Search results for: decision criteria
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6095

Search results for: decision criteria

1565 Comparative Efficacy of Angiotensin Converting Enzymes Inhibitors and Angiotensin Receptor Blockers in Patients with Heart Failure in Tanzania: A Prospective Cohort Study

Authors: Mark P. Mayala, Henry Mayala, Khuzeima Khanbhai

Abstract:

Background: Heart failure has been a rising concern in Tanzania. New drugs have been introduced, including the group of drugs called Angiotensin receptor Neprilysin Inhibitor (ARNI), but due to their high cost, angiotensin-converting enzymes inhibitors (ACEIs) and Angiotensin receptor blockers (ARBs) have been mostly used in Tanzania. However, according to our knowledge, the efficacy comparison of the two groups is yet to be studied in Tanzania. The aim of this study was to compare the efficacy of ACEIs and ARBs among patients with heart failure. Methodology: This was a hospital-based prospective cohort study done at Jakaya Kikwete Cardiac Institution (JKCI), Tanzania, from June to December 2020. Consecutive enrollment was done until fulfilling the inclusion criteria. Clinical details were measured at baseline. We assessed the relationship between ARBs and ACEIs users with N-terminal pro-brain natriuretic peptide (NT pro-BNP) levels at admission and at 1-month follow-up using a chi-square test. A Kaplan-Meier curve was used to estimate the survival time of the two groups. Results: 155 HF patients were enrolled, with a mean age of 48 years, whereby 52.3% were male, and their mean left ventricular ejection fraction (LVEF) was 37.3%. 52 (33.5%) heart failure patients were on ACEIs, 57 (36.8%) on ARBs, and 46 (29.7%) were neither using ACEIs nor ARBs. At least half of the patients did not receive a guideline-directed medical therapy (GDMT), with only 82 (52.9%) receiving a GDMT. A drop in NT pro-BNP levels was observed during admission and at 1-month follow-up on both groups, from 6389.2 pg/ml to 4000.1 pg/ml for ARB users and 5877.7 pg/ml to 1328.2 pg/ml for the ACEIs users. There was no statistical difference between the two groups when estimated by the Kaplan-Meier curve, though more deaths were observed in those who were neither on ACEIs nor ARBs, with a calculated P value of 0.01. Conclusion: This study demonstrates that ACEIs have more efficacy and overall better clinical outcome than ARBs, but this should be taken under the patient-based case, considering the side effects of ACEIs and patients’ adherence.

Keywords: angiotensin converting enzymes inhibitors, angiotensin receptor blockers, guideline direct medical therapy, N-terminal pro-brain natriuretic peptide

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1564 Deep Reinforcement Learning-Based Computation Offloading for 5G Vehicle-Aware Multi-Access Edge Computing Network

Authors: Ziying Wu, Danfeng Yan

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Multi-Access Edge Computing (MEC) is one of the key technologies of the future 5G network. By deploying edge computing centers at the edge of wireless access network, the computation tasks can be offloaded to edge servers rather than the remote cloud server to meet the requirements of 5G low-latency and high-reliability application scenarios. Meanwhile, with the development of IOV (Internet of Vehicles) technology, various delay-sensitive and compute-intensive in-vehicle applications continue to appear. Compared with traditional internet business, these computation tasks have higher processing priority and lower delay requirements. In this paper, we design a 5G-based Vehicle-Aware Multi-Access Edge Computing Network (VAMECN) and propose a joint optimization problem of minimizing total system cost. In view of the problem, a deep reinforcement learning-based joint computation offloading and task migration optimization (JCOTM) algorithm is proposed, considering the influences of multiple factors such as concurrent multiple computation tasks, system computing resources distribution, and network communication bandwidth. And, the mixed integer nonlinear programming problem is described as a Markov Decision Process. Experiments show that our proposed algorithm can effectively reduce task processing delay and equipment energy consumption, optimize computing offloading and resource allocation schemes, and improve system resource utilization, compared with other computing offloading policies.

Keywords: multi-access edge computing, computation offloading, 5th generation, vehicle-aware, deep reinforcement learning, deep q-network

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1563 Investigating the Effective Physical Factors in the Development of Coastal Ecotourism in Southern Islands of Iran: A Case Study of Hendurabi Island, Iran

Authors: Zahra Khodaee

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Background and Objective: The attractive potential for tourism in the southern islands of Iran, Kish, and Qeshm and recently Hendurabi, are becoming more and more popular and object of increased attention from the investors. The Iranian coral reef islands, with the exception of Kish and Qeshm, have not undergone sufficient development. The southern islands of Iran have faced two problems with climate change and the desire for the presence of tourists. The lack of proper planning, inefficient management, and lack of adequate knowledge of ecosystems of offshore regions have severely damaged the world natural heritage. This study was conducted to consider the correlation of tourism, development, and ecosystem because there is a need for further addressing the ecotourism in coral islands. Method: Through qualitative research, this paper was used of library studies and field studies and surveying to study the physical (objective-subjective) physical factors of ecotourism development in Honduran Island. Using SPSS software and descriptive-analytical method was shown the results. The survey was conducted with the participation of 150 tourists on Kish islands, who were chosen at random and who expressed their desire to travel to Hendurabi Island. Information was gathered using SPSS software and unique statistical T-test. The questionnaire was put together using AMOS software to ensure that the questions asked were sufficiently relevant. Findings: The results of this study presented that physical factors affecting the development of ecotourism in two categories are objective and subjective factors because IFI factor = 0.911 and CFI Factor = 0.907 into the target community. Discussion and conclusion: The results were satisfactory in that they showed that eco-tourists attached importance to see views, quiet, secluded areas, tranquility security, quality of the area being visited, easy access to services these were the top criteria for those visiting the area while they adhere to environmental compliance. Developing Management of these regions should maintain appropriate utilization along with sustainable and ecological responsibility.

Keywords: ecotourism, coral reef island, development management, Hendurabi Island

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1562 Design and Implementation of a Software Platform Based on Artificial Intelligence for Product Recommendation

Authors: Giuseppina Settanni, Antonio Panarese, Raffaele Vaira, Maurizio Galiano

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Nowdays, artificial intelligence is used successfully in academia and industry for its ability to learn from a large amount of data. In particular, in recent years the use of machine learning algorithms in the field of e-commerce has spread worldwide. In this research study, a prototype software platform was designed and implemented in order to suggest to users the most suitable products for their needs. The platform includes a chatbot and a recommender system based on artificial intelligence algorithms that provide suggestions and decision support to the customer. The recommendation systems perform the important function of automatically filtering and personalizing information, thus allowing to manage with the IT overload to which the user is exposed on a daily basis. Recently, international research has experimented with the use of machine learning technologies with the aim to increase the potential of traditional recommendation systems. Specifically, support vector machine algorithms have been implemented combined with natural language processing techniques that allow the user to interact with the system, express their requests and receive suggestions. The interested user can access the web platform on the internet using a computer, tablet or mobile phone, register, provide the necessary information and view the products that the system deems them most appropriate. The platform also integrates a dashboard that allows the use of the various functions, which the platform is equipped with, in an intuitive and simple way. Artificial intelligence algorithms have been implemented and trained on historical data collected from user browsing. Finally, the testing phase allowed to validate the implemented model, which will be further tested by letting customers use it.

Keywords: machine learning, recommender system, software platform, support vector machine

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1561 Delisting Wave: Corporate Financial Distress, Institutional Investors Perception and Performance of South African Listed Firms

Authors: Adebiyi Sunday Adeyanju, Kola Benson Ajeigbe, Fortune Ganda

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In the past three decades, there has been a notable increase in the number of firms delisting from the Johannesburg Stock Exchange (JSE) in South Africa. The recent increasing rate of delisting waves of corporate listed firms motivated this study. This study aims to explore the influence of institutional investor perceptions on the financial distress experienced by delisted firms within the South African market. The study further examined the impact of financial distress on the corporate performance of delisted firms. Using the data of delisted firms spanning from 2000 to 2023 and the FGLS (Feasible Generalized Least Squares) for the short run and PCSE (Panel-Corrected Standard Errors) for the long run effects of the relationship. The finding indicated that a decline in institutional investors’ perceptions was associated with the corporate financial distress of the delisted firms, particularly during the delisting year and the few years preceding the announcement of the delisting. This study addressed the importance of investor recognition in corporate financial distress and the delisting wave among listed firms- a finding supporting the stakeholder theory. This study is an insight for companies’ managements, investors, governments, policymakers, stockbrokers, lending institutions, bankers, the stock market, and other stakeholders in their various decision-making endeavours. Based on the above findings, it was recommended that corporate managements should improve their governance strategies that can help companies’ financial performances. Accountability and transparency through governance must also be improved upon with government support through the introduction of policies and strategies and enabling an easy environment that can help companies perform better.

Keywords: delisting wave, institutional investors, financial distress, corporate performance, investors’ perceptions

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1560 Assessing Sustainability Dimensions of Transportation as a Critical Infrastructure: Jordan as a Case Study

Authors: Malak M. Shatnawi

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Infrastructure is the fundamental facility that plays an important part in socio-economic development for modern societies, if such sector is well planned, managed by decision makers in a way that is compatible with the population growth, safety, and national security needs; it will enrich progress, prosperity, awareness, social and economic welfare for any country. Infrastructure is the most important aspect of life because it can provide materials, products, and services that will improve and facilitate living conditions and maintain sustainability at the same time, and in order to study critical infrastructure, in general, we must think sustainability. Otherwise there will be a significant gap. The planning processes for sustainability include urban infrastructure and public transportation are considered the most important sectors for economic development for both developed and developing countries as they are linked to the civilizational and urban development, meanwhile, choosing the appropriate transportation mode that will provide a good level of service, and increase the satisfaction of the potential users is a difficult task. This research paper tries to assess where is Jordan located vs. each transportation sustainability dimensions in aspects related to social, economic and environmental dimensions based on (Zietsman et al. 2006) adopted model for sustainability transportation infrastructure. Measures of performance indicators for each dimensional goal were traced and supported with needed data, figures and statistical findings. The study uses analytical, descriptive style and methodology based on different references and previous studies from secondary data sources to support the case. Recommendations for enhancing sustainability were concluded, and future reform directions were proposed which can be applied to Jordan and generalized for other developing countries with similar circumstances.

Keywords: infrastructure transportation sustainability, economic, social, environmental

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1559 Evaluating the Impact of Future Scenarios on Water Availability and Demand Based on Stakeholders Prioritized Water Management Options in the Upper Awash Basin, Ethiopia

Authors: Adey Nigatu Mersha, Ilyas Masih, Charlotte de Fraiture, Tena Alamirew

Abstract:

Conflicts over water are increasing mainly as a result of water scarcity in response to higher water demand and climatic variability. There is often not enough water to meet all demands for different uses. Thus, decisions have to be made as to how the available resources can be managed and utilized. Correspondingly water allocation goals, practically national water policy goals, need to be revised accordingly as the pressure on water increases from time to time. A case study is conducted in the Upper Awash Basin, Ethiopia, to assess and evaluate prioritized comprehensive water demand management options based on the framework of integrated water resources management in account of stakeholders’ knowledge and preferences as well as practical prominence within the Upper Awash Basin. Two categories of alternative management options based on policy analysis and stakeholders' consultation were evaluated against the business-as-usual scenario by using WEAP21 model as an analytical tool. Strong effects on future (unmet) demands are observed with major socio-economic assumptions and forthcoming water development plans. Water management within the basin will get more complex with further abstraction which may lead to an irreversible damage to the ecosystem. It is further confirmed through this particular study that efforts to maintain users’ preferences alone cannot insure economically viable and environmentally sound development and vice versa. There is always a tradeoff between these factors. Hence, all of these facets must be analyzed separately, related with each other in equal footing, and ultimately taken up in decision making in order for the whole system to function properly.

Keywords: water demand, water availability, WEAP21, scenarios

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1558 Diabetes Care in Detention Settings: A Systematic Review

Authors: A. Papachristou, A. Ntikoudi, L. Makris, V. Saridakis

Abstract:

Introduction: More than 10 million people are imprisoned or detained worldwide. Figures from 2011-12 show that prison inmates are more likely than the general population to suffer from chronic or infectious diseases, while most inmates are overweight or obese, and more than a quarter have high blood pressure. In 2011/12, the proportion of prisoners reporting diabetes or hyperglycemia was 899 per 10,000 prisoners, almost double the 2004 figure (483 per 10,000). It is important to ensure that this population has access to the same standard of care as people outside prisons, as access to services should be need-based. Diabetes is a public health problem associated with increased morbidity and mortality worldwide. According to the International Diabetes Federation (IDF) in 2017, approximately 425 million people worldwide had diabetes. This number is expected to increase to 629 million by 2045. Poor management of diabetes in prisons can lead to poor blood sugar control and increase the risk of complications. Aim: The aim of this review was to systematically evaluate all the available literature on diabetes care in custodial settings. Methods: An extensive literature search was conducted through electronic databases (PubMed, Scopus and CINAHL) with the terms ‘custody’, ‘diabetes Mellitus, ‘detention centers and ‘chronic disease’. Articles published in English until September 2022, were included; no other criteria on publication dates were set. Results: Most of the studies mentioned a diabetes prevalence of approximately 10%, among other common chronic. Hypertension, obesity, smoking, sedentary lifestyle were the most common comorbidities associated with diabetes. Conclusion: Good glycemic control is fundamental to managing diabetes, and while many prisoners enter prison poorly, access to regular medication and meals, as well as exercise, offers the potential for improvement. Not being able to get help as quickly as in the past can be extremely stressful, and some prisoners may deliberately raise their blood sugar levels to avoid the risk of developing hypoglycemia, especially if they know they have had previous episodes of nocturnal hypoglycemia. Thus, appropriate training and resources are critical to providing quality care to incarcerated people with diabetes.

Keywords: custody, diabetes mellitus, detention centers, chronic disease

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1557 Designing the Lesson Instructional Plans for Exploring the STEM Education and Creative Learning Processes to Students' Logical Thinking Abilities with Different Learning Outcomes in Chemistry Classes

Authors: Pajaree Naramitpanich, Natchanok Jansawang, Panwilai Chomchid

Abstract:

The aims of this are compared between the students’ logical thinking abilities of their learning for designing the 5-lesson instructional plans of the 2-instructional methods, namely; the STEM Education and the Creative Learning Process (CLP) for developing students’ logical thinking abilities that a sample consisted of 90 students from two chemistry classes of different learning outcomes in Wapi Phathum School with the cluster random sampling technique was used at the 11th grade level. To administer of their learning environments with the 45-experimenl student group by the STEM Education method and the 45-controlling student group by the Creative Learning Process. These learning different groups were obtained using the 5 instruments; the 5-lesson instructional plans of the STEM Education and the Creative Learning Process to enhance the logical thinking tests on Mineral issue were used. The efficiency of the Creative Learning Processes (CLP) Model and the STEM Education’s innovations of these each five instructional lesson plans based on criteria are higher than of 80/80 standard level with the IOC index from the expert educators. The averages mean scores of students’ learning achievement motives were assessed with the Pre and Post Techniques and Logical Thinking Ability Test (LTAT) and dependent t-test analysis were differentiated between the CLP and the STEM, significantly. Students’ perceptions of their chemistry classroom environment inventories with the MCI with the CLP and the STEM methods also were found, differently. Associations between students’ perceptions of their chemistry classroom learning environment inventories on the CLP Model and the STEM Education learning designs toward their logical thinking abilities toward chemistry, the predictive efficiency of R2 values indicate that 68% and 76% of the variances in students’ logical thinking abilities toward chemistry to their controlling and experimental chemistry classroom learning environmental groups with the MCI were correlated at .05 levels, significantly. Implementations of this result are showed the students’ learning by the CLP of the potential thinking life-changing roles in most their logical thinking abilities that it is revealed that the students perceive their abilities to be highly learning achievement in chemistry group are differentiated with the STEM education of students’ outcomes.

Keywords: design, the lesson instructional plans, the stem education, the creative learning process, logical thinking ability, different, learning outcome, student, chemistry class

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1556 Impact of Modern Beehive on Income of Rural Households: Evidence from Bugina District of Northern Ethiopia

Authors: Wondmnew Derebe Yohannis

Abstract:

The enhanced utilization of modern beehives holds significant potential to enhance the livelihoods of smallholder farmers who heavily rely on mixed crop-livestock farming for their income. Recognizing this, the distribution of improved beehives has been implemented across various regions in Ethiopia, including the Bugina district. However, the precise impact of these improved beehives on farmers' income has received limited attention. To address this gap, this study aims to assess the influence of adopting upgraded beehives on rural households' income and asset accumulation. To conduct this research, survey data was gathered from a sample of 350 households selected through random sampling. The collected data was then analyzed using an econometric stochastic frontier model (ESRM) approach. The findings reveal that the adoption of improved beehives has resulted in higher annual income and asset growth for beekeepers. On average, those who adopted the improved beehives earned approximately 6,077 Ethiopian Birr (ETB) more than their counterparts who did not adopt these beehives. However, it is worth noting that the impact of adoption would have been even greater for non-adopters, as evidenced by the negative transitional heterogeneity effect of 1792 ETB. Furthermore, the analysis indicates that the decision to adopt or not adopt improved beehives was driven by individual self-selection. The adoption of improved beehives also led to an increase in fixed assets for households, establishing it as a viable strategy for poverty reduction. Overall, this study underscores the positive effect of adopting improved beehives on rural households' income and asset holdings, showcasing its potential to uplift smallholder farmers and serve as an alternative mechanism for reducing poverty.

Keywords: impact, adoption, endogenous switching regression, income, improved beehives

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1555 Patient Advocates to Improve Access to Justice in Involuntary Hospitalisation

Authors: Zuzana Durajova, Natasa Diatkova, Shreya Bhardwaj

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This paper introduces the project START, its activities, goals, evaluation and final results. Over the past few decades, the legal discourse surrounding mental health has resulted in improvement in patient rights (in Netherlands, etc.), the appointment of Ombudspersons for psychiatric patients (in Austria, Sweden) and facilitating the participation of patients in decision-making processes. Czech legislation already recognizes the position of “patient’s advocate” as a person of trust. However, this instrument is not very widely known and rarely used in practice. In the pilot study of the project, legal training for patient advocacy is provided to persons with experience with mental health problems/psychiatric hospitalization chosen from a Czech-based NGO. These persons (patient advocates) visit patients in involuntary hospitalization in one closed ward in the chosen psychiatric institution. During visits, the patient advocates inform patients about their legal standing, their procedural rights and also offer them individual support in contacting their counsel, family members etc. To understand the effect of the intervention, qualitative interviews and participant observations are conducted with the patients, advocates, the hospital management and staff and other identifiable stakeholders, such as government officials responsible for mental health care reform. The interviews are held before, during and after the intervention (support from patient advocates in hospitals). Given the ethical quandaries arising from using psychiatric wards as a field setting, we assume a participatory approach to ensure respect for patient boundaries and dignity. Through this project, we seek to establish a profession of patient advocates based on professional standards.

Keywords: patient advocacy, involuntary hospitalization, Czech Republic, patient Rights, professionalization

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1554 Prescription of Lubricating Eye Drops in the Emergency Eye Department: A Quality Improvement Project

Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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1553 Public Health Campaign to Eradicate Hepatitis C Virus during the Covid-19 Emergency in the North-East of Italy

Authors: Emanuela Zilli, Antonio Madia, Milvia Marchiori, Paola Anello, Chiara Cabbia, Emanuela Velo, Delia Campagnolo, Michele Scomazzon, Emanuela Salvatico, S. Tikvina, Antonio Miotti

Abstract:

Hepatitis C is an inflammation of the liver caused by the hepatitis C virus (HCV). Antiviral medicines can cure more than 95% of cases of hepatitis C infection, but access to diagnosis and treatment remains low. The ULSS 6 Euganea – Health Trust has implemented a campaign to eradicate hepatitis C in the province of Padua (North-East of Italy), which can be subdivided into three areas: North (300.000 inhabitants), Centre (400.000) and South (300.000). In September 2021, the project was launched in the Northern area; a set of brochures was distributed in outpatient services, general practitioners’ clinics and offices, community pharmacy services, social health districts, and through social networks. The Hepatology Service contacted 460 patients selected by the Clinical Laboratory (positivity for HCV antibodies): 83 patients (18.0%) had been already cured of HCV infection, missing or deceased; 377 patients (82.0%) met the criteria to be eligible for HCV eradication therapy and were therefore included in a Day Service specific agenda and followed by a multidisciplinary team of healthcare professionals, with a dedicated telephone line. Haemato-chemical tests, general medical check-ups and ultrasound tests with fibroscan were performed. Patients were tested for Sars-CoV-2 positivity; those not yet vaccinated against Covid-19 were encouraged to complete the vaccination scheme. All 377 patients (100%) received HCV eradication therapy at the community pharmacy service; a detailed explanation of how to take their medication was provided. At the end of the first phase, Covid-19 vaccination rate was 100% (377/377), including patients already vaccinated and new-vaccinated. Check-up appointments were arranged after 2 or 3 months, according to the treatment plan. The awareness campaign and the organization of HCV eradication therapy service by ULSS 6 Euganea are proving to be effective; the project is now going to be applied to Central and Southern areas of the province (1.132 patients).

Keywords: public health, HCV-eradication, Covid-19 emergency, health communication strategies

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1552 Agroecological and Socioeconomic Determinants of Conserving Diversity On-Farm: The Case of Wheat Genetic Resources in Ethiopia

Authors: Bedilu Tafesse

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Conservation of crop genetic resources presents a challenge of identifying specific determinants driving maintenance of diversity at farm and agroecosystems. The objectives of this study were to identify socioeconomic, market and agroecological determinants of farmers’ maintenance of wheat diversity at the household level and derive implications for policies in designing on-farm conservation programs. We assess wheat diversity at farm level using household survey data. A household decision making model is conceptualized using microeconomic theory to assess and identify factors influencing on-farm rice diversity. The model is then tested econometrically by using various factors affecting farmers’ variety choice and diversity decisions. The findings show that household-specific socioeconomic, agroecological and market factors are important in determining on-farm wheat diversity. The significant variables in explaining richness and evenness of wheat diversity include distance to the nearest market, subsistence ratio, modern variety sold, land types and adult labour working in agriculture. The statistical signs of the factors determining wheat diversity are consistent in explaining the richness, dominance and evenness among rice varieties. Finally, the study implies that the cost-effective means of promoting and sustaining on-farm conservation programmes is to target them in market isolated geographic locations of high crop diversity where farm households have more heterogeneity of agroecological conditions and more active family adult labour working on-farm.

Keywords: diversity indices, dominance, evenness, on-farm conservation, wheat diversity, richness

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1551 The Impact of Iso 9001 Certification on Brazilian Firms’ Performance: Insights from Multiple Case Studies

Authors: Matheus Borges Carneiro, Fabiane Leticia Lizarelli, José Carlos De Toledo

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The evolution of quality management by companies was strongly enabled by, among others, ISO 9001 certification, which is considered a crucial requirement for several customers. Likewise, performance measurement provides useful insights for companies to identify the reflection of their decision-making process on their improvement. One of the most used performance measurement models is the balanced scorecard (BSC), which uses four perspectives to address a firm’s performance: financial, internal process, customer satisfaction, and learning and growth. Studies related to ISO 9001 and business performance have mostly adopted a quantitative approach to identify the standard’s causal effect on a firm’s performance. However, to verify how this influence may occur, an in-depth analysis within a qualitative approach is required. Therefore, this paper aims to verify the impact of ISO 9001:2015 on Brazilian firms’ performance based on the balanced scorecard perspective. Hence, nine certified companies located in the Southeast region of Brazil were studied through a multiple case study approach. Within this study, it was possible to identify the positive impact of ISO 9001 on firms’ overall performance, and four Critical Success Factors (CSFs) were identified as relevant on the linkage among ISO 9001 and firms’ performance: employee involvement, top management, process management, and customer focus. Due to the COVID-19 pandemic, the number of interviews was limited to the quality manager specialist, and the sample was limited since several companies were closed during the period of the study. This study presents an in-depth analysis of how the relationship between ISO 9001 certification and firms’ performance in a developing country is.

Keywords: balanced scorecard, Brazilian firms’ performance, critical success factors, ISO 9001 certification, performance measurement

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1550 Analysis of Municipal Solid Waste Management in Nigeria

Authors: Anisa Gumel

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This study examines the present condition of solid waste management in Nigeria. The author explores the challenges and opportunities affecting municipal solid waste management in "Nigeria" and determines the most profound challenges by analysing the interdependence and interrelationship among identified variables. In this study, multiple stakeholders, including 15 waste management professionals interviewed online, were utilised to identify the difficulties and opportunities affecting municipal solid waste in Nigeria. The interviews were transcribed and coded using NVivo to produce pertinent variables. An online survey of Nigerian internet and social media users was done to validate statements made by experts on the identified variable. In addition, a panel of five experts participated in a focus group discussion to discover the most influential factors that influence municipal solid waste management in Nigeria by analysing the interrelationships as well as the driving and reliant power of variables. The results show significant factors affecting municipal solid waste in Nigeria, including inadequate funding, lack of knowledge, and absence of legislation, as well as behavioural, financial, technological, and legal concerns grouped into five categories. Some claims stated by experts in the interview are supported by the survey data, while others are not. In addition, the focus group reveals patterns, correlations, and driving forces between variables that have been analysed. This study will provide decision-makers with a roadmap for resolving important waste management concerns in Nigeria and managing scarce resources effectively. It will also help non-governmental organisations combat malaria in Nigeria and other underdeveloped nations. In addition, the work contributes to the literature for future scholars to consult.

Keywords: municipal solid waste, stakeholders, public, experts

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1549 Osteoporosis and Weight Gain – Two Major Concerns for Menopausal Women - a Physiotherapy Perspective

Authors: Renu Pattanshetty

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The aim of this narrative review is to highlight the impact of menopause on osteoporosis and weight gain. The review also aims to summarize physiotherapeutic strategies to combat the same.A thorough literature search was conducted using electronic databases like MEDline, PUBmed, Highwire Press, PUBmed Central for English language studies that included search terms like menopause, osteoporosis, obesity, weight gain, exercises, physical activity, physiotherapy strategies from the year 2000 till date. Out of 157 studies that included metanalyses, critical reviews and randomized clinical trials, a total of 84 were selected that met the inclusion criteria. Prevalence of obesity is increasing world - wide and is reaching epidemic proportions even in the menopausal women. Prevalence of abdominal obesity is almost double than that general obesity with rates in the US with 65.5% in women ages 40-59 years and 73.8 in women aged 60 years or more. Physical activities and exercises play a vital role in prevention and treatment of osteoporosis and weight gain related to menopause that aim to boost the general well-being and any symptoms brought about by natural body changes. Endurance exercises lasting about 30 minutes /day for 5 days/ week has shown to decrease weight and prevent weight gain. In addition, strength training with at least 8 exercises of 8-12 repetitions working for whole body and for large muscle groups has shown to result positive outcomes. Hot flashes can be combatted through yogic breathing and relaxation exercises. Prevention of fall strategies and resistance training are key to treat diagnosed cases of osteoporosis related to menopause. One to three sets with five to eight repetitions of four to six weight bearing exercises have shown positive results. Menopause marks an important time for women to evaluate their risk of obesity and osteoporosis. It is known fact that bone benefit from exercises are lost when training is stopped, hence, practicing bone smart habits and strict adherence to recommended physical activity programs are recommended which are enjoyable, safe and effective.

Keywords: menopause, osteoporosis, obesity, weight gain, exercises, physical activity, physiotherapy strategies

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1548 VISSIM Modeling of Driver Behavior at Connecticut Roundabouts

Authors: F. Clara Fang, Hernan Castaneda

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The Connecticut Department of Transportation (ConnDOT) has constructed four roundabouts in the State of Connecticut within the past ten years. VISSIM traffic simulation software was utilized to analyze these roundabouts during their design phase. The queue length and level of service observed in the field appear to be better than predicted by the VISSIM model. The objectives of this project are to: identify VISSIM input variables most critical to accurate modeling; recommend VISSIM calibration factors; and, provide other recommendations for roundabout traffic operations modeling. Traffic data were collected at these roundabouts using Miovision Technologies. Cameras were set up to capture vehicle circulating activity and entry behavior for two weekdays. A large sample size of filed data was analyzed to achieve accurate and statistically significant results. The data extracted from the videos include: vehicle circulating speed; critical gap estimated by Maximum Likelihood Method; peak hour volume; follow-up headway; travel time; and, vehicle queue length. A VISSIM simulation of existing roundabouts was built to compare both queue length and travel time predicted from simulation with measured in the field. The research investigated a variety of simulation parameters as calibration factors for describing driver behaviors at roundabouts. Among them, critical gap is the most effective calibration variable in roundabout simulation. It has a significant impact to queue length, particularly when the volume is higher. The results will improve the design of future roundabouts in Connecticut and provide decision makers with insights on the relationship between various choices and future performance.

Keywords: driver critical gap, roundabout analysis, simulation, VISSIM modeling

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1547 Adequate Dietary Intake to Improve Outcome of Urine: Urea Nitrogen with Balance Nitrogen and Total Lymphocyte Count

Authors: Mardiana Madjid, Nurpudji Astuti Taslim, Suryani As'ad, Haerani Rasyid, Agussalim Bukhari

Abstract:

The high level of Urine Urea Nitrogen (UUN) indicates hypercatabolism occurs in hospitalized patients. High levels of Total Lymphocyte Count (TLC) indicates the immune system condition, adequate wound healing, and limit complication. Adequate dietary intake affects to decrease of hypercatabolism status in treated patient’s hospitals. Nitrogen Balance (NB) is simply the difference between nitrogen (N₂) intake and output. If more N₂ intake than output, then positive NB or anabolic will occur. This study aims to evaluate the effect of dietary intake in influencing balance nitrogen and total lymphocyte count. Method: A total of 43 patients admitted to a Wahidin Sudirohusodo Hospital between 2018 and 2019 for 10 days' treats are included. The inclusion criteria were patients who were treated for 10 days and receives food from the hospital orally. Patients did not experience gastrointestinal disorders such as vomiting and diarrhea and experience impair kidney function and liver function and expressed approval to participate in this study. During hospitalization, food intake, UUN, albumin serum, balance nitrogen, and TLC was assessed twice on day 1 and day 10. There is no Physician Clinical Nutritional intervention to correct food intake. UUN is 24 hours of urine collected on the second day after admission and the tenth day. Statistical analysis uses SPSS 24 with observational cohort methods. Result: The Forty-three participants completed the follow-up (27 men and 18 women). The age of fewer than 4 years is 22 people, 45 to 60 years is 16 people, and over 60 years is 4 people. The result of the study on day 1 obtained SGA score A, SGA score B, SGA score C are 8, 32, 3 until day 10 are 8, 31, 4, respectively. According to 24h dietary recalls, the energy intake during observation was from 522.5 ± 400.4 to 1011.9 ± 545.1 kcal/day P < 0.05, protein intake from 20.07 ± 17.2 to 40.3 ± 27.3 g/day P < 0.05, carbohydrates from 92.5 ± 71.6 to 184.8 ± 87.4 g/day, and fat from 5.5 ± 3.86 to 13.9 ± 13.9 g/day. The UUN during the observation was from 6.6 ± 7.3 to 5.5 ± 3.9 g/day, TLC decreased from 1622.9 ± 897.2 to 1319.9 ± 636.3/mm³ value target 1800/mm³, albumin serum from 3.07 ± 0.76 to 2.9 ± 0.57 g/day, and BN from -7.5 ± 7.2 to -3.1 ± 4.86. Conclusion: The high level of UUN needs to correct adequate dietary intake to improve NB and TLC status on hospitalized patients.

Keywords: adequate dietary intake, balance nitrogen, total lymphocyte count, urine urea nitrogen

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1546 Inequalities in Gastrointestinal Infections between UK Ethnic Groups: A Systematic Review and Narrative Synthesis

Authors: Iram Zahair, Tanith Rose, Oyinlola Oyebode, Stephen Clayton, Iman Ghosh, Michelle Maden, Ben Barr

Abstract:

Background: Gastrointestinal infections exert a significant public health burden on UK healthcare services and the community. However, there are conflicting findings on where ethnic inequalities are likely to persist. This systematic review aimed to identify studies that ascertain differences in the incidence and prevalence of gastrointestinal infections within and between UK ethnic groups and explore possible explanations for heterogeneity observed within the literature. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance, a systematic review methodology was used. Medline, Web of Science, CINAHL Plus, and grey literature were searched from 1980 to 2021 for studies reporting an association between ethnicity and gastrointestinal infections in UK population samples. Two reviewers independently screened the articles and conducted quality appraisals; data extraction was undertaken by one reviewer and verified by two reviewers (PROSPERO CRD 42021240714). A narrative synthesis was undertaken to synthesise the study findings. Results: The searches identified 8134 studies; 13 met the inclusion criteria. 12 out of 13 studies found a difference in the prevalence of gastrointestinal infections between different ethnic groups. UK ethnic minorities, predominantly men and children of Asian ethnicity, had an increased risk of infection than the white British majority in 12 studies; the Pakistani ethnic group had a higher risk of infection in three out of 13 studies. Studies reported that age and sex confounded the relationship between ethnicity and gastrointestinal infections. At the same time, the country of birth, socioeconomic status, and geographical location of ethnic groups mediated this association and significantly explained the heterogeneity observed across the studies. Harvest plots supported the textual synthesis. Conclusion: This systematic review elucidates the lack of extensive UK quantitative evidence examining the association between ethnicity and gastrointestinal infections. Insights into gastrointestinal infections and ethnicity's association can help address policy actions to mitigate the inequalities identified within and between UK ethnic groups.

Keywords: ethnic and racial populations, public health, public health policy, systematic review

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1545 Frequency of Consonant Production Errors in Children with Speech Sound Disorder: A Retrospective-Descriptive Study

Authors: Amulya P. Rao, Prathima S., Sreedevi N.

Abstract:

Speech sound disorders (SSD) encompass the major concern in younger population of India with highest prevalence rate among the speech disorders. Children with SSD if not identified and rehabilitated at the earliest, are at risk for academic difficulties. This necessitates early identification using screening tools assessing the frequently misarticulated speech sounds. The literature on frequently misarticulated speech sounds is ample in English and other western languages targeting individuals with various communication disorders. Articulation is language specific, and there are limited studies reporting the same in Kannada, a Dravidian Language. Hence, the present study aimed to identify the frequently misarticulated consonants in Kannada and also to examine the error type. A retrospective, descriptive study was carried out using secondary data analysis of 41 participants (34-phonetic type and 7-phonemic type) with SSD in the age range 3-to 12-years. All the consonants of Kannada were analyzed by considering three words for each speech sound from the Kannada Diagnostic Photo Articulation test (KDPAT). Picture naming task was carried out, and responses were audio recorded. The recorded data were transcribed using IPA 2018 broad transcription. A criterion of 2/3 or 3/3 error productions was set to consider the speech sound to be an error. Number of error productions was calculated for each consonant in each participant. Then, the percentage of participants meeting the criteria were documented for each consonant to identify the frequently misarticulated speech sound. Overall results indicated that velar /k/ (48.78%) and /g/ (43.90%) were frequently misarticulated followed by voiced retroflex /ɖ/ (36.58%) and trill /r/ (36.58%). The lateral retroflex /ɭ/ was misarticulated by 31.70% of the children with SSD. Dentals (/t/, /n/), bilabials (/p/, /b/, /m/) and labiodental /v/ were produced correctly by all the participants. The highly misarticulated velars /k/ and /g/ were frequently substituted by dentals /t/ and /d/ respectively or omitted. Participants with SSD-phonemic type had multiple substitutions for one speech sound whereas, SSD-phonetic type had consistent single sound substitutions. Intra- and inter-judge reliability for 10% of the data using Cronbach’s Alpha revealed good reliability (0.8 ≤ α < 0.9). Analyzing a larger sample by replicating such studies will validate the present study results.

Keywords: consonant, frequently misarticulated, Kannada, SSD

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1544 The Effects of Cost-Sharing Contracts on the Costs and Operations of E-Commerce Supply Chains

Authors: Sahani Rathnasiri, Pritee Ray, Sardar M. N. Isalm, Carlos A. Vega-Mejia

Abstract:

This study develops a cooperative game theory-based cost-sharing contract model for a business to consumer (B2C) e-commerce supply chain to minimize the overall supply chain costs and the individual costs within an information asymmetry scenario. The objective of this study is to address the issues of strategic interactions among the key players of the e-commerce supply chain operation, which impedes the optimal operational outcomes. Game theory has been included in the field of supply chain management to resolve strategic decision-making issues; however, most of the studies are limited only to two-echelons of the supply chains. Multi-echelon supply chain optimizations based on game-theoretic models are less explored in the previous literature. This study adopts a cooperative game model to focus on the common payoff of operations and addresses the issues of information asymmetry and coordination of a three-echelon e-commerce supply chain. The cost-sharing contract model integrates operational features such as production, inventory management and distribution with the contract related constraints. The outcomes of the model highlight the importance of maintaining lower operational costs by all players to obtain benefits from the cost-sharing contract. Further, the cost-sharing contract ensures true cost revelation, and hence eliminates the information asymmetry issues among the players. Comparing the results of the contract model with the de-centralized e-commerce supply chain operation further emphasizes that the cost-sharing contract derives Pareto-improved outcomes and minimizes the costs of overall e-commerce supply chain operation.

Keywords: cooperative game theory, cost-sharing contract, e-commerce supply chain, information asymmetry

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1543 A Comparative Study of Dengue Fever in Taiwan and Singapore Based on Open Data

Authors: Wei Wen Yang, Emily Chia Yu Su

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Dengue fever is a mosquito-borne tropical infectious disease caused by the dengue virus. After infection, symptoms usually start from three to fourteen days. Dengue virus may cause a high fever and at least two of the following symptoms, severe headache, severe eye pain, joint pains, muscle or bone pain, vomiting, feature skin rash, and mild bleeding manifestation. In addition, recovery will take at least two to seven days. Dengue fever has rapidly spread in tropical and subtropical areas in recent years. Several phenomena around the world such as global warming, urbanization, and international travel are the main reasons in boosting the spread of dengue. In Taiwan, epidemics occur annually, especially during summer and fall seasons. On the other side, Singapore government also has announced the amounts number of dengue cases spreading in Singapore. As the serious epidemic of dengue fever outbreaks in Taiwan and Singapore, countries around the Asia-Pacific region are becoming high risks of susceptible to the outbreaks and local hub of spreading the virus. To improve public safety and public health issues, firstly, we are going to use Microsoft Excel and SAS EG to do data preprocessing. Secondly, using support vector machines and decision trees builds predict model, and analyzes the infectious cases between Taiwan and Singapore. By comparing different factors causing vector mosquito from model classification and regression, we can find similar spreading patterns where the disease occurred most frequently. The result can provide sufficient information to predict the future dengue infection outbreaks and control the diffusion of dengue fever among countries.

Keywords: dengue fever, Taiwan, Singapore, Aedes aegypti

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1542 Companies and Transplant Tourists to China

Authors: Pavel Porubiak, Lukas Kudlacek

Abstract:

Introduction Transplant tourism is a controversial method of obtaining an organ, and that goes all the more for a country such as China, where sources of evidence point out to the possibility of organs being harvested illegally. This research aimed at listing the individual countries these tourists come from, or which medical companies sell transplant related products in there, with China being used as an example. Materials and methods The methodology of scoping study was used for both parts of the research. The countries from which transplant tourists come to China were identified by a search through existing medical studies in the NCBI PubMed database, listed under the keyword ‘transplantation in China’. The search was not limited by any other criteria, but only the studies available for free – directly on PubMed or a linked source – were used. Other research studies on this topic were considered as well. The companies were identified through multiple methods. The first was an online search focused on medical companies and their products. The Bloomberg Service, used by stock brokers worldwide, was then used to identify the revenue of these companies in individual countries – if data were available – as well as their business presence in China. A search through the U.S. Securities and Exchange Commission was done in the same way. Also a search on the Chinese internet was done, and to obtain more results, a second online search was done as well. The results and discussion The extensive search has identified 14 countries with transplant tourists to China. The search for a similar studies or reports resulted in finding additional six countries. The companies identified by our research also amounted to 20. Eight of them are sourcing China with organ preservation products – of which one is just trying to enter the Chinese market, six with immunosuppressive drugs, four with transplant diagnostics, one with medical robots which Chinese doctors use for transplantation as well, and another one trying to enter the Chinese market with a consumable-type product also related to transplantation. The conclusion The question of the ethicality of transplant tourism may be very pressing, since as the research shows, just the sheer amount of participating countries, sourcing transplant tourists to another one, amounts to 20. The identified companies are facing risks due to the nature of transplantation business in China, as officially executed prisoners are used as sources, and widely cited pieces of evidence point out to illegal organ harvesting. Similar risks and ethical questions are also relevant to the countries sourcing the transplant tourists to China.

Keywords: China, illegal organ harvesting, transplant tourism, organ harvesting technology

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1541 ADP Approach to Evaluate the Blood Supply Network of Ontario

Authors: Usama Abdulwahab, Mohammed Wahab

Abstract:

This paper presents the application of uncapacitated facility location problems (UFLP) and 1-median problems to support decision making in blood supply chain networks. A plethora of factors make blood supply-chain networks a complex, yet vital problem for the regional blood bank. These factors are rapidly increasing demand; criticality of the product; strict storage and handling requirements; and the vastness of the theater of operations. As in the UFLP, facilities can be opened at any of $m$ predefined locations with given fixed costs. Clients have to be allocated to the open facilities. In classical location models, the allocation cost is the distance between a client and an open facility. In this model, the costs are the allocation cost, transportation costs, and inventory costs. In order to address this problem the median algorithm is used to analyze inventory, evaluate supply chain status, monitor performance metrics at different levels of granularity, and detect potential problems and opportunities for improvement. The Euclidean distance data for some Ontario cities (demand nodes) are used to test the developed algorithm. Sitation software, lagrangian relaxation algorithm, and branch and bound heuristics are used to solve this model. Computational experiments confirm the efficiency of the proposed approach. Compared to the existing modeling and solution methods, the median algorithm approach not only provides a more general modeling framework but also leads to efficient solution times in general.

Keywords: approximate dynamic programming, facility location, perishable product, inventory model, blood platelet, P-median problem

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1540 Business Program Curriculum with Industry-Recognized Certifications: An Empirical Study of Exam Results and Program Curriculum

Authors: Thomas J. Bell III

Abstract:

Pursuing a business degree is fraught with perplexing questions regarding the rising tuition cost and the immediate value of earning a degree. Any decision to pursue an undergraduate business degree is perceived to have value if it facilitates post-graduate job placement. Business programs have decreased value in the absence of innovation in business programs that close the skills gap between recent graduates and employment opportunities. Industry-based certifications are seemingly becoming a requirement differentiator among job applicants. Texas Wesleyan University offers a Computer Information System (CIS) program with an innovative curriculum that integrates industry-recognized certification training into its traditional curriculum with core subjects and electives. This paper explores a culture of innovation in the CIS business program curriculum that creates sustainable stakeholder value for students, employers, the community, and the university. A quantitative research methodology surveying over one-hundred students in the CIS program will be used to examine factors influencing the success or failure of students taking certification exams. Researchers will analyze control variables to identify specific correlations between practice exams, teaching pedagogy, study time, age, work experience, etc. This study compared various exam preparation techniques to corresponding exam results across several industry certification exams. The findings will aid in understanding control variables with correlations that positively and negatively impact exam results. Such discovery may provide useful insight into pedagogical impact indicators that positively contribute to certification exam success and curriculum enhancement.

Keywords: taking certification exams, exam training, testing skills, exam study aids, certification exam curriculum

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1539 Efficacy of Botulinum Toxin in Alleviating Pain Syndrome in Stroke Patients with Upper Limb Spasticity

Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.

Abstract:

Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.

Keywords: botulinum toxin, pain syndrome, spasticity, stroke

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1538 The Conceptual Exploration of Comfort Zone by Using Content Analysis

Authors: Lilla Szabó Hangya, Szilvia Jambori

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The comfort zone is less studied area in the field of psychology. One of the most important definitions is that comfort zone is a psychological state in which things feel familiar to a person with low level of anxiety and stress. But the validity of comfort zone does not confirm till now. The aim of our pilot research is to test which psychological factors could determine how young adults behave during their decision process to stay in one’s comfort zone or to leave it. Every person has a number of comfort zones, so we are not able to measure it directly, only those personality traits which predict if someone leaves his comfort zone easier or harder. In our study at first we wanted to clarify the meaning of comfort zone. 110 young adults (male: 37, female: 73; ages from 18 to 70, average age: 26,6) took part in the study. Beside their demographic datas we asked them what does the comfort zone mean for them. The results showed that the meaning of the comfort zone can be grouped in five dimensions: comfort (49,6 %), leaving it-change (8,1%), ambivalent feelings (10,6%), related to other people (10,6%), pursuit of self-realization (16,8%). Our results demonstrated age related characteristics. For young people at the age of 19 the comfort zone is related to other people, because during adolescents peer relationships become more important. Subjects at the age 20-30 answered that the comfort zone means comfort and stability for them. Their life becomes stable for a while, they are studying or working. But at the age of 25, when they finish university, most of them answered comfort zone means a changing process for them. On the other hand for subjects at the age of 27 the means of the comfort zone is pursuit of self-realization. After that period at the age of 31 when they have families and stable job the stability will also dominant. We saw that the comfort zone has much more meaning besides a pleasant psychological trait. Further we would like to determine which psychological factors relate to comfort zone, and what kind of personality traits could predict leaving or staying in one’s comfort zone. We want to observe the relationship between comfort zone and subjective well-being, life satisfaction self-efficacy or self-esteem.

Keywords: comfort zone, development, personality trait, young adults

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1537 Critical Success Factors Influencing Construction Project Performance for Different Objectives: Procurement Phase

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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1536 Hardships Faced by Entrepreneurs in Marketing Projects for Acquiring Business Loans

Authors: Sudipto Sarkar

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Capital is the primary fuel for starting and running a business. Since capital is crucial for every business, entrepreneurs must successfully acquire adequate capital for executing their projects. Sources for the necessary capital for entrepreneurs include their own personal funds from existing bank accounts, or lines of credit or loans from banks or financial institutions, or equity funding from investors. The most commonly selected source of capital is a bank loan. However, acquiring a loan by any entrepreneur requires adhering to strict guidelines, conditions and norms. Because not only they have to show evidence for viability of the project, but also the means to return the acquired loan. On the bank’s part, it requires that every loan officer performs a thorough credit appraisal of the prospective borrowers and makes decisions about whether or not to lend money, how much to lend, and what conditions should be attached to it. Moreover, these credit decisions in general were often based on biases, analytical techniques, or prior experience. A loan can either turn out to be good or poor, irrespective of what type of credit decisions were followed. However, based on prior experience, the loan officers seem to differentiate between a good and a bad loan by examining the borrower’s credit history, pattern of borrowing, volume of borrowing, frequency of borrowing, and reasons for borrowing. As per an article written by Maureen Wallenfang on postcrescent.com dated May 10, 2010, it is observed that borrowers with good credit, solid business plans and adequate collateral security were able to procure loans very easily in the Fox Valley region. Since loans are required to run businesses, and also with the propensity of loans to become bad, loan officers tend to be very critical and cautious before approving and disbursing the loans. The pressure to be critical and cautious, at least partly, is a result of increased scrutiny by the Securities and Exchange Commission. As per Wall Street Journal (Sidel & Eaglesham, March, 3 2011, online), the Securities and Exchange Commission scrutinized banks that have restructured troubled loans in order to make them appear healthier than they really are. Therefore, loan officers’ loan criteria are of immense importance for entrepreneurs and banks alike.

Keywords: entrepreneur, loans, marketing, banks

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