Search results for: Healthcare Service Delivery

Authors: Metrek Almetrek, Naser Alqahtani, Eisa Ghazwani, Mona Asiri, Mohammed Alqahtani, Magboolah Balobaid

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Background: Advocacy of potential for community coalitions to positively address social determinants of health and quality of life, little is known about the views of stakeholders involved in such efforts. This study sought to assess the provinces leaders’ perspectives about social determinants related to the Health Neighborhood Initiative (HNI), a new county effort to support community coalitions. Method and Subjects: We used a descriptive, qualitative study using personal interviews in 2022. We conducted it in the community coalition's “main cities committees” set across service planning areas that serve vulnerable groups located in the seven registered healthy cities to WHO (Abha, Tareeb, Muhayel, Balqarn, Alharajah, Alamwah, and Bisha). We conducted key informant interviews with 76 governmental, profit, non-profit, and community leaders to understand their perspectives about the HNI. As part of a larger project, this study focused on leaders’ views about social determinants of health related to the HNI. All interviews were audio-recorded and transcribed. An inductive approach to coding was used, with text segments grouped by social determinant categories. Results: Provinces leaders described multiple social determinants of health and quality of life that were relevant to the HNI community coalitions: housing and safety, community violence, economic stability, city services coordination and employment and education. Leaders discussed how social determinants were interconnected with each other and the need for efforts to address multiple social determinants simultaneously to effectively improve health and quality of life. Conclusions: Community coalitions have an opportunity to address multiple social determinants of health and quality of life to meet the social needs of vulnerable groups. Future research should examine how community coalitions, like those in the HNI, can actively engage with community members to identify needs and then deliver evidence-based care.

Keywords: social determinants, health and quality of life, vulnerable groups, qualitative research

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Authors: Shaibu Baanni Azumah, William Adzawla

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Rice is an important staple crop, with current demand higher than the domestic supply in Ghana. This has led to a high and unfavourable import bill. Therefore, recent policies and interventions in the agricultural sub-sector aim at promoting various improved agricultural technologies in order to improve domestic production and reduce the importation of rice. In this study, we examined the effect of the adoption of Urea Deep Placement (UDP) technology by rice farmers on the position of the production frontier. This involved 200 farmers selected through a multi stage sampling technique in the Northern region of Ghana. A Cobb-Douglas stochastic frontier model was fitted. The result showed that the adoption of UDP technology shifts the output frontier outward and also move the farmers closer to the frontier. Farmers were also operating under diminishing returns to scale which calls for redress. Other factors that significantly influenced rice production were farm size, labour, use of certified seeds and NPK fertilizer. Although there was an opportunity for improvement, the farmers were highly efficient (92%), compared to previous studies. Farmers’ efficiency was improved through increased education, household size, experience, access to credit, and lack of extension service provision by MoFA. The study recommends the revision of Ghana’s agricultural policy to include the UDP technology. Agricultural Extension officers of the Ministry of Food and Agriculture (MoFA) should be trained on the UDP technology to support IFDC’s drive to improve adoption by rice farmers. Rice farmers are also encouraged to expand their farm lands, improve plant population, and also increase the usage of fertilizer to improve yields. Mechanisms through which credit can be made easily accessible and effectively utilised should be identified and promoted.

Keywords: efficiency, rice farmers, stochastic frontier, UDP technology

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Authors: Hi̇lal Surat

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People who want to get rid of stress and intensive working tempo for a while head for recreation operations in order to get rest and have fun. Therefore, planning recreation operation makes contributions to social, physiological, economic and psychological development of an individual and the community in a way that the needs of people meet regularly and constantly. The rapid increase of world population rate makes necessary of benefit from natural or man-made resources in a multiple way. Dams and reservoirs which are built near urban area with the aim of electrical energy conversion and agricultural irrigation are considered as natural area providing various opportunities such as recreation operations. Dams have a great importance regarding to protection and improvement of water resources and coming into service of community. There should be a priority to protect these water resources, which are essential for nature and living organisms. It should be taken into consideration that these water resources are the most important input in the area and have high nature value to make sustainability of recreation effectiveness. The Deriner reservoir that has been built yet near the province of Artvin with natural and cultural properties is considered as an alternative option for meeting the needs of people for sportive and recreation activities and as a potential for planning of water-based recreation activities. Hence, in this study, activities that meet the expectations of people who get benefit from the area considering to natural, cultural and sportive recreation opportunities will be developed. In the first place, planning criteria for some sportive and water-based recreation operations will be defined in order to use the area for recreation and sportive activities and these criteria will be a base for a macro planning work within the holistic perspective of natural, cultural, and economical structure of the area. After this time, necessities of local people and evaluation of reservoir recreational potential will be determined, end then different socio-economic groups according to their in-come, age groups will be chosen and the questionnaire which has already prepared will be done these groups, as a result of these questionnaire recreational activities in water necessities will determine and we are going to develop different suggestion for this reservoir.

Keywords: dam, dam lakes, Deriner, recreation, water based activities

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Authors: Recep Keşli, Gülşah Aşık, Cengiz Demir, Onur Türkyılmaz

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Objective: Proteus mirabilis (P. mirabilis) is one of Gram-negative pathogens in human and it causes urinary tract and nosocomial infections. P. mirabilis is susceptible to β-lactams, aminoglycosides, fluoroquinolones, and trimethoprim/sulfamethoxazole. It was aimed to investigate the resistance status to antimicrobial agents of Proteus mirabilis strains produced from samples sent to Afyon Kocatepe University, ANS Research and Practice Hospital, Microbiology Laboratory from different clinics and polyclinics during the period of 24 months. Methods: Between October 2013 and September 2015, a total of 30 Proteus were isolated from clinical samples of patients were hospitalized in intensive care units and in various departments of Afyon Kocatepe University, ANS Research and Practice Hospital. Identification of the bacteria was determined by conventional methods and VITEK 2 system (bioMérieux, France) was used additionally. Antibacterial susceptibility tests were performed by Kirby Bauer disc (Oxoid, Hempshire, England) diffusion method following the recommendations of CLSI. Results: Of the total 30 Proteus strains isolated from clinical samples, 19 from urine, 7 from wound, 4 from tracheal aspiration materials were isolated. Antimicrobial resistant for these strains were determined to 24,3% for meropenem, 26.2% for imipenem, 20.2% for amikacin 10.5% for cefepim, 33.3% for ciprofloxacin and levofloxacine, 31.6% for ceftazidime, 20% for ceftriaxone, 15.2% for gentamicin and 26.6% for amoxicillin-clavulanate, 26.2% trimethoprim-sulfamethoxale. Conclusion: In the present study, the highest number of clinical isolates of P. mirabilis were isolated from urine (63,3%), followed by the others (36,6%). The distribution of samples P. mirabilis strains to the clinics were as fallows; 16,8% intensive care unit (ICU), 29,9% polyclinics, 53,3% hospital service units The most effective antibiotic on the total of strains were found to be cefepim, the least effective antibiotics on the total of strains were found to be trimethoprim-sulfamethoxale.

Keywords: proteus mirabilis, antibiotic resistance, intensive care unit, Proteus spp.

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Authors: Md. Akiz Uddin

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This research attempted to identify the determining factors that extensively persuaded customers of the First Security Islamic Bank Limited (FSIBL) to open accounts and their perception and satisfaction level towards it. Initially, a theoretical model was established based on existing literature reviews. After that, a self-administered structured questionnaire was developed, and data were collected from 180 customers of the FSIBL of Bangladesh using purposive sampling technique. The collected data were later analyzed through a statistical software. Structural Equation Modelling (SEM) was used to verify the model of the study and test the hypotheses. The study particularly examined the determinants of opening accounts, customers’ perception and their satisfaction level towards the bank on several factors like the bank’s compliance with Shariah law, use of modern technology, assurance, reliability, empathy, profitability, and responsiveness. To examine the impact of religious belief on being FSIBL clients, the study also investigates non-Muslim clients’ perception about FSIBL. The study focused on FSIBL customers only from five branches of Dhaka city. The study found that the religious beliefs is the most significant factors for Muslim customers for considering FSIBL to open an account, and they are satisfied with the services, too. However, for non-Muslim customers, other benefits like E-banking, various user-friendly services are the most significant factors for choosing FSIBL. Their satisfaction level is also statistically significant. Furthermore, even if the non- Muslim customers didn’t consider religious beliefs as determinant factors for choosing FSIBL, the respondents informed that they have trust that people who believe in shariah law are more reliable to keep money with them. These findings open up the avenue for future researchers to conduct more study in this area through employing a larger sample size and more branches and extending the current model by incorporating new variables. The study will be an important addition to the potentials of Islamic banking system, literature of service quality and customer satisfaction level, particularly in the success of Islamic banking system in Bangladesh.

Keywords: islamic banking, customers’ satisfaction, customers’ perception, shariah law

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Authors: Chia-Ching Sun, Li-Yin Chien, Chun-Ting Hsiao

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Background: Appropriate gestation weight gain benefits pregnant women and their children; however, excessive weight gain could raise the risk of adverse health outcomes and chronicle diseases. Nevertheless, there is currently limited evidence on the effect of physical activities on pregnant women’s gestational weight gain. Purpose: This study aimed to explore the correlation between the level of physical activity and gestation weight gain during the second and third trimester of pregnancy. Methods: This longitudinal study enrolled 800 healthy pregnant women aged over 20 from six hospitals in northern Taiwan. Structured questionnaires were used to collect data twice for each participant during 14-27 and 28-40 weeks of gestation. Variables included demographic data, maternal health history, and lifestyle. The International Physical Activity Questionnaire-short form was used to measure the level of physical activity from walking and of moderate-intensity and vigorous-intensity before and during pregnancy. Weight recorded at prenatal checkups were used to calculate average weight gain in each trimester of pregnancy. T-tests, ANOVA, chi-squared tests, and multivariable logistic regression models were applied to determine the predicting factors for weight gain during the second and third trimester. Result: Participants who had achieved recommended physical activity level (150 minutes of moderate physical activity or 75 minutes of vigorous physical activity a week) before pregnancy (aOR=1.85, 95% CI=1.27-2.67) or who achieved recommended walking level (150 minutes a week) during the second trimester of pregnancy (aOR=1.43, 95% CI= 1.00-2.04) gained significantly more weight during the second trimester. Compared with those who did not reach recommended level of moderate-intensity physical activity (150 minutes a week), women who had reached that during the second trimester were more likely to be in the less than recommended weight gain group than in the recommended weight gain group (aOR=2.06, CI=1.06-4.00). However, there was no significant correlation between physical activity level and weight gain in the third trimester. Other predicting factors of excessive weight gain included education level which showed a negative correlation (aOR=0.38, CI=0.17-0.88), whereas overweight and obesity before pregnancy showed a positive correlation (OR=3.97, CI=1.23-12.78). Conclusions/implications for practice: Participants who had achieved recommended physical activity level before pregnancy significantly reduced exercise during pregnancy and gained excessive weight during the second trimester. However, women who engaged in the practice of physical activity as recommended could effectively control weight gain in the third trimester. Healthcare professionals could suggest that pregnant women who exercise maintain their pre-pregnancy level of physical activity, given activities requiring physical contact or causing falls are avoided. For those who do not exercise, health professionals should encourage them to gradually increase the level of physical activity. Health promotion strategies related to weight control and physical activity level achievement should be given to women before pregnancy.

Keywords: pregnant woman, physical activity, gestation weight gain, obesity, overweight

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Authors: Tomasz Zarebski

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A very important element of the education system is its evaluation procedure. Each education system should be systematically evaluated and improved. Among the criteria subject to evaluation, attention should be paid to the following: structure of the study programme, implementation of the study programme, admission to studies, verification of learning outcomes achievement by students, giving credit for individual semesters and years, and awarding diplomas, competence, experience, qualifications and the number of staff providing education, staff development, and in-service training, education infrastructure, cooperation with social and economic stakeholders on the development, conditions for and methods of improving the internationalisation of education provided as part of the degree programme, supporting learning, social, academic or professional development of students and their entry on the labour market, public access to information about the study programme and quality assurance policy. Concerning the assessment process and the individual assessment indicators, the participation of students in these processes is essential. The purpose of this paper is to analyse the rules of student participation in accreditation processes on the example of individual countries in Europe. The rules of students' participation in the work of accreditation committees and their influence on the final grade of the committee were analysed. Most of the higher education institutions follow similar rules for accreditation. The general model gives the individual institution freedom to organize its own quality assurance, as long as the system lives up to the criteria for quality and relevance laid down in the particular provisions. This point also applies to students. The regulations of the following countries were examined in the legal-comparative aspect: Poland (Polish Accreditation Committee), Denmark (The Danish Accreditation Institution), France (High Council for the Evaluation of Research and Higher Education), Germany (Agency for Quality Assurance through Accreditation of Study Programmes) and Italy (National Agency for the Evaluation of Universities and Research Institutes).

Keywords: accreditation, student, study programme, quality assurance in higher education

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Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

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Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

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Authors: Leslie M. Mullins

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In the face of dramatically shifting demographic trends and macroeconomic pressures on affordable housing in high-cost cities, municipalities and developers have been forced to develop new models of sustainable development that integrates elements of substantial rehabilitation and new construction while controlling for relocation and mass displacement. Community development partners in the San Francisco Bay Area of Northern California are starting to prioritize anti-displacement strategies when rehabilitating severely neglected public housing developments. This study explored the community-driven efforts to transform four dilapidated public housing sites (N=2,600 households) into thriving mixed-income housing communities. Eight interviews were conducted with frontline workers (property managers and service providers), who directly worked with residents throughout critical stages of the relocation and leasing process. Interviews were audio-recorded, transcribed, and analyzed by a systematic procedure for qualitative analysis to identify key themes on the topics of interest. Also, an extensive literature analysis was conducted to determine promising practices throughout the industry. This study highlighted that resident’s emotional attachment to their homes (regardless of the deteriorating conditions of their unit) could both a) impede the relocation process and substantially impact the budget and timeline, while b) simultaneously providing a basis for an enhanced sense of belonging and community cohesion. This phenomenon often includes the welcoming of new residents and cultures. Resident centered workshops, healing centered rituals, and extensive 'hands-on' guidance was highlighted as promising practices that resulted in residential retention rates that were two to three times the national average and positively impacted the overall project’s budget and timeline.

Keywords: anti-displacement strategies, community based practices, community cohesion, cultural preservation, healing-centered, public housing, relocation, trauma-informed

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Authors: Niharika Kaushal, Minni Singh

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Fruit crops are widely cultivated throughout the World, with citrus being one of the most common. Mandarins, oranges, grapefruits, lemons, and limes are among the most frequently grown varieties. Citrus cultivars are industrially processed into juice, resulting in approx. 25-40% by wt. of biomass in the form of peels and seeds, generally considered as waste. In consequence, a significant amount of this nutraceutical-enriched biomass goes to waste, which, if utilized wisely, could revolutionize the functional food industry, as this biomass possesses a wide range of bioactive compounds, mainly within the class of polyphenols and terpenoids, making them an abundant source of functional bioactive. Mandarin is a potential source of bioflavonoids with putative antioxidative properties, and its potential application for developing value-added products is obvious. In this study, ‘kinnow’ mandarin (Citrus nobilis X Citrus deliciosa) biomass was studied for its flavonoid profile. For this, dried and pulverized peels were subjected to green and sustainable extraction techniques, namely, supercritical fluid extraction carried out under conditions pressure: 330 bar, temperature: 40 ̊ C and co-solvent: 10% ethanol. The obtained extract was observed to contain 47.3±1.06 mg/ml rutin equivalents as total flavonoids. Mass spectral analysis revealed the prevalence of polymethoxyflavones (PMFs), chiefly tangeretin and nobiletin. Furthermore, the antioxidant potential was analyzed by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method, which was estimated to be at an IC₅₀ of 0.55μg/ml. The pre-systemic metabolism of flavonoids limits their functionality, as was observed in this study through in vitro gastrointestinal studies where nearly 50.0% of the flavonoids were degraded within 2 hours of gastric exposure. We proposed nanoencapsulation as a means to overcome this problem, and flavonoids-laden polylactic-co-glycolic acid (PLGA) nano encapsulates were bioengineered using solvent evaporation method, and these were furnished to a particle size between 200-250nm, which exhibited protection of flavonoids in the gastric environment, allowing only 20% to be released in 2h. A further step involved impregnating the nano encapsulates within alginate hydrogels which were fabricated by ionic cross-linking, which would act as delivery vehicles within the gastrointestinal (GI) tract. As a result, 100% protection was achieved from the pre-systemic release of bioflavonoids. These alginate hydrogels had key significant features, i.e., less porosity of nearly 20.0%, and Cryo-SEM (Cryo-scanning electron microscopy) images of the composite corroborate the packing ability of the alginate hydrogel. As a result of this work, it is concluded that the waste can be used to develop functional biomaterials while retaining the functionality of the bioactive itself.

Keywords: bioflavonoids, gastrointestinal, hydrogels, mandarins

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Authors: Pavel Borodkin, Nikolay Khrennikov, Azamat Gazetdinov

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The problem of ensuring of VVER type reactor equipment integrity is now most actual in connection with justification of safety of the NPP Units and extension of their service life to 60 years and more. First of all, it concerns old units with VVER-440 and VVER-1000. The justification of the VVER equipment integrity depends on the reliability of estimation of the degree of the equipment damage. One of the mandatory requirements, providing the reliability of such estimation, and also evaluation of VVER equipment lifetime, is the monitoring of equipment radiation loading parameters. In this connection, there is a problem of justification of such normative parameters, used for an estimation of the pressure vessel metal embrittlement, as the fluence and fluence rate (FR) of fast neutrons above 0.5 MeV. From the point of view of regulatory practice, a comparison of displacement per atom (DPA) and fast neutron fluence (FNF) above 0.5 MeV has a practical concern. In accordance with the Russian regulatory rules, neutron fluence F(E > 0.5 MeV) is a radiation exposure parameter used in steel embrittlement prediction under neutron irradiation. However, the DPA parameter is a more physically legitimate quantity of neutron damage of Fe based materials. If DPA distribution in reactor structures is more conservative as neutron fluence, this case should attract the attention of the regulatory authority. The purpose of this work was to show what radiation load parameters (fluence, DPA) on all VVER equipment should be under control, and give the reasonable estimations of such parameters in the volume of all equipment. The second task is to give the conservative estimation of each parameter including its uncertainty. Results of recently received investigations allow to test the conservatism of calculational predictions, and, as it has been shown in the paper, combination of ex-vessel measured data with calculated ones allows to assess unpredicted uncertainties which are results of specific unique features of individual equipment for VVER reactor. Some results of calculational-experimental investigations are presented in this paper.

Keywords: equipment integrity, fluence, displacement per atom, nuclear power plant, neutron activation measurements, neutron transport calculations

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Authors: Cristobal Miralles Insa

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The network of chairs of the "Valencian Public System of Social Services" (VPSSS) is sponsored by the Valencian Institute of Training, Research, and Quality in Social Services and aims to promote research, dissemination, and evaluation of the needs that arise in the field of the public system of social services. It also seeks to transfer knowledge to foster the development of public policies in this field. Given that it is an Interuniversity Chair among the five public universities in Valencia, there is coordination of complementary themes and roles for this objective, with Universitat Politènica de València focusing primarily on promoting innovation and social entrepreneurship to address multiple social challenges through its platform INSSPIRA. This approach is aimed at the entire university community and its various interest groups, carrying out research, teaching, and dissemination activities that promote social inclusion, personal development, and autonomy for groups in situations of vulnerability, lack of protection, dependence, or social urgency. Although it focuses on the Valencian context, both the issues in this context and the tools in process to address them, often have a universal and scalable character and has been inspiring for the innovation system of UPV. This entrepreneurial incubator goes along from early stages of students on the campus until the so-called “StartUPV” system, where students are challenged with social problems that require creative solutions. Therefore, the Chair is conceived with a holistic spirit and an inspiring vocation that engages the whole university community. In this communication, it is described the entities and individuals participating in this UPV Chair of VPSSS, followed by the presentation of different work lines and objectives for the chair. Subsequently, a description of various activities undertaken to promote innovation in social services are described, where support to teaching and extracurricular activities in this field are exposed. It must be noted that some awareness and dissemination of activities are carried out in a transversal mode as they contribute to different objectives simultaneously; with special focus on Learning-Service approaches that achieved very good results which are also summarized.

Keywords: social innovation, entrepeneurship, university, vulnerable sectors

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Authors: Renee Yi-Mond Yuan

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The fast development of tourism industries around the world, has largely contributed to many cities, and countries economical and social progress. Past year Taiwan in particular was ranked among one of fastest raise growth country. Thanks to the prominent importance of this phenomenon; seasonal mobility or multipurpose trips have reached more than 1 Billion tourists crossing International borders and more than 4 billion intramural travelers that have nourished the economy and employment in the service sector in most attractive regions, representing about one tenth of World GDP amount, including trade, research, cultural or journalistic purposes. Then the increased activities are giving pressure to the consumption of energy, water, resources, and Greenhouse Gas emissions. The further concentration of tourists in most beautiful sites of the World with consistent supply and reduced pollutions and means for waste control and risks management are challenging the preservation and protection of the natural original environment, including species and their ecosystems, ethnics and their cultures or languages, protection of inherited landscapes and monuments for the future generations to come. In this article, few projects will be analyzed, methods and directions in the EU sustainable development scheme giving way to economical and social activities and preserve rural areas and remote countryside as well as smarter cities development. EU ETS forecasting escalation in the next few decades for road and air, and will reconsider investments and reliance on Biobased alternatives that may turn out solutions and contributions to sustain popularization of tourism development. Study of Examples of Stakeholders practices and Governments efforts, consumer’s attitude to bring new forms of more responsible holidays models: ecotourism, eco-certification, partnerships, investment in technologies and facilities, and possibly create greener perceptions and less impacting demands for the longer term through association, organizations and awards.

Keywords: tourism, sustainability, protection, risks management, change in rural/urban environment

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Authors: Amaraporn Puraya, Roongtiva Boonpracom, Somsak Thojampa, Sirikanok Klankhajhon, Kittisak Kumpeera

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The objective of this qualitative research was to study the elderly health care process by community participation. Data were collected by quality research methods, including secondary data study, observation, in-depth interviews, and focus group discussions and analyzed by content analysis, reflection and review of information. The research results pointed out that the important elderly health care process by community participation consisted of 2 parts, namely the community participation development process in elderly health care and the outcomes from the participation development process. The community participation development process consisted of 4 steps as follows: 1) Building the leadership team, an important social capital of the community, which started from searching for both formal and informal leaders by giving the opportunity for public participation and creating clear agreements defining roles, duties and responsibilities; 2) investigating the problems and the needs of the community, 3) designing the elderly health care activities under the concept of self-care potential development of the elderly through participation in community forums and meetings to exchange knowledge with common goals, plans and operation and 4) the development process of sustainable health care agreement at the local level, starting from opening communication channels to create awareness and participation in various activities at both individual and group levels as well as pushing activities/projects into the community development plan consistent with the local administration policy. The outcomes from the participation development process were as follows. 1) There was the integration of the elderly for doing the elderly health care activities/projects in the community managed by the elderly themselves. 2) The service system was changed from the passive to the proactive one, focusing on health promotion rather than treating diseases or illnesses. 3) The registered nurses / the public health officers can provide care for the elderly with chronic illnesses through the implementation of activities/projects of elderly health care so that the elderly can access the services more. 4) The local government organization became the main mechanism in driving the elderly health care process by community participation.

Keywords: elderly health care process, community participation, elderly, Thailand

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Authors: Mst Shapna Akter, Hossain Shahriar

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One of the most important challenges in the field of software code audit is the presence of vulnerabilities in software source code. Every year, more and more software flaws are found, either internally in proprietary code or revealed publicly. These flaws are highly likely exploited and lead to system compromise, data leakage, or denial of service. C and C++ open-source code are now available in order to create a largescale, machine-learning system for function-level vulnerability identification. We assembled a sizable dataset of millions of opensource functions that point to potential exploits. We developed an efficient and scalable vulnerability detection method based on deep neural network models that learn features extracted from the source codes. The source code is first converted into a minimal intermediate representation to remove the pointless components and shorten the dependency. Moreover, we keep the semantic and syntactic information using state-of-the-art word embedding algorithms such as glove and fastText. The embedded vectors are subsequently fed into deep learning networks such as LSTM, BilSTM, LSTM-Autoencoder, word2vec, BERT, and GPT-2 to classify the possible vulnerabilities. Furthermore, we proposed a neural network model which can overcome issues associated with traditional neural networks. Evaluation metrics such as f1 score, precision, recall, accuracy, and total execution time have been used to measure the performance. We made a comparative analysis between results derived from features containing a minimal text representation and semantic and syntactic information. We found that all of the deep learning models provide comparatively higher accuracy when we use semantic and syntactic information as the features but require higher execution time as the word embedding the algorithm puts on a bit of complexity to the overall system.

Keywords: cyber security, vulnerability detection, neural networks, feature extraction

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Authors: Yael Wolff Sagy, Yiska Loewenberg Weisband, Vered Kaufman Shriqui, Michal Krieger, Arie Ben Yehuda, Ronit Calderon Margalit

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Background: Obesity is both a risk factor and common comorbidity of diabetes. Obesity impedes the achievement of glycemic control, and enhances damage caused by hyperglycemia to blood vessels; thus it increases diabetes-related complications. This study assessed the prevalence of obesity and morbid obesity among Israeli adults with diabetes, and estimated disparities associated with sex and socioeconomic position (SEP). Methods: A cross-sectional study was conducted in the setting of the Israeli National Program for Quality Indicators in Community Healthcare. Data on all the Israeli population is retrieved from electronic medical records of the four health maintenance organizations (HMOs). The study population included all Israeli patients with diabetes aged 20-64 with documented body mass index (BMI) in 2016 (N=180,451). Diabetes was defined as the existence of one or more of the following criteria: (a) Plasma glucose level >200 mg% in at least two tests conducted at least one month apart in the previous year; (b) HbA1c>6.5% at least once in the previous year (c) at least three prescriptions of diabetes medications were dispensed during the previous year. Two measures were included: the prevalence of obesity (defined as last BMI≥ 30 kg/m2 and <35 kg/m2) and the prevalence of morbid obesity (defined as last BMI≥ 35 kg/m2) in individuals aged 20-64 with diabetes. The cut-off value for morbid obesity was set in accordance with the eligibility criteria for bariatric surgery in diabetics. Data were collected by the HMOs and aggregated by age, sex and SEP. SEP was based on statistical areas ranking by the Israeli Central Bureau of Statistics and divided into 4 categories, ranking from 1 (lowest) to 4 (highest). Results: BMI documentation among adults with diabetes was 84.9% in 2016. The prevalence of obesity in the study population was 30.5%. Although the overall rate was similar in both sexes (30.8% in females, 30.3% in males), SEP disparities were stronger in females (32.7% in SEP level 1 vs. 27.7% in SEP level 4; 18.1% relative difference) compared to males (30.6% in SEP level 1 vs. 29.3% in SEP level 4; 4.4% relative difference). The overall prevalence of morbid obesity in this population was 20.8% in 2016. The rate among females was almost double compared to the rate in males (28.1% and 14.6%, respectively). In both sexes, the prevalence of morbid obesity was strongly associated with lower SEP. However, in females, disparities between SEP levels were much stronger (34.3% in SEP level 1 vs. 18.7% in SEP level 4; 83.4% relative difference) compared to SEP-disparities in males (15.7% in SEP level 1 vs. 12.3% in SEP level 4; 27.6% relative difference). Conclusions: The overall prevalence of BMI≥ 30 kg/m2 among adults with diabetes in Israel exceeds 50%; and the prevalence of morbid obesity suggests that 20% meet the BMI-criteria for bariatric surgery. Prevalence rates show major SEP- and sex-disparities; especially strong SEP disparities in morbid obesity among females. These findings highlight the need for greater consideration of different population groups when implementing interventions.

Keywords: diabetes, health disparities, health policy, obesity, socio-economic position

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Authors: Kirsi Korkealehto

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In Finland the transformation from homogenous culture into multicultural one as a result of heavy immigration has been rapid in the recent decades. As multilingualism and multiculturalism are growing features in our society, teachers in all educational levels need to be competent for encounters with students from diverse cultural backgrounds. Consequently, also the number of multicultural and multilingual vocational school students has increased which has not been taken into consideration in teacher education enough. To bridge this gap between teachers’ competences and the requirements of the contemporary school world, Finnish Ministry of Culture and Education established the DivEd-project. The aim of the project is to prepare all teachers to work in the linguistically and culturally diverse world they live in, to develop and increase culturally sustaining and linguistically responsive pedagogy in Finland, increase awareness among Teacher Educators working with preservice teachers and to increase awareness and provide specific strategies to in-service teachers. The partners in the nationwide project are 6 universities and 2 universities of applied sciences. In this research, the linguistically and culturally sustainable teaching practices developed within the DivEd-project are tested in practice. This research aims to explore vocational teachers’ perceptions of these multilingualism and multilingual educational practices. The participants of this study are vocational teachers in of different fields. The data were collected by individual, face-to-face interviews. The data analysis was conducted through content analysis. The findings indicate that the vocational teachers experience that they lack knowledge on linguistically and culturally responsive pedagogy. Moreover, they regard themselves in some extent incompetent in incorporating multilingually and multiculturally sustainable pedagogy in everyday teaching work. Therefore, they feel they need more training pertaining multicultural and multilingual knowledge, competences and suitable pedagogical methods for teaching students from diverse linguistic and cultural backgrounds.

Keywords: multicultural, multilingual, teacher competence, vocational school

Procedia PDF Downloads 127

Authors: Vorapoj Promasatayaprot, Sumattana Glangkarn

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Background: Early childhood, the first five years of life, is a time of rapid cognitive, linguistic, social, emotional and motor development. This study was descriptive research which the main purpose of this research was to study early childhood development in Child Center of Local Government in order to emphasize the public citizen and communities participate in the Child Development Center. Method: The study designed was Action Research and divided into four steps consisted of (1) Planning (2) Acting (3) Observing and (4) Reflecting. This study was employed the areas and the subjects consisted of 10 committees of the Child Center in Thakhonyang municipality, Kantharawichai District, Maha Sarakham Province, Thailand and 50 representative parents by using the purposive sampling technique. The instrument used in this study were questionnaires. The data were analyzed using descriptive statistic; percentage, mean, standard deviation, maximum value, minimum, median. Qualitative data was collected using the observation and interview and was analysed by content analysis. Results: The results of this research were as follows: The promoting of early childhood development in child center at Thakhonyang Municipality, Kantharawichai District, Maha Sarakham Province, Thailand were 6 procedures ; (1) workshop participation (2) workshop in action plan (3) performing in action plan (4) following supervision (5) self – assessment (6) knowledge sharing seminar. The service model of the Local Fund Health Security in Thailand was passed the qualifications of local fund health security by 6 procedures to be the high potential local fund health security. Conclusion: The key success is that the commission will have to respond the performance at all process of plan to address the issue in the future. Factor of success is to community participate with transparent procedure. Coordination committee should manipulate the child center benefits among stake holders.

Keywords: child center, develop, early childhood development, local government, promote

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Authors: Yoni Elviandri, Vivi Fitriyanti, Agung Surya Wijaya, Suryani Humayyah, Muhammad Alif Azizi

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The massive development of computing power and internet access nowadays is marked by audiovisual games and computers which are known as electronic games, one of the examples is online games. This kind of game can be found everywhere in Indonesia, both in the cities and even the villages. In the present time, online games are becoming a popular games in various layers of the community, one of them does happen to elementary school students. As the online games spread over, the traditional games gradually fade away and even thought as an old-fashioned game. Contrary, traditional games actually have the better and higher educational values such as patience, honesty, integrity and togetherness value which cannot be found in online games which are more to individualist. A brand new set of education tools is necessary to provide a convenience, safe and fun place for children to play around but still contains educational values. One interesting example goes to Cilulaba is an agricultural-based playground. It is a good place for children to play and learn as it was planned to entertain children to play around as well as introducing agriculture to them. One of the games is a 1990’s well-known traditional game which its name is Congklak. Congklak is an agricultural-based traditional game and it also introduces the home garden to the children. Some of the Cilulaba’s aims are to protect the existence of nation’s cultural inheritance through Congklak traditional game, as a tool to introduce the agriculture to the children through the methods of Congklak traditional game and giving explanation related to the advantages of a “healthy home garden” to the children. The expected output from this place is to deliver a good understanding about agriculture to the children and make them begin to love it to make an aesthetic home garden and enhance the optimalisation usage of home garden that will support the availability of various edible plants in productive and health households. The proposed method in this Student Creative Program in Society Service is Participatory Rural Appraisal (PRA) method.

Keywords: Cilubaba, Congklak, traditional game, agricultural-based playground

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Authors: Agnieszka Antończyk, MałGorzata Ochota, Wojciech Niżański, ZdzisłAw Kiełbowicz

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The goal of the cesarean section (CS) is the delivery of healthy, vigorous pups with the provision of surgical plane anesthesia, appropriate analgesia, and rapid recovery of the dam. In human medicine, spinal or epidural anesthesia is preferred for a cesarean section as associated with a lower risk of neonatal asphyxia and the need for resuscitation. Nevertheless, the specificity of veterinary patients makes the application of regional anesthesia as a sole technique impractical, thus to obtain patient compliance the general anesthesia is required. This study aimed to compare the influence of balanced (inhalant with epidural) and inhalant anesthesia on neonatal umbilical cord blood gas (UCBG) parameters and vitality (modified Apgar scoring). The bitches (31) undergoing elective CS were enrolled in this study. All females received a single dose of 0.2 mg/kg s.c. Meloxicam. Females were randomly assigned into two groups: Gr I (Isoflurane, n=16) and Gr IE (Isoflurane plus Epidural, n=15). Anesthesia was induced with propofol at 4-6 mg/kg to effect, and maintained with isoflurane in oxygen; in IE group epidural anesthesia was also done using lidocaine (3-4 mg/kg) into the lumbosacral space. CSs were performed using a standard mid-line approach. Directly after the puppy extraction, the umbilical cord was double clamped before the placenta detachment. The vessels were gently stretched between forceps to allow blood sampling. At least 100 mcl of mixed umbilical cord blood was collected into a heparinized syringe for further analysis. The modified Apgar scoring system (AS) was used to objectively score neonatal health and vitality immediately after birth (before first aid or neonatal care was instituted), at 5 and 20 min after birth. The neonates were scored as normal (AS 7-10), weak (AS 4-6), or critical (AS 0-3). During surgery, the IE group required a lower isoflurane concentration compared to the females in group I (MAC 1.05±0.2 and 1.4±0.13, respectively, p<0.01). All investigated UCBG parameters were not statistically different between groups. All pups had mild acidosis (pH 7.21±0.08 and 7.21±0.09 in Gr I and IE, respectively) with moderately elevated pCO2 (Gr I 57.18±11.48, Gr IE 58.74±15.07), HCO3- on the lower border (Gr I 22.58±3.24, Gr IE 22.83±3.6), lowered BE (Gr I -6.1±3.57, Gr IE -5.6±4.19) and mildly elevated level of lactates (Gr I 2.58±1.48, Gr IE2.53±1.03). The glucose levels were above the reference limits in both groups of puppies (74.50±25.32 in Gr I, 79.50±29.73 in Gr IE). The initial Apgar score results were similar in I and IE groups. However, the subsequent measurements of AS revealed significant differences between both groups. Puppies from the IE group received better AS scores at 5 and 20 min compared to the I group (6.86±2.23 and 8.06±2.06 vs 5.11±2.40 and 7.83±2.05, respectively). The obtained results demonstrated that administration of epidural anesthesia reduced the requirement for isoflurane in dams undergoing cesarean section and did not affect the neonatal umbilical blood gas results. Moreover, newborns from the epidural anesthesia group were scored significantly higher in AS at 5 and 20 min, indicating their better vitality and quicker improvement post-surgery.

Keywords: apgar scoring, balanced anesthesia, cesarean section, umbilical blood gas

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Authors: Maureen Royce, Joshi Jariwala, Sally Kah

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Change is inevitable, but the change process is progressive. Organisational change is the process in which an organisation changes strategies, operational methods, systems, culture, and structure to affect something different in the organisation. This process can be continuous or developed over a period and driven by internal and external factors. Organisational change is essential if organisations are to survive in dynamic and uncertain environments. However, evidence from research shows that many change initiatives fail, leading to severe consequences for organisations and their resources. The complex models of third sector organisations, i.e., social enterprise, compounds the levels of change in these organisations. Interestingly, innovation is associated with a change in social enterprises due to the hybridity of product and service development. Furthermore, the creation of social intervention has offered a new process and outcomes to the lifecycle of change. Therefore, different forms of organisational innovation are developed, i.e., total, evolutionary, expansionary, and developmental, which affect the interventions of social enterprises. This raises both theoretical and business concerns on how the competing hybrid nature of social enterprises change, how change is managed, and the impact on these organisations. These perspectives present critical questions for further investigation. In this study, we investigate the impact of organisational change on employees and organisational development at DaDaFest –a disability arts organisation with a social focus based in Liverpool. The three main objectives are to explore the drivers of change and the implementation process; to examine the impact of organisational change on employees and; to identify barriers to organisation change and development. To address the preceding research objectives, qualitative research design is adopted using semi-structured interviews. Data is analysed using a six-step thematic analysis framework, which enables the study to develop themes depicting the impact of change on employees and organisational development. This study presents theoretical and practical contributions for academics and practitioners. The knowledge contributions encapsulate the evolution of change and the change cycle in a social enterprise. However, practical implications provide critical insights into the change management process and the impact of change on employees and organisational development.

Keywords: organisational change, change management, organisational change system, social enterprise

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Authors: Thomas J. Bell III

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This paper explores the value of assimilating certification training within a traditional course curriculum. This innovative approach is believed to increase stakeholder value within the Computer Information System program at Texas Wesleyan University. Stakeholder value is obtained from increased job marketability and critical thinking skills that create employment-ready graduates. This paper views value as first developing the capability to earn an industry-recognized certification, which provides the student with more job placement compatibility while allowing the use of critical thinking skills in a liberal arts business program. Graduates with industry-based credentials are often given preference in the hiring process, particularly in the information technology sector. And without a pioneering curriculum that better prepares students for an ever-changing employment market, its educational value is dubiously questioned. Since certifications are trending in the hiring process, academic programs should explore the viability of incorporating certification training into teaching pedagogy and courses curriculum. This study will examine the use of the balanced scorecard across four performance dimensions (financial, customer, internal process, and innovation) to measure the stakeholder value of certification training within a traditional course curriculum. The balanced scorecard as a strategic management tool may provide insight for leveraging resource prioritization and decisions needed to achieve various curriculum objectives and long-term value while meeting multiple stakeholders' needs, such as students, universities, faculty, and administrators. The research methodology will consist of quantitative analysis that includes (1) surveying over one-hundred students in the CIS program to learn what factor(s) contributed to their certification exam success or failure, (2) interviewing representatives from the Texas Workforce Commission to identify the employment needs and trends in the North Texas (Dallas/Fort Worth) area, (3) reviewing notable Workforce Innovation and Opportunity Act publications on training trends across several local business sectors, and (4) analyzing control variables to identify specific correlations between industry alignment and job placement to determine if a correlation exists. These findings may provide helpful insight into impactful pedagogical teaching techniques and curriculum that positively contribute to certification credentialing success. And should these industry-certified students land industry-related jobs that correlate with their certification credential value, arguably, stakeholder value has been realized.

Keywords: certification exam teaching pedagogy, exam preparation, testing techniques, exam study tips, passing certification exams, embedding industry certification and curriculum alignment, balanced scorecard performance evaluation

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Authors: Sarah Pfoser, Lisa-Maria Putz, Thomas Berger

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In the EU, the transport sector accounts for roughly one fourth of the total greenhouse gas emissions. In fact, the transport sector is one of the main contributors of greenhouse gas emissions. Climate protection targets aim to reduce the negative effects of greenhouse gas emissions (e.g. climate change, global warming) worldwide. Achieving a modal shift to foster environmentally friendly modes of transport such as rail and inland waterways is an important strategy to fulfill the climate protection targets. The present paper goes beyond these conventional transport modes and reflects upon currently emerging high-performance transport modes that yield the potential of complementing future transport systems in an efficient way. It will be defined which properties describe high-performance transport modes, which types of technology are included and what is their potential to contribute to a sustainable future transport network. The first step of this paper is to compile state-of-the-art information about high-performance transport modes to find out which technologies are currently emerging. A multidimensional impact analysis will be conducted afterwards to evaluate which of the technologies is most promising. This analysis will be performed from a spatial, social, economic and environmental perspective. Frequently used instruments such as cost-benefit analysis and SWOT analysis will be applied for the multidimensional assessment. The estimations for the analysis will be derived based on desktop research and discussions in an interdisciplinary team of researchers. For the purpose of this work, high-performance transport modes are characterized as transport modes with very fast and very high throughput connections that could act as efficient extension to the existing transport network. The recently proposed hyperloop system represents a potential high-performance transport mode which might be an innovative supplement for the current transport networks. The idea of hyperloops is that persons and freight are shipped in a tube at more than airline speed. Another innovative technology consists in drones for freight transport. Amazon already tests drones for their parcel shipments, they aim for delivery times of 30 minutes. Drones can, therefore, be considered as high-performance transport modes as well. The Trans-European Transport Networks program (TEN-T) addresses the expansion of transport grids in Europe and also includes high speed rail connections to better connect important European cities. These services should increase competitiveness of rail and are intended to replace aviation, which is known to be a polluting transport mode. In this sense, the integration of high-performance transport modes as described above facilitates the objectives of the TEN-T program. The results of the multidimensional impact analysis will reveal potential future effects of the integration of high-performance modes into transport networks. Building on that, a recommendation on the following (research) steps can be given which are necessary to ensure the most efficient implementation and integration processes.

Keywords: drones, future transport networks, high performance transport modes, hyperloops, impact analysis

Procedia PDF Downloads 311

Authors: Spencer Rutherford, Shadi Saleh

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War and conflict negatively impact all facets of a health system; services cease to function, resources become depleted, and any semblance of governance is lost. Following cessation of conflict, the rebuilding process includes a wide array of international and local actors. During this period, stakeholders must contend with various trade-offs, including balancing sustainable outcomes with immediate health needs, introducing health reform measures while also increasing local capacity, and reconciling external assistance with local legitimacy. Compounding these factors are additional challenges, including coordination amongst stakeholders, the re-occurrence of conflict, and ulterior motives from donors and governments, to name a few. Therefore, the present paper evaluated health system development in three post-conflict countries over a 12-year timeline. Specifically, health policies, health inputs (such infrastructure and human resources), and measures of governance, from the post-conflict periods of Afghanistan, Cambodia, and Mozambique, were assessed against health outputs and other measures. All post-conflict countries experienced similar challenges when rebuilding the health sector, including; division and competition between donors, NGOs, and local institutions; urban and rural health inequalities; and the re-occurrence of conflict. However, countries also employed unique and effective mechanisms for reconstructing their health systems, including; government engagement of the NGO and private sector; integration of competing factions into the same workforce; and collaborative planning for health policy. Based on these findings, best-practice development strategies were determined and compiled into a 12-year framework. Briefly, during the initial stage of the post-conflict period, primary stakeholders should work quickly to draft a national health strategy in collaboration with the government, and focus on managing and coordinating NGOs through performance-based partnership agreements. With this scaffolding in place, the development community can then prioritize the reconstruction of primary health care centers, increasing and retaining health workers, and horizontal integration of immunization services. The final stages should then concentrate on transferring ownership of the health system national institutions, implementing sustainable financing mechanisms, and phasing-out NGO services. Overall, these findings contribute post-conflict health system development by evaluating the process holistically and along a timeline and can be of further use by healthcare managers, policy-makers, and other health professionals.

Keywords: Afghanistan, Cambodia, health system development, health system reconstruction, Mozambique, post-conflict, state-building

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Authors: Alexandru Grigorescu, Alexandra Protesanu

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Background: Approximately 34-67 percent of cancer patients experience an episode of uncontrolled pain during the course of their disease, depending on the stage. The aim is to provide evidence-based data for pain prevalence, diagnosis and treatment recommendations on an integrative model of medical oncology and palliative care for patients with cancer diagnostic in a day hospital. Patients and method: Consultation registers and electronic records of 166 Patients (Pts) were studied from April 2022 to March 2023. Pts with pain syndrome were selected. The pain was objectified by the visual pain scale. To elucidate the causes of the pain, investigations were carried out: bone scintigraphy, CT scan, and PET-CT. The analgesic treatments were represented by weak and strong morphine, radiotherapy, and bisphosphonates. Result: During the mentioned period, 166 oncological patients (74 women and 92 men) were treated in the oncology day hospitalization service. There were 1,500 consultations, 40 of which were only for pain. The neoplastic locations were: gynecological, malignant melanoma, breast, gastric, bronchopulmonary, colorectal, liver, pancreatic, bladder, and kidney. 70 Pts presented pain syndrome. The causes of the pain were represented by bone metastases, compressive tumors, and post-surgical status. Drug treatment: Tramadol 47 Pts, of which 10 switched to a major opioid (Oxycodonum, Morphine sulfate), 20 Pts were treated with Oxycodonum as the first intention. In 5 patients ry to rotated morphine, 20 Pts received palliative radiotherapy, 10 Pts were treated with bisphosphonates. 2 Pts required neurosurgery consultation for an antalgic intervention. 5 Pts had important adverse reactions to morphine. All patients and their families were advised by a medical oncologist and psychologist for a lifestyle change. Conclusions: The prevalence of pain was similar to that described in the literature. In most cases, the pain could be managed in the day hospital. Weak and strong morphine represented the main pain therapy. Palliative radiotherapy was the second most effective therapy. Treatment with bisphosphonates was useful. Surgical interventions were rarely indicated. Discussions with patients and their families regarding the lifestyle change were important.

Keywords: cancer pain, opioids, medical oncology, palliative care

Procedia PDF Downloads 47

Authors: Lizinis Cassendra Frederick Dony, Jirom Jeremy Frederick Dony, Cyril Supain Christopher

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The purpose of this paper is to improve the devotion to leadership through HR practices implementation at the PETRONAS stations. This emphasize the importance of personal grooming and Customer Care hospitality training for their front line working individuals and teams’ at PETRONAS stations in Sabah. Based on Thomas Edison, International Leadership Journal, theory, research, education and development practice and application to all organizational phenomena may affect or be affected by leadership. FINDINGS – PETRONAS in short called Petroliam Nasional Berhad is a Malaysian oil and gas company that was founded on August 17, 1974. Wholly owned by the Government of Malaysia, the corporation is vested with the entire oil and gas resources in Malaysia and is entrusted with the responsibility of developing and adding value to these resources. Fortune ranks PETRONAS as the 68th largest company in the world in 2012. It also ranks PETRONAS as the 12th most profitable company in the world and the most profitable in Asia. As of the end of March 2005, the PETRONAS Group comprised 103 wholly owned subsidiaries, 19 partly owned outfits and 57 associated companies. The group is engaged in a wide spectrum of petroleum activities, including upstream exploration and production of oil and gas to downstream oil refining, marketing and distribution of petroleum products, trading, gas processing and liquefaction, gas transmission pipeline network operations, marketing of liquefied natural gas; petrochemical manufacturing and marketing; shipping; automotive engineering and property investment. PETRONAS has growing their marketing channel in a competitive market. They have combined their resources to pursue common goals. PETRONAS provides opportunity to carry out Industrial Training Job Placement to the University students in Malaysia for 6-8 months. The effects of the Industrial Training have exposed them to the real working environment experience acting representing on behalf of General Manager for almost one year. Thus, the management education and reward incentives schemes have aspire the working teams transformed to gain their good leadership. Furthermore, knowledge and experiences are very important in the human capital development transformation. SPSS extends the accurate analysis PETRONAS achievement through 280 questionnaires and 81 questionnaires through excel calculation distributed to interview face to face with the customers, PETRONAS dealers and front desk staffs stations in the 17 stations in Kota Kinabalu, Sabah. Hence, this research study will improve its service quality innovation and business sustainability performance optimization. ORIGINALITY / VALUE – The impact of Transformational Leadership practices have influenced the working team’s behaviour as a Brand Ambassadors of PETRONAS. Finally, the findings correlation indicated that PETRONAS stations needs more HR resources practices to deploy more customer care retention resources in mitigating the business challenges in oil and gas industry. Therefore, as the business established at stiff competition globally (Cooper, 2006; Marques and Simon, 2006), it is crucial for the team management should be capable to minimize noises risk, financial risk and mitigating any other risks as a whole at the optimum level. CONCLUSION- As to conclude this research found that both transformational and transactional contingent reward leadership4 were positively correlated with ratings of platoon potency and ratings of leadership for the platoon leader and sergeant were moderately inter correlated. Due to this identification, we recommended that PETRONAS management should offers quality team management in PETRONAS stations in a broader variety of leadership training specialization in the operation efficiency at the front desk Customer Care hospitality. By having the reliability and validity of job experiences, it leverages diversity teamwork and cross collaboration. Other than leveraging factor, PETRONAS also will strengthen the interpersonal front liners effectiveness and enhance quality of interaction through effective communication. Finally, through numerous CSR correlation studies regression PETRONAS performance on Corporate Social Performance and several control variables.1 CSR model activities can be mis-specified if it is not controllable under R & D which evident in various feedbacks collected from the local communities and younger generation is inclined to higher financial expectation from PETRONAS. But, however, it created a huge impact on the nation building as part of its social adaptability overreaching their business stakeholders’ satisfaction in Sabah.

Keywords: human resources practices implementation (hrpi), source of competitive advantage in people’s development (socaipd), corporate social responsibility (csr), service quality at front desk stations (sqafd), impacts of petronas leadership (iopl)

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Authors: M. S. Nandana, K. Udaya Bhat, C. M. Manjunatha

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In this study aluminum alloy 7010 was subjected to three different ageing treatments i.e., peak ageing (T6), over-ageing (T7451) and retrogression and re ageing (RRA) to study the influence of precipitate microstructure on the fatigue crack growth rate behavior. The microstructural modification was studied by using transmission electron microscope (TEM) to examine the change in the size and morphology of precipitates in the matrix and on the grain boundaries. The standard compact tension (CT) specimens were fabricated and tested under constant amplitude fatigue crack growth tests to evaluate the influence of heat treatment on the fatigue crack growth rate properties. The tests were performed in a computer-controlled servo-hydraulic test machine applying a load ratio, R = 0.1 at a loading frequency of 10 Hz as per ASTM E647. The fatigue crack growth was measured by adopting compliance technique using a CMOD gauge attached to the CT specimen. The average size of the matrix precipitates were found to be of 16-20 nm in T7451, 5-6 nm in RRA and 2-3 nm in T6 conditions respectively. The grain boundary precipitate which was continuous in T6, was disintegrated in RRA and T7451 condition. The PFZ width was lower in RRA compared to T7451 condition. The crack growth rate was higher in T7451 and lowest in RRA treated alloy. The RRA treated alloy also exhibits an increase in threshold stress intensity factor range (∆Kₜₕ). The ∆Kₜₕ measured was 11.1, 10.3 and 5.7 MPam¹/² in RRA, T6 and T7451 alloys respectively. The fatigue crack growth rate in RRA treated alloy was nearly 2-3 times lower than that in T6 and was one order lower than that observed in T7451 condition. The surface roughness of RRA treated alloy was more pronounced when compared to the other conditions. The reduction in fatigue crack growth rate in RRA alloy was majorly due to the increase in roughness and partially due to increase in spacing between the matrix precipitates. The reduction in crack growth rate and increase in threshold stress intensity range is expected to benefit the damage tolerant capability of aircraft structural components under service loads.

Keywords: damage tolerance, fatigue, heat treatment, PFZ, RRA

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Authors: Marcel Schneider, Nils Nießen

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Microscopic simulation programs enable the description of the two processes of railway operation and the previous timetabling. Occupation conflicts are often solved based on defined train priorities on both process levels. These conflict resolutions produce knock-on delays for the involved trains. The sum of knock-on delays is commonly used to evaluate the quality of railway operations. It is either compared to an acceptable level-of-service or the delays are evaluated economically by linearly monetary functions. It is impossible to properly evaluate dispatching decisions without a well-founded objective function. This paper presents a new approach for evaluation of dispatching decisions. It uses models of choice of transport and considers the behaviour of the end-costumers. These models evaluate the knock-on delays in more detail than linearly monetary functions and consider other competing modes of transport. The new approach pursues the coupling of a microscopic model of railway operation with the macroscopic model of choice of transport. First it will be implemented for the railway operations process, but it can also be used for timetabling. The evaluation considers the possibility to change over to other transport modes by the end-costumers. The new approach first looks at the rail-mounted and road transport, but it can also be extended to air transport. The split of the end-costumers is described by the modal-split. The reactions by the end-costumers have an effect on the revenues of the railway undertakings. Various travel purposes has different pavement reserves and tolerances towards delays. Longer journey times affect besides revenue changes also additional costs. The costs depend either on time or track and arise from circulation of workers and vehicles. Only the variable values are summarised in the contribution margin, which is the base for the monetary evaluation of the delays. The contribution margin is calculated for different resolution decisions of the same conflict. The conflict resolution is improved until the monetary loss becomes minimised. The iterative process therefore determines an optimum conflict resolution by observing the change of the contribution margin. Furthermore, a monetary value of each dispatching decision can also be determined.

Keywords: choice of transport, knock-on delays, monetary evaluation, railway operations

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Authors: Shahin Marjan Nanaje

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The present century is the time that social worker faced complicated issues in the area of their work. All the focus are on bringing change in the life of those that they live in margin or live in poverty became the cause that we have forgotten to look at ourselves and start to bring change in the way we address issues. It seems that there is new area of needs that social worker should response to that. In need of dialogue and collaboration, to address the issues and needs of community both individually and as a group we need to have new method of dialogue as tools to reach to collaboration. The social worker as link between community, organization and government play multiple roles. They need to focus in the area of communication with new ability, to transfer all the narration of the community to those organization and government and vice versa. It is not relate only in language but it is about changing dialogue. Migration for survival by job seeker to the big cities created its own issues and difficulty and therefore created new need. Collaboration is not only requiring between government sector and non-government sectors but also it could be in new way between government, non-government and communities. To reach to this collaboration we need healthy, productive and meaningful dialogue. In this new collaboration there will not be any hierarchy between members. The methodology that selected by researcher were focusing on observation at the first place, and used questionnaire in the second place. Duration of the research was three months and included home visits, group discussion and using communal narrations which helped to bring enough evidence to understand real need of community. The sample selected randomly was included 70 immigrant families which work as sweepers in the slum community in Bangalore, Karnataka. The result reveals that there is a gap between what a community is and what organizations, government and members of society apart from this community think about them. Consequently, it is learnt that to supply any service or bring any change to slum community, we need to apply new skill to have dialogue and understand each other before providing any services. Also to bring change in the life of those marginal groups at large we need to have collaboration as their challenges are collective and need to address by different group and collaboration will be necessary. The outcome of research helped researcher to see the area of need for new method of dialogue and collaboration as well as a framework for collaboration and dialogue that were main focus of the paper. The researcher used observation experience out of ten NGO’s and their activities to create framework for dialogue and collaboration.

Keywords: collaboration, dialogue, community development, empowerment

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Authors: An-Yi Wang, Wei-Fong Kao, Shin-Han Tsai

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Introduction: Information as patient characteristics, resuscitation scene, resuscitation provider perspectives and families wish affects on resuscitation decision-making for out-of-hospital cardiac arrest (OHCA). There is no consistency consensus on how families and emergency physicians approach this decision. The main purpose of our study is to evaluate the characteristics of withholding resuscitation efforts arrival at the hospital. Methods: We retrospectively analyzed patients with OHCA without pre-hospital return-of-spontaneous circulation (ROSC) who was sent to our emergency department (ED) between January 2014 and December 2015. Baseline characteristics, pre-hospital course, and causes of the cardiopulmonary arrest among patients were compared. Results: In 2 years, total 155 arrest patients without pre-hospital ROSC was included. 33(21.3%) patients withhold the resuscitation efforts in ED with mean resuscitation duration 4.45 ± 7.04 minutes after ED arrival. In withholding group, the initial rhythm of arrests was all non-shockable. 9 of them received endotracheal intubation before decision-making. None of the patients in withhold resuscitation group survived to discharge. There was no significant difference among gender, underlying cardiovascular disease, malignancy, chronic renal disease, nor witness collapse between withhold and continue resuscitation groups. Univariate analysis showed there was lower percentage of bystander resuscitation (32.3% vs. 50.4%, p=0.071), and the lower percentage of transport via emergency medical service (EMS) (78.8% vs. 91.8%, p=0.054) in withholding group. Multivariate analysis showed old age (adjusted odds ratio=1.06, 95% C.I.=[1.02-1.11], p<0.05), with underlying respiratory insufficiency (adjusted odds ratio=12.16, 95% C.I.=[3.34-44.29], p<0.05), living at home compared with nursing home (adjusted odds ratio=37.75, 95% C.I.=[1.09-1110.70], p<0.05) were more likely to withhold resuscitation. Transport via EMS was more likely to continue resuscitation (adjusted odds ratio=0.11, 95% C.I.=[0.02-0.71], p<0.05). Conclusion: The decision-making for families and emergency physicians to withhold or continue resuscitation for out-of-hospital cardiac arrest is complex and multi-factorial. Continue resuscitation efforts in nursing home residents is high, and further study among this population is warranted.

Keywords: cardiopulmonary resuscitation, out-of-hospital cardiac arrest, termination resuscitation, withhold resuscitation

Procedia PDF Downloads 235