating the dielectric properties in the frequency domain of the PCB insulation system is a must. The paper presents the frequency-dependent, temperature-dependent, and voltage-dependent dielectric properties, permittivity, conductivity, and dielectric loss tangents of PCB insulation systems. The dielectric properties mechanisms associated with frequency, temperature, and voltage are revealed from the design perspective. It can be concluded that the dielectric properties of PCB in the frequency domain show a strong dependence on voltage, frequency, and temperature. The voltage-, frequency-, and temperature-dependent dielectric properties are associated with intrinsic conduction behavior and polarization patterns from the perspective of dielectric theory. The results may provide some reference for the PCB insulation system design in high voltage, high frequency, and high-temperature power electronics applications.

Keywords: electrical insulation system, dielectric properties, high voltage and frequency, printed circuit board

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6009 Parabolic Impact Law of High Frequency Exchanges on Price Formation in Commodities Market

Authors: L. Maiza, A. Cantagrel, M. Forestier, G. Laucoin, T. Regali

Abstract:

Evaluation of High Frequency Trading (HFT) impact on financial markets is very important for traders who use market analysis to detect winning transaction opportunity. Analysis of HFT data on tobacco commodity market is discussed here and interesting linear relationship has been shown between trading frequency and difference between averaged trading prices above and below considered trading frequency. This may open new perspectives on markets data understanding and could provide possible interpretation of Adam Smith invisible hand.

Keywords: financial market, high frequency trading, analysis, impacts, Adam Smith invisible hand

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6008 Predicting Factors for Occurrence of Cardiac Arrest in Critical, Emergency and Urgency Patients in an Emergency Department

Authors: Angkrit Phitchayangkoon, Ar-Aishah Dadeh

Abstract:

Background: A key aim of triage is to identify the patients with high risk of cardiac arrest because they require intensive monitoring, resuscitation facilities, and early intervention. We aimed to identify the predicting factors such as initial vital signs, serum pH, serum lactate level, initial capillary blood glucose, and Modified Early Warning Score (MEWS) which affect the occurrence of cardiac arrest in an emergency department (ED). Methods: We conducted a retrospective data review of ED patients in an emergency department (ED) from 1 August 2014 to 31 July 2016. Significant variables in univariate analysis were used to create a multivariate analysis. Differentiation of predicting factors between cardiac arrest patient and non-cardiac arrest patients for occurrence of cardiac arrest in an emergency department (ED) was the primary outcome. Results: The data of 527 non-trauma patients with Emergency Severity Index (ESI) 1-3 were collected. The factors found to have a significant association (P < 0.05) in the non-cardiac arrest group versus the cardiac arrest group at the ED were systolic BP (mean [IQR] 135 [114,158] vs 120 [90,140] mmHg), oxygen saturation (mean [IQR] 97 [89,98] vs 82.5 [78,95]%), GCS (mean [IQR] 15 [15,15] vs 11.5 [8.815]), normal sinus rhythm (mean 59.8 vs 30%), sinus tachycardia (mean 46.7 vs 21.7%), pH (mean [IQR] 7.4 [7.3,7.4] vs 7.2 [7,7.3]), serum lactate (mean [IQR] 2 [1.1,4.2] vs 7 [5,10.8]), and MEWS score (mean [IQR] 3 [2,5] vs 5 [3,6]). A multivariate analysis was then performed. After adjusting for multiple factors, ESI level 2 patients were more likely to have cardiac arrest in the ER compared with ESI 1 (odds ratio [OR], 1.66; P < 0.001). Furthermore, ESI 2 patients were more likely than ESI 1 patients to have cardiovascular disease (OR, 1.89; P = 0.01), heart rate < 55 (OR, 6.83; P = 0.18), SBP < 90 (OR, 3.41; P = 0.006), SpO2 < 94 (OR, 4.76; P = 0.012), sinus tachycardia (OR, 4.32; P = 0.002), lactate > 4 (OR, 10.66; P = < 0.001), and MEWS > 4 (OR, 4.86; P = 0.028). These factors remained predictive of cardiac arrest at the ED. Conclusion: The factors related to cardiac arrest in the ED are ESI 1 patients, ESI 2 patients, patients diagnosed with cardiovascular disease, SpO2 < 94, lactate > 4, and a MEWS > 4. These factors can be used as markers in the event of simultaneous arrival of many patients and can help as a pre-state for patients who have a tendency to develop cardiac arrest. The hemodynamic status and vital signs of these patients should be closely monitored. Early detection of potentially critical conditions to prevent critical medical intervention is mandatory.

Keywords: cardiac arrest, predicting factor, emergency department, emergency patient

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6007 Confidence Levels among UK Emergency Medicine Doctors in Performing Emergency Lateral Canthotomy: Should it be a Key Skill in the ED

Authors: Mohanad Moustafa, Julia Sieberer, Rhys Davies

Abstract:

Background: Orbital compartment syndrome (OCS) is a sight-threatening Ophthalmologic emergency caused by rapidly increasing intraorbital pressure. It is usually caused by a retrobulbar hemorrhage as a result of trauma. If not treated in a timely manner, permanent vision loss can occur. Lateral canthotomy and cantholysis are minor procedures that can be performed bedside with equipment available in the emergency department. The aim of the procedure is to release the attachments between the suspensory ligaments of the eye and the bony orbital wall, leading to a decrease in intraorbital pressure and preventing irreversible loss of vision. As most Ophthalmologists across the UK provide non-resident on-call service, this may lead to a delay in the treatment of OCS and stresses the need for Emergency medical staff to be able to provide this sight-saving procedure independently. Aim: To survey current training, experience, and confidence levels among Emergency Medicine doctors in performing emergency lateral canthotomy and to establish whether these variables change the following teaching from experienced ophthalmologists. RESULTS: Most EM registrars had little to no experience in performing lateral canthotomy and cantholysis. The majority of them showed a significant increase in their confidence to perform the procedure following ophthalmic-led teaching. The survey also showed that the registrars felt such training should be added to/part of the EM curriculum. Conclusion: The involvement of Ophthalmologists in the teaching of EM doctors to recognise and treat OCS independently may prevent delays in treatment and reduce the risk of permanent sight loss. This project showed potential in improving patient care and will lead to a National Survey of EM doctors across the UK.

Keywords: lateral canthotomy, retrobulbar hemorrhage, Ophthalmology, orbital compartment syndrome, sight loss, blindness

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6006 The Development of Asset Valuation Techniques for Government Business Enterprises in Australia

Authors: Malcolm Abbott, Angela Tan-Kantoor

Abstract:

The purpose of this paper is to look at the varieties of ways in which regulators have undertaken asset valuations in Australia of government business enterprises as part of utility regulation. Regulation of the monopoly elements, through use of a building block approach, led to a need to estimate regulated asset bases. This development has had an influence on the manner in which Australian companies (both government and privately owned ones) have valued assets for the purpose of financial reporting. As the regulators in Australia did not always use a consistent approach it had meant that a variety of ways have been used to value the assets of government owned enterprises, and meant a varied impact on asset valuation more generally.

Keywords: sset valuation, regulation, government business enterprises

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6005 Barriers to Health Promotion Advice Delivered by Paramedics and Emergency Department Nurses – Promoted Study

Authors: B. Schofield, F. Gul, S. McClean, R. Hoskins, R. Terry, U. Rolfe, A. Gibson, S. Voss, J. Benger

Abstract:

Aim: The aim of this study is to determine whether and how health promotion activities are undertaken by paramedics and emergency department nurses and investigate ways of overcoming potential barriers. Background: Paramedics and emergency department nurses are uniquely placed to reach millions of people and could use these contacts as positive opportunities to help people improve their health by identifying people with risk factors and provide information, brief interventions, and signposting to locally provided services. These interventions can be carried out when the opportunity arises, typically take no more than a few minutes, have a low financial cost and can be a highly efficient method of health promotion. Methodology: Three NHS Emergency Departments and four Ambulance Trusts in England were recruited to the study. A link to an online survey was distributed to paramedics and emergency department nurses at participating sites. Staff were invited to participate in virtual semi-structured interviews. Patients seen, treated, and discharged at the participating sites were invited to virtual semistructured interviews. Findings: A total of 331 survey responses were received, 21 virtual semi-structured staff interviews and 11 patient interviews were completed. Staff reported lack of time to prioritise, lack of knowledge, resources, and confidence as barriers. Receptiveness of patients guided their decision to undertake health promotion activities. They reported a desire to learn how to undertake health promotion conversations. Emergency department nurses felt more supported than paramedics by their organisations to undertake health promotion activities. Patients were not aware of health promotion activities and reported fear and lack of privacy as barriers. Conclusions: These results will guide the development of an intervention to support the provision of health promotion by staff in urgent and emergency care settings. The components of the intervention will be mapped to a framework which will consider the needs of staff working within these settings, patients they treat, and organisational issues and practices related to the implementation of such an intervention.

Keywords: emergency service, hospital, nursing, allied health personnel, emergency medical services, health promotion

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6004 Design and Optimization for a Compliant Gripper with Force Regulation Mechanism

Authors: Nhat Linh Ho, Thanh-Phong Dao, Shyh-Chour Huang, Hieu Giang Le

Abstract:

This paper presents a design and optimization for a compliant gripper. The gripper is constructed based on the concept of compliant mechanism with flexure hinge. A passive force regulation mechanism is presented to control the grasping force a micro-sized object instead of using a sensor force. The force regulation mechanism is designed using the planar springs. The gripper is expected to obtain a large range of displacement to handle various sized objects. First of all, the statics and dynamics of the gripper are investigated by using the finite element analysis in ANSYS software. And then, the design parameters of the gripper are optimized via Taguchi method. An orthogonal array L9 is used to establish an experimental matrix. Subsequently, the signal to noise ratio is analyzed to find the optimal solution. Finally, the response surface methodology is employed to model the relationship between the design parameters and the output displacement of the gripper. The design of experiment method is then used to analyze the sensitivity so as to determine the effect of each parameter on the displacement. The results showed that the compliant gripper can move with a large displacement of 213.51 mm and the force regulation mechanism is expected to be used for high precision positioning systems.

Keywords: flexure hinge, compliant mechanism, compliant gripper, force regulation mechanism, Taguchi method, response surface methodology, design of experiment

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6003 Application of Acoustic Emissions Related to Drought Can Elicit Antioxidant Responses and Capsaicinoids Content in Chili Pepper Plants

Authors: Laura Helena Caicedo Lopez, Luis Miguel Contreras Medina, Ramon Gerardo Guevara Gonzales, Juan E. Andrade

Abstract:

In this study, we evaluated the effect of three different hydric stress conditions: Low (LHS), medium (MHS), and high (HHS) on capsaicinoid content and enzyme regulation of C. annuum plants. Five main peaks were detected using a 2 Hz resolution vibrometer laser (Polytec-B&K). These peaks or “characteristic frequencies” were used as acoustic emissions (AEs) treatment, transforming these signals into audible sound with the frequency (Hz) content of each hydric stress. Capsaicinoids (CAPs) are the main, secondary metabolites of chili pepper plants and are known to increase during hydric stress conditions or short drought-periods. The AEs treatments were applied in two plant stages: the first one was in the pre-anthesis stage to evaluate the genes that encode the transcription of enzymes responsible for diverse metabolic activities of C. annuum plants. For example, the antioxidant responses such as peroxidase (POD), superoxide dismutase (Mn-SOD). Also, phenyl-alanine ammonia-lyase (PAL) involved in the biosynthesis of the phenylpropanoid compounds. The chalcone synthase (CHS) related to the natural defense mechanisms and species-specific aquaporin (CAPIP-1) that regulate the flow of water into and out of cells. The second stage was at 40 days after flowering (DAF) to evaluate the biochemical effect of AEs related to hydric stress on capsaicinoids production. These two experiments were conducted to identify the molecular responses of C. annuum plants to AE. Moreover, to define AEs could elicit any increase in the capsaicinoids content after a one-week exposition to AEs treatments. The results show that all AEs treatment signals (LHS, MHS, and HHS) were significantly different compared to the non-acoustic emission control (NAE). Also, the AEs induced the up-regulation of POD (~2.8, 2.9, and 3.6, respectively). The gene expression of another antioxidant response was particularly treatment-dependent. The HHS induced and overexpression of Mn-SOD (~0.23) and PAL (~0.33). As well, the MHS only induced an up-regulation of the CHs gene (~0.63). On the other hand, CAPIP-1 gene gas down-regulated by all AEs treatments LHS, MHS, and HHS ~ (-2.4, -0.43 and -6.4, respectively). Likewise, the down-regulation showed particularities depending on the treatment. LHS and MHS induced downregulation of the SOD gene ~ (-1.26 and -1.20 respectively) and PAL (-4.36 and 2.05, respectively). Correspondingly, the LHS and HHS showed the same tendency in the CHs gene, respectively ~ (-1.12 and -1.02, respectively). Regarding the elicitation effect of AE on the capsaicinoids content, additional treatment controls were included. A white noise treatment (WN) to prove the frequency-selectiveness of signals and a hydric stressed group (HS) to compare the CAPs content. Our findings suggest that WN and NAE did not present differences statically. Conversely, HS and all AEs treatments induced a significant increase of capsaicin (Cap) and dihydrocapsaicin (Dcap) after one-week of a treatment. Specifically, the HS plants showed an increase of 8.33 times compared to the NAE and WN treatments and 1.4 times higher than the MHS, which was the AEs treatment with a larger induction of Capsaicinoids among treatments (5.88) and compared to the controls.

Keywords: acoustic emission, capsaicinoids, elicitors, hydric stress, plant signaling

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6002 Return on Investment of a VFD Drive for Centrifugal Pump

Authors: Benhaddadi M., Déry D.

Abstract:

Electric motors are the single biggest consumer of electricity, and the consumption will have more than to double by 2050. Meanwhile, the existing technologies offer the potential to reduce the motor energy demand by up to 30 %, whereas the know-how to realise energy savings is not extensively applied. That is why the authors first conducted a detailed analysis of the regulation of the electric motor market in North America To illustrate the colossal energy savings potential permitted by the VFD, the authors have equipped experimental setup, based on centrifugal pump, simultaneously equipped with regulating throttle valves and variable frequency drive VFD. The obtained experimental results for 1.5 HP motor pump are extended to another motor powers, as centrifugal pumps that are different in power may have similar operational characteristics if they are located in a similar kind of process, permitting the simulations for 5 HP and 100 HP motors. According to the obtained results, VFDs tend to be most cost-effective when fitted to larger motor pumps, in addition to higher duty cycle of the motor and relative time operating at lower than full load. The energy saving permitted by the VFD use is huge, and the payback period for drive investment is short. Nonetheless, it’s important to highlight that there is no general rule of thumb that can be used to obtain the impact of the relative time operating at lower than full load. Indeed, in terms of energy-saving differences, 50 % flow regulation is tremendously better than 75 % regulation, but a slightly enhanced relative to 25 %. Two main distinct reasons can explain this somewhat not anticipated results: the characteristics of the process and the drop in efficiency when motor is operating at low speed.

Keywords: motor, drive, energy efficiency, centrifugal pump

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6001 Frequency-Dependent and Full Range Tunable Phase Shifter

Authors: Yufu Yin, Tao Lin, Shanghong Zhao, Zihang Zhu, Xuan Li, Wei Jiang, Qiurong Zheng, Hui Wang

Abstract:

In this paper, a frequency-dependent and tunable phase shifter is proposed and numerically analyzed. The key devices are the dual-polarization binary phase shift keying modulator (DP-BPSK) and the fiber Bragg grating (FBG). The phase-frequency response of the FBG is employed to determine the frequency-dependent phase shift. The simulation results show that a linear phase shift of the recovered output microwave signal which depends on the frequency of the input RF signal is achieved. In addition, by adjusting the power of the RF signal, the full range phase shift from 0° to 360° can be realized. This structure shows the spurious free dynamic range (SFDR) of 70.90 dB·Hz2/3 and 72.11 dB·Hz2/3 under different RF powers.

Keywords: microwave photonics, phase shifter, spurious free dynamic range, frequency-dependent

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6000 Injection of Bradykinin in Femoral Artery Elicits Cardiorespiratory Reflexes Involving Perivascular Afferents in Rat Models

Authors: Sanjeev K. Singh, Maloy B. Mandal, Revand R.

Abstract:

The physiology of baroreceptors and chemoreceptors present in large blood vessels of the heart is well known in regulation of cardiorespiratory functions. Since large blood vessels and peripheral blood vessels are of same mesodermal origin, therefore, involvement of the latter in regulation of cardiorespiratory system is expected. Role of perivascular nerves in mediating cardiorespiratory alterations produced after intra-arterial injection of a nociceptive agent (bradykinin) was examined in urethane anesthetized male rats. Respiratory frequency, blood pressure, and heart rate were recorded for 30 min after the retrograde injection of bradykinin/saline in the femoral artery. In addition, paw edema was determined and water content was expressed as percentage of wet weight. Injection of bradykinin produced immediate tachypnoeic, hypotensive and bradycardiac responses of shorter latency (5-8 s) favoring the neural mechanisms involved in it. Injection of equi-volume of saline did not produce any responses and served as time matched control. Paw edema was observed in the ipsilateral hind limb. Pretreatment with diclofenac sodium significantly attenuated the bradykinin-induced responses and also blocked the paw edema. Ipsilateral femoral and sciatic nerve sectioning attenuated bradykinin-induced responses significantly indicating the origin of responses from the local vascular bed. Administration of bradykinin in the segment of an artery produced reflex cardiorespiratory changes by stimulating the perivascular nociceptors involving prostaglandins. This is a novel study exhibiting the role of peripheral blood vessels in regulation of cardiorespiratory system.

Keywords: vasosensory reflex, cardiorespiratory changes, nociceptive agent, bradykinin, VR1 receptors

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