Search results for: work-related risk factors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14632

Search results for: work-related risk factors

10312 Development of Nursing Service System Integrated Case Manager Concept for the Patients with Epilepsy at the Tertiary Epilepsy Clinic of Thailand

Authors: C. Puangsawat, C. Limotai, P. Srikhachin

Abstract:

Bio-psycho-social caring was required for promoting the quality of life of the patients with epilepsy (PWE), despite controlled seizures. Multifaceted issues emerge at the epilepsy clinic. Unpredicted seizures, antiepileptic drug compliance problems/adverse effects, psychiatric, and social problems are all needed to be explored and managed. The Nursing Service System (NSS) at the tertiary epilepsy clinic (TEC) was consequently developed for improving the clinical care for PWE. Case manager concept was integrated as the framework guiding the processes and strategies used for developing the NSS as well as the roles of the multidisciplinary team at the clinic. This study aimed to report the outcomes of the developed NSS integrated case manager concept. The processes of our developed NSS program included 1) screening for patient’s problems using questionnaire prior to seeing epileptologists i.e., assessing the patient’s risk to develop acute seizures at the clinic, issues related to medication use, and uncovered psychiatric and social problems; and 2) assigning the patients at risk to be evaluated and managed by appropriate team. Nurses specializing in epilepsy in coordination with the multidisciplinary team implemented the NSS to promote coordinated work among the team which consists of epileptologists, nurses, pharmacists, psychologists, and social workers. Determination of the role of each person and their responsibilities along with joint care plan were clearly established. One year after implementation, the rate of acute seizure occurrence at the clinic was decreased, and satisfactory feedback from the patients was received. In order to achieve an optimal goal to promote self-management behaviors in PWE, continuing the NSS and systematic assessment of its effectiveness is required.

Keywords: case manager concept, nursing service system, patients with epilepsy, quality of life

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10311 Cost Effectiveness Analysis of a Community Intervention for Anti-Retroviral Therapy Delivery in Cambodia

Authors: Esabelle Lo Yan Yam, Pheak Chhoun, Sovannary Tuot, Emily Lancsar, Siyan Yi

Abstract:

Persons living with HIV (PLHIV) need lifelong antiretroviral treatment (ART) to keep their viral load suppressed to an undetectable level, maintain a healthy immune system, and reduce the risk of transmitting HIV to others. However, many factors affect PLHIV's adherence to ART, including access to antiretrovirals (ARV), stigma, lack of social support, and the burden of seeking lifelong care. Community-based care has been shown to be instrumental in the experience of PLHIV in many countries, including Cambodia. In this study based in Cambodia, a community-based ART delivery (CAD) intervention involving community action workers (CAWs) who are PLHIVs was introduced. These workers collect pre-packaged ARVs from the ART clinics and dispense them to PLHIVs in the communities. The quasi-experimental study involved approximately 2000 stable PLHIV in the intervention arm and another 2000 PLHIV in the control arm (receiving usual care). A cost-effectiveness analysis is currently conducted to complement the clinical effectiveness of the CAD intervention on the care continuum and treatment outcomes for stable PLHIV, as well as the operational effectiveness in increasing the efficiency of the ART clinics and the health system. The analysis will consider health system and societal perspectives based on primary outcomes, including retention in care, viral load suppression, and adherence to ART. Additionally, a consultation with the National Centre for HIV/AIDS, Dermatology, and STD under the Cambodia Ministry of Health will be done to discuss the conduct of a budget impact analysis that can quantify the financial impact on the government's budget when adopting the CAD intervention at the provincial and national levels. The budget impact analysis will take into consideration various scaling-up scenarios for the interventions in the country. The research will assess the cost-effectiveness of the CAD intervention to support national stakeholders in Cambodia to make an informed decision on the adoption and scaling up of the intervention in Cambodia. The results are currently being analyzed and will be available at the time of the conference.

Keywords: Cambodia, community intervention, economic evaluation, global health, HIV/AIDs, implementation research

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10310 Language and the Politics of Feminism through the Lens of Ba’s ‘So Long a Letter’ and Alkali’s ‘The Stillborn’

Authors: Jummai Aliyu Mohammed

Abstract:

The Sapir-Whorfian hypothesis postulates that the structure of a language determines the way in which species of that language view the world. It also states that the culture of a people finds reflection in their language. Consequently language becomes a vehicle of thought; a channel through which negative stereotypes of women is created and also one through which such images are dispelled. Women are generally portrayed as weaker vessels and inferior to men; a position which draws a counter reaction from women through their writings. In their writings, they attempt to reinvent womanhood and liberate the woman from the hitherto negative light they were portrayed. This position best describes the term feminism which argues that women be given equal rights in all spheres of life as men. This paper attempts to evaluate Ba’s ‘So Long a Letter’ and Alkali’s ‘The Stillborn’ with the view to identify the relationship between language and feminism. In evaluating this relationship, the paper concludes that there are several factors responsible for the variation in the speech pattern of male and female. All of these factors favour the male gender and further condemns the woman to oppression. Although the writers come from two different cultural backgrounds, the works amplify feminism and captured them as apostles of feminism.

Keywords: feminism, language, politics, Sapir-Whorfian hypothesis

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10309 Impact of Nitrogenous Wastewater and Seawater Acidification on Algae

Authors: Pei Luen Jiang

Abstract:

Oysters (Ostreidae) and hard clams (Meretrix lusoria) are important shallow sea-cultured shellfish in Taiwan, and are mainly farmed in Changhua, Yunlin, Chiayi and Tainan. As these shellfish are fed primarily on natural plankton, the artificial feed is not required, leading to high economic value in aquatic farming. However, in recent years, though mariculture production areas have expanded steadily, large-scale deaths of farmed shellfish have also become increasingly common due to climate change and human factors. Through studies over the past few years, our research team has determined the impact of nitrogen deprivation on growth and morphological variations in algae and sea anemones (Actiniaria) and identified the target genes affected by adverse environmental factors. In mariculture, high-density farming is commonly adopted, which results in elevated concentrations of nitrogenous waste in the water. In addition, excessive carbon dioxide from the atmosphere also dissolves in seawater, causing a steady decrease in the pH of seawater, leading to acidification. This study to observe the impact of high concentrations of nitrogen sources and carbon dioxide on algae.

Keywords: algae, shellfish, nitrogen, acidification

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10308 Neonatal Subcutaneous Fat Necrosis with Severe Hypercalcemia: Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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10307 Development of a Robust Procedure for Generating Structural Models of Calcium Aluminosilicate Glass Surfaces

Authors: S. Perera, T. R. Walsh, M. Solvang

Abstract:

The structure-property relationships of calcium aluminosilicate (CAS) glass surfaces are of scientific and technological interest regarding dissolution phenomena. Molecular dynamics (MD) simulations can provide atomic-scale insights into the structure and properties of the CAS interfaces in vacuo as the first step to conducting computational dissolution studies on CAS surfaces. However, one limitation to date is that although the bulk properties of CAS glasses have been well studied by MD simulation, corresponding efforts on CAS surface properties are relatively few in number (both theoretical and experimental). Here, a systematic computational protocol to create CAS surfaces in vacuo is developed by evaluating the sensitivity of the resultant surface structure with respect to different factors. Factors such as the relative thickness of the surface layer, the relative thickness of the bulk region, the cooling rate, and the annealing schedule (time and temperature) are explored. Structural features such as ring size distribution, defect concentrations (five-coordinated aluminium (AlV), non-bridging oxygen (NBO), and tri-cluster oxygen (TBO)), and linkage distribution are identified as significant features in dissolution studies.

Keywords: MD simulation, CAS glasses, surface structure, structure-property, CAS interface

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10306 A Comparative Study on Fish Raised with Feed Formulated with Various Organic Wastes and Commercial Feed

Authors: Charles Chijioke Dike, Hugh Clifford Chima Maduka, Chinwe A. Isibor

Abstract:

Fish is among the products consumed at a very high rate. In most countries of the world, fish are used as part of the daily meal. The high cost of commercial fish feeds in Africa has made it necessary the development of an alternative source of fish feed processing from organic waste. The objective of this research is to investigate the efficacy of fish feeds processed from various animal wastes in order to know whether those feeds shall be alternatives to commercial feeds. This work shall be carried out at the Research Laboratory Unit of the Department of Human Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, Nnamdi Azikiwe University (NAU), Nnewi Campus, Anambra State. The fingerlings to be used shall be gotten from the Agricultural Department of NAU, Awka, Anambra State, and allowed to acclimatize for 14 d. Animal and food wastes shall be gotten from Nnewi. The fish shall be grouped into 1-13 (Chicken manure only, cow dung only, pig manure only, chicken manure + yeast, cow dung + yeast, pig manure + yeast, chicken manure + other wastes + yeast, cow dung + other wastes + yeast, and pig manure + other wastes + yeast. Feed assessment shall be carried out by determining bulk density, feed water absorption, feed hardness, feed oil absorption, and feed water stability. The nutritional analysis shall be carried out on the feeds processed. The risk assessment shall be done on the fish by determining methylmercury (MeHg), polycyclic aromatic hydrocarbons (PAHs), and dichloro-diphenyl-trichloroethane (DDT) in the fish. The results from this study shall be analyzed statistically using SPSS statistical software, version 25. The hypothesis is that fish feeds processed from animal wastes are efficient in raising catfish. The outcome of this study shall provide the basis for the formulation of fish feeds from organic wastes.

Keywords: assessment, feeds, health risk, wastes

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10305 Bank Failures: A Question of Leadership

Authors: Alison L. Miles

Abstract:

Almost all major financial institutions in the world suffered losses due to the financial crisis of 2007, but the extent varied widely. The causes of the crash of 2007 are well documented and predominately focus on the role and complexity of the financial markets. The dominant theme of the literature suggests the causes of the crash were a combination of globalization, financial sector innovation, moribund regulation and short termism. While these arguments are undoubtedly true, they do not tell the whole story. A key weakness in the current analysis is the lack of consideration of those leading the banks pre and during times of crisis. This purpose of this study is to examine the possible link between the leadership styles and characteristics of the CEO, CFO and chairman and the financial institutions that failed or needed recapitalization. As such, it contributes to the literature and debate on international financial crises and systemic risk and also to the debate on risk management and regulatory reform in the banking sector. In order to first test the proposition (p1) that there are prevalent leadership characteristics or traits in financial institutions, an initial study was conducted using a sample of the top 65 largest global banks and financial institutions according to the Banker Top 1000 banks 2014. Secondary data from publically available and official documents, annual reports, treasury and parliamentary reports together with a selection of press articles and analyst meeting transcripts was collected longitudinally from the period 1998 to 2013. A computer aided key word search was used in order to identify the leadership styles and characteristics of the chairman, CEO and CFO. The results were then compared with the leadership models to form a picture of leadership in the sector during the research period. As this resulted in separate results that needed combining, SPSS data editor was used to aggregate the results across the studies using the variables ‘leadership style’ and ‘company financial performance’ together with the size of the company. In order to test the proposition (p2) that there was a prevalent leadership style in the banks that failed and the proposition (P3) that this was different to those that did not, further quantitative analysis was carried out on the leadership styles of the chair, CEO and CFO of banks that needed recapitalization, were taken over, or required government bail-out assistance during 2007-8. These included: Lehman Bros, Merrill Lynch, Royal Bank of Scotland, HBOS, Barclays, Northern Rock, Fortis and Allied Irish. The findings show that although regulatory reform has been a key mechanism of control of behavior in the banking sector, consideration of the leadership characteristics of those running the board are a key factor. They add weight to the argument that if each crisis is met with the same pattern of popular fury with the financier, increased regulation, followed by back to business as usual, the cycle of failure will always be repeated and show that through a different lens, new paradigms can be formed and future clashes avoided.

Keywords: banking, financial crisis, leadership, risk

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10304 Mapping Social and Natural Hazards: A Survey of Potential for Managed Retreat in the United States

Authors: Karim Ahmed

Abstract:

The purpose of this study was to investigate how factoring the impact of natural disasters beyond flooding would affect managed retreat policy eligibility in the United States. For the study design, a correlation analysis method compared weighted measures of flooding and other natural disasters (e.g., wildfires, tornadoes, heatwaves, etc.) to CBSA Populated areas, the prevalence of cropland, and relative poverty on a county level. The study found that the vast majority of CBSAs eligible for managed retreat programs under a policy inclusive of non-flooding events would have already been covered by flood-only managed retreat policies. However, it is noteworthy that a majority of those counties that are not covered by a flood-only managed retreat policy have high rates of poverty and are either heavily populated and/or agriculturally active. The correlation is particularly strong between counties that are subject to multiple natural hazards and those that have both high rates of relative poverty and cropland prevalence. There is currently no managed retreat policy for agricultural land in the United States despite the environmental implications and food supply chain vulnerabilities related to at-risk cropland. The findings of this study suggest both that such a policy should be created and, when it is, that special attention should be paid to non-flood natural disasters affecting agricultural areas. These findings also reveal that, while current flood-based policies in the United States serve many areas that do need access to managed retreat funding and implementation, other vulnerable areas are overlooked by this approach. These areas are often deeply impoverished and are therefore particularly vulnerable to natural disaster; if and when those disasters do occur, these areas are often less financially prepared to recover or retreat from the disaster’s advance and, due to the limitations of the current policies discussed above, are less able to take the precautionary measures necessary to mitigate their risk.

Keywords: flood, hazard, land use, managed retreat, wildfire

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10303 Prioritizing the Factors Effective on Decreasing the Rate of Accidents on Freeways in Iran between 2013-2015

Authors: Mansour Hadji Hosseinlou, Alireza Mahdavi

Abstract:

Transportation is one of any society's needs which have developed after improving economically and socially and is one of civilization symbols today. Although it is so useful for human, it leads to many serious harms and injuries. The development of communication system and building new roads has resulted in increasing the rate of accidents; therefore, in practice, this increasing rate has decreased the advantages of transportation. Traffic accidents are one of the causes of death, serious financial and bodily harms and its significant social, economic and cultural consequences threatens the societies seriously. Iran's ground transportation system is one of the most eventful transportation systems in the world and mortality rate and financial harms cost too much for the country in national aspect. Therefore, we have presented a data collection by referring to recorded statistics of the accidents occurred in freeways from 2013 to 2015. These statistics are recorded in different related databases, generally police and road transportation system. The data is separated and arranged in tables and after preparing, processing and prioritizing the factors, the achieved collection is presented to the departments, managers and researchers to help them suggest practical solutions.

Keywords: freeways’ accidents, humane causes, death, tiredness, drowsiness

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10302 Workers’ Prevention from Occupational Chemical Exposures during Container Handling

Authors: Balázs Ádám, Randi Nørgaard Fløe Pedersen, Jørgen Riis Jepsen

Abstract:

Volatile chemicals that accumulate and release from freight containers constitute significant health risks. Fumigation to prevent spread of pests and off-gassing of freight are sources of hazardous chemicals. The aim of our study was to investigate the regulation and practice of container handling with focus on preventive measures applied against chemical exposures in Denmark. A comprehensive systematic search of scientific literature and organizational domains of international and Danish regulatory bodies was performed to explore regulations related to safe work with transport containers. The practice of container work was investigated in a series of semi-structured interviews with managers and health and safety representatives of organizations that handle transport containers. Although there are several international and national regulations and local safety instructions that relate to container handling, the provided information is not specific or up-to-date enough to conduct safe practice in many aspects. The interviewees estimate high frequency of containers with chemical exposure and deem that they can potentially damage health, although recognizable health effects are rare. Knowledge is limited about the chemicals and most of them cannot be measured by available devices. Typical preventive measures are passive ventilation and personal protective equipment but their use is not consistent and may not provide adequate protection. Hazardous chemicals are frequently present in transport containers; however, managers, workers and even occupational health professionals have limited knowledge about the problem. Detailed risk assessment and specific instructions on risk management are needed to provide safe conditions for work with containers.

Keywords: chemical exposure, fumigation, occupational health and safety regulation, transport container

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10301 Thermal Comfort Investigation Based on Predicted Mean Vote (PMV) Index Using Computation Fluid Dynamic (CFD) Simulation: Case Study of University of Brawijaya, Malang-Indonesia

Authors: Dewi Hardiningtyas Sugiono

Abstract:

Concerning towards the quality of air comfort and safety to pedestrians in the University area should be increased as Indonesia economics booming. Hence, the University management needs guidelines of thermal comfort to innovate a new layout building. The objectives of this study is to investigate and then to evaluate the distribution of thermal comfort which is indicated by predicted mean vote (PMV) index at the University of Brawijaya (UB), Malang. The PMV figures are used to evaluate and to redesign the UB layout. The research is started with study literature and early survey to collect all information of building layout and building shape at the University of Brawijaya. The information is used to create a 3D model in CAD software. The model is simulated by Computational Fluid Dynamic (CFD) software to measure the PMV factors of air temperature, relative humidity and air speed in some locations. Validation is done by comparing between PMV value from observation and PMV value from simulation. The resuls of the research shows the most sensitive of microclimatic factors is air temperature surrounding the UB building. Finally, the research is successfully figure out the UB layout and provides further actions to increase the thermal comfort.

Keywords: thermal comfort, heat index (HI), CFD, layout

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10300 Rare Diagnosis in Emergency Room: Moyamoya Disease

Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

Abstract:

Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

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10299 Early Impact Prediction and Key Factors Study of Artificial Intelligence Patents: A Method Based on LightGBM and Interpretable Machine Learning

Authors: Xingyu Gao, Qiang Wu

Abstract:

Patents play a crucial role in protecting innovation and intellectual property. Early prediction of the impact of artificial intelligence (AI) patents helps researchers and companies allocate resources and make better decisions. Understanding the key factors that influence patent impact can assist researchers in gaining a better understanding of the evolution of AI technology and innovation trends. Therefore, identifying highly impactful patents early and providing support for them holds immeasurable value in accelerating technological progress, reducing research and development costs, and mitigating market positioning risks. Despite the extensive research on AI patents, accurately predicting their early impact remains a challenge. Traditional methods often consider only single factors or simple combinations, failing to comprehensively and accurately reflect the actual impact of patents. This paper utilized the artificial intelligence patent database from the United States Patent and Trademark Office and the Len.org patent retrieval platform to obtain specific information on 35,708 AI patents. Using six machine learning models, namely Multiple Linear Regression, Random Forest Regression, XGBoost Regression, LightGBM Regression, Support Vector Machine Regression, and K-Nearest Neighbors Regression, and using early indicators of patents as features, the paper comprehensively predicted the impact of patents from three aspects: technical, social, and economic. These aspects include the technical leadership of patents, the number of citations they receive, and their shared value. The SHAP (Shapley Additive exPlanations) metric was used to explain the predictions of the best model, quantifying the contribution of each feature to the model's predictions. The experimental results on the AI patent dataset indicate that, for all three target variables, LightGBM regression shows the best predictive performance. Specifically, patent novelty has the greatest impact on predicting the technical impact of patents and has a positive effect. Additionally, the number of owners, the number of backward citations, and the number of independent claims are all crucial and have a positive influence on predicting technical impact. In predicting the social impact of patents, the number of applicants is considered the most critical input variable, but it has a negative impact on social impact. At the same time, the number of independent claims, the number of owners, and the number of backward citations are also important predictive factors, and they have a positive effect on social impact. For predicting the economic impact of patents, the number of independent claims is considered the most important factor and has a positive impact on economic impact. The number of owners, the number of sibling countries or regions, and the size of the extended patent family also have a positive influence on economic impact. The study primarily relies on data from the United States Patent and Trademark Office for artificial intelligence patents. Future research could consider more comprehensive data sources, including artificial intelligence patent data, from a global perspective. While the study takes into account various factors, there may still be other important features not considered. In the future, factors such as patent implementation and market applications may be considered as they could have an impact on the influence of patents.

Keywords: patent influence, interpretable machine learning, predictive models, SHAP

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10298 Urban Big Data: An Experimental Approach to Building-Value Estimation Using Web-Based Data

Authors: Sun-Young Jang, Sung-Ah Kim, Dongyoun Shin

Abstract:

Current real-estate value estimation, difficult for laymen, usually is performed by specialists. This paper presents an automated estimation process based on big data and machine-learning technology that calculates influences of building conditions on real-estate price measurement. The present study analyzed actual building sales sample data for Nonhyeon-dong, Gangnam-gu, Seoul, Korea, measuring the major influencing factors among the various building conditions. Further to that analysis, a prediction model was established and applied using RapidMiner Studio, a graphical user interface (GUI)-based tool for derivation of machine-learning prototypes. The prediction model is formulated by reference to previous examples. When new examples are applied, it analyses and predicts accordingly. The analysis process discerns the crucial factors effecting price increases by calculation of weighted values. The model was verified, and its accuracy determined, by comparing its predicted values with actual price increases.

Keywords: apartment complex, big data, life-cycle building value analysis, machine learning

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10297 On the Use of Reliability Factors to Reduce Conflict between Information Sources in Dempster-Shafer Theory

Authors: A. Alem, Y. Dahmani, A. Hadjali, A. Boualem

Abstract:

Managing the problem of the conflict, either by using the Dempster-Shafer theory, or by the application of the fusion process to push researchers in recent years to find ways to get to make best decisions especially; for information systems, vision, robotic and wireless sensor networks. In this paper we are interested to take account of the conflict in the combination step that took the conflict into account and tries to manage such a way that it does not influence the decision step, the conflict what from reliable sources. According to [1], the conflict lead to erroneous decisions in cases where was with strong degrees between sources of information, if the conflict is more than the maximum of the functions of belief mass K > max1...n (mi (A)), then the decision becomes impossible. We will demonstrate in this paper that the multiplication of mass functions by coefficients of reliability is a decreasing function; it leads to the reduction of conflict and a good decision. The definition of reliability coefficients accurately and multiply them by the mass functions of each information source to resolve the conflict and allow deciding whether the degree of conflict. The evaluation of this technique is done by a use case; a comparison of the combination of springs with a maximum conflict without, and with reliability coefficients.

Keywords: Dempster-Shafer theory, fusion process, conflict managing, reliability factors, decision

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10296 Soil Erosion Assessment Using the RUSLE Model, Remote Sensing, and GIS in the Shatt Al-Arab Basin (Iraq-Iran)

Authors: Hadi Allafta, Christian Opp

Abstract:

Soil erosion is a major concern in the Shatt Al-Arab basin owing to the steepness of its topography as well as the remarkable altitudinal deference between the upstream and downstream parts of the basin. Such conditions resulted in soil vulnerability to erosion; huge amounts of soil are annually transported, creating enormous implications such as land degradation, structure damage, biodiversity loss, productivity decline, etc. Thus, evaluation of soil erosion risk and its spatial distribution is crucial to build adatabase for efficient control measures. The present study used revised universal soil loss equation (RUSLE) model integrated with Geographic Information System (GIS) for depicting soil erosion hazard zones in the Shatt Al-Arab basin. The RUSLE model incorporated several parameters such as rainfall-runoff erosivity, soil erodibility, slope length and steepness, land cover and management, and conservation support practice for soil erosion zonation. High to medium soil loss of 100 to 20 ton perhectare per year represents around 25% of the basin area, while the areas of low soil loss of less than 20 ton per hectare per year occupied the rest of the total area. The high soil loss rates are linked to areas of high rainfall levels, loamy soil domination, elevated terrains/plateau margins with steep side slope, and high cultivation activities. The findings of the current study can be useful for managers and policy makers in the implementation of a suitable conservation program to reduce soil erosion or to recommend soil conservation acts if development projects are to be continued at regions of high soil erosion risk.

Keywords: geographic information system, revised universal soil loss equation, shatt Al-Arab basin, soil erosion

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10295 Factor Associated with Uncertainty Undergoing Hematopoietic Stem Cell Transplantation

Authors: Sandra Adarve, Jhon Osorio

Abstract:

Uncertainty has been studied in patients with different types of cancer, except in patients with hematologic cancer and undergoing transplantation. The purpose of this study was to identify factors associated with uncertainty in adults patients with malignant hemato-oncology diseases who are scheduled to undergo hematopoietic stem cell transplantation based on Merle Mishel´s Uncertainty theory. This was a cross-sectional study with an analytical purpose. The study sample included 50 patients with leukemia, myeloma, and lymphoma selected by non-probability sampling by convenience and intention. Sociodemographic and clinical variables were measured. Mishel´s Scale of Uncertainty in Illness was used for the measurement of uncertainty. A bivariate and multivariate analyses were performed to explore the relationships and associations between the different variables and uncertainty level. For this analysis, the distribution of the uncertainty scale values was evaluated through the Shapiro-Wilk normality test to identify statistical tests to be used. A multivariate analysis was conducted through a logistic regression using step-by-step technique. Patients were 18-74 years old, with a mean age of 44.8. Over time, the disease course had a median of 9.5 months, an opportunity was found in the performance of the transplantation of < 20 days for 50% of the patients. Regarding the uncertainty scale, a mean score of 95.46 was identified. When the dimensions of the scale were analyzed, the mean score of the framework of stimuli was 25.6, of cognitive ability was 47.4 and structure providers was 22.8. Age was identified to correlate with the total uncertainty score (p=0.012). Additionally, a statistically significant difference was evidenced between different religious creeds and uncertainty score (p=0.023), education level (p=0.012), family history of cancer (p=0.001), the presence of comorbidities (p=0.023) and previous radiotherapy treatment (p=0.022). After performing logistic regression, previous radiotherapy treatment (OR=0.04 IC95% (0.004-0.48)) and family history of cancer (OR=30.7 IC95% (2.7-349)) were found to be factors associated with the high level of uncertainty. Uncertainty is present in high levels in patients who are going to be subjected to bone marrow transplantation, and it is the responsibility of the nurse to assess the levels of uncertainty and the presence of factors that may contribute to their presence. Once it has been valued, the uncertainty must be intervened from the identified associated factors, especially all those that have to do with the cognitive capacity. This implies the implementation and design of intervention strategies to improve the knowledge related to the disease and the therapeutic procedures to which the patients will be subjected. All interventions should favor the adaptation of these patients to their current experience and contribute to seeing uncertainty as an opportunity for growth and transcendence.

Keywords: hematopoietic stem cell transplantation, hematologic diseases, nursing, uncertainty

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10294 Ibrutinib and the Potential Risk of Cardiac Failure: A Review of Pharmacovigilance Data

Authors: Abdulaziz Alakeel, Roaa Alamri, Abdulrahman Alomair, Mohammed Fouda

Abstract:

Introduction: Ibrutinib is a selective, potent, and irreversible small-molecule inhibitor of Bruton's tyrosine kinase (BTK). It forms a covalent bond with a cysteine residue (CYS-481) at the active site of Btk, leading to inhibition of Btk enzymatic activity. The drug is indicated to treat certain type of cancers such as mantle cell lymphoma (MCL), chronic lymphocytic leukaemia and Waldenström's macroglobulinaemia (WM). Cardiac failure is a condition referred to inability of heart muscle to pump adequate blood to human body organs. There are multiple types of cardiac failure including left and right-sided heart failure, systolic and diastolic heart failures. The aim of this review is to evaluate the risk of cardiac failure associated with the use of ibrutinib and to suggest regulatory recommendations if required. Methodology: Signal Detection team at the National Pharmacovigilance Center (NPC) of Saudi Food and Drug Authority (SFDA) performed a comprehensive signal review using its national database as well as the World Health Organization (WHO) database (VigiBase), to retrieve related information for assessing the causality between cardiac failure and ibrutinib. We used the WHO- Uppsala Monitoring Centre (UMC) criteria as standard for assessing the causality of the reported cases. Results: Case Review: The number of resulted cases for the combined drug/adverse drug reaction are 212 global ICSRs as of July 2020. The reviewers have selected and assessed the causality for the well-documented ICSRs with completeness scores of 0.9 and above (35 ICSRs); the value 1.0 presents the highest score for best-written ICSRs. Among the reviewed cases, more than half of them provides supportive association (four probable and 15 possible cases). Data Mining: The disproportionality of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by WHO-UMC to measure the reporting ratio. Positive IC reflects higher statistical association while negative values indicates less statistical association, considering the null value equal to zero. The results of (IC=1.5) revealed a positive statistical association for the drug/ADR combination, which means “Ibrutinib” with “Cardiac Failure” have been observed more than expected when compared to other medications available in WHO database. Conclusion: Health regulators and health care professionals must be aware for the potential risk of cardiac failure associated with ibrutinib and the monitoring of any signs or symptoms in treated patients is essential. The weighted cumulative evidences identified from causality assessment of the reported cases and data mining are sufficient to support a causal association between ibrutinib and cardiac failure.

Keywords: cardiac failure, drug safety, ibrutinib, pharmacovigilance, signal detection

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10293 Investigating Chinese Students' Perceptions of and Responses to Teacher Feedback: Multiple Case Studies in a UK University

Authors: Fangfei Li

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Studies on teacher feedback have produced a wide range of findings in aspects of characteristics of good feedback, factors influencing the quality of feedback and teachers’ perspectives on teacher feedback. However, perspectives from students on how they perceive and respond to teacher feedback are still under scrutiny. Especially for Chinese overseas students who come from a feedback-sparse educational context in China, they might have different experiences when engaging with teacher feedback in the UK Higher Education. Therefore, the research aims to investigate and shed some new light on how Chinese students engage with teacher feedback in the UK higher education and how teacher feedback could enhance their learning. Research questions of this study are 1) What are Chinese overseas students’ perceptions of teacher feedback in courses of the UK higher education? 2) How do they respond to the teacher feedback they obtained? 3) What factors might influence their’ engagement with teacher feedback? Qualitative case studies of five Chinese postgraduate students in a UK university have been conducted by employing various types of interviews, such as background interviews, scenario-based interviews, stimulated recall interviews and retrospective interviews to address the research inquiries. Data collection lasted seven months, covering two phases – the pre-sessional language programme and the first semester of the Master’s degree programme. Research findings until now indicate that some factors, such as tutors’ handwriting, implicit instruction and value comments, influence students understanding and internalizing tutor feedback. Except for difficulties in understanding tutor feedback, students’ responses to tutor feedback are also influenced by quantity and quality of tutor-student communication, time constraints and trust to tutor feedback, etc. Findings also reveal that tutor feedback is able to improve students’ learning in aspects of promoting reflection on professional knowledge, promoting students’ communication with peers and tutors, increasing problem awareness and writing with the reader in mind. This paper will mainly introduce the research topic, the methodological procedure and research findings gained until now.

Keywords: Chinese students, students’ perceptions, teacher feedback, the UK higher education

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10292 Factors Affecting Students' Performance in the Examination

Authors: Amylyn F. Labasano

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A significant number of empirical studies are carried out to investigate factors affecting college students’ performance in the academic examination. With a wide-array of literature-and studies-supported findings, this study is limited only on the students’ probability of passing periodical exams which is associated with students’ gender, absences in the class, use of reference book, and hours of study. Binary logistic regression was the technique used in the analysis. The research is based on the students’ record and data collected through survey. The result reveals that gender, use of reference book and hours of study are significant predictors of passing an examination while students’ absenteeism is an insignificant predictor. Females have 45% likelihood of passing the exam than their male classmates. Students who use and read their reference book are 38 times more likely pass the exam than those who do not use and read their reference book. Those who spent more than 3 hours in studying are four (4) times more likely pass the exam than those who spent only 3 hours or less in studying.

Keywords: absences, binary logistic regression, gender, hours of study prediction-causation method, periodical exams, random sampling, reference book

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10291 The Reflections of the K-12 English Language Teachers on the Implementation of the K-12 Basic Education Program in the Philippines

Authors: Dennis Infante

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This paper examined the reflections of teachers on curriculum reforms, the implementation of the K-12 Basic Education Program in the Philippines. The results revealed that problems and concerns raised by teachers could be classified into curriculum materials and design; competence, readiness and motivation of the teachers; the learning environment, and support systems; readiness, competence and motivation of students; and other relevant factors. The best features of the K-12 curriculum reforms included (1) the components, curriculum materials; (2) the design, structure and delivery of the lessons; (3) the framework and theoretical approach; (3) the qualities of the teaching-learning activities; (4) and other relevant features. With the demanding task of implementing the new curriculum, the teachers expressed their needs which included (1) making the curriculum materials available to achieve the goals of the curriculum reforms; (2) enrichment of the learning environments; (3) motivating and encouraging the teachers to embrace change; (4) providing appropriate support systems; (5) re-tooling, and empowering teachers to implement the curriculum reforms; and (6) other relevant factors. The research concluded with a synthesis that provided a paradigm for implementing curriculum reforms which recognizes the needs of the teachers and the features of the new curriculum.

Keywords: curriculum reforms, K-12, teachers' reflections, implementing curriculum change

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10290 Religiosity and Involvement in Purchasing Convenience Foods: Using Two-Step Cluster Analysis to Identify Heterogenous Muslim Consumers in the UK

Authors: Aisha Ijaz

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The paper focuses on the impact of Muslim religiosity on convenience food purchases and involvement experienced in a non-Muslim culture. There is a scarcity of research on the purchasing patterns of Muslim diaspora communities residing in risk societies, particularly in contexts where there is an increasing inclination toward industrialized food items alongside a renewed interest in the concept of natural foods. The United Kingdom serves as an appropriate setting for this study due to the increasing Muslim population in the country, paralleled by the expanding Halal Food Market. A multi-dimensional framework is proposed, testing for five forms of involvement, specifically Purchase Decision Involvement, Product Involvement, Behavioural Involvement, Intrinsic Risk and Extrinsic Risk. Quantitative cross-sectional consumer data were collected through a face-to-face survey contact method with 141 Muslims during the summer of 2020 in Liverpool located in the Northwest of England. proportion formula was utilitsed, and the population of interest was stratified by gender and age before recruitment took place through local mosques and community centers. Six input variables were used (intrinsic religiosity and involvement dimensions), dividing the sample into 4 clusters using the Two-Step Cluster Analysis procedure in SPSS. Nuanced variances were observed in the type of involvement experienced by religiosity group, which influences behaviour when purchasing convenience food. Four distinct market segments were identified: highly religious ego-involving (39.7%), less religious active (26.2%), highly religious unaware (16.3%), less religious concerned (17.7%). These segments differ significantly with respects to their involvement, behavioural variables (place of purchase and information sources used), socio-cultural (acculturation and social class), and individual characteristics. Choosing the appropriate convenience food is centrally related to the value system of highly religious ego-involving first-generation Muslims, which explains their preference for shopping at ethnic food stores. Less religious active consumers are older and highly alert in information processing to make the optimal food choice, relying heavily on product label sources. Highly religious unaware Muslims are less dietary acculturated to the UK diet and tend to rely on digital and expert advice sources. The less-religious concerned segment, who are typified by younger age and third generation, are engaged with the purchase process because they are worried about making unsuitable food choices. Research implications are outlined and potential avenues for further explorations are identified.

Keywords: consumer behaviour, consumption, convenience food, religion, muslims, UK

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10289 Using Hierarchical Modelling to Understand the Role of Plantations in the Abundance of Koalas, Phascolarctos cinereus

Authors: Kita R. Ashman, Anthony R. Rendall, Matthew R. E. Symonds, Desley A. Whisson

Abstract:

Forest cover is decreasing globally, chiefly due to the conversion of forest to agricultural landscapes. In contrast, the area under plantation forestry is increasing significantly. For wildlife occupying landscapes where native forest is the dominant land cover, plantations generally represent a lower value habitat; however, plantations established on land formerly used for pasture may benefit wildlife by providing temporary forest habitat and increasing connectivity. This study investigates the influence of landscape, site, and climatic factors on koala population density in far south-west Victoria where there has been extensive plantation establishment. We conducted koala surveys and habitat characteristic assessments at 72 sites across three habitat types: plantation, native vegetation blocks, and native vegetation strips. We employed a hierarchical modeling framework for estimating abundance and constructed candidate multinomial N-mixture models to identify factors influencing the abundance of koalas. We detected higher mean koala density in plantation sites (0.85 per ha) than in either native block (0.68 per ha) or native strip sites (0.66 per ha). We found five covariates of koala density and using these variables, we spatially modeled koala abundance and discuss factors that are key in determining large-scale distribution and density of koala populations. We provide a distribution map that can be used to identify high priority areas for population management as well as the habitat of high conservation significance for koalas. This information facilitates the linkage of ecological theory with the on-ground implementation of management actions and may guide conservation planning and resource management actions to consider overall landscape configuration as well as the spatial arrangement of plantations adjacent to the remnant forest.

Keywords: abundance modelling, arboreal mammals plantations, wildlife conservation

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10288 The Potential Use of Flavin Mononucleotide for Photoluminescent and Bioluminescent Textile

Authors: Sweta Iyer, Nemeshwaree Behary, Jinping Guan, Guoqiang Chen, Vincent Nierstrasz

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Flavin mononucleotide widely known as 'FMN' is a biobased resource derived from riboflavin. The isoalloxazine ring present in the FMN molecule attributes the photoluminescence phenomenon, whereas FMN molecule in the presence of bacterial luciferase enzyme and co-factors such as NADH, long chain aldehyde leads to bioluminescence reaction. In this study, the FMN molecule was treated on cellulosic textile using chromojet technique and the photoluminescence property was characterized using spectroscopy technique. Further, the FMN was used as a substrate along with enzymes and co-factors to treat the non-woven textile, and the bioluminescence property was explored using luminometer equipment. The investigation revealed photoluminescence property on cellulosic textile, and the emission peak was observed at a wavelength around 530 nm with an average corrected spectral intensity of 10×106 CPS/Microamps. In addition, the measurement of nonwoven textile using bioluminescence reaction system exhibited light intensity measured in the form of relative light units (RLU). The study enabled to explore the use of FMN as both photoluminescent and bioluminescent textile. Further investigation would require for stability study of the same to provide an eco-efficient approach to obtain luminescent textile.

Keywords: flavin mononucleotide, photoluminescence, bioluminescence, luminescent textile

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10287 Food Insecurity and Other Correlates of Individual Components of Metabolic Syndrome in Women Living with HIV (WLWH) in the United States

Authors: E. Wairimu Mwangi, Daniel Sarpong

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Background: Access to effective antiretroviral therapy in the United States has resulted in the rise in longevity in people living with HIV (PLHIV). Despite the progress, women living with HIV (WLWH) experience increasing rates of cardiometabolic disorders compared with their HIV-negative counterparts. Studies focusing on the predictors of metabolic disorders in this population have largely focused on the composite measure of metabolic syndrome (METs). This study seeks to identify the predictors of composite and individual METs factors in a nationally representative sample of WLWH. In particular, the study also examines the role of food security in predicting METs. Methods: The study comprised 1800 women, a subset of participants from the Women’s Interagency HIV Study (WIHS). The primary exposure variable, food security, was measured using the U.S. 10-item Household Food Security Survey Module. The outcome measures are the five metabolic syndrome indicators (elevated blood pressure [systolic BP > 130 mmHg and diastolic BP ≥ 85 mmHg], elevated fasting glucose [≥ 110 mg/dL], elevated fasting triglyceride [≥ 150 mg/dL], reduced HDL cholesterol [< 50 mg/dL], and waist circumference > 88 cm) and the composite measure - Metabolic Syndrome (METs) Status. Each metabolic syndrome indicator was coded one if yes and 0 otherwise. The values of the five indicators were summed, and participants with a total score of 3 or greater were classified as having metabolic syndrome. Participants classified as having metabolic syndrome were assigned a code of 1 and 0 otherwise for analysis. The covariates accounted for in this study fell into sociodemographic factors and behavioral and health characteristics. Results: The participants' mean (SD) age was 47.1 (9.1) years, with 71.4% Blacks and 10.9% Whites. About a third (33.1%) had less than a high school (HS) diploma, 60.4% were married, 32.8% were employed, and 53.7% were low-income. The prevalence of worst dietary diversity, low, moderate, and high food security were 24.1%, 26.6%, 17.0%, and 56.4%, respectively. The correlate profile of the five individual METs factors plus the composite measure of METs differ significantly, with METs based on HDL having the most correlates (Age, Education, Drinking Status, Low Income, Body Mass Index, and Health Perception). Additionally, metabolic syndrome based on waist circumference was the only metabolic factor where food security was significantly correlated (Food Security, Age, and Body Mass Index). Age was a significant predictor of all five individual METs factors plus the composite METs measure. Except for METs based on Fasting Triglycerides, body mass index (BMI) was a significant correlate of the various measures of metabolic syndrome. Conclusion: High-density Lipoprotein (HDL) cholesterol significantly correlated with most predictors. BMI was a significant predictor of all METs factors except Fasting Triglycerides. Food insecurity, the primary predictor, was only significantly associated with waist circumference.

Keywords: blood pressure, food insecurity, fasting glucose, fasting triglyceride, high-density lipoprotein, metabolic syndrome, waist circumference, women living with HIV

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10286 Attitude Towards E-Learning: A Case of University Teachers and Students

Authors: Muhamamd Shahid Farooq, Maazan Zafar, Rizawana Akhtar

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E-learning technologies are the blessings of advancements in science and technology. These facilitate the learners to get information at any place and any time by improving their self-confidence, self-efficacy and effectiveness in teaching learning process. E-learning provides an individualized learning experience for learners and remove barriers faced by students during new and creative ways of gaining information. It provides a wide range of facilities to enable the teachers and students for effective and purposeful learning. This study was conducted to explore the attitudes of university students and teachers towards e-learning working in a metropolitan university of Pakistan. The personal, institutional and technological characteristics of the teachers and students of higher education institution effect the adoption of e-learning. For this descriptive study 449 students and 35 university teachers were surveyed by using a Likert scale type questionnaire consisting of 52 statements relating to six factors "perceived usefulness, intention to adopt e-learning, ease of e-learning use, availability resources, e-learning stressors, and pressure to use e-learning". Data were analyzed by making comparisons on the basis of different demographic factors. The findings of the study show that both type of respondents have positive attitude towards e-learning. However, the male and female respondents differ in their opinion for e-learning implementation.

Keywords: e-learning, ICT, e-sources of learning, questionnaire

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10285 Heavy Vehicles Crash Injury Severity at T-Intersections

Authors: Sivanandan Balakrishnan, Sara Moridpour, Richard Tay

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Heavy vehicles make a significant contribution to many developed economies, including Australia, because they are a major means of transporting goods within these countries. With the increase in road freight, there will be an increase in the heavy vehicle traffic proportion, and consequently, an increase in the possibility of collisions involving heavy vehicles. Crashes involving heavy vehicles are a major road safety concern because of the higher likelihood of fatal and serious injury, especially to any small vehicle occupant involved. The primary objective of this research is to identify the factors influencing injury severity to occupants in vehicle collisions involving heavy vehicle at T- intersection using a binary logit model in Victoria, Australia. Our results show that the factors influencing injury severity include occupants' gender, age and restraint use. Also, vehicles' type, movement, point-of-impact and damage, time-of-day, day-of-week and season, higher percentage of trucks in traffic volume, hit pedestrians, number of occupants involved and type of collisions are associated with severe injury.

Keywords: binary logit model, heavy vehicle, injury severity, T-intersections

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10284 Barriers to Health Promotion Advice Delivered by Paramedics and Emergency Department Nurses – Promoted Study

Authors: B. Schofield, F. Gul, S. McClean, R. Hoskins, R. Terry, U. Rolfe, A. Gibson, S. Voss, J. Benger

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Aim: The aim of this study is to determine whether and how health promotion activities are undertaken by paramedics and emergency department nurses and investigate ways of overcoming potential barriers. Background: Paramedics and emergency department nurses are uniquely placed to reach millions of people and could use these contacts as positive opportunities to help people improve their health by identifying people with risk factors and provide information, brief interventions, and signposting to locally provided services. These interventions can be carried out when the opportunity arises, typically take no more than a few minutes, have a low financial cost and can be a highly efficient method of health promotion. Methodology: Three NHS Emergency Departments and four Ambulance Trusts in England were recruited to the study. A link to an online survey was distributed to paramedics and emergency department nurses at participating sites. Staff were invited to participate in virtual semi-structured interviews. Patients seen, treated, and discharged at the participating sites were invited to virtual semistructured interviews. Findings: A total of 331 survey responses were received, 21 virtual semi-structured staff interviews and 11 patient interviews were completed. Staff reported lack of time to prioritise, lack of knowledge, resources, and confidence as barriers. Receptiveness of patients guided their decision to undertake health promotion activities. They reported a desire to learn how to undertake health promotion conversations. Emergency department nurses felt more supported than paramedics by their organisations to undertake health promotion activities. Patients were not aware of health promotion activities and reported fear and lack of privacy as barriers. Conclusions: These results will guide the development of an intervention to support the provision of health promotion by staff in urgent and emergency care settings. The components of the intervention will be mapped to a framework which will consider the needs of staff working within these settings, patients they treat, and organisational issues and practices related to the implementation of such an intervention.

Keywords: emergency service, hospital, nursing, allied health personnel, emergency medical services, health promotion

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10283 Model Development of Health Tourism at Ban Nam Chieo Community, Laem Ngop, Trat Province

Authors: Pradapet Krutchangthong, Jirawat Sudsawart

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This research aims to study the health tourism administration and factors related to health tourism promotion at Ban Nam Chieo Community, Laem Ngop, Trat Province. The sample in this research is 361 tourists who use the service and Ban Nam Chieo Community residents who provide the service. Sampling was done from a population size of 3,780 using Taro Yamane’s formula. The tools used in the study were questionnaires and interviews. The statistics used in this research are percentage, mean and standard deviation. The result of Model Development of Health Tourism at Ban Nam Chieo Community, Laem Ngop , Trat Province shows that most of them are female with bachelor degree. They are government officers with an average income between 16,001-20,000 Baht. Suggested health system activities for health tourism development are: 1) health massage, 2) herbal compress, 3) exercise in the water by walking on shell. Meanwhile, factors related to health tourism promotion at Ban Nam Chieo Community, Laem Ngop, Trat Province are: 1) understanding the context of the community and service providers, 2) cooperation from related government and private sectors.

Keywords: health tourism, health system activities, promotion, administration

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