STRESSES IN SYIMMETRICALLY LOADED STEPPED CIRCULAR PLATES USING FINITE ELEMENT METHOD

This paper deals with theoretical and numerical investigations for the stresses induced in circular plates with variable thickness and exposed by static loads. The effects of different types of loads on stresses are considered. The radial and hoop stresses are obtained for stepped circular plates widely used in industry. Two different forms of such plates are considered, one has a raised central region and the other has an unraised one. The results are obtained by finite element method using a tapered annulus bending element. The graphs presented in this work show the effect of the different values of step radius, type of the applied load and the effect of the different boundary conditions on the stresses from the point of view of design. When the step radius vanishes or equals to the plate radius, the plate becomes of uniform thickness. Consequently, the results obtained can be compared with the values of exact solutions. The limits of this simple finite element model for stepped plates are investigated by a more advanced finite element model having three dimensional axisymmetric annular element

A whole-health-economy approach to antimicrobial stewardship: Analysis of current models and future direction.

Antimicrobial stewardship (AMS) strategies are widely implemented in single healthcare sectors and organisations; however, the extent and impact of integrated AMS initiatives across the whole health economy are unknown. Assessing degree of integration of AMS across the whole health economy and its impact is essential if we are to achieve a ‘One Health’ approach to addressing antimicrobial resistance (AMR), and therefore we searched systematically for and analysed published examples of integrated AMS initiatives to address this gap. Application of a system-level framework to analyse integration of AMS initiatives across and within healthcare sectors shows that integration is emerging but needs strengthening. Findings from a small number of evaluations in high-income countries suggest that antimicrobial prescribing and healthcare-associated infections can be reduced using a multisectoral integrated AMS approach. More robust research designs to evaluate and understand the impact of multisectoral integrated AMS are needed, particularly with respect to differing health systems in different countries and local organisational contexts. Our analysis highlights a number of challenges and ways forward for enhancing the delivery of AMS through an integrated approach

The Effect Of Sexual Counseling Program On Pain Level And Sexual Function Among Women With Dyspareunia

Dyspareunia is a sexual dysfunction manifested as pain in reproductive organs before, during or soon after sexual intercourse. In spite of the fact that this disorder may be found in both genders, it is much more frequent in women. For these women, sexual activity results in burning pain that can alter a woman’s sense of sexual competency and identity. Study aim was to determine the effect of sexual counseling program on pain level and sexual function among women with dyspareunia. The study setting was conducted at obstetrical& gynecological clinics in El-mansoura University Hospital after obtaining hospital director approval. A subject was consisted of 392 women: 107 out of them with dyspareunia and 100 women complete counseling program, Tools three tools were used by the researchers to collect pertinent data consisted of Women Structured Interviewing Schedule, Dyspareunia Self Assessment Tool, and Female Sexual Function Index (FSFI). Results revealed that 27.3% of the study sample was complained with dyspareunia their age was ranged between 20-40 years with a mean age of 33.79±5.92 years. Regards FSFI scores a difference existed between pre and post scores in favor of post scores.  t= 18.7 (P<0.001) with highly statistical significant difference regarding Desire t= 4.6, (P>0.001), Arousal t=7.97, (P>0.001), Orgasm t= 3.7 (P 0.002), Satisfaction t=12.9, (P>0.001) and Pain t=26.4, (P>0.001).  Conclusion female dyspareunia is an under recognized and significantly affected women and their sexual function, the present study proved also that sexual counseling program was effective on pain level and sexual function improvement among women with dyspareunia. Recommendations include application of sexual counseling program on wide range of women complaining sexual problems. Also, sexual health or problem inquiry should be ask as an important part of health care services and the health care team should be encouraged to initiate discussions about dyspareunia and in service education program for nurses about how to deal and manage various sexual problems is must. Key words: Counseling    Pain level       Sexual function       Dyspareuni

Effect of Nursing Intervention on Clinical Outcomes and Patient Satisfaction among Upper Gastrointestinal Bleeding

Upper gastrointestinal (GI) Gastrointestinal (GI) bleeding is an extremely common clinical problem, resulting in significant morbidity, mortality, and cost. Aim: determine the effect of nursing intervention on expected clinical outcomes and satisfaction of patients with upper gastrointestinal bleeding. Design: This quasi-experimental design. Setting: was conducted at the emergency department. Sample: a convenience sample 50 adult patients diagnosed with upper gastrointestinal bleeding (UGIB). Tools: used for data collection included sociodemographic and medical data sheet, patient clinical outcome and patient satisfaction. Results: Statistically significant differences were found between the study and control group after application of nursing intervention regarding patients' clinical outcomes items ( bleeding attack, vital signs, laboratory tests, mental status and medical co-morbidities) at level P= 0.040, 0.000, 0.001, 0.066 and 0.045respectively, highly statistically significant differences were existed between the study and control group after application of nursing intervention regarding level of patients' satisfaction as a total score recorded 77.20±4.24 for the study group while it was 57.68±10.6 for the control group, achievement of the average scores for the most of the checklist items which related to nurses' performance. Conclusions: Findings illustrate that nursing intervention improve patients' expected clinical outcomes and their satisfaction. Recommendations: These findings suggest that generalization of the standardized nursing intervention in form of booklet for patients with UGIB at all hematemsis departments of Mansoura University Hospitals is important to maximize the expected clinical outcomes for patients with UGIB. Keywords: Upper gastrointestinal bleeding, Nursing intervention, Patient satisfaction, Outcom

Effect of Cardiac Rehabilitation Program on Lifestyle Pattern of Patients with Myocardial Infraction

Cardiovascular disorders are the leading cause of mortality and morbidity in the industrialized world, accounting for almost 50% of all deaths annually. The survivors constitute an additional reservoir of cardiovascular disease morbidity. In the United States alone, over 14 million persons suffer from some form of coronary artery disease (CAD) or its complications. Traditionally, cardiac rehabilitation has been provided to somewhat lower-risk patients who could exercise without getting into trouble. So, this study aimed to examine  the effect  of the cardiac rehabilitation program on lifestyle practices by patients with myocardial infarction.  Settings. The study was conducted at the cardiac ICU and coronary care unit of the Main University Hospital at  Mansoura University. Subject. The study included a convenience sample of 50 adult patients admitted to the previously mentioned settings during the study period and having (M.I). we included in this study patients from both sex, adult less than 60 years. Results,  Finding of the present study revealed that, there was highly statistical significant positive change in lifestyle pattern of patients with myocardial infarction to control the physiological problems associated with the disease and medications received after implementation of the cardiac rehabilitation program. Keywords: Cardiac rehabilitation, myocardial infarction, compilations, lifestyle practice

The theme of alienation in Matthew Arnold

Summary available on pp. i-vi

An inexpensive method of small paraffin tissue microarrays using mechanical pencil tips

<p>Abstract</p> <p>Background</p> <p>Tissue microarray technology has provided a high throughput means of evaluating potential biomarkers in archival pathological specimens. This study was carried out in order to produce tissue microarray blocks using mechanical pencil tips without high cost.</p> <p>Method</p> <p>Conventional mechanical pencil tips (Rotring Tikky II Mechanical Pencil 1.0 mm) were used to cut out 1 mm wax cylinders from the recipient block, creating from 36 to 72 holes. Three cores of tumor areas were punched out manually by using the mechanical pencil tips from donor paraffin embedded tissue blocks and transferred to the holes of the paraffin tissue microarrays.</p> <p>Results</p> <p>This technique was easy and caused little damage to the donor blocks. We successfully performed H&E slides and immunodetection without substantial tissue cylinder loss.</p> <p>Conclusion</p> <p>Our mechanical pencil tip technique is the most inexpensive easy technique among the literature. It also takes a reasonable amount of time and reduces antibody consumption during immunohistochemistry</p

Extinction of Nonpremixed Opposed-Flow Hydrocarbon Flames by Chemically-Passive Fire Suppressants

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/77191/1/AIAA-2007-5662-560.pd

Bees visiting the broad bean (Vicia faba L.) and the impact of border planting on their abundance and the yield improvement in Ismailia, Egypt:

Incorporating flowering plants into cropping systems has the potential to actively enhance pollination and crops yields. This study evaluated whether the introduction of border planting affects bee visitation and yield of a broad bean (Vicia faba L.). Experiments were carried out in 2018 and 2019 in Ismailia, Egypt.  Bee visitation and broad bean yields were compared between plots with and without border planting. Results showed that open flowers achieved higher yields than netted flowers. Apis mellifera L. was the dominant visitor, followed by four solitary bee species, Chalicodoma siculum (Rossi), Colletes lacunatus Dours, 1872, Andrena ovatula and Xylocopa pubescens (Kirby, 1802).  The addition of border planting was associated with a significant increase in the abundance of all five bee visitors and the associated yields. Findings showed that flowering border plants adjacent to broad bean can actively enhance pollination services and yields of this commercially valuable crop, whilst helping to conserve vulnerable bee populations