Search results for: Baby boomers

Authors: Sharmistha Roy

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In Singapore, there are about 1 million baby boomers, defined as those born between 1947 and 1964. They constitute a sizeable proportion (about 30 per cent) of the resident population comprising Singapore citizens and permanent residents. The first batches of these baby boomers have already 65 years old by 2012. Thereafter, baby boomers will swell the ranks of the elderly population in Singapore until 2030. The baby boomers in this study are divided into broad groups, namely, the early baby boomers (born 1947-54) and late baby boomers (1955-64). Continuing decline in fertility and mortality rates in the past three decades as well as improvements in health care facilities and services have changed the demography of Singapore from a “pyramid-shape” young, post war baby boomers population to a rapidly ageing population. With the ageing of the baby boom generation, the population of Singapore is about to grey rapidly over the next three decades. As such, there is a need for Singapore to understand the profile, perceptions and aspirations of this group, and devise strategies to address the needs and concerns as well as opportunities that arise with the ageing of baby boomers are discussed and presented in this work.

Keywords: Ageing index, Baby boomers, Demographic dependency ratio (DDR), Fertility and mortality rate, Life expectancy, Singapore.

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Authors: Muhammad Yasir Babar, Ebrahim Panah

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Over the past 20 years, internet has seen continual advancement and with the advent of online technology, various types of web-based games have been developed. Games are frequently being used among different age groups from baby boomers to generation Z. Games are not only used for entertainment but also utilized as a learning approach transmitting education to a level that is more interesting and effective for students. One of the popular web-based education games is Kahoot with growing popularity and usage, which is being used in different fields of studies. However, little knowledge is available on university students’ perception of Kahoot environment and application for learning subjects. Hence, the objective of the current study is to investigate students’ perceptions of Kahoot application and environment as a learning tool. The study employed a survey approach by distributing Google Forms –created questionnaire, with high level of reliability index, to 62 students (11 males and 51 females). The findings show that students have positive attitudes towards Kahoot application and its environment for learning. Regarding Kahoot application, it was indicated that activities created using Kahoot are more interesting for students, Kahoot is useful for collaborative learning, and Kahoot enhances interest in learning lesson. In terms of Kahoot environment, it was found that using this application through mobile is easy for students, its design is simple and useful, Kahoot-created activities can easily be shared, and the application can easily be used on any platform. The findings of the study have implications for instructors, policymakers and curriculum developers.

Keywords: Application, environment, Kahoot, learning tool.

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Authors: Chinlun Lai, Lunjyh Jiang

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Due to the heavy burden and pressure of caring for infants, an integrated automatic baby watching system based on IoT smart sensing and deep learning machine vision techniques is proposed in this paper. By monitoring infant body conditions such as heartbeat, breathing, body temperature, sleeping posture, as well as the surrounding conditions such as dangerous/sharp objects, light, noise, humidity and temperature, the proposed system can analyze and predict the obvious/potential dangerous conditions according to observed data and then adopt suitable actions in real time to protect the infant from harm. Thus, reducing the burden of the caregiver and improving safety efficiency of the caring work. The experimental results show that the proposed system works successfully for the infant care work and thus can be implemented in various life fields practically.

Keywords: Baby care system, internet of things, deep learning, machine vision.

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Authors: B. Karakas, S. Lakestani, C. Guler, B. Guciz Dogan, S. Acar Vaizoglu, A. Taner, B. Sekerel, R. Tıpırdamaz, G. Gullu

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Particulate matter (PM) in ambient air is responsible for adverse health effects in adults and children. Relatively little is known about the concentrations, sources and health effects of PM in indoor air. A monitoring study was conducted in Ankara by three campaigns in order to measure PM levels in indoor and outdoor environments to identify and quantify associations between sources and concentrations. Approximately 82 homes (1st campaign for 42, 2nd campaign for 12, and 3rd campaign for 28), three rooms (living room, baby-s room and living room used as a baby-s room) and outdoor ambient at each home were sampled with Grimm Environmental Dust Monitoring (EDM) 107, during different seasonal periods of 2011 and 2012. In this study, the relationship between indoor and outdoor PM levels for particulate matter less than 10 micrometer (.m) (PM10), particulate matter less than 2.5.m (PM2.5) and particulate matter less than 1.0.m (PM1) were investigated. The mean concentration of PM10, PM2.5, and PM1.0 at living room used as baby-s room is higher than living and baby-s room (or bedroom) for three sampling campaigns. It is concluded that the household activities and environmental conditions are very important for PM concentrations in the indoor environments during the sampling periods. The amount of smokers, being near a main street and/or construction activities increased the PM concentration. This study is based on the assessment the relationship between indoor and outdoor PM levels and the household activities and environmental conditions

Keywords: Indoor air quality, particulate matter (PM), PM10, PM2.5, PM1.0.

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Authors: S. Lakestani, B. Karakas, S. Acar Vaizoglu, B. Guciz Dogan, C. Guler, B. Sekerel, A. Taner, G. Gullu

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Abstract–Indoor air (VOCs) samples were collected simultaneously from variety of indoors (e.g. living rooms, baby-s rooms) and outdoor environments which were voluntarily selected from the houses in which pregnant residents live throughout Ankara. This is the first comprehensive study done in Turkey starting from prenatal period and continued till the babies had one year old. VOCs levels were measured over 76 homes. Air samples were collected in Tenax TA sorbent filled tubes with active sampling method and analyzed with Thermal Desorber and Gas Chromatography/Mass spectrometry (TD-GC/MS). At the first sampling period in the baby-s rooms maximum concentration of toluene was measured about 240.77μg.m-3 and in the living rooms maximum concentration of naphthalene was 180.24μg.m-3. At the second sampling period in the baby-s rooms maximum concentration of toluene was measured about 144.97μg.m-3 and in the living rooms maximum concentration of naphthalene was 247.89μg.m-3. Concentration of TVOCs in the first period was generally higher than the second period.

Keywords: Indoor Air, Volatile Organic Compounds (VOCs), Gas Chromatography

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Authors: Kristyanto B.

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Plenty of analyses based on Biomechanics were carried out on many jobs in manufactures or services. Now Biomechanics analysis is being applied on mothers who are giving birth. The analysis conducted in terms of normal condition of the birth process without Gyn Bed (Obstetric Bed). The aim of analysis is to study whether it is risky or not when choosing the position of mother’s postures when delivering the baby. This investigation was applied on two positions that generally appear in common birth process. Results will show the analysis of both positions to support the birth process based on the Biomechanics analysis (Ergonomic approaches). 

Keywords: Biomechanics analysis, Birth process, Position of postures analysis, Ergonomic approaches.

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Authors: Hooman Jafarabadi

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In this paper application of artificial intelligence for baby and children caring is studied. Then a new idea for injury prevention and safety announcement is presented by using digital image processing. The paper presents the structure of the proposed system. The system determines the possibility of the dangers for children and babies in yards, gardens and swimming pools or etc. In the presented idea, multi camera System is used and receiver videos are processed to find the hazardous areas then the entrance of children and babies in the determined hazardous areas are analyzed. In this condition the system does the programmed action capture, produce alarm or tone or send message.

Keywords: Baby and children Care and Nursing, Intelligent Control Systems for Nursing, Electronic Care and Nursing, Dangers and safety for children and babies, Motion detection, Expert danger alarm systems.

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Authors: Ana Paula Melchiors Stahlschmidt

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This paper discusses the role of music as a ludic activity and constituent element of voice in the construction and consolidation of the relationship of the baby and his/her mother or caretaker, evaluating its implications in his/her psychic structure and constitution as a subject. The work was based on the research developed as part of the author’s doctoral activities carried out from her insertion in a project of the Music Department of Federal University of Rio Grande do Sul - UFRGS, which objective was the development of musical activities with groups of babies from 0 to 24 months old and their caretakers. Observations, video recordings of the meetings, audio testemonies, and evaluation tools applied to group participants were used as instruments for this research. Information was collected on the participation of 195 babies, among which 8 were more focused on through interviews with their mothers or caretakers. These interviews were analyzed based on the referential of French Discourse Analysis, Psychoanalysis, Psychology of Development and Musical Education. The results of the research were complemented by other posterior experiences that the author developed with similar groups, in a context of a private clinic. The information collected allowed the observation of the ludic and structural functions of musical activities, when developed in a structured environment, as well as the importance of the musicality of the mother’s voice to the psychical structuring of the baby, allowing his/her insertion in the language and his/her constitution as a subject.

Keywords: Music and babies, maternal voice, Psychoanalysis and music, Psychology and music.

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Authors: Jureerat Buakaew

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The purpose of this research was to investigate Thai Muslims’ way of life through the way their clothes. The data of this qualitative research were collected from related documents and research reports, ancient cloths and clothing, and in-depth interviews with clothes owners and weavers.

The research found that in the 18^th century Thai Muslims in the three southern border provinces used many types of clothing in their life. At home women wore plain clothes. They used checked cloths to cover the upper part of their body from the breasts down to the waist. When going out, they used Lima cloth and So Kae with a piece of Pla-nging cloth as a head scarf. For men, they wore a checked sarong as a lower garment, and wore no upper garment. However, when going out, they wore Puyo Potong. In addition, Thai Muslims used cloths in various religious rites, namely, the rite of placing a baby in a cradle, the Masoyawi rite, the Nikah rite, and the burial rite. These types of cloths were related to the way of life of Thai Muslims from birth to death. They reflected the race, gender, age, social status, values, and beliefs in traditions that have been inherited.

Practical Implication: Woven in these cloths are the lost local wisdom, and therefore, aesthetics on the cloths are like mirrors reflecting the background of people in this region that is fading away. These cloths are pages of a local history book that is of importance and value worth for preservation and publicity so that they are treasured. Government organizations can expand and materialize the knowledge received from the study in accordance with government policy in supporting the One Tambon, One Product project.

Keywords: Way of life, rite of placing a baby in a cradle, Masoyawi rite, Thai Muslims.

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Authors: Lubis A., Widayanti R., Hikmah Z., Endaryanto A., Harsono A., Harianto A., Etika R., Handayani D. K., Sampurna M.

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: Neonatus lupus erythematous, maternal autoantibody, clinical characteristic.

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Authors: Baby Joseph, Sankarganesh Palaniyandi

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The enzyme alkaline protease production was determined under solid state fermentation using the soil bacteria Serratia marcescens sp7. The maximum production was obtained from wheat bran medium than ground nut shell and chemically defined medium. The physiological fermentation factors such as pH of the medium (pH 8), Temperature (40oC) and incubation time (48 hrs) played a vital role in alkaline protease production in all the above. 100Mm NaCl has given better resolution during elution of the enzymes. The enzyme production was found to be associated with growth of the bacterial culture.

Keywords: Alkaline protease, Wheat bran, Ground nut shell, Serratia marcescens

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Authors: Cheika Jahangeer, Naushad Mamode Khan, Maleika Heenaye-Mamode Khan

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Exclusive breastfeeding is the feeding of a baby on no other milk apart from breast milk. Exclusive breastfeeding during the first 6 months of life is of fundamental importance because it supports optimal growth and development during infancy and reduces the risk of obliterating diseases and problems. Moreover, in developed countries, exclusive breastfeeding has decreased the incidence and/or severity of diarrhea, lower respiratory infection and urinary tract infection. In this paper, we study the factors that influence exclusive breastfeeding and use the Generalized Poisson regression model to analyze the practices of exclusive breastfeeding in Mauritius. We develop two sets of quasi-likelihood equations (QLE)to estimate the parameters.

Keywords: Exclusive breastfeeding, Regression model, Quasilikelihood.

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Authors: Naushad Mamode Khan, Cheika Jahangeer, Maleika Heenaye-Mamode Khan

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Exclusive breastfeeding is the feeding of a baby on no other milk apart from breast milk. Exclusive breastfeeding during the first 6 months of life is very important as it supports optimal growth and development during infancy and reduces the risk of obliterating diseases and problems. Moreover, it helps to reduce the incidence and/or severity of diarrhea, lower respiratory infection and urinary tract infection. In this paper, we make a survey of the factors that influence exclusive breastfeeding and use two dispersed statistical models to analyze data. The models are the Generalized Poisson regression model and the Com-Poisson regression models.

Keywords: Exclusive breastfeeding, regression model, generalized poisson, com-poisson.

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Authors: Naushad Mamode Khan, Cheika Jahangeer, Maleika Heenaye-Mamode Khan

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Breastfeeding is an important concept in the maternal life of a woman. In this paper, we focus on exclusive breastfeeding. Exclusive breastfeeding is the feeding of a baby on no other milk apart from breast milk. This type of breastfeeding is very important during the first six months because it supports optimal growth and development during infancy and reduces the risk of obliterating diseases and problems. Moreover, in Mauritius, exclusive breastfeeding has decreased the incidence and/or severity of diarrhea, lower respiratory infection and urinary tract infection. In this paper, we give an overview of exclusive breastfeeding in Mauritius and the factors influencing it. We further analyze the local practices of exclusive breastfeeding using the Generalized Poisson regression model and the negative-binomial model since the data are over-dispersed.

Keywords: Exclusive breast feeding, regression model, generalized poisson, negative binomial.

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Authors: Tun Myat Aung, Ni Ni Hla

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This paper begins by describing basic properties of finite field and elliptic curve cryptography over prime field and binary field. Then we discuss the discrete logarithm problem for elliptic curves and its properties. We study the general common attacks on elliptic curve discrete logarithm problem such as the Baby Step, Giant Step method, Pollard’s rho method and Pohlig-Hellman method, and describe in detail experiments of these attacks over prime field and binary field. The paper finishes by describing expected running time of the attacks and suggesting strong elliptic curves that are not susceptible to these attacks.c

Keywords: Discrete logarithm problem, general attacks, elliptic curves, strong curves, prime field, binary field, attack experiments.

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Authors: Robin Becker, Maike Eilers, Nane Roetmann, Manfred Helmus

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The shortage of junior staff in the construction industry is a problem that will be further exacerbated in the coming years by the retirement of the baby-boom generations (1955-1969) from employment. In addition, the current working conditions in the field of construction management are not attractive for young professionals. A survey of students as part of the paper revealed a desire for an increase in flexibility and an improved work-life balance in everyday working life. Students of civil engineering and architecture are basically interested in a career in construction management but have reservations due to the image of the profession and the current working conditions. A survey among experts from the construction industry, also as a part of the paper, shows that the profession can become more attractive. This report provides recommendations for action in the form of working modules to improve the working conditions of employees. If these are taken into account, graduates can be attracted to the profession of construction management, and existing staff can be retained more effectively. The aim of this report is to show incentives for employers to respond to the wishes and needs of their current and future employees to the extent that can be implemented.

Keywords: Modern construction management, construction industry, work modules, shortage of junior staff, sustainable personnel management, making construction management more attractive, working time model.

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Authors: Reihaneh Ahmadzadeh Ghavidel, Mehdi Ghiafeh Davoodi

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The usefulness of weaning foods to meet the nutrient needs of children is well recognized, and most of them are precooked roller dried mixtures of cereal and/or legume flours which posses a high viscosity and bulk when reconstituted. The objective of this study was to formulate composite weaning foods using cereals, malted legumes and vegetable powders and analyze them for nutrients, functional properties and sensory attributes. Selected legumes (green gram and lentil) were germinated, dried and dehulled. Roasted wheat, rice, carrot powder and skim milk powder also were used. All the ingredients were mixed in different proportions to get four formulations, made into 30% slurry and dried in roller drier. The products were analyzed for proximate principles, mineral content, functional and sensory qualities. The results of analysis showed following range of constituents per 100g of formulations on dry weight basis, protein, 18.1-18.9 g ; fat, 0.78-1.36 g ; iron, 5.09-6.53 mg; calcium, 265-310 mg. The lowest water absorption capacity was in case of wheat green gram based and the highest was in rice lentil based sample. Overall sensory qualities of all foods were graded as “good" and “very good" with no significant differences. The results confirm that formulated weaning foods were nutritionally superior, functionally appropriate and organoleptically acceptable.

Keywords: malted legumes, weaning foods, nutrition, functional properties

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Authors: Morten Stigaard Laursen, Rasmus Nyholm Jørgensen, Henrik Skov Midtiby, Anders Krogh Mortensen, Sanmohan Baby

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This work contributes a statistical model and simulation framework yielding the best estimate possible for the potential herbicide reduction when using the MoDiCoVi algorithm all the while requiring a efficacy comparable to conventional spraying. In June 2013 a maize field located in Denmark were seeded. The field was divided into parcels which was assigned to one of two main groups: 1) Control, consisting of subgroups of no spray and full dose spraty; 2) MoDiCoVi algorithm subdivided into five different leaf cover thresholds for spray activation. In addition approximately 25% of the parcels were seeded with additional weeds perpendicular to the maize rows. In total 299 parcels were randomly assigned with the 28 different treatment combinations. In the statistical analysis, bootstrapping was used for balancing the number of replicates. The achieved potential herbicide savings was found to be 70% to 95% depending on the initial weed coverage. However additional field trials covering more seasons and locations are needed to verify the generalisation of these results. There is a potential for further herbicide savings as the time interval between the first and second spraying session was not long enough for the weeds to turn yellow, instead they only stagnated in growth.

Keywords: Weed crop discrimination, macrosprayer, herbicide reduction, site-specific, sprayer-boom.

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Authors: Ravi Kiran Pothamsetty, Radha Rani Ghosh, Baby Paul Thaliath

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Radiation therapy has undergone many advancements and evloved from 2D to 3D. Recently, with rapid pace of drug discoveries, cutting edge technology, and clinical trials has made innovative advancements in computer technology and treatment planning and upgraded to intensity modulated radiotherapy (IMRT) which delivers in homogenous dose to tumor and normal tissues. The present study was a hospital-based experience comparing two different conformal radiotherapy techniques for brain tumors. This analytical study design has been conducted at Regional Cancer Centre, India from January 2014 to January 2015. Ten patients have been selected after inclusion and exclusion criteria. All the patients were treated on Artiste Siemens Linac Accelerator. The tolerance level for maximum dose was 6.0 Gyfor lenses and 54.0 Gy for brain stem, optic chiasm and optical nerves as per RTOG criteria. Mean and standard deviation values of PTV98%, PTV 95% and PTV 2% in IMRT were 93.16±2.9, 95.01±3.4 and 103.1±1.1 respectively; for 3DCRT were 91.4±4.7, 94.17±2.6 and 102.7±0.39 respectively. PTV max dose (%) in IMRT and 3D-CRT were 104.7±0.96 and 103.9±1.0 respectively. Maximum dose to the tumor can be delivered with IMRT with acceptable toxicity limits. Variables such as expertise, location of tumor, patient condition, and TPS influence the outcome of the treatment.

Keywords: IMRT, 3D CRT, Brain, tumors, OARs, RTOG.

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Authors: Abdulfatah Al-Jaradi, Marzoq Ali Odhah, Abdulnasser A. Haza’a

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Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of Antenatal Care (ANC) include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding ANC. Methodology: A descriptive knowledge, attitude, and practice (KAP) study was conducted in public hospitals in Sana'a City, Yemen. The study population included all pregnant women that intended to the prenatal department and clinical outpatient department; the final sample size was 371 pregnant women. A self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women had correct answers in total knowledge regarding ANC, and about two-thirds (67%) of pregnant women had performance practice regarding ANC and two-third (68%) of pregnant women had a positive attitude. Conclusions: More than three quarter of pregnant women had good knowledge level, most of pregnant women had moderate practice level, and more than two-thirds of pregnant women had a positive attitude regarding antenatal care. There was a statistically significant association between overall knowledge and practice level toward ANC and demographic characteristics of pregnant women, at P-value ≤ 0.05. Recommendations: we recommended more education and training courses, lecturers, and education sessions in clinical facilitators focused on ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

Keywords: Antenatal care, knowledge, practice, attitude, pregnant women.

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Authors: Raghavi Janaswamy, Saraswathi K. Vasudev

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Music is ubiquitous in human lives. Ever since the foetus hears the sound inside the mother’s womb and later upon birth the baby experiences alluring sounds, the curiosity of learning emanates and evokes exploration. Music is an education than a mere entertainment. The intricate balance between music, education and entertainment has well been recognized by the scientific community and is being explored as a viable tool to understand and improve the human cognition. There are seven basic swaras (notes) Sa, Ri, Ga, Ma, Pa, Da and Ni in the Carnatic music system that are analogous to C, D, E, F, G, A and B of the western system. The Carnatic music builds on the conscious use of microtones, gamakams (oscillation) and rendering styles that evolved over centuries and established its stance. The complex but erudite raga system has been designed with elaborate experiments on srutis (musical sounds) and human perception abilities. In parallel, ‘rasa’- the emotions evoked by certain srutis and hence the ragas been solidified along with the power of language in combination with the musical sounds. The Carnatic music branches out as Kalpita sangeetam (pre-composed music) and Manodharma sangeetam (improvised music). This article explores the Manodharma sangeetam and its subdivisions such as raga alapana, swara kalpana, neraval and ragam-tanam-pallavi (RTP). The intrinsic mathematical strategies in its practice methods toward improvising the music have been discussed in detail with concert examples. The techniques on swara weaving for swara kalpana rendering and methods on the alapana development are also discussed at length with an emphasis on the impact on the human cognitive abilities. The articulation of the outlined conscious practice methods not only helps to leave a long-lasting melodic impression on the listeners but also onsets cognitive developments.

Keywords: Carnatic, Manodharmam, music cognition, Alapana.

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Authors: Saeed Rezaeian, M. Rezaee Boroon

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Nitrogen accumulates in soils during the process of fertilizer addition to promote the plant growth. When the organic matter decomposes, the form of available nitrogen produced is in the form of nitrate, which is highly mobile. The most significant health effect of nitrate ingestion is methemoglobinemia in infants under six months of age (blue baby syndrome). The mobile nutrients, like nitrate nitrogen, are not stored in the soil as the available forms for the long periods and in large amounts. It depends on the needs for the crops such as vegetables. On the other hand, the vegetables will compete actively for nitrate nitrogen as a mobile nutrient and water. The mobile nutrients must be shared. The fewer the plants, the larger this share is for each plant. Also, this nitrate nitrogen is poisonous for the people who use these vegetables. Nitrate is converted to nitrite by the existing bacteria in the stomach and the Gastro-Intestinal (GI) tract. When nitrite is entered into the blood cells, it converts the hemoglobin to methemoglobin, which causes the anoxemia and cyanosis. The increasing use of pesticides and chemical fertilizers, especially the fertilizers with nitrates compounds, which have been common for the increased production of agricultural crops, has caused the nitrate pollution in the (soil, water, and environment). They have caused a lot of damage to humans and animals. In this research, the nitrate accumulation in different kind of vegetables such as; green pepper, tomatoes, egg plants, watermelon, cucumber, and red pepper were observed in the suburbs of Mashhad, Neisabour, and Sabzevar cities. In some of these cities, the information forms of agronomical practices collected were such as; different vegetable crops fertilizer recommendations, varieties, pesticides, irrigation schedules, etc., which were filled out by some of our colleagues in the research areas mentioned above. Analysis of the samples was sent to the soil and water laboratory in our department in Mashhad. The final results from the chemical analysis of samples showed that the mean levels of nitrates from the samples of the fruit crops in the mentioned cities above were all lower than the critical levels. These fruit crop samples were in the order of: 35.91, 8.47, 24.81, 6.03, 46.43, 2.06 mg/kg dry matter, for the following crops such as; tomato, cucumber, eggplant, watermelon, green pepper, and red pepper. Even though, this study was conducted with limited samples and by considering the mean levels, the use of these crops from the nutritional point of view will not cause the poisoning of humans.

Keywords: Environmental pollution, human health, nitrate accumulations, nitrate fertilizers.

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Authors: Cherryl Lowe

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Background - The TrendCare Patient Dependency System is currently used by a large number of maternity Services across Australia, New Zealand and Singapore. In 2012, 2013 and 2014 validation studies were initiated in all three countries to validate the acuity tools used for women in labour, and postnatal mothers and babies. This paper will present the findings of the validation study. Aim - The aim of this study was to; identify if the care hours provided by the TrendCare acuity system was an accurate reflection of the care required by women and babies; obtain evidence of changes required to acuity indicators and/or category timings to ensure the TrendCare acuity system remains reliable and valid across a range of maternity care models in three countries. Method - A non-experimental action research methodology was used across maternity services in four District Health Boards in New Zealand, a large tertiary and a large secondary maternity service in Singapore and a large public maternity service in Australia. Standardised data collection forms and timing devices were used to collect midwife contact times, with women and babies included in the study. Rejection processes excluded samples when care was not completed/rationed, and contact timing forms were incomplete. The variances between actual timed midwife/mother/baby contact and the TrendCare acuity category times were identified and investigated. Results - Thirty two (88.9%) of the 36 TrendCare acuity category timings, fell within the variance tolerance levels when compared to the actual timings recorded for midwifery care. Four (11.1%) TrendCare categories provided less minutes of care than the actual timings and exceeded the variance tolerance level. These were all night shift category timings. Nine postnatal categories were not able to be compared as the sample size for these categories was statistically insignificant. 100% of labour ward TrendCare categories matched actual timings for midwifery care, all falling within the variance tolerance levels. The actual time provided by core midwifery staff to assist lead maternity carer (LMC) midwives in New Zealand labour wards showed a significant deviation to previous studies. The findings of the study demonstrated the need for additional time allocations in TrendCare to accommodate an increased level of assistance given to LMC midwives. Conclusion - The results demonstrated the importance of regularly validating the TrendCare category timings with actual timings of the care hours provided. It was evident from the findings that variances to models of care and length of stay in maternity units have increased midwifery workloads on the night shift. The level of assistance provided by the core labour ward staff to the LMC midwife has increased substantially. Outcomes - As a consequence of this study, changes were made to the night duty TrendCare maternity categories, additional acuity indicators were developed and times for assisting LMC midwives in labour ward increased. The updated TrendCare version was delivered to maternity services in 2014.

Keywords: Maternity, acuity, midwifery research, midwifery workloads.

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Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

Abstract:

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: Anemia, haemoglobinopathies, pregnancy, sickle cell disease.

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