Search results for: clinical assessment

Authors: Mahdi Bastan, Ali Mohammad Ahmadvand, Fatemeh Soltani Khamsehpour

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Health organizations’ sustainable development has nowadays become highly affected by customers’ satisfaction due to significant changes made in the business environment of the healthcare system and emerging of Competitiveness paradigm. In case we look at the hospitals and other health organizations as service providers concerning profit issues, the satisfaction of employees as interior customers, and patients as exterior customers would be of significant importance in health business success. Furthermore, satisfaction rate could be considered in performance assessment of healthcare organizations as a perceived quality measure. Several researches have been carried out in identification of effective factors on patients’ satisfaction in health organizations. However, considering a systemic view, the complex causal relations among many components of healthcare system would be an issue that its acquisition and sustainability requires an understanding of the dynamic complexity, an appropriate cognition of different components, and effective relationships among them resulting ultimately in identifying the generative structure of patients’ satisfaction. Hence, the presenting paper applies system dynamics approaches coherently and methodologically to represent the systemic structure of customers’ satisfaction of a health system involving the constituent components and interactions among them. Then, the results of different policies taken on the system are simulated via developing mathematical models, identifying leverage points, and using scenario making technique and then, the best solutions are presented to improve customers’ satisfaction of the services. The presenting approach supports taking advantage of decision support systems. Additionally, relying on understanding of system behavior Dynamics, the effective policies for improving the health system would be recognized.

Keywords: customer satisfaction, healthcare, scenario, simulation, system dynamics

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Authors: Levicatus Mugenyi, Joaniter Nankabirwa, Emmanuel Arinaitwe, John Rek, Niel Hens, Moses Kamya, Grant Dorsey

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Background: Indoor residual spraying (IRS) reduces vector densities and malaria transmission, however, the most effective spraying intervals for IRS have not been well established. We aim to estimate the optimal timing interval for IRS using a modeling approach. Methods: We use a generalized additive model to estimate the optimal timing interval for IRS using the predicted malaria incidence. The model is applied to post IRS cohort clinical data from children aged 0.5–10 years in selected households in Tororo, historically a high malaria transmission setting in Uganda. Six rounds of IRS were implemented in Tororo during the study period (3 rounds with bendiocarb: December 2014 to December 2015, and 3 rounds with actellic: June 2016 to July 2018). Results: Monthly incidence of malaria from October 2014 to February 2019 decreased from 3.25 to 0.0 per person-years in the children under 5 years, and 1.57 to 0.0 for 5-10 year-olds. The optimal time interval for IRS differed between bendiocarb and actellic and by IRS round. It was estimated to be 17 and 40 weeks after the first round of bendiocarb and actellic, respectively. After the third round of actellic, 36 weeks was estimated to be optimal. However, we could not estimate from the data the optimal time after the second and third rounds of bendiocarb and after the second round of actellic. Conclusion: We conclude that to sustain the effect of IRS in a high-medium transmission setting, the second rounds of bendiocarb need to be applied roughly 17 weeks and actellic 40 weeks after the first round, and the timing differs for subsequent rounds. The amount of rainfall did not influence the trend in malaria incidence after IRS, as well as the IRS timing intervals. Our results suggest that shorter intervals for the IRS application can be more effective compared to the current practice, which is about 24 weeks for bendiocarb and 48 weeks for actellic. However, when considering our findings, one should account for the cost and drug resistance associated with IRS. We also recommend that the timing and incidence should be monitored in the future to improve these estimates.

Keywords: incidence, indoor residual spraying, generalized additive model, malaria

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Authors: Vignesh Ratnaraj, Jaewon Chang

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Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

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Authors: Carla S. C. da Silva, Cristiano Coelho, Junio Souza

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The universe of luxury has charmed and seduced consumers for centuries. Since the middle ages, their symbols are displayed as objects of power and status, arousing desire and provoking social covetousness. In this way, the counterfeit market is growing every day, offering a group of consumers the opportunity to enter into a distinct social position, where the beautiful and shiny brand logo signals an inclusion passport to everything this group wants. This work sought to investigate how the context and the social environment can influence consumers to choose products of symbolic brands even if they are not legitimate and how this behavior is accepted in society. The study proposed: a) to evaluate the measures of knowledge and quality of a set of marks presented in the manipulation of two contexts (luxury x academic) between buyers and non-buyers of forgeries, both for original products and their correspondence with counterfeit products; b) measure the effect of layout on the verbal responses of buyers and non-buyers in relation to their assessment of the behavior of buyers of counterfeits. The present study, in addition to measuring the level of knowledge and quality attributed to each brand investigated, also verified the willingness of consumers to pay for a falsified good of the brands of predilection compared to the original study. This data can serve as a parameter for luxury brand managers in their counterfeit coping strategies. The investigation into the frequency of purchase has shown that those who buy counterfeit goods do so regularly, and there is a propensity to repeat the purchase. It was noted that a significant majority of buyers of counterfeits are prone to invest in illegality to meet their expectations of being in line with the standards of their interest groups.

Keywords: luxury, consumers, counterfeits, context, behaviorism

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Authors: Jackqueline Uy, Hannah Miriam Verano, Crysler Luis Verbo, Irene Gueco

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Educational tours are part of the curriculum of the College of Tourism and Hospitality Management, De La Salle University-Dasmarinas. They are highly significant to the students, especially Tourism students. The purpose of this study was to determine how effective educational tours were as a learning tool using the Experiential Learning Theory by David Kolb. This study determined the demographic profile of the third year tourism students in terms of gender, section, educational tours joined, and monthly family income and lastly, this study determined if there is a significant difference between the demographic profile of the respondents and their assessment of educational tours as a learning tool. The researchers used a historical research design with the third-year students of the bachelor of science in tourism management as the population size and used a random sampling method. The researchers made a survey questionnaire and utilized statistical tools such as weighted mean, frequency distribution, percentage, standard deviation, T-test, and ANOVA. The result of the study answered the profile of the respondents such as the gender, section, educational tour/s joined, and family monthly income. The findings of the study showed that the 3rd year tourism management students strongly agree that educational tours are a highly effective learning tool in terms of active experimentation, concrete experience, reflective observation, and abstract conceptualisation based on the data gathered from the respondents.

Keywords: CTHM, educational tours, experiential learning theory, De La Salle University Dasmarinas, tourism

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Authors: Fathi Ali Swaid

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Soil salinization is one of the most hazardous phenomenons accelerating the land degradation processes. It either occurs naturally or is human-induced. High levels of soil salinity negatively affect crop growth and productivity leading land degradation ultimately. Thus, it is important to monitor and map soil salinity at an early stage to enact effective soil reclamation program that helps lessen or prevent future increase in soil salinity. Geophysical method has outperformed the traditional method for assessing soil salinity offering more informative and professional rapid assessment techniques for monitoring and mapping soil salinity. Soil sampling, EM38 and 2D conductivity imaging have been evaluated for their ability to delineate and map the level of salinity variations at Second Ponds Creek. The three methods have shown that the subsoil in the study area is saline. Salt variations were successfully observed under either method. However, EM38 reading and 2D inversion data show a clear spatial structure comparing to EC1:5 of soil samples in spite of that all soil samples, EM38 and 2D imaging were collected from the same location. Because EM38 readings and 2D imaging data are a weighted average of electrical soil conductance, it is more representative of soil properties than the soil samples method. The mapping of subsurface soil at the study area has been successful and the resistivity imaging has proven to be an advantage. The soil salinity analysis (EC1:5) correspond well to the true resistivity bringing together a good result of soil salinity. Soil salinity clearly indicated by previous investigation EM38 have been confirmed by the interpretation of the true resistivity at study area.

Keywords: 2D conductivity imaging, EM38 readings, soil salinization, true resistivity, urban salinity

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Authors: Michael Smalenberger

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Intelligent tutoring systems (ITS) are computer-based platforms which can incorporate artificial intelligence to provide step-by-step guidance as students practice problem-solving skills. ITS can replicate and even exceed some benefits of one-on-one tutoring, foster transactivity in collaborative environments, and lead to substantial learning gains when used to supplement the instruction of a teacher or when used as the sole method of instruction. A common facet of many ITS is their use of Bayesian Knowledge Tracing (BKT) to estimate parameters necessary for the implementation of the artificial intelligence component, and for the probability of mastery of a knowledge component relevant to the ITS. While various techniques exist to estimate these parameters and probability of mastery, none directly and reliably ask the user to self-assess these. In this study, 111 undergraduate students used an ITS in a college-level introductory statistics course for which detailed transaction-level observations were recorded, and users were also routinely asked direct questions that would lead to such a self-assessment. Comparisons were made between these self-assessed values and those obtained using commonly used estimation techniques. Our findings show that such self-assessments are particularly relevant at the early stages of ITS usage while transaction level data are scant. Once a user’s transaction level data become available after sufficient ITS usage, these can replace the self-assessments in order to eliminate the identifiability problem in BKT. We discuss how these findings are relevant to the number of exercises necessary to lead to mastery of a knowledge component, the associated implications on learning curves, and its relevance to instruction time.

Keywords: Bayesian Knowledge Tracing, Intelligent Tutoring System, in vivo study, parameter estimation

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Authors: Merfat Algethami, Anton Blencowe, Bryce Feltis, Stephen Best, Moshi Geso

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Nano-materials with high atomic number atoms have been demonstrated to enhance the effective radiation dose and thus potentially could improve therapeutic efficacy in radiotherapy. The optimal nanoparticulate agents require high X-ray absorption coefficients, low toxicity, and should be cost effective. The focus of our research is the development of a nanoparticle therapeutic agent that can be used in radiotherapy to provide optimal enhancement of the radiation effects on the target. In this study, we used bismuth (Bi) nanoparticles coated with starch and bismuth sulphide nanoparticles (Bi2S3) coated with polyvinylpyrrolidone (PVP). These NPs are of low toxicity and are one of the least expensive heavy metal-based nanoparticles. The aims of this study were to synthesise Bi2S3 and Bi NPs, and examine their cytotoxicity to human lung adenocarcinoma epithelial cells (A549). The dose enhancing effects of NPs on A549 cells were examined at both KV and MV energies. The preliminary results revealed that bismuth based nanoparticles show increased radio-sensitisation of cells, displaying dose enhancement with KV X-ray energies and to a lesser degree for the MV energies. We also observed that Bi NPs generated a greater dose enhancement effect than Bi2S3 NPs in irradiated A549 cells. The maximum Dose Enhancement Factor (DEF) was obtained at lower energy KV range when cells treated with Bi NPs (1.5) compared to the DEF of 1.2 when cells treated with Bi2S3NPs. Less radiation dose enhancement was observed when using high energy MV beam with higher DEF value of Bi NPs treatment (1.26) as compared to 1.06 DEF value with Bi2S3 NPs. The greater dose enhancement was achieved at KV energy range, due the effect of the photoelectric effect which is the dominant process of interaction of X-ray. The cytotoxic effect of Bi NPs on enhancing the X-ray dose was higher due to the higher amount of elemental Bismuth present in Bi NPs compared to Bi2S3 NPs. The results suggest that Bismuth based NPs can be considered as valuable dose enhancing agents when used in clinical applications.

Keywords: A549 lung cancer cells, Bi2S3 nanoparticles, dose enhancement effect, radio-sensitising agents

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Authors: Randhir Singh Ranta

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The attempt to achieve and maintain an optimum state of health has always drilled the human mind and consequently, a number of healing systems have evolved around the world. Communities have contrived procedures to alleviate the wearisome condition arising out of ailments, using their own system, which differ from one community to another. Each culture has evolved a viewpoint regarding the cause of disease and the same is embedded in their belief systems. In India, the elementary proposition of mental health is within the community. From the theoretical perspective, the individual obeying and adhering to the institution of village deity represents the two changeovers i.e. from biological to psychological and from psychological to spiritual. In order to understand the cultural notion of mental health and role of local deities, a study was conducted in North-western Himalaya with a purpose to study the belief system of people in context of institution of village deity and establish a relationship between religiosity and general well-being among the believers. An effort was made to compare the mental health status of people facing psychosomatic disorders with the normal. Quantitative and qualitative methods were used for the purpose. Case studies were made to have an understanding of nature of mental and behavioural disorders and the role of institutions of local deities in managing the same. The results revealed that mountain communities have firm beliefs in local deities. A significant difference was found on the scores of belief and wellbeing, and a positive correlation was found between the belief assessment and general wellbeing.

Keywords: culture notion, mental health, healing system, deities

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Authors: Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshenas, Fatemeh Rezaei

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Surgical procedures aim at preserving human life and improving quality of their life. However, there are many potential risk sources that can cause serious harm to patients. For centuries, managers believed that technical competence of a surgeon is the only key to a successful surgery. But over the past decade, risks are considered in terms of process-based safety procedures, teamwork and inter departmental communication. Aims: This study aims to determine how the process- biased surgical risk management should be done in terms of project management tool named ABS (Activity Breakdown Structure). Settings and Design: This study was conducted in two stages. First, literature review and meeting with professors was done to determine principles and framework of surgical risk management. Next, responsible teams for surgical patient journey were involved in following meeting to develop the process- biased surgical risk management. Methods and Material: This study is a qualitative research in which focus groups with the inductive approach is used. Sampling was performed to achieve representativeness through intensity sampling biased on experience and seniority. Analysis Method used: context analysis of interviews and consensus themes extracted from FDG meetings discussion was the analysis tool. Results: we developed the patient journey process in 5 main phases, 24 activities and 108 tasks. Then, responsible teams, transposition and allocated places for performing determined. Some activities and tasks themes were repeated in each phases like patient identification and records review because of their importance. Conclusions: Risk management of surgical departments is significant as this facility is the hospital’s largest cost and revenue center. Good communication between surgical team and other clinical teams outside surgery department through process- biased perspective could improve safety of patient under this procedure.

Keywords: risk management, activity breakdown structure (ABS), surgical department, medical sciences

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Authors: Prachi Bhatt

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Motivated workforce is an important asset of an organisation. Intrinsic motivation is one of the key aspects of people operations and performance. Researches have emphasized the significance of internal factors in individuals’ motivation. In the changing business scenario, it is a challenge for the organizations’ leaders to inspire and motivate their workforce. The present study deals with the intrinsic motivation potential of an individual which govern the innate capability of an individual driving him or her to behave or perform in the changing work environment, tasks, teams. Differences at individual level significantly influence differences in levels of motivation. In the above context, the present research attempts to explore behavioral trait dimensions which influence motivational potential of an individual. The present research emphasizes the significance of intrinsic motivational potential and the significance of exploring the differences in the intrinsic motivational potential levels of individuals at work places. Thus, this paper empirically tests the framework of behavioral traits which affects motivational potential of an individual. With the help of two studies i.e., Study 1 and Study 2, exploratory factor analysis and confirmatory factor analysis, respectively, indicated a reliable measure assessing intrinsic motivational potential of an individual. Given the variety of challenges of motivating contemporary workforce, and with increasing importance of intrinsic motivation, the paper discusses the relevance of the findings and of the measure assessing intrinsic motivational potential. Assessment of such behavioral traits would assist in the effective realization of intrinsic motivational potential of individuals. Additionally, the paper discusses the practical implications and furnishes scope for future research.

Keywords: behavioral traits, individual differences, intrinsic motivational potential, intrinsic motivation, motivation, workplace motivation

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Authors: Gebremedhin Kiros, Amba Shetty, Lakshman Nandagiri

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Soil erosion is a major threat to the sustainability of land and water resources in the catchment and there is a need to identify critical areas of erosion so that suitable conservation measures may be adopted. The present study was taken up to understand the temporal and spatial distribution of soil erosion and daily sediment yield in Geba catchment (5137 km2) located in the Northern Highlands of Ethiopia. Soil and Water Assessment Tool (SWAT) was applied to the Geba catchment using data pertaining to rainfall, climate, soils, topography and land use/land cover (LU/LC) for the historical period 2000-2013. LU/LC distribution in the catchment was characterized using LANDSAT satellite imagery and the GIS-based ArcSWAT version of the model. The model was calibrated and validated using sediment concentration measurements made at the catchment outlet. The catchment was divided into 13 sub-basins and based on estimated soil erosion, these were prioritized on the basis of susceptibility to soil erosion. Model results indicated that the average sediment yield estimated of the catchment was 12.23 tons/ha/yr. The generated soil loss map indicated that a large portion of the catchment has high erosion rates resulting in significantly large sediment yield at the outlet. Steep and unstable terrain, the occurrence of highly erodible soils and low vegetation cover appeared to favor high soil erosion. Results obtained from this study prove useful in adopting in targeted soil and water conservation measures and promote sustainable management of natural resources in the Geba and similar catchments in the region.

Keywords: Ethiopia, Geba catchment, MUSLE, sediment yield, SWAT Model

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Authors: Vasudha Thapa, Kiran Chappa

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There is a pressing need to prepare cities in the developing countries of the global south such as India against the chaos created by COVID 19 pandemic and future disaster risks. This pandemic posed the nation with an unprecedented challenge of dealing with a wave of stranded migrant workers. These workers comprise the most vulnerable section of the society in case of any pandemic or disaster risks. The COVID 19 pandemic exposed the vulnerability of migrant workers in the urban form and the need for capacity-building strategies against future pandemics. This paper highlights the challenges of these migrant workers in the case of Mumbai city in lockdown, post lockdown, and the current uncertain scenarios. The paper deals with a thorough investigation of the existing and the recent policies and strategies taken by the Urban Local Bodies (ULBs), state, and central government to assist these migrants in the city during this mayhem of uncertainties. The paper looks further deep into the challenges and opportunities presented in the current scenario through the assessment of existing data and response to policy measures taken by the government organizations. The ULBs are at the forefront in the response to any disaster risk, hence the paper assesses the capacity gaps of the Urban local bodies in mitigating the risks posed by any pandemic-like situation. The study further recommends capacity-building strategies at various levels of governance and uniform policy measures to assist the migrant population of the city.

Keywords: urban resilience, covid 19, migrant population, India, capacity building, governance

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Authors: Yating Yang, Xue Zhang, Chengli Zhao

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In the increasingly interconnected global environment brought about by globalization, it is crucial for countries to timely grasp the development motivations in relevant research fields of other countries and seize development opportunities. Motivation, as the intrinsic driving force behind actions, is abstract in nature, making it difficult to directly measure and evaluate. Drawing on the ideas of social influence network theory, the research motivations of a country can be understood as the driving force behind the development of its science and technology sector, which is simultaneously influenced by both the country itself and other countries/regions. In response to this issue, this paper improves upon Friedkin's social influence network theory and applies it to motivation description, constructing a dynamic alliance network and hostile network centered around the United States and China, as well as a sensitivity matrix, to remotely assess the changes in national research motivations under the influence of international relations. Taking artificial intelligence as a case study, the research reveals that the motivations of most countries/regions are declining, gradually shifting from a neutral attitude to a negative one. The motivation of the United States is hardly influenced by other countries/regions and remains at a high level, while the motivation of China has been consistently increasing in recent years. By comparing the results with real data, it is found that this model can reflect, to some extent, the trends in national motivations.

Keywords: influence network theory, remote assessment, relation matrix, dynamic sensitivity matrix

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Authors: Inosha Bimali, Shambhu P. Adhikari, Sumana Baidya, Nishchal R. Shakya

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Background: An earthquake of 7.8 magnitudes with an epicenter in Gorkha on 25th April 2015 and second earthquake of 6.5 magnitudes with an epicenter at Sindhupalchwok on 12th May 2015 struck the beautiful country of Nepal, killing more than 8,500 people and over 18,500 individuals were left injured with various forms of disabilities. Objectives: To explore number, type and level of disability among post earthquake victims. A door to door physiotherapy rehabilitation program will be conducted at the community level as a continuation of this study. Methods: A survey was carried out in the catchment area of Bahunepati and Manekharka outreach centers of Sindhupalchowk district and Gaurishankar outreach center of Dolakha district of Dhulikhel Hospital. Physical disability was identified using a disability survey form given by Ministry of women, children and social welfare Nepal Government. World health organization disability assessment schedule-2 was used to identify the level of disability. Results: Twenty-nine person with disabilities at Bahunepati, four person with disabilities at Manekharkha and two person with disabilities at Gaurishankar and its catchment area were identified. Level of disability was an average of 56% with majority of survivors having upper extremities fractures followed by lower extremities fractures and miscellaneous injury. Few spinal cord injuries and head injuries were also identified. Conclusion: Though number of person with disabilities was found relatively less, disability level is high; hence an urgent need of physiotherapy rehabilitation is reflected to improve the quality of life of the affected people.

Keywords: community, disability, Nepal earthquake, physiotherapy

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Authors: Samar Saadeldin Abdelmotalab Omer, Ikram Mohammed Eltayeb Elsiddig, Amna Beshir Medani Ahmed, Saad Mohammed Hussein Ayoub

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Many herbal medicinal products are considered as potential hypocholesterolemic agents with encouraging safety profiles, however, only a limited amount of clinical research exists to support their efficacy. The present study was designed to compare the antihypercholesterolaemic and antioxidant activities of the crude ethanolic extracts of Citrus reticulata peel, Zingiber officinale rhizome, and Sesamum indicum seeds. Forty-five rats were used throughout the experiment, which were divided into nine groups, five rats in each as follows; normal control group (normal rats fed with standard normal diet), rats fed hypercholesterolemic diet consisting of 1% cholesterol and 10% saturated animal fat, which were further divided into eight groups; hypercholesterolemic control group (rats only fed hypercholesterolemic diet), groups 3,4,5,6,7, and 8 were given Citrus reticulata, Zingiber officinale, and Sesamum indicum ethanolic extracts at doses of (250mg/kg and 500mg/kg, respectively) orally; and group 9 rats were given atorvastatin (0.18mg/kg) orally as a reference antihypercholesterolaemic drug. Blood samples were obtained four weeks following treatment from the retro-orbital venous plexus after fasting overnight from all groups and the lipid profile (serum total cholesterol (TC), high-density-lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and triglycerides levels) was measured and the risk ratio (TC/HDL-C) was assessed. The antioxidant activity of the three plant extracts was determined using DPPH free-radical assay. Results of in vivo and in vitro antihypercholesterolaemic and antioxidant assay, respectively, revealed that the three extracts possess comparable antioxidant and anti-hypercholesterolaemic activities.

Keywords: anti hypercholesterolemic effects, antioxidant activity, HDL, LDL, TC, TGs, citrus reticulata, sesamum indicum, zingiber officinale

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Authors: Iftekhar Hassan, Sayedil Morsalin, Easir A Khan

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Accidents involving fire occur frequently in recent times and their causes showing a great deal of variety which require intervention methods and risk assessment strategies are unique in each case. On September 4, 2020, a fire and explosion occurred in a confined space caused by a methane gas leak from an underground pipeline in Baitus Salat Jame mosque during Night (Esha) prayer in Narayanganj District, Bangladesh that killed 34 people. In this research, this incident is simulated using Fire Dynamics Simulator (FDS) software to analyze and understand the nature of the accident and associated consequences. FDS is an advanced computational fluid dynamics (CFD) system of fire-driven fluid flow which solves numerically a large eddy simulation form of the Navier–Stokes’s equations for simulation of the fire and smoke spread and prediction of thermal radiation, toxic substances concentrations and other relevant parameters of fire. This study focuses on understanding the nature of the fire and consequence evaluation due to thermal radiation caused by vapor cloud explosion. An evacuation modeling was constructed to visualize the effect of evacuation time and fractional effective dose (FED) for different types of agents. The results were presented by 3D animation, sliced pictures and graphical representation to understand fire hazards caused by thermal radiation or smoke due to vapor cloud explosion. This study will help to design and develop appropriate respond strategy for preventing similar accidents.

Keywords: consequence modeling, fire and explosion, fire dynamics simulation (FDS), thermal radiation

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Authors: Chia-Ying Lin

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This paper explains how to enhance doctor-patient communication and nurse-patient communication through multiple intelligence signing methods and user-centered. It is hoped that through the implementation of the "electronic consent", the problems faced by the paper consent can be solved: storage methods, resource utilization, convenience, correctness of information, integrated management, statistical analysis and other related issues. Make better use and allocation of resources to provide better medical quality. First, invite the ｍedical records department to assist in the inventory of paper consent in the hospital: organising, classifying, merging, coding, and setting. Second, plan the electronic consent configuration file: set the form number, consent form group, fields and templates, and the corresponding doctor's order code. Next, Summarize four types of rapid methods of electronic consent: according to the doctor's order, according to the medical behavior, according to the schedule, and manually generate the consent form. Finally, system promotion and adjustment: form an "electronic consent promotion team" to improve, follow five major processes: planning, development, testing, release, and feedback, and invite clinical units to raise the difficulties faced in the promotion, and make improvements to the problems. The electronic signature rate of the whole hospital will increase from 4% in January 2022 to 79% in November 2022. Use the saved resources more effectively, including: reduce paper usage (reduce carbon footprint), reduce the cost of ink cartridges, re-plan and use the space for paper medical records, and save human resources to provide better services. Through the introduction of information technology and technology, the main spirit of "lean management" is implemented. Transforming and reengineering the process to eliminate unnecessary waste is also the highest purpose of this project.

Keywords: smart signature, electronic consent, electronic medical records, user-centered, doctor-patient communication, nurse-patient communication

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Authors: Saima Kalsoom, Sobia Masood, Muhammad Faran

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This study aimed to examine the association between emotional intelligence and gender role attitudes of married individuals. Another aim of this study was to test the moderating role of gender work status of married individuals for predicting gender role attitudes from emotional intelligence. A sample of (N = 500) married working men and women (both working & housewives) was approached through purposive convenience sampling technique. The data was collected employing cross-sectional research design. The indigenous versions of the Gender Role Attitudes Scale and perceived Emotional Intelligence Scale were used. The results of alpha coefficients for both the scales and subscales used in this study designated satisfactory evidence for internal consistency and reliability. Assessment of correlation coefficients showed significant positive correlation between gender role attitudes and emotional intelligence, subfactors of emotional intelligence i.e., emotional self-regulation, emotional self-awareness, and interpersonal skills with gender role attitudes. Results of model testing revealed that gender (the effect was significant for women) and work status (the effect was more significant for married working women than married working men and housewives) of the married individuals significantly moderated the relationship between emotional intelligence and gender role attitudes into the positive direction. Further, it was also found that gender and work status also moderated the relationship between emotional self-regulation (as sub factor of emotional intelligence) and gender role attitudes in a positive direction. In conclusion, this empirical evidence is vital contribution derived from the traditional and collectivistic socio-cultural background of Pakistan.

Keywords: gender role attitudes, emotional intelligence, emotional self-regulation, gender, work status, married working women

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Authors: Ahmad Esmaillzadeh, Javad Anjom-Shoae, Omid Sadeghi,

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Background: Although considerable research has been devoted to the link between consumption of legume and nuts and metabolic abnormalities, few studies have examined legume and nuts consumption in relation to psychological disorders. Objective: The current study aimed to examine the association of legume and nuts consumption with depression, anxiety and psychological distress in Iranian adults. Methods: This cross-sectional study was carried out among 3172 adult participants aged 18-55 years. Assessment of legume and nuts consumption was conducted using a validated dish-based 106-item semi-quantitative food frequency questionnaire. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was used to examine psychological health. Scores of 8 or more on either subscale in the questionnaire were considered to indicate the presence of depression or anxiety. Data on psychological distress were collected through the use of General Health Questionnaire (GHQ), in which the score of 4 or more was considered as having psychological distress. Results: Mean age of participants was 36.5±7.9 years. Compared with the lowest quintile, men in the highest quintile of legume and nuts consumption had lower odds of anxiety; such that after adjusting for potential confounding variables, men in the top quintile of legume and nuts consumption were 66% less likely to be anxious than those in the bottom quintile (OR: 0.34; 95% CI: 0.14-0.82). Such relationship was not observed among women. We failed to find any significant association between legume plus nuts consumption and depression or psychological distress after adjustment for potential confounders. Conclusion: We found that consumption of legume and nuts was associated with lower odds of anxiety in men, but not in women. No significant association was seen between consumption of legume and nuts and odds of depression or psychological disorder. Further prospective studies are required to confirm these findings.

Keywords: anxiety, depression, legumes, nuts, psychological distress

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Authors: Junzhang Wu, Yifeng Zou, Alessandro Manzardo, Antonio Scipioni

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Dynamic expiration dates (DEDs) play an essential role in reducing food waste in the context of the sustainable cold chain and food system. However, it is unknown for the trades-off in retail benefits when setting an expiration date on fresh food products. This study aims to develop a multi-dimensional decision-making model that integrates DEDs with food waste based on wireless sensor network technology. The model considers the initial quality of fresh food and the change rate of food quality with the storage temperature as cross-independent variables to identify the potential impacts of food waste in retail by applying s DEDs system. The results show that retail benefits from the DEDs system depend on each scenario despite its advanced technology. In the DEDs, the storage temperature of the retail shelf leads to the food waste rate, followed by the change rate of food quality and the initial quality of food products. We found that the DEDs system could reduce food waste when food products are stored at lower temperature areas. Besides, the potential of food savings in an extended replenishment cycle is significantly more advantageous than the fixed expiration dates (FEDs). On the other hand, the information-sharing approach of the DEDs system is relatively limited in improving sustainable assessment performance of food waste in retail and even misleads consumers’ choices. The research provides a comprehensive understanding to support the techno-economic choice of the DEDs associated with food waste in retail.

Keywords: dynamic expiry dates (DEDs), food waste, retail benefits, fixed expiration dates (FEDs)

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Authors: Yildiray Korkmaz, Mehmet Aksoy

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In today's operations, countries want to reach their aims in the shortest way due to economical, political and humanitarian aspects. The most effective way of achieving this goal is to be able to penetrate strategic targets. Strategic targets are generally located deep inside of the countries and are defended by modern and efficient surface to air missiles (SAM) platforms which are operated as integrated with Intelligence, Surveillance and Reconnaissance (ISR) systems. On the other hand, these high valued targets are buried deep underground and hardened with strong materials against attacks. Therefore, to penetrate these targets requires very detailed intelligence. This intelligence process should include a wide range that is from weaponry to threat assessment. Accordingly, the framework of the attack package will be determined. This mission package has to execute missions in a high threat environment. The way to minimize the risk which depends on loss of life is to use packages which are formed by UAVs. However, some limitations arising from the characteristics of UAVs restricts the performance of the mission package consisted of UAVs. So, the mission package should be formed with UAVs under the leadership of a fifth generation manned aircraft. Thus, we can minimize the limitations, easily penetrate in the deep inside of the enemy territory with minimum risk, make a decision according to ever-changing conditions and finally destroy the strategic targets. In this article, the strengthens and weakness aspects of UAVs are examined by SWOT analysis. And also, it revealed features of a mission package and presented as an example what kind of a mission package we should form in order to get marginal benefit and penetrate into strategic targets with the development of autonomous mission execution capability in the near future.

Keywords: UAV, autonomy, mission package, strategic attack, mission planning

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Authors: Eyüp S. Akbas, Betul Ayaz, Beyza S. Haksever, Sema Basat

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We aimed to evaluate the relationship between insulin resistance, muscle mass and muscle strength in patients with Hepatitis B virus-related cirrhosis. In our study, there were 65 patients with hepatitis B virus-related cirrhosis in Child A and B group and 65 healthy control individual. Control group was chosen between patients who admitted to the internal medicine clinic and had no pathological values in a routine examination. Muscle mass index was calculated with bioimpedance analysis for both groups to determine muscle strength and muscle mass. Handgrip strength, arm, and calf circumference were measured. In both groups, HOMA-IR was calculated to determine insulin resistance. Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) value was detected 3,47±3,80 in the study group and 1,83±1,20 in control group. There were significant differences between the two groups in arm circumference, fasting insulin, fasting glucose, HOMA-IR, High-density lipoprotein (HDL) and total cholesterol parameters. The correlation coefficient between muscle mass and insulin resistance was statistically insignificant, especially in the study group. In healthy individuals group and all the groups, there wasn’t a correlation between muscle mass and insulin resistance. The upper limit for HOMA-IR was determined as 3,2. In control group, %78,9 of individuals were in HOMA-IR ( < 3.2) group and %21,1 of them were in ( ≥ 3,2) group. In study group, %68,3 of individuals were in HOMA-IR ( < 3,2) group and %31.7 were in HOMA-IR ( ≥ 3,2) group. In our study, we did not find a relationship between muscle mass and insulin resistance in patients with liver cirrhosis. In the study group, we detected a positive relationship between muscle mass, handgrip strength, and calf circumference. We did not find a relationship between insulin resistance and handgrip strength in our study.

Keywords: cirrhosis, hepatitis B, Insulin resistance, muscle mass

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Authors: Pronob Kumar Mozumder, M. Abdur Rob Mollah

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This research was conducted in two coastal locations of Bangladesh from February, 2013 to January, 2014.The objective of this research was to assess the potential vulnerabilities of climate change on local ecosystem and people and to identify and recommend local level adaptation strategies to climate change. Focus group discussions, participatory rural appraisal, interviewing local elderly people were conducted. Perceptions about climate change indicate that local people are experiencing impacts of climate change. According to local people, temperature, cyclone, rain, water-logging, siltation, salinity, erosion, and flash flood are increasing. Vulnerability assessment revealed that local people are variously affected by abnormal climate related disasters. This is jeopardizing their livelihoods, risking their lives, health, and their assets. This prevailing climatic situation in the area is also impacting their environmental conditions, biodiversity and natural resources, and their economic activities. The existing adaptation includes using traditional boat and mobile phone while fishing and making house on high land and lower height. Proposed adaptation for fishing boat are using more than 60 feet length with good timber, putting at least 3 longitudinal bar along upper side, using enough vertical side bars. The homestead measures include use of cross bracing of wall frame, roof tying with extra-post by ropes and plantation of timber tree against wind.

Keywords: community level vulnerabilities, climate change, Cox’s Bazar-Teknaf Coastal Area, Bangladesh

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Authors: Hossein Hassani, Ali Rezaei

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In recent years, the study of soil contamination problems surrounding mines and smelting plants has attracted some serious attention of the environmental experts. These elements due to the non- chemical disintegration and nature are counted as environmental stable and durable contaminants. Variability of these contaminants in the soil and the time and financial limitation for the favorable environmental application, in order to reduce the risk of their irreparable negative consequences on environment, caused to apply the favorable grading of these contaminant for the further success of the risk management processes. In this study, we use the contaminants factor risk indices, average concentration, enrichment factor and geoaccumulation indices for evaluating the metal contaminant of including Pb, Ni, Se, Mo and Zn in the soil of Sarcheshmeh copper mine area. For this purpose, 120 surface soil samples up to the depth of 30 cm have been provided from the study area. And the metals have been analyzed using ICP-MS method. Comparison of the heavy and potentially toxic elements concentration in the soil samples with the world average value of the uncontaminated soil and shale average indicates that the value of Zn, Pb, Ni, Se and Mo is higher than the world average value and only the Ni element shows the lower value than the shale average. Expert opinions on the relative importance of each indicators were used to assign a final weighting of the metals and the heavy metals were ranked using the TOPSIS approach. This allows us to carry out efficient environmental proceedings, leading to the reduction of environmental ricks form the contaminants. According to the results, Ni, Pb, Mo, Zn, and Se have the highest rate of risk contamination in the soil samples of the study area.

Keywords: contamination coefficient, geoaccumulation factor, TOPSIS techniques, Sarcheshmeh copper complex

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Authors: Francesca Carta, Giovanna Linfante, Laura Agneni, Debora Radicchia, Camilla Micheletta, Angelo Del Cimmuto

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Overtaking competence mismatches and fostering career pathways congruent with the individual skills profile would significantly contribute to fighting unemployment. The aim of this paper is to examine the usefulness and efficiency of qualitative tools in supporting and improving the quality of caseworkers’ activities during the jobseekers’ profile analysis and career guidance process. The selected target groups are long-term and middle term unemployed, job seekers, young people at the end of the vocational training pathway and unemployed woman with social disadvantages. The experimentation is conducted in Italy at public employment services in 2017. In the framework of Italian labour market reform, the experimentation represents the first step to develop a customized qualitative model profiling; the final general object is to improve the public employment services quality. The experimentation tests the transferability of an OECD self-assessment competences tool in the Italian public employment services. On one hand, the first analysis results will indicate the user’s perception concerning the tool’s application and their different competence levels (literacy, numeracy, problem solving, career interest, subjective well-being and health, behavioural competencies) with reference to the specific target. On the other hand, the experimentation outcomes will show caseworkers understanding regarding the tool’s usability and efficiency for career guidance and reskilling and upskilling programs.

Keywords: career guidance, evaluation competences, reskilling pathway, unemployment

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Authors: Mengjia Zhi, Xingmei Wei, Xiang Gao, Shiyang Liu, Zhiran Huang, Li Yang, Jing Sun

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Background: To understand the consumption trend of opioid analgesics and the consumption adequacy of opioid analgesic treatment for moderate to severe pain in China, as well as the pain control level of China with international perspective. Importance: To author’s best knowledge, this is the first study in China to measure the adequacy of opioid analgesic treatment for moderate to severe pain considering disease pattern and with the standardized pain treatment guideline. Methods: A retrospective analysis was carried out to show the consumption frequency (daily defined doses, DDDs) of opioid analgesics and its trend in China from 2006 to 2016. Adequacy of consumption measure (ACM) was used to measure the number of needed morphine equivalents and the overall adequacy of opioid analgesic treatment of moderate to severe pain in China, and compared with international data. Results: The consumption frequency of opioid analgesics (DDDs) in China increased from 13,200,000 DDDs in 2006 to 44,200,000 DDDs in 2016, and showed an increasing trend. The growth rate was faster at first, especially in 2013, then slowed down, decreased slightly in 2015. The ACM of China increased from 0.0032 in 2006 to 0.0074 in 2016, with an overall trend of growth. The ACM level of China has been always a very poor level during 2006-2016. Conclusion: The consumption of opioid analgesics for the treatment of moderate to severe pain in China has always been inadequate. There is a huge gap between China and the international level. There are many reasons behind this problem, which lie in different aspects, including medical staff, patients and the public, health systems and social & cultural aspects. It is necessary to strengthen the training and education of medical staff and the patients, to use mass media to disseminate scientific knowledge of pain management, to encourage communications between doctors and patients, to improve regulatory system for the controlled medicines and the overall health systems, and to balance the regulatory goal for avoidance of abuse, and the social goal of meeting the increasing needs of the people for better life.

Keywords: opioid analgesics, adequate consumption measure, pain control, China

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Authors: Prakriti Chand, Binayak Prasad Rajbhandari, Ram Prasad Mainali

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Local indigenous community in Lalitpur, Nepal, use Ignored, Underutilized and Uncommercialized Horticultural Species (IUUHS) for medicine, food, spice, pickles, and religious purposes. But, research and exploration about usage, status, potentialities, and importance of these future sustainable crops are inadequately documented and have been ignored for a positive food transformation system. The study aimed to assess the use and diversity of NUWHS in terms of current status investigation, documentation, management, and future potentialities of IUUHS. A wide range of participatory tools through the household survey ( 100 respondents), 8 focus group discussions, 20 key informant interviews was followed by individual assessment, participatory rural assessments and supplemented by literature review. This study recorded 95 IUUHS belonging to 43 families, of which 92 were angiosperms, 2 pteridophytes, and 1 gymnosperm. Twenty seven species had multiple uses. The IUUHS observed during the study were 31 vegetables, 20 fruits, 14 wild species, 7 spices, 7 pulses, 7 pickle, 7 medicine, and 2 religious species. Vegetables and fruits were the most observed category of IUUHS. Eighty nine species were observed as medicinally valued species, and 86% of the women had taken over all the agricultural activities. 84% of respondents used these species during food deficient period. IUUHS have future potential as an alternative food to major staple crops due to its remarkable ability to be adapted in marginal soil and thrive harsh climatic condition. There are various constraints regarding the utilization and development of IUUHS, which needs initiation of promotion, utilization, management, and conservation of species from the grass root level.

Keywords: agrobiodiversity, Ignored and underutilized species, uncultivated horticultural species, diversity use

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Authors: Ryoo Hye Jin Agnes

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This study aims to investigate the efficacy of clickers in fostering L2 class interaction. In an L2 classroom, active learner-to-learner interactions and learner-to-teacher interactions play an important role in language acquisition. In light of this, introducing learning tools that promote such interactions would benefit L2 classroom by fostering interaction. This is because the anonymity of clickers allows learners to express their needs without the social risks associated with speaking up in the class. clickers therefore efficiently help learners express their level of understanding during the process of learning itself. This allows for an evaluative feedback loop where both learners and teachers understand the level of progress of the learners, better enabling classrooms to adapt to the learners’ needs. Eventually this tool promotes participation from learners. This, in turn, is believed to be effective in fostering classroom interaction, allowing learning to take place in a more comfortable yet vibrant way. This study is finalized by presenting the result of an experiment conducted to verify the effectiveness of this approach when teaching pragmatic aspect of Korean expressions with similar semantic functions. The learning achievement of learners in the experimental group was found higher than the learners’ in a control group. A survey was distributed to the learners, questioning them regarding the efficacy of clickers, and how it contributed to their learning in areas such as motivation, self-assessment, increasing participation, as well as giving feedback to teachers. Analyzing the data collected from the questionnaire given to the learners, the study presented data suggesting that this approach increased the scope of interactivity in the classroom, thus not only increasing participation but enhancing the type of classroom participation among learners. This participation in turn led to a marked improvement in their communicative abilities.

Keywords: second language acquisition, interaction, clickers, learner response system, output from learners, learner’s cognitive process

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Authors: C. F. Glover, J. Marinaccio, A. Barnes, I. Mabbett, G. Williams

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The aim of the current study is to optimise formulations, in terms of charging efficiency, of a printed Ni(OH)2 precursor coating of a battery anode. Through the assessment of the current densities during charging, the efficiency of a range of formulations are compared. The Scanning vibrating electrode technique (SVET) is used extensively in the field of corrosion to measure area-averaged current densities of freely-corroding metal surfaces when fully immersed in electrolyte. Here, a Ni(OH)2 electrode is immersed in potassium hydroxide (30% w/v solution) electrolyte and charged using a range of applied currents. Samples are prepared whereby multiple coatings are applied to one substrate, separated by a non-conducting barrier, and charged using a constant current. With a known applied external current, electrode efficiencies can be calculated based on the current density outputs measured using SVET. When fully charged, a green Ni(OH)2 is oxidised to a black NiOOH surface. Distinct regions displaying high current density, and hence a faster oxidising reaction rate, are located using the SVET. This is confirmed by a darkening of the region upon transition to NiOOH. SVET is a highly effective tool for assessing homogeneity of electrodes during charge/discharge. This could prove particularly useful for electrodes where there are no visible surface appearance changes. Furthermore, a scanning Kelvin probe technique, traditionally used to assess underfilm delamination of organic coatings for the protection of metallic surfaces, is employed to study the change in phase of oxides, pre and post charging.

Keywords: battery, electrode, nickel hydroxide, SVET, printed

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