Extent of risk management implementation in some of rock laboratory tests for tunnel projects by means of AHP method

In any project, especially infrastructure ones such as tunnels, tests play a major role in predicting and showing the properties of the ground built on. For such construction through a rock mountain terrain, it is quite not easy to predict the engineering property of such materials. Since working with rock is a quite challenge because of the nature of rock materials, it needs a lot of care and persuasion when dealing with such. For such rock materials, it needs both of field and laboratory tests to ensure the process of obtaining the final engineering property of the materials. This paper concentrate on some of the laboratory tests required for tunnel project held in rock profile sites. Emphasizing on safety, accuracy that enquired during such tests and try to run those under risk management process by means of AHP to get the responded weights for those factors such as test procedure with average of weight (49.43%) indicates the caution to be taken during test beside major parameters such as sample size and mass in accurate manner to avoid risk in test and results obtained

Contribution of AHP method in prioritizing risk factors regarding tunnel project phases

Tunnel projects are consistently regarded to be mostly a complex and risky engineering projects, owing to the features of the projects, since they increasingly achieve high risk and complexity during the execution of the project. this led to the fact that the necessity of risk management understanding and implementing is a crucial quest with the intention to obtain tunnel project objectives considering (time, cost, quality & safety) to avoid time and cost overruns and any other obstacles. it was observed the most affecting objective was Safety (47.3%) by AHP method in which it is actually reasonable as such project of tunnel need a great concern regarding that matter for many reasons for instance the closed construction area, ventilation considerations, blasting, and so on. the second major objective is quality (31.1%) in which as experts always say it has to be maintained as a high quality as possible

Evaluation of the nursing management for patients undergoing to water seal chest tube drainage system

Abstract:Objective(s): The study objectives are to identify the nursing management provided to patients undergoing to water- seal chest tube drainage system..Methodology: A descriptive study which was using the quantitative design. The study was conducted in Alhariri ,Alyarmouk, and Alkindy teaching hospitals starting from October 10th 2012 up to the September 30th 2013. To achieve the objectives of the study, A non-probability (purposive) samples of (50) nurses delete was consisted of all nurses who provides management for patients under-water –seal chest tube drainage systems. The questionnaire tool was constructed, consisting of two parts, first one the demographical data of the sample & the second is the 13th steps of observational checklist for nursing management of patients with under-water –seal chest tube drainage system, the questionnaire validity& reliability was determined by a panel of experts in and out of Nursing College, a suitable statistical analysis was applied for the data.stem . Data were collected by an application of direct observation as a means of data collection. Nurses were evaluated while they are working in the thoracic or surgical wards during the day. Instrument validity and reliability were determined through content validity, by a panel of experts and a suitable statistical analysis was applied for the data.Results: The results of the study showed that most of the sample were males nurses at age group of (20-30) and (31-40)years old working at thoracic surgical wards since 1-5 years only with a poor nursing experience. Also, the result of study indicated that the male nurses who are with nursing institute(22) , preparatory nursing school(20) and nursing school (8) were providing care to patients with chest tube under water- seal drainage not accepted. They were with knowledge deficit and experience in maintain patency and sterility when changing down tube, they do not note the presence of bubbling and recording the consistency of the drainage, which indicating poor management and technique provided and this may lead to complication such as pneumonia and pneumothorax, which may leads to pulmonary failure.Conclusion: The study concluded that the most of nurses that work in thoracic or surgical wards have deficit knowledge in some aspects related to nursing management provided to patients with under water- seal chest tube drainage system.Recommendations: The study emphasize that nurses working in thoracic wards must be at least with Diploma or Bachelorette degree of well educated to provide complete and accurate management for patients with chest tube. Also, the study recommends to apply an intensive courses for already these nurses to improve their knowledge and practice in caring for under – water –seal chest tube drainage system patients..Keywords: Assessment, Nursing Management, Under- Water Seal Chest Tube Drainage System

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Towards Effective Environmental Sustainability Reporting in the Large Industrial Sector of Bahrain

The industrial sector plays a vital role in economic development; therefore, there is a necessity to integrate sustainability into industrial development to maintain the economy and avoid any degradation impacts on the environment, and thereafter on society. Thus, do Bahraini companies have sustainability reports and if so, are these reports based on GRI guidelines? Has the status of their sustainability reports been analyzed? This research aims to examine the sustainability reports of companies by analyzing the status of sustainability aspects in their materiality matrices to assist in identifying and prioritizing the most significant sustainability issues for advancement in their future reporting and to improve their environmental performance. This study employs a content analysis approach and analyzes 11 reports from the period 2016–2020 for three companies in Bahrain’s large industrial sector. The study reveals that the companies using materiality analysis in their reporting benefit from better monitoring and measuring of their environmental performance, and from implementing SDGs. Furthermore, the study indicates that the utilization of a materiality matrix as a reporting tool can define and improve report contents by considering stakeholders’ views, consequently, improving the quality of the sustainability reports. The study concludes by proposing a set of recommendations

Gum Arabic (Acacia Senegal) Augmented Total Antioxidant Capacity and Reduced C-Reactive Protein among Haemodialysis Patients in Phase II Trial

Background. Oxidative processes might increase in patients with end-stage renal disease (ESRD) according to the current literature. Oxidative stress (OS) is a risk factor of atherosclerosis and cardiovascular complications, which are major causes of mortality among ESRD patients. Haemodialysis (HD) is life-saving procedure, nevertheless it is an active chronic inflammatory status that could augment cardiovascular disease and increase mortality. Gum Arabic (GA) has been claimed to act as an antioxidant and anti-inflammatory agent in experimental studies and clinical trials. Therefore, we assumed GA supplementation among haemodialysis patients would reduce oxidative stress and consequently reduce the state of chronic inflammatory activation associated with haemodialysis. Methods. Forty end-stage renal failure (ESRF) patients aged 18–80 years who were on regular haemodialysis in Arif Renal Center, Omdurman, Sudan, were recruited. All recruited patients met the inclusion criteria and signed informed consent prior to enrolment. The patients received 30 g/day of GA for 12 weeks. C-reactive protein (CRP) and complete blood count (CBC) were measured as baseline and monthly. Total antioxidant capacity (TAC) and oxidative stress marker malondialdehyde (MDA) levels were measured before and after GA intake. Ethical approval from the National Medicines and Poisons Board was obtained. Results. Gum Arabic significantly augmented total antioxidant capacity level (P<0.001) (95% CI, 0.408–0.625) and also attenuated oxidative marker MDA and C-reactive protein (P<0.001). Conclusions. GA has revealed potent antioxidative and anti-inflammatory properties in haemodialysis patients. Oral digestion of GA (30 g/day) decreased oxidative stress and inflammatory markers among haemodialysis patients. Trial registration. ClinicalTrials.gov Identifier: NCT03214692, registered 11 July 2017 (prospective registration)

HIV viral suppression in Oman: Encouraging progress toward achieving the United Nations ‘third 90’

Objective: To assess the impact of capacity-building interventions introduced by the Oman National AIDS Programme on the quality of HIV care in the country. Methods: HIV viral load (VL) suppression and loss to follow-up (LTFU) rates were calculated for the period before (in December 2015; n = 1098) and after (in June 2017; n = 1185) the introduction of the interventions: training, support, and care pathway development. Three HIV VL cuts-offs at last measurement in the year of interest were used to define VL suppression. Results: In the intention-to-treat (ITT) analysis, rates of VL <200 copies/ml and <1000 copies/ml increased from 51.9% in 2015 to 65.5% in 2017 (relative risk (RR) 1.26, 95% confidence interval (CI) 1.17–1.36) and from 58.1% in 2015 to 70.9% in 2017 (RR 1.22, 95% CI 1.14–1.30), respectively; p < 0.0001 for both. Similarly, in the on-treatment analysis, rates of VL <200 copies/ml and <1000 copies/ml increased from 64.2% in 2015 to 76.9% in 2017 (RR 1.20, 95% CI 1.12–1.28) and from 71.9% in 2015 to 83.2% in 2017 (RR 1.16, 95% CI 1.10–1.22), respectively. Fewer patients were LTFU in 2017 than in 2015 (14.7% (157/1061) vs. 19.2% (188/981); RR 0.77, 95% CI 0.64–0.94). Conclusions: Achieving the UNAIDS target of 90% of HIV patients on treatment having VL suppression by 2020 is feasible in Oman