Introduction: This study evaluates the attitude of physicians regarding cancer the disease and patients with cancer, which may influence their management allowing for recommendations of appropriate ...interventions.Methods: This is a cross-sectional study, which interviewed 251 physicians of Jose R Reyes Memorial Medical Center regarding their attitudes on cancer and cancer patients. The study also explored and identified factors associated with such attitudes. The validated modified Cancer Attitude Scale of Haley et al (1968, 1977) was used. Ordinal (proportional odds) regression via Stata was used to examine the association between independent and dependent variables. A score of 1 to 5 was given from strongly agree to strongly disagree for all 21 negatively affirmed questions and a score of 1 to 5 was given from strongly disagree to strongly agree for the 11 positively affirmed questions. The cut off levels to say positive or negative attitude was set as a median score of above 3 for each question representing positive attitude and score of below 3 representing negative attitude.Results: In general the overall attitude of physicians working in Jose R Reyes Memorial Medical Center towards cancer and cancer patients is positive. However the physicians are skeptical of the patient’s inner resource to cope with cancer. Expertise, years of practice (of more than 25 years), having experience with cancer patients, being active in religion, Filipino nationality and protecting oneself from carcinogens showed to be associated with positive attitude. Conclusion: The factors that affect physicians’ attitude towards cancer and cancer patients should be further explored with a larger and more representative population of physicians for a wider view of attitudes across age groups, clinical experience, religion, medical specialty among others; so that appropriate interventions may be devised to determine ways that can positively impact their perception. Hence, improving patient management.
Background: Chronic obstructive pulmonary disease is most common disease entity and third leading cause of mortality worldwide. The presence of bronchiectasis in severe chronic obstructive pulmonary ...disease patients had led to frequent exacerbation requiring hospitalizations. The purpose of this study was to identify the factors associated with bronchiectasis, using routine data collected during medical visits from patients diagnosed with chronic obstructive pulmonary disease.Materials and Methods: This is hospital based cross sectional study conducted on 120 chronic obstructive pulmonary disease patients. All patients were subjected through history, examination, pulmonary function test, sputum samples and imaging of chest.Results: Out of 120 patients among them 67 patients (55.8%) were chronic obstructive pulmonary disease without bronchiectasis while 53 patients (44.1%) had chronic obstructive pulmonary disease with bronchiectasis. Thirty patients (56.6%) having chronic obstructive pulmonary disease with bronchiectasis and 18 patient (26.8%) having chronic obstructive pulmonary disease without bronchiectasis had exacerbation in one year requiring hospitalisation. Most common organisms isolated were Pseudomonas Aeruginosa in 20 patients (55.5%), Klebsillae Pneumoniae in 6 patients (16.6%) among chronic obstructive pulmonary disease with bronchiectasis group.Conclusion: Chronic obstructive pulmonary disease patient with severe airflow limitation, with frequent exacerbation and colonisation with isolation of organisms resulting in bronchiectasis requiring frequent hospitalisation.
•Experimental and analytical dynamic investigation of six full-scale timber beams.•Performed impact hammer tests on the timber beams with two different spans.•The fundamental frequency of all tested ...beams was above 8Hz, which is acceptable.•Analytical models predicted fundamental frequency of all beams within acceptable range of ±5%.•Mean damping ratio of 6m and 8m span beams was 0.65% and 0.58%, respectively.
Timber floors are more susceptible to vibrations and have low impact insulation due to low stiffness and poor damping properties. Recent trends towards long-span and light-weight construction make floor vibration even more critical in satisfying serviceability requirements of floor constructions. This paper presents the results of dynamic tests conducted on timber floor modules (beams) with 6 and 8m clear spans using an instrumented hammer for floor excitation. Dynamic parameters such as natural frequencies, damping ratios and mode shapes from the tests were evaluated to assess dynamic performance of the beams. The fundamental frequency of the beams was predicted using simple analytical models and good correlation between the test results and predicted values could be obtained.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
•Experimental and analytical dynamic investigation of four full-scale TCC beams.•Performed impact hammer tests on the TCC beams with three different connections.•The fundamental frequency of all ...tested beams was above 8Hz, which is acceptable.•Analytical models predicted frequency of all beams within acceptable range of ±8%.•Beam-3 with six bird-mouth notches showed best dynamic performance.
Timber-concrete composite (TCC) construction provides an effective and efficient solution for long-span floors in multi-storey buildings. Because of the light-weight and long-span of the floors, the design of these floors are normally governed by serviceability criteria such as deflection, vibration, acoustic, etc and design for strength limits are generally not an issue. Floor vibration caused by dynamic actions such as people walking on the floor, machinery or any similar repetitive actions may not only cause discomfort to occupants but may also result in structural failure as a result of resonance. However, limited design guidance is available in the design codes to address the vibration behaviour of TCC floors owing to a lack of reliable performance data and as such, there is a need to undertake further research into the behaviour of TCC floors. This paper reports on the tests performed on four identical TCC beams, which represent part of a floor system, with different shear connector arrangements, to assess their dynamic performance under the application of impact action using modal parameters (natural frequencies, damping ratios and mode shapes). Five analytical models are used to predict natural frequency of the beams and their reliability is checked.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
•Vibration measurements for the integrity assessment of shear connectors in composite systems.•Dynamic-based testing and analysis to provide a good alternative to static load tests.•Experimental and ...numerical study of timber composite systems.•The method allows the use of a few mode measurements without compromising good results.
This paper presents a dynamic-based method for the evaluation of connection systems of timber composite structures. The good bonding of the composite elements is crucial for the proper functioning of timber composite structures, as the design capacity and performance of the system cannot be achieved unless an adequate connection condition can be assured. The proposed dynamic method provides an alternative to traditional static load testing and uses vibration measurements to derive a Loss of Composite Action Index, based on an expanded Damage Index method, indicating the reduction in composite action due to the failure of shear connectors. The proposed method is validated on experimental and numerical models of a timber composite beam structure and a timber-concrete composite flooring system. The results demonstrate the effectiveness of the proposed dynamic-based approach that can achieve a good agreement between statically and dynamically derived composite action indicators.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
In recent years, there has been an increasing trend in Australia and New Zealand towards the use of long-span timber and timber-concrete composite (TCC) flooring systems for the construction of ...multi-storey timber buildings. The popularity of these flooring systems is because of their low cost, easy construction and the use of environmentally sustainable materials. Due to their light-weight, such long-span floors are however highly susceptible to vibrations induced by service loads. Although longspan timber and TCC flooring systems can easily be designed to resist the static loads using currently available design guidelines, it is crucial to also investigate the dynamic behaviour of these floors as the occupant discomfort due to excessive vibration may govern the design. Moreover, many structural failures are caused by dynamic interactions due to resonances, which highlight the importance of investigating the dynamic behaviour of flooring systems. To date, there are very limited design guidelines to address the vibration in long-span floors, especially composite floors, due to a lack of sufficient investigation.In 2009, a research consortium named Structural Timber Innovation Company (STIC) was founded, with the aim to address various issues encountered with structural timber buildings including timber and TCC flooring systems. STIC is conducting Research and Development (R & D) work in a number of key areas to provide a new competitive edge for commercial and industrial structural timber buildings. The R & D work is undertaken with three parallel objectives at three universities, namely, the University of Technology Sydney (UTS), the University of Canterbury (UC) and the University of Auckland (UA). The focus of UTS is the assessment of various performance issues of long-span timber only and TCC flooring systems for multi-storey timber buildings. The work presented in this thesis deals with the investigation of the dynamic performance of timber only and TCC flooring systems, which is one of the sub-objectives of the research focus at UTS.In particular, the presented research assesses the dynamic performance of long-span timber and TCC flooring systems using different experimental und numerical test structures. For the experimental investigations, experimental modal testing and analysis is executed to determine the modal parameters (natural frequencies, damping ratios and mode shapes) of various flooring systems. For the numerical investigations, finite element models are calibrated against experimental results, and are utilised for parametric studies for flooring systems of different sizes. Span tables are generated for both timber and TCC flooring systems that can be used in the design of long-span flooring systems to satisfy the serviceability fundamental frequency requirement of 8 Hz or above. For floors where vibration is deemed to be critical, the dynamic assessment using the 8 Hz frequency requirement alone may not be sufficient and additional dynamic criteria such as response factor, peak acceleration and unit load deflection need to be satisfied. To predict the fundamental frequency of various TCC beams and timber floor modules (beams), five different analytical models are utilised and investigated.To predict the cross-sectional characteristics of TCC systems and to identify the effective flexural stiffness of partially composite beams, the “Gamma method” is utilised. Essential input parameters for the “Gamma method” are the shear connection properties (strength, serviceability stiffness and ultimate stiffness) that must be identified. Therefore, a number of experimental tests are carried out using small scale specimens to identify strength and serviceability characteristics of four different types of shear connection systems and three of them were adopted in the TCC beams. The connections included two types of mechanical fasteners (normal wood screw and SFS screw) and two types of notched connectors (bird-mouth and trapezoidal shape) with coach screw.Traditionally, the composite action of a system is determined from static load testing using deflection measurements. However, static load testing is expensive, time consuming and difficult to perform on existing flooring systems. Therefore, two novel methods are developed in this thesis that determines the degree of composite action of timber composite flooring systems using only measurements from non-destructive dynamic testing. The core of both methods is the use of an existing mode-shape-based damage detection technique, namely, the Damage Index (DI) method to derive the loss of composite action indices (LCAIs) named as LCAI1 and LCAI2.The DI method utilises modal strain energies derived from mode shape measurements of a flooring system before and after failure of shear connectors. The proposed methods are tested and validated on a numerical and experimental timber composite beam structure consisting of two LVL components (flange and web). To create different degrees of composite action, the beam is tested with different numbers of shear connectors to simulate the failure of connection screws. The results acquired from the proposed dynamic-based method are calibrated to make them comparable to traditional static-based composite action results. It is shown that the two proposed methods can successfully be used for timber composite structures to determine the composite action using only mode shapes measurements from dynamic testing.
Introduction: Ear disease in children is a major public health concern in developing countries. In spite of availability of potent antibiotics, severe life threatening complications of ear diseases ...can occur. Objective: This study was done to find out the prevalence of different types of otological disease in school going children of Kathmandu valley. Method: This is prospective study among 1245 school children aged between 5-12 years in the time period of June 2007 - May 2008. Students were randomly selected from 4 different schools of Kathmandu valley. All these children were interviewed, examined otoscopically and findings were noted in the performa. Informed consent was taken from guardians to participate in this study. Statistical analysis was done using frequency and percentage. Results: Out of 1245 children, 64.0% were male and 36.0% female children. The most common otological diseases were wax (60.6%), followed by chronic suppurative otitis media (5.7%) and otitis media with effusion (3.7%). In CSOM, there was 85.9% tubotympanic type. Overall otological diseases were present in 75.7% children. Conclusion: There is a high prevalence of otological diseases in school going children of Kathmandu valley. Health education, improvement of socioeconomic status and health facilities will be helpful in reducing the prevalence of otological diseases.
Xpert MTB/RIF assay is regarded as a great achievement of modern medicine for the rapid diagnosis of multidrug-resistant tuberculosis (MDR-TB). The main purpose of this study was to determine the ...performance of Xpert MTB/RIF assay compared to conventional drug susceptibility testing (DST) method for the diagnosis of MDR-TB. A comparative cross sectional study was carried out at German-Nepal Tuberculosis Project, Kathmandu, Nepal, from April 2014 to September 2014. A total of 88 culture positive clinical samples (83 pulmonary and 5 extra-pulmonary) received during the study period were analyzed for detection of multidrug-resistant tuberculosis by both GeneXpert MTB/RIF assay and conventional DST method. McNemar chi square test was used to compare the performance of Xpert with that of DST method. A p-value of less than 0.05 was considered as statistically significant. Of total 88 culture positive samples, one was reported as invalid while 2 were found to contain nontuberculous Mycobacteria (NTM). Among remaining 85 Mycobacterium tuberculosis culture positive samples, 69 were found to be MDR-TB positive by both methods. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of GeneXpert MTB/RIF assay were found to be 98.6%, 100%, 100% and 93.8% respectively. Statistically, there was no significant difference between the diagnostic performance of Xpert and conventional DST method for detection of MDR-TB. GeneXpert MTB/RIF assay was found to be highly sensitive, specific and comparable to gold standard conventional DST method for the diagnosis of MDR-TB.
Full text
Available for:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Farmers’ knowledge on pesticides and their safe use are critical for implementing effective pest management program. A household survey was conducted using the semi-structured questionnaire to ...evaluate vegetable growers’ knowledge on pesticide safety and pest management practices in Nepal. Results indicated that chemical pesticides were the primary choice of over 80% growers for pest management. Notably, 90% growers were aware of adverse effects of pesticides on human health and to the environment. Over 84% growers used at least one form of personal protection equipment (PPE) during pesticide spray or handling, although the quality and appropriateness of the PPE warrants further investigation. Nearly 17% growers received at least one short-term training on integrated pest management (IPM); however, all of them neither knew the harmful effects of pesticide residues nor practiced proper pesticide disposal methods. Over 90% of growers rely on local pesticide retailers (i.e., Agro-vets) for technical know-how about pesticide selection, handling, and use. This study highlighted a need for immediate implementation of strict pesticide use regulations and recommended educational programs for pest control professionals, growers, and pesticide retailers.