Search results for: Kyle Rank

Authors: Adawati Suhaili, Kamisah Osman, Mohd Effendi, Ewan Mohd Matore

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The global education reform has prompted Malaysia to transform the education system in Malaysia through the Malaysian Education Blueprint (MEB) 2013-2025. This transformation is aimed to achieve the top one-third rank in international assessment. The low achievement of student scientific literacy in TIMMS (Trends in International Mathematics and Science Study ) and PISA (Programme for International Student Assessment) has caused concern to the Ministry Of Education (MOE) despite various reform efforts. Therefore, an alternative action by enhancing the role of the Head of Science Panels (HoSPs) as a key change agent in catalyzing the improvement of student performance should be considered. Highlights of previous studies have shown that subject leadership is able to enhance teacher teaching quality in order to increase student learning. To lead the Science department and guide Science teachers more effectively, HoSPs need to strengthen their leadership skills. However, the issue of weaknesses in the leadership competencies of HoSPs in Malaysia has caused them to lack confidence and ability in leading the Science Department. The main objective of this study is to explore the factors that contribute to the problems faced by HoSPs at Sarawak in their leadership roles. This study used a qualitative design framework and using a semi-structured interview method for data collection. There were six informants involved in the interview consisting of lecturers, Senior Administrative Assistant Teacher and HoSPs. The findings of the study had been identified four main factors that contribute to problems in the leadership competencies of HoSPs in Sarawak, namely leadership practices, leadership structure, academic subjects and school change. The results are significant to the MOE in strengthening the leadership competencies of HoSPs in a more focus for improving the achievement of scientific literacy of students in Malaysia. This study can help improve the Hosps' leadership competencies in Malaysia.

Keywords: issues, problems, Malaysia education blueprint, leadership competencies, head of science panels

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Authors: Nattapol Pourprasert

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This research is to study qualitative research having two objectives: 1. to study comparison of private sector of government to compare with ASEAN Member States, 2. to study trend of private enterprise administration of ASEAN Member States. The results are: (1) Thai people focus on personal resource administrative system, (2) Indonesia focuses on official system by good administrative principles, (3) Malaysia focuses on technology development to service people, (4) Philippines focuses on operation system development, (5) Singapore focuses on public service development, (6) Brunei Darussalam focuses on equality in government service of people, (7) Vietnam focuses on creating government labor base and develop testing and administration of operation test, (8) Myanmar focuses on human resources development, (9) Laos focuses on form of local administration, (10) Cambodia focuses on policy revolution in personal resources. The result of the second part of the study are: (1) Thailand created government personnel to be power under qualitative official structural event, (2) Indonesia has Bureaucracy Reform Roadmap of Bureaucracy Reform and National Development Plan Medium Term, (3) Malaysia has database for people service, (4) Philippines follows up control of units operation by government policy, (5) Singapore created reliability, participation of people to set government policy people’s demand, (6) Brunei Darussalam has social welfare to people, (7) Vietnam revolved testing system and administration including manpower base construction of government effectively, (8) Myanmar creates high rank administrators to develop country, (9) Laos distributes power to locality, and (10) Cambodia revolved personnel resource policy.

Keywords: public administration development, ASEAN member states, private sector, government

Procedia PDF Downloads 240

Authors: Sarthak Kumar Jena, Chandra Sekhar Mishra, Prabina Rajib

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Purpose: This paper aims to derive undervaluation signal from the insiders trading of Indian companies where the ownership is complex and concentrated, investors protection is weak, and the insider rules and regulations are not stringent like developed country. This study examines the relationship between insider trading with short term and long term abnormal return. The study also examines the relationship between insider trading and the actual share repurchase by the firm. Methodology: A sample of 78 companies over the period 2008-2013 are analyzed in the study due to not availability of insider data in Indian context. For preliminary analysis T-test and Wilcoxon rank sum test is used to find the difference between the insider trading before and after the share repurchase announcement. Tobit model is used to find out whether insider trading influence shares repurchase decisions or not. Return on the basis of market model and buy hold are calculated in the previous year and the following year of share repurchase announcement. Findings: The paper finds that insider trading around share repurchase is more than control firms and there is positive and significant difference in insider buying between the previous year of share buyback announcement and the following year of buyback announcement. Insider buying before share repurchase announcement has a positive influence on share repurchase decisions. We find insider buying has a positive and significant relationship with announcement return, whereas insider selling has a negative significant relationship with announcement return. Actual share repurchase and program completion also depend on insider trading before share repurchase. Research limitation: The study is constrained by the small sample size, so the results should be viewed by keeping this limitation in mind. Originality: The paper is to our best knowledge the first study based on Indian context to extend the insider trading literature to share repurchase event and examine insider trading to find out undervaluation signal associated with insider buying.

Keywords: insider trading, buyback, open market share repurchase, signalling

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Authors: Kathryn L. Duncan, Charles A. Kuntz, Alessandra C. Santamaria, James O. Simcock

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Access to megavoltage radiation therapy for small animals is limited in many locations around the world. This can preclude the use of palliative radiation therapy for the treatment of appendicular osteosarcoma in dogs. The objective of this study was to retrospectively assess the adverse effects and survival times of dogs with appendicular osteosarcoma that were treated with hypofractionated orthovoltage radiation therapy and adjunctive carboplatin chemotherapy administered via a single subcutaneous infusion. Medical records were reviewed retrospectively to identify client-owned dogs with spontaneously occurring appendicular osteosarcoma that was treated with palliative orthovoltage radiation therapy and a single subcutaneous infusion of carboplatin. Data recorded included signalment, tumour location, results of diagnostic imaging, haematologic and serum biochemical analyses, adverse effects of radiation therapy and chemotherapy, and survival times. Kaplan-Meier survival analysis was performed, and log-rank analysis was used to determine the impact of specific patient variables on survival time. Twenty-three dogs were identified that met the inclusion criteria. Median survival time for dogs was 182 days. Eleven dogs had adverse haematologic effects, 3 had adverse gastrointestinal effects, 6 had adverse effects at the radiation site and 7 developed infections at the carboplatin infusion site. No statistically significant differences were identified in survival times based on sex, tumour location, development of infection, or pretreatment serum alkaline phosphatase. Median survival time and incidence of adverse effects were comparable to those previously reported in dogs undergoing palliative radiation therapy with megavoltage or cobalt radiation sources and conventional intravenous carboplatin chemotherapy. The use of orthovoltage palliative radiation therapy may be a reasonable alternative to megavoltage radiation in locations where access is limited.

Keywords: radiotherapy, veterinary oncology, chemotherapy, osteosarcoma

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Authors: Madelaine F. Gatchalian, Mary Jane D. Tepora

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This study was designed to determine the relationship between learning environment and motivation of CNHS, SY 2012-2013. There were 376 respondents taken randomly. Frequency distribution, percentage, mean, standard deviation, Mann Whitney Test, Kruskall Wallis One-way ANOVA and Spearman Rank Correlational Coefficient were used in analyzing the data. As to age, most of the respondents were 13 years old while female students outnumbered the male students. Majority of parents’ educational attainment of CNHS students were high school/vocational graduates. Most fathers worked in the private sector, while majority of the mothers were unemployed whose family income range from Php 5,000.00 to Php 14,999.00. Most of the respondents were first child composed of five family members. Findings showed no significant differences in perceived learning environment when respondents were grouped in terms of age, sex, parents’ educational attainment, parents’ occupation, sibling order and number of family members. Only monthly family income showed significant differences in perceived learning environment. There are no significant differences in perceived learning motivation when respondents were grouped in terms of age, sex, parents’ educational attainment (father), parents’ occupation (father), sibling order, and number of family members. Parents’ educational attainment (mother), parents’ occupation (mother) and monthly family income showed significant differences in perceived learning motivation. There is significant relationship between the six subscales of perceived learning environment, namely: student cohesiveness, teacher support, involvement, task orientation, cooperation and equity and perceived learning motivation of CNHS students, SY, 2012-2013. The results of this study indicated that learning environment including student cohesiveness, teachers support, involvement, task orientation, cooperation and equity is significantly related to students’ learning motivation.

Keywords: learning environment, motivation, demographic profile, secondary students

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Authors: Ogbonnaya Elom, Francis N. Azunku, Ogochukwu Onah

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This study was carried out to determine the correlates of cost effectiveness analysis of rating scale and psycho-productive multiple choice test for assessing students’ performance in rice production. Four research questions were developed and answered, while one hypothesis was formulated and tested. Survey and correlation designs were adopted. The population of the study was 20,783 made up of 20,511 senior secondary (SSII) students and 272 teachers of agricultural science from 221 public secondary schools. Two schools with one intact class of 30 students each was purposely selected as sample based on certain criteria. Four sets of instruments were used for data collection. One of the instruments-the rating scale, was subjected to face and content validation while the other three were subjected to face validation only. Cronbach alpha technique was utilized to determine the internal consistency of the rating scale items which yielded a coefficient of 0.82 while the Kudder-Richardson (K-R 20) formula was involved in determining the stability of the psycho-productive multiple choice test items which yielded a coefficient of 0.80. Method of data collection involved a step-by-step approach in collecting data. Data collected were analyzed using percentage, weighted mean and sign test to answer the research questions while the hypothesis was tested using Spearman rank-order of correlation and t-test statistic. Findings of the study revealed among others, that psycho-productive multiple choice test is more effective than rating scale when the former is applied on the two groups of students. It was recommended among others, that the external examination bodies should integrate the use of psycho- productive multiple choice test into their examination policy and direct secondary schools to comply with it.

Keywords: correlates, cost-effectiveness, psycho-productive multiple-choice scale, rating scale

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Authors: Iris Sauerbrei, Jörg Trojan, Erich Lehner

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Introduction and significance of the study: This study examines if three-dimensional shapes elicit distinct patterns of perceptions. If so, it is relevant for all fields of design, especially for the design of the built environment. Description of basic methodologies: The five platonic solids are the geometrical base for all other three-dimensional shapes, among which tetrahedron and icosahedron provide the clearest representation of the qualities sharp and round. The component pair of attributes ‘sharp versus round’ has already been examined in various surveys in a psychology of perception and in neuroscience by means of graphics, images of products of daily use, as well as by photographs and walk-through-videos of landscapes and architecture. To verify a transfer of outcomes of the existing surveys to the perception of three-dimensional shapes, walk-in models (total height 2.2m) of tetrahedron and icosahedron were set up in a public park in Frankfurt am Main, Germany. Preferences of park visitors were tested by questionnaire; also they were asked to write down associations in a free text. In summer 2015, the tetrahedron was assembled eight times, the icosahedron seven times. In total 288 participants took part in the study; 116 rated the tetrahedron, 172 rated the icosahedron. Findings: Preliminary analyses of the collected data using Wilcoxon Rank-Sum tests show that the perceptions of the two solids differ in respect to several attributes and that each of the tested model show significance for specific attributes. Conclusion: These findings confirm the assumptions and provide first evidence that the perception of three-dimensional shapes are associated to characteristic attributes and to which. In order to enable conscious choices for spatial arrangements in design processes for the built environment, future studies should examine attributes for the other three basic bodies - Octahedron, Cube, and Dodecahedron. Additionally, similarities and differences between the perceptions of two- and three-dimensional shapes as well as shapes that are more complex need further research.

Keywords: 3D shapes, architecture, geometrical features, space perception, walk-in models

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Authors: Chalachew Gashu, Yoseph Kassa, Habtamu Geremew, Mengestie Mulugeta

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Background and Aims: Severe acute malnutrition remains a significant health challenge, particularly in low‐ and middle‐income countries. The aim of this study was to determine the survival time of under‐five children with severe acute malnutrition. Methods: A retrospective cohort study was conducted at a hospital, focusing on under‐five children with severe acute malnutrition. The study included 322 inpatients admitted to the Chiro hospital in Chiro, Ethiopia, between September 2019 and August 2020, whose data was obtained from medical records. Survival functions were analyzed using Kaplan‒Meier plots and log‐rank tests. The survival time of severe acute malnutrition was further analyzed using the Cox proportional hazards model and Bayesian parametric survival models, employing integrated nested Laplace approximation methods. Results: Among the 322 patients, 118 (36.6%) died as a result of severe acute malnutrition. The estimated median survival time for inpatients was found to be 2 weeks. Model selection criteria favored the Bayesian Weibull accelerated failure time model, which demonstrated that age, body temperature, pulse rate, nasogastric (NG) tube usage, hypoglycemia, anemia, diarrhea, dehydration, malaria, and pneumonia significantly influenced the survival time of severe acute malnutrition. Conclusions: This study revealed that children below 24 months, those with altered body temperature and pulse rate, NG tube usage, hypoglycemia, and comorbidities such as anemia, diarrhea, dehydration, malaria, and pneumonia had a shorter survival time when affected by severe acute malnutrition under the age of five. To reduce the death rate of children under 5 years of age, it is necessary to design community management for acute malnutrition to ensure early detection and improve access to and coverage for children who are malnourished.

Keywords: Bayesian analysis, severe acute malnutrition, survival data analysis, survival time

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Authors: C. S. Subhashini, H. L. Premaratne

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Landslides are the most recurrent and prominent disaster in Sri Lanka. Sri Lanka has been subjected to a number of extreme landslide disasters that resulted in a significant loss of life, material damage, and distress. It is required to explore a solution towards preparedness and mitigation to reduce recurrent losses associated with landslides. Artificial Neural Networks (ANNs) and Hidden Markov Model (HMMs) are now widely used in many computer applications spanning multiple domains. This research examines the effectiveness of using Artificial Neural Networks and Hidden Markov Model in landslides predictions and the possibility of applying the modern technology to predict landslides in a prominent geographical area in Sri Lanka. A thorough survey was conducted with the participation of resource persons from several national universities in Sri Lanka to identify and rank the influencing factors for landslides. A landslide database was created using existing topographic; soil, drainage, land cover maps and historical data. The landslide related factors which include external factors (Rainfall and Number of Previous Occurrences) and internal factors (Soil Material, Geology, Land Use, Curvature, Soil Texture, Slope, Aspect, Soil Drainage, and Soil Effective Thickness) are extracted from the landslide database. These factors are used to recognize the possibility to occur landslides by using an ANN and HMM. The model acquires the relationship between the factors of landslide and its hazard index during the training session. These models with landslide related factors as the inputs will be trained to predict three classes namely, ‘landslide occurs’, ‘landslide does not occur’ and ‘landslide likely to occur’. Once trained, the models will be able to predict the most likely class for the prevailing data. Finally compared two models with regards to prediction accuracy, False Acceptance Rates and False Rejection rates and This research indicates that the Artificial Neural Network could be used as a strong decision support system to predict landslides efficiently and effectively than Hidden Markov Model.

Keywords: landslides, influencing factors, neural network model, hidden markov model

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Authors: Abdul Rahman Chamseddine

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Tawfiq al-Hakim remains one of the most prominent playwrights in his native in Egypt, and in the broader Arab world. His works, at the time of their release, drew international attention and acclaim. His first 1933 masterpiece Ahl al-Kahf (The People of the Cave) especially, garnered fame and recognition in both Europe and the Arab world. Borrowing its title from the Qur’anic Sura, al-Hakim’s play relays the untold story of the life of those 'three saints' after they wake up from their prolonged sleep. The playwright’s selection of topics upon which to base his works displays a deep appreciation of Arabic and Islamic heritage. Al-Hakim was clearly influenced by Islam, to such a degree that he wrote the biography of the Prophet Muhammad in 1936 very early in his career. Knowing that Al-Hakim was preceded by many poets and creative writers in writing the Prophet Muhammad’s biography. Notably like Al-Barudi, Ahmad Shawqi, Haykal, Al-‘Aqqad, and Taha Husayn who have had their own ways in expressing their views of the Prophet Muhammad. The attempt to understand the concern of all those renaissance men and others in the person of the Prophet would be indispensable in this study. This project will examine the reasons behind al-Hakim’s choice to draw upon these particular texts, embedded as they are in the context of Arabic and Islamic heritage, and how the use of traditional texts serves his contemporary goals. The project will also analyze the image of Islam in al-Hakim’s imagination. Elsewhere, he envisions letters or conversations between God and himself, which offers a window into understanding the powerful impact of the Divine on Tawfiq al-Hakim, one that informs his literature and merits further scholarly attention. His works occupying a major rank in Arabic literature, does not reveal Al-Hakim solely but the unquestioned assumptions operative in the life of his community, its mental make-up and its attitudes. Furthermore, studying the reception of works that touch on sensitive issues, like writing a letter to God, in Al-Hakim’s historical context would be of a great significance in the process of comprehending the mentality of the Muslim community at that time.

Keywords: Arabic language, Arabic literature, Arabic theology, modern Arabic literature

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Authors: Manal Elgallal, Louise Fletcher, Barbara Evans

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Water scarcity is a growing concern in many arid and semi-arid countries. The increase of water scarcity threatens economic development and sustainability of human livelihoods as well as environment especially in developing countries. Globally, agriculture is the largest water consumption sector, accounting for approximately 70% of all freshwater extraction. Growing competition between the agricultural and higher economic value in urban and industrial uses of high-quality freshwater supplies, especially in regions where water scarcity major problems, will increase the pressure on this precious resource. In this circumstance, wastewater may provide reliable source of water for agriculture and enable freshwater to be exchanged for more economically valuable purposes. Concern regarding the risks from microbial and toxic components to human health and environment quality is a serious obstacle for wastewater reuse particularly in agriculture. Although powerful approaches and tools for microbial risk assessment and management for safe use of wastewater are now available, few studies have attempted to provide any mechanism to quantitatively assess and manage the environmental risks resulting from reusing wastewater. In seeking pragmatic solutions to sustainable wastewater reuse, there remains a lack of research incorporating both health and environmental risk assessment and management with economic analysis in order to quantitatively combine cost, benefits and risks to rank alternative reuse options. This study seeks to enhance effective reuse of wastewater for irrigation in arid and semi-arid areas, the outcome of the study is an evaluation approach that can be used to assess different reuse strategies and to determine the suitable scale at which treatment alternatives and interventions are possible, feasible and cost effective in order to optimise the trade-offs between risks to protect public health and the environment and preserving the substantial benefits.

Keywords: environmental risks, management, life cycle costs, waste water irrigation

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Authors: Fares Elturki, Shaban Ismael Albrka Ali Zangena, H. A. M. Yahia

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Safety is an important consideration in the design and operation of streets and highways. Traffic and highway engineers working with law enforcement officials are constantly seeking for better methods to ensure safety for motorists and pedestrians. Also, a highway safety improvement process involves planning, implementation, and evaluation. The planning process requires that engineers collect and maintain traffic safety data, identify the hazards location, conduct studies and establish project priorities. Unfortunately, in Libya, the increase in demand for private transportation in recent years, due to poor or lack of public transportation led to some traffic problems especially in the capital (Tripoli). Also, the growth of private transportation has significant influences on the society regarding road traffic accidents (RTAs). This study investigates the most critical factors affect RTAs in Tripoli the capital city of Libya. Four main classifications were chosen to build the questionnaire, namely; human factors, road factors, vehicle factors and environmental factors. Moreover, a quantitative method was used to collect the data from the field, the targeted sample size 400 respondents include; drivers, pedestrian and passengers and relative importance index (RII) were used to rank the factors of one group and between all groups. The results show that the human factors have the most significant impacts compared with other factors. Also, 84% of respondents considered the over speeding as the most significant factor cusses of RTAs while 81% considered the disobedience to driving regulations as the second most influential factor in human factors. Also, the results showed that poor brakes or brake failure factor a great impact on the RTAs among the vehicle factors with nearly 74%, while 79% categorized poor or no street lighting factor as one of the most effective factors on RTAs in road factors and third effecting factor concerning all factors. The environmental factors have the slights influences compared with other factors.

Keywords: road traffic accidents, Libya, vehicle factors, human factors, relative importance index

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Authors: Pedram Saadati, Zahra Nazari

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Today, the role and importance of financial technology businesses in Iran have increased significantly. Although, in Iran, there is no Islamic or non-Islamic personal financial planning field of study in the universities or educational centers, the profession of personal financial planning is not defined, and there is no software introduced in this regard for advisors or consumers. The largest sales network of financial services in Iran belongs to the insurance industry, and there is an untapped market for international companies in Iran that can contribute to 130 thousand representatives in the insurance industry and 28 million families by providing training and personal financial advisory software. To the best of the author's knowledge, despite the lack of previous internal studies in this field, the present study investigates the level of readiness of the salesforce of the insurance industry to accept this career and its technology. The statistical population of the research is made up of managers, insurance sales representatives, assistants and heads of sales departments of insurance companies. An 18-minute video was prepared that introduced and taught the job of Islamic personal financial planning and explained its difference from its non-Islamic model. This video was provided to the respondents. The data collection tool was a research-made questionnaire. To investigate the factors affecting technology acceptance and job change, independent T descriptive statistics and Pearson correlation were used, and Friedman's test was used to rank the effective factors. The results indicate the mental perception and very positive attitude of the insurance industry activists towards the usefulness of this job and its technology, and the studied sample confirmed the intention of training in this knowledge. Based on research results, the change in the customer's attitude towards the insurance advisor and the possibility of increasing income are considered as the reasons for accepting. However, Restrictions on using investment opportunities due to Islamic financial services laws and the uncertainty of the position of the central insurance in this regard are considered as the most important obstacles.

Keywords: fintech, insurance, personal financial planning, wealth management

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Authors: Ayedh Alqahtani

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Many construction firms in Saudi Arabia dedicated to building projects agree that the most important factor in the real estate market is the value that they can give to their customer. These firms understand the value of their client in different ways. Value can be defined as the size of the building project in relationship to the cost or the design quality of the materials utilized in finish work or any other features of building rooms such as the bathroom. Value can also be understood as something suitable for the money the client is investing for the new property. A quality tool is required to support companies to achieve a solution for the building project and to understand and manage the customer’s needs. Quality Function Development (QFD) method will be able to play this role since the main difference between QFD and other conventional quality management tools is QFD a valuable and very flexible tool for design and taking into the account the VOC. Currently, organizations and agencies are seeking suitable models able to deal better with uncertainty, and that is flexible and easy to use. The primary aim of this research project is to incorporate customer’s requirements in the conceptual design of construction projects. Towards this goal, QFD is selected due to its capability to integrate the design requirements to meet the customer’s needs. To develop QFD, this research focused upon the contribution of the different (significantly weighted) input factors that represent the main variables influencing QFD and subsequent analysis of the techniques used to measure them. First of all, this research will review the literature to determine the current practice of QFD in construction projects. Then, the researcher will review the literature to define the current customers of residential projects and gather information on customers’ requirements for the design of the residential building. After that, qualitative survey research will be conducted to rank customer’s needs and provide the views of stakeholder practitioners about how these needs can affect their satisfy. Moreover, a qualitative focus group with the members of the design team will be conducted to determine the improvements level and technical details for the design of residential buildings. Finally, the QFD will be developed to establish the degree of significance of the design’s solution.

Keywords: quality function development, construction projects, Saudi Arabia, quality tools

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Authors: Sagar Mahendrakar

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Testers' roles have changed dramatically as automation continues to revolutionise the software development lifecycle. There's a general belief that manual testing is becoming outdated with the introduction of advanced testing frameworks and tools. This abstract, however, disproves that notion by examining the complex and dynamic role that testers play in automated environments. In this work, we explore the complex duties that testers have when everything is automated. We contend that although automation increases productivity and simplifies monotonous tasks, it cannot completely replace the cognitive abilities and subject-matter knowledge of human testers. Rather, testers shift their focus to higher-value tasks like creating test strategies, designing test cases, and delving into intricate scenarios that are difficult to automate. We also emphasise the critical role that testers play in guaranteeing the precision, thoroughness, and dependability of automated testing. Testers verify the efficacy of automated scripts and pinpoint areas for improvement through rigorous test planning, execution, and result analysis. They play the role of quality defenders, using their analytical and problem-solving abilities to find minute flaws that computerised tests might miss. Furthermore, the abstract emphasises how testing in automated environments is a collaborative process. In order to match testing efforts with business objectives, improve test automation frameworks, and rank testing tasks according to risk, testers work closely with developers, automation engineers, and other stakeholders. Finally, we discuss how testers in the era of automation need to possess a growing skill set. To stay current, testers need to develop skills in scripting languages, test automation tools, and emerging technologies in addition to traditional testing competencies. Soft skills like teamwork, communication, and flexibility are also essential for productive cooperation in cross-functional teams. This abstract clarifies the ongoing importance of testers in automated settings. Testers can use automation to improve software quality and provide outstanding user experiences by accepting their changing role as strategic partners and advocates for quality.

Keywords: testing, QA, automation, leadership

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Authors: Elżbieta Turska

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Introduction: One of the most difficult times in a person’s life is adolescence. The experiences in this period may shape the future life of this person to a large extent. This is the reason why many young people experience sadness, dejection, hopelessness, sense of worthlessness, as well as losing interest in various activities and social relationships, all of which are often classified as mood disorders. As many as 15-40% adolescents experience depressed moods and for most of them they resolve and are not carried into adulthood. However, (5-6%) of those affected by mood disorders develop the depressive syndrome and as many as (1-3%) develop full-blown clinical depression. Materials: A large questionnaire was given to 2508 students, aged 13–16 years old, and one of its parts was the Burns checklist, i.e. the standard test for identifying depressed mood. The questionnaire asked about many aspects of the student’s life, it included a total of 53 questions, most of which had subquestions. It is important to note that the data suffered from many problems, the most important of which were missing data and collinearity. Aim: In order to identify the correlates of mood disorders we built predictive models which were then trained and validated. Our aim was not to be able to predict which students suffer from mood disorders but rather to explore the factors influencing mood disorders. Methods: The problems with data described above practically excluded using all classical statistical methods. For this reason, we attempted to use the following Artificial Intelligence (AI) methods: classification trees with surrogate variables, random forests and xgboost. All analyses were carried out with the use of the mlr package for the R programming language. Resuts: The predictive model built by classification trees algorithm outperformed the other algorithms by a large margin. As a result, we were able to rank the variables (questions and subquestions from the questionnaire) from the most to least influential as far as protection against mood disorder is concerned. Thirteen out of twenty most important variables reflect the relationships with parents. This seems to be a really significant result both from the cognitive point of view and also from the practical point of view, i.e. as far as interventions to correct mood disorders are concerned.

Keywords: mood disorders, adolescents, family, artificial intelligence

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Authors: Elham A. Kwildi, Yahia S. Abugnah, Nuri S. Madi

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This study was designed to evaluate the microbiological quality and safety of two types of salads prepared at a catering center affiliated with Libyan Airlines in Tripoli, Libya. Two hundred and twenty-one (221) samples (132 economy-class and 89 first- class) were used in this project which lasted for ten months. Biweekly, microbiological tests were performed which included total plate count (TPC) and total coliforms (TCF), in addition to enumeration and/or detection of some pathogenic bacteria mainly Escherichia coli, Staphylococcus aureus, Bacillus cereus, Salmonella sp, Listeria sp and Vibrio parahaemolyticus parahaemolyticus, By using conventional as well as compact dry methods. Results indicated that TPC of type 1 salad ranged between (<10 – 62 x 103 cfu/gm) and (<10 to 36 x103 cfu/g), while TCF were (<10 – 41 x 103 cfu/gm) and (< 10 to 66 x102 cfu/g) using both methods of detection respectively. On the other hand, TPC of type 2 salad were: (1 × 10 – 52 x 103) and (<10 – 55 x 103 cfu/gm) and in the range of (1 x10 to 45x103 cfu/g), and the (TCF) counts were between (< 10 to 55x103 cfu/g) and (< 10 to 34 x103 cfu/g) using the 1st and the 2nd methods of detection respectively. Also, the pathogens mentioned above were detected in both types of salads, but their levels varied according to the type of salad and the method of detection. The level of Staphylococcus aureus, for instance, was 17.4% using conventional method versus 14.4% using the compact dry method. Similarly, E. coli was 7.6% and 9.8%, while Salmonella sp. recorded the least percentage i.e. 3% and 3.8% with the two mentioned methods respectively. First class salads were also found to contain the same pathogens, but the level of E. coli was relatively higher in this case (14.6% and 16.9%) using conventional and compact dry methods respectively. The second rank came Staphylococcus aureus (13.5%) and (11.2%), followed by Salmonella (6.74%) and 6.70%). The least percentage was for Vibrio parahaemolyticus (4.9%) which was detected in the first class salads only. The other two pathogens Bacillus cereus and Listeria sp. were not detected in either one of the salads. Finally, it is worth mentioning that there was a significant decline in TPC and TCF counts in addition to the disappearance of pathogenic bacteria after the 6-7th month of the study which coincided with the first trial of the HACCP system at the center. The ups and downs in the counts along the early stages of the study reveal that there is a need for some important correction measures including more emphasis on training of the personnel in applying the HACCP system effectively.

Keywords: air travel, vegetable salads, foodborne outbreaks, Libya

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Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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Authors: Riina I. Bray, Yifan Wang, Nikolas Argiropoulos, Stephanie Robins, John Molot, Kelly Tragash, Lynn M. Marshall, Margaret E. Sears, Marie-Andrée Pigeon, Michel Gaudet, Pierre Auger, Emily Bélanger, Rohini Peris

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Multiple chemical sensitivity (MCS) is a chronic medical condition characterized by intolerances to chemical substances. Since the arrival of the COVID-19 pandemic and associated health measures, people experiencing MCS (PEMCS) are at a heightened risk of environmental exposures associated with cleaners, disinfectants, and sanitizers. Little attention has been paid to the well-being of PEMCS in the context of the COVID-19 pandemic. Objective: This study assesses the lived experiences of Canadian adults with MCS in relation to their living environment, access to healthcare, and levels of perceived social support before and during the pandemic. Methods: A total of 119 PEMCS completed an online questionnaire. McNemar Chi-Squared and Wilcoxon Signed Rank tests were used to evaluate if there were statistically significant changes in participants’ perception of their living environment, access to healthcare, and levels of social support before and after March 11, 2020. Results: Both positive and negative outcomes were noted. Participants reported an increase in exposure to disinfectants/sanitizers that entered their living environment (p<.001). There was a reported decrease in access to a family doctor during the pandemic (p<0.001). Although PEMCS experienced increased social isolation (p<0.001), they also reported an increase in understanding from family (p<0.029) and a decrease in stigma for wearing personal protective equipment (p<0.001). Conclusion: PEMCS reported experiencing: increased exposure to disinfectants or sanitizers, a loss of social support, and barriers in accessing healthcare during the pandemic. However, COVID-19 provided an opportunity to normalize the living conditions of PEMCS, such as wearing masks and social isolation. These findings can guide decision-makers on the importance of implementing nontoxic alternatives for cleaning and disinfection, as well as improving accommodation measures for PEMCS.

Keywords: covid-19, multiple chemical sensitivity, MCS, quality of life, social isolation, physical environment, healthcare

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Authors: Katarina Rogulj, Ivana Racetin, Jelena Kilic

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In this study, the fuzzy logic approach (FLA) was developed for construction project management (CPM) under uncertainty and duality. The focus was on decision making in selecting the type of the glass facade for a residential-commercial building in the main design. The adoption of fuzzy sets was capable of reflecting construction managers’ reliability level over subjective judgments, and thus the robustness of the system can be achieved. An α-cuts method was utilized for discretizing the fuzzy sets in FLA. This method can communicate all uncertain information in the optimization process, taking into account the values of this information. Furthermore, FLA provides in-depth analyses of diverse policy scenarios that are related to various levels of economic aspects when it comes to the construction projects' valid decision making. The developed approach is applied to CPM to demonstrate its applicability. Analyzing the materials of glass facades, variants were defined. The development of the FLA for the CPM included relevant construction projec'ts stakeholders that were involved in the criteria definition to evaluate each variant. Using fuzzy Decision-Making Trial and Evaluation Laboratory Method (DEMATEL) comparison of the glass facade was conducted. This way, a rank, according to the priorities for inclusion into the main design, of variants is obtained. The concept was tested on a residential-commercial building in the city of Rijeka, Croatia. The newly developed methodology was then compared with the existing one. The aim of the research was to define an approach that will improve current judgments and decisions when it comes to the material selection of buildings facade as one of the most important architectural and engineering tasks in the main design. The advantage of the new methodology compared to the old one is that it includes the subjective side of the managers’ decisions, as an inevitable factor in each decision making. The proposed approach can help construction projects managers to identify the desired type of glass facade according to their preference and practical conditions, as well as facilitate in-depth analyses of tradeoffs between economic efficiency and architectural design.

Keywords: construction projects management, DEMATEL, fuzzy logic approach, glass façade selection

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Authors: Samart Homthong, Wutthipong Moungnoi

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Critical success factors (CSFs) and the criteria to measure project success have received much attention over the decades and are among the most widely researched topics in the context of project management. However, although there have been extensive studies on the subject by different researchers, to date, there has been little agreement on the CSFs. The aim of this study is to identify the CSFs that influence the performance of construction projects, and determine their relative importance for different objectives across five stages in the project life cycle. A considerable literature review was conducted that resulted in the identification of 179 individual factors. These factors were then grouped into nine major categories. A questionnaire survey was used to collect data from three groups of respondents: client representatives, consultants, and contractors. Out of 164 questionnaires distributed, 93 were returned, yielding a response rate of 56.7%. Using the mean score, relative importance index, and weighted average method, the top 10 critical factors for each category were identified. The agreement of survey respondents on those categorised factors were analysed using Spearman’s rank correlation. A one-way analysis of variance was then performed to determine whether the mean scores among the various groups of respondents were statistically significant. The findings indicate the most CSFs in each category in procurement phase are: proper procurement programming of materials (time), stability in the price of materials (cost), and determining quality in the construction (quality). They are then followed by safety equipment acquisition and maintenance (health and safety), budgeting allowed in a contractual arrangement for implementing environmental management activities (environment), completeness of drawing documents (productivity), accurate measurement and pricing of bill of quantities (risk management), adequate communication among the project team (human resource), and adequate cost control measures (client satisfaction). An understanding of CSFs would help all interested parties in the construction industry to improve project performance. Furthermore, the results of this study would help construction professionals and practitioners take proactive measures for effective project management.

Keywords: critical success factors, procurement phase, project life cycle, project performance

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Authors: Nyong Princely Awazi, Gadinga Walter Forje, Barnabas Neba Nfornkah, Ndzifon Jude Kimengsi

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Ecotourism is documented as a sustainable measure of bridging conservation goals and livelihood sustenance around protected areas, due to its ability of not just providing alternative livelihood, but also in providing the necessary resources that can help finance conservation initiatives. In Cameroon, all ecotourism activities around national parks are aimed at generating revenue through the conservation service while providing sustainable livelihood options to the local population. There exists an information lacuna regarding the contribution of ecotourism finances to conservation efforts in the country. This study was aimed at establishing the contribution of ecotourism finances to conservation initiatives in and around the Campo Ma’an National Park (CMNP). Data were collected through the administering of 120 structured questionnaires to ecotourism actors and 15 key/expert interviews with tourism and conservation actors in the Campo Ma’an landscape. Chi-square test, Spearman’s rank correlation and regressions were used for data analysis. The study revealed that the main sources of ecotourism financing to the park service are through entrance fees, cameras and vehicle fees paid by tourists as well as ecotourism project financing through NGOs. Calculations from the tourism register of the park showed that the park was able to raise as much as 1,576,000 FCFA (US$ 3,152) annually. It was further established that ecotourism revenue has not greatly supported conservation, with 54% of respondents perceiving ecotourism not contributing to biodiversity conservation. Chi Square test results highlighted poor ecotourism governance, low level of ecotourism development, corruption from park management staff, obsolete nature of the current finance law on the management of protected area revenue as key factors hindering ecotourism financing in conservation. For ecotourism financing to contribute to biodiversity conservation in the CMNP and in Cameroon’s protected areas, the government needs to revise the finance law on the management of revenue generated from protected areas, improve park governance to fight corruption and enhance transparency, invest in the development and marketing of the Campo Ma’an national park as a tourism destination in the country.

Keywords: Cameroon, Campo Ma’an National Park, conservation, ecotourism, ecotourism financing

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Authors: Florenda B. Cardinoza

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This study was conducted to determine the determinants of Grade III and grade VI pupils’ performance in the National Achievement Test in the Division of Cavite City, School Year 2011-2012. Specifically, the research aimed to: (1) describe the demographic profile of the respondents in terms of age, sex, birth order, family size, family income, and occupation of parents; (2) determine the level of attitude towards NAT; and (3) describe the degree of relationship between the following variables: school support, teachers’ support, and lastly family support for the pupils’ performance in 2012 NAT. The study used the descriptive-correlation research method to investigate the determinants of pupils’ performance in the National Achievement Test of Public Elementary Schools in the Division of Cavite City. The instrument used in data gathering was a self-structured survey. The NAT result for SY 2011-2012 provided by NETRC and DepEd Cavite City was also utilized. The statistical tools used to process and analyze the data were frequency distribution, percentage, mean, standard deviation, Kruskall Wallis, Mann-Whitney, t-test for independent samples, One-way ANOVA, and Spearman Rank Correlational Coefficient. Results revealed that there were more female students than males in the Division of Cavite City; out of 659 respondents, 345 were 11 years old and above; 390 were females; 283 were categorized as first child in the family; 371 of the respondents were from small family; 327 had Php5000 and below family income; 450 of the fathers’ respondents were non professionals; and 431 of the mothers respondents had no occupation. The attitude towards NAT, with a mean of 1.65 and SD of .485, shows that respondents considered NAT important. The school support towards NAT, with a mean of 1.89 and SD of .520, shows that respondents received school support. The pupils had a very high attitude towards teachers’ support in NAT with a mean of 1.60 and SD of .572. Family support, with t-test of 16.201 with a p-value of 0.006, shows significant at 5 percent level. Thus, the determinants of pupils’ performance in NAT in terms of family support for NAT preparation is not significant according to their family income. The grade level, with the t-test is 4.420 and a p-value of 0.000, is significant at 5 percent level. Therefore, the determinants of pupils’ performance in NAT in terms of grade level for NAT preparation vary according to their grade level. For the determinants of pupils’ performance of NAT sample test for attitude towards NAT, school support, teachers’ support, and family support were noted highly significant with a p value of 0.000.

Keywords: achievement, determinants, national, performance, public, pupils', test

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Authors: D. Avila

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The tourism industry is a phenomenon that has become a growing presence in international socio-economic dynamics, which in most cases exceeds the control parameters in the various environmental regulations and sustainability of existing resources. Because of this, the effects on the natural environment at the regional and national levels represent a challenge, for which a number of strategies are necessary to minimize the environmental impact generated by the occupation of the territory. The hotel tourist building and sustainable development in the coastal zone, have an important impact on the environment and on the physical and psychological health of the inhabitants. Environmental quality associated with the comfort of humans to the sustainable development of natural resources; applied to the hotel architecture this concept involves the incorporation of new demands on all of the constructive process of a building, changing customs of developers and users. The methodology developed provides an initial analysis to determine and rank the different tourist buildings, with the above it will be feasible to establish methods of study and environmental impact assessment. Finally, it is necessary to establish an overview regarding the best way to implement tourism development on the coast, containing guidelines to improve and protect the natural environment. This paper analyzes the parameters and strategies to reduce environmental impacts derived from deployments tourism on the coast, through a series of recommendations towards sustainability, in the context of the Bahia de Banderas, Puerto Vallarta, Jalisco. The environmental impact caused by the implementation of tourism development, perceived in a coastal environment, forcing a series of processes, ranging from the identification of impacts, prediction and evaluation of them. For this purpose are described below, different techniques and valuation procedures: Identification of impacts. Methods for the identification of damage caused to the environment pursue general purpose to obtain a group of negative indicators that are subsequently used in the study of environmental impact. There are several systematic methods to identify the impacts caused by human activities. In the present work, develops a procedure based and adapted from the Ministry of works public urban reference in studies of environmental impacts, the representative methods are: list of contrast, arrays, and networks, method of transparencies and superposition of maps.

Keywords: environmental impact, physical health, sustainability, tourist building

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Authors: Lara Dutil-Fafard, Caroline Rhéaume, Patrick Archambault, Daniel Lafond, Neal W. Pollock

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Improving resources for medical autonomy of astronauts in prolonged space missions, such as a Mars mission, requires not only technology development, but also decision-making support systems. The Advanced Crew Medical System - Medical Condition Requirements study, funded by the Canadian Space Agency, aimed to create knowledge content and a scenario-based query capability to support medical autonomy of astronauts. The key objective of this study was to create a prototype tool for identifying medical infrastructure requirements in terms of medical knowledge, skills and materials. A multicriteria decision-making method was used to prioritize the highest risk medical events anticipated in a long-term space mission. Starting with those medical conditions, event sequence diagrams (ESDs) were created in the form of decision trees where the entry point is the diagnosis and the end points are the predicted outcomes (full recovery, partial recovery, or death/severe incapacitation). The ESD formalism was adapted to characterize and compare possible outcomes of medical conditions as a function of available medical knowledge, skills, and supplies in a given mission scenario. An extensive literature review was performed and summarized in a medical condition database. A PostgreSQL relational database was created to allow query-based evaluation of health outcome metrics with different medical infrastructure scenarios. Critical decision points, skill and medical supply requirements, and probable health outcomes were compared across chosen scenarios. The three medical conditions with the highest risk rank were acute coronary syndrome, sepsis, and stroke. Our efforts demonstrate the utility of this approach and provide insight into the effort required to develop appropriate content for the range of medical conditions that may arise.

Keywords: decision support system, event-sequence diagram, exploration mission, medical autonomy, scenario-based queries, space medicine

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Authors: Mercy Marimirofa, Farai Machinga, Alfred Zvoushe, Tsitsidzaishe Musvosvi

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The Government of Zimbabwe embarked on integrating family planning with Sexually Transmitted Infection (STI) and Human Immunodeficiency Virus (HIV) services in May 2020 with support from the World Health Organization (WHO). There was high HIV prevalence, incidence rates and STI infections among women attending FP clinics. Spilhaus is a specialized center of excellence clinic which offers a range of sexual reproductive health services. HIV services were limited to testing only, and clients were referred to other facilities for further management. Integration of services requires that all the services be available at one point so that clients will access them during their visit to the facility. Objectives: The study was conducted to assess the impact the one-stop-shop model has made in accessing integrated Family Planning services and sexual reproductive health services compared to the supermarket approach. It also assessed the relationship family planning services have with other sexual reproductive health services. Methods: A secondary data analysis was conducted at Spilhaus clinic in Harare using family planning registers and HIV services registers comparing years 2019 and 2021. A 2 sample t-test was used to determine the difference in clients accessing the services under the two models. A Spearman’s rank correlation was used to determine if accessing family planning services has a relationship with other sexual reproductive health services. Results: In 2019, 7,548 clients visited the Spilhaus clinic compared to 8,265 during the period January to December 2021. The median age for all clients accessing services was 32 years. An increase of 69% in the number of services accessed was recorded from 2019 to 2021. More services were accessed in 2021. There was no difference in the number of clients accessing family planning services cervical cancer, and HIV services. A difference was found in the number of clients who were offered STI screening services. There was also a relationship between accessing family planning services and STI screening services (ρ = 0.729, p-value=0.006). Conclusion: Programming towards SRH services was a great achievement, the use of an integrated approach proved to be cost-effective as it minimised the required resources for separate programs. Clients accessed important health needs at once. The integration of these services provided an opportunity to offer comprehensive information which addressed an individual’s sexual reproductive health needs.

Keywords: intergration, one stop shop, family planning, reproductive health

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Authors: Mahbuba Rahman, Sabri Boughorbel, Scott Presnell, Charlie Quinn, Darawan Rinchai, Damien Chaussabel, Nico Marr

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Collections of large-scale datasets made available in public repositories can be used to identify and fill gaps in biomedical knowledge. But first, these data need to be made readily accessible to researchers for analysis and interpretation. Here a collection of transcriptome datasets was made available to investigate the functional programming of human hematopoietic cells in early life. Thirty two datasets were retrieved from the NCBI Gene Expression Omnibus (GEO) and loaded in a custom, interactive web application called the Gene Expression browser (GXB), designed for visualization and query of integrated large-scale data. Multiple sample groupings and gene rank lists were created based on the study design and variables in each dataset. Web links to customized graphical views can be generated by users and subsequently be used to graphically present data in manuscripts for publication. The GXB tool also enables browsing of a single gene across datasets, which can provide information on the role of a given molecule across biological systems. The dataset collection is available online. As a proof-of-principle, one of the datasets (GSE25087) was re-analyzed to identify genes that are differentially expressed by regulatory T cells in early life. Re-analysis of this dataset and a cross-study comparison using multiple other datasets in the above mentioned collection revealed that PMCH, a gene encoding a precursor of melanin-concentrating hormone (MCH), a cyclic neuropeptide, is highly expressed in a variety of other hematopoietic cell types, including neonatal erythroid cells as well as plasmacytoid dendritic cells upon viral infection. Our findings suggest an as yet unrecognized role of MCH in immune regulation, thereby highlighting the unique potential of the curated dataset collection and systems biology approach to generate new hypotheses which can be tested in future mechanistic studies.

Keywords: early-life, GEO datasets, PMCH, interactive query, systems biology

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Authors: David Obafemi Adebayo

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An occupational challenge has been identified as one of the factors that could cripple set goals and life ambitions of an Internally Displaced Person (IDP). The main thrust of this study is therefore, explore the use of life support/adjustment strategy with a view to repositioning these internally displaced persons in Nigeria in revamping their goals and achieving their life-long ambitions. The study intends to investigate whether there exist, on the basis of gender, religion, years of working experience and educational qualification any significant difference in the occupational challenges and adjustment strategies of IDPs. The study being descriptive of survey type adopted a multi-stage sampling technique to select the minimum of 400 internally displaced persons from IDP camps in Yimitu Village, Waru District in the Federal Capital Territory (FCT), Abuja. The research instrument used for the study was a researcher-designed questionnaire entitled “Questionnaire on Occupational Challenges and Adjustment Strategy of Internally Displaced Persons (QOCASIDPs)”. Eight null hypotheses were tested at 0.05 alpha levels of significance. Frequency counts and percentages, means and rank order, t-test, Analysis of Variance (ANOVA) and Duncan Multiple Range Test (DMRT) (where applicable) were employed to analyze the data. The Study determined whether occupational challenges of internally displaced persons included loss of employment, vocational discrimination, marginalization by employers of labour, isolation due to joblessness, lack of occupational freedom, which were found to be true. The results were discussed in line with the findings. The study established the place of notable adjustment strategies adopted by internally displaced person like engaging in petty trading, sourcing soft loans from NGOs, setting up small-scale businesses in groups, acquiring new skills, engaging in further education, among others. The study established that there was no significant difference in the occupational challenges of IDPs on the basis of years of working experience and highest educational qualifications, though there was significant difference on the basis of gender as well as religion. Based on the findings of the study, recommendations were made.

Keywords: internally displaced persons, occupational challenges, adjustment strategies, Abuja-Nigeria

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Authors: Nuttapimon Bhirommuang, Kulapong Jayanama

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Background: Prevalence of malnutrition in hospitalized patient is higher than general population. As a result of the unawareness of consequence and the more concerning in the other aspects of care, many patients with high risk of malnutrition are unrecognized. Even if malnutrition has been identified as affecting in many patient outcomes, the impact may differ in each population and group of patients. Objectives: The aims of this study were to examine the association between the nutritional status and the length of stay and hospital costs in hospitalized patients, to investigate the factors related these outcomes and to determine the frequency of malnutrition in hospitals. Method: This retrospective cohort study enrolled all patients aged 15 years old or older and admitted in SDMC, Ramathibodi Hospital between 1st January 2016 and 30th September 2016. The nutritional status assessment by Nutrition Alert Form (NAF) was performed by well-trained nurses in all patients at admission. Baseline characteristics were recorded. Length of stay and hospital costs were collected during their hospitalization. Univariate analysis, nonparametric rank test, Kruskal-Wallis test were used to compare means in the case of nonnormally and noncontinuously distributed data. Chi-square used to analyze categorical variables, the nutritional status and the length of stay and hospital costs and identify possible confounding factors (data were analyzed using SPSS version 18.0). Result: Of the 2,906 patients, 3.9% were severe malnutrition (NAF-C score > 10) and 11.4% were moderate malnutrition (NAF-B score 6 - 10). Both length of stay and hospital costs were found significantly higher in more severe malnutrition group (p < 0.001), NAF = A: 3.21 days, 95% CI 3.06-3.35 and 111,544.25 THB, 95% CI 106,994.41 – 116,094.1; NAF = B: 7.54 days, 95% CI 6.32 – 8.76 and 162,302.4 THB, 95% CI 129,557.88 – 195,046.92; NAF =C: 14.77 days, 95% CI 11.34 – 18.2 and 323,572.11 THB, 95% CI 226,958.1 – 420,096.13 (1 THB = 0.03019 USD). Age of each nutritional status group had also significant increase from NAF A to NAF C (p < 0.001): 55.07, 67.03 and 73.88 years old, respectively. Conclusion: The prevalence of malnutrition in Ramathibodi hospital is voluminous. Severe malnutrition screening by NAF is significantly correlated with worse clinical outcome, especially higher length of stay and hospital costs. Elderly is also a significant factor which correlates with malnutrition. The results of this study could change the awareness of health personnel and the practice protocol. Moreover, the further study concerning nutritional support in high-risk group of malnutrition is ongoing to confirm this hypothesis.

Keywords: malnutrition, NAF, length of stay, hospital costs

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Authors: Noman Shahzad, Amyn Pardhan, Hasnain Zafar

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Introduction: Though short term survival advantage of damage control laparotomy in management of critically ill trauma patients is established, there is little known about the long-term quality of life of these patients. Facial closure rate after damage control laparotomy is reported to be 20-70 percent. Abdominal wall reconstruction in those who failed to achieve facial closure is challenging and can potentially affect quality of life of these patients. Methodology: We conducted retrospective matched cohort study. Adult patients who underwent damage control laparotomy from Jan 2007 till Jun 2013 were identified through medical record. Patients who had concomitant disabling brain injury or limb injuries requiring amputation were excluded. Age, gender and presentation time matched non exposure group of patients who underwent laparotomy for trauma but no damage control were identified for each damage control laparotomy patient. Quality of life assessment was done via telephonic interview at least one year after the operation, using Urdu version of EuroQol Group Quality of Life (QOL) questionnaire EQ5D after permission. Wilcoxon signed rank test was used to compare QOL scores and McNemar test was used to compare individual parameters of QOL questionnaire. Study was approved by institutional ethical review committee. Results: Out of 32 patients who underwent damage control laparotomy during study period, 20 fulfilled the selection criteria for which 20 matched controls were selected. Median age of patients (IQ Range) was 33 (26-40) years. Facial closure rate in damage control laparotomy group was 40% (8/20). One third of those who did not achieve facial closure (4/12) underwent abdominal wall reconstruction. Self-reported QOL score of damage control laparotomy patients was significantly worse than non-damage control group (p = 0.032). There was no statistically significant difference in two groups regarding individual QOL measures. Significantly, more patients in damage control group were requiring use of abdominal binder, and more patients in damage control group had to either change their job or had limitations in continuing previous job. Our study was not adequately powered to detect factors responsible for worse QOL in damage control group. Conclusion: Quality of life of damage control patients is worse than their age and gender matched patients who underwent trauma laparotomy but not damage control. Adequately powered studies need to be conducted to explore factors responsible for this finding for potential improvement.

Keywords: damage control laparotomy, laparostomy, quality of life

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