Search results for: new manoeuvre

Authors: Amr Hamdy

Abstract:

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Many methods have been developed to decrease its rate. The aim of this study was to evaluate the applicability of a new non-pharmacologic maneuver in decreasing its rate. Methods: This case series study was conducted in one centre in Cairo, Egypt, from January-2010 to June-2013. 400 pregnant–women aged 18 years or more and candidate for normal labour; were enrolled to this study. High-risk subjects for PPH were excluded. After placental delivery, the new maneuver was done by sustained traction of the anterior and posterior lips of the cervix by two ovum forceps for duration of 90 seconds. The amount of blood loss was estimated by standardized visual estimation after removal of the forceps. All subjects were followed up for 6 hours. Results: The rate of PPH, defined as more than 500 ml, was 8 cases (2%) with 95% CI (0.63-3.37%). The rate of PPH was not affected by parity, gestational age, episiotomy or the presence of tears. PPH is more in cases with anemia (p 0.032). It occurred in all cases with uterine atony (p <0.001). The range of estimated blood loss was 550-600ml in cases with PPH and 150-450ml in cases without PPH. Severe PPH more than 1000 ml, did not occur. Conclusion: This pilot study introduced a novel maneuver that can be helpful in decreasing the rate of PPH and reducing the amount of post partum blood loss.Despite the low rate of PPH showed in this study, the need for conducting a randomized controlled study is at its highest level before further inclusion of such manoeuvre to be a part of the current medical practice and before considering it as an evident tool to decrease the burden of PPH.

Keywords: maternal mortality, new manoeuvre, post-partum haemorrhage, uterine atony

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Authors: L. Nathaniel-Wurie

Abstract:

The Sellick manoeuvre a.k.a the application of cricoid force (CF), was first described by Brian Sellick in 1961. CF is the application of digital pressure against the cricoid cartilage with the intention of posterior force causing oesophageal compression against the vertebrae. This is designed to prevent passive regurgitation of gastric contents, which is a major cause of morbidity and mortality during emergency airway management inside and outside of the hospital. To the authors knowledge, there is no universally standardised training modality and, therefore, no reliable way to examine if there are appropriate outcomes. If force is not measured during training, how can one surmise that appropriate, accurate, or precise amounts of force are being used routinely. Poor homogeneity in teaching and untested outcomes will correlate with reduced efficacy and increased adverse effects. For this study, the accuracy of force delivery in trained professionals was tested, and outcomes contrasted against a novice control and a novice study group. In this study, 20 operating department practitioners were tested (with a mean experience of 5.3years of performing CF). Subsequent contrast with 40 novice students who were randomised into one of two arms. ‘Arm A’ were explained the procedure, then shown the procedure then asked to perform CF with the corresponding force measurement being taken three times. Arm B had the same process as arm A then before being tested, they had 10, and 30 Newtons applied to their hands to increase intuitive understanding of what the required force equated to, then were asked to apply the equivalent amount of force against a visible force metre and asked to hold that force for 20 seconds which allowed direct visualisation and correction of any over or under estimation. Following this, Arm B were then asked to perform the manoeuvre, and the force generated measured three times. This study shows that there is a wide distribution of force produced by trained professionals and novices performing the procedure for the first time. Our methodology for teaching the manoeuvre shows an improved accuracy, precision, and homogeneity within the group when compared to novices and even outperforms trained practitioners. In conclusion, if this methodology is adopted, it may correlate with higher clinical outcomes, less adverse events, and more successful airway management in critical medical scenarios.

Keywords: airway, cricoid, medical education, sellick

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Authors: Zachary Cooper-Baldock, Paulo E. Santos, Russell S. A. Brinkworth, Karl Sammut

Abstract:

In recent years, large unmanned underwater vehicles such as the Boeing Voyager and Anduril Ghost Shark have been developed. These vessels can be structured to contain onboard internal payload bays. These payload bays can serve a variety of purposes – including the launch and recovery (LAR) of smaller underwater vehicles. The LAR of smaller vessels is extremely important, as it enables transportation over greater distances, increased time on station, data transmission and operational safety. The larger vessel and its payload bay structure complicate the LAR of UUVs in contrast to static docks that are affixed to the seafloor, as they actively impact the local flow field. These flow field impacts require analysis to determine if UUV vessels can be safely launched and recovered inside the motherships. This research seeks to determine the hydrodynamic forces exerted on a vertically over-actuated, small, unmanned underwater vehicle (OUUV) during an internal LAR manoeuvre and compare this to an under-actuated vessel (UUUV). In this manoeuvre, the OUUV is navigated through the stern wake region of the larger vessel to a set point within the internal payload bay. The manoeuvre is simulated using ANSYS Fluent computational fluid dynamics models, covering the entire recovery of the OUUV and UUUV. The analysis of the OUUV is compared against the UUUV to determine the differences in the exerted forces. Of particular interest are the drag, pressure, turbulence and flow field effects exerted as the OUUV is driven inside the payload bay of the larger vessel. The hydrodynamic forces and flow field disturbances are used to determine the feasibility of making such an approach. From the simulations, it was determined that there was no significant detrimental physical forces, particularly with regard to turbulence. The flow field effects exerted by the OUUV are significant. The vertical thrusters exert significant wake structures, but their orientation ensures the wake effects are exerted below the UUV, minimising the impact. It was also seen that OUUV experiences higher drag forces compared to the UUUV, which will correlate to an increased energy expenditure. This investigation found no key indicators that recovery via a mothership payload bay was not feasible. The turbulence, drag and pressure phenomenon were of a similar magnitude to existing static and towed dock structures.

Keywords: underwater vehicles, submarine, autonomous underwater vehicles, AUV, computational fluid dynamics, flow fields, pressure, turbulence, drag

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Authors: Zachary Cooper-Baldock, Paulo E. Santos, Russell S. A. Brinkworth, Karl Sammut

Abstract:

- In recent years, large unmanned underwater vehicles such as the Boeing Voyager and Anduril Ghost Shark have been developed. These vessels can be structured to contain onboard internal payload bays. These payload bays can serve a variety of purposes – including the launch and recovery (LAR) of smaller underwater vehicles. The LAR of smaller vessels is extremely important, as it enables transportation over greater distances, increased time on station, data transmission and operational safety. The larger vessel and its payload bay structure complicate the LAR of UUVs in contrast to static docks that are affixed to the seafloor, as they actively impact the local flow field. These flow field impacts require analysis to determine if UUV vessels can be safely launched and recovered inside the motherships. This research seeks to determine the hydrodynamic forces exerted on a vertically over-actuated, small, unmanned underwater vehicle (OUUV) during an internal LAR manoeuvre and compare this to an under-actuated vessel (UUUV). In this manoeuvre, the OUUV is navigated through the stern wake region of the larger vessel to a set point within the internal payload bay. The manoeuvre is simulated using ANSYS Fluent computational fluid dynamics models, covering the entire recovery of the OUUV and UUUV. The analysis of the OUUV is compared against the UUUV to determine the differences in the exerted forces. Of particular interest are the drag, pressure, turbulence and flow field effects exerted as the OUUV is driven inside the payload bay of the larger vessel. The hydrodynamic forces and flow field disturbances are used to determine the feasibility of making such an approach. From the simulations, it was determined that there was no significant detrimental physical forces, particularly with regard to turbulence. The flow field effects exerted by the OUUV are significant. The vertical thrusters exert significant wake structures, but their orientation ensures the wake effects are exerted below the UUV, minimising the impact. It was also seen that OUUV experiences higher drag forces compared to the UUUV, which will correlate to an increased energy expenditure. This investigation found no key indicators that recovery via a mothership payload bay was not feasible. The turbulence, drag and pressure phenomenon were of a similar magnitude to existing static and towed dock structures.

Keywords: underwater vehicles, submarine, autonomous underwater vehicles, auv, computational fluid dynamics, flow fields, pressure, turbulence, drag

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Authors: Pawan Kumar, Dhananjoy Shaw, Manoj Kumar Rathi

Abstract:

Purpose of the study were to compare between (a) frequencies among the four quartiles of percentile norms of autonomic variables from power events and (b) frequencies among the four quartiles percentile norms of autonomic variables from aerobic events of Indian sportspersons withdrawn from competitive games and sports in regard to number of samples falling in each quartile. The study was conducted on 430 males of 30 to 35 years of age. Based on the nature of game/sports the retired sportspersons were classified into power events (throwers, judo players, wrestlers, short distance swimmers, cricket fast bowlers and power lifters) and aerobic events (long distance runners, long distance swimmers, water polo players). Date was collected using ECG polygraphs. Data were processed and extracted using frequency domain analysis and time domain analysis. Collected data were computed with frequency, percentage of each quartile and finally the frequencies were compared with the chi square analysis. The finding pertaining to norm reference comparison of frequencies among the four quartiles of Indian sportspersons withdrawn from competitive games and sports from (a) power events suggests that frequency distribution in four quartile namely Q1, Q2, Q3, and Q4 are significantly different at .05 level in regard to variables namely, SDNN, Total Power (Absolute Power), HF (Absolute Power), LF (Normalized Power), HF (Normalized Power), LF/HF ratio, deep breathing test, expiratory respiratory ratio, valsalva manoeuvre, hand grip test, cold pressor test and lying to standing test, whereas, insignificantly different at .05 level in regard to variables namely, SDSD, RMSSD, SDANN, NN50 Count, pNN50 Count, LF (Absolute Power) and 30: 15 Ratio (b) aerobic events suggests that frequency distribution in four quartile are significantly different at .05 level in regard to variables namely, SDNN, LF (Normalized Power), HF (Normalized Power), LF/HF ratio, deep breathing test, expiratory respiratory ratio, hand grip test, cold pressor test, lying to standing test and 30: 15 ratio, whereas, insignificantly different at .05 level in regard to variables namely, SDSD, RMSSD. SDANN, NN50 count, pNN50 count, Total Power (Absolute Power), LF(Absolute Power) HF(Absolute Power), and valsalva manoeuvre. The study concluded that comparison of frequencies among the four quartiles of Indian retired sportspersons from power events and aerobic events are different in four quartiles in regard to selected autonomic functions, hence the developed percentile norms are not homogenously distributed across the percentile scale; hence strengthen the percentage distribution towards normal distribution.

Keywords: power, aerobic, absolute power, normalized power

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Authors: Idahosa Osagie Ojo

Abstract:

This research is on colonial racism and the Benin bronze artefacts between 1862 and 1960. It analyses the British racial sentiments against the Benin people that heralded colonial rule and how they influenced the perceptions of the artworks during the period. The aim is to contribute to the knowledge of colonial rule in Benin by bringing to the fore its impacts on the perception and interpretation of the Benin bronze artefacts during the period. Primary and secondary sources were utilised and the historical method was adopted. The findings reveal that the first British racial propaganda against the Benin people started in 1862 and that it was consciously orchestrated to manoeuvre public opinion for the ill-conceived colonial project. The research also reveals that the Benin people were not alone in this, as other peoples of Africa that were targeted for British colonial domination suffered the same fate. Findings also show that racial propaganda was actually used to rationalised colonial rule in Benin and that it later influenced the interpretations and perception of the Benin bronze artefacts throughout the colonial period and beyond.

Keywords: Benin, Bronzes, colonial, racism

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Authors: Kavitha Madhu, Karthik K. Srinivasan, R. Sivanandan

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Indian traffic can be considered as mixed and heterogeneous due to the presence of various types of vehicles that operate with weak lane discipline. Consequently, vehicles can position themselves anywhere in the traffic stream depending on availability of gaps. The choice of lateral positioning is an important component in representing and characterizing mixed traffic. The field data provides evidence that the trajectory of vehicles in Indian urban roads have significantly varying longitudinal and lateral components. Further, the notion of headway which is widely used for homogeneous traffic simulation is not well defined in conditions lacking lane discipline. From field data it is clear that following is not strict as in homogeneous and lane disciplined conditions and neighbouring vehicles ahead of a given vehicle and those adjacent to it could also influence the subject vehicles choice of position, speed and acceleration. Given these empirical features, the suitability of using headway distributions to characterize mixed traffic in Indian cities is questionable, and needs to be modified appropriately. To address these issues, this paper attempts to analyze the time gap distribution between consecutive vehicles (in a time-sense) crossing a section of roadway. More specifically, to characterize the complex interactions noted above, the influence of composition, manoeuvre types, and lateral placement characteristics on time gap distribution is quantified in this paper. The developed model is used for evaluating various performance measures such as link speed, midblock delay and intersection delay which further helps to characterise the vehicular fuel consumption and emission on urban roads of India. Identifying and analyzing exact interactions between various classes of vehicles in the traffic stream is essential for increasing the accuracy and realism of microscopic traffic flow modelling. In this regard, this study aims to develop and analyze time gap distribution models and quantify it by lead lag pair, manoeuvre type and lateral position characteristics in heterogeneous non-lane based traffic. Once the modelling scheme is developed, this can be used for estimating the vehicle kilometres travelled for the entire traffic system which helps to determine the vehicular fuel consumption and emission. The approach to this objective involves: data collection, statistical modelling and parameter estimation, simulation using calibrated time-gap distribution and its validation, empirical analysis of simulation result and associated traffic flow parameters, and application to analyze illustrative traffic policies. In particular, video graphic methods are used for data extraction from urban mid-block sections in Chennai, where the data comprises of vehicle type, vehicle position (both longitudinal and lateral), speed and time gap. Statistical tests are carried out to compare the simulated data with the actual data and the model performance is evaluated. The effect of integration of above mentioned factors in vehicle generation is studied by comparing the performance measures like density, speed, flow, capacity, area occupancy etc under various traffic conditions and policies. The implications of the quantified distributions and simulation model for estimating the PCU (Passenger Car Units), capacity and level of service of the system are also discussed.

Keywords: lateral movement, mixed traffic condition, simulation modeling, vehicle following models

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Authors: Elzyata Kuberlinova

Abstract:

This study explores how the Kalmyk Buddhist sangha responded to the Russian empire’s administrative integration and how the Buddhist clerical institutions were shaped in the process of interaction with representatives of the predominantly Orthodox state. The eighteenth-nineteenth century Russian imperial regime adhered to a religion-centred framework to govern its diverse subjects. Within this framework, any form of religious authority was considered a useful tool in the imperial quest for legibility. As such, rather than imposing religious homogeneity, the Russian administration engineered a framework of religious toleration and integrated the non-Orthodox clerical institutions in the empire’s administration. In its attempt to govern the large body of Kalmyk Buddhist sangha, the Russian government had to incorporate the sangha into the imperial institutional establishment. To this end, the Russian government founded the Lamaist Spiritual Governing Board in 1834, which became a part of the civil administration, where the Kalmyk Buddhist affairs were managed under the supervision of the Russian secular authorities. In 1847 the Lamaist Spiritual Board was abolished and Buddhist religious authority was transferred to the Lama of the Kalmyk people. From 1847 until the end of the empire in 1917 the Lama was the manager and intermediary figure between the Russian authorities and the Kalmyks where religious affairs were concerned. Substantial evidence collected in archives in Elista, Astrakhan, Stavropol and St.Petersburg show that despite being on the government’s payroll, first the Lamaist Spiritual Governing Board and later on the Lama did not always serve the interests of the state, and did not always comply with the Russian authorities’ orders. Although being incorporated into the state administrative system the Lama often found ways to manoeuvre the web of the Russian imperial bureaucracy in order to achieve his own goals. The Lama often used ‘every-day forms of resistance’ such as feigned misinterpretation, evasion, false compliance, feigned ignorance, and sabotage in order to resist without directly confronting or challenging the state orders.

Keywords: Buddhist Sangha, intermediary, Kalmyks, Lama, legibility, resistance, reform, Russian empire

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Authors: Daniela Lamaison Sepulveda

Abstract:

Critical media literacy teaches people to think analytically about the information they receive through the media. It is heavily influenced by Paulo Freire’s critical pedagogy and the necessity of becoming conscious of one’s reality in order to transform it. This qualitative research examines the case of Bolivia, which experienced dramatic political change after the first indigenous president, Evo Morales, was elected in 2006. In 2010, the government passed an education reform — the Avelino Siñani Elizardo Pérez (ASEP) —that draws heavily on decolonial thought and the Freirean notion of critical consciousness. The extent to which these theories were implemented in practice is evaluated in context of a media literacy project, run by an NGO, that trains secondary school teachers from public schools across Bolivia through yearly workshops ranging from producing media to identifying fake news. This context is examined against the backdrop of the highly contested general elections in October 2019. While there is plenty of literature that outlines the benefits of teaching media literacy in the classroom and different ways to apply it, little research has been done analysing implementation at an institutional level and how to best enable teachers who are motivated to teach the subject. Through semi-structured interviews, document analysis and naturalistic observations, this study aims to identify the struggles faced by teachers who are dedicated to teaching critical media literacy in their classrooms and how they navigate educational spaces while being subject to a demanding national curriculum that supposedly also seeks to promote critical thinking. The interplay between the aspirations of teachers and NGOs in contrast to the top-down discourse and policy of governmental institutions provides for a very enlightening case. By exploring these institutional, cultural, sociopolitical and economic barriers the teachers face, this research attempts to contribute to the debate in media literacy theories concerned with implementing the practice in schools.

Keywords: media literacy, critical pedagogy, teacher agency, misinformation, education reform, Bolivia

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Authors: Mokgadi Julia Ngoepe-Ntsoane

Abstract:

The article aims to make a case for a legislative framework for the fire sector in South Africa. Robust legislative framework is essential for empowering those with obligatory mandate within the sector. This article contributes to the body of knowledge in the field of policy reviews particularly with regards to the legal framework. It has been observed overtime that the scholarly contributions in this field are limited. Document analysis was the methodology selected for the investigation of the various legal frameworks existing in the country. It has been established that indeed the national legislation on the fire industry does not exist in South Africa. From the documents analysed, it was revealed that the sector is dominated by cartels who are exploiting the new entrants to the market particularly SMEs. It is evident that these cartels are monopolising the system as they have long been operating in the system turning it into self- owned entities. Commitment to addressing the challenges faced by fire services and creating a framework for the evolving role that fire brigade services are expected to execute in building safer and sustainable communities is vital. Legislation for the fire sector ought to be concluded with immediate effect. The outdated national fire legislation has necessitated the monopolisation and manipulation of the system by dominating organisations which cause a painful discrimination and exploitation of smaller service providers to enter the market for trading in that occupation. The barrier to entry bears long term negative effects on national priority areas such as employment creation, poverty, and others. This monopolisation and marginalisation practices by cartels in the sector calls for urgent attention by government because if left attended, it will leave a lot of people particularly women and youth being disadvantaged and frustrated. The downcast syndrome exercised within the fire sector has wreaked havoc and is devastating. This is caused by cartels that have been within the sector for some time, who know the strengths and weaknesses of processes, shortcuts, advantages and consequences of various actions. These people take advantage of new entrants to the sector who in turn find it difficult to manoeuvre, find the market dissonant and end up giving up their good ideas and intentions. There are many pieces of legislation which are industry specific such as housing, forestry, agriculture, health, security, environmental which are used to regulate systems within the institutions involved. Other regulations exist as bi-laws for guiding the management within the municipalities.

Keywords: sustainable job creation, growth and development, transformation, risk management

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Authors: Nurten Akgun, Dilum Dissanayake, Neil Thorpe, Margaret C. Bell

Abstract:

Cycling has gained a great attention with comparable speeds, low cost, health benefits and reducing the impact on the environment. The main challenge associated with cycling is the provision of safety for the people choosing to cycle as their main means of transport. From the road safety point of view, cyclists are considered as vulnerable road users because they are at higher risk of serious casualty in the urban network but more specifically at roundabouts. This research addresses the development of an enhanced mathematical model by including a broad spectrum of casualty related variables. These variables were geometric design measures (approach number of lanes and entry path radius), speed limit, meteorological condition variables (light, weather, road surface) and socio-demographic characteristics (age and gender), as well as contributory factors. Contributory factors included driver’s behavior related variables such as failed to look properly, sudden braking, a vehicle passing too close to a cyclist, junction overshot, failed to judge other person’s path, restart moving off at the junction, poor turn or manoeuvre and disobeyed give-way. Tyne and Wear in the UK were selected as a case study area. The cyclist casualty data was obtained from UK STATS19 National dataset. The reference categories for the regression model were set to slight and serious cyclist casualties. Therefore, binary logistic regression was applied. Binary logistic regression analysis showed that approach number of lanes was statistically significant at the 95% level of confidence. A higher number of approach lanes increased the probability of severity of cyclist casualty occurrence. In addition, sudden braking statistically significantly increased the cyclist casualty severity at the 95% level of confidence. The result concluded that cyclist casualty severity was highly related to approach a number of lanes and sudden braking. Further research should be carried out an in-depth analysis to explore connectivity of sudden braking and approach number of lanes in order to investigate the driver’s behavior at approach locations. The output of this research will inform investment in measure to improve the safety of cyclists at roundabouts.

Keywords: binary logistic regression, casualty severity, cyclist safety, roundabout

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Authors: Somya Sharma

Abstract:

Ahalya, the critically acclaimed short film, is known to demolish the gender constructs of the age old myth of Ahalya. The paper tries to crack the overt meaning of the short film by reading between the dialogues and deconstructing the idea of the pseudo feminism in the short film Ahalya by Sujoy Ghosh. The film, by subverting the role of male character by making it seem submissive as compared to the female character's role seems to be just a surface level reading of the text. It seems that Sujoy Ghosh has played not just with changing the paradigm, but also trying to alter the history by doing so. The age old myth of putting Ahalya as a part of the five virgins (panchkanya) of Hindu mythology is explored in the paper. God's manoeuvre cannot be questioned and the two male characters tend to again shape the deed and the life of the female character, Ahalya. It is of importance to note that even in the 21st century, progressive actors like Radhika Apte fail to acknowledge the politics of altering history, not in a progressive way. The film blinds the viewer in the first watch to fall for the female strength and ownership of her sexuality, which is reflected in the opening scene itself where she opens the gate for the police man Indra Sen (representing God Indra who seduced her) who is charmed by her white dress. White, in Hindu mythology, stands for mourning, and this can be a hint towards the prophecy of what is about to come. Ahalya, bold, strong, and confident in this scene seems to be in total ownership of her sexual identity. Further, as the film progresses, control of Ahalya over her acts becomes even more dominant. In the myth of Ahalya, Gautama Maharishi, her husband, who wins her by Brahma's courtesy, curses her for her infidelity. She is then turned into a stone because of the curse and is redeemed when Lord Rama's foot brushes the stone. In the film, it is with the help of Ahalya that Goutam Sadhu turns Indra Sen into a stone doll. Ahalya is seen as a seductress who bewitches Indra Sen, and because the latter falls for the trap laid by the husband wife duo, he is turned into a doll. The attempt made by the paper is to read Ahalya as a character of the stand in wife who is yet again a pawn in the play of Goutama's revenge from Indra (who in the myth is able to escape from any curse or punishment for the act). The paper, therefore, reverts the idea which has till now been signified by the film and attempts to study the feminism this film appropriates. It is essential to break down the structure formed by such overt transgressing films in order to provide a real outlook of how feminism is twisted and moulded according to a man’s wishes.

Keywords: deconstructing, Hindu mythology, Panchkanya, predominant feminism, seductress, stone doll

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