Patients’ Perceptions of Receiving a Diagnosis of a Hematological Malignancy, Following the SPIKES Protocol

Objective: Sharing devastating news with patients is often considered the most difficult task of doctors. This study aimed to explore patients’ perceptions of receiving bad news including which features improve the experience and which areas need refining. Methods: A questionnaire was written based on the steps of the SPIKES model for breaking bad new. 20 patients receiving treatment for a hematological malignancy completed the questionnaire. Results: Overall, the results are promising as most patients praised their consultation. ‘Poor’ was more commonly rated by women and participants aged 45-64. The main differences between the ‘excellent’ and ‘poor’ consultations include the doctor’s sensitivity and checking the patients’ understanding. Only 35% of patients were asked their existing knowledge and 85% of consultations failed to discuss the impact of the diagnosis on daily life. Conclusion: This study agreed with the consensus of existing literature. The commended aspects include consultation set-up and information given. Areas patients felt needed improvement include doctors determining the patient’s existing knowledge and checking new information has been understood. Doctors should also explore how the diagnosis will affect the patient’s life. With a poorer prognosis, doctors should work on conveying appropriate hope. The study was limited by a small sample size and potential recall bias.

Hierarchically Modeling Cognition and Behavioral Problems of an Under-Represented Group

This study examined the mental health and behavioral problems in early adolescence with the instrument of Achenbach System of Empirically Based Assessment (ASEBA). The purpose of the study was stratified sampling method was used to collect data from 1975 participants. Multiple regression models and hierarchical regression models were applied to examine the relations between the background variables and internalizing problems, and the ones between students’ performance and internalizing problems. The results indicated that several background variables as predictors could significantly predict the anxious/depressed problem; reading and social study scores could significantly predict the anxious/depressed problem. However the class as a hierarchical macro factor did not indicate the significant effect. In brief, the majority of these models represented that the background variables, behaviors and academic performance were significantly related to the anxious/depressed problem.

Attitude and Knowledge of Primary Health Care Physicians and Local Inhabitants about Leishmaniasis and Sandfly in West Alexandria

Leishmaniasis is the collective name for a number of diseases caused by protozoan flagellates of the genus Leishmania, which is transmitted by Phlebotomine sandfly, the disease has diverse clinical manifestations and found in many areas of the world, particularly in Africa, Latin America, South and Central Asia, the Mediterranean basin and the Middle East. This study was done to assess primary health care physicians’ knowledge (PHP) and attitude about leishmaniasis and to assess awareness of local inhabitants about the disease and its vector in four areas in west Alexandria, Egypt. It is a cross sectional survey that was conducted in four PHC units in west Alexandria. All physicians currently working in these units during the study period were invited to participate in the study; only 20 PHP completed the questionnaire. 60 local inhabitants were selected randomly from the four areas of the study, 15 from each area; Data was collected through two different specially designed questionnaires. Results showed that 11 (55%) percent of the physicians had satisfactory knowledge; they answered more than 9 (60%) questions out of a total 14 questions about leishmaniasis and sandfly. On the other hand when attitude of the primary health care physicians about leishmaniasis was measured, results showed that 17 (85%) had good attitude and 3 (15%) had poor attitude. The second questionnaire showed that the awareness of local inhabitants about leishmaniasis and sandfly as a vector of the disease is poor and needs to be corrected. (90%) of the interviewed inhabitants had not heard about leishmaniasis, Only 3 (5%) of them said they know sandfly and its role in transmission of leishmaniasis. Thus we conclude that knowledge and attitudes of physicians are acceptable. However, there is, room for improvement and could be done through formal training courses and distribution of guidelines. In addition to raising the awareness of primary health care physicians about the importance of early detection and notification of cases of leishmaniasis, health education for raising awareness of the public regarding the vector and the disease is necessary because related studies have demonstrated that for inhabitants to take enough protective measures against the vector, they should perceive that it is responsible for causing a disease.

A Two-Stage Airport Ground Movement Speed Profile Design Methodology Using Particle Swarm Optimization

Automation of airport operations can greatly improve ground movement efficiency. In this paper, we study the speed profile design problem for advanced airport ground movement control and guidance. The problem is constrained by the surface four-dimensional trajectory generated in taxi planning. A decomposed approach of two stages is presented to solve this problem efficiently. In the first stage, speeds are allocated at control points, which ensure smooth speed profiles can be found later. In the second stage, detailed speed profiles of each taxi interval are generated according to the allocated control point speeds with the objective of minimizing the overall fuel consumption. We present a swarm intelligence based algorithm for the first-stage problem and a discrete variable driven enumeration method for the second-stage problem, since it only has a small set of discrete variables. Experimental results demonstrate the presented methodology performs well on real world speed profile design problems.

Personas Help Understand Users’ Needs, Goals and Desires in an Online Institutional Repository

Communicating users' needs, goals and problems help designers and developers overcome challenges faced by end users. Personas are used to represent end users’ needs. In our research, creating personas allowed the following questions to be answered: Who are the potential user groups? What do they want to achieve by using the service? What are the problems that users face? What should the service provide to them? To develop realistic personas, we conducted a focus group discussion with undergraduate and graduate students and also interviewed a university librarian. The personas were created to help evaluating the Institutional Repository that is based on the DSpace system. The profiles helped to communicate users' needs, abilities, tasks, and problems, and the task scenarios used in the heuristic evaluation were based on these personas. Four personas resulted of a focus group discussion with undergraduate and graduate students and from interviewing a university librarian. We then used these personas to create focused task-scenarios for a heuristic evaluation on the system interface to ensure that it met users' needs, goals, problems and desires. In this paper, we present the process that we used to create the personas that led to devise the task scenarios used in the heuristic evaluation as a follow up study of the DSpace university repository.

Determining Earthquake Performances of Existing Reinforced Concrete Buildings by Using ANN

In this study, an Artificial Neural Network (ANN) analytical method has been developed for analyzing earthquake performances of the Reinforced Concrete (RC) buildings. 66 RC buildings with four to ten storeys were subjected to performance analysis according to the parameters which are the existing material, loading and geometrical characteristics of the buildings. The selected parameters have been thought to be effective on the performance of RC buildings. In the performance analyses stage of the study, level of performance possible to be shown by these buildings in case of an earthquake was determined on the basis of the 4-grade performance levels specified in Turkish Earthquake Code-2007 (TEC-2007). After obtaining the 4-grade performance level, selected 23 parameters of each building have been matched with the performance level. In this stage, ANN-based fast evaluation algorithm mentioned above made an economic and rapid evaluation of four to ten storey RC buildings. According to the study, the prediction accuracy of ANN has been found about 74%.

Performance of Modified Wedge Anchorage System for Pre-Stressed FRP Bars

Fiber Reinforced Polymer (FRP) is a composite material with exceptional properties that are capable to replace conventional steel reinforcement in reinforced and pre-stressed concrete structures. However, the main obstacle for their wide use in pre-stressed concrete application is the anchorage system. Due to the weakness of FRP in the transverse direction, the pre-stressing capacity of FRP bars are limited. This paper investigates the modification of the conventional wedge anchorage system to be used for stressing of FRP bars in pre-stressed applications. Epoxy adhesive material with glass FRP (GFRP) bars and conventional steel wedge were used in this paper. The GFRP bars are encased with epoxy at the anchor zone and the wedge system was used in pull-out test. The results showed a loading capacity of 47.6 kN which is 69% of the bar ultimate capacity. Additionally, nylon wedge was made with the same dimensions of the steel wedge and tested for GFRP bars without epoxy layer. The nylon wedge showed a loading capacity of 19.7 kN which is only 28.5% of the ultimate bar capacity.

Quality Assessment of Hollow Sandcrete Blocks in Minna, Nigeria

The properties of hollow sandcrete blocks produced in Minna, Nigeria are presented. Sandcrete block is made of cement, water and sand binded together in certain mix proportions. For the purpose of this work, fifty (50) commercial sandcrete block industries were visited in Minna, Nigeria to obtain block samples and aggregates used for the manufacture, and to take inventory of the mix composition and the production process. Sieve analysis tests were conduction on the soil sample from various block industries to ascertain their quality to be used for block making. The mix ratios were also investigated. Five (5) nine inches (9’’ or 225mm) blocks were obtained from each block industry and tested for dimensional compliance and compressive strength. The results of the soil test shows that the grading fall within the limit for natural aggregate and can easily are used to obtain workable mix. Physical examinations of the block sizes show slight deviation from the standard requirement in NIS 87:2000. Compressive strength of hollow sandcrete blocks in range of 0.12 N/mm2 to 0.54 N/mm2 was obtained which is below the recommendable value of 3.45 N/mm2 for load bearing hollow sandcrete blocks. This indicates that these blocks are below the standard for load-bearing sandcrete blocks and cannot be used as load bearing walling units. The mix composition also indicated low cement content resulting in low compressive strength. Most of the commercial block industries visited does not take curing very serious. Water were only sprinkled ones or twice before the blocks were stacked and made readily available for sale. It is recommended that a mix ratio of 1:4 to 1:6 should be used for the production of sandcrete blocks and proper curing practice should be adhered. Blocks should also be cured for 14 days before making them available for consumers.

Application of Moringa oleifera Seed in Removing Colloids from Turbid Wastewater

The present study aims to investigate the performance of Moringa oleifera seed extract as natural coagulant in clarification of secondary wastewater treatment plant (MWWTP) located in East of Algiers, Algeria. Coagulation flocculation performance of Moringa oleifera was evaluated through supernatant residual turbidity after jar test trials. Various influence parameters namely Moringa oleifera dosage and pH have been considered. Tests on Reghaia wastewater, having 129 NTU of initial turbidity, showed a removal of 69.45% of residual turbidity with only 1.5 mg/l of Moringa oleifera. This sufficient removal capability encourages the use of this bioflocculant for treatment of turbid waters. Indeed, Moringa oleifera which is a natural resource available locally (South of Algeria) coupled to the non-toxicity, biocompatibility and biodegradability, may be a very interesting alternative to the conventional coagulants used so far.

Optimal Trajectory Finding of IDP Ventilation Control with Outdoor Air Information and Indoor Health Risk Index

This study was carried out for an underground subway station at Seoul Metro, Korea. The optimal set-points of the ventilation control system are determined every 3 hours, then, the ventilation controller adjusts the ventilation fan speed according to the optimal set-point changes. Compared to manual ventilation system which is operated irrespective of the OAQ, the IDP-based ventilation control system saves 3.7% of the energy consumption. Compared to the fixed set-point controller which is operated irrespective of the IAQ diurnal variation, the IDP-based controller shows better performance with a 2% decrease in energy consumption, maintaining the comfortable IAQ range inside the station.

The Role of Ionic Strength and Mineral Size to Zeta Potential for the Adhesion of P. putida to Mineral Surfaces

Electrostatic interaction energy (ΔEEDL) is a part of the Extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) theory, which, together with van der Waals (ΔEVDW) and acid base (ΔEAB) interaction energies, has been extensively used to investigate the initial adhesion of bacteria to surfaces. Electrostatic or electrical double layer interaction energy is considerably affected by surface potential; however it cannot be determined experimentally and is usually replaced by zeta (ζ) potential via electrophoretic mobility. This paper focusses on the effect of ionic concentration as a function of pH and the effect of mineral grain size on ζ potential. It was found that both ionic strength and mineral grain size play a major role in determining the value of ζ potential for the adhesion of P. putida to hematite and quartz surfaces. Higher ζ potential values lead to higher electrostatic interaction energies and eventually to higher total XDLVO interaction energy resulting in bacterial repulsion.

Evaluation of Fuel Properties of Six Tropical Hardwood Timber Species for Briquettes

The fuel potential of six tropical hardwood species namely: Triplochiton scleroxylon, Ceiba pentandra, Aningeria robusta, Terminalia superba, Celtis mildbreadii and Piptadenia africana were studied. Properties studied included species density, gross calorific value, volatile matter, ash content, organic carbon and elemental composition. Fuel properties were determined using standard laboratory methods. The result indicates that the gross calorific value (GCV) of the species ranged from 20.16 to 22.22 MJ/kg and they slightly varied from each other. Additionally, the GCV of the biomass materials were higher than that of other biomass materials like; wheat straw, rice straw, maize straw and sugar cane. The ash and volatile matter content varied from 0.6075 to 5.0407%, and 75.23% to 83.70% respectively. The overall rating of the properties of the six biomass materials suggested that Piptadenia africana has the best fuel property to be used as briquettes and Aningeria robusta the worse. This study therefore suggests that a holistic assessment of a biomass material needs to be done before selecting it for fuel purpose.

Competency-Based Social Work Practice and Challenges in Child Case Management: Studies in the Districts Social Welfare Services, Malaysia

This study aimed to explore the practical experience of child welfare caseworkers and professionalism in child case management in Malaysia. This paper discussed the specific social work practice competency and the challenges faced by child caseworkers in the fieldwork. This research was qualitative with grounded theory approach. Four sessions of focused group discussion (FGD) were conducted involving a total of 27 caseworkers (child protector and probation officers) in the Klang Valley. The study found that the four basic principles of knowledge in child case management namely: 1. knowledge in child case management; 2. professional values of caseworkers towards children; 3. skills in managing cases; and 4. culturally competent practice in child case management. In addition, major challenges faced by the child case manager are the capacity and commitment of the family in children’s rehabilitation program, the credibility of caseworkers are being challenged, and the challenges of support system from intra and interagency. This study is important for policy makers to take into account the capacity and the needs of the child’s caseworker in accordance with the national social work competency framework. It is expected that case management services for children will improve systematically in line with national standards.

Association between Job Satisfaction, Motivation and Five Factors of Organizational Citizenship Behavior

The research aims to study the association between job satisfaction, motivation and the five factors of organizational citizenship behavior (i.e. Altruism, Conscientiousness, Sportsmanship, Courtesy and Civic virtue) among Public Sector Employees in Pakistan. In this research Structure Equation Modeling with confirmatory factor analysis was used to test the relationship between two independent and five dependent variables. Data was collected through questionnaire survey from 152 Public Servants Working in Gujrat District-Pakistan in different capacities. Stratified Random Sampling Technique was used to conduct this survey. The results of the study indicate that five factors of OCB have positive significant relation with both motivation and job satisfaction except the relationship of Civic Virtue with Motivation. The research findings implicate that factors other than motivation and job satisfaction may also affect OCB. Likewise, all the five factors of OCB may not be present in all populations. Thus, Managers must concentrate on increasing motivation and job satisfaction to increase OCB. Furthermore, the present research gives a direction to future researchers to use more independent variables (e.g. Culture, leadership, workplace environment, various job attitudes, types of motivation, etc.) on different types of populations with larger sample size in order to find the reasons behind insignificant relationship of civic virtue with Motivation in the research in hand and to generalize the tested model.

An Investigation of Quality Practices in Libyan Industrial Companies

This paper describes the collection and analysis of data obtained from face-to-face interviews conducted in selected Libyan industrial companies. The objectives of the interviews are to enhance understanding, and generate explanations of current issues in culture and quality management systems in Libyan companies. The method used in analyzing the questions, as well as the main finding of each question are explained. The interviews probed areas identify national and organizational culture, quality management systems, current methods, effects, barriers and other factors affecting the success of quality management implementation. Eleven questions are prepared and been discussed with the interviewees.

Safety Study of Intravenously Administered Human Cord Blood Stem Cells in the Treatment of Symptoms Related to Chronic Inflammation

Numerous investigations suggest that Mesenchymal Stem Cells (MSCs) in general represent a valuable tool for therapy of symptoms related to chronic inflammatory diseases. Blue Horizon Stem Cell Therapy Program is a leading provider of adult and children’s stem cell therapies. Uniquely we have safely and efficiently treated more than 600 patients with documenting each procedure. The purpose of our study is primarily to monitor the immune response in order to validate the safety of intravenous infusion of human umbilical cord blood derived MSCs (UC-MSCs), and secondly, to evaluate effects on biomarkers associated with chronic inflammation. Nine patients were treated for conditions associated with chronic inflammation and for the purpose of antiaging. They have been given one intravenous infusion of UCMSCs. Our study of blood test markers of 9 patients with chronic inflammation before and within three months after MSCs treatment demonstrates that there is no significant changes and MSCs treatment was safe for the patients. Analysis of different indicators of chronic inflammation and aging included in initial, 24-hours, two weeks and three months protocols showed that stem cell treatment was safe for the patients; there were no adverse reactions. Moreover data from follow up protocols demonstrates significant improvement in energy level, hair, nails growth and skin conditions. Intravenously administered UC-MSCs were safe and effective in the improvement of symptoms related to chronic inflammation. Further close monitoring and inclusion of more patients are necessary to fully characterize the advantages of UC-MSCs application in treatment of symptoms related to chronic inflammation.

A Teaching Learning Based Optimization for Optimal Design of a Hybrid Energy System

This paper introduces a method to optimal design of a hybrid Wind/Photovoltaic/Fuel cell generation system for a typical domestic load that is not located near the electricity grid. In this configuration the combination of a battery, an electrolyser, and a hydrogen storage tank are used as the energy storage system. The aim of this design is minimization of overall cost of generation scheme over 20 years of operation. The Matlab/Simulink is applied for choosing the appropriate structure and the optimization of system sizing. A teaching learning based optimization is used to optimize the cost function. An overall power management strategy is designed for the proposed system to manage power flows among the different energy sources and the storage unit in the system. The results have been analyzed in terms of technical and economic. The simulation results indicate that the proposed hybrid system would be a feasible solution for stand-alone applications at remote locations.

Music for Peace, a Model for Socialization

This study discusses a Turkish music education model similar to its Venezuelan counterpart El Sistema, in which socialization and human development are the main goals. The Music for Peace (Baris Icin Muzik) model, founded in 2005 by an idealist humanitarian in Istanbul, started as a pilot project with accordion and today makes symphonic music education. The program aims to offer social change through free-of-charge. In such a big city like Istanbul, in a deprived inner city center people have poor economic, social and cultural conditions. In that Edirnekapi district people don’t have opportunities to join the cultural and social life, like music or sports. It is believed that this initiative covered a part of this gap by giving children the opportunities to participate in social and cultural life. In this study it is planned to understand what social changes could music education could make in children’s lives. In the complimentary music lessons children works in groups, which helps them to learn the feelings of solidarity, friendship, communion and sharing. By Music for Peace project children connect with the community, they have the belief to succeed in life because they feel that they are loved by their friends, instructors and families. In short they feel that they are important, thus brings the success in life. Additionally, it is believed that, this program has achieved success. Today approximately 400 children participate in this programs orchestras and choirs. Some of the students get into the conservatories. And the center is not just a place where they get music lessons but also a place where they get socialized. And music education helps children to have strong sense of identity, self-confidence and self-esteem.

Relation between Properties of Internally Cured Concrete and Water Cement Ratio

In this paper, relationship between different properties of IC concrete and water cement ratio, obtained from a comprehensive experiment conducted on IC using local materials (Burnt clay chips- BC) is presented. In addition, saturated SAP was used as an IC material in some cases. Relationships have been developed through regression analysis. The focus of this analysis is on developing relationship between a dependent variable and an independent variable. Different percent replacements of BC and water cement ratios were used. Compressive strength, modulus of elasticity, water permeability and chloride permeability were tested and variations of these parameters were analyzed with respect to water cement ratio.

Clinical Comparative Study Comparing Efficacy of Intrathecal Fentanyl and Magnesium as an Adjuvant to Hyperbaric Bupivacaine in Mild Pre-Eclamptic Patients Undergoing Caesarean Section

Adequate analgesia following caesarean section decreases morbidity, hastens ambulation, improves patient outcome and facilitates care of the newborn. Intrathecal magnesium, an NMDA antagonist, has been shown to prolong analgesia without significant side effects in healthy parturients. The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of magnesium or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine in patients with mild preeclampsia undergoing caesarean section. Sixty women with mild preeclampsia undergoing elective caesarean section were included in a prospective, double blind, controlled trial. Patients were randomly assigned to receive spinal anesthesia with 2 mL 0.5% hyperbaric bupivacaine with 12.5 μg fentanyl (group F) or 0.1 ml of 50% magnesium sulphate (50 mg) (group M) with 0.15ml preservative free distilled water. Onset, duration and recovery of sensory and motor block, time to maximum sensory block, duration of spinal anaesthesia and postoperative analgesic requirements were studied. Statistical comparison was carried out using the Chi-square or Fisher’s exact tests and Independent Student’s t-test where appropriate. The onset of both sensory and motor block was slower in the magnesium group. The duration of spinal anaesthesia (246 vs. 284) and motor block (186.3 vs. 210) were significantly longer in the magnesium group. Total analgesic top up requirement was less in group M. Hemodynamic parameters were similar in both the groups. Intrathecal magnesium caused minimal side effects. Since Fentanyl and other opioid congeners are not available throughout the country easily, magnesium with its easy availability and less side effect profile can be a cost effective alternative to fentanyl in managing pregnancy induced hypertension (PIH) patients given along with Bupivacaine intrathecally in caesarean section.