Search results for: foster care stability

Authors: Seyed Reza Mirdehghan, Mohammad Reza Haeri Yazdi

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In this paper, the stability and the performance of a two-degree-of-freedom robot under an interaction with a unknown environment has been investigated. The time when the robot returns to its initial position after an interaction and the primary resistance of the robot against the impact must be reduced. Thus, the applied torque on the motor will be reduced. The impedance control is an appropriate method for robot control in these conditions. The stability of the robot at interaction moment was transformed to be a robust stability problem. The dynamic of the unknown environment was modeled as a weight function and the stability of the robot under an interaction with the environment has been investigated using the robust control concept. To improve the performance of the system, a force controller has been designed which the normalized impedance after interaction has been reduced. The resistance of the robot has been considered as a normalized cost function and its value was 0.593. The results has showed reduction of resistance of the robot against impact and the reduction of convergence time by lower than one second.

Keywords: impedance control, control system, robots, interaction

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Authors: Narong Anurak

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This study aimed to find out the hair-care purchasing behavior at hypermarkets and to investigate two factors, package design and advertising channels, that influenced hair-care purchasing behavior. The subjects of the study consisted of 100 housewives aged between 20-60 who usually shopped at Big C Tiwanon. They were selected by accidental sampling, and were asked to complete a questionnaire. The main findings of the survey were that the majority of respondents regarding their brand selection of hair-care products, they gave priority to the product quality followed by a reasonable price, and fragrance, respectively. Besides, more than half of the respondents had brand loyalty while the rest were attracted by an attractive package design and advertising promotion campaigns. The respondents who were attracted by the package design said that the information on the labels influenced their purchasing decision the most, and television was a medium that best reached them as well.

Keywords: advertising channels, consumer purchasing decisions, hair-care market, package design

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Authors: R. Bužgová, R. Kozáková, M. Škutová, M. Bar, P. Ressner, P. Bártová

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Introduction: Currently, there has been an increasing concern about the provision of palliative care in non-oncological patients in both professional literature and clinical practice. However, there is not much scientific information on how to provide neurological and palliative care together. The main objective of the project is to create and to verify a concept of neuro-palliative and rehabilitative care for patients with selected neurological diseases in an advanced stage of the disease and also to evaluate bio-psychosocial and spiritual needs of these patients and their caregivers related to the quality of life using created standardized tools. Methodology: Triangulation of research methods (qualitative and quantitative) will be used. A concept of care and assessment tools will be developed by analyzing interviews and focus groups. Qualitative data will be analyzed using grounded theory. The concept of care will be tested in the context of the intervention study. Using quantitative analysis, we will assess the effect of an intervention provided on the saturation of needs, quality of life, and quality of care. A research sample will be made up of the patients with selected neurological diseases (Parkinson´s syndrome, motor neuron disease, multiple sclerosis, Huntington’s disease), together with patients´ family members. Based on the results, educational materials and a certified course for health care professionals will be created. Findings: Based on qualitative data analysis, we will propose the concept of integrated care model combining neurological, rehabilitative and specialist palliative care for patients with selected neurological diseases in different settings of care and services. Patients´ needs related to quality of life will be described by newly created and validated measuring tools before the start of intervention (application of neuro-palliative and palliative approach) and then in the time interval. Conclusion: Based on the results, educational materials and a certified course for doctors and health care professionals will be created.

Keywords: multidisciplinary approach, neuropalliative care, research, quality of life

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Authors: Qirat Naz

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The aim of this research study is to explore the perspectives of migrants and interpreters from diverse backgrounds on language barriers, their English language proficiency and access to health care facilities. A qualitative research methodology was used including in-depth interviews and focus group discussions. Data was collected from 20 migrants who have difficulty conversing in the English language and 12 interpreters including family members and friends who provide translation services as part of accessing health care. The findings seek to address three key research questions: how language is a barrier for non-national language speakers to access the health care facilities, what is the impact of various socio-cultural and linguistic backgrounds on health compliance, and what is the role of interpreters in providing access to, usage of, and satisfaction with health-care facilities. The most crucial component of providing care was found to be effective communication between patient and health care professionals. Language barrier was the major concern for healthcare professionals in providing and for migrants in accessing sufficient, suitable, and productive health care facilities. Language and sociocultural background play a significant role in health compliance as this research reported; respondents believe that patients who interact with the doctors who have same sociocultural and linguistic background benefit from receiving better medical care than those who do not. Language limitations and the socio-cultural gap make it difficult for patients and medical staff to communicate clearly with one another, which has a negative effect on quality of care and patient satisfaction. The use of qualified interpreters was found to be beneficial but there were also drawbacks such as accessibility and availability of them in a timely manner for patient needs. The findings of this research can help health care workers and policy makers working to improve health care delivery system and to create appropriate strategies to overcome this challenge.

Keywords: migration, migrants, language barrier, healthcare access

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Authors: TranThi Ly, Ligang Yang, Hechun Liu, Dengfeng Xu, Haiteng Zhou, Shaokang Wang, Shiqing Chen, Guiju Sun

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This study aims to evaluate the oxidative stability of Chinese vegetable oils during repeated deep-frying. For frying media, palm oil (PO), sunflower oil (SFO), soybean oil (SBO), and canola oil (CO) were used. French fries were fried in oils heated to 180 ± 50℃. The temperature was kept constant during the eight h of the frying process. The oil quality was measured according to the fatty acid (FA) content, trans fatty acid (TFA) compounds, and chemical properties such as peroxide value (PV), acid value (AV), anisidine value (AnV), and malondialdehyde (MDA). Additionally, the sensory characteristics such as color, flavor, greasiness, crispiness, and overall acceptability of the French fries were assessed. Results showed that the PV, AV, AnV, MDA, and TFA content of SFO, CO, and SBO significantly increased in conjunction with prolonged frying time. During the deep-frying process, the SBO showed the lowest oxidative stability at all indices, while PO retained oxidative stability and generated the lowest level of TFA. The French fries fried in PO also offered better sensory properties than the other oils. Therefore, results regarding oxidative stability and sensory attributes suggested that among the examined vegetable oils, PO appeared to be the best oil for frying food products.

Keywords: vegetable oils, French fries, oxidative stability, sensory properties, frying oil

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Authors: Anuar Ishak

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The characteristics of fluid flow and heat transfer over a permeable shrinking sheet is studied. The governing partial differential equations are transformed into a set of ordinary differential equations, which are then solved numerically using MATLAB routine boundary value problem solver bvp4c. Numerical results show that dual solutions are possible for a certain range of the suction parameter. A stability analysis is performed to determine which solution is linearly stable and physically realizable.

Keywords: dual solutions, heat transfer, shrinking sheet, stability analysis

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Authors: Kenneth Larsen, Astrid Aasland, Synnve Schjølberg, Trond Diseth

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Autism Spectrum Disorders (ASD) are neurodevelopmental disorders emerging in early development characterized by impairment in social communication skills and a restricted, repetitive and stereotyped patterns of behavior and interests. Early identification and interventions potentially improve development and quality of life of children with ASD. Symptoms of ASD are apparent through the second year of life, yet diagnostic age are still around 4 years of age. This study explored whether symptoms associated with ASD are possible to identify in typical Norwegian day-care centers in the second year of life. Results of this study clearly indicates that most described symptoms also are identifiable by day-care staff, and that a short observation list of 5 symptoms clearly identify children with ASD from a sample of normal developing peers.

Keywords: autism, early identification, day-care, screening

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Authors: Taoufik Benchelha, Toufik Remmal, Rachid El Hamdouni, Hamou Mansouri, Houssein Ejjaouani, Halima Jounaid, Said Benchelha

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During the earthworks for the construction of Marrakech-Agadir highway in southern Morocco, which crosses mountainous areas of the High Western Atlas, the main problem faced is the stability of the slopes. Indeed, the use of explosives as a means of excavation associated with the geological structure of the terrain encountered can trigger major ruptures and cause damage which depends on the intrinsic characteristics of the rock mass. The study consists of a geological and geotechnical analysis of several unstable zones located along the route, mobilizing millions of cubic meters of rock, with deduction of the parameters influencing slope stability. From this analysis, a predictive model for rock mass stability is carried out, based on a statistic method of logistic regression, in order to predict the geomechanical behavior of the rock slopes constrained by earthworks.

Keywords: explosive, logistic regression, rock mass, slope stability

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Authors: N. R. N. Mendis, S. N. Silva

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Introduction: Patient satisfaction of services provided by primary care health services depends on many factors. One key factor in this depends on is the nursing services received in primary care. Since majority of the primary care in Sri Lanka is provided by the private sector, it is important to assess patient satisfaction on this. Objective: To assess the satisfaction among the public on nurses working in dispensaries in Sri Lanka. Methods: A descriptive study was done on 200 individual selected using convenient sampling among dispensaries in Gampaha district, Sri Lanka. Results: 59.3% of the sample had long term illnesses or disabilities and all of them preferred speaking to a nurse. 70.9% of the sample used to make appointments with nurses while 57.8% out of them were comfortable in discussing their health concerns. 98.9 % agreed that they get individual attention by the nurses. Majority of the sample that is 34.2% spends around 20 minutes with the nurse without even making any pay. Significantly, the whole sample believes that the nurses are professional and admits that the care given is of high quality. All 100% of the sample said that the nurses could understand their concerns while 93.5% admitted that it was very useful in their recovery. Conclusions: Majority of the public were very much satisfied with the nurses and their practice at the dispensaries.

Keywords: health education, nurses practices, patient satisfaction, primary care

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Authors: Maria Santana, Jose Estaire

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Even though recycling strategies are becoming more important in recent years, there is still a huge amount of industrial by-products that are the disposal of at landfills. Due to the size, possible dangerous composition, and heterogeneity, most of the wastes are located at landfills without a basic geotechnical characterization. This lack of information may have an important influence on the correct stability calculations. This paper presents the results of geotechnical characterization of some industrial wastes disposed at one landfill. The shear strength parameters were calculated based on direct shear test results carried out in a large shear box owned by CEDEX, which has a shear plane of 1 x 1 m. These parameters were also compared with the results obtained in a 30 x 30 cm shear box. The paper includes a sensitive analysis of the global safety factor of the landfill's overall stability as a function of shear strength variation. The stability calculations were assessed for various hydrological scenarios to simulate the design and performance of the leachate drainage system. The characterization was completed with leachate tests to study the potential impact on the environment.

Keywords: industrial wastes, landfill, leachate tests, stability

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Authors: Expedito J. S. Parente Jr., Italo C. Rios, Joao Paulo C. Marques, Rosana M. A. Saboya, F. Murilo T. Luna, Célio L. Cavalcante Jr.

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Increasing constraints of environmental regulation around the world have led to higher demand for biodegradable products. Vegetable oils present some properties that may favor their use as biolubricants; however, there are others, such as resistance to oxidation and pour point, which affect possible commercial applications. In this study, the physicochemical properties of biolubricants synthesized from different vegetable oils were evaluated and compared with petroleum-based lubricant and pure vegetable oil. Chemical modifications applied to the original vegetable oil improved their oxidative stability and pour point significantly. The addition of commercial antioxidants to the bio-based lubricants was evaluated, yielding values of oxidative stability close to those of mineral basestock oil.

Keywords: biolubricant, vegetable oil, oxidative stability, pour point, antioxidants

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Authors: Praveen Battula

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Any high performance car has the tendency to over steer and Understeer under slippery conditions, An Electronic Stability Control System is needed under these conditions to regulate the steering of the car. It uses Anti-Lock Braking System (ABS) and Traction Control and Wheel Speed Sensor, Steering Angle Sensor, Rotational Speed Sensors to correct the problems. The focus of this paper is to improve the driving dynamics and safety by controlling the forces applied on each wheel. ESC Control the Yaw Stability, traction controls the Roll Stability, where actually the vehicle slip rate and lateral acceleration is controlled. ESC uses differential braking on all four brakes independently to control the vehicle’s motion. A mathematical model is developed in Simulink for the FlexRay based Electronic Stability Control. Vehicle steering is developed using Neuro Fuzzy Logic Controller. 7 Degrees of Freedom Vehicle Model is used as a Plant Model using dSpace autobox. The Performance of the system is assessed using two different road Scenarios, Vehicle Control under standard maneuvering conditions. The entire system is set using Dspace Control Desk. Results are provided by comparison of how a Vehicle with and without Electronic Stability Control which shows an improved performance in control.

Keywords: ESC, flexray, chassis control, steering, neuro fuzzy, vehicle dynamics

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Authors: Chui Ling Teng, R. Matsa

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We report a case with combined overdose of Lercanidipine (non-dihydropyridine calcium channel blocker), Quetiapine (Atypical antipsychotic), Ramipril and Duloxetine. A 66-year old male presented to the Emergency Department 12-hours after the ingestion of 1.2g Lercanidipine, 3g Quetiapine, 280mg of Ramipril and 420mg of Duloxetine. He describes lethargic, drowsiness and was unable to pass any urine since overdosed. He was found to be bradycardic, hypotensive and anuric. He had refractory hypotension and anuric despite fluid resuscitation, glucagon therapy and intravenous naloxone. His care was escalated to Intensive care, requiring noradrenaline, adrenaline, vasopressin, and hyperinsulinaemic euglycaemia therapy. He achieved haemodynamic stability and kidney function improved gradually with the support received. The total length of therapy lasted for 30 horus in which individual therapy was weaned down based on the requirement. He was then transferred to medical ward for further psychiatric assessment. This is a the first repored case of mixed overdose with lercanidipine, Quetiapine, Rampmipril and Duloxetine.

Keywords: calcium channel blocker, hyperinsulinaemic Euglycaemia therapy, lercanidipine, overdose

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Authors: M. V. Belubekyan, S. R. Martirosyan

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On the example of an elastic rectangular plate streamlined by a supersonic gas flow, we have investigated the phenomenon of divergence and of panel flatter of the overrunning of the gas flow at a free edge under assumption of the presence of concentrated inertial masses and moments at the free edge. We applied a new approach of finding of solution of these problems, which was developed based on the algorithm for an analytical solution finding. This algorithm is easy to use for theoretical studies for the wides circle of nonconservative problems of linear elastic stability. We have established the relation between the characteristics of natural vibrations of the plate and velocity of the streamlining gas flow, which enables one to draw some conclusions on the stability of disturbed motion of the plate depending on the parameters of the system plate-flow. Its solution shows that either the divergence or the localized divergence and the flutter instability are possible. The regions of the stability and instability in space of parameters of the problem are identified. We have investigated the dynamic behavior of the disturbed motion of the panel near the boundaries of region of the stability. The safe and dangerous boundaries of region of the stability are found. The transition through safe boundary of the region of the stability leads to the divergence or localized divergence arising in the vicinity of free edge of the rectangular plate. The transition through dangerous boundary of the region of the stability leads to the panel flutter. The deformations arising at the flutter are more dangerous to the skin of the modern aircrafts and rockets resulting to the loss of the strength and appearance of the fatigue cracks.

Keywords: stability, elastic plate, divergence, localized divergence, supersonic panels flutter

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Authors: Adekunle O. Afolabi, Pekka Toivanen

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The world is expected to experience growth in the number of ageing population, and this will bring about high cost of providing care for these valuable citizens. In addition, many of these live with chronic diseases that come with old age. Providing adequate care in the face of rising costs and dwindling personnel can be challenging. However, advances in technologies and emergence of the Internet of Things are providing a way to address these challenges while improving care giving. This study proposes the integration of recommendation systems into homecare to provide real-time recommendations for effective management of people receiving care at home and those living with chronic diseases. Using the simplified Training Logic Concept, stakeholders and requirements were identified. Specific requirements were gathered from people living with cancer. The solution designed has two components namely home and community, to enhance recommendations sharing for effective care giving. The community component of the design was implemented with the development of a mobile app called Recommendations Sharing Community for Aged and Chronically Ill People (ReSCAP). This component has illustrated the possibility of real-time recommendations, improved recommendations sharing among care receivers and between a physician and care receivers. Full implementation will increase access to health data for better care decision making.

Keywords: recommendation systems, Internet of Things, healthcare, homecare, real-time

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Authors: Virgil Florescu, Lucian Capitanu

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The studies performed by the author and presented here focus mainly on the FE simulation of some relevant phenomena related to stability of orthopedic implants, especially those components of Total Hip Prostheses. The objectives are to study the mechanisms of achieving stability of acetabular prosthetic components and the influence of some characteristic parameters, to evaluate the effect of femoral stem fixation modality on the stability of prosthetic component and to predict long-term behavior, to analyze a critical phenomena which influence the loading transfer mechanism through artificial joints and could lead to aseptic loosening – the wear of joint frictional surfaces. After a theoretical background an application is made considering only three activities: normal walking, stair ascending and stair descending. For each activity, this function is maximized in a different locations: if for normal walking the maxima is in the superior-posterior part of the acetabular cup, for stair descending this maxim value could be located rather in the superior-anterior part, for stair ascending being even closer to the central area of the cup.

Keywords: THA, acetabular stability, FEM simulation, stresses and displacements, wear tests, wear simulation

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Authors: V. M. B. K. T. Malwanage, S. Samita

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Core stability is one of the major determinants that contribute to preventing injuries, enhance performance, and improve quality of life of the human. Endurance of the four major muscle groups of the central ‘core’ of the human body is identified as the most reliable determinant of core stability amongst the other numerous causes which contribute to readily make one’s core stability. This study aimed to develop a ‘Core Stability Index’ to confer a single value for an individual’s core stability based on the four endurance test scores. Since it is possible that at least some of the test scores are not independent, possibility of constructing a single index using the multivariate method exploratory factor analysis was investigated in the study. The study sample was consisted of 400 healthy young individuals with the mean age of 23.74 ± 1.51 years and mean BMI (Body Mass Index) of 21.1 ± 4.18. The correlation analysis revealed highly significant (P < 0.0001) correlations between test scores and thus construction an index using these highly inter related test scores using the technique factor analysis was justified. The mean values of all test scores were significantly different between males and females (P < 0.0001), and therefore two separate core stability indices were constructed for the two gender groups. Moreover, having eigen values 3.103 and 2.305 for males and females respectively, indicated one factor exists for all four test scores and thus a single factor based index was constructed. The 95% reference intervals constructed using the index scores were -1.64 to 2.00 and -1.56 to 2.29 for males and females respectively. These intervals can effectively be used to diagnose those who need improvement in core stability. The practitioners should find that with a single value measure, they could be more consistent among themselves.

Keywords: construction of indices, endurance test scores, muscle endurance, quality of life

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Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

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Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

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Authors: Dil Ware Alam, Faiza Zebeen, Sumaya Binte Masud

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COVID-19) has impacted the whole world, including Bangladesh. The epidemic has reduced access to health care, particularly for women, creating challenges for an increasingly disadvantaged population. Women's health and well-being in Bangladesh are susceptible to a rise in domestic violence and need to be addressed quickly. The planet has been greatly influenced by Coronavirus disease 2019 (COVID-19), and Bangladesh is no difference. The pandemic has resulted in a decline in the availability of health care, notably for women's health problems, leading to an increase in difficulties for an increasingly marginalized group. Maternity care, maternal health programs, medical interventions, nutritional counseling and mental health care, are not discussed, and women's health and well-being in Bangladesh is vulnerable with a spike in domestic violence and needs to be resolved urgently.

Keywords: Covid-19, mental health, reproductive health, Bangladesh

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Authors: Khaled M. EL-Naggar

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Synchronizing and damping torque coefficients of a synchronous machine can give a quite clear picture for machine behavior during transients. These coefficients are used as a power system transient stability measurement. In this paper, a crow search optimization algorithm is presented and implemented to study the power system stability during transients. The algorithm makes use of the machine responses to perform the stability study in time domain. The problem is formulated as a dynamic estimation problem. An objective function that minimizes the error square in the estimated coefficients is designed. The method is tested using practical system with different study cases. Results are reported and a thorough discussion is presented. The study illustrates that the proposed method can estimate the stability coefficients for the critical stable cases where other methods may fail. The tests proved that the proposed tool is an accurate and reliable tool for estimating the machine coefficients for assessment of power system stability.

Keywords: optimization, estimation, synchronous, machine, crow search

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Authors: Reda Goweda, Mokhtar Shatla, Arawa Alzaidi, Arij Alzaidi, Bashair Aldhawani, Hibah Alharbi, Noran Sultan, Daniah Alnemari, Badr Rawa

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Background: 20.5% of Saudis between 20 and 79 years are diabetics. Diabetic foot is a chronic complication of diabetes. The incidence of non traumatic lower extremity amputations is at least 15 times greater in those with diabetes than non diabetics. Patient education is important to reduce lower extremity complications. Objective: To assess the knowledge and practices of the diabetic patients regarding foot care and diabetic foot complications. Methods: In Makkah hospitals, 350 diabetic patients who met the inclusion criteria were involved in this cross sectional study. Interviewing questionnaire and patients’ charts review were used to collect the data. Results: Mean age of patients was 53.0083±13.1 years, and mean duration of diabetes was 11.24±8.7 years. 35.1% had history of foot ulcer while 25.7% had ulcer on the time of interview. 11.7 % had history of amputation and 83.1% had numbness. 77.1 % examine their feet while 49.1% received foot care education and 34% read handouts on foot care. 34% walk around in bare feet. There is a significant statistical association between foot education, foot care practices, and diabetic foot ulcer (p-value < 0.022). Conclusion: Patient knowledge and practices regarding diabetic foot care is significantly associated with the reduction of diabetic foot ulcer.

Keywords: knowledge, practice, attitude, diabetes, foot, care

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Authors: Nattanon Peerapen, Wanwisa Insang, Lanlalin Khumman, Wipada Juanprajak, Sikan Na Chiangmai, Wacharin Suksanan, Thanasak Tantinakom

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This research was intended to study guidelines from elderly care businesses that are continuously growing and rapidly benefitting because these businesses respond to the needs of those who cannot find time to in take care of their elderly people, including intimate care services from the caregivers, thus rapidly expanding elderly care businesses to have recently become interesting domestically and internationally. Chiang Mai is a popular choice for the businesses because of excellent weathers and simple and peaceful ways of living, thus making the businesses grow rapidly and continuously. The sample group consisted of 5 persons, executives and staff, from each of the 4 businesses that provide elderly cares chosen to interview by the researches, which were Vivo Bene Village, Baan Donsuk, PT Nursing Home, and PD Nursing Home. The interviews indicated that most elderly care businesses are located in rural areas with moving traffics, shady environments, and far from crowded urban areas since elderly people need peacefulness and clean environments that will affect their physical and mental health directly. The sections within the businesses are distinctly divided with definite duties assigned to each personnel, including welfares, remunerations, uniforms, accommodations, food and social occasions, such as birthdays or New Year festivities.

Keywords: elderly, elderly care, business strategy, success factors

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Authors: Jui-Chen Huang

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The purpose of this study is to explore the effects of telecare on preventing and delaying the quality of disability care in elderly people with portable comfort Bluetooth brainwave devices with remote healthcare functions. Through the teaching videos and remotely teaching the elderly, which had ever learned the care courses of the prevent and delay disability, these elderly did muscle strength training. Then this paper explores the effect of training with the data by SPSS 18.0 statistical software. The data is collected with pre-test, post-test and analyze data from the measure of the Bluetooth brain wave equipment including the pressure index, relaxation index, attention and fatigue index of the elderly. In this study, 30 elderly people who had taken preventive and delayed disability care courses were studied to explore the effect of their care quality improvement. The results showed that the pressure index, relaxation index, attention, and fatigue index of the elderly had statistically significant differences in two months. It can be seen that elderly people who have been treated to prevent and delay disability care courses can significantly improve their care quality if they continue to receive intensive training to prevent and delay disability through remote mode. This telecare is applied to the elderly program that has been used to prevent and delay disability care courses. It is worth continuing to promote, and it is recommended that follow-up studies be conducted in a longer-term manner to explore long-term benefits. It can solve the current insufficiency of long-term care resources, but the demand is urgent.

Keywords: telecare, bluetooth brainwave equipment, prevention and delay of disability, the elderly, care quality

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Authors: Ratna Sen

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As due to very high temperature of Plasma it is very difficult to confine it for sufficient time so that nuclear fusion reactions to take place, As we know Plasma escapes faster than the binary collision rates. We studied the ball analogy and the ‘energy principle’ and calculated the total potential energy for the whole Plasma. If δ ⃗w is negative, that is decrease in potential energy then the plasma will be unstable. We also discussed different approaches of stability analysis such as Nyquist Method, MHD approximation and Vlasov approach of plasma stability. So that by using magnetic field configurations we can able to create a stable Plasma in Tokamak for generating energy for future generations.

Keywords: jello, magnetic field configuration, MHD approximation, energy principle

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Authors: Emni Omar Daw Hussin, Pathmawathi Subramanian, Wong Li Ping

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Background: To provide quality care at the end of life, nurses should possess knowledge and skills to provide effective end-of-life care, as well as develop the attitudes and interpersonal competence to provide compassionate care. Aim: This study aimed to assess nurses’ knowledge and attitude towards end of life care and caring for terminal ill patients and to examine relationships among demographic variables and nurse’s knowledge and attitudes toward end of life care and caring for terminal ill patients. Method: a cross-sectional study was conducted at 1 tertiary hospital located in Kuala Lumpur, Malaysia. Self-administrative questionnaire was used to collect data from 553 nurses from over all departments except emergency department, operation theater and outpatient clinic. Two tools were used in this study, the Frommelt’s Attitude Toward Care of the Dying (FATCOD) Scale to assess the nurses’ attitude and End of Life Knowledge Assessment to assess the nurses’ knowledge. Result: the result of this study yielded that, the majority of participants (54.8%) and (54.4%) have less positive attitude and knowledge towards end of life care and caring for terminal ill patients respectively. As well as there is no significant relationship were found between nurses’ ethnicity, religion, and the total score of FATCOD scale; End of Life Knowledge Assessment score. On other hand there is significant relationship among nurses’ age, working experience, level of education, attending any post basic courses and the total score of both FATCOD scale and End of Life Knowledge Assessment. Conclusion: A lack of education and experience and post basic course about end of life care and palliative care may contribute to the negative attitudes and poor knowledge regarding end of life care. Providing sufficient courses about end of life care could enhance the nurses’ knowledge towards end of life care, as well as providing a reflective narrative environment in which nurses can express their personal feelings about death and dying could be a potentially effective approach. Implication for Practice: This study elaborates the need for further research to develop an effective educational programs to enhance nurses’ knowledge and to promote positive attitude towards death and dying, as well as enhance communication skills, and coping strategies.

Keywords: knowledge, attitude, nurse, end of life care

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Authors: Amira Amamou, Mnaouar Chouchane

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This paper investigates the bifurcation and nonlinear behavior of two degrees of freedom model of a symmetrical balanced rigid rotor supported by two identical journal bearings. The fluid film hydrodynamic reactions are modeled by applying both the short and the long bearing approximation and using half Sommerfeld solution. A numerical integration of equations of the journal centre motion is presented to predict the presence and the size of stable or unstable limit cycles in the neighborhood of the stability critical speed. For their stability margins, a continuation method based on the predictor-corrector mechanism is used. The numerical results of responses show that stability and bifurcation behaviors of periodic motions depend strongly on bearing parameters and its dynamic characteristics.

Keywords: hydrodynamic journal bearing, nonlinear stability, continuation method, bifurcations

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Authors: W. Handoko, F. Pahlevani, V. Sahajwalla

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Dual-phase high carbon steels (DHCS) are commonly known for their improved strength, hardness, and abrasive resistance properties due to co-presence of retained austenite and martensite at the same time. Retained austenite is a meta-stable phase at room temperature, and stability of this phase governs the response of DHCS at different conditions. This research paper studies the effect of RA stability on corrosion behaviour of high carbon steels after they have been immersed into 1.0 M NaCl solution for various times. For this purpose, two different steels with different RA stabilities have been investigated. The surface morphology of the samples before and after corrosion attack was observed by secondary electron microscopy (SEM) and atomic force microscopy (AFM), along with the weight loss and Vickers hardness analysis. Microstructural investigations proved the preferential attack to retained austenite phase during corrosion. Hence, increase in the stability of retained austenite in dual-phase steels led to decreasing the weight loss rate.

Keywords: high carbon steel, austenite stability, atomic force microscopy, corrosion

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Authors: Alya Al Ghufli, Kelaithim Al Tunaiji, Sara Al Ali, Khalid Samara

Abstract:

It is well known that health care systems encompass a variety of key knowledge sources that need to be integrated and shared amongst all types of users to attain higher-levels of motivation and productivity. The development of Health Integrated Systems (HIS) is often seen as a crucial step in strengthening the integration of knowledge to help serve the information needs of health care users. As an emergent economy, the United Arab Emirates (UAE) is regarded as a new arrival in the area of health information systems. As a new nation, there may be several challenges in terms of organisational climate and the sufficient skills and knowledge activities for effective use of HIS. In this regard, the lack of coordination, attitudes and practice of health-related systems can eventually result in unnecessary data and generally poor use of the system. This paper includes results from a qualitative preliminary study carried out from a case study investigation in a single large primary health care organisation in the United Arab Emirates (UAE) comprising various health care users. The study explored health care user’s perceptions about health integration and the impact it has on their practice. The main sources of information were semi-structured interviews and non-obtrusive observations. The authors conclude by presenting various recommendations for the development of HIS and knowledge activities and areas for further study.

Keywords: health integrated systems, knowledge sharing, knowledge activities, health information systems

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Authors: Eddy K. Mukadi

Abstract:

The aim of this study was to provide contributing elements to improve the management of the asthma crisis in the intensive care unit of the General Reference Hospital of Kinshasa. This was a descriptive study of all patients in the intensive care unit presenting with the asthma attack during the period from February 5, 2013 to February 5, 2014. The main data were obtained from consultation registry and medical records. A total of 35 patients, 21 of whom were male (majority) compared to 14 female. Average age of patients was 46.48 plus or minus 16.98 with extremes ranging from 21-75 years. The clinic was dominated by dyspnea in 100% of cases, followed by rales with 91.4% of cases. In spite of the control of the crisis obtained after the treatment with B2 mimetic by inhalation was introduced A 91.5%; 88% corticosteroids; 80% oxygen, the therapeutic principle recommended for the management of asthma attacks was not respected in the majority of cases. This is why we suggest that improving the quality of care to be administered to patients will yield more adequate results.

Keywords: asthma crisis, intensive care, general hospital, Kinshasa

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Authors: D. M. Lewis, L. Frisby, U. Stead

Abstract:

Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

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