Knowledge and Practices of Nurses Regarding the Management of Elderly Patient with Dysphagia at Tertiary Care Hospital Lahore

Introduction: Dysphagia is the subjective sensation of difficulty swallowing and there are many potential etiologies. It also negatively impacts quality of life and decreases work productivity, and it is the 10th leading cause of ambulatory care visits in the United States among gastrointestinal (GI) symptoms, with more than 600,000 visits annually. Method: Quantitative cross-sectional study design was used to determine the knowledge and practices of nurses regarding the management of elderly patient with dysphagia at tertiary care hospital. 111 nurses working at gastro, medical and surgical wards were selected as sample. Data was collected through the standardized well adopted 14 item questionnaires. Results: Results revealed that only (52) 47 % nurses have good knowledge and majority (59) 53% nurses have poor knowledge. Further the practices of nurses regarding dysphagia management analysis revealed that 41 % nurses have adequate practices and majority 59% nurses have inadequate practices. Conclusions: The results of the present study showed that the participants had a moderate/low knowledge practice of the definition, diagnosis, and clinical management of liquid dysphagia and inadequate. So necessary tools must be provided for their training in this field. This training must be multidisciplinary and should be directed to all professionals who provide healthcare to patients with liquid dysphagia. Keywords: knowledge, practices, dysphagia, management, elderly DOI: 10.7176/JHMN/100-04 Publication date:May 31st 202

Components of Motivation in the ESL/EFL Classroom

Motivation is clearly a critical factor for second language and foreign language learning because it affects students' willingness to approach learning and using English language. Teachers who hope to provide meaningful instruction need to consider how to increase the motivational levels of their students in order to ensure student success in learning.  This paper examines what university students studying English as a second language or a foreign language (ESL/EFL) have to say about what does or does not positively affect their motivation to study English language. The ways in which intrinsic and extrinsic motivation affect ESL/EFL learners are explained by examining student surveys and current research. How self-directed or autonomous learning stimulates intrinsic motivation is a major part of the paper, as is how teacher-centered classrooms tend to make ESL students more extrinsically motivated

Potential of Jelly as a Matrix in Printmaking

Contemporary printmaking focuses on producing a series of monoprints produced by the alternative printmaking matrix. The primary objectives of this research are to investigate the suitability of jelly as an alternative matrix for printmaking and to create a series of printmaking works based on the marks made by the jelly plate. This project aims to develop a series of artworks composed of the mark-makings generated by the alternative matrix. The process of exploration of the jelly plate making to establish the final consistency of the jelly plate as a potential matrix suitable for producing monoprints. The process of trial and error is practised in finding the right ingredients for jelly plate making. The final matrix will be produced as the consistency of the ingredients is found. Hence, producing mark-making from collected material results in a beautiful pattern-making process. Keywords: Alternative Printmaking; Jelly Plate; Printmaking Matrix; Monoprint eISSN: 2398-4287 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under the responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians), and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v7iSI7.379

Physical and Psychological Impacts on COVID-19 Hospitalized Patients of 3rd Wave

Background: COVID shelters and many emergency centers were established as a countermeasure to control this pandemic that hit the word by the end of 2019. Due to unavailability of medical care, along with physical health issues, these patients suffer with mental health related issues. Aims: This study aimed to explore the both, physical and psychological impacts upon the patients diagnosed with COVID-19 and admitted in intensive care units of hospitals of Pakistan during the third wave. Methods: This cross-sectional survey was performed during the peak time of COVID-19 for the duration of two months i.e. April & May 2021. After getting ethical approval from Shifa International Hopsital (Ref# 070-021), permission was sorted from public and private hospitals of Pakistan. 183 conscious patients diagnosed with COVID and currently admitted in intensive care units were randomly selected from hospitals of Islamabad and Rawalpindi. Written consent was taken from patients and their caregivers after they were briefed regarding the importance of the study. PHQ-15 was used to assess somatic symptoms related to COVID-19 whereas DASS-21 was used to assess level of depression, anxiety and stress among patients. Results: Of 183 hospitalized patients of COVID-19 in intensive care units, 170 (92.9%) participants showed mild to severe level of somatic symptoms on PHQ-15. Shortness of breath, feeling hearth race, back pain, stomach pain, low energy and sleeping difficulties were the most common somatic complaints reported by patients. The statistics of DASS-21 showed that 51 (27.86%) participants had mild to severe level of depression, 74 (40.4%) had mild to profound level of anxiety and 96 (52.45%) reported mild to profound level of stress. Conclusion: This study portrayed a better understanding and confirms the physical and psychological impacts upon hospitalized COVID-19 patients, therefore highlighting the need of both physical and mental health interventions to minimize these impacts

Combine and Multilevel Implementation of Cryptographic and Data Hiding Algorithms to Provide a Hybrid Data-Security Scheme

It is generally accepted that data encryption is the key role in current and future technologies for information security. Cryptography plays an important task in accomplishing information security. Elliptic Curve Cryptography (ECC) is considered as more suitable for limited resources applications such as RFID, and for Chip based Systems such as modern day Pervasive and ubiquitous Computing Communication Systems, than other public key cryptography algorithms because of its small key size. Generally, a random generator is used to produce. ECC domain parameters. Here in this work, we have proposed “Combine and Multilevel Implementation of AES & ECC along with Steganography to provide a Hybrid Cryptographic Security technic in Data communication Systems. Which will help in development of an algorithm to secure the data of users (both Wired and Wireless/Satellite Communication) in complex manner with more security and accuracy by implementing multilevel and hybrid scheme of AES and ECC encryption algorithms along with Steganography. The design is implemented using the MATLAB R2012a simulations. The data is secured using the resulted public and private keys (generated by ECC in combination with (AES) encryption and decryption process) along with the technic of steganography for hiding this encrypted data in a fake message or Image to provide the strong cryptographic solution for highly secured data communication systems. It is tested over plain text and image with multiple data sizes. Furthermore, in order to elaborate the effectiveness of the proposed scheme, we provided a comprehensive performance analysis (evaluation) of the approach: hybrid implementation of symmetric and asymmetric key cryptographic algorithms w.r.t these parameters: time elapsed, data sizes, key sizes (variance of Key Space) and impact of steganography.

Non-Local Deformation of a Supersymmetric Field Theory

In this paper, we will analyse a supersymmetric field theory deformed by generalized uncertainty principle and Lifshitz scaling. It will be observed that this deformed supersymmetric field theory contains non-local fractional derivative terms. In order to construct such deformed N=1 supersymmetric theory, a harmonic extension of functions will be used. However, the supersymmetry will be only preserved for a free theory and will be broken by the inclusion of interaction terms.Comment: 12 pages, pulished versio

Real-time patient satisfaction of emergency department services in a tertiary-care hospital in Karachi, Pakistan

Background: In Emergency Department (ED), patient satisfaction is an important quality indicator. The aim of this study was to assess the patient satisfaction with ED services using real- time patient satisfaction survey. Methods: The study was conducted for two weeks in the ED of Aga Khan University in December 2011. A structured questionnaire was used to capture patient’s feedback on service quality in the ED. Patient response was recorded using five-level Likert scale; strongly agree, agree, neutral, disagree and strongly disagree. Respondents were either patients or their relatives. Results: Total 348 real-time survey forms were completed. Of these 18.6% (n=61) were in P1 triage category, 32.6% (n=107) in P2 and 48.8% (n=160) were P3 patients. An overall satisfaction rate was 4.27 with satisfactory response from 84.6% patients with ED services. About 87.7% of patients were satisfied with time taken to be attended by the triage staff at the counter, Time taken to get an ED bed was 86.8% and time taken until beginning of treatment after getting an ED bed is 84.3%. Conclusion: Patient satisfaction is an important quality indicator which enables to identify areas of improvement in ED so as to provide better care & services to patients

Comprehensive performance analysis of flexible asynchronous AC link under various unbalanced grid voltage conditions

A flexible asynchronous AC link (FASAL) system is a technology that interconnects two power system networks operating at the same or different frequencies. The FASAL system is a newly developed technology; therefore, it requires a thorough investigation under different unbalanced grid voltage conditions for better behavioral understanding and appropriate future controller design. In this paper, the FASAL system is analyzed under various symmetrical and asymmetrical unbalanced grid voltage conditions. Moreover, the performance of the back-to-back voltage source converter (VSC) based HVDC link is also analyzed to establish its comparison with the FASAL system under the same conditions. The FASAL and VSC-HVDC systems are modeled in PSCAD/EMTDC software environment. The simulation results illustrate that the FASAL system performance is better under transient as well as steady-state conditions. Furthermore, the reduction in power at the receiving end side is also lesser in the FASAL system. For example, a 10% sag contributes only a 15% dip in power in the FASAL system, whereas VSC-HVDC reports a 30% power dip for the same sag condition.The APC is funded by the Qatar National Library, Qatar.Scopu

Exergoeconomic optimization of a shell-and-tube heat exchanger

The paper presents an economic optimization of a STHX with two commonly adopted (i.e., Kern and Bell-Delaware) and one rarely explored (i.e., Wills-Johnston) methods. A detailed numerical code concerning thermal, hydraulic, exergy, and economic analysis of STHX is developed for all three methods. Normalized sensitivity analysis, parametric study, and Genetic Algorithm are used to ascertain the most influential parameters and optimize the total cost. It is observed that the calculations made using the Wills-Johnston method were reasonably close to the Bell-Delaware method. While the Kern method showed a significant deviation in the shell side calculations because of the several assumptions in this method. The parametric analysis showed that increasing the mass flow rate and the number of baffles increased the operating cost because of an exponential increase in the pressure drops. Finally, the optimization reduced the heat transfer area by ~26.4%, capital cost by ~20%, operational cost by ~50%, total cost by ~22%, and the stream cost by ~21%

Use of platelet-rich plasma in treating low back pain: A review of the current literature

Low back pain (LBP) is a common problem encountered by physicians. It is a considerable cause of morbidity and socioeconomic loss and is one of the most expensive musculoskeletal disorders. Conventional treatments include bed rest, analgesics, therapeutic exercises, lumbar or caudal epidural corticosteroids, and surgery. Several new biological therapies are being investigated for use in LBP and one of these is platelet-rich plasma (PRP). In this article, we summarize the current literature published on PRP concerning its composition, classification, and application in LBP. We believe our review will prove useful to clinicians and academics alike, interested in new developing therapies for LBP