Search results for: prevention level

Authors: Anil Giri, Kyle Lovercamp, Sankalp Sharma

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Farm level incomes fluctuate significantly due to extreme weather events such as drought. In the light of recent extreme weather events it is important to understand the implications of extreme weather events, flood and drought, on farm level incomes. This study examines the variation in farm level incomes for the United States in drought and no- drought years. Factoring heterogeneity in different enterprises (crop, livestock) and geography this paper analyzes the impact of drought in farm level incomes at state and national level. Livestock industry seems to be affected more by the lag in production of input feed for production, crops, as preliminary results show. Furthermore, preliminary results also show that while crop producers are not affected much due to drought, as price and quantity effect worked on opposite direction with same magnitude, that was not the case for livestock and horticulture enterprises. Results also showed that even when price effect was not as high the crop insurance component helped absorb much of shock for crop producers. Finally, the effect was heterogeneous for different states more on the coastal states compared Midwest region. This study should generate a lot of interest from policy makers across the world as some countries are actively seeking to increase subsidies in their agriculture sector. This study shows how subsidies absorb the shocks for one enterprise more than others. Finally, this paper should also be able to give an insight to economists to design/recommend policies such that it is optimal given the production level of different enterprises in different countries.

Keywords: farm level income, United States, crop, livestock

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Authors: Somkiat Korbuakaew, Bongkoch Puttawong

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This research aims to study the level of e-office system competence of Suan Sunandha Rajabhat University graded by age, education background, position and work experience. Sample of this research is 291 staff at Suan Sunandha Rajabhat University. Data were collected by questionnaire. Statistics used in the research are percentage, mean and standard deviation. The result shows that the overall competence of E-office System of the university staff is at average level. When considered in each aspect, it was found that competency level for creating-forwarding-signing documents is high, while competency level for booking meeting rooms, requesting for transportation service, blackboard system, public relations and making appointment and meeting are average.

Keywords: competence, e-office, education background, work experience

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Authors: Yousfi Abdelkader, Chaker Abdelkader, Bot Youcef

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This article proposes a five-level shunt active power filter for power quality improvement using a interval type-2 fuzzy logic controller (IT2 FLC). The reference compensating current is extracted using the P-Q theory. The majority of works previously reported are based on two-level inverters with a conventional Proportional integral (PI) controller, which requires rigorous mathematical modeling of the system. In this paper, a IT2 FLC controlled five-level active power filter is proposed to overcome the problem associated with PI controller. The IT2 FLC algorithm is applied for controlling the DC-side capacitor voltage as well as the harmonic currents of the five-level active power filter. The active power filter with a IT2 FLC is simulated in MATLAB Simulink environment. The simulated response shows that the proposed shunt active power filter controller has produced a sinusoidal supply current with low harmonic distortion and in phase with the source voltage.

Keywords: power quality, shunt active power filter, interval type-2 fuzzy logic controller (T2FL), multilevel inverter

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Authors: Sandra Thomas

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This study tries to analyse the level of food security and dietary diversity among households of different socio-economic classes in the urban centers of Thrissur. The study revealed that there is no much difference in purchasing patterns of food articles among the socio-economic classes indicating a very high level of both physical and economic accessibility of food. On analysing the dietary diversity of the households none of the households scored below five and fifty-three per cent of the households scored eleven or twelve indicating higher diversity in diet. It was also found that income and education are the two important factors that influence the level of household food security.

Keywords: food security, dietary diversity, household level, socio-economic classes

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Authors: Shamila Ahmed

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The paper examines how the fluidity between the local level and the global level is an intrinsic feature of new terrorism. Through using cosmopolitanism, the narratives of the two opposing sides of ISIS and the ‘war on terrorism’ response are explored. It is demonstrated how the fluidity between these levels facilitates the radicalisation process through exploring how groups such as ISIS highlight the perceived injustices against Muslims locally and globally and therefore exploit the globalisation process which has reduced the space between these levels. Similarly, it is argued that the ‘war on terror’ involves the intersection of fear, security, threat, risk and social control as features of both the international ‘war on terror’ and intra state policies.

Keywords: terrorism, war on terror, cosmopolitanism, global level terrorism

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Authors: Mohab Magdy Mostafa Mohamed

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The objective of this paper is to introduce a vertical handover (VHO) algorithm between wireless LANs (WLANs) and LTE mobile networks. The proposed algorithm is based on the fuzzy control theory and takes into consideration power level, subscriber velocity, and target cell load instead of only power level in traditional algorithms. Simulation results show that network performance in terms of number of handovers and handover occurrence distance is improved.

Keywords: vertical handover, fuzzy control theory, power level, speed, target cell load

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Authors: Zahra Tabarsi, Mehdi Marjani, Alireza Najafpour, Alborz Mirzade

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The aim of this study was to evaluate and compare the macroscopic effect of low level laser and plasma jet for wound healing in rats. The study was performed on 40 old male white rats with an average weight of 250 g and an average age of the same age. After preparing the rats from Ibn Sina Research Institute, they were kept the same for one week under environmental conditions such as temperature, humidity and light, and nutrition such as the type of diet and the number of meals. Then, to start the research, rats were randomly divided into two groups (A): laser treatment of wounds, group (B): plasma wound treatment. All rats were inhibited 4 hours before each anesthesia under conditions of abstinence and up to 2 hours after drinking water. Rats were anesthetized by intraperitoneal injection of ketamine 10% and xylazine 2%.After scrubbing between two shoulders of each rat, a circular wound was created by sterile 5 mm biopsy puncture. Group A rats were treated with low level laser in three sessions and group B in three sessions with argon plasma. Based on the observed results, it seems that Low level laser radiation has more acceptable and appropriate effects than cold plasma on the healing of rat skin wounds.

Keywords: low-level laser, plasma jet, rat, wound healing

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Authors: Thouraya Majoul

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Obesity is now a real public health issue throughout the world, and it is well-established that obesity leads to cardiovascular diseases. The prevention and treatment of obesity using nutritional supplements has become a realistic and effective approach. This study was carried out to analyze the incidence of a high-fat diet on rat heart metabolism as well as on fatty acids composition, then to investigate the eventual protective effects of a grape seed extract (GSE). The experimental design consisted of three rat groups subjected to three different conditions; standard (SD), high-fat diet (HFD) and HFD+GSE (HG). We showed that GSE counteracted the effect of HFD on fatty acid composition, namely, docosapentaenoic acid, docosahexaenoic acid, arachidonic acid (ARA), palmitic acid (PA) and palmitoleic acid. Besides, GSE treatment restored HFD-altered metabolic pathways through the recovery of some cardiac enzyme activities such as lipase, glucose 6 phosphate dehydrogenase and pyruvate dehydrogenase. The cardiac lactate level and lactate dehydrogenase activity were also analyzed in relation to HFD and GSE administration. To our knowledge, this is the first study showing the anti-obesity and cardioprotective effects of GSE in relation to fatty acid composition and some cardiac enzymes, supporting its role as a therapeutic agent of obesity.

Keywords: Grape seed extract, phenolic, obesity, cardioprotective, lipotoxicity, energy metabolism

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Authors: Masaumi Nakahara, Sou Watanabe, Hiromichi Ogi, Atsuhiro Shibata, Kazunori Nomura

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In the Japan Atomic Energy Agency, three types of experimental research, advanced reactor fuel reprocessing, radioactive waste disposal, and nuclear fuel cycle technology, have been carried out at the Chemical Processing Facility. The facility has generated high level radioactive liquid and solid wastes in hot cells. The high level radioactive solid waste is divided into three main categories, a flammable waste, a non-flammable waste, and a solid reagent waste. A plastic product is categorized into the flammable waste and molten with a heating mantle. The non-flammable waste is cut with a band saw machine for reducing the volume. Among the solid reagent waste, a used adsorbent after the experiments is heated, and an extractant is decomposed for its stabilization. All high level radioactive solid wastes in the hot cells are packed in a high level radioactive solid waste can. The high level radioactive solid waste can is transported to the 2nd High Active Solid Waste Storage in the Tokai Reprocessing Plant in the Japan Atomic Energy Agency.

Keywords: high level radioactive solid waste, advanced reactor fuel reprocessing, radioactive waste disposal, nuclear fuel cycle technology

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Authors: Abhishek Ranga

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The study examined the effect of accounting choice and level of disclosure on the firm’s implied cost of equity in Indian environment. For the study accounting choice was classified as aggressive or conservative depending upon the firm’s choice of accounting methods, accounting policies and accounting estimates. Level of disclosure is the quantum of financial and non-financial information disclosed in firm’s annual report, essentially in note to accounts section, schedules forming part of financial statements and Management Discussion and Analysis report. Regression models were developed with cost of equity as a dependent variable and accounting choice, level of disclosure as an independent variable along with selected control variables. Cost of equity was measured using Edward-Bell-Ohlson (EBO) valuation model, to measure accounting choice Modified-Jones-Model (MJM) was used and level of disclosure was measured using a disclosure index essentially drawn from Botosan study. Results indicated a negative association between the implied cost of equity and conservative accounting choice and also between level of disclosure and cost of equity.

Keywords: aggressive accounting choice, conservative accounting choice, disclosure, implied cost of equity

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Authors: Tayyab Hassan, Talha Rehman, Qasim Abdul Aziz, Ahmad Salman

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The constant monitoring of blood glucose level is necessary for maintaining health of patients and to alert medical specialists to take preemptive measures before the onset of any complication as a result of diabetes. The current clinical monitoring of blood glucose uses invasive methods repeatedly which are uncomfortable and may result in infections in diabetic patients. Several attempts have been made to develop non-invasive techniques for blood glucose measurement. In this regard, the existing methods are not reliable and are less accurate. Other approaches claiming high accuracy have not been tested on extended dataset, and thus, results are not statistically significant. It is a well-known fact that acetone concentration in breath has a direct relation with blood glucose level. In this paper, we have developed the first of its kind, reliable and high accuracy breath analyzer for non-invasive blood glucose measurement. The acetone concentration in breath was measured using MQ 138 sensor in the samples collected from local hospitals in Pakistan involving one hundred patients. The blood glucose levels of these patients are determined using conventional invasive clinical method. We propose a linear regression classifier that is trained to map breath acetone level to the collected blood glucose level achieving high accuracy.

Keywords: blood glucose level, breath acetone concentration, diabetes, linear regression

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Authors: Payal Maheshwari, Bansari Shah

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The research aimed to study the level of emotional intelligence (EI) and organizational role stress (ORS) of fire-fighters and the relationship between the two variables. Hundred and twenty fire-fighters were selected from different fire stations of Mumbai by purposive sampling. The firefighters who had the basic training, a minimum experience of 2 years and had been on the field during a crisis situation were selected for the study. The firefighters selected ranged from 23-58 years of age, and the number of years of experience ranged from 2 to 33 years. The findings of the study revealed that majority of the firefighters perceived themselves to be at an above average (57) and high (58) level of EI (M=429.35, SD=38.712). Domain-wise analysis disclosed that compared to self-awareness (92) and relationship management (93), more number of participants perceived themselves in the high category in the domains of self-management (108) and social management (106). Further, examination of the subdomain scores conveyed that a large number of participants rated themselves in the average level of these skills of accurate self-assessment (50), emotional self-control (50), adaptability (56) initiative (41), influence (66), change catalyst (53), and conflict management (50). With relation to the stress variable, it was found that almost half the number of the participants (59) rated themselves as having an average level of stress (M=137.44, SD=28.800). In most of the domains, majority of the participants perceived themselves as having an average level of stress, while in the domain of role isolation, self-role distance, and role ambiguity, majority of the firefighters rated themselves as having a low level of stress. A strong negative correlation (r=-.360**, p=.000) was found between EI and ORS. This study is a contribution to the literature and has implications for fire-fighters at the personal level, for the policymakers, and the fire department.

Keywords: emotional intelligence, organizational role stress, firefighters, relationship

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Authors: Brenagh E. Schlingermann, Clare Lodge, Paula Rankin

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Background: Gaelic football, hurling and camogie are highly popular field games in Ireland. Research into the epidemiology of injury in Gaelic games revealed that approximately three quarters of the injuries in the games occur in the lower extremity. These injuries can have player, team and institutional impacts due to multiple factors including financial burden and time loss from competition. Research has shown it is possible to record injury data consistently with the GAA through a closed online recording system known as the GAA injury surveillance database. It has been established that determining the incidence of injury is the first step of injury prevention. The goals of this study were to create a dynamic GAA15 injury prevention programme which addressed five key components/goals; avoid positions associated with a high risk of injury, enhance flexibility, enhance strength, optimize plyometrics and address sports specific agilities. These key components are internationally recognized through the Prevent Injury, Enhance performance (PEP) programme which has proven reductions in ACL injuries by 74%. In national Gaelic games the programme is known as the GAA15 which has been devised from the principles of the PEP. No such injury prevention strategies have been published on this cohort in Gaelic games to date. This study will investigate the effects of the GAA15 on injury incidence and neuromuscular function in Gaelic games. Methods: A total of 154 players (mean age 20.32 ± 2.84) were recruited from the GAA teams within the Institute of Technology Carlow (ITC). Preseason and post season testing involved two objective screening tests; Y balance test and Three Hop Test. Practical workshops, with ongoing liaison, were provided to the coaches on the implementation of the GAA15. The programme was performed before every training session and game and the existing GAA injury surveillance database was accessed to monitor player’s injuries by the college sports rehabilitation athletic therapist. Retrospective analysis of the ITC clinic records were performed in conjunction with the database analysis as a means of tracking injuries that may have been missed. The effects of the programme were analysed by comparing the intervention groups Y balance and three hop test scores to an age/gender matched control group. Results: Year 1 results revealed significant increases in neuromuscular function as a result of the GAA15. Y Balance test scores for the intervention group increased in both the posterolateral (p=.005 and p=.001) and posteromedial reach directions (p= .001 and p=.001). A decrease in performance was determined for the three hop test (p=.039). Overall twenty-five injuries were reported during the season resulting in an injury rate of 3.00 injuries/1000hrs of participation; 1.25 injuries/1000hrs training and 4.25 injuries/1000hrs match play. Non-contact injuries accounted for 40% of the injuries sustained. Year 2 results are pending and expected April 2016. Conclusion: It is envisaged that implementation of the GAA15 will continue to reduce the risk of injury and improve neuromuscular function in collegiate Gaelic games athletes.

Keywords: GAA15, Gaelic games, injury prevention, neuromuscular training

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Authors: Nina Miklavčič, Urška Kugovnik, Natalia Galkina, Primož Ribarič, Rudi Vončina

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Today, the need for weather predictions is deeply rooted in the everyday life of people as well as it is in industry. The forecasts influence final decision-making processes in multiple areas, from agriculture and prevention of natural disasters to air traffic regulations and solutions on a national level for health, security, and economic problems. Namely, in Slovenia, alongside other existing forms of application, weather forecasts are adopted for the prognosis of electrical current transmission through powerlines. Meteorological parameters are one of the key factors which need to be considered in estimations of the reliable supply of electrical energy to consumers. And like for any other measured value, the knowledge about measurement uncertainty is also critical for the secure and reliable supply of energy. The estimation of measurement uncertainty grants us a more accurate interpretation of data, a better quality of the end results, and even a possibility of improvement of weather forecast models. In the article, we focused on the estimation of measurement uncertainty of the diagnostic microscale meteorological model CALMET. For the purposes of our research, we used a network of meteorological stations spread in the area of our interest, which enables a side-by-side comparison of measured meteorological values with the values calculated with the help of CALMET and the measurement uncertainty estimation as a final result.

Keywords: uncertancy, meteorological model, meteorological measurment, CALMET

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Authors: Minho Kwon, Jeonghee Lim, Yeongseok Jeong, Donghoon Shin, Kiyoung Kim

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Recently, global warming phenomenon has led to natural disasters caused by global environmental changes, and due to abnormal weather events, the frequency and intensity of heavy rain storm typhoons are increasing. Therefore, it is imperative to prepare for future heavy rain storms and typhoons. This study selects arbitrary target bridges and performs numerical analysis to evaluate the safety of bridge piers in the event that the water level changes. The numerical model is based on two-dimensional surface elements. Actual reinforced concrete was simulated by modeling concrete to include reinforcements, and a contact boundary model was applied between the ground and the concrete. The water level applied to the piers was considered at 18 levels between 7.5 m and 16.1 m. The elastic modulus, compressive strength, tensile strength, and yield strength of the reinforced concrete were calculated using 250 random combinations and numerical analysis was carried out for each water level. In the results of analysis, the bridge exceeded the stated limit at 15.0 m. At the maximum water level of 16.1m, the concrete’s failure rate was 35.2%, but the probability that the reinforcement would fail was 61.2%.

Keywords: Monte-Carlo method, pier, water level change, limit state

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Authors: Ali Hesari, Arezoo Esmaeeli

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Regarding to dramatic changes of fertility and higher order births during recent decades in Iran, access to knowledge about affecting factors on different birth orders has crucial importance. In this study, According to hierarchical structure of many of social sciences data and the effect of variables of different levels of social phenomena that determine different birth orders in 365 days ending to 1390 census have been explored by multilevel approach. In this paper, 2% individual row data for 1390 census is analyzed by HLM software. Three different hierarchical linear regression models are estimated for data analysis of the first and second, third, fourth and more birth order. Research results displays different outcomes for three models. Individual level variables entered in equation are; region of residence (rural/urban), age, educational level and labor participation status and province level variable is GDP per capita. Results show that individual level variables have different effects in these three models and in second level we have different random and fixed effects in these models.

Keywords: fertility, birth order, hierarchical approach, fixe effects, random effects

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Authors: Denise Allison D. Garcia, Camille C. Garcia, Keanu Raphael Garrido, Crestita B. Tan

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Introduction: Anxiety is a common problem among pre-operative patients. Several methods or interventions are being applied in order to relieve anxiety. Laughter yoga, however, is a method that has been used to relieve anxiety but has not yet been tested to pre-operative patients. Therefore, this study determined the effectiveness of laughter yoga in reducing anxiety among pre-operative middle-aged patients scheduled for major surgery. Methods: After Ethics Review Board approval, a quasi-experimental study was conducted among 40 purposely-selected pre-operative patients in two tertiary hospitals. Anxiety level was measured prior to administration of laughter yoga using the State-Trait Anxiety Inventory with a Cronbach alpha of 0.83. After Laughter yoga, anxiety level was then measured again. Gathered data were analyzed in SPSS version 20 using paired and independent t-test and ANCOVA. Results: After analysis of the data gathered, the results showed that there was a significant decrease in the anxiety level of patients in the experimental group. From an anxiety level of 44.00, the rating went down to 36.85. Meanwhile in the control group, the anxiety level at the pretest at 41.25 went up to 42.50. Laughter yoga was an effective non-pharmacologic intervention for reducing anxiety of pre-operative patients. Conclusion: It is therefore concluded that laughter yoga causes a significant decrease in the anxiety level of patients.

Keywords: anxiety, laughter yoga, non-pharmacologic, pre-operative

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Authors: Sanja Bracun, Nikolina Kasunic

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After graduation, the student population of applied sciences will become the population of employees on IT experts’ positions or "just" business users of certain IT technologies for which the level of awareness of existing cybersecurity risks is extremely important. This research results define the current cybersecurity awareness level of students at Zagreb University of Applied Sciences (TVZ), what can be useful not only for teaching staff to form a curriculum related to cybersecurity more accurately but also to employers to know what to expect from their future employees regarding cybersecurity awareness level.

Keywords: student population cybersecurity awareness, cybersecurity awareness, cybersecurity, applied sciences students

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Authors: Nefrijanti Sutikno

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This paper highlights puberty and sexuality on children with special needs (SNC) in which they are very vulnerable to child sexual abuse (CSA). By providing sufficient knowledge and skill to teachers, they can synergise with parents to better anticipate, prevent and reduce the possibility of CSA and when it has already happened, together they are able to provide proper support and assistance to the victims of CSA.

Keywords: Special Needs Children (SNC), puberty, sexuality, child sexual abuse (CSA), prevention of CSA, anticipation of CSA

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Authors: Julius Denafas, Irina Kliopova, Gintaras Denafas

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Three opportunities for implementation of industrial ecology principles in the real industrial production of c-Si solar cells and modules are presented in this study. It includes: material flow dematerialisation, product modification and industrial symbiosis. Firstly, it is shown how the collaboration between R&D institutes and industry helps to achieve significant reduction of material consumption by a) refuse from phosphor silicate glass cleaning process and b) shortening of silicon nitride coating production step. Secondly, it was shown how the modification of solar module design can reduce the CO2 footprint for this product and enhance waste prevention. It was achieved by implementing a frameless glass/glass solar module design instead of glass/backsheet with aluminium frame. Such a design change is possible without purchasing new equipment and without loss of main product properties like efficiency, rigidity and longevity. Thirdly, industrial symbiosis in the solar cell production is possible in such case when manufacturing waste (silicon wafer and solar cell breakage) also used solar modules are collected, sorted and supplied as raw-materials to other companies involved in the production chain of c-Si solar cells. The obtained results showed that solar cells produced from recycled silicon can have a comparable electrical parameters like produced from standard, commercial silicon wafers. The above mentioned work was performed at solar cell producer Soli Tek R&D in the frame of H2020 projects CABRISS and Eco-Solar.

Keywords: manufacturing, process optimisation, recycling, solar cells, solar modules, waste prevention

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Authors: Fadi Al Khatib, Raouf Mbarki, Malek Adouni

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In various sport and recreational activities, the patellofemoral joint undergoes large forces and moments while accommodating the significant knee joint movement. In doing so, this joint is commonly the source of anterior knee pain related to instability in normal patellar tracking and excessive pressure syndrome. One well-observed explanation of the instability of the normal patellar tracking is the patellofemoral ligaments and patellar tendon damage. Improved knowledge of the damage mechanism mediating ligaments and tendon injuries can be a great help not only in rehabilitation and prevention procedures but also in the design of better reconstruction systems in the management of knee joint disorders. This damage mechanism, specifically due to excessive mechanical loading, has been linked to the micro level of the fibred structure precisely to the tropocollagen molecules and their connection density. We argue defining a clear frame starting from the bottom (micro level) to up (macro level) in the hierarchies of the soft tissue may elucidate the essential underpinning on the state of the ligaments damage. To do so, in this study a multiscale fibril reinforced hyper elastoplastic Finite Element model that accounts for the synergy between molecular and continuum syntheses was developed to determine the short-term stresses/strains patellofemoral ligaments and tendon response. The plasticity of the proposed model is associated only with the uniaxial deformation of the collagen fibril. The yield strength of the fibril is a function of the cross-link density between tropocollagen molecules, defined here by a density function. This function obtained through a Coarse-graining procedure linking nanoscale collagen features and the tissue level materials properties using molecular dynamics simulations. The hierarchies of the soft tissues were implemented using the rule of mixtures. Thereafter, the model was calibrated using a statistical calibration procedure. The model then implemented into a real structure of patellofemoral ligaments and patellar tendon (OpenKnee) and simulated under realistic loading conditions. With the calibrated material parameters the calculated axial stress lies well with the experimental measurement with a coefficient of determination (R2) equal to 0.91 and 0.92 for the patellofemoral ligaments and the patellar tendon respectively. The ‘best’ prediction of the yielding strength and strain as compared with the reported experimental data yielded when the cross-link density between the tropocollagen molecule of the fibril equal to 5.5 ± 0.5 (patellofemoral ligaments) and 12 (patellar tendon). Damage initiation of the patellofemoral ligaments was located at the femoral insertions while the damage of the patellar tendon happened in the middle of the structure. These predicted finding showed a meaningful correlation between the cross-link density of the tropocollagen molecules and the stiffness of the connective tissues of the extensor mechanism. Also, damage initiation and propagation were documented with this model, which were in satisfactory agreement with earlier observation. To the best of our knowledge, this is the first attempt to model ligaments from the bottom up, predicted depending to the tropocollagen cross-link density. This approach appears more meaningful towards a realistic simulation of a damaging process or repair attempt compared with certain published studies.

Keywords: tropocollagen, multiscale model, fibrils, knee ligaments

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Authors: E. M. Vieira, C. S. Vieira, L. P. Bonifácio, L. M. de Oliveira Ciabati, A. C. A. Franzon, F. S. Zaratini, J. A. C. Sanchez, M. S. Andrade, J. P. Dias de Souza

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The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20^th week of pregnancy up to 12^th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12^th and 24^th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.

Keywords: cellphone, health technology, prenatal care, prevention

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Authors: Malinda Sabrina, F. Andree Yohanes, Khoerul Anwar

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There are many sources that cause noise in a car, one of them is noise from radiator cooling fan. This part is used to control engine temperature by ensuring adequate airflow through radiator. Radiator cooling fan noise is a very important matter especially for vehicle manufacturers. This can affect brand image of the car and their customer satisfaction. Therefore, some experiments to measure noise level of the fan are required. Sound pressure level measurements for two axial fans with different diameter have been investigated in a hemi-anechoic chamber based on standard JIS-B8346, focusing on aerodynamic noise. Both fans have the same profile and shape with diameter respectively 43 cm and 49 cm. The measurement was performed in hemi-anechoic chamber in order to obtain a background noise at measuring point as low as possible. Noise characterizations of these radiator cooling fans were measured in five different rotating speed and the results were compared. The measurement result shows that the sound pressure level increases with increasing rotational speed of the fan. In comparison with a smaller diameter, it is shown that fan with larger diameter produces higher noise level at the same rotational speed.

Keywords: aerodynamics noise, hemi-anechoic chamber, radiator cooling fan, sound pressure level

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Authors: N. R. N. Idris, S. Baharom

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A meta-analysis may be performed using aggregate data (AD) or an individual patient data (IPD). In practice, studies may be available at both IPD and AD level. In this situation, both the IPD and AD should be utilised in order to maximize the available information. Statistical advantages of combining the studies from different level have not been fully explored. This study aims to quantify the statistical benefits of including available IPD when conducting a conventional summary-level meta-analysis. Simulated meta-analysis were used to assess the influence of the levels of data on overall meta-analysis estimates based on IPD-only, AD-only and the combination of IPD and AD (mixed data, MD), under different study scenario. The percentage relative bias (PRB), root mean-square-error (RMSE) and coverage probability were used to assess the efficiency of the overall estimates. The results demonstrate that available IPD should always be included in a conventional meta-analysis using summary level data as they would significantly increased the accuracy of the estimates. On the other hand, if more than 80% of the available data are at IPD level, including the AD does not provide significant differences in terms of accuracy of the estimates. Additionally, combining the IPD and AD has moderating effects on the biasness of the estimates of the treatment effects as the IPD tends to overestimate the treatment effects, while the AD has the tendency to produce underestimated effect estimates. These results may provide some guide in deciding if significant benefit is gained by pooling the two levels of data when conducting meta-analysis.

Keywords: aggregate data, combined-level data, individual patient data, meta-analysis

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Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin

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Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.

Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation

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Authors: Samawi Zepure, Beck Christine, Gallagher Peg

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This community immersion employs the NLN Excellence Model which challenges nursing programs to create student-centered, interactive, and innovative experiences to prepare students for roles in providing high quality care, effective teaching, and leadership in the delivery of nursing services to individuals, families, and communities (NLN, 2006). Senior nursing students collaborate with ethnically and linguistically diverse participants at community-based sites and develop leadership roles of coordination of care linkage within the larger healthcare system, adherence, and self-care management. The immersion encourages students to develop competencies of the NLN Nursing Education Competencies Model (NLN, 2012), proposed to address fast changes in health care delivery, which include values of caring, diversity, and holism; and integrating concepts of context and environment, relationship, and teamwork. Students engage in critical thinking and leadership as they: 1) assess health/illness beliefs, values, attitudes, and practices, explore community resources, interview key informants, and collaborate with community participants to identify learning goals, 2) develop and implement appropriate holistic health promotion and disease prevention teaching interventions promoting continuity, sustainability, and innovation, 3) evaluate interventions through participant feedback and focus groups and, 4) reflect on the immersion experience and future professional role as advocate and citizen.

Keywords: quality of care, health of communities, students as leaders, health promotion

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Authors: Ingrid Van Der Heijden, Naeemah Abrahams, Jane Harries

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Background: Commonly, womanhood is defined as the qualities considered to be natural to or characteristic of a woman. However, womanhood is not a static concept; it is contextual and negotiable. For women with disabilities, gender roles or ‘qualities’ of womanhood are often overstated or contradicted because of assumptions of weakness, passivity, asexuality and infertility. Currently, little is known about how disability stigma intersects with notions of womanhood to make women with disabilities vulnerable to violence, or how women navigate this intersection to prevent or protect themselves from violence. Objective: To describe how the stigmatized constructions of womanhood and disability promote women with physical disabilities’ exposure to or protection from violence. Methods: Qualitative data for this paper comes from a doctoral study involving women with disabilities living in Cape Town, South Africa. It presents data from repeat in-depth interviews with 30 women with a range of physical impairments. Women attending protective workshops, rehabilitative centers and residential care facilities for people living with disabilities were invited to participate. Consent procedures and interviews were conducted by the first author (who is herself a woman living with a physical disability), and a female research assistant/translator who is a qualified occupational therapist. Reasonable accommodation is central to the methodology and the study as a whole. Findings: Descriptive and thematic analyses reveal how stigma and local constructions around womanhood, as well as women’s self-image and physical limitations, promotes women’s exposure to psychological, physical and sexual violence. It reveals how disabled women feel they are presumed incapable of living up to expectations of a ‘proper’ woman. This plays out as psychological violence, with women reporting that they feel ‘devalued,' ‘rejected’ and deprived of lasting intimate relationships. Furthermore, forms of psychological violence perpetuate physical and sexual violence. Women also discuss using strategies to prevent violence; by refusing to date, avoiding certain places or avoiding isolation, creating awareness, hiding their physical impairments, and exaggerating their ‘femininity.' Implications: Service providers need to be made aware of women’s violence experiences, and provide a range of accessible psychological and mental health services to women living with disabilities, as well as raising awareness around disability, and violence prevention, among caregivers, men, and women. Violence awareness and prevention interventions need to involve disability experts, researchers and people with disabilities.

Keywords: disability, gender, stigma, violence awareness and prevention interventions

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Authors: Umut Erksan Senalp

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The aim of this study is to examine the link between firm level productivity heterogeneity and firm’s decision to export. Thus, we test the self selection hypothesis which suggests only more productive firms self select themselves to export markets. We analyze UK manufacturing sector by using firm-level data for the period 2003-2011. Although our preliminary results suggest that exporters outperform non-exporters when we pool all manufacturing industries, when we examine each industry individually, we find that self-selection hypothesis does not hold for each industries.

Keywords: total factor productivity, firm heterogeneity, international trade, decision to export

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Authors: Alexandre D. Ferraz, Dario H. Alliprandini, Mauro Sampaio

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Companies and other institutions are constantly seeking better organizational performance and greater competitiveness. In order to fulfill this purpose, there are many tools, methodologies and models for increasing performance. However, the Lean Management approach seems to be the most effective in terms of achieving a significant improvement in productivity relatively quickly. Although Lean tools are relatively easy to understand and implement in different contexts, many organizations are not able to transform themselves into 'Lean companies'. Most of the efforts in its implementation have shown single benefits, failing to achieve the desired impact on the performance of the overall enterprise system. There is also a growing perception of the importance of management in Lean transformation, but few studies have empirically investigated and described the 'Lean Management'. In order to understand more clearly the ideas that guide Lean Management and its influence on the maturity level of the production system, the objective of this research is analyze the relationship between the Lean Management principles and the Lean maturity level in the organizations. The research also analyzes the principles of Lean Management and its relationship with the 'Lean culture' and the results obtained. The research was developed using the case study methodology. Three manufacturing units of a German multinational company from industrial automation segment, located in different countries were studied, in order to have a better comparison between the practices and the level of maturity in the implementation. The primary source of information was the application of a research questionnaire based on the theoretical review. The research showed that higher the level of Lean Management principles, higher are the Lean maturity level, the Lean culture level, and the level of Lean results obtained in the organization. The research also showed that factors such as time for application of Lean concepts and company size were not determinant for the level of Lean Management principles and, consequently, for the level of Lean maturity in the organization. The characteristics of the production system showed much more influence in different evaluated aspects. The present research also left recommendations for the managers of the plants analyzed and suggestions for future research.

Keywords: lean management, lean principles, lean maturity level, lean manufacturing

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Authors: Atanu K Samanta, Asim Ali Khan

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Due to the acquisition of huge amounts of brain tumor magnetic resonance images (MRI) in clinics, it is very difficult for radiologists to manually interpret and segment these images within a reasonable span of time. Computer-aided diagnosis (CAD) systems can enhance the diagnostic capabilities of radiologists and reduce the time required for accurate diagnosis. An intelligent computer-aided technique for automatic detection of a brain tumor through MRI is presented in this paper. The technique uses the following computational methods; the Level Set for segmentation of a brain tumor from other brain parts, extraction of features from this segmented tumor portion using gray level co-occurrence Matrix (GLCM), and the Artificial Neural Network (ANN) to classify brain tumor images according to their respective types. The entire work is carried out on 50 images having five types of brain tumor. The overall classification accuracy using this method is found to be 98% which is significantly good.

Keywords: brain tumor, computer-aided diagnostic (CAD) system, gray-level co-occurrence matrix (GLCM), tumor segmentation, level set method

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