Search results for: Greek public hospital sector
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10239

Search results for: Greek public hospital sector

4839 Enhancing Disaster Response Capabilities in Asia-Pacific: An Explorative Study Applied to Decision Support Tools for Logistics Network Design

Authors: Giuseppe Timperio, Robert de Souza

Abstract:

Logistics operations in the context of disaster response are characterized by a high degree of complexity due to the combined effect of a large number of stakeholders involved, time pressure, uncertainties at various levels, massive deployment of goods and personnel, and gigantic financial flow to be managed. It also involves several autonomous parties such as government agencies, militaries, NGOs, UN agencies, private sector to name few, to have a highly collaborative approach especially in the critical phase of the immediate response. This is particularly true in the context of L3 emergencies that are the most severe, large-scale humanitarian crises. Decision-making processes in disaster management are thus extremely difficult due to the presence of multiple decision-makers involved, and the complexity of the tasks being tackled. Hence, in this paper, we look at applying ICT based solutions to enable a speedy and effective decision making in the golden window of humanitarian operations. A high-level view of ICT based solutions in the context of logistics operations for humanitarian response in Southeast Asia is presented, and their viability in a real-life case about logistics network design is explored.

Keywords: decision support, disaster preparedness, humanitarian logistics, network design

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4838 Synthetic Method of Contextual Knowledge Extraction

Authors: Olga Kononova, Sergey Lyapin

Abstract:

Global information society requirements are transparency and reliability of data, as well as ability to manage information resources independently; particularly to search, to analyze, to evaluate information, thereby obtaining new expertise. Moreover, it is satisfying the society information needs that increases the efficiency of the enterprise management and public administration. The study of structurally organized thematic and semantic contexts of different types, automatically extracted from unstructured data, is one of the important tasks for the application of information technologies in education, science, culture, governance and business. The objectives of this study are the contextual knowledge typologization, selection or creation of effective tools for extracting and analyzing contextual knowledge. Explication of various kinds and forms of the contextual knowledge involves the development and use full-text search information systems. For the implementation purposes, the authors use an e-library 'Humanitariana' services such as the contextual search, different types of queries (paragraph-oriented query, frequency-ranked query), automatic extraction of knowledge from the scientific texts. The multifunctional e-library «Humanitariana» is realized in the Internet-architecture in WWS-configuration (Web-browser / Web-server / SQL-server). Advantage of use 'Humanitariana' is in the possibility of combining the resources of several organizations. Scholars and research groups may work in a local network mode and in distributed IT environments with ability to appeal to resources of any participating organizations servers. Paper discusses some specific cases of the contextual knowledge explication with the use of the e-library services and focuses on possibilities of new types of the contextual knowledge. Experimental research base are science texts about 'e-government' and 'computer games'. An analysis of the subject-themed texts trends allowed to propose the content analysis methodology, that combines a full-text search with automatic construction of 'terminogramma' and expert analysis of the selected contexts. 'Terminogramma' is made out as a table that contains a column with a frequency-ranked list of words (nouns), as well as columns with an indication of the absolute frequency (number) and the relative frequency of occurrence of the word (in %% ppm). The analysis of 'e-government' materials showed, that the state takes a dominant position in the processes of the electronic interaction between the authorities and society in modern Russia. The media credited the main role in these processes to the government, which provided public services through specialized portals. Factor analysis revealed two factors statistically describing the used terms: human interaction (the user) and the state (government, processes organizer); interaction management (public officer, processes performer) and technology (infrastructure). Isolation of these factors will lead to changes in the model of electronic interaction between government and society. In this study, the dominant social problems and the prevalence of different categories of subjects of computer gaming in science papers from 2005 to 2015 were identified. Therefore, there is an evident identification of several types of contextual knowledge: micro context; macro context; dynamic context; thematic collection of queries (interactive contextual knowledge expanding a composition of e-library information resources); multimodal context (functional integration of iconographic and full-text resources through hybrid quasi-semantic algorithm of search). Further studies can be pursued both in terms of expanding the resource base on which they are held, and in terms of the development of appropriate tools.

Keywords: contextual knowledge, contextual search, e-library services, frequency-ranked query, paragraph-oriented query, technologies of the contextual knowledge extraction

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4837 Characterization of the Microbial Induced Carbonate Precipitation Technique as a Biological Cementing Agent for Sand Deposits

Authors: Sameh Abu El-Soud, Zahra Zayed, Safwan Khedr, Adel M. Belal

Abstract:

The population increase in Egypt is urging for horizontal land development which became a demand to allow the benefit of different natural resources and expand from the narrow Nile valley. However, this development is facing challenges preventing land development and agriculture development. Desertification and moving sand dunes in the west sector of Egypt are considered the major obstacle that is blocking the ideal land use and development. In the proposed research, the sandy soil is treated biologically using Bacillus pasteurii bacteria as these bacteria have the ability to bond the sand partials to change its state of loose sand to cemented sand, which reduces the moving ability of the sand dunes. The procedure of implementing the Microbial Induced Carbonate Precipitation Technique (MICP) technique is examined, and the different factors affecting on this process such as the medium of bacteria sample preparation, the optical density (OD600), the reactant concentration, injection rates and intervals are highlighted. Based on the findings of the MICP treatment for sandy soil, conclusions and future recommendations are reached.

Keywords: soil stabilization, biological treatment, microbial induced carbonate precipitation (MICP), sand cementation

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4836 Comparing the Effect of Virtual Reality and Sound on Landscape Perception

Authors: Mark Lindquist

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This paper presents preliminary results of exploratory empirical research investigating the effect of viewing 3D landscape visualizations in virtual reality compared to a computer monitor, and how sound impacts perception. Five landscape types were paired with three sound conditions (no sound, generic sound, realistic sound). Perceived realism, preference, recreational value, and biodiversity were evaluated in a controlled laboratory environment. Results indicate that sound has a larger perceptual impact than display mode regardless of sound source across all perceptual measures. The results are considered to assess how sound can impact landscape preference and spatiotemporal understanding. The paper concludes with a discussion of the impact on designers, planners, and the public and targets future research endeavors in this area.

Keywords: landscape experience, perception, soundscape, virtual reality

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4835 Energy Analysis of Sugarcane Production: A Case Study in Metehara Sugar Factory in Ethiopia

Authors: Wasihun Girma Hailemariam

Abstract:

Energy is one of the key elements required for every agricultural activity, especially for large scale agricultural production such as sugarcane cultivation which mostly is used to produce sugar and bioethanol from sugarcane. In such kinds of resource (energy) intensive activities, energy analysis of the production system and looking for other alternatives which can reduce energy inputs of the sugarcane production process are steps forward for resource management. The purpose of this study was to determine input energy (direct and indirect) per hectare of sugarcane production sector of Metehara sugar factory in Ethiopia. Total energy consumption of the production system was 61,642 MJ/ha-yr. This total input energy is a cumulative value of different inputs (direct and indirect inputs) in the production system. The contribution of these different inputs is discussed and a scenario of substituting the most influential input by other alternative input which can replace the original input in its nutrient content was discussed. In this study the most influential input for increased energy consumption was application of organic fertilizer which accounted for 50 % of the total energy consumption. Filter cake which is a residue from the sugar production in the factory was used to substitute the organic fertilizer and the reduction in the energy consumption of the sugarcane production was discussed

Keywords: energy analysis, organic fertilizer, resource management, sugarcane

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4834 The Global Children’s Challenge Program: Pedometer Step Count in an Australian School

Authors: D. Hilton

Abstract:

The importance and significance of this research is based upon the fundamental knowledge reported in the scientific literature that physical activity is inversely associated with obesity. In addition, it is recognized there is a global epidemic of sedentariness while at the same time it is known that morbidity and mortality are associated with physical inactivity and as a result of overweight or obesity. Hence this small study in school students is an important area of research in our community. An application submitted in 2005 for the inaugural Public Health Education Research Trust [PHERT] Post Graduate Research Scholarship scheme organized by the Public Health Association of Australia [PHAA] was awarded 3rd place within Australia. The author and title was: D. Hilton, Methods to increase physical activity in school aged children [literature review, a trial using pedometers and a policy paper]. Third place is a good result, however this did not secure funding for the project, as only first place received $5000 funding. Some years later within Australia, a program commenced called the Global Children's Challenge [GCC]. Given details of the 2005 award above were included an application submission prepared for Parkhill Primary School [PPS] which is located in Victoria, Australia was successful. As a result, an excited combined grade 3/ 4 class at the school [27 students] in 2012 became recipients of these free pedometers. Ambassadors for the program were Mrs Catherine Freeman [OAM], Olympic Gold Medalist – Sydney 2000 [400 meters], while another ambassador was Mr Colin Jackson [CBE] who is a Welsh former sprint and hurdling athlete. In terms of PPS and other schools involved in 2012, website details show that the event started on 19th Sep 2012 and students were to wear the pedometer every day for 50 days [at home and at school] aiming for the recommended 15,000 steps/day recording steps taken in a booklet provided. After the finish, an analysis of the average step count for this school showed that the average steps taken / day was 14, 003 [however only a small percentage of students returned the booklets and units] as unfortunately the dates for the program coincided with school holidays so some students either forgot or misplaced the units / booklets. Unfortunately funding for this program ceased in 2013, however the lasting impact of the trial on student’s knowledge and awareness remains and in fact becomes a good grounding for students in how to monitor basic daily physical activity using a method that is easy, fun, low cost and readily accessible.

Keywords: walking, physical activity, exercise, Australian school

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4833 Intelligent Crowd Management Systems in Trains

Authors: Sai S. Hari, Shriram Ramanujam, Unnati Trivedi

Abstract:

The advent of mass transit systems like rail, metro, maglev, and various other rail based transport has pacified the requirement of public transport for the masses to a great extent. However, the abatement of the demand does not necessarily mean it is managed efficiently, eloquently or in an encapsulating manner. The primary problem identified that the one this paper seeks to solve is the dipsomaniac like manner in which the compartments are occupied. This problem is solved by using a comparison of an empty train and an occupied one. The pixel data of an occupied train is compared to the pixel data of an empty train. This is done using canny edge detection technique. After the comparison it intimates the passengers at the consecutive stops which compartments are not occupied or have low occupancy. Thus, redirecting them and preventing overcrowding.

Keywords: canny edge detection, comparison, encapsulation, redirection

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4832 Unequal Traveling: How School District System and School District Housing Characteristics Shape the Duration of Families Commuting

Authors: Geyang Xia

Abstract:

In many countries, governments have responded to the growing demand for educational resources through school district systems, and there is substantial evidence that school district systems have been effective in promoting inter-district and inter-school equity in educational resources. However, the scarcity of quality educational resources has brought about varying levels of education among different school districts, making it a common choice for many parents to buy a house in the school district where a quality school is located, and they are even willing to bear huge commuting costs for this purpose. Moreover, this is evidenced by the fact that parents of families in school districts with quality education resources have longer average commute lengths and longer average commute distances than parents in average school districts. This "unequal traveling" under the influence of the school district system is more common in school districts at the primary level of education. This further reinforces the differential hierarchy of educational resources and raises issues of inequitable educational public services, education-led residential segregation, and gentrification of school district housing. Against this background, this paper takes Nanjing, a famous educational city in China, as a case study and selects the school districts where the top 10 public elementary schools are located. The study first identifies the spatio-temporal behavioral trajectory dataset of these high-quality school district households by using spatial vector data, decrypted cell phone signaling data, and census data. Then, by constructing a "house-school-work (HSW)" commuting pattern of the population in the school district where the high-quality educational resources are located, and based on the classification of the HSW commuting pattern of the population, school districts with long employment hours were identified. Ultimately, the mechanisms and patterns inherent in this unequal commuting are analyzed in terms of six aspects, including the centrality of school district location, functional diversity, and accessibility. The results reveal that the "unequal commuting" of Nanjing's high-quality school districts under the influence of the school district system occurs mainly in the peripheral areas of the city, and the schools matched with these high-quality school districts are mostly branches of prestigious schools in the built-up areas of the city's core. At the same time, the centrality of school district location and the diversity of functions are the most important influencing factors of unequal commuting in high-quality school districts. Based on the research results, this paper proposes strategies to optimize the spatial layout of high-quality educational resources and corresponding transportation policy measures.

Keywords: school-district system, high quality school district, commuting pattern, unequal traveling

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4831 The Impact of Organizational Culture on Advancing Women to Leadership Roles

Authors: Huda Zakaria

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The concept of the glass ceiling persists as a barrier to women's advancement in leadership roles, shaped significantly by organizational culture and climate. This study examines the impact of organizational culture on advancing women to top leadership roles in the Egyptian banking sector. The research explores how varying organizational cultures and climates either facilitate or hinder women's progress in breaking through the glass ceiling. Data suggests that women are underrepresented in senior management positions globally, including in Egypt, indicating a barrier to their advancement. Organizational norms often align more with masculine traits, creating challenges for women in leadership. Stereotypes and biases affect how women are treated, leading to limited advancement opportunities and a lack of sponsors advocating for their skills. Female managers also exhibit lower levels of career confidence compared to male counterparts. To address these issues, organizations must tackle cultural biases and provide equal opportunities to promote genuine gender diversity and empower women in leadership roles. Understanding the impact of organizational culture is crucial for creating inclusive workplaces that foster gender equality and provide equal opportunities for women to succeed in leadership roles.

Keywords: glass ceiling, leadership, banking, bias

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4830 Bi-objective Network Optimization in Disaster Relief Logistics

Authors: Katharina Eberhardt, Florian Klaus Kaiser, Frank Schultmann

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Last-mile distribution is one of the most critical parts of a disaster relief operation. Various uncertainties, such as infrastructure conditions, resource availability, and fluctuating beneficiary demand, render last-mile distribution challenging in disaster relief operations. The need to balance critical performance criteria like response time, meeting demand and cost-effectiveness further complicates the task. The occurrence of disasters cannot be controlled, and the magnitude is often challenging to assess. In summary, these uncertainties create a need for additional flexibility, agility, and preparedness in logistics operations. As a result, strategic planning and efficient network design are critical for an effective and efficient response. Furthermore, the increasing frequency of disasters and the rising cost of logistical operations amplify the need to provide robust and resilient solutions in this area. Therefore, we formulate a scenario-based bi-objective optimization model that integrates pre-positioning, allocation, and distribution of relief supplies extending the general form of a covering location problem. The proposed model aims to minimize underlying logistics costs while maximizing demand coverage. Using a set of disruption scenarios, the model allows decision-makers to identify optimal network solutions to address the risk of disruptions. We provide an empirical case study of the public authorities’ emergency food storage strategy in Germany to illustrate the potential applicability of the model and provide implications for decision-makers in a real-world setting. Also, we conduct a sensitivity analysis focusing on the impact of varying stockpile capacities, single-site outages, and limited transportation capacities on the objective value. The results show that the stockpiling strategy needs to be consistent with the optimal number of depots and inventory based on minimizing costs and maximizing demand satisfaction. The strategy has the potential for optimization, as network coverage is insufficient and relies on very high transportation and personnel capacity levels. As such, the model provides decision support for public authorities to determine an efficient stockpiling strategy and distribution network and provides recommendations for increased resilience. However, certain factors have yet to be considered in this study and should be addressed in future works, such as additional network constraints and heuristic algorithms.

Keywords: humanitarian logistics, bi-objective optimization, pre-positioning, last mile distribution, decision support, disaster relief networks

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4829 Flipped Classroom in a European Public Health Program: The Need for Students' Self-Directness

Authors: Nynke de Jong, Inge G. P. Duimel-Peeters

Abstract:

The flipped classroom as an instructional strategy and a type of blended learning that reverses the traditional learning environment by delivering instructional content, off- and online, in- and outside the classroom, has been implemented in a 4-weeks module focusing on ageing in Europe at the Maastricht University. The main aim regarding the organization of this module was implementing flipped classroom-principles in order to create meaningful learning opportunities, while educational technologies are used to deliver content outside of the classroom. Technologies used in this module were an online interactive real time lecture from England, two interactive face-to-face lectures with visual supports, one group session including role plays and team-based learning meetings. The cohort of 2015-2016, using educational technologies, was compared with the cohort of 2014-2015 on module evaluation such as organization and instructiveness of the module, who studied the same content, although conforming the problem-based educational strategy, i.e. educational base of the Maastricht University. The cohort of 2015-2016 with its specific organization, was also more profound evaluated on outcomes as (1) experienced duration of the lecture by students, (2) experienced content of the lecture, (3) experienced the extent of the interaction and (4) format of lecturing. It was important to know how students reflected on duration and content taken into account their background knowledge so far, in order to distinguish between sufficient enough regarding prior knowledge and therefore challenging or not fitting into the course. For the evaluation, a structured online questionnaire was used, whereby above mentioned topics were asked for to evaluate by scoring them on a 4-point Likert scale. At the end, there was room for narrative feedback so that interviewees could express more in detail, if they wanted, what they experienced as good or not regarding the content of the module and its organization parts. Eventually, the response rate of the evaluation was lower than expected (54%), however, due to written feedback and exam scores, we dare to state that it gives a good and reliable overview that encourages to work further on it. Probably, the response rate may be explained by the fact that resit students were included as well, and that there maybe is too much evaluation as some time points in the program. However, overall students were excited about the organization and content of the module, but the level of self-directed behavior, necessary for this kind of educational strategy, was too low. They need to be more trained in self-directness, therefore the module will be simplified in 2016-2017 with more clear and fewer topics and extra guidance (step by step procedure). More specific information regarding the used technologies will be explained at the congress, as well as the outcomes (min and max rankings, mean and standard deviation).

Keywords: blended learning, flipped classroom, public health, self-directness

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4828 The Importance and Role of Sukuk Marketing as an Islamic Bond in the Economy

Authors: Ilhan Keskin, Hasan Bulent Kantarci

Abstract:

In this study, one of the tools of Islamic financing known as “Sukuk” a non-interest bearing investment which has started to be implemented in Turkey and the world as a whole is discussed. In order to increase the vitality and efficiency of the economy, by taking lessons from the recent economic crisis new developments in the banking and investment sector are being expanded. The purpose of all investors is to obtain more revenue through the use of capital. The inability of traditional investment tools to meet the expectations of investors and the interest based financial system where one investor benefits at the expense of another there has been the need for a different, reliable and non-interest bearing financial market that is consistent with the Islamic rule. As a result an alternative and more reliable interest free financing tool “Sukuk” rental certificates covering people who are sensitive to Islamic rules, appeal to all segments, hidden remaining capital that contributes to the economy, reduce disparities in income distribution, common risk sharing system of profit and loss sharing has emerged. Today, for the structural countries by examining the state of the world market economy the applicability, enactment and future issues associated with this attractive kind of Islamic finance namely the “Sukuk” market has been explained.

Keywords: Islamic finance, islamic markets, non-interest bearing, rental certificates

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4827 A New Asset: The Role of Money in the Evolution of 20th Century Street Art

Authors: Eileen Kim

Abstract:

As socioeconomic disparities grew in New York during the 1970s, artists represented new values that came with the times. Street art, in particular, was birthed from a distinctly urban, fringe setting to ultimately become one of the most lucrative forms of art today. Examining the economic and psychological reasons behind the rise of street art, this paper delves into the development of the art market as a parallel insight into human behaviors and economic models such as supply and demand. The purpose of this study is to show the role of the increasingly divided socioeconomic classes and the rise of art collecting as an asset-building form. This study concludes that the iconography and market value of street art represented distinct values that came from a series of intertwined social matters such as racial tensions and revolutions in industrial innovation.

Keywords: art industry, cultural representation, ethnicity, markets, public property, social classes, street art

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4826 Do Formalization and Centralization Influence Self-Efficacy and Its Outcomes? A Study of Direct and Moderating Effects

Authors: Ghulam Mustafa, Richard Glavee-Geo

Abstract:

This study examined the relationship between traditional variables of organizational structure (formalization and centralization), employee work related self-efficacy and employee subjective performance. The study further explored the moderating role of formalization and centralization on the link between employee self-efficacy and job performance. Five hypotheses were tested using a sample of employees from a large public organization in Pakistan. The results indicated a significant positive relationship between employee self-efficacy and job performance. Regarding the direct effects of formalization and centralization on self-efficacy, the results showed that formalization relates positively while centralization has a negative impact on self-efficacy. However, the results revealed no empirical evidence to confirm the hypotheses that formalization and centralization strengthen or weaken the relationship between self-efficacy and job performance.

Keywords: centralization, formalization, job performance, self-efficacy

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4825 Establishment of a Nomogram Prediction Model for Postpartum Hemorrhage during Vaginal Delivery

Authors: Yinglisong, Jingge Chen, Jingxuan Chen, Yan Wang, Hui Huang, Jing Zhnag, Qianqian Zhang, Zhenzhen Zhang, Ji Zhang

Abstract:

Purpose: The study aims to establish a nomogram prediction model for postpartum hemorrhage (PPH) in vaginal delivery. Patients and Methods: Clinical data were retrospectively collected from vaginal delivery patients admitted to a hospital in Zhengzhou, China, from June 1, 2022 - October 31, 2022. Univariate and multivariate logistic regression were used to filter out independent risk factors. A nomogram model was established for PPH in vaginal delivery based on the risk factors coefficient. Bootstrapping was used for internal validation. To assess discrimination and calibration, receiver operator characteristics (ROC) and calibration curves were generated in the derivation and validation groups. Results: A total of 1340 cases of vaginal delivery were enrolled, with 81 (6.04%) having PPH. Logistic regression indicated that history of uterine surgery, induction of labor, duration of first labor, neonatal weight, WBC value (during the first stage of labor), and cervical lacerations were all independent risk factors of hemorrhage (P <0.05). The area-under-curve (AUC) of ROC curves of the derivation group and the validation group were 0.817 and 0.821, respectively, indicating good discrimination. Two calibration curves showed that nomogram prediction and practical results were highly consistent (P = 0.105, P = 0.113). Conclusion: The developed individualized risk prediction nomogram model can assist midwives in recognizing and diagnosing high-risk groups of PPH and initiating early warning to reduce PPH incidence.

Keywords: vaginal delivery, postpartum hemorrhage, risk factor, nomogram

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4824 A Review on Trends in Measurement of Port Performance

Authors: J. Racedo, J. Torres

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Globalization has led to a worldwide competition for participation in markets of goods and productive factors, with significant effects on transports requirements. The port industry has not been an exception to this event, in fact, it has received increasing attention in recent years due to its crucial role on international trade. Because of this, the measurement of port performance has become an important issue in transport policy. Port performance and port efficiency has been widely studied in the last decades, resulting in noteworthy contributions to improving the industry competitiveness. In this paper, we aim to present a review of the literature on port performance and the relation between this concept and transport policies. This study has the objective to describe the approaches that have been developed in recent years, and especially those that include the modeling of public policies. Finally, we highlight existing gaps in this field, as well as possible directions for future research.

Keywords: port performance, port efficiency, transport, policy

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4823 Information and Communication Technology in Architectural Education: The Challenges

Authors: Oluropo Stephen Ilesanmi, Oluwole Ayodele Alejo

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Architectural education, beyond training the students to become architects, impacts in them the appreciation of the responsibilities relating to public health, safety, and welfare. Architecture is no longer a personal philosophical or aesthetic pursuit by individuals, rather, it has to consider everyday needs of the people and use technology to give a liveable environment. In the present age, architectural education must have to grapple with the recent integration of technology, in particular, facilities offered by information and communication technology. Electronic technologies have moved architecture from the drawing board to cyberspace. The world is now a global village in which new information and methods are easily and quickly available to people at different poles of the globe. It is the position of this paper that in order to remain relevant in the ever-competing forces within the building industry, architectural education must show the impetus to continue to draw from technological advancements associated with the use of computers.

Keywords: architecture, education, communication, information, technology

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4822 A Retrospective Study on the Age of Onset for Type 2 Diabetes Diagnosis

Authors: Mohamed A. Hammad, Dzul Azri Mohamed Noor, Syed Azhar Syed Sulaiman, Majed Ahmed Al-Mansoub, Muhammad Qamar

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There is a progressive increase in the prevalence of early onset Type 2 diabetes mellitus. Early detection of Type 2 diabetes enhances the length and/or quality of life which might result from a reduction in the severity, frequency or prevent or delay of its long-term complications. The study aims to determine the onset age for the first diagnosis of Type 2 diabetes mellitus. A retrospective study conducted in the endocrine clinic at Hospital Pulau Pinang in Penang, Malaysia, January- December 2016. Records of 519 patients with Type 2 diabetes mellitus were screened to collect demographic data and determine the age of first-time diabetes mellitus diagnosis. Patients classified according to the age of diagnosis, gender, and ethnicity. The study included 519 patients with age (55.6±13.7) years, female 265 (51.1%) and male 254 (48.9%). The ethnicity distribution was Malay 191 (36.8%), Chinese 189 (36.4%) and Indian 139 (26.8%). The age of Type 2 diabetes diagnosis was (42±14.8) years. The female onset of diabetes mellitus was at age (41.5±13.7) years, while male (42.6±13.7) years. Distribution of diabetic onset by ethnicity was Malay at age (40.7±13.7) years, Chinese (43.2±13.7) years and Indian (42.3±13.7) years. Diabetic onset was classified by age as follow; ≤20 years’ cohort was 33 (6.4%) cases. Group >20- ≤40 years was 190 (36.6%) patients, and category >40- ≤60 years was 270 (52%) subjects. On the other hand, the group >60 years was 22 (4.2%) patients. The range of diagnosis was between 10 and 73 years old. Conclusion: Malay and female have an earlier onset of diabetes than Indian, Chinese and male. More than half of the patients had diabetes between 40 and 60 years old. Diabetes mellitus is becoming more common in younger age <40 years. The age at diagnosis of Type 2 diabetes mellitus has decreased with time.

Keywords: age of onset, diabetes diagnosis, diabetes mellitus, Malaysia, outpatients, type 2 diabetes, retrospective study

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4821 The Long-Run Impact of Financial Development on Greenhouse Gas Emissions in India: An Application of Regime Shift Based Cointegration Approach

Authors: Javaid Ahmad Dar, Mohammad Asif

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The present study investigates the long-run impact of financial development, energy consumption and economic growth on greenhouse gas emissions for India, in presence of endogenous structural breaks, over a period of 1971-2013. Autoregressive distributed lag bounds testing procedure and Hatemi-J threshold cointegration technique have been used to test the variables for cointegration. ARDL bounds test did not confirm any cointegrating relationship between the variables. The threshold cointegration test establishes the presence of long-run impact of financial development, energy use and economic growth on greenhouse gas emissions in India. The results reveal that the long-run relationship between the variables has witnessed two regime shifts, in 1978 and 2002. The empirical evidence shows that financial sector development and energy consumption in India degrade environment. Unlike previous studies, this paper finds no statistical evidence of long-run relationship between economic growth and environmental deterioration. The study also challenges the existence of environmental Kuznets curve in India.

Keywords: cointegration, financial development, global warming, greenhouse gas emissions, regime shift, unit root

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4820 Effect of Atrial Flutter on Alcoholic Cardiomyopathy

Authors: Ibrahim Ahmed, Richard Amoateng, Akhil Jain, Mohamed Ahmed

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Alcoholic cardiomyopathy (ACM) is a type of acquired cardiomyopathy caused by chronic alcohol consumption. Frequently ACM is associated with arrhythmias such as atrial flutter. Our aim was to characterize the patient demographics and investigate the effect of atrial flutter (AF) on ACM. This was a retrospective cohort study using the Nationwide Inpatient Sample database to identify admissions in adults with principal and secondary diagnoses of alcoholic cardiomyopathy and atrial flutter from 2019. Multivariate linear and logistic regression models were adjusted for age, gender, race, household income, insurance status, Elixhauser comorbidity score, hospital location, bed size, and teaching status. The primary outcome was all-cause mortality, and secondary outcomes were the length of stay (LOS) and total charge in USD. There was a total of 21,855 admissions with alcoholic cardiomyopathy, of which 1,635 had atrial flutter (AF-ACM). Compared to Non-AF-ACM cohort, AF-ACM cohort had fewer females (4.89% vs 14.54%, p<0.001), were older (58.66 vs 56.13 years, p<0.001), fewer Native Americans (0.61% vs2.67%, p<0.01), had fewer smaller (19.27% vs 22.45%, p<0.01) & medium-sized hospitals (23.24% vs28.98%, p<0.01), but more large-sized hospitals (57.49% vs 48.57%, p<0.01), more Medicare (40.37% vs 34.08%, p<0.05) and fewer Medicaid insured (23.55% vs 33.70%, p=<0.001), fewer hypertension (10.7% vs 15.01%, p<0.05), and more obesity (24.77% vs 16.35%, p<0.001). Compared to Non-AF-ACM cohort, there was no difference in AF-ACM cohort mortality rate (6.13% vs 4.20%, p=0.0998), unadjusted mortality OR 1.49 (95% CI 0.92-2.40, p=0.102), adjusted mortality OR 1.36 (95% CI 0.83-2.24, p=0.221), but there was a difference in LOS 1.23 days (95% CI 0.34-2.13, p<0.01), total charge $28,860.30 (95% CI 11,883.96-45,836.60, p<0.01). In patients admitted with ACM, the presence of AF was not associated with a higher all-cause mortality rate or odds of all-cause mortality; however, it was associated with 1.23 days increase in LOS and a $28,860.30 increase in total hospitalization charge. Native Americans, older age and obesity were risk factors for the presence of AF in ACM.

Keywords: alcoholic cardiomyopathy, atrial flutter, cardiomyopathy, arrhythmia

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4819 Estimation of Effective Radiation Dose Following Computed Tomography Urography at Aminu Kano Teaching Hospital, Kano Nigeria

Authors: Idris Garba, Aisha Rabiu Abdullahi, Mansur Yahuza, Akintade Dare

Abstract:

Background: CT urography (CTU) is efficient radiological examination for the evaluation of the urinary system disorders. However, patients are exposed to a significant radiation dose which is in a way associated with increased cancer risks. Objectives: To determine Computed Tomography Dose Index following CTU, and to evaluate organs equivalent doses. Materials and Methods: A prospective cohort study was carried at a tertiary institution located in Kano northwestern. Ethical clearance was sought and obtained from the research ethics board of the institution. Demographic, scan parameters and CT radiation dose data were obtained from patients that had CTU procedure. Effective dose, organ equivalent doses, and cancer risks were estimated using SPSS statistical software version 16 and CT dose calculator software. Result: A total of 56 patients were included in the study, consisting of 29 males and 27 females. The common indication for CTU examination was found to be renal cyst seen commonly among young adults (15-44yrs). CT radiation dose values in DLP, CTDI and effective dose for CTU were 2320 mGy cm, CTDIw 9.67 mGy and 35.04 mSv respectively. The probability of cancer risks was estimated to be 600 per a million CTU examinations. Conclusion: In this study, the radiation dose for CTU is considered significantly high, with increase in cancer risks probability. Wide radiation dose variations between patient doses suggest that optimization is not fulfilled yet. Patient radiation dose estimate should be taken into consideration when imaging protocols are established for CT urography.

Keywords: CT urography, cancer risks, effective dose, radiation exposure

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4818 Assessment of the Association between Serum Thrombospondin-1 Levels at the Time of Admission and the Severity of Neurological Deficit in Patients with Ischemic Stroke

Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares

Abstract:

Introduction: Despite improvements in stroke management, it remains the leading cause of disability worldwide. It has been suggested that enhancing brain angiogenesis after stroke will improve stroke outcome. Promoting post stroke angiogenesis requires the upregulation of angiogenic factors with a simultaneous reduction of anti-angiogenic factors. Thrombospondin-1 is the main anti-angiogenic protein in the living cells. Counterintuitively, it has been shown that animals with Thrombospondin-1 knockdown will have better stroke outcome. Data about the clinical significance of Thrombspondin-1 levels at the time of admission is still lacking. The objective of this work is to assess the association between serum Thrombospondin-1 levels measured at the time of admission and baseline neurologic severity after stroke. Patients and Methods: Blood samples were collected from patients admitted to the King Abdullah University Hospital (KAUH) with ischemic stroke at the time of admission and serum Thrombopsondin-1 levels were measured using ELISA. Patients neurologic severity was evaluated using the National Institute of Health Stroke Scale (NIHSS). Results: Samples from 50 patients admitted between January 2016 and December 2016 were collected. The median age of participants was 68 years and the median NIHSS was 3. Multinomial regression identified serum Thrombospondin-1 as an independent predictor of stroke outcome (p=0.003). Baseline serum Thrombsopondin-1 was negatively associated with NIHSS at the time of admission (spearman rho correlation coefficient=0.272, p=0.032). Conclusion: Serum Thrombospondin-1 at the time of admission may be a useful marker of stroke severity that predicts more severe neurologic severity.

Keywords: thrombospondin, stroke, neuroprotection, biomarkers

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4817 A Review on the Importance of Nursing Approaches in Nutrition of Children with Cancer

Authors: Ş. Çiftcioğlu, E. Efe

Abstract:

In recent years, cancer has been at the top of diseases that cause death in children. Adequate and balanced nutrition plays an important role in the treatment of cancer. Cancer and cancer treatment is affecting food intake, absorption and metabolism, causing nutritional disorders. Appropriate nutrition is very important for the cancerous child to feel well before, during and after the treatment. There are various difficulties in feeding children with cancer. These are the cancer-related factors. Other factors are environmental and behavioral. As health professionals who spend more time with children in the hospital, nurses should be able to support the children on nutrition and help them to have balanced nutrition. This study aimed to evaluate the importance of nursing approaches in the nutrition of children with cancer. This article is planned as a review article by searching the literature on this field. Anorexia may develop due to psychogenic causes or chemotherapeutic agents or accompanying infections and nutrient uptake may be reduced.  In addition, stomatitis, mucositis, taste and odor changes in the mouth, the feeling of nausea, vomiting and diarrhea can also reduce oral intake and result in significant losses in the energy deficit. In assessing the nutritional status of children with cancer, determining weight loss and good nutrition is essential anamnesis of a child.  Some anthropometric measurements and biochemical tests should be used to evaluate the nutrition of the child. The nutritional status of pediatric cancer patients has been studied for a long time and malnutrition, in particular under nutrition, in this population has long been recognized. Yet, its management remains variable with many malnourished children going unrecognized and consequently untreated. Nutritional support is important to pediatric cancer patients and should be integrated into the overall treatment of these children.

Keywords: cancer treatment, children, complication, nutrition, nursing approaches

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4816 Does The Implementation Of A Mindfulness Based Intervention Effect Stress and Burnout In Nursing

Authors: Jennifer Foss, DNP, RN-BC, NEA-BC

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Stress and burnout in the bedside registered nurse have deleterious consequences for registered nurses, patients, and the hospitals that employ them. The objective of this study was to determine whether a sixty-minute mindfulness workshop was effective in reducing perceived levels of stress and decreasing mindfulness in registered nurses working in the acute care setting. Registered nurses at a community hospital in the Northeast part of the country were recruited through e-mail and flyers in breakrooms. Participants completed the Perceived Stress Scale (PSS) and Mindfulness Attention Awareness Scale (MAAS) two weeks prior to taking part in the intervention and two weeks post intervention. Of the twenty-three registered nurses who completed the baseline questionnaires, 91% were female with an average age between 30-39 years. Sixty-five percent of subjects completed the questionnaires two weeks post intervention. Two weeks post intervention, registered nurses reported a decrease in perception of stress (pre and post PSS was .133) and was not significant (t=1.293, df=14, p=.217). Likewise, an increase in mindful attention .325 was reported two-weeks post intervention and indicated a favorable tendency to enter a mindful state. This finding was also not significant (t=-1.990, df=14, p=.066). In this study, nurses reported decreases in perceived stress and increases in mindfulness after attending a sixty-minute mindfulness workshop. Further research is needed to determine the long-term impact of mindfulness-based training on nurses' stress and mindfulness skills. The results of this study add to the body of literature that supports the benefits of mindfulness-based interventions in the healthcare setting.

Keywords: Stress, burnout, nursing, acute care nursing

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4815 Closing down the Loop Holes: How North Korea and Other Bad Actors Manipulate Global Trade in Their Favor

Authors: Leo Byrne, Neil Watts

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In the complex and evolving landscape of global trade, maritime sanctions emerge as a critical tool wielded by the international community to curb illegal activities and alter the behavior of non-compliant states and entities. These sanctions, designed to restrict or prohibit trade by sea with sanctioned jurisdictions, entities, or individuals, face continuous challenges due to the sophisticated evasion tactics employed by countries like North Korea. As the Democratic People's Republic of Korea (DPRK) diverts significant resources to circumvent these measures, understanding the nuances of their methodologies becomes imperative for maintaining the integrity of global trade systems. The DPRK, one of the most sanctioned nations globally, has developed an intricate network to facilitate its trade in illicit goods, ensuring the flow of revenue from designated activities continues unabated. Given its geographic and economic conditions, North Korea predominantly relies on maritime routes, utilizing foreign ports to route its illicit trade. This reliance on the sea is exploited through various sophisticated methods, including the use of front companies, falsification of documentation, commingling of bulk cargos, and physical alterations to vessels. These tactics enable the DPRK to navigate through the gaps in regulatory frameworks and lax oversight, effectively undermining international sanctions regimes Maritime sanctions carry significant implications for global trade, imposing heightened risks in the maritime domain. The deceptive practices employed not only by the DPRK but also by other high-risk jurisdictions, necessitate a comprehensive understanding of UN targeted sanctions. For stakeholders in the maritime sector—including maritime authorities, vessel owners, shipping companies, flag registries, and financial institutions serving the shipping industry—awareness and compliance are paramount. Violations can lead to severe consequences, including reputational damage, sanctions, hefty fines, and even imprisonment. To mitigate risks associated with these deceptive practices, it is crucial for maritime sector stakeholders to employ rigorous due diligence and regulatory compliance screening measures. Effective sanctions compliance serves as a protective shield against legal, financial, and reputational risks, preventing exploitation by international bad actors. This requires not only a deep understanding of the sanctions landscape but also the capability to identify and manage risks through informed decision-making and proactive risk management practices. As the DPRK and other sanctioned entities continue to evolve their sanctions evasion tactics, the international community must enhance its collective efforts to demystify and counter these practices. By leveraging more stringent compliance measures, stakeholders can safeguard against the illicit use of the maritime domain, reinforcing the effectiveness of maritime sanctions as a tool for global security. This paper seeks to dissect North Korea's adaptive strategies in the face of maritime sanctions. By examining up-to-date, geographically, and temporally relevant case studies, it aims to shed light on the primary nodes through which Pyongyang evades sanctions and smuggles goods via third-party ports. The goal is to propose multi-level interaction strategies, ranging from governmental interventions to localized enforcement mechanisms, to counteract these evasion tactics.

Keywords: maritime, maritime sanctions, international sanctions, compliance, risk

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4814 The Role of the Media in Foreign Policy Formulation: A Case Study of Turkey-Greece Relations from 2004 to 2011

Authors: Mohammed Kamal Alhassan

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The closeness of Turkey to Greece has often been a cause of many disagreements between the people of the two countries. This is against the backdrop of the fact that they have many things in common. In the past, the two countries have had unhealthy relations, which threatened to cut diplomatic ties between them. The 1996 Imia/ Kardak incident and the Öcalan crisis, for instance, nearly resulted in war between them. There were events that also brought the two countries together, for instance, the 1999 earthquake. This was because many lives were lost during the disaster. It is important to note that these events were duly covered by the media in the two countries. First of all, the study intends to look at the role of the media in the formulation of foreign policy in Turkey-Greece relations. It examines the role of the media in the formulation of foreign policy with particular emphasis on agenda-setting and positioning theories of the media as the theoretical framework. Also, the study will discuss the media landscapes in Turkey and Greece, the ownership pattern of the media sector and the relationship between media organizations and the government in the two countries. Moreover, the core foreign policy objectives of the countries will be delved into. Finally, the study employs a qualitative method to critically analyze the role of the media in the formulation of foreign policy in Turkey-Greece relations. It uses the invitation of the Former Prime Minister of Greece, George Andreas Papandreou, to the Ambassadors Conference in Turkey as a case study. In the end, the analysis will prove that, indeed, the media in Greece was effective in the formulation of foreign policy in its relations with Turkey.

Keywords: media organizations, foreign policy, government, diplomacy

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4813 Determinants of Infrastructure Provision in Ghana

Authors: Clifford Kwakwa Amoah, De-Graft Owusu-Manu, Prince Antwi-Afari

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Infrastructure is the lifeline for economic development of any country. Hence, obtaining infrastructure quality cannot be overemphasized. Nevertheless, challenges of infrastructure quality persist, and it is worse in developing countries despite the diverse study on the subject matter. Therefore, this study was formulated to identify the prevalent determinants of infrastructure quality using synthesis of extant literature (to identify key variables), and analysis of survey questionnaire of data collected by means of the inductive methodology approach, mean score ranking and descriptive statistics. The variables “partner with the private sector, growth stimulation and poverty reduction, and adherence to procurement core principles” were the most significant challenges that the government faces. Moreover, it would be of utmost concern to adopt some stringent measures to help improve and accelerate on the growth and development of the nation, thereby achieving the best quality required. This study is novel conducted to provide insight into some of the punitive measures, considered in ensuring that quality infrastructure is obtained in both developing (specifically) and developed economies. The research findings therefore provide some guidance for overcoming the accumulative challenges. Application of the stated findings will help bridge the gap of infrastructure challenges; this is because the study found strong empirical evidence that infrastructure plays a pivotal role in the productivity enhancement.

Keywords: challenges, development, economic growth, government, infrastructure quality

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4812 Preliminary Evaluation of Passive UHF-Band RFID for Identifying Floating Objects on the Sea

Authors: Yasuhiro Sato, Kodai Noma, Kenta Sawada, Kazumasa Adachi, Yoshinori Matsuura, Saori Iwanaga

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RFID system is used to identify objects such as passenger identification in public transportation, instead of linear or 2-dimensional barcodes. Key advantages of RFID system are to identify objects without physical contact, and to write arbitrary information into RFID tag. These advantages may help to improve maritime safety and efficiency of activity on the sea. However, utilization of RFID system for maritime scenes has not been considered. In this paper, we evaluate the availability of a generic RFID system operating on the sea. We measure RSSI between RFID tag floating on the sea and RFID antenna, and check whether a RFID reader can access a tag or not, while the distance between a floating buoy and the ship, and the angle are changed. Finally, we discuss the feasibility and the applicability of RFID system on the sea through the results of our preliminary experiment.

Keywords: RFID, experimental evaluation, RSSI, maritime use

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4811 Rehabilitation Approach for Cancer Patients: Indication, Management and Outcome

Authors: Juliani Rianto, Emma Lumby, Tracey Smith

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Cancer patients’ survival are growing with the new approach and therapy in oncology medicine. Cancer is now a new chronic disease, and rehabilitation program has become an ongoing program as part of cancer care. The focus of Cancer rehabilitation is maximising person’s physical and emotional function, stabilising general health and reducing unnecessary hospital admission. In Australia there are 150000 newly diagnosed cancer every year, and the most common Cancer are prostate, Breast, Colorectal, Melanoma and Lung Cancer. Through referral from the oncology team, we recruited cancer patient into our cancer rehabilitation program. Patients are assessed by our multi-disciplinary team including rehabilitation specialist, physiotherapist, occupational therapist, dietician, exercise physiologist, and psychologist. Specific issues are identified, including pain, side effect of chemo and radiation therapy and mental well-being. The goals were identified and reassessed every fortnight. Common goals including nutritional status, improve endurance and exercise performance, working on balance and mobility, improving emotional and vocational state, educational program for insomnia and tiredness, and reducing hospitalisation are identified and assessed. Patients are given 2 hours exercise program twice a week for 6 weeks with focus on aerobic and weight exercises and education sessions. Patients are generally benefited from the program. The quality of life is improved, support and interaction from the therapist has played an important factor in directing patient for their goals.

Keywords: cancer, exercises, benefit, mental health

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4810 A Case Study on Barriers in Total Productive Maintenance Implementation in the Abu Dhabi Power Industry

Authors: A. Alseiari, P. Farrell

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Maintenance has evolved into an imperative function, and contributes significantly to efficient and effective equipment performance. Total Productive Maintenance (TPM) is an ideal approach to support the development and implementation of operation performance improvement. It systematically aims to understand the function of equipment, the service quality relationship with equipment and the probable critical equipment failure conditions. Implementation of TPM programmes need strategic planning and there has been little research applied in this area within Middle-East power plants. In the power sector of Abu Dhabi, technologically and strategically, the power industry is extremely important, and it thus needs effective and efficient equipment management support. The aim of this paper is to investigate barriers to successful TPM implementation in the Abu Dhabi power industry. The study has been conducted in the context of a leading power company in the UAE. Semi-structured interviews were conducted with 16 employees, including maintenance and operation staff, and senior managers. The findings of this research identified seven key barriers, thus: managerial; organisational; cultural; financial; educational; communications; and auditing. With respect to the understanding of these barriers and obstacles in TPM implementation, the findings can contribute towards improved equipment operations and maintenance in power organisations.

Keywords: Abu Dhabi Power Industry, TPM implementation, key barriers, organisational culture, critical success factors

Procedia PDF Downloads 238