Search results for: evidence base

Authors: Faris Algahtani

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The current study aimed to reveal the extent to which evidence-based practices are applied in programs to integrate students with intellectual disabilities from the point of view of their teachers in Yanbu Governorate, and to reveal statistically significant differences in their application of evidence-based practices according to the following variables: gender, educational qualification, experience and training courses. The researcher used the descriptive approach, and accordingly; she designed a questionnaire consisting of 22 phrases applied it to a random sample of (97) teachers of intellectual disability in the integration programs of the Ministry of Education in the government sector in Yanbu Governorate, with (49) male teachers and (48) female teachers. The study showed that teachers of students with intellectual disabilities apply evidence-based practices in programs to integrate students with intellectual disabilities to a large extent. Among the most prominent of these practices came reinforcement in the first place, followed by using visual stimuli/aids, and in the third-place came starting with less complex or challenging skills then moving to more difficult skills. The results also showed no statistically significant differences over the extent of the application attributed to the variables of experience, qualification or training. On the other hand, there were statistically significant differences over the extent of the application attributed to gender in favor of females.

Keywords: evidence-based practices, intellectual disability, inclusion programs, teachers of students with intellectual disabilities

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Authors: Yvonne Howard

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This project currently under development is centered around current learning processes, including a thorough literature review and ongoing practical experiences gained as a deputy head in a school. These daily experiences with students engaging in animal-assisted interventions and the school therapy dog form a strong base for this research. The primary objective of this research is to comprehensively explore the impact of dog-assisted well-being interventions on student motivation and affective engagement within primary and secondary school settings. The educational domain currently encounters a significant challenge due to the lack of substantial research in this area. Despite the perceived positive outcomes of such interventions being acknowledged and shared in various settings, the evidence supporting their effectiveness in an educational context remains limited. This study aims to bridge the gap in the research and shed light on the potential benefits of dog-assisted well-being interventions in promoting student motivation and affective engagement. The significance of this topic recognizes that education is not solely confined to academic achievement but encompasses the overall well-being and emotional development of students. Over recent years, there has been a growing interest in animal-assisted interventions, particularly in healthcare settings. This interest has extended to the educational context. While the effectiveness of these interventions in these areas has been explored in other fields, the educational sector lacks comprehensive research in this regard. Through a systematic and thorough research methodology, this study seeks to contribute valuable empirical data to the field, providing evidence to support informed decision-making regarding the implementation of dog-assisted well-being interventions in schools. This research will utilize a mixed-methods design, combining qualitative and quantitative measures to assess the research objectives. The quantitative phase will include surveys and standardized scales to measure student motivation and affective engagement, while the qualitative phase will involve interviews and observations to gain in-depth insights from students, teachers, and other stakeholders. The findings will contribute evidence-based insights, best practices, and practical guidelines for schools seeking to incorporate dog-assisted interventions, ultimately enhancing student well-being and improving educational outcomes.

Keywords: therapy dog, wellbeing, engagement, motivation, AAI, intervention, school

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Authors: Najaf Hamadzadeh Arbabi

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Crime scene management is the first and most critical step in criminal investigations and all the criminal investigations are based on the ability of the crime scene investigation officers for diagnosing the importance and the role of physical evidence at the crime scene. According to the role of available physical evidence at the scene to prove the crime and identify the perpetrator and prove the innocence of those accused have been unduly and also impossible due to the rejection of these reasons, the maintenance and investigation of crime scene and collect evidence are very important in the crime scene. This research, by identifying the factors affecting the management of the crime scene, looking for presenting the effective and efficient indigenous pattern for managing of the crime scene in Iran. Method: This study is an applied and development research. Wilcoxon signed-rank test and the Friedman test for ranking, were used for analyzing the data and all hypotheses were tested at 95% confidence level. The target population is 50 judges and experts in Tehran.

Keywords: crime scene, identification, designation, individualization, reconstruction

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Authors: Jiping Cai, Ningzhi Wangyang, Jun Shao

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Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain, such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perception are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity have a variable presentation and was not necessarily related to the severity of the craniocerebral trauma. Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.

Keywords: bitemporal hemianopia, brain injury, optic chiasma, traumatic chiasmal syndrome.

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Authors: Emily Jin, Harry Sharples, Anne Weist

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Introduction: NICE Evidence Search Student Champion Scheme is a peer-assisted learning scheme that aims to improve the routine use of evidence-based information by future health and social care staff. The focus is on the NICE evidence search portal that provides selected information from more than 800 reliable health, social care, and medicines sources, including up-to-date guidelines and information for the public. This paper aims to evaluate the effectiveness of the scheme when implemented in Liverpool School of Medicine and to understand the experiences of those attending. Methods: Twelve student champions were recruited and trained in February 2020 as peer tutors during a workshop facilitated by NICE. Cascade sessions were then organised and delivered on an optional basis for students, in small groups of < 10 to approximately 70 attendees. Surveys were acquired immediately before and 8-12 weeks after cascade sessions (n=47 and 45 respectively). Data from these surveys facilitated the analysis of the scheme. Results: Surveys demonstrated 74% of all attendees frequently searched for health and social care information online as a part of their studies. However, only 15% of attendees reported having prior formal training on searching for health information, despite receiving such training earlier on in the curriculum. After attending cascade sessions, students reported a 58% increase in confidence when searching for information using evidence search, from a pre-session a baseline of 36%. Conclusion: NICE Evidence Search Student Champion Scheme provided clear benefits for attending students, increasing confidence in searching for peer-reviewed, mainly secondary sources of health information. The lack of reported training represents the unmet need that the champion scheme satisfies, and this likely benefits student champions as well as attendees. Increasing confidence in searching for healthcare information online may support future evidence-based decision-making.

Keywords: evidence-based medicine, NICE, medical education, medical school, peer-assisted learning

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Authors: M. Amoura, M. Benmoussa, N. Zeraibi

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The flow and heat transfer is an important phenomenon in engineering systems due to its wide application in electronic cooling, heat exchangers, double pane windows etc.. The enhancement of heat transfer in these systems is an essential topic from an energy saving perspective. Lower heat transfer performance when conventional fluids, such as water, engine oil and ethylene glycol are used hinders improvements in performance and causes a consequent reduction in the size of such systems. The use of solid particles as an additive suspended into the base fluid is a technique for heat transfer enhancement. Therefore, the heat transfer enhancement in a horizontal circular tube that is maintained at a constant temperature under laminar regime has been investigated numerically. A computational code applied to the problem by use of the finite volume method was developed. Nanofluid was made by dispersion of Al2O3 nanoparticles in pure water and ethylene glycol. Results illustrate that the suspended nanoparticles increase the heat transfer with an increase in the nanoparticles volume fraction and for a considered range of Reynolds numbers. On the other hand, the heat transfer is very sensitive to the base fluid.

Keywords: Al2O3 nanoparticles, circular tube, heat transfert enhancement, numerical simulation

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Authors: Jim S. Meng, Mammo H. Yewondwossen

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As a part of routine oesophageal HDR brachytherapy procedure, treatment planning takes about 45 minutes while patients are under light sedation. Some patients may suffer gagging and/or spasms, and the treatment may need to be aborted. A pre-prepared plan generated before the patient’s sedation may reduce the brachytherapy procedure time by forty minutes. This paper reports the rationality and evidence of pre-prepared treatment plans. A retrospective study of 28 patients confirm that all of the pre-prepared plans would be acceptable. The rationality of pre-prepared HDR brachytherapy plans is further confirmed by a systemic study with a wide range of applicator curvature and treatment volume. Detailed comparison between CT based treatment plans and pre-prepared plans are discussed. This argument holds also for endobronchial HDR brachytherapy. With the above evidence, pre-prepared plans have been used for all oesophagus and bronchus HDR brachytherapy cases in our clinic.

Keywords: HDR brachytherapy, treatment planning, oesophageal carcinoma, pre-planning

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Authors: Fahad Alanazi, Andrew Jones

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Digital forensics seeks to achieve the successful investigation of digital crimes through obtaining acceptable evidence from digital devices that can be presented in a court of law. Thus, the digital forensics investigation is normally performed through a number of phases in order to achieve the required level of accuracy in the investigation processes. Since 1984 there have been a number of models and frameworks developed to support the digital investigation processes. In this paper, we review a number of the investigation processes that have been produced throughout the years and introduce a proposed digital forensic model which is based on the scope of the Saudi Arabia investigation process. The proposed model has been integrated with existing models for the investigation processes and produced a new phase to deal with a situation where there is initially insufficient evidence.

Keywords: digital forensics, process, metadata, Traceback, Sauid Arabia

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Authors: Helena Baffoe

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The US has developed numerous programs over the past 50 years to enhance the lives of those who suffer from mental health illnesses and substance abuse, as well as the effectiveness of their treatments. Despite these advances over the past 50 years, there hasn't been a corresponding improvement in American public attitudes and beliefs about mental health disorders and substance abuse. Highly publicized acts of violence frequently elicit comments that blame the perpetrator's perceived mental health disorder since such people are thought to be substance abusers. Despite these strong public beliefs and perception about mental disorder and substance abuse, concreate empirical evidence that entail this perception is lacking, and evidence of their effectiveness has not been integrated. A rich data was collected from Substance Abuse and Mental Health Services Administration (SAMHSA) with a hypothesis that people who are diagnosed with a mental health disorder are likely to be diagnosed with substance abuse using logit regression analysis and Instrumental Variable. It was found that depressive, anxiety, and trauma/stressor mental disorders constitute the most common mental disorder in the United States, and the study could not find statistically significant evidence that being diagnosed with these leading mental health disorders in the United States does necessarily imply that such a patient is diagnosed with substances abuse. Thus, the public has a misconception of mental health and substance abuse issues, and social workers' responsibilities are outlined in order to assist ameliorate this attitude and perception.

Keywords: mental health disorder, substance abuse, role of a social worker, evidence based research

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Authors: David Simpson, Kyle Nash

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There is considerable evidence linking slow, deliberative reasoning (system 2) with utilitarian judgments in dilemmas involving the sacrificing of another person for the greater good (other-sacrificial dilemmas). Joshua Greene has argued, based on this kind of evidence, that system 2 drives utilitarian judgments. However, the evidence on whether system 2 is associated with utilitarian judgments in self-sacrificial dilemmas is more mixed. We employed process dissociation to measure a self-sacrificial utilitarian (SU) parameter and an other-sacrificial (OU) utilitarian parameter. It was initially predicted that contra Greene, the cognitive reflection test (CRT) would only be positively correlated with the OU parameter and not the SU parameter. However, Greene’s hypothesis was corroborated: the CRT positively correlated with both the OU parameter and the SU parameter. By contrast, the CRT did not correlate with the other two moral parameters we extracted (altruism and deontology).

Keywords: dual-process model, utilitarianism, altruism, reason, emotion, process dissociation

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Authors: Siddique Ullah Baig, Alisha Manzoor

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The remotest, mountainous, and icy Broghil Valley is a high-profile protected area as a national park, which hosts one of the highest altitude permanent human settlements on the earth. This park hosts a distributed but diverse range of habitats. Due to a lack of infrastructures, higher altitudes, and harsh environmental conditions, poverty-stricken inhabitants mostly rely on its resources, causing ecological dis-balance. This study aims to investigate the environmental degradation of natural resources of the park based on empirical evidence from stakeholders and geoinformatics. The result shows that one-fourth of the park is a gently undulating basin dotted with water bodies / grass, and agricultural land and three fourth is entirely rugged with steep mountains and glaciers. There are virtually no forests as the arid cold tundra climate and high altitude prevent tree growth. Rapid three-decadal land cover changes have led to ecological disequilibrium of the park, narrowing the traditional diverse food base, decreasing the resilience of biodiversity and local livelihoods as crop-land has shifted towards fallow, alpine-grass to peat-land and snow/glacial ice area to bare-soil/rocks. The local community believes in exploiting whatever vegetation or organic material is available for use as food, fodder, and fuel. The permanent presence of the community and limited cost-effective options in the park will be a challenge forever to maintain undisturbed natural processes as the objective of a national park.

Keywords: Broghil National Park, natural resources, environmental degradation, land cover

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Authors: Hilda Kundai Chikwanda, Lawrence Thabo Mokhadi

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The study aimed to review the factors that lead the freight railway suppliers base in South Africa (SA) to apply the Lean and Six Sigma (L&SS) methodologies. A thorough review of the factors that lead organisations, in the different industries, to implement these methodologies was done. L&SS applications were found to be prominent in the automotive industry. In particular, the railway industry in SA and the region were reviewed in terms of challenges in capturing the freight logistics market and growing market share. Qualitative methods have been used to collect primary data and descriptive statistics was used to calculate, describe, and summarize collected research data. The results show that external factors have a greater influence on the implementation of L&SS. The study drew inferences between freight railway supplier base and the application of Lean and Six Sigma (L&SS) methodologies in the SA context. It identified challenges that leads the SA freight railway to lose market share to road freight users. It further observes and recommends that L&SS methodologies are the ideal strategy required to implement a turnaround in the trajectory of freight railways as a competitive freight transport solution.

Keywords: production, methodology, manufacturing, lean, six sigma

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Authors: Marcus Smith

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DNA profiling has made a valuable contribution to criminal investigations over the past thirty years. Direct matching DNA profiles from a crime scene and suspect, or between a suspect and a database remain of great importance to crimes such as murder, assault, and property theft. As scientific and technological advancement continues, a wide range of new DNA profiling applications has been developed. The application of new techniques involves an interesting balancing act between admitting probative evidence in a criminal trial, evaluating its degree of relevance and validity, and limiting its prejudicial impact. The impact of new DNA profiling applications that have significant implications for law enforcement and the legal system can be evaluated through a review of relevant case law, legislation and the latest empirical evidence from jurisdictions around the world including the United States, United Kingdom, and Australia. There are benefits in further examining the implications of these new developments, including how the criminal law can best be adapted to ensure that new technology is used to enhance criminal investigation and prosecution while ensuring it is applied in a measured way that respects individual rights and maintains principles of fairness enshrined in the legal system.

Keywords: criminal procedure, forensic evidence, DNA profiling, familial searching, phenotyping

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Authors: Arun Kumar Singh, Rupesh M. Das, Shailendra Saini

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The present work is an attempt to evaluate the sub-auroral ionospheric behavior under changing space weather conditions especially during high solar activity year 2014. In view of this, the GPS TEC along with Ionosonde data over Indian permanent scientific base 'Maitri', Antarctica (70°46′00″ S, 11°43′56″ E) has been utilized. The results suggested that the nature of ionospheric responses to the geomagnetic disturbances mainly depended upon the status of high latitudinal electro-dynamic processes along with the season of occurrence. Fortunately, in this study, both negative and positive ionospheric impact to the geomagnetic disturbances has been observed in a single year but in different seasons. The study reveals that the combination of equator-ward plasma transportation along with ionospheric compositional changes causes a negative ionospheric impact during summer and equinox seasons. However, the combination of pole-ward contraction of the oval region along with particle precipitation may lead to exhibiting positive ionospheric response during the winter season. Other than this, some Ionosonde based new experimental evidence also provided clear evidence of particle precipitation deep up to the low altitudinal ionospheric heights, i.e., up to E-layer by the sudden and strong appearance of E-layer at 100 km altitudes. The sudden appearance of E-layer along with a decrease in F-layer electron density suggested the dominance of NO⁺ over O⁺ at a considered region under geomagnetic disturbed condition. The strengthening of E-layer is responsible for modification of auroral electrojet and field-aligned current system. The present study provided a good scientific insight on sub-auroral ionospheric to the changing space weather condition.

Keywords: high latitude ionosphere, space weather, geomagnetic storms, sub-storm

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Authors: V. Miller, T. Jariel, C. Cooper-Chadwick

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Early treatment of stroke leads to higher survival and lower disability rates. Increasing knowledge to activate the emergency medical system for signs of stroke can improve outcomes for patients with stroke and decrease morbidity and mortality. Even though patients who get discharged from the hospital receive standard verbal and printed education, nearly 20% of them answer the question incorrectly when asked, “What will you do if you or someone you know have signs of stroke?” The main goal of this evidence-based project was to improve patients’ knowledge of what to do if they have signs of stroke. Evidence suggests that using video education in conjunction with verbal and printed education improves patient comprehension and retention. The percentage of patients who noted that they needed to call 911 for stroke symptoms increased from 80% to 87% in six months after project implementation. The results of this project demonstrate significant improvement in patients’ knowledge about the necessity of activation of emergency medical systems for stroke symptoms.

Keywords: emergency medical systems activation, evidence-based practice nursing, stroke education, video education

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Authors: M. A. Hassan, M. H. Sakinah, K. Kadirgama, D. Ramasamy, M. M. Noor, M. M. Rahman

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Tribological properties that include nanoparticles are an alternative to improve the tribological behaviour of lubricating oil, which has been investigated by many researchers for the past few decades. Various nanostructures can be used as additives for tribological improvement. However, this also depends on the characteristics of the nanoparticles. In this study, tribological investigation was performed to examine the effect of CuO nanoparticles on the tribological behaviour of Syntium 800 SL 10W−30. Three parameters used in the analysis using the wear tester (piston ring) were load, revolutions per minute (rpm), and concentration. The specifications of the nanoparticles, such as size, concentration, hardness, and shape, can affect the tribological behaviour of the lubricant. The friction and wear experiment was conducted using a tribo-tester and the Response Surface Methodology method was used to analyse any improvement of the performance. Therefore, two concentrations of 40 nm nanoparticles were used to conduct the experiments, namely, 0.005 wt % and 0.01 wt % and compared with base oil 0 wt % (control). A water bath sonicator was used to disperse the nanoparticles in base oil, while a tribo-tester was used to measure the coefficient of friction and wear rate. In addition, the thermal properties of the nanolubricant were also measured. The results have shown that the thermal conductivity of the nanolubricant was increased when compared with the base oil. Therefore, the results indicated that CuO nanoparticles had improved the tribological behaviour as well as the thermal properties of the nanolubricant oil.

Keywords: concentration, improvement, tribological, copper (II) oxide, nano lubricant

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Authors: Muna Khethier Abbass, Bassma Finner Sultan

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In this research the effect of Al2O3 nanoparticles on corrosion behavior of aluminum base alloy(Al-4.5wt%Cu-1.5wt%Mg) has been investigated. Nanocomopsites reinforced with variable contents of 1,3 & 5wt% of Al2O3 nanoparticles were fabricated using powder metallurgy. All samples were prepared from the base alloy powders under the best powder metallurgy processing conditions of 6 hr of mixing time , 450 MPa of compaction pressure and 560°C of sintering temperature. Density and micro hardness measurements, and electrochemical corrosion tests are performed for all prepared samples in 3.5wt%NaCl solution at room temperature using potentiostate instrument. It has been found that density and micro hardness of the nanocomposite increase with increasing of wt% Al2O3 nanoparticles to Al matrix. It was found from Tafel extrapolation method that corrosion rates of the nanocomposites reinforced with alumina nanoparticles were lower than that of base alloy. From results of corrosion test by potentiodynamic cyclic polarization method, it was found the pitting corrosion resistance improves with adding of Al2O3 nanoparticles . It was noticed that the pits disappear and the hysteresis loop disappears also from anodic polarization curve.

Keywords: powder metallurgy, nano composites, Al-Cu-Mg alloy, electrochemical corrosion

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Authors: K. Sandjak, B. Tiliouine

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This article presents the main results of three-dimensional (3-D) numerical investigation of asphalt pavement structures behaviour using a coupled Finite Element-Mapped Infinite Element (FE-MIE) model. The validation and numerical performance of this model are assessed by confronting critical pavement responses with Burmister’s solution and FEM simulation results for multi-layered elastic structures. The coupled model is then efficiently utilised to perform 3-D simulations of a typical asphalt pavement structure in order to investigate the impact of two tire configurations (conventional dual and new generation wide-base tires) on critical pavement response parameters. The numerical results obtained show the effectiveness and the accuracy of the coupled (FE-MIE) model. In addition, the simulation results indicate that, compared with conventional dual tire assembly, single wide base tire caused slightly greater fatigue asphalt cracking and subgrade rutting potentials and can thus be utilised in view of its potential to provide numerous mechanical, economic, and environmental benefits.

Keywords: 3-D numerical investigation, asphalt pavements, dual and wide base tires, Infinite elements

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Authors: Ahmad Amiri, Hamed K. Arzani, S. N. Kazi, B. T. Chew

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Since graphene nanoplatelet (GNP) is a promising material due to desirable thermal properties, this paper is related to the thermophysical and heat transfer performance of covalently functionalized GNP-based water/ethylene glycol nanofluid through an annular channel. After experimentally measuring thermophysical properties of prepared samples, a computational fluid dynamics study has been carried out to examine the heat transfer and pressure drop of well-dispersed and stabilized nanofluids. The effect of concentration of GNP and Reynolds number at constant wall temperature boundary condition under turbulent flow regime on convective heat transfer coefficient has been investigated. Based on the results, for different Reynolds numbers, the convective heat transfer coefficient of the prepared nanofluid is higher than that of the base fluid. Also, the enhancement of convective heat transfer coefficient and thermal conductivity increase with the increase of GNP concentration in base-fluid. Based on the results of this investigation, there is a significant enhancement on the heat transfer rate associated with loading well-dispersed GNP in base-fluid.

Keywords: nanofluid, turbulent flow, forced convection flow, graphene, annular, annulus

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Authors: Sunghyun Kim, Hong-Gun Park

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In the performance-based design (PBD), by using the nonlinear dynamic analysis (NDA), the actual performance of the structure is evaluated. Unlike frame structures, in the wall structures, base shear force which is resulted from the NDA, is greatly amplified than that from the elastic analysis. This shear amplifying effect causes repeated designs which make designer difficult to apply the PBD. Therefore, in this paper, factors which affect shear amplification were studied. For the 20-story wall model, the NDA was performed. From the analysis results, the base shear amplification factor was proposed.

Keywords: performance based design, shear amplification factor, nonlinear dynamic analysis, RC shear wall

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Authors: CarlyWill Sloan

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Racial disparities in criminal justice outcomes are well-documented. However, there is little evidence on the extent to which racial bias by prosecutors is responsible for these disparities. This paper tests for racial bias in conviction by prosecutors. To identify effects, this paper leverages as good as random variation in prosecutor race using detailed administrative data on the case assignment process and case outcomes in New York County, New York. This paper shows that the assignment of an opposite-race prosecutor leads to a 5 percentage point (~ 8 percent) increase in the likelihood of conviction for property crimes. There is no evidence of effects for other types of crimes. Additional results indicate decreased dismissals by opposite-race prosecutors likely drive my property crime estimates.

Keywords: criminal justice, discrimination, prosecutors, racial disparities

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Authors: Vahid Bairami Rad, Shapoor Norazar, Moslem Talebi Asl

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The fast growing accessibility and capability of emerging technologies have fashioned enormous possibilities of designing, developing and implementing innovative teaching methods in the classroom. Using teaching methods and technology together have a fantastic results, because the global technological scenario has paved the way to new pedagogies in teaching-learning process. At the other side methods by focusing on students and the ways of learning in them, that can demonstrate logical ways of improving student achievement in English as a foreign language in Iran. The sample of study was 90 students of 10th grade of high school located in Ardebil. A pretest-posttest equivalent group designed to compare the achievement of groups. Students divided to 3 group, Control base, computer base, method and technology base. Pretest and post test contain 30 items each from English textbook were developed and administrated, then obtained data were analyzed. The results showed that there was an important difference. The 3rd group performance was better than other groups. On the basis of this result it was obviously counseled that teaching-learning capabilities.

Keywords: method, technology based environment, computer based environment, english as a foreign language, student achievement

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Authors: Abhishek Oswal

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Background: Inconsistencies between the guidelines for childhood asthma can pose a diagnostic challenge to clinicians. NICE guidelines are the most commonly followed guidelines in primary care in the UK; they state that to be diagnosed with asthma, a child must be more than 5 years old and must have objective evidence of the disease. When diagnoses are coded in general practice (GP), these guidelines may be superseded by communications from secondary care. Hence it is imperative that diagnoses are correct, as per up to date guidelines and evidence, as this affects follow up and management both in primary and secondary care. Methods: A snapshot audit at a general practice surgery was undertaken of children (less than 16 years old) with a coded diagnosis of 'asthma', to review the age at diagnosis and whether any objective evidence of asthma was documented at diagnosis. 50 cases of asthma in children presenting to the emergency department (ED) were then audited to review the age at presentation, whether there was evidence of previous asthma diagnosis and whether the patient was discharged from ED. A repeat audit is planned in ED this winter. Results: In a GP surgery, there were 83 coded cases of asthma in children. 51 children (61%) were diagnosed under 5, with 9 children (11%) who had objective evidence of asthma documented at diagnosis. In ED, 50 cases were collected, of which 4 were excluded as they were referred to the other services, or for incorrect coding. Of the 46 remaining, 27 diagnoses confirmed to NICE guidelines (59%). 33 children (72%) were discharged from ED. Discussion: The most likely reason for the apparent low rate of a correct diagnosis is the significant challenge of obtaining objective evidence of asthma in children. There were a number of patients who were diagnosed from secondary care services and then coded as 'asthma' in GP, without having objective documented evidence. The electronic patient record (EPR) system used in our emergency department (ED) did not allow coding of 'suspected diagnosis' or of 'viral induced wheeze'. This may have led to incorrect diagnoses coded in primary care, of children who had no confirmed diagnosis of asthma. We look forward to the re-audit, as the EPR system has been updated to allow suspected diagnoses. In contrast to the NICE guidelines used here, British Thoracic Society (BTS) guidelines allow for a trial of treatment and subsequent confirmation of diagnosis without objective evidence. It is possible that some of the cases which have been classified as incorrect in this audit may still meet other guidelines. Conclusion: The diagnosis of asthma in children is challenging. Incorrect diagnoses may be related to clinical pressures and the provision of services to allow compliance with NICE guidelines. Consensus statements between the various groups would also aid the decision-making process and diagnostic dilemmas that clinicians face, to allow more consistent care of the patient.

Keywords: asthma, diagnosis, primary care, emergency department, guidelines, audit

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Authors: Abdulsalami Muyideen Deji

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Nigeria as nation got independence in 1960 from British government which allowed indigenous people to form self-government and rule themselves base on the acceptable laws and orders provided by indigenes. All citizens saw it as a welcome development that gave them opportunity to develop at their own pace. Certainly, this occurred at the first instance up to the first republic of 1963. But things became worse for the country when the first military coup of January 15, 1966 sowed apple of discord between the three major tribes in Nigeria Hausa, Yoruba and Igbo as a result of miscarriage of well-conceived plan of master-minder of that coup Major Chukwuma Kaduna Nzeogwu. Although, the argument had emanated from different quarters that if Nigeria was given opportunity to develop at the pace it was going at that time probably the Nigeria would have been among developed nation today, but that ill-fated coup was a clog in the wheel of nation’s progress. The base of this argument is that Nigeria achievements after independence still depend on the work of leaders who secure independence and also directed the affairs of nation within that short period of time up till today. Since then Nigeria has been grasping with different system of government, yet, the nation is still far from the solution. This paper will analyze Nigeria politics from independence, offer suggestion on the way forward. The source is strictly base on secondary source from textbook, newspapers, internet and journals.

Keywords: politics, government, independence, development

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Authors: Bismark Agbemble

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This paper talks about how project-based learning (PBL) is being infused or implemented in the educational sphere of Africa. The paper navigates through the liminal aspects of PBL as a pedagogical approach to bridge the divide between theoretical knowledge and its application within school curriculums. Given that contextualized learning can be embodied, the abstract vehemently discusses that PBL creates an opportunity for students to work on projects that are of academic relevance in their local settings. It presents PBL’s growth of critical thinking, problem-solving, cooperation, and communications, which is vital in getting young citizens to prepare for the 21st-century revolution. In addition, the abstract stresses the possibility that PBL could become a stimulus to creativity and innovation wherein learning becomes motivated from within by intrinsic motivations. The paper advocates for a holistic approach that is based on teacher’s professional development with the provision of adequate infrastructural facilities and resource allocation, thus ensuring the success and sustainability of PBLs in African education systems. In the end, the paper positions this as a transformative educational methodology that has great potential in helping to shape an African generation that is prepared for a great future.

Keywords: student centered pedagogy, constructivist learning theory, self-directed learning, active exploration, real world challenges, STEM, 21st century skills, curriculum design, classroom management, project base learning curriculum, global intelligence, social and communication skills, transferable skills, critical thinking, investigatable learning, life skills

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Authors: Marinelle El-Khoury, Lina Bouhaya, Nivine Abbas, Hassan Sleiman

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The road network in the north of Lebanon is a prime example of the lack of pavement design and execution in Lebanon.  These roads show major distresses and hence, should be tested and evaluated. The aim of this research is to investigate and determine the deficiencies in road surface design in Lebanon, and to propose an environmentally friendly asphalt mix design. This paper consists of several parts: (i) evaluating pavement performance and structural behavior, (ii) identifying the distresses using visual examination followed by laboratory tests, (iii) deciding the optimal solution where rehabilitation or reconstruction is required and finally, (iv) identifying a sustainable method, which uses recycled material in the proposed mix. The asphalt formula contains Reclaimed Asphalt Pavement (RAP) in the base course layer and in the asphalt layer. Visual inspection of the roads in Tripoli shows that these roads face a high level of distress severity. Consequently, the pavement should be reconstructed rather than simply rehabilitated. Coring was done to determine the pavement layer thickness. The results were compared to the American Association of State Highway and Transportation Officials (AASHTO) design methodology and showed that the existing asphalt thickness is lower than the required asphalt thickness. Prior to the pavement reconstruction, the road materials were tested according to the American Society for Testing and Materials (ASTM) specification to identify whether the materials are suitable. Accordingly, the ASTM tests that were performed on the base course are Sieve analysis, Atterberg limits, modified proctor, Los Angeles, and California Bearing Ratio (CBR) tests. Results show a CBR value higher than 70%. Hence, these aggregates could be used as a base course layer. The asphalt layer was also tested and the results of the Marshall flow and stability tests meet the ASTM specifications. In the last section, an environmentally friendly mix was proposed. An optimal RAP percentage of 30%, which produced a well graded base course and asphalt mix, was determined through a series of trials.

Keywords: asphalt mix, reclaimed asphalt pavement, California bearing ratio, sustainability

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Authors: Nicolò Vaiana, Filip C. Filippou, Giorgio Serino

Abstract:

In order to reduce numerical computations in the nonlinear dynamic analysis of seismically base-isolated structures, a Mixed Explicit-Implicit time integration Method (MEIM) has been proposed. Adopting the explicit conditionally stable central difference method to compute the nonlinear response of the base isolation system, and the implicit unconditionally stable Newmark’s constant average acceleration method to determine the superstructure linear response, the proposed MEIM, which is conditionally stable due to the use of the central difference method, allows to avoid the iterative procedure generally required by conventional monolithic solution approaches within each time step of the analysis. The main aim of this paper is to investigate the stability and computational efficiency of the MEIM when employed to perform the nonlinear time history analysis of base-isolated structures with sliding bearings. Indeed, in this case, the critical time step could become smaller than the one used to define accurately the earthquake excitation due to the very high initial stiffness values of such devices. The numerical results obtained from nonlinear dynamic analyses of a base-isolated structure with a friction pendulum bearing system, performed by using the proposed MEIM, are compared to those obtained adopting a conventional monolithic solution approach, i.e. the implicit unconditionally stable Newmark’s constant acceleration method employed in conjunction with the iterative pseudo-force procedure. According to the numerical results, in the presented numerical application, the MEIM does not have stability problems being the critical time step larger than the ground acceleration one despite of the high initial stiffness of the friction pendulum bearings. In addition, compared to the conventional monolithic solution approach, the proposed algorithm preserves its computational efficiency even when it is adopted to perform the nonlinear dynamic analysis using a smaller time step.

Keywords: base isolation, computational efficiency, mixed explicit-implicit method, partitioned solution approach, stability

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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

Procedia PDF Downloads 216

Authors: Chen Zhi-Wei, Hsieh Wei-Fang

Abstract:

Taiwan annual rainfall is global average of 2.5 times, plus city excessive development, green constantly to reduced, instead of is big area of artificial base disc, makes Taiwan rainy season during occurred of storm cannot timely of emissions, led to flood constantly, and rain also cannot was retained again using, led to city hydrological balance suffered damage, and to Regulation city of by brings of negative effect, increased green covered rate became most effective of method, and city land limited, so roof green gradually became a alternative program. Green roofs have become one of the Central and local government policy initiatives for urban development, in foreign countries, such as the United States, and Japan, and Singapore etc. Development of roof greening as an important policy, has become a trend of the times. In recent years, many experts and scholars are also on the roof greening all aspects of research, mostly for green roof for the environmental impact of benefits, such as: carbon reduction, cooling, thermostat, but research on the benefits of green roofs under water cut but it is rare. Therefore, this research literature from green roof in to view and analyze what kind of medium suitable for roof greening and use of green base plate combination simulated green roof structure, via different proportions of the medium with water retention plate and drainage board, experiment with different planting base plate combination of water conservation performance. Research will want to test the effect of roof planting base mix, promotion of relevant departments and agencies in future implementation of green roofs, prompted the development of green roofs, which in the end Taiwan achieve sustainable development of the urban environment help.

Keywords: thin-layer roof greening and planting medium, water efficiency

Procedia PDF Downloads 326

Authors: Joshua Chew, Vesa Cheng, David Thomson

Abstract:

Background: Hereditary angioedema (HAE) or C1 esterase deficiency is a relatively rare entity that has a potential for significant anesthetic complications. Methods: A literature review was performed of published cases of surgery in patients with HAE. Results were limited to English language only and cases were examined for management strategies and successful prevention of acute attacks. Results: The literature revealed the successful use of C1 esterase inhibitors as the most common agent in surgical prophylaxis therapy. Other therapeutic targets described included kallikrein inhibitors and bradykinin B2 receptor antagonists. Conclusions: Therapeutic targets that exist for the management of acute attacks in HAE have been successfully employed in the setting of surgery. The data is currently limited and could not be used as a firm evidence base, but the limited outcomes seen are positive and reassuring for the prospective anesthetic management of this potentially fatal condition.

Keywords: anesthesia, C1 esterase deficiency, hereditary angioedema, surgical prophylaxis

Procedia PDF Downloads 368