Metal Spoon Research Articles

A Simple Fecal Flotation Method for Diagnosing Zoonotic Nematodes Under Field and Laboratory Conditions.

Diagnosis of canine parasites with zoonotic potential such as Toxocara canis and Ancylostoma caninum under field conditions is usually difficult due to limited access to a laboratory in rural and suburban areas in Mexico. This study aimed to detect T. canis and Ancylostoma spp. in fecal samples collected from dogs in Mexico from 2017 to 2021 under field conditions. Sample size calculation resulted in a target enrollment of 534 dogs across the country. Samples were collected directly from the rectum or the ground after defecation. Samples were stored in individual, tightly sealed, plastic bags at 4 °C. A saturated solution of sodium chloride (specific gravity [SpG] 1.20) was prepared both under field and laboratory conditions. Within 3 days of collection, 2-4 g of feces were tested for parasites using a flotation method by suspending each fecal sample in a saline solution. Feces were mixed with the flotation solution and crushed using a metal spoon. Once a uniform consistency was achieved, the fecal sample was poured into a new plastic cup using a sieve and allowed to sit for 10-15 min. Three drops from the top of the mixture were collected using a sterilized inoculating loop. The slides were placed on the microscope and parasites were identified by trained parasitologists. Fecal samples from 1,055 dogs were screened microscopically. The number of positive samples for Ancylostoma spp.was 833 (78.95% frequency) and 222 (21.04%) for T. canis. These findings illustrate the importance of identifying zoonotic helminths in dogs living in urban and rural areas in Mexico using a coproparasitoscopic technique in the laboratory and under field conditions.

Metal spoons of the 14th-18th centuries from the archaeology collection of the National Museum of Lithuania: Typology, chronology and provenance

Metal spoons from archaeological excavations in Lithuania are a rare find. Therefore, no research has been done on their shape, chronology or provenance. The aim of this article is to identify what types of metal spoons were owned by the residents of the Grand Duchy of Lithuania, whether the spoons were imported or produced locally, and whether the western European spoon trends had any influence on the material culture of the Grand Duchy of Lithuania. Only 19 spoons from the archaeology collection of the National Museum of Lithuania are attributed to the 14th–18th centuries. A morphological typology based on the spoons’ finials and handles was chosen in the current study. The first type is a spoon with a hexagonal ball finial from the second half of the 14th century. The other five types of spoons, from the second half of the 16th century and the 17th century, are characterised by a strawberry-shaped finial, an apostle figure, a twisted handle, a flat handle, and a hexagonal handle, respectively. The last type — a spoon with a rounded top — belongs to the end of the 17th century and the18th century. The spoon types and their chronology correspond to the types of spoons produced in northern, western and central Europe during the same period. This indicates that residents of the Grand Duchy of Lithuania not only followed the trends of the European cutlery fashion but also reacted promptly to changes. Although there is insufficient data to say with certainty whether non-precious metal spoons were produced in the Grand Duchy of Lithuania, it can be shown at least that the goldsmiths there produced silver spoons which were popular in the region at the time.

Environmental Pollution by Lost Fishing Tackle: A Systematic Assessment in Lake Eixendorf

Environmental pollution by lost fishing tackle is hardly considered in freshwater management. We collected and classified lost angling tackle during the dewatering of Lake Eixendorf, Germany. Based on the results, 1 item per 100 m2 lake area was found, resulting in 5442 items, with an overall weight of more than 65 kg. This included more than 5 km of braided and monofilament fishing lines of various diameters. Lures used for active fishing methods such as stickbaits (shads and twister), metal spoons, spinners, and hard plastic baits had the greatest weight contribution (53.4%). Tackle lost from passive fishing methods (45.1%) mostly comprised groundbaiting feeder baskets and classical lead sinkers. Concerning the chemical composition, most lost items contained a composite mix of different materials. Lead was most abundant (45 kg), followed by plastics (13 kg) and steel (6 kg). Other materials such as copper, aluminum, brass (altogether 376 g), and chemicals from glow sticks (25 g) were less frequently found. Environmental pollution by lost fishing tackle deserves attention and, due to its potential environmental consequences, needs to be integrated into the pollution management of aquatic ecosystems, e.g., by identifying the most problematic items and by regulating the production and use of gear containing hazardous substances.

The Parties

The Parties Bipin Aurora (bio) Yes, this was the pattern in those Embassy days. The men sat on one side of the room, drank their whisky and gossiped about the office. The women sat on the other side, drank their ginger ale and took care of the children. Mr. Ratra's singing, this was the highlight of the evening. "The voice of a nightingale," they said. "You should be on All India Radio." This was the highlight of the evening and no one—no one—wanted to miss it. "One song, Ratraji," spoke the host of the party. "You embarrass me, Mr. Bhatia." "One song, Ratraji, that is all we ask for." Mr. Ratra yielded to the pressure—how could he not? Mr. Kumar was sitting on the hard chair beside the end table. He moved the table a little and started tapping on it with the heel of his hand. Mr. Bhatia, who sat at the opposite end table, started tapping on the table with his metal spoon. These were the accompaniments, the rhythm. Mr. Ratra opened his mouth—a long aaah, another long aaah, and he ventured into the song. It was a Hindi film song, "Yeh Mera Prem Patra Par Kar." The words went like this: Upon reading this letterI hope you will not be upsetYou are my lifeYou are my devotion. "Wah wah! Wah wah!" came the sounds of approval from the audience. I used to call you the moon,But even in that there is a stain.I used to call you the sun,But even in that there is fire.So this only I will say to you:That I love you, I love you, I love you. This song was by Mohammed Rafi. But sometimes the song was by Mukesh or Hemant Kumar. These were Mr. Ratra's three favorite singers. It was a slow song—perhaps a ghazal of some kind; it was a fast song—no doubt a love song. And Mr. Ratra was off: [End Page 36] I will consider you the GangaI will consider you the YamunaYou are so close to my heartThat I will consider you mine. If I die, then my soul will roamWaiting for you, waiting for you. And so on. The men and women listened in earnest. A few of the women cradled babies in their arms and tried to put them to sleep. If the baby fussed or began to cry, the mother rose quickly and hurried to the hallway outside. This was a performance and she did not want to disturb it. It was a sacrifice for the mother to leave the room. Of course it was. But a performance is a performance, even a work of art, and it should not be disturbed. Also, every Indian mother knows the importance of raising a child, even the sacredness of it. And so how can a crying child be ignored? Must its needs not be attended to? One time I still remember—remember to this day. A child began to cry and the mother, Mrs. Jaitly, did not leave the room. At first Mr. Ratra bravely tried to go on with the song. But the child's cries grew louder and louder, and at last Mr. Ratra stopped. An awkward silence filled the room. "Kusum!" the harsh voice was heard from the corner. It was the woman's husband, Mr. Jaitly. "Have you no shame?" Have you no shame? The harsh, stinging words, and in front of everyone. But this Kusum understood, even she. She was not the brightest of women but even she understood. She rose, patting now the back of the child who rested on her shoulder. "Son, son," she said. "No need to cry. Mummy is with you, Mummy is with you." And even she left the room. Mr. Ratra returned to his song—indeed he did—and order was restored to the room. Yes, this was the pattern in those Embassy days. The men sat on one side, drank their whisky and gossiped. The women sat on the other side, drank their ginger ale and took care of the children. And then other...

The accumulation of polycyclic aromatic hydrocarbons in snails and soil in Igbekebo, Ondo State, Nigeria

Polycyclic Aromatic Hydrocarbons (PAHs) are harmful to human health and can cause cancer. The PAHs concentration in soil and snail samples collected from the Igbekebo region of Ondo state was measured in this study. Using metal spoons, soil samples were taken from five separate sites and placed in foil paper bags at a depth of 10 cm. For each type of snail under study, eight (8) samples were randomly taken from five distinct locations. Gas chromatography flame ionization detector (GC-FID) was used to analyze the samples. The estimated daily intake (EDI) and bioaccumulation factor (BAF) in the snail samples, as well as the toxic equivalence quotient (TEQ) and mutagenicity equivalence quotient (MEQ) in the soil samples, were calculated. This study showed that concentration levels of PAHs in soil, freshwater snail (Bulinus globosus), and land snail (Achatina marginata) samples were within the range of 0.1894–48.8063 μgkg−1, 0.15–40.14 μgkg−1, and 0.56–60.79 μgkg−1 respectively. Dibenzo(a,h)anthracene, anthracene, and Dibenzo(a,h)anthracene, respectively, were the most common PAHs found in soil, freshwater snails, and land snails. The total PAHs concentration in freshwater snail sample was lower when compared to other studies. The toxicity of each PAH in the soil sample was determined using Toxic Equivalent Factor (TEF) and Mutagenic Equivalent Factor (MEF) values, and the results were compared to the National Institute for Public Health and the Environment’s (Dutch: Rijksinstuut voor Volksgezondheid en Milieu (RIVM)) toxicity limits. It is advised to restrict crop and land snail consumption in Igbekebo since the soil samples from Igbekebo had a higher PAH toxicity value than the RIVM toxicity limit.

Unusual Roman Iron Age burials on the Links of Pierowall, Westray, Orkney

Antiquarian accounts and surviving finds allow two Iron Age cist-burials found in the late 18th century on the Links of Pierowall on Westray, Orkney, to be reconstructed, although no details of the bodies survive (but both were most probably inhumations); the unusual finds have not previously received full attention. One burial contained a polished stone disc, used as a palette for grinding some valued substance, probably cosmetic, medical or narcotic. A review of the type emphasises its particular prevalence in northern Scotland, and places it within the wider context of an increase in artefacts linked to personal appearance and behaviour in the Roman Iron Age. The other burial contained a well-known Roman glass cup and a hitherto ignored ‘metal spoon’ which can reasonably be identified as a Roman import as well, plausibly of silver. Such spoons are rare import goods, known from rich burials beyond the frontier on continental Europe in the late 2nd and 3rd century AD. This suggests that the Roman world adopted similar approaches to its varied neighbours in terms of the goods offered in (most likely) political or diplomatic connections.

Pre-hospital management of childhood convulsions in Ilesa, South-west, Nigeria

Convulsion evokes a lot of fear in mothers and caregivers whenever it occurs. They even think that their child is dying. Many interventions are often carried out because of anxiety and limited knowledge. The aim of this study is to examine the interventions instituted by caregivers for children with convulsions before presentation in the hospital for treatment. We prospectively studied all the 276 children that presented to the emergency room with convulsion over a period of seven months and the care administered at home before presenting in the hospital was noted. One hundred and nine (39.5%) of the children had water poured on them during convulsion. Substances administered orally were; salt 32 (11.6%), onions 14 (5.1%), palm oil 3 (1.1%) and herbal concoctions 13 (4.7%), of which two contained cow urine. Metal spoons were used as mouth gag in 41 (14.9%) of subjects while 29 (10.5%) children had intramuscular (IM) injections given by health workers at home (eight) in various health centres (15) and hospitals (6). Other interventions were scarifications and drinking of their mothers’ urine. While 40 (14.5%) children had more than one treatment given to them before their arrival, 99 (35.9%) had no treatment given before their arrival. Caregivers continue to carry out various interventions at home for convulsions in children. Majority of the interventions are not beneficial while some are harmful. There is, therefore, need to continue to educate caregivers on the appropriate prehospital interventions of convulsions in children before presenting in the hospital. Key words: Convulsion, pre-hospital interventions.

A Case of Oropharyngeal Trauma with Mediastinal Emphysema Caused by a Metal Spoon

A Case of Oropharyngeal Trauma with Mediastinal Emphysema Caused by a Metal Spoon

Verification of a Stability of Polymer Matrix for the Salivary-Nitrate-ISFETS

[Introduction] We have studied the stress measurement by making use of salivary nitrate, which can be a candidate of stress markers. Ion-selective Field-Effect Transistors (ISFETs) are suitable for the on-site single-drop analysis of salivary nitrate within 10 seconds. The ISFETs are based on field-effect transistors (FET) combined with an ion-selective membrane (ISM). The ISFETs are characterized by the ISM which consists of ionophore, plasticizer and polymer matrix. An ionophore and a plasticizer of the ISM are optimized to determine salivary nitrate from our researches. However, the performance of the polymer matrix is not enough to do so. Hence, the ISFETs have a problem for salivary nitrate which is called the initial drift. The initial drift makes it difficult to determine salivary nitrate. Fogt, et al. considered that the cause of the initial drift is the aqueous layer on between the ISM and the ISFETs’ gate (gate)-interface generating the pH change. This pH change is concerned with CO2 gas diffusion which approaches the aqueous layer through the ISM. The gate is made of pH-sensitive material (Ta2O5, SiO2, and Si3N4), hereinafter pH-sensitive ISFETs called pH-ISFETs. Other previous researches attempted to insert the inner layer: pHEMA-gel saturated buffer, Ag/AgCl and H+ selective membrane in the aqueous layer. On the other hand, Abramova, et al. considered that the cause of initial drift is the protein adsorption to the ISM surface. Photocurable polyurethane as a matrix membrane is effective to measure the electrolyte of blood electrolyte. However, there is no report that aims to suppress drift in saliva. In this research, we verified polymer stability of ISM and introduce the novel polyurethane matrix. Actually we used three polyurethanes as polymer matrix: a novel polyurethane A and a conventional B and C. The polyurethane is widely used as a catheter in the medical field. Hence, polyurethane is expected to suppress the adsorption of glycoproteins in saliva. Furthermore, the ISM based on the novel polyurethane A is adhesiveness and it can be closely adhered to the gate to restrict the appearance of the aqueous layer. [Method] Nitrate selective ISFETs (NO3-ISFETs) are prepared by the following procedure. We dissolve completely and make the THF solution which forms the nitrate-selective membrane, containing 5 wt% of the nitrate ionophore ([Cu(bcp)2]NO3), 65 wt % of the plasticizer (NPDDE) and 30 wt% of the polymer matrixes. We cast the THF solution onto the gate part of the pH-ISFETs. After this casting, THF solution on the gate part is evaporated in a clean space, and this manner repeats several times. After all, the nitrate-selective membrane is completely dried half a day. The thickness of the nitrate selective membrane is ca. 0.2 mm. The NO3-ISFETs was conditioned in 1 mM (mol/L) KNO3 solution (standard solution) for 3 hours. Its calibration curve and selectivity coefficients are determined using the Nicolsky-Eisenman’s equation. The evaluation of initial drift is performed by looking at the output values of ISFETs immersed in various solution about 8 hours. Main measurement target is human saliva. Two types of human saliva are prepared for the sampling method. The one is obtained from the saliva-collection kit (Salivette®) and another is obtained from a metal spoon. For comparison of the initial drift, we use four kinds of solutions: standard solution, artificial saliva, the standard solution with 0.5 wt% of Mucin (mucin solution), and standard solution with CO2 bubbling (CO2 solution). Artificial saliva is the aqueous solution reproducing human’s salivary electrolytes. All subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki, and the saliva sample experiments were approved by the Ethics Committee of National Institute of Advanced Industrial Science and Technology (AIST). [Results and Discussion] The calibration curves and selectivity the coefficients show that potential determinants are not polymer matrix but ionophore and plasticizer. The drift characteristics of ISFETs based on the novel polyurethane A is more stable than other ISFETs based on the conventional polyurethanes B and C. These results may be due to the adhesiveness of the novel polyurethane A. On the other hand, we hypothesize that the urethane bond captures H+ and OH- in the ISM. However, this hypothesis is not applied for the initial drift in conventional polyurethane membrane. Therefore, this hypothesis is under investigation and we would like to introduce and discuss the details on the day of my presentation.

A novel fingerprint powder formulation based on niagra blue dye: A preliminary evaluation

Fingerprints are the most infallible means of identification. It is important physical evidence usually found on various items recovered from the crime scenes. It can be used to ascertain the identity of person and provide a direct link to the suspect. Wide range of methods (optical, physical and chemical) can be used detect latent fingermarks on porous and non-porous items recovered from crime scenes. A novel fingerprint powder composition based on Niagara blue has been formulated and used for developing latent fingermarks. The formulation develops sharp and clear fingerprints on wide range of dry, smooth, non-porous surfaces such as glass, aluminum foil, metallic spoon, wooden table etc. which may be discerned in natural light. This formulation is useful in detecting and developing weak and fragmented chance prints from scene of crime. The developed formulation is non-hazardous, non-toxic and cost-effective in nature.

Zihinsel Yetersizliğe Sahip Öğrencilere “Sert-Yumuşak” Maddelerin Öğretimi İçin Öğretim Materyallerinin Seçim Süreci

Bu çalışmada ortaokul özel alt sınıfta öğrenim gören zihinsel yetersizliğe sahip öğrencilere bazı maddelerin “Sert-Yumuşak” özelliklerinin öğretimi için hazırlanan materyaller ve bu materyallerin seçimini etkileyen unsurlar incelenmiştir. Çalışmada nitel araştırma yaklaşımlarından durum çalışması kullanılmıştır. Katılımcılar zihinsel yetersizliğe sahip üç öğrenciden oluşmaktadır. Çalışmada materyaller seçilirken öncelikle alan yazın taraması yapılmış ve ders kitapları incelenmiştir. Ayrıca öğrenciler bir dönem boyunca haftada üç gün yapılandırılmamış gözlem tekniğiyle gözlenmiştir. Bu gözlemler kodlanarak materyallerin seçimi için zihinsel yetersizliğe sahip öğrencilerin öğrenme ihtiyaçları sosyal ve akademik yönden belirlenmiştir. Bu ihtiyaçlar süreç boyunca yapılan uzman görüşmeleri ile birleştirilerek sert-yumuşak maddelerin öğretiminde kullanılacak materyaller belirlenmiştir. Materyallerin farklı duyu organlarına hitap etmesine, öğrenci seviyesine uygun, günlük yaşamla ilişkili, basit ve sade olmasına dikkat edilmiştir. Çalışmanın sonucunda sert kavramının öğretimi için taş, cam bardak, kitap, kurşun kalem, plastik lego ve metal kaşık; yumuşak kavramının öğretimi için ise pamuk, oyun hamuru, örgü yünü ipi, yastık, sünger ve plastik top seçilmiştir.

Hand or spoon? Exploring the neural basis of affective touch in 5-month-old infants

In adults, affective touch leads to widespread activation of cortical areas including posterior Superior Temporal Sulcus (pSTS) and Inferior Frontal Gyrus (IFG). Using functional Near Infrared Spectroscopy (fNIRS), we asked whether similar areas are activated in 5-month-old infants, by comparing affective to non-affective touch. We contrasted a human touch stroke to strokes performed with a cold metallic spoon. The hypothesis that adult-like activation of cortical areas would be seen only in response to the human touch stroke was not confirmed. Similar patterns of activation were seen in both conditions. We conclude that either the posterior STS and IFG have not yet developed selective responses to affective touch, or that additional social cues are needed to be able to identify this type of touch.

MODERN METHOD OF DETECTION OF TAXONOMIC COMPOSITION OF MICROBIALS IN URINARY WAYS OF WOMEN

In case of necessity to conduct a more qualitative examination of women with inflammatory processes, which are localized in the organs of the genitourinary system and in order to obtain an objective assessment of normal and pathogenic microflora in the urogenital pathways of a woman, a polymerase chain reaction method is proposed with the use of the diagnostic test of the system Femoflore-16. This system help identification of Lactobacillus spp., Enterobacterium spp., Streptococcus spp., Staphylococcus spp., Gardnerella vaginalis, Eubacterium spp., Fusobacterium spp., Veilonella spp., Clostridium spp., Mobiluncus spp., Peptostreptococcus spp., Atopobium vaginae, Mycoplasma hominis and genitalium, Ureaplasma (urealyticum and parvum), Candida spp. and perform complex analysis qualitative and quantitative composition of pathogenic and comditionaly pathogenis microorganismsare described. An original binary metal spoon probe is proposed for qualitative selection of the test material, tested in practice. This metal spoon probe is a cylindrical section of length 180 and a diameter of 2.0 mm made of stainless high quality chromium-nickel steel of the mark 12 KhNZA. The ends of the segment through the advancement of the formed permeable spoon-shaped terminals with a capacity of 0.025 and 0.05 ml. For the maximum reduction of the adhesive of the test material, the working surface of the probe of its surface has a roughness of 13-14 a-b classes according to the state standards 2.309.13. Sterile probe by way of (sterilization carried out by 96 ° ethanol or by heating) of local small pressure and scraping of the mucous membranes is easily carried out with a dosage capture of material in volume 0.025 or 0>0.5 ml. The volume of material taken with the probe is quite sufficient for the molecular-genetic method of investigation, in particular, the polymerase chain reaction. Clinical material is then placed in a prepared sterile test tube - eppendorf. After that, on the test tube, indicate the name of the patient, date and name of the analysis and send it to the laboratory.Described testimony to conduct a study and the requirements that a woman must observe before conducting a selection of material for PCR. The data on composition of microflora in different periods of a woman's life are given.

An extraordinary case of a hungry man: an unusual foreign body - A Case Report

This case reports a rare case of accidental metal spoon swallowed by a normal adult which was successfully removed without complication under local anesthesia using a McGill forceps via laryngoscope. Aerodigestive foreign bodies are almost always managed by the otolaryngologist.

Proventricular–Ventricular Impaction in two ostrich chicks (Struthio camelus)

Impaction of the proventriculus and ventriculus due to ingestion of stones, wood, ceramic tiles, metal spoons and plastic materials was confirmed at postmortem examination in two ostrich chicks (Struthio camelus) aged 8-months and 4-months from two flocks in Gwagwalada and Lugbe in Abuja, Nigeria respectively. Both cases were presented to the Veterinary Teaching Hospital (VTH) of University of Abuja (U.A.) in November, 2014 (first case) and in May 2016 (second case) with pale mucous membranes, sternal recumbency, outstretched neck, ruffled feathers, dehydration and emaciation. Abdominal palpation in both cases revealed firm and gritty sensations. Antibiotic (oxytetracycline) long acting, Vitamin B-complex and 5% Dextrose saline therapy was instituted in both cases. However, both ostriches later died and were autopsied. The post-mortem revealed impaction of the proventriculus and ventriculus with foreign bodies (such as stones and sand, spoons, wood fragments and ceramic tiles). In addition, there was thickened mucosa of the proventriculus with ulcers, hydropericardium, petechiae on mucosal and serosal surfaces of cervical part of the trachea in the first case; while the second case had petechiae in the mucosa of the duodenum. Proventricular-ventricular foreign body impaction was diagnosed as the cause of death in both ostrich chicks.

Predictors of early relapse in adolescent crack users after hospital discharge

Predictors of early relapse in adolescent crack users after hospital discharge

Foreign in Colon

An amulet with a blue bead and metal coin are the most common causes of foreign body ingestion in childhood in Turkey. There are few case reports of metal spoons ingested in the literature. In this case report, our aim is to report a teaspoon that was found incidentally in the ascending colon as an uncommon cause of foreign body ingestion. (JAEM 2014; 13: 204-5)

Assessment of Liceo de Cagayan University’s Solid Waste Management System

This study aimed at assessing the solid waste management system of Liceo de Cagayan University as basis for the crafting of a solid waste management plan for the university. This study included all personnel of the different departments in the main campus of the university. The data were collected using a survey questionnaire and analyzed using descriptive statistics. Findings reveal that the respondents were moderately aware that R.A. 9003 is known as “the “Ecological Solid Waste Management Act of 2000”; that solid wastes must be segregated according to their classification at source as “recyclables”, “non recyclables”, “compostable” and “special waste” and must be placed at the designated containers; and that a Material Recovery Facility (MRF) is required to avoid pollution that poses danger to public health and safety, wildlife, aquatic life, and vegetation. Moreover, the respondents were moderately receptive to the implementation of the solid waste management system that starts with waste characterization and waste composition to waste minimization through the use of substitute materials like metal spoon and fork instead of plastic and food tray or plates instead of styrofoam boxes. As found, the respondents’ level of awareness of R.A. 9003 and level of receptiveness to solid waste management differed significantly. The respondents in the non-academe had significantly higher level of awareness of R.A. 9003 and receptiveness to solid waste management than those in the academe.  Keywords - Solid waste management system, solid waste, R.A. 9003. Â

Structure Design and Optimization of the Metal Spoon Cross Rolling Mills

We used to adopt the manual operation on the closed cross rolling mills to produce metal spoons in the traditional ways which is inefficient and hard to handle. The open cross rolling mill developed in this paper enables automation coordinating with the conveyer belt. Productivity can rise through rack structure optimization and parameter adjustment. Compared with the traditional manual operation, the open cross rolling mill is safer, more efficient and more convenient to handle.

Accurately administering oral medication to children isn't child's play

ObjectiveParents administer oral medications with various measuring devices including metal teaspoons, calibrated spoons and oral syringes. We aimed to determine which was the most accurate.DesignSelf-controlled, non-randomised, experimental study.SettingCaregivers attending paediatric...