Assessing the Impact of High Fidelity Human Patient Simulation on Teamwork among Nursing, Medicine and Pharmacy Undergraduate Students

High fidelity human patient simulation has been used for many years by health sciences education programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork among nursing, medicine and pharmacy undergraduate students. This study compared the impact of high fidelity and low fidelity simulation education on teamwork among nursing, medicine and pharmacy students. For the purpose of this study, two innovative teaching scenarios were developed based on the care of an adult patient experiencing acute anaphylaxis: one high fidelity using a human patient simulator and one low fidelity using case based discussions. A within subjects, pretest-posttest, repeated measures design was used with two-treatment levels and random assignment of individual subjects to teams of two or more professions. A convenience sample of twenty-four (n=24) undergraduate students participated, including: nursing (n=11), medicine (n=9), and pharmacy (n=4). The Interprofessional Teamwork Questionnaire was used to assess for changes in students’ perception of their functionality within the team, importance of interprofessional collaboration, comprehension of roles, and confidence in communication and collaboration. Student satisfaction was also assessed. Students reported significant improvements in their understanding of the importance of interprofessional teamwork and of the roles of nursing and medicine on the team after participation in both the high fidelity and the low fidelity simulation. However, only participants in the high fidelity simulation reported a significant improvement in their ability to function effectively as a member of the team. All students reported that both simulations were a meaningful learning experience and all students would recommend both experiences to other students. These findings suggest there is merit in both high fidelity and low fidelity simulation as a teaching and learning approach to foster teamwork among undergraduate nursing, medicine and pharmacy students. However, participation in high fidelity simulation may provide a more realistic opportunity to practice and function as an effective member of the interprofessional health care team.

Analysis of the Operational Performance of Three Unconventional Arterial Intersection Designs: Median U-Turn, Superstreet and Single Quadrant

This paper is aimed to evaluate and compare the operational performance of three Unconventional Arterial Intersection Designs (UAIDs) including Median U-Turn, Superstreet, and Single Quadrant Intersection using real traffic data. For this purpose, the heavily congested signalized intersection of Wadi Saqra in Amman was selected. The effect of implementing each of the proposed UAIDs was not only evaluated on the isolated Wadi Saqra signalized intersection, but also on the arterial road including both surrounding intersections. The operational performance of the isolated intersection was based on the level of service (LOS) expressed in terms of control delay and volume to capacity ratio. On the other hand, the measures used to evaluate the operational performance on the arterial road included traffic progression, stopped delay per vehicle, number of stops and the travel speed. The analysis was performed using SYNCHRO 8 microscopic software. The simulation results showed that all three selected UAIDs outperformed the conventional intersection design in terms of control delay but only the Single Quadrant Intersection design improved the main intersection LOS from F to B. Also, the results indicated that the Single Quadrant Intersection design resulted in an increase in average travel speed by 52%, and a decrease in the average stopped delay by 34% on the selected corridor when compared to the corridor with conventional intersection design. On basis of these results, it can be concluded that the Median U-Turn and the Superstreet do not perform the best under heavy traffic volumes.

Development and Validation of an Instrument Measuring the Coping Strategies in Situations of Stress

Stress causes deleterious effects to the physical, psychological and organizational levels, which highlight the need to use effective coping strategies to deal with it. Several coping models exist, but they don’t integrate the different strategies in a coherent way nor do they take into account the new research on the emotional coping and acceptance of the stressful situation. To fill these gaps, an integrative model incorporating the main coping strategies was developed. This model arises from the review of the scientific literature on coping and from a qualitative study carried out among workers with low or high levels of stress, as well as from an analysis of clinical cases. The model allows one to understand under what circumstances the strategies are effective or ineffective and to learn how one might use them more wisely. It includes Specific Strategies in controllable situations (the Modification of the Situation and the Resignation-Disempowerment), Specific Strategies in non-controllable situations (Acceptance and Stubborn Relentlessness) as well as so-called General Strategies (Wellbeing and Avoidance). This study is intended to undertake and present the process of development and validation of an instrument to measure coping strategies based on this model. An initial pool of items has been generated from the conceptual definitions and three expert judges have validated the content. Of these, 18 items have been selected for a short form questionnaire. A sample of 300 students and employees from a Quebec university was used for the validation of the questionnaire. Concerning the reliability of the instrument, the indices observed following the inter-rater agreement (Krippendorff’s alpha) and the calculation of the coefficients for internal consistency (Cronbach's alpha) are satisfactory. To evaluate the construct validity, a confirmatory factor analysis using MPlus supports the existence of a model with six factors. The results of this analysis suggest also that this configuration is superior to other alternative models. The correlations show that the factors are only loosely related to each other. Overall, the analyses carried out suggest that the instrument has good psychometric qualities and demonstrates the relevance of further work to establish predictive validity and reconfirm its structure. This instrument will help researchers and clinicians better understand and assess coping strategies to cope with stress and thus prevent mental health issues.

Machine Learning Methods for Network Intrusion Detection

Network security engineers work to keep services available all the time by handling intruder attacks. Intrusion Detection System (IDS) is one of the obtainable mechanisms that is used to sense and classify any abnormal actions. Therefore, the IDS must be always up to date with the latest intruder attacks signatures to preserve confidentiality, integrity, and availability of the services. The speed of the IDS is a very important issue as well learning the new attacks. This research work illustrates how the Knowledge Discovery and Data Mining (or Knowledge Discovery in Databases) KDD dataset is very handy for testing and evaluating different Machine Learning Techniques. It mainly focuses on the KDD preprocess part in order to prepare a decent and fair experimental data set. The J48, MLP, and Bayes Network classifiers have been chosen for this study. It has been proven that the J48 classifier has achieved the highest accuracy rate for detecting and classifying all KDD dataset attacks, which are of type DOS, R2L, U2R, and PROBE.

Longitudinal Vibration of a Micro-Beam in a Micro-Scale Fluid Media

In this paper, longitudinal vibration of a micro-beam in micro-scale fluid media has been investigated. The proposed mathematical model for this study is made up of a micro-beam and a micro-plate at its free end. An AC voltage is applied to the pair of piezoelectric layers on the upper and lower surfaces of the micro-beam in order to actuate it longitudinally. The whole structure is bounded between two fixed plates on its upper and lower surfaces. The micro-gap between the structure and the fixed plates is filled with fluid. Fluids behave differently in micro-scale than macro, so the fluid field in the gap has been modeled based on micro-polar theory. The coupled governing equations of motion of the micro-beam and the micro-scale fluid field have been derived. Due to having non-homogenous boundary conditions, derived equations have been transformed to an enhanced form with homogenous boundary conditions. Using Galerkin-based reduced order model, the enhanced equations have been discretized over the beam and fluid domains and solve simultaneously in order to obtain force response of the micro-beam. Effects of micro-polar parameters of the fluid as characteristic length scale, coupling parameter and surface parameter on the response of the micro-beam have been studied.

Surface Modification of Titanium Alloy with Laser Treatment

The effect of laser surface treatment parameters on the residual strength of titanium alloy has been investigated. The influence of the laser surface treatment on the bonding strength between the titanium and poly-ether-ketone-ketone (PEKK) surfaces was also evaluated and compared to those offered by titanium foils without surface treatment to optimize the laser parameters. Material characterization using an optical microscope was carried out to study the microstructure and to measure the mean roughness value of the titanium surface. The results showed that the surface roughness shows a significant dependency on the laser power parameters in which surface roughness increases with the laser power increment. Moreover, the results of the tensile tests have shown that there is no significant dropping in tensile strength for the treated samples comparing to the virgin ones. In order to optimize the laser parameter as well as the corresponding surface roughness, single-lap shear tests were conducted on pairs of the laser treated titanium stripes. The results showed that the bonding shear strength between titanium alloy and PEKK film increased with the surface roughness increment to a specific limit. After this point, it is interesting to note that there was no significant effect for the laser parameter on the bonding strength. This evidence suggests that it is not necessary to use very high power of laser to treat titanium surface to achieve a good bonding strength between titanium alloy and the PEKK film.

Investigating Elements of Identity of Traditional Neighborhoods in Isfahan and Using These Elements in the Design of Modern Neighborhoods

The process of planning, designing and building neighborhoods is a complex and multidimensional part of urban planning. Understanding the elements that give a neighborhood a sense of identity can lead to successful city planning and result in a cohesive and functional community where people feel a sense of belonging. These factors are important in ensuring that the needs of the urban population are met to live in a safe, pleasant and healthy society. This research paper aims to identify the elements of the identity of traditional neighborhoods in Isfahan and analyzes ways of using these elements in the design of modern neighborhoods to increase social interaction between communities and cultural reunification of people. The neighborhood of Jolfa in Isfahan has a unique socio-cultural identity as it dates back to the Safavid Dynasty of the 16th century, and most of its inhabitants are Christian Armenians of a religious minority. The elements of the identity of Jolfa were analyzed through the following research methods: field observations, distribution of questionnaires and qualitative analysis. The basic methodology that was used to further understand the Jolfa neighborhood and deconstruct the identity image that residents associate with their respective neighborhoods was a qualitative research method. This was done through utilizing questionnaires that respondents had to fill out in response to a series of research questions. From collecting these qualitative data, the major finding was that traditional neighborhoods that have elements of identity embedded in them are seen to have closer-knit communities whose residents have strong societal ties. This area of study in urban planning is vital to ensuring that new neighborhoods are built with concepts of social cohesion, community and inclusion in mind as they are what lead to strong, connected, and prosperous societies.

Impact of Brand Origin on Brand Loyalty: A Case of Personal Care Products in Pakistan

As the world is progressing, the needs and demands of the consumer market are also changing. Nowadays the trends of consumer purchase decisions are dependent upon multiple factors. This study aims to identify the influential impact of country of origin over the perception and devotion towards daily personal care products specifically in reference to the knowledge and awareness regarding that particular brand in Pakistan. To corroborate this study, a 30-item brand origin questionnaire has been used with 300 purchase decision makers belonging to different age groups. To illustrate this study, a model has been developed based on brand origin, brand awareness and brand loyalty. Correlation and regression analysis have been used to find out the results which conclude the findings on the perspective of Pakistan’s consumer market as that brand origin has a direct relationship with brand loyalty provided that the consumer has a positive brand awareness. Support for the fact that brand origin impacts brand loyalty through brand awareness has been presented in this study.

Analytical and Numerical Results for Free Vibration of Laminated Composites Plates

The reinforcement and repair of concrete structures by bonding composite materials have become relatively common operations. Different types of composite materials can be used: carbon fiber reinforced polymer (CFRP), glass fiber reinforced polymer (GFRP) as well as functionally graded material (FGM). The development of analytical and numerical models describing the mechanical behavior of structures in civil engineering reinforced by composite materials is necessary. These models will enable engineers to select, design, and size adequate reinforcements for the various types of damaged structures. This study focuses on the free vibration behavior of orthotropic laminated composite plates using a refined shear deformation theory. In these models, the distribution of transverse shear stresses is considered as parabolic satisfying the zero-shear stress condition on the top and bottom surfaces of the plates without using shear correction factors. In this analysis, the equation of motion for simply supported thick laminated rectangular plates is obtained by using the Hamilton’s principle. The accuracy of the developed model is demonstrated by comparing our results with solutions derived from other higher order models and with data found in the literature. Besides, a finite-element analysis is used to calculate the natural frequencies of laminated composite plates and is compared with those obtained by the analytical approach.

An Alternative and Complementary Medicine Method in Vulnerable Pediatric Cancer Patients: Yoga

Pediatric cancer patients experience multiple distressing, challenges, physical symptom such as fatigue, pain, sleep disturbance, and balance impairment that continue years after treatment completion. In recent years, yoga is often used in children with cancer to cope with these symptoms. Yoga practice is defined as a unique physical activity that combines physical practice, breath work and mindfulness/meditation. Yoga is an increasingly popular mind-body practice also characterized as a mindfulness mode of exercise. This study aimed to evaluate the impact of yoga intervention of children with cancer. This article planned searching the literature in this field. It has been determined that individualized yoga is feasible and provides benefits for inpatient children, improves health-related quality of life, physical activity levels, physical fitness. After yoga program, children anxiety score decreases significantly. Additionally, individualized yoga is feasible for inpatient children receiving intensive chemotherapy. As a result, yoga is an alternative and complementary medicine that can be safely used in children with cancer.

Optimization of Tolerance Grades of a Bearing and Shaft Assembly in a Washing Machine with Regard to Fatigue Life

The drum is one of the critical parts in a washing machine in which the clothes are washed and spin by the rotational movement. It is activated by the drum shaft which is attached to an electric motor and subjected to dynamic loading. Being one of the critical components, failures of the drum require costly repairs of dynamic components. In this study, tolerance bands between the drum shaft and its two bearings were examined to develop a relationship between the fatigue life of the shaft and the interaction tolerances. Optimization of tolerance bands was completed in consideration of the fatigue life of the shaft as the cost function. The following methodology is followed: multibody dynamic model of a washing machine was constructed and used to calculate dynamic loading on the components. Then, these forces were used in finite element analyses to calculate the stress field in critical components which was used for fatigue life predictions. The factors affecting the fatigue life were examined to find optimum tolerance grade for a given test condition. Numerical results were verified by experimental observations.

Pareidolia and Perception of Anger in Vehicle Styles: Survey Results

Most people see human faces in car front and back ends because of the process of pareidolia. 96 people were surveyed to see how many of them saw a face in the vehicle styling. Participants were aged 18 to 72 years. 94% of the participants saw faces in the front-end design of production models. All participants that recognized faces indicated that most styles showed some degree of an angry expression. It was found that women were more likely to see faces in inanimate objects. However, with respect to whether women were more likely to perceive anger in the vehicle design, the results need further clarification. Survey responses were correlated to the design features of vehicles to determine what cues the respondents were likely looking at when responding. Whether the features looked anthropomorphic was key to anger perception. Features such as the headlights which could represent eyes and the air intake that could represent a mouth had high correlations to trends in scores. Results are compared among models, makers, by groupings of body styles classifications for the top 12 brands sold in the US, and by year for the top 20 models sold in the US in 2016. All of the top models sold increased in perception of an angry expression over the last 20 years or since the model was introduced, but the relative change varied by body style grouping.

Musculoskeletal Pain, Work Characteristics and Presenteeism among Hotel Employees

Musculoskeletal problems in the hotel sector have been little studied. The aim of this study was to examine relationships of musculoskeletal pain and work characteristics with presenteeism, i.e., feeling sick but going to work anyway. Data of a self-reported questionnaire were collected from 1,101 employees, who joined the study on a voluntary basis from four hotels in northern Taiwan. The results showed that respondents who were female, were younger, had a higher educational level, and worked in the real-service department had higher presenteeism. There were significant positive associations between presenteeism and heavy loads, frequent beatings or hits of hard objects, improper bench height, employees’ lower limb and lower back pain. Our study results imply that knowledge of work characteristics and employees' musculoskeletal problems could be advantageously used to reduce presenteeism in the workplace.

Improving the Performance of Gas Turbine Power Plant by Modified Axial Turbine

Computer-based optimization techniques can be employed to improve the efficiency of energy conversions processes, including reducing the aerodynamic loss in a thermal power plant turbomachine. In this paper, towards mitigating secondary flow losses, a design optimization workflow is implemented for the casing geometry of a 1.5 stage axial flow turbine that improves the turbine isentropic efficiency. The improved turbine is used in an open thermodynamic gas cycle with regeneration and cogeneration. Performance estimates are obtained by the commercial software Cycle – Tempo. Design and off design conditions are considered as well as variations in inlet air temperature. Reductions in both the natural gas specific fuel consumption and in CO2 emissions are predicted by using the gas turbine cycle fitted with the new casing design. These gains are attractive towards enhancing the competitiveness and reducing the environmental impact of thermal power plant.

Estimation of PM2.5 Emissions and Source Apportionment Using Receptor and Dispersion Models

Source apportionment using Dispersion model depends primarily on the quality of Emission Inventory. In the present study, a CMB receptor model has been used to identify the sources of PM2.5, while the AERMOD dispersion model has been used to account for missing sources of PM2.5 in the Emission Inventory. A statistical approach has been developed to quantify the missing sources not considered in the Emission Inventory. The inventory of each grid was improved by adjusting emissions based on road lengths and deficit in measured and modelled concentrations. The results showed that in CMB analyses, fugitive sources - soil and road dust - contribute significantly to ambient PM2.5 pollution. As a result, AERMOD significantly underestimated the ambient air concentration at most locations. The revised Emission Inventory showed a significant improvement in AERMOD performance which is evident through statistical tests.

Performance Assessment of Carrier Aggregation-Based Indoor Mobile Networks

The intelligent management and optimisation of radio resource technologies will lead to a considerable improvement in the overall performance in Next Generation Networks (NGNs). Carrier Aggregation (CA) technology, also known as Spectrum Aggregation, enables more efficient use of the available spectrum by combining multiple Component Carriers (CCs) in a virtual wideband channel. LTE-A (Long Term Evolution–Advanced) CA technology can combine multiple adjacent or separate CCs in the same band or in different bands. In this way, increased data rates and dynamic load balancing can be achieved, resulting in a more reliable and efficient operation of mobile networks and the enabling of high bandwidth mobile services. In this paper, several distinct CA deployment strategies for the utilisation of spectrum bands are compared in indoor-outdoor scenarios, simulated via the recently-developed Realistic Indoor Environment Generator (RIEG). We analyse the performance of the User Equipment (UE) by integrating the average throughput, the level of fairness of radio resource allocation, and other parameters, into one summative assessment termed a Comparative Factor (CF). In addition, comparison of non-CA and CA indoor mobile networks is carried out under different load conditions: varying numbers and positions of UEs. The experimental results demonstrate that the CA technology can improve network performance, especially in the case of indoor scenarios. Additionally, we show that an increase of carrier frequency does not necessarily lead to improved CF values, due to high wall-penetration losses. The performance of users under bad-channel conditions, often located in the periphery of the cells, can be improved by intelligent CA location. Furthermore, a combination of such a deployment and effective radio resource allocation management with respect to user-fairness plays a crucial role in improving the performance of LTE-A networks.

Investigation of the Effect of Teaching a Thinking and Research Lesson by Cooperative and Traditional Methods on the Creativity of Sixth Grade Students

The present study investigates the effect of teaching a Thinking and Research lesson by cooperative and traditional methods on the creativity of sixth-grade students in Piranshahr province. The statistical society includes all the sixth-grade students of Piranshahr province. The sample of this studytable was selected by available sampling from among male elementary schools of Piranshahr. They were randomly assigned into two groups of cooperative teaching method and traditional teaching method. The design of the study is quasi-experimental with a control group. In this study, to assess students’ creativity, Abedi’s creativity questionnaire was used. Based on Cronbach’s alpha coefficient, the reliability of the factor flow was 0.74, innovation was 0.61, flexibility was 0.63, and expansion was 0.68. To analyze the data, t-test, univariate and multivariate covariance analysis were used for evaluation of the difference of means and the pretest and posttest scores. The findings of the research showed that cooperative teaching method does not significantly increase creativity (p > 0.05). Moreover, cooperative teaching method was found to have significant effect on flow factor (p < 0.05), but in innovation and expansion factors no significant effect was observed (p < 0.05).

Dietary Habit and Anthropometric Status in Hypertensive Patients Compared to Normotensive Participants in the North of Iran

Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.

Non-Linear Load-Deflection Response of Shape Memory Alloys-Reinforced Composite Cylindrical Shells under Uniform Radial Load

Shape memory alloys (SMA) are often implemented in smart structures as the active components. Their ability to recover large displacements has been used in many applications, including structural stability/response enhancement and active structural acoustic control. SMA wires or fibers can be embedded with composite cylinders to increase their critical buckling load, improve their load-deflection behavior, and reduce the radial deflections under various thermo-mechanical loadings. This paper presents a semi-analytical investigation on the non-linear load-deflection response of SMA-reinforced composite circular cylindrical shells. The cylinder shells are under uniform external pressure load. Based on first-order shear deformation shell theory (FSDT), the equilibrium equations of the structure are derived. One-dimensional simplified Brinson’s model is used for determining the SMA recovery force due to its simplicity and accuracy. Airy stress function and Galerkin technique are used to obtain non-linear load-deflection curves. The results are verified by comparing them with those in the literature. Several parametric studies are conducted in order to investigate the effect of SMA volume fraction, SMA pre-strain value, and SMA activation temperature on the response of the structure. It is shown that suitable usage of SMA wires results in a considerable enhancement in the load-deflection response of the shell due to the generation of the SMA tensile recovery force.

Mechanical Properties of Ordinary Portland Cement Modified Cold Bitumen Emulsion Mixture

Cold bitumen emulsion mixture (CBEM) offers a series benefits as compared with hot mix asphalt (HMA); these include environmental factors, energy saving, the resolution of logistical challenges that can characterise hot mix, and the potential to reserve funds. However, this mixture has some problems similar to any bituminous mixtures as it has low early strength, long curing time that needed to obtain the maximum performance, high air voids and considered inferior to HMA. Thus, CBEM has been used in limited applications such as lightly trafficked roads, footways and reinstatements. This laboratory study describes the development of CBEM using ordinary Portland cement (OPC) instead of the traditional mineral filler. Stiffness modulus, moisture damage and temperature sensitivity tests were used to evaluate the mechanical properties of the produced mixtures. The study concluded that there is a substantial improvement in the mechanical properties and moisture damage resistance of CBEMs containing OPC. Also, the produced cement modified CBEM shows a considerable lower thermal sensitivity than the conventional CBEM.