Search results for: medical decision support

Authors: Naeemeh Silvari

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The tourism industry is important for different nations in two ways. Apart from economic benefits, it provides a basis for getting acquainted with the culture of different regions of the world. Depending on the capacities and contexts of their geography, countries try to attract more people to their country in different ways. Health tourism has been an important branch of the tourism industry in recent years, and many countries around the world are trying to make progress in this field and attract many tourists from around the world. Iran, like many developing countries in the Middle East and East Asia, is trying to improve and develop tourist attractions in the field of health. Due to the cheapness of providing medical services to tourists, many people have traveled to Iran for medical and health care. However, there is a long way to go before recognizing and reaching the desired position in this field. Due to the direct relationship between tourism and culture, the negative attitude towards the context of Iran has caused foreign travelers not to choose this country as their tourist destination. In this article, we tried to study the change in their attitude towards Iran by using semi-structured interviews of foreign travelers who traveled to Iran for treatment and medical services. The text of the interviews was coded and analyzed by MAX QDA software. Many of the people in the sample were from Middle Eastern and Arabic-speaking countries. Influenced by the media, they felt rejected by the Iranians before the trip. During their stay in Iran and in connection with the health care staff, in the first stage, they pointed out that many of their anxieties about the kind of treatment of Iranians have been allayed. In addition to the satisfaction with the medical services provided, they considered the atmosphere of Iranians' interaction with foreign travelers to be relatively appropriate, and some stated that Iran would be the destination of their leisure trip in the future. At the end of the research, policymakers were suggested that in order to resolve cultural contradictions rooted in values, they should first be recognized and seek to use other opportunities to resolve contradictions and form interactions with other cultures.

Keywords: cultural conflict, health tourism, cultural prejudice, advertising and media

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Authors: Shir Daphna-Tekoah, Nurit Eitan-Gutman, Uri Balla

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Background: Systemic documentation is essential in social work practice. Collaboration between an institution of higher education and social work health care services enabled adaptation of the medical documentation model of SOAP in the field of social work, by creating the ISOAPS model (Introduction, Subjective, Objective, Assessment, Plan, Summary) model. Aims: The article describes the ISOAPS model and its implementation in the field of social work, as a tool for standardization of documentation and the enhancement of multidisciplinary collaboration. Methods: We examined the changes in standardization using a mixed methods study, both before and after implementation of the model. A review of social workers’ documentation was carried out by medical staff and social workers in the Clalit Healthcare Services, the largest provider of public and semi-private health services in Israel. After implementation of the model, semi-structured qualitative interviews were undertaken. Main findings: The percentage of reviewers who evaluated their documentation as correct increased from 46%, prior to implementation, to 61% after implementation. After implementation, 81% of the social workers noted that their documentation had become standardized. The training process prepared them for the change in documentation and most of them (83%) started using the model on a regular basis. The qualitative data indicate that the use of the ISOAPS model creates uniform documentation, improves standards and is important to teach social work students. Conclusions: The ISOAPS model standardizes documentation and promotes communication between social workers and medical staffs. Implications for practice: In the intricate realm of healthcare, efficient documentation systems are pivotal to ensuring coherent interdisciplinary communication and patient care. The ISOAPS model emerges as a quintessential instrument, meticulously tailored to the nuances of social work documentation. While it extends its utility across the broad spectrum of social work, its specificity is most pronounced in the medical domain. This model not only exemplifies rigorous academic and professional standards but also serves as a testament to the potential of contextualized documentation systems in elevating the overall stature of social work within healthcare. Such a strategic documentation tool can not only streamline the intricate processes inherent in medical social work but also underscore the indispensable role that social workers play in the broader healthcare ecosystem.

Keywords: ISOAPS, professional documentation, medial social-work, social work

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Authors: F. Gallop, C. Ward, M. Zaky, M. Vaghela, R. Sabaratnam

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Nitrous oxide (N₂O) has been used in anaesthesia for over 150 years owing to advantageous physical and pharmacological properties. However, with a global warming potential of 310, we have an urgent responsibility to reduce its usage and emission. Anecdotal evidence in our hospital trust suggests minimal N₂O usage, yet our theatres receive a staggering supply. This warranted further investigation. We used a data collection tool to prospectively capture quantitative and qualitative data regarding N₂O cases during one week: this recorded demographics, N₂O indications, clinical management, and total N₂O consumption in litres. In addition, N₂O usage in dental sedation suites and paediatric theatres was separately quantified. Pipeline supply data was acquired from British Oxygen Company accounts. We captured 490 cases. 4% (n=19) used N₂O, 63% (n=12) of these in dental theatres. Common N₂0 indications were induction speed (37%) and rapidly increasing anaesthesia depth (32%). In adult cases, N₂O was always used intraoperatively rather than solely at induction. 74% (n=14) of anaesthetists reported environmental concern over using N₂O. The week’s total N₂O usage was 8109 litres, amounting to 421,668 litres annually. However, the annual N₂O pipeline supply is 2,997,000 litres; an enormous 1.8 million Kg of CO₂. Our results supportively demonstrate that the N₂O pipeline supply greatly exceeds its clinical use. Acknowledging clinical areas not audited, the discrepancy between supply and usage suggests approximately 2.5 million litres of yearly wastage. We consequently recommend terminating the N₂O pipeline supply in minimally used areas, eliminating 1.5 million Kg of CO₂ emissions. High usage clinical areas could consider portable N₂O cylinders as an alternative. In Sweden, N₂O destruction technology is routinely used to minimise CO₂ emissions. Our results support National Health System investment in similar infrastructure.

Keywords: anaesthesia, environment, medical gases, nitrous oxide, sustainability

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Authors: Angelis P. Barlampas

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The purpose of this study is to inform the reader, about the various applications of artificial intelligence (AI), in cardiac imaging. AI grows fast and its role is crucial in medical specialties, which use large amounts of digital data, that are very difficult or even impossible to be managed by human beings and especially doctors.Artificial intelligence (AI) refers to the ability of computers to mimic human cognitive function, performing tasks such as learning, problem-solving, and autonomous decision making based on digital data. Whereas AI describes the concept of using computers to mimic human cognitive tasks, machine learning (ML) describes the category of algorithms that enable most current applications described as AI. Some of the current applications of AI in cardiac imaging are the follows: Ultrasound: Automated segmentation of cardiac chambers across five common views and consequently quantify chamber volumes/mass, ascertain ejection fraction and determine longitudinal strain through speckle tracking. Determine the severity of mitral regurgitation (accuracy > 99% for every degree of severity). Identify myocardial infarction. Distinguish between Athlete’s heart and hypertrophic cardiomyopathy, as well as restrictive cardiomyopathy and constrictive pericarditis. Predict all-cause mortality. CT Reduce radiation doses. Calculate the calcium score. Diagnose coronary artery disease (CAD). Predict all-cause 5-year mortality. Predict major cardiovascular events in patients with suspected CAD. MRI Segment of cardiac structures and infarct tissue. Calculate cardiac mass and function parameters. Distinguish between patients with myocardial infarction and control subjects. It could potentially reduce costs since it would preclude the need for gadolinium-enhanced CMR. Predict 4-year survival in patients with pulmonary hypertension. Nuclear Imaging Classify normal and abnormal myocardium in CAD. Detect locations with abnormal myocardium. Predict cardiac death. ML was comparable to or better than two experienced readers in predicting the need for revascularization. AI emerge as a helpful tool in cardiac imaging and for the doctors who can not manage the overall increasing demand, in examinations such as ultrasound, computed tomography, MRI, or nuclear imaging studies.

Keywords: artificial intelligence, cardiac imaging, ultrasound, MRI, CT, nuclear medicine

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Authors: Igor Kontorovich, Rina Zazkis

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We present a framework of researcher knowledge ‎development in conducting a study in mathematics education. The key ‎components of the framework are: knowledge germane to conducting a ‎particular study, processes of knowledge accumulation, and catalyzing ‎filters that influence a researcher decision making. The components of ‎the framework originated from a confluence between constructs and ‎theories in Mathematics Education, Higher Education and Sociology. ‎Drawing on a self-reflective interview with a leading researcher in ‎mathematics education, professor Michèle Artigue, we illustrate how ‎the framework can be utilized in data analysis. Criteria for framework ‎evaluation are discussed. ‎

Keywords: community of practice, knowledge development, mathematics education research, researcher knowledge

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Authors: N. W. Paul, M. Banerjee

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Discussing the nexus between global health policy and local practices, this article addresses the recent Ebola outbreak as a role model for narrative co-constructions of epidemic risk. We will demonstrate in how far a theory-driven and methodologically rooted analysis of narrativity can help to improve mechanisms of prevention and intervention whenever epidemic risk needs to be addressed locally in order to contribute to global health. Analyzing the narrative transformation of Ebola, we will also address issues of transcultural problem-solving and of normative questions at stake. In this regard, we seek to contribute to a better understanding of a key question of global health and justice as well as to the underlying ethical questions. By highlighting and analyzing the functions of narratives, this paper provides a translational approach to refine our practices by which we address epidemic risk, be it on the national, the transnational or the global scale.

Keywords: ebola, epidemic risk, medical ethics, medical humanities

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Authors: Tirimisiyu Olaide Gbadamosi

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Individuals go into business for the sake of obtaining regular income, becoming self-employed. Although, there different kinds of business enterprises that female and male can go into, often times, some businesses are regarded more suitable for a particular sex and not the other. This means that there is some gender discrimination in the choice of business one goes into and by extension in entrepreneurship development. Apparently, gender attitudes and behaviors will have positive or negative effects on entrepreneurship development in a society or economy. This research work therefore intends to take a critical look at gender discrimination as they affect entrepreneurship development with particular reference to northern Nigeria in general, using Exceptional Production Services Limited Kaduna, Kaduna North Local Government area as a case study, and also to suggest the possible solution to unidentified problems and give recommendation where necessary. Statement of research problem: Entrepreneurship has generally been recognised as a good medium or strategy for economic development of an individual, a community and a nation. It is also a known a known fact that some gender discrimination are often used in the choice of business or even the decision to go into business. For example, some businesses are regarded as more suitable to men than women. The question here is, is this the right approach to economic development through entrepreneurship? Of what effect is this approach to entrepreneurship development? These and the other questions are what this research intends to find answers to and if possible make recommendations. Significance of the study: The findings of this study will provide a guide for anyone for the establishment of a business in Nigeria. The study will help any prospective entrepreneur to make the right decision of which business to go into and how to contend with gender related issues that might influence its success in business. Furthermore, it is hoped that the study will assist the government and her agencies in the process in developing entrepreneurship development programs. Conclusion: There has been growing recognition that various types of discrimination do not always affect women and men in the same way. Moreover, gender discrimination may be intensified and facilitated by all other forms of discrimination. It has been increasingly recognized that without gender analysis of all forms of discrimination in business, including multiple forms of discrimination, and, in particular, in this context, related intolerance, violations of the human rights of women might escape detection and remedies to address racism may also fail to meet the needs of women and girls. It is also important that efforts to address gender discrimination incorporate approaches to the elimination of all forms of discrimination. Recommendation: Campaigning and raising awareness among young men and women, parents, teachers and employers about gender stereotypical attitudes towards academic performances and the likely consequences of overall educational choices for employment and entrepreneurship opportunities, career progression and earnings.

Keywords: entrepreneurship, economic development, small medium enterprises, gender discrimination

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Authors: Amy Darwin, Claire Blacklock

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Background: Existing literature about delivering evidence-based mental health and psychosocial support (MHPSS) in emergency settings is limited. It is difficult to monitor and evaluate the approach to MHPSS in informal refugee camps such as ‘The Jungle’ in Calais, where there are multiple service providers and where the majority of providers are volunteers. AIM: To identify experiences of MHPSS delivery by service providers in an informal camp environment in Calais, France and describe MHPSS barriers and opportunities in this type of setting. Method: Qualitative semi-structured interviews were conducted with 13 individuals from different organisations offering MHPSS in Calais and analysed using conventional content analysis. Results: Unsafe, uncertain and unsanitary conditions in the camp meant MHPSS was difficult to implement, and such conditions contributed to the poor mental health of the residents. The majority of MHPSS was offered by volunteers who lacked resources and training, and there was no overall official camp leadership which meant care was poorly coordinated and monitored. Strong relationships existed between volunteers and camp residents, but volunteers felt frustrated that they could not deliver the kind of MHPSS that they felt residents required. Conclusion: While long-term volunteers had built supportive relationships with camp residents, lack of central coordination and leadership of MHPSS services and limited access to trained professionals made implementation of MHPSS problematic. Similarly, the camp lacked the necessary infrastructure to meet residents’ basic needs. Formal recognition of the camp, and clear central leadership were identified as necessary steps to improving MHPSS delivery.

Keywords: calais, mental health, refugees, the jungle, MHPSS

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Authors: P. Vosynek, T. Návrat, M. Peč, J. Pořízka, P. Diviš

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Changes of mechanical properties and response behavior of bones is an important external sign of medical problems like osteoporosis, bone remodeling after fracture or surgery, osteointegration, or bone tissue loss of astronauts in space. Measuring of mechanical behavior of bones in physiological and osteoporotic states, quantified by different degrees of protein (collagen) and mineral loss, is thus an important topic in biomechanical research. This contribution deals with the relation between mechanical properties of the turkey long bone–tibia in physiological, demineralized, and deproteinized state. Three methods for comparison were used: densitometry, three point bending and harmonic response analysis. The results help to find correlations between the methods and estimate their possible application in medical practice.

Keywords: bone properties, long bone, osteoporosis, response behavior

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Authors: Pascal Rey, Anaïs Weber

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Many mining projects are being developed in Africa the last decades. Due to the economic opportunities they offer, these projects result in a massive and rapid influx of migrants to the surrounding area. In areas where central government representation is low and local administration lack financial resources, urban development is often anarchical, beyond all public control. It leads to socio-spatial segregation, insecurity and the risk of social conflicts rising. Aware that their economic development is very correlated with local situation, mining companies get more and more involved in regional planning in setting up tools and Strategic Directions document. One of the commonly used tools in this regard is the “Influx Management Plan”. It consists in looking at the region’s absorption capacities in order to ensure its coherent development and by developing several urban centers than one macrocephalic city. It includes many other measures such as urban governance support, skills transfer, creation of strategic guidelines, financial support (local taxes, mining taxes, development funds etc.) local development projects. Through various examples of mining projects in Guinea, A country that is host to many large mining projects, we will look at the implications of regional and urban planning of which mining companies are key playor as well as public authorities. While their investment capacity offers advantages and accelerates development, their actions raise questions of the unilaterality of interests and local governance. By interfering in public affairs are mining companies not increasing the risk of central and local government shirking their responsibilities in terms of regional development, or even calling their legitimacy into question? Is such public-private collaboration really sustainable for the region as a whole and for all stakeholders?

Keywords: Africa, guinea, mine, urban planning

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Authors: Rafla Attia, Claudio Zucca, Bao Quang Le, Sana Dridi, Thouraya Sahli, Taoufik Hermassi

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In Tunisia, landscape change and land degradation are critical issues for landscape conservation, management, and planning. Landscapes are undergoing crucial environmental problems made evident by soil degradation and desertification. Human improper uses of land resources (e.g., unsuitable land uses, unsustainable crop intensification, and poor rangeland management) and climate change are the main factors leading to the landscape transformation and desertification affecting high proportions of the Tunisian lands. Land use planning (LUP) to achieve Land Degradation Neutrality (LDN) must be supported by methodologies and technologies that help identify best solutions and practices and design context-specific sustainable land management (SLM) strategies. Such strategies must include restoration or rehabilitation efforts in areas with high land degradation, as well as prevention of degradation that could be caused by improper land use (LU) and land management (LM). The geoinformatics Land Use Planning for LDN (LUP4LDN) tool has been designed for this purpose. Its aim is to support national and sub-national planners in i) mapping geographic patterns of current land degradation; ii) anticipating further future land degradation expected in areas that are unsustainably managed; and iii) providing an interactive procedure for developing participatory LU-LM transitional scenarios over selected regions of interest and timeframes, visualizing the related expected levels of impacts on ecosystem services via maps and graphs. The tool has been co-developed and piloted with national stakeholders in Tunisia. The piloting implementation assessed how the LUP4LDN tool fits with existing LUP processes and the benefits achieved by using the tool to support land use planning for LDN.

Keywords: land use system, land cover, sustainable land management, land use planning for land degradation neutrality

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Authors: Chih-Hsiang Chang, I-Fan Ho

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This study examines the credibility of the signaling as explanation for IPO initial underpricing. Findings reveal the initial underpricing and the long-term underperformance of IPOs in Taiwan. However, we only find weak support for signaling as explanation of IPO underpricing.

Keywords: signaling, IPO initial underpricing, IPO long-term underperformance, Taiwan’s stock market

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Authors: Rachel Y. Zhang, Christopher K. Anderson

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A critical aspect of revenue management is a firm’s ability to predict demand as a function of price. Historically hotels have used simple time series models (regression and/or pick-up based models) owing to the complexities of trying to build casual models of demands. Machine learning approaches are slowly attracting attention owing to their flexibility in modeling relationships. This study provides an overview of approaches to forecasting hospitality demand – focusing on the opportunities created by machine learning approaches, including K-Nearest-Neighbors, Support vector machine, Regression Tree, and Artificial Neural Network algorithms. The out-of-sample performances of above approaches to forecasting hotel demand are illustrated by using a proprietary sample of the market level (24 properties) transactional data for Las Vegas NV. Causal predictive models can be built and evaluated owing to the availability of market level (versus firm level) data. This research also compares and contrast model accuracy of firm-level models (i.e. predictive models for hotel A only using hotel A’s data) to models using market level data (prices, review scores, location, chain scale, etc… for all hotels within the market). The prospected models will be valuable for hotel revenue prediction given the basic characters of a hotel property or can be applied in performance evaluation for an existed hotel. The findings will unveil the features that play key roles in a hotel’s revenue performance, which would have considerable potential usefulness in both revenue prediction and evaluation.

Keywords: hotel revenue, k-nearest-neighbors, machine learning, neural network, prediction model, regression tree, support vector machine

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Authors: Parvin Berenjkar, Qiuyan Yuan, Richard Sparling, Stan Lozecznik

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Landfills highly contribute to anthropological global warming through CH₄ emissions. Landfills are usually capped by a conventional soil cover to control the migration of gases. Methane is consumed by CH₄-oxidizing microorganisms known as methanotrophs that naturally exist in the landfill soil cover. The growth of methanotrophs can be optimized in a bio-cover that typically consists of a gas distribution layer (GDL) to homogenize landfill gas fluxes and an overlying oxidation layer composed of suitable materials that support methanotrophic populations. Materials such as mature yard waste composts can provide an inexpensive and favourable porous support for the growth and activity of methanotrophs. In areas with seasonal cold climates, it is valuable to know if methanotrophs in a bio-cover can survive in winter until the next spring, and how deep they are active in the bio-cover to mitigate CH₄. In this study, a pilot bio-cover was constructed in a closed landfill cell in Winnipeg that has a very cold climate in Canada. The bio-cover has a surface area of 2.5 m x 3.5 m and 1.5 m of depth, filled with 50 cm of gravel as a GDL and 70 cm of biosolids compost amended with yard and leaf waste compost. The observed in situ potential of methanotrophs for CH₄ oxidation was investigated at a specific period of time from December 2016 to April 2017 as well as November 2017 to April 2018, when the transition to surface frost and thawing happens in the bio-cover. Compost samples taken from different depths of the bio-cover were incubated in the laboratory under standardized conditions; an optimal air: methane atmosphere, at 22ºC, but at in situ moisture content. Results showed that the methanotrophs were alive oxidizing methane without a lag, indicating that there was the potential for methanotrophic activity at some depths of the bio-cover.

Keywords: bio-cover, global warming, landfill, methanotrophic activity

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Authors: Dalila Lino

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Practicum is a central dimension of teacher education programs. Learning how to teach is, in effect, a complex process that integrates periods of observation, experimentation, reflection, planning, and evaluation in a real context of practices, providing opportunities for prospective teachers to understand the various dimensions of education and to implement the knowledge built over the theoretical courses they have taken. At the pre-service training of early childhood teachers, specialized guidance and in particular pedagogical supervision assumes a key role in the professional development of students in training. The main goal of this study is to describe and analyze the supervision process that occurs during the practicum of preschool education master programs in Portugal. The objectives of the study are: (i) to describe the cooperative process of professional development experienced by student teachers during the practicum; (ii) to identify the strengths and weaknesses of supervision process; (iii) to identify the supervision styles used by university supervisors and cooperating teachers. The methodology used is the mix-method research and data was collected through semi-structured interviews and online questionnaires. The participants are newly graduated Portuguese early childhood teachers, university supervisors and cooperating teachers. The results reveal gaps in the specialized training of cooperating teachers and university supervisors, a large number of trainees per supervisor, which makes it difficult to support students, and those interpersonal relationships between university supervisors and students and/or cooperating teachers and students interfere in the development of the supervisory processes. The study highlights the need to invest in the specialized training of university supervisors and cooperating teachers to create better opportunities to support the professional development of prospective teachers.

Keywords: mentoring, pedagogical supervision, practicum, preschool teacher education

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Authors: Shashi Sharma, Uaday Singh, V. K. Katiyar

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Blood flow through a stenosed tube, which is of great interest to mechanical engineers as well as medical researchers. If stenosis exists in an artery, normal blood flow is disturbed. The deposition of fatty substances, cholesterol, cellular waste products in the inner lining of an artery results to plaque formation .The present study deals with a mathematical model for blood flow in constricted arteries. Blood is considered as a Newtonian, incompressible, unsteady and laminar fluid flowing in a cylindrical rigid tube along the axial direction. A time varying pressure gradient is applied in the axial direction. An analytical solution is obtained using the numerical inversion method for Laplace Transform for calculating the velocity profile of fluid as well as particles.

Keywords: blood flow, stenosis, Newtonian fluid, medical biology and genetics

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Authors: Ali Bhayani

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College is a high involvement decision making where students are expected to evaluate several college offerings before selecting a college or a course to study. However, even in high involvement product like college, students get influenced by opinion leaders and suffer from social contagion. This narrative style study, involving 98 first year students, was able to demonstrate that social contagion differs with regards to gender, ethnicity and personality. Recommendations from students with academically strong background would impact on the college choice of the undergraduate students and limit information search. Study was able to identify the incidence of anchoring heuristics amongst the students. Managerial implications with regards to design of marketing campaign follows at the end of the study.

Keywords: social contagion, opinion leaders, higher education, consumer behavior

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Authors: Emre Kara, Ali Kurşun, Halil Aykul

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The lightweight sandwiches obtained with the use of various core materials such as foams, honeycomb, lattice structures etc., which have high energy absorbing capacity and high strength to weight ratio, are suitable for several applications in transport industry (automotive, aerospace, shipbuilding industry) where saving of fuel consumption, load carrying capacity increase, safety of vehicles and decrease of emission of harmful gases are very important aspects. While the sandwich structures with foams and honeycombs have been applied for many years, there is a growing interest on a new generation sandwiches with micro lattice cores. In order to produce these core structures, various production methods were created with the development of the technology. One of these production technologies is an additive manufacturing technique called selective laser sintering/melting (SLS/SLM) which is very popular nowadays because of saving of production time and achieving the production of complex topologies. The static bending and the dynamic low velocity impact tests of the sandwiches with carbon fiber/epoxy skins and the micro lattice cores produced via SLS/SLM were already reported in just a few studies. The goal of this investigation was the analysis of the flexural response of the sandwiches consisting of glass fiber reinforced plastic (GFRP) skins and the micro lattice cores manufactured via SLS under thermo-mechanical loads in order to compare the results in terms of peak load and absorbed energy values respect to the effect of core cell size, temperature and support span length. The micro lattice cores were manufactured using SLS technology that creates the product drawn by a 3D computer aided design (CAD) software. The lattice cores which were designed as body centered cubic (BCC) model having two different cell sizes (d= 2 and 2.5 mm) with the strut diameter of 0.3 mm were produced using titanium alloy (Ti6Al4V) powder. During the production of all the core materials, the same production parameters such as laser power, laser beam diameter, building direction etc. were kept constant. Vacuum Infusion (VI) method was used to produce skin materials, made of [0°/90°] woven S-Glass prepreg laminates. The combination of the core and skins were implemented under VI. Three point bending tests were carried out by a servo-hydraulic test machine with different values of support span distances (L = 30, 45, and 60 mm) under various temperature values (T = 23, 40 and 60 °C) in order to analyze the influences of support span and temperature values. The failure mode of the collapsed sandwiches has been investigated using 3D computed tomography (CT) that allows a three-dimensional reconstruction of the analyzed object. The main results of the bending tests are: load-deflection curves, peak force and absorbed energy values. The results were compared according to the effect of cell size, support span and temperature values. The obtained results have particular importance for applications that require lightweight structures with a high capacity of energy dissipation, such as the transport industry, where problems of collision and crash have increased in the last years.

Keywords: light-weight sandwich structures, micro lattice cores, selective laser sintering, transport application

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Authors: Shilpa Murthy, Hazlina Binti Abu Bakar, Juliet Mathew, Chandrashekhar Thummala Hlly Sreerama Reddy, Pathiyil Ravi Shankar

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Simulation is defined as a technique that replaces or expands real experiences with guided experiences that interactively imitate real-world processes or systems. Simulation enables learners to train in a safe and non-threatening environment. For decades, simulation has been considered an integral part of clinical teaching and learning strategy in medical education. The several types of simulation used in medical education and the clinical environment can be applied to several models, including full-body mannequins, task trainers, standardized simulated patients, virtual or computer-generated simulation, or Hybrid simulation that can be used to facilitate learning. Simulation allows healthcare practitioners to acquire skills and experience while taking care of patient safety. The recent COVID pandemic has also led to an increase in simulation use, as there were limitations on medical student placements in hospitals and clinics. The learning is tailored according to the educational needs of students to make the learning experience more valuable. Simulation in the pre-clinical years has challenges with resource constraints, effective curricular integration, student engagement and motivation, and evidence of educational impact, to mention a few. As instructors, we may have more reliance on the use of simulation for pre-clinical students while the students’ confidence levels and perceived competence are to be evaluated. Our research question was whether the implementation of simulation-based learning positively influences preclinical medical students' confidence levels and perceived competence. This study was done to align the teaching activities with the student’s learning experience to introduce more low-fidelity simulation-based teaching sessions for pre-clinical years and to obtain students’ input into the curriculum development as part of inclusivity. The study was carried out at International Medical University, involving pre-clinical year (Medical) students who were started with low-fidelity simulation-based medical education from their first semester and were gradually introduced to medium fidelity, too. The Student Satisfaction and Self-Confidence in Learning Scale questionnaire from the National League of Nursing was employed to collect the responses. The internal consistency reliability for the survey items was tested with Cronbach’s alpha using an Excel file. IBM SPSS for Windows version 28.0 was used to analyze the data. Spearman’s rank correlation was used to analyze the correlation between students’ satisfaction and self-confidence in learning. The significance level was set at p value less than 0.05. The results from this study have prompted the researchers to undertake a larger-scale evaluation, which is currently underway. The current results show that 70% of students agreed that the teaching methods used in the simulation were helpful and effective. The sessions are dependent on the learning materials that are provided and how the facilitators engage the students and make the session more enjoyable. The feedback provided inputs on the following areas to focus on while designing simulations for pre-clinical students. There are quality learning materials, an interactive environment, motivating content, skills and knowledge of the facilitator, and effective feedback.

Keywords: low-fidelity simulation, pre-clinical simulation, students satisfaction, self-confidence

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Authors: Nsenga Bakinahe

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Background: Adolescent girls and young women (AGYW) globally and, particularly in Rwanda, face significant challenges related to HIV prevention and sexual and reproductive health (SRH). Rwanda has a young population, with 65.3% below 30 years of age, demonstrating a need for SRH promotion and HIV prevention for this population. We aimed to determine the knowledge, attitudes, and practices (KAP) of integrated HIV prevention and SRH services among AGYW in Rwanda. Methodology: We conducted a cross-sectional survey among 384 AGYW aged 15-24 years who had ever been pregnant and currently reside in Nyagatare district, Eastern Rwanda from January to April 2023. A questionnaire was developed to collect data, participants were randomly selected and data were collected by one-on-one interviews and were analyzed using SPSS V21. The statistical relationship between variables was significant at P-Value of 0.05 and 95% confidence interval. Results: The majority (97.9%) of respondents demonstrated a good level of knowledge, (52.2%) of the respondents had positive attitudes towards integrated HIV prevention and SRH services. Looking at the practice of integrated HIV prevention and SRH services use, 51.4% of respondents have a low level of practice. The practice of integrated HIV prevention and SRH services was significantly associated with school drop-out and family status (P>0.05). Conclusion: The findings from these studies collectively emphasize the need for comprehensive education, targeted interventions, and community-based support to achieve better health outcomes regarding HIV prevention and overall sexual and reproductive health among adolescent girls and young women. Empowering adolescent girls and young women with accurate information and comprehensive support will enable them to make informed decisions, protect their health effectively, and contribute to reducing the burden of HIV and improving sexual and reproductive health outcomes.

Keywords: integrated HIV prevention, sexual and reproductive health services, among adolescentes girls, and young women

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Authors: Rachel C. F. Sun

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This study examined the predictive effects of moral competence, prosocial norms and positive behavior recognition on school misbehavior among Chinese junior secondary school students. Results of multiple regression analysis showed that students were more likely to misbehave in school when they had lower levels of moral competence and prosocial norms, and when they perceived their positive behavior being less likely recognized. Practical implications were discussed on how to guide students to make the right choices to behave appropriately in school. Implications for future research were also discussed.

Keywords: moral competence, positive behavior recognition, prosocial norms, school misbehavior

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Authors: Keith Schofield, Garry R. Prentice

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The perceptions of the work an academic does, and the environment in which they do it, contributes to the professional identity of that academic. In turn, this has implications for the level of involvement they have in their job, their satisfaction, and their work product. This research explores academic identities in British and Irish institutions and considers the complex interplay between identity, practice, and participation. Theoretical assumptions made in this paper assert that meaningful work has positive effects on work pride, organisational commitment, organisational citizenship, and motivation; when employees participate enthusiastically they are likely to be more engaged, more successful, and more satisfied. Further examination is given to the context in which this participation happens; the nature of institutional process, management, and relationships with colleagues, team members, and students is considered. The present study follows a mixed-methods approach to explore work satisfaction constructs in a number of academic contexts in the UK and Ireland. The quantitative component of this research (Convenience Sample: 155 academics, and support/ administrative staff; 36.1% male, 63.9% female; 60.8% academic staff, 39.2% support/ administration staff; across a number of universities in the UK and Ireland) was based on an established emotional labour model and was tested across gender groups, job roles, and years of service. This was complimented by qualitative semi-structured interviews (Purposive Sample: 10 academics, and 5 support/ administrative staff across the same universities in the UK and Ireland) to examine various themes including values within academia, work conditions, professional development, and transmission of knowledge to students. Experiences from both academic and support perspectives were sought in order to gain a holistic view of academia and to provide an opportunity to explore the dynamic of the academic/administrator relationship within the broader institutional context. The quantitative emotional labour model, tested via a path analysis, provided a robust description of the relationships within the data. The significant relationships found within the quantitative emotional labour model included a link between non-expression of true feelings resulting in emotional labourious work and lower levels of intrinsic motivation and higher levels of extrinsic motivation. Higher levels of intrinsic motivation also linked positively to work pride. These findings were further explored in the qualitative elements of the research where themes emerged including the disconnection between faculty management and staff, personal fulfilment and the friction between the identities of teacher, researcher/ practitioner and administrator. The implications of the research findings from this study are combined and discussed in relation to possible identity-related and emotional labour management-related interventions. Further, suggestions are made to institutions concerning the application of these findings including the development of academic practices, with specific reference to the duality of identity required to service the combined teacher/ researcher role. Broader considerations of the paper include how individuals and institutions may engage with the changing nature of students-as-consumers as well as a recommendation to centralise personal fulfillment through the development of professional academic identities.

Keywords: academic work, emotional labour, identity friction, mixed methods

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Authors: Oljana Hoxhaj

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The integration process of Albania into the European family carries many difficulties. In this context, the Albanian legislator is inclined to implement in the domestic legal framework models which have been successful in other countries. Our paper aims to present an analytical and comparative approach to the health system in Albania and France, mainly focusing on citizen’s access to these services. Different standards and cultures between states, in the context of an approximate model, will be the first challenge of our paper. Over the last few years, the Albanian government has undertaken concrete reforms in this sector, aiming to transform the vision on which the previous health system was structured. In this perspective, the state fulfills not only an obligation to its citizens, but also consolidates progressive steps toward alignment with European Union standards. The necessity to undertake a genuine reform in this area has come as an exigency of society, which has permanently identified problems within this sector, considering it ineffective, out of standards, and corrupt. The inclusion of health services on the Albanian government agenda reflects its will in the function of good governance, transparency, and broadening access to the provision of quality health services in the public and private sectors. The success of any initiative in the health system consists of giving priority to patient needs. Another objective that should be in the state's consideration is to create the premise to provide a comprehensive process on whose foundations partnership and broader co-operation with beneficiary entities are established in any decision-making that is directly related to their interests. Some other important and widespread impacts on the effective realization of citizens' access to the healthcare system coincide with the construction of appropriate infrastructure, increasing the professionalism and qualification of medical staff, and the allocation of a higher budget. France has one of the most effective healthcare models in Europe. That is why we have chosen to analyze this country, aiming to highlight the advantages of this system, as well as the commitment of the French state to drafting effective health policies. In the framework of the process of harmonization of the Albanian legislation with that of the European Union, through our work, we aim to identify the space to implement the whole of these legislative innovations in the Albanian legislation.

Keywords: effective service, harmonization level, innovation, reform

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Authors: Yina Donald Orga

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Osun Osogbo festival is one of the biggest art festivals in Nigeria with over 235, 518 tourist visits in 2014. The purpose of this study is to generate data on the tourists’ perception of Osun Osogbo Festival in Osogbo, Osun State Nigeria. Based on the population of 199, 860 tourist visits at Osun Osogbo festival in 2013, Krejcie and Morgan sample size table was used to select 768 tourists/respondents. Likert questionnaire were used to elicit data from the respondents. Descriptive statistic was used to describe the characteristics of respondents and analyse the tourists’ perception of the festival. The findings from data analysed suggest that the trend of domestic and international tourist visits in the past ten years for the festival had shown a consistent increase since 2004 except in 2007 and 2008 and continue to increase up to 2013. This is an indication that the tourists are satisfied with traditional, historical and authenticity features of the festival. Also, findings from the study revealed that the tourists are not satisfied with the number of toilets at Osun Sacred Grove, crowd control of visitors during the festival, medical personnel to cater for visitors during the festival, etc. In view of the findings of the study, the following recommendations are suggested; provision of more toilets at Osun Sacred grove, Osogbo Heritage Council to recruit festival guides to help control the huge crowd at the festival, the Government of State of Osun in conjunction with Red Cross Society should engage adequate medical personnel to cater for medical needs of visitors at the festival, etc.

Keywords: festival, perception, positive, tourists

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Authors: Mahdi Pirmoradian, Olayinka Adigun, Christos Politis

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Cooperative spectrum sensing is a crucial challenge in cognitive radio networks. Cooperative sensing can increase the reliability of spectrum hole detection, optimize sensing time and reduce delay in cooperative networks. In this paper, an efficient central capacity optimization algorithm is proposed to minimize cooperative sensing time in a homogenous sensor network using OR decision rule subject to the detection and false alarm probabilities constraints. The evaluation results reveal significant improvement in the sensing time and normalized capacity of the cognitive sensors.

Keywords: cooperative networks, normalized capacity, sensing time

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Authors: ShuYing Chung, Minchuan Huang, Iping Chen

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Taking the medical staff in an emergency ward of a medical center in Central Taiwan as the research object, the questionnaire data were collected by anonymous and voluntary reporting methods with structured questionnaire to explore the actual situation, willingness and attitude of organ donation. Only 80 valid questionnaires were collected. Among the 8 questions, the average correct rate was 5.9 + 1.2, and the correct rate was 73.13%. The willingness of organ donation that 7.5% of the people are not willing; 92.5% of the people are willing, of which 62.5% have considered but have not yet decided; 21.3% are willing but have not signed the consent of organ donation; They have signed the consent of organ donation 8.7%. The average total score (standard deviation) of attitude towards organ donation was 36.2. There is no significant difference between the demographic variables and the awareness and willingness of organ donation, but there is a significant correlation between the marital status and the attitude of organ donation.

Keywords: clinical psychology, organ donation, doctors affecting psychological disorders, commitment

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Authors: Jui-Hung Hung, Ching-Liang Hsieh, Yi-Wen Lin

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Modern medicine highly emphasizes the importance of palliative treatment. The inception of palliative and hospice care recently developed into the concept of caring for the patients’ and families’ physical, psychological and spiritual problems. There are several benefits related to palliative care such as reducing medical expenses, decreasing patients’ suffer, and supporting patient go through the finale of the life. Nowadays, in Taiwan, over 60-70% terminal cancer patients were covered in hospice care, and the coverage rate increased annually. Acupuncture is a well-known therapy used more than thousand years to relieve symptoms of cancer patient. Many reports showed that, even in the Western society, many reputable medical centers can provide Acupuncture therapy for patients. Accordingly, using Acupuncture for cancer patient care is a global trend. There are increased evidences indicate that Acupuncture can relieve the symptoms for cancer patients including pain, reduce the dosage of anesthetic, improve the cancer-related fatigue, relieve the chemotherapy-related nausea and vomiting, ease anxiety mood and even improving the quality of life. Furthermore, some trials show that Acupuncture may help relieve xerostomia, hot flash, sleep disorders, and some GI discomfort and so on. Acupuncture therapy has many advantages for clinical use with effective, low-cost, minimal side effect, suitable for cancer patients and even for elderly population. Especially in nowadays, there are more diversified challenges in modern medicine, all of them will make the higher medical budget. We suggest that Acupuncture will be one of methods for palliative care for cancer patients.

Keywords: Acupuncture, cancer, integrative medicine, palliative care

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Authors: Chang Hsueh-Sheng, Chen Tzu-Ling

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Earthquake is an unpredictable natural disaster and intensive earthquakes have caused serious impacts on social-economic system, environmental and social resilience, and further increase vulnerability. Due to earthquakes do not kill people, buildings do. When buildings located nearby earthquake-prone areas and constructed upon poorer soil areas might result in earthquake-induced ground damage. In addition, many existing buildings built before any improved seismic provisions began to be required in building codes and inappropriate land usage with highly dense population might result in much serious earthquake disaster. Indeed, not only do earthquake disaster impact seriously on urban environment, but urban growth might increase the vulnerability. Since 1980s, ‘Cutting down risks and vulnerability’ has been brought up in both urban planning and architecture and such concept has way beyond retrofitting of seismic damages, seismic resistance, and better anti-seismic structures, and become the key action on disaster mitigation. Land use planning and zoning are two critical non-structural measures on controlling physical development while it is difficult for zoning boards and governing bodies restrict development of questionable lands to uses compatible with the hazard without credible earthquake loss projection. Therefore, identifying potential earthquake exposure, vulnerability people and places, and urban development areas might become strongly supported information for decision makers. Taiwan locates on the Pacific Ring of Fire where a seismically active zone is. Some of the active faults have been found close by densely populated and highly developed built environment in the cities. Therefore, this study attempts to base on the perspective of carrying capacity and draft out micro-zonation according to both vulnerability index and urban growth index while considering spatial variances of multi factors via geographical weighted principle components (GWPCA). The purpose in this study is to construct supported information for decision makers on revising existing zoning in high-risk areas for a more compatible use and the public on managing risks.

Keywords: earthquake disaster, vulnerability, urban growth, carrying capacity, /geographical weighted principle components (GWPCA), bivariate spatial association statistic

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Authors: Pia Moschall, Kathrin Sackmann

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Considering a purchasing volume of around two trillion Euros per year, which equals about 14% of the European Union’s gross domestic product, European public authorities have significant market power. Making use of this market power by prioritizing the procurement of green products and services offers a great potential to contribute to the Green New Deal. The market demand that is created by Green Public Procurement (GPP) sets incentives for European producers to design and develop Green Products and Eco-Innovations. However, most procurement still does not consider environmental criteria. The goal of the work is to encourage the adaptation of GPP in the European Union. To this end, the drivers for the adaptation were investigated over different case studies. The paper analyzes good-practice cases from European authorities from 2010 to 2020 that were provided by the European Commission. This analysis was guided by Philipp Mayring’s method of qualitative content analysis, whereby the inductively formed categories led to the identification of nine major drivers. The most important ones are ‘use of official guidelines and standards, ‘political support and requirements as well as ‘market research and involvement.’ Further, the paper discusses mutual dependencies between several drivers and how to exploit them. A supporting infrastructure was identified as a crucial factor for the successful adaption of green public procurement. In the next step, the work aims to examine on which administrative level the single drivers can be implemented most effectively. Practical implications of this research are recommendations on how to create a supporting structure on a municipal, federal and national level, including training for the responsible staff, support tools, as well as guidelines and standards for involved stakeholders.

Keywords: content analysis, green public procurement, public authorities, sustainable procurement

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Authors: Yasmin Sayed, Hala Hamdy, Hafez Bazaraa, Hanaa Rady, Sherif Elanwary

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Intravenous and inhaled magnesium sulfate (MgSO₄) had been recently used as an adjuvant therapy in cases suffering from the wheezy chest. Objective: We aimed to determine the possible change in the hemodynamic state in cases received intravenous or inhaled MgSO₄ in comparison to cases received standard treatment in critically ill infants and children with the wheezy chest. Methods: A randomized controlled trial comprised 81 patients suffering from wheezy chest divided into 3 groups. In addition to bronchodilators and systemic steroids, MgSO₄ was given by inhalation in group A, intravenously in group B, and group C didn't receive MgSO₄. The hemodynamic state was determined by assessment of blood pressure, heart rate, capillary refill time and the need for shock therapy or inotropic support just before and 24 hours after receiving treatment in 3 groups. Results: There was no significant difference in the hemodynamic state of the studied groups before and after treatment. Means of blood pressure were 102.2/63.2, 105.1/64.8 before and after inhaled MgSO₄; respectively. Means of blood pressure were 105.5/64.2, 104.1/64.9 before and after intravenous MgSO₄; respectively. Means of blood pressure were 107.4/62.8, 104.4/62.1 before and after standard treatment, respectively. There was a statistically insignificant reduction of the means of the heart rate in group A and group B after treatment rather than group C. There was no associated prolongation in capillary refill time and/or the need for inotropic support or shock therapy after treatment in the studied groups. Conclusion: MgSO₄ is a safe adjuvant therapy and not associated with significant alteration in the hemodynamic state in critically ill infants and children with the wheezy chest.

Keywords: critically ill infants and children, inhaled MgSO₄, intravenous MgSO₄, wheezy chest

Procedia PDF Downloads 141