Search results for: care knowledge

Authors: Mattia Testuzza

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Public health is a social endeavour, which involves many different actors: from extremely stratified, structured health systems to unofficial networks of people and knowledge. Health and diseases are an intertwined individual and social experiences. Both patients and health workers navigate this public space through relations of trust. Trust in healthcare goes from the personal trust between a patient and her/his doctor to the trust of both the patient and the health worker in the medical knowledge and the healthcare system. Trust it is not a given, but it is continuously negotiated, given and gained. The key to understand these essential relations of trust in health is to recognise them as a social practice, which therefore implies agency and power. In these terms, health is constantly public and made public, as trust emerges as a meaningfully political phenomenon. Trust as a power relation can be observed at play in the implementation of public health policies such as the WHO’s Directly-Observed Theraphy Short-course (DOTS), and with the increasing concern for drug-resistance that tuberculosis pose, looking at the role of trust in the healthcare delivery system and implementation of public health policies becomes significantly relevant. The ethnographic fieldwork was carried out in four months through observation of the daily practices at the National Tuberculosis Center of Nepal, and semi-structured interviews with MultiDrug-Resistant Tuberculosis (MDR-TB) patients at different stages of the treatment, their relatives, MDR-TB specialised nurses, and doctors. Throughout the research, the role which trust plays in tuberculosis treatment emerged as one fundamental ax that cuts through all the different factors intertwined with drug-resistance development, unfolding a tension between the DOTS policy, which undermines trust, and the day-to-day healthcare relations and practices which cannot function without trust. Trust also stands out as a key component of the solutions to unforeseen issues which develop from the overall uncertainty of the context - for example, political instability and extreme poverty - in which tuberculosis treatment is carried out in Nepal.

Keywords: trust, tuberculosis, drug-resistance, politics of health

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Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal

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Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.

Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis

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Authors: Lani Fraizer

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Increasingly, individuals from diverse professional and academic backgrounds are making a conscious choice to pursue careers related to social change; a sophisticated understanding of social entrepreneur education is becoming ever more important. Social entrepreneurs are impassioned change makers who characteristically combine leadership and entrepreneurial spirits to problem solve social ills affecting our planet. Generating partnership opportunities and nurturing them is an important part of their change-making work. Faced with the complexities of these partnerships, social entrepreneurs and people who work with them need to be well prepared to tackle new and unforeseen challenges faced. As partnerships become even more critical to advance initiatives at scale, for example, understanding the partnership brokering role is even more important for educators who prepare these leaders to establish and sustain multi-stakeholder partnerships. This paper aims to provide practitioners in social entrepreneurship with enhanced knowledge of partnership brokering and identify directions for future research. A literature review search from January 1977 to May 2015 was conducted using the combined keywords ‘partnership brokering’ and ‘social entrepreneurship’ via WorldCat, one of the largest database catalogs in the world with collections of more than 10,000 worldwide. This query focused on literature written in the English language and analyzed solely the role of partnership brokering in social entrepreneurship. The synthesis of the literature review found three main themes emerging: the need for more professional awareness of partnership brokering and its value add in systems change-making work, the need for more knowledge on developing partnership brokering competencies, and the need for more applied research in the area of partnership brokering and how it is practiced by practitioners in social entrepreneurship. The results of the review serve to emphasize and reiterate the importance of partnership brokers in social entrepreneurship work, and act as a reminder of the need for further scholarly research in this area to bridge the gap between practice and research.

Keywords: partnership brokering, leadership, social entrepreneurship, systems changemaking

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Authors: Ju-Chun Chien

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Rapid aging and depopulation could lead to serious problems, including workforce shortages and health expenditure costs. The current and predicted future LTC workforce shortages could be a real threat to Taiwan’s society. By means of comparison of data from 144 nursing aide trainees and 727 general public, the main purpose of the present study was to determine whether there were any notable differences between the two groups toward engaging in LTC services. Moreover, this study focused on recognizing the attributes of the general public who had the willingness to take LTC jobs but continue to ride the fence. A self-developed questionnaire was designed based on Ajzen’s Theory of Planned Behavior model. After conducting exploratory factor analysis (EFA) and reliability analysis, the questionnaire was a reliable and valid instrument for both nursing aide trainees and the general public. The main results were as follows: Firstly, nearly 70% of nursing aide trainees showed interest in LTC jobs. Most of them were middle-aged female (M = 46.85, SD = 9.31), had a high school diploma or lower, had unrelated work experience in healthcare, and were mostly unemployed. The most common reason for attending the LTC training program was to gain skills in a particular field. The second most common reason was to obtain the license. The third and fourth reasons were to be interested in caring for people and to increase income. The three major reasons that might push them to leave LTC jobs were physical exhaustion, payment is bad, and being looked down on. Secondly, the variables that best-predicted nursing aide trainees’ intention to engage in LTC services were having personal willingness, perceived behavior control, with high school diploma or lower, and supported from family and friends. Finally, only 11.80% of the general public reported having interest in LTC jobs (the disapproval rating was 50% for the general public). In comparison to nursing aide trainees who showed interest in LTC settings, 64.8% of the new workforce for LTC among the general public was male and had an associate degree, 54.8% had relevant healthcare experience, 67.1% was currently employed, and they were younger (M = 32.19, SD = 13.19) and unmarried (66.3%). Furthermore, the most commonly reason for the new workforce to engage in LTC jobs were to gain skills in a particular field. The second priority was to be interested in caring for people. The third and fourth most reasons were to give back to society and to increase income, respectively. The top five most commonly reasons for the new workforce to quitting LTC jobs were listed as follows: physical exhaustion, being looked down on, excessive working hours, payment is bad, and excessive job stress.

Keywords: long-term care services, nursing aide trainees, Taiwanese people, theory of planned behavior

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Authors: Zainab Mutlaq Ibrahim, Mohamed Bader-El-Den, Mihaela Cocea

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Students' textual feedback can hold unique patterns and useful information about learning process, it can hold information about advantages and disadvantages of teaching methods, assessment components, facilities, and other aspects of teaching. The results of analysing such a feedback can form a key point for institutions’ decision makers to advance and update their systems accordingly. This paper proposes a data mining framework for analysing end of unit general textual feedback using part of speech feature (PoS) with four machine learning algorithms: support vector machines, decision tree, random forest, and naive bays. The proposed framework has two tasks: first, to use the above algorithms to build an optimal model that automatically classifies the whole data set into two subsets, one subset is tailored to assessment practices (assessment related), and the other one is the non-assessment related data. Second task to use the same algorithms to build an optimal model for whole data set, and the new data subsets to automatically detect their sentiment. The significance of this paper is to compare the performance of the above four algorithms using part of speech feature to the performance of the same algorithms using n-grams feature. The paper follows Knowledge Discovery and Data Mining (KDDM) framework to construct the classification and sentiment analysis models, which is understanding the assessment domain, cleaning and pre-processing the data set, selecting and running the data mining algorithm, interpreting mined patterns, and consolidating the discovered knowledge. The results of this paper experiments show that both models which used both features performed very well regarding first task. But regarding the second task, models that used part of speech feature has underperformed in comparison with models that used unigrams and bigrams.

Keywords: assessment, part of speech, sentiment analysis, student feedback

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Authors: Ankur Chauhan, Amol Singh

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The increasing human resource has led to the rapid increment in the generation of healthcare waste across the world. Since, this waste consists of the infectious and hazardous components emerged from the patient care activities in different healthcare facilities; therefore, its proper management becomes vital for mitigating its negative impact on society and environment. The present research work focuses on the identification of the key success factors for developing a successful healthcare waste management plan. In addition, the key success factors have been studied by developing a causal diagram with the help of a decision making trial and evaluation (DEMATEL) approach. The findings of the study would help in the filtration of dominant key success factors which would further help in making a comparative assessment of the waste management plan of different hospitals.

Keywords: healthcare waste disposal, environment and society, multi-criteria decision making, DEMATEL

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Authors: Fernanda Goulart, Rita de Cássia Barbirato

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Task-based language teaching has received attention among researchers as it has been pointed out with the potential to provide more significant opportunities for using the target language and therefore generate successful language acquisition. Nevertheless, in the Brazilian context, few studies have analyzed the potential of tasks in English language acquisition. There is also a need for textbooks to meet the needs of Brazilian students. This work is part of doctoral research in its initial phase. It aims to demonstrate and discuss thematic textbook samples on tasks designed to be applied among high school and undergraduate students in a public technological educational context in São Paulo State, Brazil. It is a qualitative study. The data collection process for course design and textbook development initially included a survey administered to 159 students. Questions related to students’ English background knowledge, main learning interests, and needs. Most students reported difficulties communicating in English and showed a strong interest in a communicative English course. The theme “Cultural diversity” was chosen among other options provided. The textbook was then designed and comprised nine task cycles divided into four sequences. Cycles were composed of pre-tasks, tasks, and post-tasks. The main findings of this first phase of the research revealed that designing a task-based textbook is not easy and requires the necessary steps and lots of effort to meet students’ language needs. Several revisions were needed before the conclusion of the final version of the textbook. The material will be further applied in a three-month English course. In this presentation, we hope to contribute to discussions in research on task-based teaching. Also, we intend to support teachers with their knowledge of tasks and thematic material development in this field.

Keywords: task-based language teaching, language acquisition, English language teaching, task cycles

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Authors: L. Ereku, R. E. Mackay, A. Naveenathayalan, K. Ajayi, W. Balachandran

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Over the past decade the increase of sexually transmitted infections (STIs) especially in the developing world due to high cost and lack of sufficient medical testing have given rise to the need for a rapid, low cost point of care medical diagnostic that is disposable and most significantly reproduces equivocal results achieved within centralised laboratories. This paper present the development of a disposable PDMS microfluidic cartridge incorporating blisters filled with reagents required for isothermal DNA amplification in clinical diagnostics and point-of-care testing. In view of circumventing the necessity for external complex microfluidic pumps, designing on-chip pressurised fluid reservoirs is embraced using finger actuation and blister storage. The fabrication of the blisters takes into consideration three proponents that include: material characteristics, fluid volume and structural design. Silicone rubber is the chosen material due to its good chemical stability, considerable tear resistance and moderate tension/compression strength. The case of fluid capacity and structural form go hand in hand as the reagent need for the experimental analysis determines the volume size of the blisters, whereas the structural form has to be designed to provide low compression stress when deformed for fluid expulsion. Furthermore, the top and bottom section of the blisters are embedded with miniature polar opposite magnets at a defined parallel distance. These magnets are needed to lock or restrain the blisters when fully compressed so as to prevent unneeded backflow as a result of elasticity. The integrated chip is bonded onto a large microscope glass slide (50mm x 75mm). Each part is manufactured using a 3D printed mould designed using Solidworks software. Die-casting is employed, using 3D printed moulds, to form the deformable blisters by forcing a proprietary liquid silicone rubber through the positive mould cavity. The set silicone rubber is removed from the cast and prefilled with liquid reagent and then sealed with a thin (0.3mm) burstable layer of recast silicone rubber. The main microfluidic cartridge is fabricated using classical soft lithographic techniques. The cartridge incorporates microchannel circuitry, mixing chamber, inlet port, outlet port, reaction chamber and waste chamber. Polydimethylsiloxane (PDMS, QSil 216) is mixed and degassed using a centrifuge (ratio 10:1) is then poured after the prefilled blisters are correctly positioned on the negative mould. Heat treatment of about 50C to 60C in the oven for about 3hours is needed to achieve curing. The latter chip production stage involves bonding the cured PDMS to the glass slide. A plasma coroner treater device BD20-AC (Electro-Technic Products Inc., US) is used to activate the PDMS and glass slide before they are both joined and adequately compressed together, then left in the oven over the night to ensure bonding. There are two blisters in total needed for experimentation; the first will be used as a wash buffer to remove any remaining cell debris and unbound DNA while the second will contain 100uL amplification reagents. This paper will present results of chemical cell lysis, extraction using a biopolymer paper membrane and isothermal amplification on a low-cost platform using the finger actuated blisters for reagent storage. The platform has been shown to detect 1x105 copies of Chlamydia trachomatis using Recombinase Polymerase Amplification (RPA).

Keywords: finger actuation, point of care, reagent storage, silicone blisters

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Authors: B.-Y.-S. Lau, Y.-C.-T. Jonathan, M.-S. Alias

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Heritage trees are natural large, individual trees with exceptionally value due to association with age or event or distinguished people. In Malaysia, there is an abundance of tropical heritage trees throughout the country. It is essential to set up a repository of heritage trees to prevent valuable trees from being cut down. In this cross domain study, a web-based online expert system namely the Heritage Tree Expert Assessment and Classification (HTEAC) is developed and deployed for public to nominate potential heritage trees. Based on the nomination, tree care experts or arborists would evaluate and verify the nominated trees as heritage trees. The expert system automatically rates the approved heritage trees according to pre-defined grades via Delphi technique. Features and usability test of the expert system are presented. Preliminary result is promising for the system to be used as a full scale public system.

Keywords: arboriculture, Delphi, expert system, heritage tree, urban forestry

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Authors: Ana Carolina Lima, Carlos Sérgio Agostinho, Amadeu M. V. M. Soares, Kieran A. Monaghan

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Neotropical freshwaters host some of the most biodiverse ecosystems in the world and are among the most threatened by habitat alterations. The high number of species and lack of basic ecological knowledge provides a major obstacle to understanding the effects of environmental change. We assessed the impact of dam closure on the fish communities of a neotropical river by applying simple descriptions of community organizations: Species Abundance Distribution (SAD) and Abundance Biomass Comparison (ABC) curves. Fish data were collected during three distinct time periods (one year before, one year after and five years after closure), at eight sites located downstream of the dam, in the reservoir and reservoir transition zone and upstream of the regulated flow. Dam closure was associated with changes in the structural and functional organization of fish communities at all sites. Species richness tended to increase immediately after dam closure while evenness decreased. Changes in taxonomic structure were accompanied by a change in the distribution of biomass with the proportionate contribution by smaller individuals significantly increased relative to larger individuals. Five years on, richness had fallen to below pre-closure levels at all sites, while the comparative stability of the transformed habitats was reflected by biomass-abundance distribution patterns that approximated pre-disturbance ratios. Despite initial generality, respective sites demonstrated distinct ecological responses that were related to the environmental characteristics of their transformed habitats. This simplistic analysis provides a sensitive and informative assessment of ecological conditions that highlights the impact to ecosystem process and ecological networks and has particular value in regions where detailed ecological knowledge precludes the application of traditional bioassessment methods.

Keywords: ABC curves, SADs, biodiversity, damming, tropical fish

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Authors: Nevruz Zogu, Shpetim Rezniqi

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In the framework of transformational economic development social pluralism and the free, market health systems operating in the countries of our region are naturally involved in a process of profound change and reform. Health systems actually represent complex ensembles centers and public and private institutions (domestic and foreign), who administer substantial amounts of human, technological, material, financial, information and scientific facts • The goal of health systems is much more than medical care. It includes the promotion, protection, treatment and rehabilitation of health of the population. • Meeting the needs of increasingly diverse broader health services efficient, secure the quality and affordability of their increasing cost of unstoppable, requires the necessary reform of health systems and implementing policies and new management methods, to ensure effectiveness and health benefits as higher population.

Keywords: health, management, economy, finance

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Authors: Carlos Alberto Ríos Reyes, Andrés Felipe Mejía Durán, Oscar Mauricio Castellanos Alarcón

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There is no doubt of great importance to make it known that planet Earth is an entity in constant change and transformation; processes such as construction and destruction are part of the evolution of the territory. Geoeducation workshops represent a significant contribution to the search for educational projects focused on teaching relevant geoscience topics to make natural threats known in schools through recreational and didactic activities. This initiative represents an educational alternative that must be developed with the participation of primary and secondary schools, universities, and local communities. The methodology is based on several phases, which include: diagnosis to know the best teaching method for basic concepts and establish a starting point for the topics to be taught, as well as to identify areas and concepts that need to be reinforced and/or deepened; design of activities that involve all students regardless of their ability or level; use of accessible materials and experimentation to support clear and concise explanations for all students; adaptation of the teaching-learning process to individual needs; sensitization about natural threats; and evaluation and feedback. It is expected to offer a series of activities and materials as a significant contribution to the search for educational projects focused on teaching relevant geoscientific topics such as natural threats associated with earthquakes, volcanic eruptions, floods, landslides, etc. The major findings of this study are the pedagogical strategies that primary and secondary school teachers can appropriate to face the challenge of transferring geological knowledge and to advise decision-makers and citizens on the importance of geosciences for daily life. We conclude that the knowledge of the natural threats to our planet is very important to contribute to mitigating their risk.

Keywords: workshops, geoeducation, curriculum, geosciences, natural threats

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Authors: N. Das, N. Samanta, L. Pandey, C. Roy Chaudhuri

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Early diagnosis of infection like Hep-B virus in blood is important for low cost medical treatment. For this purpose, it is desirable to develop a point of care device which should be able to detect trace quantities of the target molecule in blood. In this paper, we report a nanoporous silicon oxide sensor which is capable of detecting down to 1fM concentration of Hep-B surface antigen in blood without the requirement of any centrifuge or pre-concentration. This has been made possible by the presence of resonant peak in the sensitivity characteristics. This peak is observed to be dependent only on the concentration of the specific antigen and not on the interfering species in blood serum. The occurrence of opposite impedance change within the pores and at the bottom of the pore is responsible for this effect. An electronic interface has also been designed to provide a display of the virus concentration.

Keywords: impedance spectroscopy, ultrasensitive detection in blood, peak frequency, electronic interface

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Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar

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Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.

Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth

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Authors: Reem Osama Yousif Ali, Osama Yousif Ali Al Gibali

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Introduction: Balanced nutrition is undeniably essential for maintaining health, body functions, and integrity of cell metabolism; however, some sick patients cannot tolerate oral or enteral feeding to meet their nutritional needs, so partial or total parenteral nutrition (PN) may be the most suitable alternative route in such situations. Dietitians are fundamental personnel among the medical team to ensure the proper provision of PN service, which was introduced in Sudan in the 1980s. Objective: The study aimed to recognize the dietitians' awareness of parenteral nutrition and their role in providing this service in Sudan – Khartoum State. Methodology: Formulated questionnaire forms composed of twelve questions were distributed to the dietitians working in four tertiary level hospitals. Results: The majority (75%) of the responded dietitians had reasonable knowledge about the importance of PN, its advantages, and its indications. Sixty percent of them were mindful of the PN side effects. Most of the dietitians were aware of the different assessment measurements and PN calculations and were exposed in their clinical practice to patients who were in need of PN, but only a few of them (about 30%) had the actual chance to participate in the formulation and application of PN therapy. The unavailability of the multidisciplinary team, lack of the required equipment and financial support, and associated complications were basic obstacles to the provision of long-term PN service in Khartoum state hospitals. Conclusion: Although dietitians in Khartoum state hospitals have good information about PN definition, indications, accesses, and assessment measures, they do not have enough knowledge and clinical exposure that make them confident to provide the PN service. Establishing a few models of parenteral nutrition units in tertiary hospitals will be of great help, as well as providing the dietitian's training in the area of parenteral nutrition. Further study can explore more requirements to run this service.

Keywords: nutrition support, dietitian, Sudan, parenteral nutrition, nutrition support team

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Authors: Gracie Tredget, Raymond McGrath, Karen Ang, Julie Williams, Nick Sevdalis, Fiona Gaughran, Jorge Aria de la Torre, Ioannis Bakolis, Andy Healey, Zarnie Khadjesari, Euan Sadler, Natalia Stepan

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Background: Preventable physical health problems have been found to increase morbidity rates amongst adults living with serious mental illness (SMI). Community mental health clinicians have a role in identifying, and preventing physical health problems worsening, and supporting primary care services to administer routine physical health checks for their patients. However, little is known about how mental health staff perceive and approach their role when providing physical healthcare amongst patients with SMI, or the impact these attitudes have on routine practice. Methods: The present study involves a prospective service evaluation specific to Adult Community Mental Health Services at South London and Maudsley NHS Foundation Trust (SLaM). A qualitative methodology will use semi-structured interviews, focus groups and observations to explore attitudes, perceptions and experiences of staff, patients, and carers (n=64) towards physical healthcare, and barriers or facilitators that impact upon it. 1South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK 2 Centre for Implementation Science, King’s College London, London, SE5 8AF, UK 3 Psychosis Studies, King's College London, London, SE5 8AF, UK 4 Department of Biostatistics and Health Informatics, King’s College London, London, SE5 8AF, UK 5 Kings Health Economics, King's College London, London, SE5 8AF, UK 6 Behavioural and Implementation Science (BIS) research group, University of East Anglia, Norwich, UK 7 Department of Nursing, Midwifery and Health, University of Southampton, Southampton, UK 8 Mind and Body Programme, King’s Health Partners, Guy’s Hospital, London, SE1 9RT *[email protected] Analysis: Data from across qualitative tasks will be synthesised using Framework Analysis methodologies. Staff, patients, and carers will be invited to participate in co-development of recommendations that can improve routine physical healthcare within Adult Community Mental Health Teams at SLaM. Results: Data collection is underway at present. At the time of the conference, early findings will be available to discuss. Conclusions: An integrated approach to mind and body care is needed to reduce preventable deaths amongst people with SMI. This evaluation will seek to provide a framework that better equips staff to approach physical healthcare within a mental health setting.

Keywords: severe mental illness, physical healthcare, adult community mental health, nursing

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Authors: Birsel Canan Demirbag, Kıymet Yesilcicek Calik, Hacer Kobya Bulut

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Objective: This study was conducted to evaluate the problems of women over 65 with incontinence diagnosis. Methods: This descriptive study was conducted with women over 65 with incontinence diagnosis in four Family Health Centers in a city in Eastern Black Sea region between November 1, and December 20, 2015. 203, 107, 178, 180 women over 65 were registered in these centers and 262 had incontinence diagnosis at least once and had an ongoing complaint. 177 women were volunteers for the study. During home visits and using face-to-face survey methodology, participants were given socio-demographic characteristics survey, Sandvik severity scale, Incontinence Quality of Life Scale, Urogenital Distress Inventory and a questionnaire including challenges experienced due to incontinence developed by the researcher. Data were analyzed with SPSS program using percentages, numbers, Chi-square, Man-Whitney U and t test with 95% confidence interval and a significance level p <0.05. Findings: 67 ± 1.4 was the mean age, 2.05 ± 0.04 was parity, 44.5 ± 2.12 was menopause age, 66.3% were primary school graduates, 45.7% had deceased spouse, 44.4% lived in a large family, 67.2% had their own room, 77.8% had income, 89.2% could meet self- care, 73.2% had a diagnosis of mixed incontinence, 87.5% suffered for 6-20 years % 78.2 had diuretics, antidepressants and heart medicines, 20.5% had urinary fecal cases, 80.5% had bladder training at least once, 90.1% didn’t have bladder diary calendar/control training programs, 31.1% had hysterectomy for prolapse, 97.1'i% was treated with lower urinary tract infection at least once, 66.3% saw a doctor to get drug in the last three months, 76.2 could not go out alone, 99.2 % had at least one chronic disease, 87.6 % had constipation complain, 2.9% had chronic cough., 45.1% fell due to a sudden rise for toilet. Incontinence Impact Questionnaire Average score was (QOL) 54.3 ± 21.1, Sandvik score was 12.1 ± 2.5, Urogenital Distress Inventory was 47.7 ± 9.2. Difficulties experienced due to incontinence were 99.5% feeling of unhappiness, 67.1% constant feeling of urine smell due to failing to change briefs frequently, % 87.2 move away from social life, 89.7 unable to use pad, 99.2% feeling of disturbing households / other individuals, 87.5% feel dizziness/fall due to sudden rise, 87.4% feeling of others’ imperceptions about the situation, % 94.3 insomnia, 78.2 lack of assistance, 84.7% couldn’t afford urine protection briefs. Results: With this study, it was found out that there were a lot of unsolved issues at individual and community level affecting the life quality of women with incontinence. In accordance with this common problem in women, to facilitate daily life it is obvious that regular home care training programs at institutional level in our country will be effective.

Keywords: health problems, incontinence, incontinence quality of life questionnaire, old age, urinary urogenital distress inventory, Sandviken severity, women

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Authors: Wasse Uddin Ahmed Saleh, Nawreenbinte Anwar

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A well-written operating note is crucial as a teaching tool for providing patients with high-quality medical care and fending off medico-legal claims. In this review article, some adjustments have been advised to the operative note guidelines by the Royal College of Surgeons (RCS) for different methods of ocular anesthesia and ophthalmic procedures like cataract surgeries, kerato-refractive surgeries, glaucoma surgeries, oculoplastic surgeries, etc. Some modifications of the WHO Surgical Safety Checklist have also been mentioned, including pre-operative responsibilities of the nurses, operative assistants and operating ophthalmologists. It has become essential to assemble globally accepted structured operative note guidelines modified for each ocular surgery.

Keywords: ocular surgeries, operation notes, cataract surgery, kerato-refractive surgery, Oculoplastic surgeries, guidelines

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Authors: Maciej Zaręba, Sławomir Lasota

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The monitoring of manufacturing processes is an important issue in nowadays ERP systems. The identification and analysis of appropriate data for the units that take part in the production process are ones of the most crucial problems. In this paper, the authors introduce a new approach towards modelling the relation between production units, signals, and factors possible to obtain from the production system. The main idea for the system is based on the ontology of production units.

Keywords: manufacturing operation management, OWL, ontology implementation, ontology modeling

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Authors: Vahid Borji

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The interaction between photons and particles is a common phenomenon in nature that is discussed in order to obtain information about the environment and the conditions governing the phenomena. In the astrophysics, like others, we study these interactions to get useful knowledge and can be predict aftercoming events. One of the events is the transition of photon beam through medium with special conditions, like shocked medium. In our discussion, we have studied this situation and obtained results for different conditions that transition of photon depends on the energy of photon and distributions of electrons in medium.

Keywords: cross section, astrophysics, GRB, photon

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Authors: Mohan Li

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Nowadays, intelligent research technology is more and more important than traditional research methods in urban research work, and this proportion will greatly increase in the next few decades. Frequently such analyzing work cannot be carried without some software engineering knowledge. And here, domain models of urban research will be necessary when applying software engineering knowledge to urban work. In many urban plan practice projects, making rational models, feeding reliable data, and providing enough computation all make indispensable assistance in producing good urban planning. During the whole work process, domain models can optimize workflow design. At present, human beings have entered the era of big data. The amount of digital data generated by cities every day will increase at an exponential rate, and new data forms are constantly emerging. How to select a suitable data set from the massive amount of data, manage and process it has become an ability that more and more planners and urban researchers need to possess. This paper summarizes and makes predictions of the emergence of technologies and technological iterations that may affect urban research in the future, discover urban problems, and implement targeted sustainable urban strategies. They are summarized into seven major domain models. They are urban and rural regional domain model, urban ecological domain model, urban industry domain model, development dynamic domain model, urban social and cultural domain model, urban traffic domain model, and urban space domain model. These seven domain models can be used to guide the construction of systematic urban research topics and help researchers organize a series of intelligent analytical tools, such as Python, R, GIS, etc. These seven models make full use of quantitative spatial analysis, machine learning, and other technologies to achieve higher efficiency and accuracy in urban research, assisting people in making reasonable decisions.

Keywords: big data, domain model, urban planning, urban quantitative analysis, machine learning, workflow design

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Authors: Leen Sulaimani, Maryam Hafiz, Naba Ali, Roba Alsharif

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One of Amazon’s most crucial online systems is artificial intelligence. Amazon would not have a worldwide successful online store, an easy and secure way of payment, and other services if it weren’t for artificial intelligence and machine learning. Amazon uses AI to expand its operations and enhance them by upgrading the website daily; having a strong base of artificial intelligence in a worldwide successful business can improve marketing, decision-making, feedback, and more qualities. Aiming to have a rational AI system in one’s business should be the start of any process; that is why Amazon is fortunate that they keep taking care of the base of their business by using modern artificial intelligence, making sure that it is stable, reaching their organizational goals, and will continue to thrive more each and every day. Artificial intelligence is used daily in our current world and is still being amplified more each day to reach consumer satisfaction and company short and long-term goals.

Keywords: artificial intelligence, Amazon, business, customer, decision making

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Authors: Aishvarya Gupta, Keerthana Anand, Sasirekha Rengaraj, Latha Chathurvedula

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Introduction: Advances in assisted reproductive technology and increase in the proportion of infertile couples have both contributed to the steep increase in the incidence of twin pregnancies in past decades. Maternal and perinatal complications are higher in twins than in singleton pregnancies. Studies comparing the maternal and perinatal outcomes of ART twin pregnancies versus spontaneously conceived twin pregnancies report heterogeneous results making it unclear whether the complications are due to twin gestation per se or because of assisted reproductive techniques. The present study aims to compare both maternal and perinatal outcomes in twin pregnancies which are spontaneously conceived and after assisted conception methods, so that targeted steps can be undertaken in order to improve maternal and perinatal outcome of twins. Objectives: To study perinatal and maternal outcome in twin pregnancies conceived spontaneously as well as with assisted methods and compare the outcomes between the two groups. Setting: Women delivering at JIPMER (tertiary care institute), Pondicherry. Population: 380 women with twin pregnancies who delivered in JIPMER between June 2015 and March 2017 were included in the study. Methods: The study population was divided into two cohorts – one conceived by spontaneous conception and other by assisted reproductive methods. Association of various maternal and perinatal outcomes with the method of conception was assessed using chi square test or Student's t test as appropriate. Multiple logistic regression analysis was done to assess the independent association of assisted conception with maternal outcomes after adjusting for age, parity and BMI. Multiple logistic regression analysis was done to assess the independent association of assisted conception with perinatal outcomes after adjusting for age, parity, BMI, chorionicity, gestational age at delivery and presence of hypertension or gestational diabetes in the mother. A p value of < 0.05 was considered as significant. Result: There was increased proportion of women with GDM (21% v/s 4.29%) and premature rupture of membranes (35% v/s 22.85%) in the assisted conception group and more anemic women in the spontaneous group (71.27% v/s 55.1%). However assisted conception per se increased the incidence of GDM among twin gestations (OR 3.39, 95% CI 1.34 – 8.61) and did not influence any of the other maternal outcomes. Among the perinatal outcomes, assisted conception per se increased the risk of having very preterm (<32 weeks) neonates (OR 3.013, 95% CI 1.432 – 6.337). The mean birth weight did not significantly differ between the two groups (p = 0.429). Though there were higher proportion of babies admitted to NICU in the assisted conception group (48.48% v/s 36.43%), assisted conception per se did not increase the risk of admission to NICU (OR 1.23, 95% CI 0.76 – 1.98). There was no significant difference in perinatal mortality rates between the two groups (p = 0.829). Conclusion: Assisted conception per se increases the risk of developing GDM in women with twin gestation and increases the risk of delivering very preterm babies. Hence measures should be taken to ensure appropriate screening methods for GDM and suitable neonatal care in such pregnancies.

Keywords: assisted conception, maternal outcomes, perinatal outcomes, twin gestation

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Authors: Duangsamorn Rungsawanpho

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The objectives of this paper are to explore the corporate cultures management as determinants of employee retention company in Thailand. This study using mixed method methodology. Data collection using questionnaires and in-depth interviews. The statistics used for data analysis were percentage, mean, standard deviation and inferential statistics will include. The results show that the corporate management culture is perfect for any organization but it depends on the business and the industry because the situations or circumstances that corporate executives are met is different. Because the finding explained that the employees of the company determine the achievement of value-oriented by the corporate culture and international relations is perceived most value for their organizations. In additional we found the employees perceiving with participation can be interpreted as a positive example, many employees feel that they are part of management because they care about their opinions or ideas related with their work.

Keywords: corporate culture, employee retention, retention of employees, management approaches

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Authors: Akram Hatami, Naser Firoozi, Vesa Puhakka

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Ethics and responsibility are rapidly becoming a distinguishing feature of organizations. In this paper, we analyze ethics and responsibility in shadow factories in China. We engage ourselves with Bauman’s moral impulse perspective because his idea can contextualize ethics and responsibility. Moral impulse is a feeling of a selfless, infinite and unconditional responsibility towards, and care for, Others. We analyze a case study from a secondary data source because, for such a critical phenomenon as business ethics in shadow factories, collecting primary data is difficult, since they are unregistered factories. We argue that there has not been enough attention given to the ethics and responsibility in shadow factories in China. Our main goal is to demonstrate that, considering the Other, more importantly the employees, in ethical decision-making is a simple instruction beyond the narrow version of ethics by ethical codes and rules.

Keywords: moral impulse, responsibility, shadow factories, Bauman’s moral impulse

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Authors: Mohsina Aktar, Bishawjit Mallick

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Bangladesh faces the multidimensional manifestations of climate change e.g. flood, cyclone, sea level rise, drainage congestion, salinity, etc. This study aimed at to find out the community’s perception of the perceived impact of climate change on their wetland resource based livelihood, to analyze their present livelihood scenario and to find out required institutional setup to strengthen present livelihood scenario. Therefore, this study required both quantitative analysis like quantification of wetland resources, occupation, etc. and also exploratory information like policy and institutional reform. For quantitative information 200 questionnaire survey and in some cases observation survey and for socially shareable qualitative and quantitative issues case study and focus group discussion were conducted. In-Depth interview was conducted for socially non-shareable qualitative issues. The overall findings of this study have been presented maintaining a sequence- perception about climate change effect, livelihood scenario and required institutional support of the wetland community. Flood has been ranked where cyclone effect is comparatively less disastrous in this area. Heavy rainfall comes after the cyclone. Female members responded almost same about the ranking and effects of frequently occurred and devastating effects of climate change. People are much more aware of the impact of climate change. Training of Care in RVCC project helps to increase their knowledge level. If the level of education can be increased, people can fight against calamity and poverty with more confidence. People seem to overcome the problems of water logging and thus besides involving in Hydroponics (33.3%) as prime occupation in monsoon; they are also engaged in other business related activities. January to May is the low-income season for the farmers. But some people don’t want to change their traditional occupation and their age is above 45. The young earning member wants to utilize their lean income period by alternative occupation. People who do not have own land and performing water transportation or other types of occupation are now interested about Hydroponics. People who give their land on rent are now thinking about renting their land in monsoon as through that they can earn a sound amount rather than get nothing. What they require is just seed, training, and capital. Present marketing system faces the problem of communication. So this sector needed to be developed. Involvement of women in income earning activity is very low (5.1%), and 100% women are housewives. They became inferior due to their educational level and dominance of their husband. Only one NGO named BCAS (Bangladesh Center for Advanced Studies) has been found engage training facilities and advocacy for this purpose. Upazilla agricultural extension office like other GO remains inactive to give support the community for extension and improvement of Hydroponics agriculture. If the community gets proper support and inspiration, they can fight against crisis of low-income and climate change, with the Hydroponics cultivation system successfully.

Keywords: wetland community, hydroponics, climate change adaptation, livelihood

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Authors: Muhammad Azeem Qureshi, Hammad Tahir, Fawwad Mahmood Butt

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Purpose: This study examines empirically the effect of brand satisfaction, brand trust and brand experience on brand loyalty which can be helpful to retain and increase customer base and satisfying customer needs as well. Methodology: Data has been collected on convenient sampling method and cause and effect among variables has been measured by applying regression analysis technique. Findings: Finding of this study have supported the proposed hypotheses and results show that brand loyalty is significantly explained by brand satisfaction, brand trust and brand experience. Practical Implications: The outcome of this study provides a useful framework and importance of brand loyalty culture in Pakistan. Marketers can be benefited trough the findings of this study.

Keywords: brand experience, brand satisfaction, brand trust, brand loyalty, hair-care products

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Authors: Emily Simone Doffing, Danielle Kohfeldt

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Disabled students are underrepresented in graduate-level degree enrollment and completion. There is limited research on disabled students' progression during the pandemic. Disabled graduate students (DGS) face unique interpersonal and institutional barriers, yet, limited research explores these barriers, buffering facilitators, and aids to academic persistence. This study adopts an asset-based, embodied disability approach using the critical pedagogy theoretical framework instead of the deficit research approach. The Participatory Action Research (PAR) paradigm, the critical pedagogy theoretical framework, and emancipatory disability research share the same purpose -creating a socially just world through reciprocal learning. This study is one of few, if not the first, to center solely on DGS’ lived understanding using a Participatory Action Research (PAR) epistemology. With a PAR paradigm, participants and investigators work as a research team democratically at every stage of the research process. PAR has individual and systemic outcomes. PAR lessens the researcher-participant power gap and elevates a marginalized community’s knowledge as expertise for local change. PAR and critical pedagogy work toward enriching everyone involved with empowerment, civic engagement, knowledge proliferation, socio-cultural reflection, skills development, and active meaning-making. The PAR process unveils the tensions between disability and graduate school in policy and practice during the pandemic. Likewise, institutional and ideological tensions influence the PAR process. This project is recruiting 10 DGS until September through purposive and snowball sampling. DGS will collectively practice praxis during four monthly focus groups in the fall 2023 semester. Participant researchers can attend a focus group or an interview, both with field notes. September will be our orientation and first monthly meeting. It will include access needs check-ins, ice breakers, consent form review, a group agreement, PAR introduction, research ethics discussion, research goals, and potential research topics. October and November will be available for meetings for dialogues about lived experiences during our collaborative data collection. Our sessions can be semi-structured with “framing questions,” which would be revised together. Field notes include observations that cannot be captured through audio. December will focus on local social action planning and dissemination. Finally, in January, there will be a post-study focus group for students' reflections on their experiences of PAR. Iterative analysis methods include transcribed audio, reflexivity, memos, thematic coding, analytic triangulation, and member checking. This research follows qualitative rigor and quality criteria: credibility, transferability, confirmability, and psychopolitical validity. Results include potential tension points, social action, individual outcomes, and recommendations for conducting PAR. Tension points have three components: dubious practices, contestable knowledge, and conflict. The dissemination of PAR recommendations will aid and encourage researchers to conduct future PAR projects with the disabled community. Identified stakeholders will be informed of DGS’ insider knowledge to drive social sustainability.

Keywords: participatory action research, graduate school, disability, higher education

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Authors: Zahra Fotovatnia, Jeffery A. Jones, Alexandra Gottardo

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Speech communication often occurs in environments where noise conceals part of a message. Listeners should compensate for the lack of auditory information by picking up distinct acoustic cues and using semantic and sentential context to recreate the speaker’s intended message. This situation seems to be more challenging in a nonnative than native language. On the other hand, early bilinguals are expected to show an advantage over the late bilingual and monolingual speakers of a language due to their better executive functioning components. In this study, English monolingual speakers were compared with early and late nonnative speakers of English to understand speech in noise processing (SIN) and the underlying neurobiological features of this phenomenon. Auditory mismatch negativities (MMNs) were recorded using a double-oddball paradigm in response to a minimal pair that differed in their middle vowel (beat/bit) at Wilfrid Laurier University in Ontario, Canada. The results did not show any significant structural and electroneural differences across groups. However, vocabulary knowledge correlated positively with performance on tests that measured SIN processing in participants who learned English after age 6. Moreover, their performance on the test negatively correlated with the integral area amplitudes in the left superior temporal gyrus (STG). In addition, the STG was engaged before the inferior frontal gyrus (IFG) in noise-free and low-noise test conditions in all groups. We infer that the pre-attentive processing of words engages temporal lobes earlier than the fronto-central areas and that vocabulary knowledge helps the nonnative perception of degraded speech.

Keywords: degraded speech perception, event-related brain potentials, mismatch negativities, brain regions

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Authors: Xin Li

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The uncertainty and the complexity of the urban environment combining with the threat of climate change are contributing factors to the vulnerability in multiple-dimensions in Chinese megacities, especially in Shanghai. The urban area occupied high valuable technological infrastructure and density buildings is under the threats of climate change and can provide insufficient ecological service to remain the trade-off on urban sustainable development. Urban ecological-based adaptation (UEbA) combines practices and theoretical work and integrates ecological services into multiple-layers of urban environment planning in order to reduce the impact of the complexity and uncertainty. To understand and to respond to the challenges in the urban level, this paper considers Shanghai as the research objective. It is necessary that its urban adaptation strategies should be reflected and contain the concept and knowledge of EbA. In this paper, we firstly use software to illustrates the visualizing patterns and trends of UEBA research in the current 10 years. Specifically, Citespace software was used for interpreting the significant hubs, landmarks points of peer-reviewed literature on the context of ecological service research in recent 10 years. Secondly, 135 evidence-based EbA literature were reviewed for categorizing the methodologies and framework of evidence-based EbA by the systematic map protocol. Finally, a conceptual framework combined with culture, economic and social components was developed in order to assess the current adaptation strategies in Shanghai. This research founds that the key to reducing urban vulnerability does not only focus on co-benefit arguments but also should pay more attention to the concept of trade-off. This research concludes that the designed framework can provide key knowledge and indicates the essential gap as a valuable tool against climate variability in the process of urban adaptation in Shanghai.

Keywords: urban ecological-based adaptation, climate change, sustainable development, climate variability

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