CAGE Questionnaire as a Screening Tool for Hazardous Drinking in an Acute Admissions Ward: Frequency of Application and Comparison with AUDIT-C Questionnaire

The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

An Investigation of Current Potato Nitrogen Fertility Programs' Contribution to Ground Water Contamination

Nitrogen fertility is an important component for optimum potato yield and quality. Best management practices are necessary in regards to N applications to achieve these goals without applying excess N with may contribute to ground water contamination. Eight potato fields in the Southern San Joaquin Valley were sampled for nitrogen inputs and uptake, tuber and vine dry matter and residual soil nitrate-N. The fields had substantial soil nitrate-N prior to the potato crop. Nitrogen fertilizer was applied prior to planting and in irrigation water as needed based on in-season petiole sampling in accordance with published recommendations. Average total nitrogen uptake was 237 kg ha-1 on 63.5 Mg ha-1 tuber yield and nitrogen use efficiency was very good at 81 percent. Sixty-nine percent of the plant nitrogen was removed in tubers. Soil nitrate-N increased 14 percent from pre-plant to post-harvest averaged across all fields and was generally situated in the upper soil profile. Irrigation timing and amount applied did not move water into the lower profile except for a single location where nitrate also moved into the lower soil profile. Pre-plant soil analysis is important information to be used. Rotation crops having deeper rooting growth would be able to utilize nitrogen that remained in the soil profile.

Communicating with Spirits: Bridging the Nether World of Spirits and the Real World in Healing Performances

Traditional Malay performances are carried out for both entertainment and curing purposes. In curing rituals, the men and women serving as shamans, communicates with the spirits and beings from the nether world to facilitate the curing process. The dependency on engaging with these other-worldly beings however, have raised religious issues of being syirik, namely practicing in rituals which are religiously forbidden. This study aims to observe how ritual leaders attempt to negotiate the fine balance between what has been religiously forbidden and the psychological and sociological needs of the patient. Two curing rituals, the main peteri and the malibobou were chosen to exemplify the communication between the physical and spiritual realities. In both rituals, the healers engaged in procedures of curing as they attempted to diagnose sicknesses and proffer cures with the help of the spirits. The main peteri was conducted by a male shaman, the tuk teri whereas the malibobou was conducted by a female ritual specialist, the bobohizan. Main peteri and the malibobou both ended with ritually thanking and sending off the spirits back to their nether, invisible domains. These curing rituals heal not only the sick individual, but by extension, the village community. Therefore, there is a need to reconcile these rituals with religious tenets, beliefs and sociological-political-cultural dimensions.

Occurrence of Foreign Matter in Food: Applied Identification Method - Association of Official Agricultural Chemists (AOAC) and Food and Drug Administration (FDA)

The aim of this study is to present the results of a retrospective survey on the foreign matter found in foods analyzed at the Adolfo Lutz Institute, from July 2001 to July 2015. All the analyses were conducted according to the official methods described on Association of Official Agricultural Chemists (AOAC) for the micro analytical procedures and Food and Drug Administration (FDA) for the macro analytical procedures. The results showed flours, cereals and derivatives such as baking and pasta products were the types of food where foreign matters were found more frequently followed by condiments and teas. Fragments of stored grains insects, its larvae, nets, excrement, dead mites and rodent excrement were the most foreign matter found in food. Besides, foreign matters that can cause a physical risk to the consumer’s health such as metal, stones, glass, wood were found but rarely. Miscellaneous (shell, sand, dirt and seeds) were also reported. There are a lot of extraneous materials that are considered unavoidable since are something inherent to the product itself, such as insect fragments in grains. In contrast, there are avoidable extraneous materials that are less tolerated because it is preventable with the Good Manufacturing Practice. The conclusion of this work is that although most extraneous materials found in food are considered unavoidable it is necessary to keep the Good Manufacturing Practice throughout the food processing as well as maintaining a constant surveillance of the production process in order to avoid accidents that may lead to occurrence of these extraneous materials in food.

A Framework for Early Differential Diagnosis of Tropical Confusable Diseases Using the Fuzzy Cognitive Map Engine

The overarching aim of this study is to develop a soft-computing system for the differential diagnosis of tropical diseases. These conditions are of concern to health bodies, physicians, and the community at large because of their mortality rates, and difficulties in early diagnosis due to the fact that they present with symptoms that overlap, and thus become ‘confusable’. We report on the first phase of our study, which focuses on the development of a fuzzy cognitive map model for early differential diagnosis of tropical diseases. We used malaria as a case disease to show the effectiveness of the FCM technology as an aid to the medical practitioner in the diagnosis of tropical diseases. Our model takes cognizance of manifested symptoms and other non-clinical factors that could contribute to symptoms manifestations. Our model showed 85% accuracy in diagnosis, as against the physicians’ initial hypothesis, which stood at 55% accuracy. It is expected that the next stage of our study will provide a multi-disease, multi-symptom model that also improves efficiency by utilizing a decision support filter that works on an algorithm, which mimics the physician’s diagnosis process.

Software Engineering Inspired Cost Estimation for Process Modelling

Up to this point business process management projects in general and business process modelling projects in particular could not rely on a practical and scientifically validated method to estimate cost and effort. Especially the model development phase is not covered by a cost estimation method or model. Further phases of business process modelling starting with implementation are covered by initial solutions which are discussed in the literature. This article proposes a method of filling this gap by deriving a cost estimation method from available methods in similar domains namely software development or software engineering. Software development is regarded as closely similar to process modelling as we show. After the proposition of this method different ideas for further analysis and validation of the method are proposed. We derive this method from COCOMO II and Function Point which are established methods of effort estimation in the domain of software development. For this we lay out similarities of the software development process and the process of process modelling which is a phase of the Business Process Management life-cycle.

Study of Pre-Handwriting Factors Necessary for Successful Handwriting in Children

Handwriting is essential to academic success; however, the current literature is limited in the identification of pre-handwriting skills. The purpose of this study was to identify the pre-handwriting skills, which occupational therapy practitioners deem important to handwriting success, as well as those which aid in intervention planning. The online survey instrument consisted of 33 questions that assessed various skills related to the development of handwriting, as well as captured demographic information. Both occupational therapists and occupational therapy assistants were included in the survey study. The survey found that the respondents were in agreement that purposeful scribbling, the ability of a child to copy (vertical/horizontal lines, circle, squares, and triangles), imitating an oblique cross, cognitive skills (attention, praxis, self-regulation, sequencing), grasp patterns, hand dominance, in hand manipulation skills (shift, translation, rotation), bilateral integration, stabilization of paper, crossing midline, and visual perception were important indicators of handwriting readiness. The results of the survey support existing research regarding the skills necessary for the successful development of handwriting in children.

Neighborhood Sustainability Assessment Tools: A Conceptual Framework for Their Use in Building Adaptive Capacity to Climate Change

Climate change remains a challenging matter for the human and the built environment in the 21st century, where the need to consider adaptation to climate change in the development process is paramount. However, there remains a lack of information regarding how we should prepare responses to this issue, such as through developing organized and sophisticated tools enabling the adaptation process. This study aims to build a systematic framework approach to investigate the potentials that Neighborhood Sustainability Assessment tools (NSA) might offer in enabling both the analysis of the emerging adaptive capacity to climate change. The analysis of the framework presented in this paper aims to discuss this issue in three main phases. The first part attempts to link sustainability and climate change, in the context of adaptive capacity. It is argued that in deciding to promote sustainability in the context of climate change, both the resilience and vulnerability processes become central. However, there is still a gap in the current literature regarding how the sustainable development process can respond to climate change. As well as how the resilience of practical strategies might be evaluated. It is suggested that the integration of the sustainability assessment processes with both the resilience thinking process, and vulnerability might provide important components for addressing the adaptive capacity to climate change. A critical review of existing literature is presented illustrating the current lack of work in this field, integrating these three concepts in the context of addressing the adaptive capacity to climate change. The second part aims to identify the most appropriate scale at which to address the built environment for the climate change adaptation. It is suggested that the neighborhood scale can be considered as more suitable than either the building or urban scales. It then presents the example of NSAs, and discusses the need to explore their potential role in promoting the adaptive capacity to climate change. The third part of the framework presents a comparison among three example NSAs, BREEAM Communities, LEED-ND, and CASBEE-UD. These three tools have been selected as the most developed and comprehensive assessment tools that are currently available for the neighborhood scale. This study concludes that NSAs are likely to present the basis for an organized framework to address the practical process for analyzing and yet promoting Adaptive Capacity to Climate Change. It is further argued that vulnerability (exposure & sensitivity) and resilience (Interdependence & Recovery) form essential aspects to be addressed in the future assessment of NSA’s capability to adapt to both short and long term climate change impacts. Finally, it is acknowledged that further work is now required to understand impact assessment in terms of the range of physical sectors (Water, Energy, Transportation, Building, Land Use and Ecosystems), Actor and stakeholder engagement as well as a detailed evaluation of the NSA indicators, together with a barriers diagnosis process.

Comparative Study of IC and Perturb and Observe Method of MPPT Algorithm for Grid Connected PV Module

The purpose of this paper is to study and compare two maximum power point tracking (MPPT) algorithms in a photovoltaic simulation system and also show a simulation study of maximum power point tracking (MPPT) for photovoltaic systems using perturb and observe algorithm and Incremental conductance algorithm. Maximum power point tracking (MPPT) plays an important role in photovoltaic systems because it maximize the power output from a PV system for a given set of conditions, and therefore maximize the array efficiency and minimize the overall system cost. Since the maximum power point (MPP) varies, based on the irradiation and cell temperature, appropriate algorithms must be utilized to track the (MPP) and maintain the operation of the system in it. MATLAB/Simulink is used to establish a model of photovoltaic system with (MPPT) function. This system is developed by combining the models established of solar PV module and DC-DC Boost converter. The system is simulated under different climate conditions. Simulation results show that the photovoltaic simulation system can track the maximum power point accurately.

Budget Optimization for Maintenance of Bridges in Egypt

Allocating limited budget to maintain bridge networks and selecting effective maintenance strategies for each bridge represent challenging tasks for maintenance managers and decision makers. In Egypt, bridges are continuously deteriorating. In many cases, maintenance works are performed due to user complaints. The objective of this paper is to develop a practical and reliable framework to manage the maintenance, repair, and rehabilitation (MR&R) activities of Bridges network considering performance and budget limits. The model solves an optimization problem that maximizes the average condition of the entire network given the limited available budget using Genetic Algorithm (GA). The framework contains bridge inventory, condition assessment, repair cost calculation, deterioration prediction, and maintenance optimization. The developed model takes into account multiple parameters including serviceability requirements, budget allocation, element importance on structural safety and serviceability, bridge impact on network, and traffic. A questionnaire is conducted to complete the research scope. The proposed model is implemented in software, which provides a friendly user interface. The framework provides a multi-year maintenance plan for the entire network for up to five years. A case study of ten bridges is presented to validate and test the proposed model with data collected from Transportation Authorities in Egypt. Different scenarios are presented. The results are reasonable, feasible and within acceptable domain.

Stress Analysis of Water Wall Tubes of a Coal-fired Boiler during Soot Blowing Operation

This research aimed to study the influences of a soot blowing operation and geometrical variables to the stress characteristic of water wall tubes located in soot blowing areas which caused the boilers of Mae Moh power plant to lose their generation hour. The research method is divided into 2 parts (a) measuring the strain on water wall tubes by using 3-element rosette strain gages orientation during a full capacity plant operation and in periods of soot blowing operations (b) creating a finite element model in order to calculate stresses on tubes and validating the model by using experimental data in a steady state plant operation. Then, the geometrical variables in the model were changed to study stresses on the tubes. The results revealed that the stress was not affected by the soot blowing process and the finite element model gave the results 1.24% errors from the experiment. The geometrical variables influenced the stress, with the most optimum tubes design in this research reduced the average stress from the present design 31.28%.

Art and Culture in the Development Period to Modernization in the Reign of King Rama VI

The growth of Thai society in western style in the middle of Rattanakosin period can be defined as modernization /civilization. These terms had an influence on the development of the country in the reign of King Rama V owing to the governance reform, and cultures influenced by the West. Those were passed on until the reign of King Rama VI. The preference was not only for the renovation of architecture and arts based on Thai customs reflecting the prosperity and beauty of handicrafts but also for the acceptance of westernization. The remain of this acceptance includes the concept of such value as gentlemanly behavior like that in Victorian Era of the United Kingdom, and the support of women’s status. Moreover, the wide spread of modernization leads to the movement to change the country’s governance system from absolute monarchy to democracy by a group of people called Rattanakosin Era (R.E.) 130 party.

Model Studies on Shear Behavior of Reinforced Reconstituted Clay

In this paper, shear behavior of reconstituted clay reinforced with varying diameter of sand compaction piles with area replacement-ratio (as) of 6.25, 10.24, 16, 20.25 and 64% in 100mm diameter and 200mm long clay specimens is modeled using consolidated drained and undrained triaxial tests under different confining pressures ranging from 50kPa to 575kPa. The test results show that the stress-strain behavior of the clay was highly influenced by the presence of SCP. The insertion of SCPs into soft clay has shown to have a positive effect on the load carrying capacity of the clay, resulting in a composite soil mass that has greater shear strength and improved stiffness compared to the unreinforced clay due to increased reinforcement area ratio. In addition, SCP also acts as vertical drain in the clay thus accelerating the dissipation of excess pore water pressures that are generated during loading by shortening the drainage path and activating radial drainage, thereby reducing post-construction settlement. Thus, sand compaction piles currently stand as one of the most viable and practical techniques for improving the mechanical properties of soft clays.

Optimal Network of Secondary Warehouses for Production-Distribution Inventory Model

This work proposed a multi-objective mathematical programming approach to select the appropriate supply network elements. The multi-item multi-objective production-distribution inventory model is formulated with possible constraints under fuzzy environment. The unit cost has taken under fuzzy environment. The inventory model and warehouse location model has combined to formulate the production-distribution inventory model. Warehouse location is important in supply chain network. Particularly, if a company maintains more selling stores it cannot maintain individual secondary warehouse near to each selling store. Hence, maintaining the optimum number of secondary warehouses is important. Hence, the combined mathematical model is formulated to reduce the total expenditure of the organization by arranging the network of minimum number of secondary warehouses. Numerical example has been taken to illustrate the proposed model.

Building Information Modeling and Its Application in the State of Kuwait

Recent advances of Building Information Modeling (BIM) especially in the Middle East have increased remarkably. Dubai has been taking a lead on this by making it mandatory for BIM to be adopted for all projects that involve complex architecture designs. This is because BIM is a dynamic process that assists all stakeholders in monitoring the project status throughout different project phases with great transparency. It focuses on utilizing information technology to improve collaboration among project participants during the entire life cycle of the project from the initial design, to the supply chain, resource allocation, construction and all productivity requirements. In view of this trend, the paper examines the extent of applying BIM in the State of Kuwait, by exploring practitioners’ perspectives on BIM, especially their perspectives on main barriers and main advantages. To this end structured interviews were carried out based on questionnaires and with a range of different construction professionals. The results revealed that practitioners perceive improved communication and mitigated project risks by encouraged collaboration between project participants. However, it was also observed that the full implementation of BIM in the State of Kuwait requires concerted efforts to make clients demanding BIM, counteract resistance to change among construction professionals and offer more training for design team members. This paper forms part of an on-going research effort on BIM and its application in the State of Kuwait and it is on this basis that further research on the topic is proposed.

Analytical Slope Stability Analysis Based on the Statistical Characterization of Soil Shear Strength

Increasing our ability to solve complex engineering problems is directly related to the processing capacity of computers. By means of such equipments, one is able to fast and accurately run numerical algorithms. Besides the increasing interest in numerical simulations, probabilistic approaches are also of great importance. This way, statistical tools have shown their relevance to the modelling of practical engineering problems. In general, statistical approaches to such problems consider that the random variables involved follow a normal distribution. This assumption tends to provide incorrect results when skew data is present since normal distributions are symmetric about their means. Thus, in order to visualize and quantify this aspect, 9 statistical distributions (symmetric and skew) have been considered to model a hypothetical slope stability problem. The data modeled is the friction angle of a superficial soil in Brasilia, Brazil. Despite the apparent universality, the normal distribution did not qualify as the best fit. In the present effort, data obtained in consolidated-drained triaxial tests and saturated direct shear tests have been modeled and used to analytically derive the probability density function (PDF) of the safety factor of a hypothetical slope based on Mohr-Coulomb rupture criterion. Therefore, based on this analysis, it is possible to explicitly derive the failure probability considering the friction angle as a random variable. Furthermore, it is possible to compare the stability analysis when the friction angle is modelled as a Dagum distribution (distribution that presented the best fit to the histogram) and as a Normal distribution. This comparison leads to relevant differences when analyzed in light of the risk management.

Exploring Counting Methods for the Vertices of Certain Polyhedra with Uncertainties

Vertex Enumeration Algorithms explore the methods and procedures of generating the vertices of general polyhedra formed by system of equations or inequalities. These problems of enumerating the extreme points (vertices) of general polyhedra are shown to be NP-Hard. This lead to exploring how to count the vertices of general polyhedra without listing them. This is also shown to be #P-Complete. Some fully polynomial randomized approximation schemes (fpras) of counting the vertices of some special classes of polyhedra associated with Down-Sets, Independent Sets, 2-Knapsack problems and 2 x n transportation problems are presented together with some discovered open problems.

Development of a Secured Telemedical System Using Biometric Feature

Access to advanced medical services has been one of the medical challenges faced by our present society especially in distant geographical locations which may be inaccessible. Then the need for telemedicine arises through which live videos of a doctor can be streamed to a patient located anywhere in the world at any time. Patients’ medical records contain very sensitive information which should not be made accessible to unauthorized people in order to protect privacy, integrity and confidentiality. This research work focuses on a more robust security measure which is biometric (fingerprint) as a form of access control to data of patients by the medical specialist/practitioner.

Streamwise Vorticity in the Wake of a Sliding Bubble

In many practical situations, bubbles are dispersed in a liquid phase. Understanding these complex bubbly flows is therefore a key issue for applications such as shell and tube heat exchangers, mineral flotation and oxidation in water treatment. Although a large body of work exists for bubbles rising in an unbounded medium, that of bubbles rising in constricted geometries has received less attention. The particular case of a bubble sliding underneath an inclined surface is common to two-phase flow systems. The current study intends to expand this knowledge by performing experiments to quantify the streamwise flow structures associated with a single sliding air bubble under an inclined surface in quiescent water. This is achieved by means of two-dimensional, two-component particle image velocimetry (PIV), performed with a continuous wave laser and high-speed camera. PIV vorticity fields obtained in a plane perpendicular to the sliding surface show that there is significant bulk fluid motion away from the surface. The associated momentum of the bubble means that this wake motion persists for a significant time before viscous dissipation. The magnitude and direction of the flow structures in the streamwise measurement plane are found to depend on the point on its path through which the bubble enters the plane. This entry point, represented by a phase angle, affects the nature and strength of the vortical structures. This study reconstructs the vorticity field in the wake of the bubble, converting the field at different instances in time to slices of a large-scale wake structure. This is, in essence, Taylor’s ”frozen turbulence” hypothesis. Applying this to the vorticity fields provides a pseudo three-dimensional representation from 2-D data, allowing for a more intuitive understanding of the bubble wake. This study provides insights into the complex dynamics of a situation common to many engineering applications, particularly shell and tube heat exchangers in the nucleate boiling regime.

Factors Affecting M-Government Deployment and Adoption

Governments constantly seek to offer faster, more secure, efficient and effective services for their citizens. Recent changes and developments to communication services and technologies, mainly due the Internet, have led to immense improvements in the way governments of advanced countries carry out their interior operations Therefore, advances in e-government services have been broadly adopted and used in various developed countries, as well as being adapted to developing countries. The implementation of advances depends on the utilization of the most innovative structures of data techniques, mainly in web dependent applications, to enhance the main functions of governments. These functions, in turn, have spread to mobile and wireless techniques, generating a new advanced direction called m-government. This paper discusses a selection of available m-government applications and several business modules and frameworks in various fields. Practically, the m-government models, techniques and methods have become the improved version of e-government. M-government offers the potential for applications which will work better, providing citizens with services utilizing mobile communication and data models incorporating several government entities. Developing countries can benefit greatly from this innovation due to the fact that a large percentage of their population is young and can adapt to new technology and to the fact that mobile computing devices are more affordable. The use of models of mobile transactions encourages effective participation through the use of mobile portals by businesses, various organizations, and individual citizens. Although the application of m-government has great potential, it does have major limitations. The limitations include: the implementation of wireless networks and relative communications, the encouragement of mobile diffusion, the administration of complicated tasks concerning the protection of security (including the ability to offer privacy for information), and the management of the legal issues concerning mobile applications and the utilization of services.