Search results for: quality care

Authors: Rattanathip Rattanachai, Kunyanuth Kularbphettong

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This paper describes the development of a Vegetation Searching System based on Web Application in case of Suan Sunandha Rajabhat University. The model was developed by PHP, JavaScript, and MySQL database system and it was designed to support searching endemic and rare species of tree on web site. We describe the design methods and functional components of this prototype. To evaluate the system performance, questionnaires for system usability and Black Box Testing were used to measure expert and user satisfaction. The results were satisfactory as followed: Means for experts and users were 4.3 and 4.5, and standard deviation for experts and users were 0.61 and 0.73 respectively. Further analysis showed that the quality of plant searching web site was also at a good level as well.

Keywords: endemic species, vegetation, web-based system, black box testing, Thailand

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Authors: Wan Azuati Wan Omar, Selva Rani John Jasudass, Siti Rohaiza Md. Saad

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Introduction & objective: The objectives of this study were to assess patient’s knowledge of appropriate sublingual glyceryl trinitrate (GTN) use as well as to investigate how patients commonly store and carry their sublingual GTN tablets. Methodology: This was a cross-sectional survey, using a validated researcher-administered questionnaire. The study involved cardiac patients receiving sublingual GTN attending the outpatient and inpatient departments of Taiping Hospital, a non-academic public care hospital. The minimum calculated sample size was 92, but 100 patients were conveniently sampled. Respondents were interviewed on 3 areas, including demographic data, knowledge and use of sublingual GTN. Eight items were used to calculate each subject’s knowledge score and six items were used to calculate use score. Results: Of the 96 patients who consented to participate, majority (96.9%) were well aware of the indication of sublingual GTN. With regards to the mechanism of action of sublingual GTN, 73 (76%) patients did not know how the medication works. Majority of the patients (66.7%) knew about the proper storage of the tablet. In relation to the maximum number of sublingual GTN tablets that can be taken during each angina episode, 36.5% did not know that up to 3 tablets of sublingual GTN can be taken during each episode of angina. Fifty four (56.2%) patients were not aware that they need to replace sublingual GTN every 8 weeks after receiving the tablets. Majority (69.8%) of the patients demonstrated lack of knowledge with regards to the use of sublingual GTN as prevention of chest pain. Conclusion: Overall, patients’ knowledge regarding the self administration of sublingual GTN is still inadequate. The findings support the need for more frequent reinforcement of patient education, especially in the areas of preventive use, storage and drug stability.

Keywords: glyceryl trinitrate, knowledge, adherence, patient education

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Authors: Jui-Ting Hsu, Heng-Li Huang, Ming-Tzu Tsai, Kuo-Chih Su, Lih-Jyh Fuh

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The objectives of this study were to measure the initial stability of the dental implant (ISQ and PTV) in the artificial foam bone block with three different quality levels. In addition, the 3D bone to implant contact percentage (BIC%) was measured based on the micro-computed tomography images. Furthermore, the relation between the initial stability of dental implant (ISQ and PTV) and BIC% were calculated. The experimental results indicated that enhanced the material property of the artificial foam bone increased the initial stability of the dental implant. The Pearson’s correlation coefficient between the BIC% and the two approaches (ISQ and PTV) were 0.652 and 0.745.

Keywords: dental implant, implant stability quotient, peak insertion torque, bone-implant contact, micro-computed tomography

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Authors: Mohammed Mustafa, Fatima Abusin, Mariam Abufatema

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Objective: This audit aims to evaluate the practices and outcomes of operative vaginal deliveries (OPVD) at Mayo University Hospital, focusing on identifying trends, complications, and adherence to clinical guidelines. Methods: A retrospective review was conducted on all cases of operative vaginal deliveries at Mayo University Hospital over one year. Data was collected from patient records, including demographics, OPVD indications, types of instruments used (forceps or vacuum), maternal and neonatal outcomes, and any associated complications. Statistical analyses were performed to assess the rates of successful and unsuccessful OPVDs and identify factors influencing outcomes. Results: The study included 159 [out of 174 total OPVD in 1 year] cases of operative vaginal deliveries. The indications predominantly consisted of the prolonged second stage of labor, fetal distress and suspicious CTG. The success rate of OVD was [97.5%]; maternal perineal tears [10 cases], hemorrhage[43 cases] and neonatal outcomes needed for SCBU admission[12 cases] were also assessed. Conclusion: This audit provides insights into the current practices and outcomes of operative vaginal deliveries at Mayo University Hospital. The findings underline the importance of adherence to clinical guidelines and highlight areas for potential improvement in practice

Keywords: OPVD operative vaginal delivery, GTG green top guidelines, PPH postpartum hemorrhage, SCBU special care baby unit

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Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

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Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

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Authors: Babak H. Tabrizi, Seyed Farid Ghaderi

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Concurrent planning of project scheduling and material ordering has been increasingly addressed within last decades as an approach to improve the project execution costs. Therefore, we have taken the problem into consideration in this paper, aiming to maximize schedules quality robustness, in addition to minimize the relevant costs. In this regard, a bi-objective mathematical model is developed to formulate the problem. Moreover, it is possible to utilize the all-unit discount for materials purchasing. The problem is then solved by the constraint method, and the Pareto front is obtained for a variety of robustness values. The applicability and efficiency of the proposed model is tested by different numerical instances, finally.

Keywords: e-constraint method, material ordering, project management, project scheduling

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Authors: N. Dlamini, Mpumelelo G. Ndlela, Philisiwe Dlamini, Nicholus Kisyeri, Bhekizitha Sithole

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Accessing health services during the COVID-19 pandemic have exacerbated scarcity to routine medication. To ensure continuous accessibility to services, Eswatini launched Community Health Commodities Distribution (CHCD). Eligible Antiretroviral Therapy(ART) stable clients (VL<1,000) and patients on Non-Communicable Disease (NCD) medications were attended at community pick up points (PUP) based on distance between clients’ residence and the public health facility. Services provided includes ART and Pre-Exposure prophylaxis (PrEP) refills and NCD drug refills). The number of community PUP was 14% higher than health facility visits. Among all medications and commodities distributed between April and October 2020 at the PUP, 64% were HIV-related (HIV rapid test, HIVST, VL test, PrEP meds), and 36% were NCD related. The rapid roll out of CHCD during COVID-19 pandemic reduced the risk of COVID-19 transmission to clients as travel to health facilities was eliminated. It Additionally increased access to commodities during COVID-19-driven lockdown, decongested health facilities, integrated model of care, and increase service coverage. It was also noted that CHCD added different curative and HIV related services based on client specific needs and availability of the commodities.

Keywords: community health commodities distribution, pick up points, antiretroviral therapy, pre-exposure prophylaxis

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Authors: Kristen Erekson, Sarah Spendlove Caswell

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Nurse educators have the challenge of training future nurses that will provide compassionate care to an increasingly diverse population of patients in a culturally sensitive way. One approach to this challenge is an immersive public and global health experience as part of the nursing program curriculum. Undergraduate nursing students at our institution are required to participate in a Public and Global Health course. They participate in a didactic preparatory course followed by a 3-to-4-week program in one of the following locations: The Czech Republic, Ecuador, Finland/Poland, Ghana, India, Spain, Taiwan, Tonga, an Honor Flight to Washington D.C. with Veterans, or in local (Utah) communities working with marginalized populations (including incarcerated individuals, refugees, etc.). The students are required to complete 84 clinical hours and 84 culture hours (which involve exposure to local history, art, architecture, customs, etc.). As Faculty, we feel strongly that these public and global health experiences help cultivate cultural awareness in our students and prepare nurses who are better prepared to serve a diverse population of patients throughout their careers. This presentation will highlight our experiences and provide ideas for other nurse educators who have an interest in developing similar programs in their schools but do not know where to start. Suggestions about how to start building relationships that can lead to these opportunities, along with logistics for continuing the programs, will be highlighted.

Keywords: global health nursing, nursing education, clinical education, public health nursing

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Authors: Katja Wiedemann, Melinda Gainschnigg

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This paper deals with gender inequality in companies. In the context of this paper, it is analyzed how women are discriminated by means of Human Resources instruments. The existing gender inequality is made apparent by the ‘Equal Pay Day. Women in Austria work without payment from 20 October onwards, which represents inequality of 21.7 percent points. This gender pay gap is due to the unequal distribution of paid and unpaid work between men and women. Since the majority of activities related to the family and care are carried out by women, there are human capital deficits on women’s side. In addition to the discrimination of women in compensation, there are also discrimination cases caused by other Human Resources instruments. The aim of this paper is to analyze the use of Human Resources instruments with regard to the discrimination of women and to identify measures to counteract this discrimination. Within the scope of this paper, possible instructions for companies on how to design and implement Human Resources instruments will be elaborated. Therefore personnel planning, recruiting, workforce management, compensation, and leadership are used as the basis for that analysis. The data were collected by a literature review and evaluated by means of a summary content analysis. The literature analysis includes papers of scientific journals from various business fields. On the basis of the results of the literature review, it is clear that women are discriminated by all analyzed Human Resources instruments. As a result, existing potentials are not optimally used. In order to limit or even prevent this loss of potential, companies must take specific measures to counteract the discrimination of women.

Keywords: employment issues, gender inequality , women's studies, workplace

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Authors: T. Mohammed Chikouche, K. Hartani

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In order to solve the instantaneous power ripple and achieve better performance of direct power control (DPC) for a three-phase PWM rectifier, a control method is proposed in this paper. This control method is applied to overcome the instantaneous power ripple, to eliminate line current harmonics and therefore reduce the total harmonic distortion and to improve the power factor. A switching table is based on the analysis on the change of instantaneous active and reactive power, to select the optimum switching state of the three-phase PWM rectifier. The simulation result shows feasibility of this control method.

Keywords: power quality, direct power control, power ripple, switching table, unity power factor

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Authors: Jian Wang

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Teachers’ lesson-based discussions presume central to their effective learning to teach. Whether and to what extent such discussions offer opportunities for teachers to learn to teach effectively is worth a careful empirical examination. This study examines this assumption by drawing on lesson-based discussions and relevant curriculum materials from Chinese teachers in three urban schools. Their lesson-based discussions consistently focused on pedagogical content knowledge and offered specific and reasoned suggestions for teachers to refine their teaching practices. The mandated curriculum and their working language-mediated their lesson-based discussions.

Keywords: Chinese teachers, curriculum materials, lesson discussion, mathematics instruction

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Authors: Abdoullah Fath-Allah, Laila Cheikhi, Rafa E. Al-Qutaish, Ali Idri

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The e-government emerging concept transforms the way in which the citizens are dealing with their governments. Thus, the citizens can execute the intended services online anytime and anywhere. This results in great benefits for both the governments (reduces the number of officers) and the citizens (more flexibility and time saving). Therefore, building a maturity model to assess the e-government portals becomes desired to help in the improvement process of such portals. This paper aims at proposing an e-government maturity model based on the measurement of the best practices’ presence. The main benefit of such maturity model is to provide a way to rank an e-government portal based on the used best practices, and also giving a set of recommendations to go to the higher stage in the maturity model.

Keywords: best practices, e-government portal, maturity model, quality model

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Authors: Everard van Kemenade

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Many quality improvement activities are planned. Leaders are strongly involved in missions, visions and strategic planning. They use, consciously or unconsciously, the PDCA-cycle, also know as the Deming cycle. After the planning, the plans are carried out and the results or effects are measured. If the results show that the goals in the plan have not been achieved, adjustments are made in the next plan or in the execution of the processes. Then, the cycle is run through again. Traditionally, the PDCA-cycle is advocated as a means to an end. However, PDCA is especially fit for planned, ordered, certain contexts. It fits with the empirical and referential quality paradigm. For uncertain, unordered, unplanned processes, something else might be needed instead of Plan-Do-Check-Act. Due to the complexity of our society, the influence of the context, and the uncertainty in our world nowadays, not every activity can be planned anymore. At the same time organisations need to be more innovative than ever. That provides leaders with ‘wicked tendencies’. However, that raises the question how one can innovate without being able to plan? Complexity science studies the interactions of a diverse group of agents that bring about change in times of uncertainty, e.g. when radical innovation is co-created. This process is called emergence. This research study explores the role of leadership in the emergence paradigm. Aim of the article is to study the way that leadership can support the emergence of innovation in a complex context. First, clarity is given on the concepts used in the research question: complexity, emergence, innovation and leadership. Thereafter a literature search is conducted to answer the research question. The topics ‘emergent leadership’ or ‘complexity leadership’ are chosen for an exploratory search in Google and Google Scholar using the berry picking method. Exclusion criterion is emergence in other disciplines than organizational development or in the meaning of ‘arising’. The literature search conducted gave 45 hits. Twenty-seven articles were excluded after reading the title and abstract because they did not research the topic of emergent leadership and complexity. After reading the remaining articles as a whole one more was excluded because the article used emergent in the limited meaning of ‗arising‘ and eight more were excluded because the topic did not match the research question of this article. That brings the total of the search to 17 articles. The useful conclusions from the articles are merged and grouped together under overarching topics, using thematic analysis. The findings are that 5 topics prevail when looking at possibilities for leadership to facilitate innovation: enabling, sharing values, dreaming, interacting, context sensitivity and adaptivity. Together they form In Dutch the acronym Medusa.

Keywords: complexity science, emergence, leadership in the emergence paradigm, innovation, the Medusa principles

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Authors: Jeongyeob Hong, Myeonghoon Park, Taeson Yoon

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After the advent of Achaeans which utilize different metabolism pathway and contain conspicuously different cellular structure, they have been recognized as possible materials for developing quality of human beings. Among diverse Achaeans, in this paper, we compared 16s RNA Sequences of four different species of Thermococcus: Achaeans genus specialized in sulfur-dealing metabolism. Four Species, Barophilus, Kodakarensis, Hydrothermalis, and Onnurineus, live near the hydrothermal vent that emits extreme amount of sulfur and heat. By comparing ribosomal sequences of aforementioned four species, we found similarities in their sequences and expressed protein, enabling us to expect that certain ribosomal sequence or proteins are vital for their survival. Apriori algorithms and Decision Tree were used. for comparison.

Keywords: Achaeans, Thermococcus, apriori algorithm, decision tree

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Authors: Supaporn Yamuangmorn, Chanakan Prom-U-Thai

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Wetland and upland purple rice are the two major types classified by its original ecotypes in Northern Thailand. Wetland rice is grown under flooded condition from transplanting until the mutuality, while upland rice is naturally grown under well-drained soil known as aerobic cultivations. Both ecotypes can be grown and adapted to the reverse systems but little is known on its responses of grain yield and qualities between the 2 ecotypes. This study evaluated responses of grain yield as well as anthocyanin and antioxidant capacity between the wetland and upland purple rice genotypes grown in the submerged and aerobic conditions. A factorial arrangement in a randomized complete block design (RCBD) with two factors of rice genotype and water condition were carried out in three replications. The two wetland genotypes (Kum Doi Saket: KDK and Kum Phayao: KPY) and two upland genotypes (Kum Hom CMU: KHCMU and Pieisu1: PES1) were used in this study by growing under submerged and aerobic conditions. Grain yield was affected by the interaction between water condition and rice genotype. The wetland genotypes, KDK and KPY grown in the submerged condition produced about 2.7 and 0.8 times higher yield than in the aerobic condition, respectively. The 0.4 times higher grain yield of upland genotype (PES1) was found in the submerged condition than in the aerobic condition, but no significant differences in KHCMU. In the submerged condition, all genotypes produced higher yield components of tiller number, panicle number and percent filled grain than in the aerobic condition by 24% and 32% and 11%, respectively. The thousand grain weight and spikelet number were affected by water condition differently among genotypes. The wetland genotypes, KDK and KPY, and upland genotype, PES1, grown in the submerged condition produced about 19-22% higher grain weight than in the aerobic condition. The similar effect was found in spikelet number which the submerged condition of wetland genotypes, KDK and KPY, and the upland genotype, KHCMU, had about 28-30% higher than the aerobic condition. In contrast, the anthocyanin concentration and antioxidant capacity were affected by both the water condition and genotype. Rice grain grown in the aerobic condition had about 0.9 and 2.6 times higher anthocyanin concentration than in the submerged condition was found in the wetland rice, KDK and upland rice, KHCMU, respectively. Similarly, the antioxidant capacity of wetland rice, KDK and upland rice, KHCMU were 0.5 and 0.6 times higher in aerobic condition than in the submerged condition. There was a negative correlation between grain yield and anthocyanin concentration in wetland genotype KDK and upland genotype KHCMU, but it was not found in the other genotypes. This study indicating that some rice genotype can be adapted in the reverse ecosystem in both grain yield and quality, especially in the wetland genotype KPY and upland genotype PES1. To maximize grain yield and quality of purple rice, proper water management condition is require with a key consideration on difference responses among genotypes. Increasing number of rice genotypes in both ecotypes is needed to confirm their responses on water management.

Keywords: purple rice, water condition, anthocyanin, grain yield

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Authors: Aïcha Ben Salem, Faouzi Boufares, Sebastiao Correia

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The subject covered in this paper aims at assisting the user in its quality approach. The goal is to better extract, mix, interpret and reuse data. It deals with the semantic schema recognition of a data source. This enables the extraction of data semantics from all the available information, inculding the data and the metadata. Firstly, it consists of categorizing the data by assigning it to a category and possibly a sub-category, and secondly, of establishing relations between columns and possibly discovering the semantics of the manipulated data source. These links detected between columns offer a better understanding of the source and the alternatives for correcting data. This approach allows automatic detection of a large number of syntactic and semantic anomalies.

Keywords: schema recognition, semantic data profiling, meta-categorisation, semantic dependencies inter columns

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Authors: Sudheer Moorkoth, Leslie Edward Lewis, Pragna Rao

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Newborn screening (NBS) is a part of routine newborn care in many countries worldwide to detect early any rare treatable conditions and inborn errors of metabolism (IEM). India has not started this program yet. In an attempt to understand the challenges in implementing a national newborn screening program in India, we initiated a pilot newborn screening project funded by the Government of Canada. Along with initiating the newborn screening at Kasturba Hospital, Manipal in South India, for screening six disorders (Congenital Hypothyroidism(CH), Congenital Adrenal Hyperplasia (CAH), Galactosemia, Biotinidase deficiency, Glucose-6-Phosphate Dehydrogenase deficiency (G-6PD) and Phenylketonurea), we also studied the awareness of various stakeholders on the newborn screening. In a period of nine months from August 2017 to March 2018 we could screen 1915 newborns (999 male and 916 female). The result showed that there were seven babies screened positive. This interim result points to an incidence rate of 1 in 270 children for these rare disorders collectively. This includes three confirmed cases of CH, two cases of G-6PD deficiency, and one case each for Galctosemia and CAH. A questionnaire based study to understand the awareness among various stakeholders revealed that there is little awareness among parents, adolescents and anganwadi workers (public health worker). The interim data points to the need for a national newborn screening programme in India. There is also an immediate need to undertake large-scale awareness programme to create knowledge on NBS among the various stakeholders.

Keywords: awareness, inborn errors of metabolism (IEM), newborn screening, rare disease

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Authors: Alberto Mínguez-Martínez, Jesús de Vicente y Oliva

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Modern manufacturing processes have led to the miniaturization of systems and, as a result, parts at the micro-and nanoscale are produced. This trend seems to become increasingly important in the near future. Besides, as a requirement of Industry 4.0, the digitalization of the models of production and processes makes it very important to ensure that the dimensions of newly manufactured parts meet the specifications of the models. Therefore, it is possible to reduce the scrap and the cost of non-conformities, ensuring the stability of the production at the same time. To ensure the quality of manufactured parts, it becomes necessary to carry out traceable measurements at scales lower than one millimeter. Providing adequate traceability to the SI unit of length (the meter) to 2D and 3D measurements at this scale is a problem that does not have a unique solution in industrial environments. Researchers in the field of dimensional metrology all around the world are working on this issue. A solution for industrial environments, even if it is not complete, will enable working with some traceability. At this point, we believe that the study of the surfaces could provide us with a first approximation to a solution. Among the different options proposed in the literature, the areal topography methods may be the most relevant because they could be compared to those measurements performed using Coordinate Measuring Machines (CMM’s). These measuring methods give (x, y, z) coordinates for each point, expressing it in two different ways, either expressing the z coordinate as a function of x, denoting it as z(x), for each Y-axis coordinate, or as a function of the x and y coordinates, denoting it as z (x, y). Between others, optical measuring instruments, mainly microscopes, are extensively used to carry out measurements at scales lower than one millimeter because it is a non-destructive measuring method. In this paper, the authors propose a calibration procedure for the scales of optical measuring instruments, particularizing for a confocal microscope, using material standards easy to find and calibrate in metrology and quality laboratories in industrial environments. Confocal microscopes are measuring instruments capable of filtering the out-of-focus reflected light so that when it reaches the detector, it is possible to take pictures of the part of the surface that is focused. Varying and taking pictures at different Z levels of the focus, a specialized software interpolates between the different planes, and it could reconstruct the surface geometry into a 3D model. As it is easy to deduce, it is necessary to give traceability to each axis. As a complementary result, the roughness Ra parameter will be traced to the reference. Although the solution is designed for a confocal microscope, it may be used for the calibration of other optical measuring instruments by applying minor changes.

Keywords: industrial environment, confocal microscope, optical measuring instrument, traceability

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Authors: Kalyani Kulkarni, Bharat Chaudhari

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This paper addresses the issue of resource allocation in the emerging cognitive technology. Focusing the quality of service (QoS) of primary users (PU), a novel method is proposed for the resource allocation of secondary users (SU). In this paper, we propose the unique utility function in the game theoretic model of Cognitive Radio which can be maximized to increase the capacity of the cognitive radio network (CRN) and to minimize the interference scenario. The utility function is formulated to cater the need of PUs by observing Signal to Noise ratio. The existence of Nash equilibrium is for the postulated game is established.

Keywords: cognitive networks, game theory, Nash equilibrium, resource allocation

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Authors: Fatima M. Jadu, Asmaa A. Alzahrani, Maha A. Almutairi, Salma O. Al-Amoudi, Mawya A. Khafaji

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Introduction: Estimating the potential radiation risk for a widely used imaging technique such as cone beam CT (CBCT) is crucial. The aim of this study was to examine the effect of varying two CBCT technical factors, the voxel size (VOX) and the Field-of-View (FOV) centralization, on the radiation dose. Methodology: The head and neck slices of a RANDO® man phantom (Alderson Research Laboratories) were used with nanoDot™ OSLD dosimeters to measure the absorbed radiation dose at 25 predetermined sites. Imaging was done using the i-CAT® (Imaging Science International, Hatfield, PA, USA) CBCT unit. The VOX was changed for every three cycles of exposures from 0.2mm to 0.3mm and then 0.4mm. Then the FOV was centered on the maxilla and mandible alternatively while holding all other factors constant. Finally, the effective radiation dose was calculated for each view and voxel setting. Results: The effective radiation dose was greatest when the smallest VOX was chosen. When the FOV was centered on the maxilla, the highest radiation doses were recorded in the eyes and parotid glands. While on the mandible, the highest radiation doses were recorded in the sublingual and submandibular glands. Conclusion: Minor variations in the CBCT exposure factors significantly affect the effective radiation dose and thus the radiation risk to the patient. Therefore, extreme care must be taken when choosing these parameters especially for vulnerable patients such as children.

Keywords: CBCT, cone beam CT, effective dose, field of view, mandible, maxilla, resolution, voxel

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Authors: Fauzik Lendriyono, Isbandi Rukminto Adi

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Muhammadiyah is an Islamic-based organization taking care to human suffering. The existence of Muhammadiyah organization is strong supported by its members. Muhammadiyah as the oldest Islamic organization in Indonesia, since its establishment has had main activities, such as in the fields of education, health, and social services, one of the form is Orphanage. However, at present, Muhammadiyah orphanage was in a dilemma because of differences in orientation and commitment of the caretaker-managers. This research on Muhammadiyah orphanage is very important because it is able to know the problem identification and to find the ideal concept for the better management of an orphanage in Muhammadiyah. This research is a phenomenology study by research subjects: caretaker of the orphanage in Muhammadiyah at Great Malang. The research data was obtained after the observation, in-depth interviews, review of documentation and the discussion focused. Data were analyzed with interpretative phenomenological analysis. Basic problems for causes of differences in orientation and commitment administrators of Muhammadiyah orphanage is the influence of organizational culture and organizational environment factors. Organizational culture factors include the Islamic-based value and organization ideology, so that the Islamic values and the values of Muhammadiyah are used as guidelines in the orphanage. Environmental factors include the demand for its organization sustainability as characterized by economically productive activities organized by Orphanage and a program to produce a cadre of Muhammadiyah. To support the social welfare of Muhammadiyah, the ideal Orphanage concept for Muhammadiyah is a missionary and self-sufficient orphanage.

Keywords: orphanage, Muhammadiyah, misionary, Great Malang

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Authors: Zeynep Karacor, Rahime Hulya Ozturk

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In recent years, the rise of population density and the problem of aging population took attention to the health expenditures. In Turkey, some regulations and infrastructure changes in health sector have occurred. These changes are called Health Transformation Program. The productivity of health services, patient satisfaction, quality of services are tried to be improved with this program. Some radical changes are applied in Turkish economy in this context. The aim of this paper is to present the effects of Health Transformation Program on health expenditures. In the first part of the paper, some information’s about health system and applications in Turkey are discussed. In the second part, the aims of Health Transformation Program are explained. And in the third part the effects of Health Transformation Program on health expenditures are examined.

Keywords: health transformation program, Turkey, health services, health expenditures

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Authors: H. M. Alfrihidi, H.A. Albarakaty

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Flattening filter-free (FFF) photon beam radiotherapy has increased in the last decade, which is enabled by advancements in treatment planning systems and radiation delivery techniques like multi-leave collimators. FFF beams have higher dose rates, which reduces treatment time. On the other hand, FFF beams have a higher surface dose, which is due to the loss of beam hardening effect caused by the presence of the flatting filter (FF). The possibility of improving FFF beam quality using filters from low-z materials such as steel and aluminium (Al) was investigated using Monte Carlo (MC) simulations. The attenuation coefficient of low-z materials for low-energy photons is higher than that of high-energy photons, which leads to the hardening of the FFF beam and, consequently, a reduction in the surface dose. BEAMnrc user code, based on Electron Gamma Shower (EGSnrc) MC code, is used to simulate the beam of a 6 MV True-Beam linac. A phase-space (phosphor) file provided by Varian Medical Systems was used as a radiation source in the simulation. This phosphor file was scored just above the jaws at 27.88 cm from the target. The linac from the jaw downward was constructed, and radiation passing was simulated and scored at 100 cm from the target. To study the effect of low-z filters, steel and Al filters with a thickness of 1 cm were added below the jaws, and the phosphor file was scored at 100 cm from the target. For comparison, the FF beam was simulated using a similar setup. (BEAM Data Processor (BEAMdp) is used to analyse the energy spectrum in the phosphorus files. Then, the dose distribution resulting from these beams was simulated in a homogeneous water phantom using DOSXYZnrc. The dose profile was evaluated according to the surface dose, the lateral dose distribution, and the percentage depth dose (PDD). The energy spectra of the beams show that the FFF beam is softer than the FF beam. The energy peaks for the FFF and FF beams are 0.525 MeV and 1.52 MeV, respectively. The FFF beam's energy peak becomes 1.1 MeV using a steel filter, while the Al filter does not affect the peak position. Steel and Al's filters reduced the surface dose by 5% and 1.7%, respectively. The dose at a depth of 10 cm (D10) rises by around 2% and 0.5% due to using a steel and Al filter, respectively. On the other hand, steel and Al filters reduce the dose rate of the FFF beam by 34% and 14%, respectively. However, their effect on the dose rate is less than that of the tungsten FF, which reduces the dose rate by about 60%. In conclusion, filters from low-z material decrease the surface dose and increase the D10 dose, allowing for a high-dose delivery to deep tumors with a low skin dose. Although using these filters affects the dose rate, this effect is much lower than the effect of the FF.

Keywords: flattening filter free, monte carlo, radiotherapy, surface dose

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Authors: Colleen Cleveland, W. Adam Baldowski

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In the dynamic realm of online education, the integration of games and entertainment has emerged as a powerful strategy to captivate learners, drive active participation, and cultivate meaningful learning experiences. This abstract presents an overview of the upcoming conference, "Game On," dedicated to exploring the transformative impact of gamification, interactive simulations, and multimedia content in the digital learning landscape. Introduction: The conference aims to blur the traditional boundaries between education and entertainment, inspiring learners of diverse ages and backgrounds to actively engage in their online learning journeys. By leveraging the captivating elements of games and entertainment, educators can enhance motivation, retention, and deep understanding among virtual classroom participants. Conference Highlights: Commencing with an exploration of theoretical foundations drawing from educational psychology, instructional design, and the latest pedagogical research, participants will gain valuable insights into the ways gamified elements elevate the quality of online education. Attendees can expect interactive sessions, workshops, and case studies showcasing best practices and innovative strategies, including game-based assessments and virtual reality simulations. Inclusivity and Diversity: The conference places a strong emphasis on inclusivity, accessibility, and diversity in the integration of games and entertainment for educational purposes. Discussions will revolve around accommodating diverse learning styles, overcoming potential challenges, and ensuring equitable access to engaging educational content for all learners. Educational Transformation: Educators, instructional designers, and e-learning professionals attending "Game On" will acquire practical techniques to elevate the quality of their online courses. The conference promises a stimulating and informative exploration of blending education with entertainment, unlocking the untapped potential of games and entertainment in online education. Conclusion: "Game On" invites participants to embark on a journey that transforms online education by harnessing the power of entertainment. This event promises to be a cornerstone in the evolution of virtual learning, offering valuable insights for those seeking to create a more engaging and effective online educational experience. Join us as we explore new horizons, pushing the boundaries of online education through the fusion of games and entertainment.

Keywords: online education, games, entertainment, psychology, therapy, pop culture

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Authors: Inderpreet Kaur, Ravinder Pal Singh, Kamal Kant Sharma

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This paper addresses the different configurations used of optical amplifiers with 16 channels in Wavelength Division Multiplexed system. The systems with 16 channels have been simulated for evaluation of various parameters; Bit Error Rate, Quality Factor, for threshold values for a range of wavelength from 1471 nm to 1611 nm. Comparison of various combination of configurations have been analyzed with EDFA and FRA but EDFA-FRA configuration performance has been found satisfactory in terms of performance indices and stable region. The paper also compared various parameters quantized with different configurations individually. It has been found that Q factor has high value with less value of BER and high resolution for EDFA-FRA configuration.

Keywords: EDFA, FRA, WDM, Q factor, BER

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Authors: Souheila Zemmouchi

Abstract:

Introduction: Diabetes is currently the leading cause of end-stage chronic kidney disease and dialysis, so it adds additional complexity to the management of chronic hemodialysis patients. These patients are extremely fragile because of their multiple cardiovascular and metabolic comorbidities. Clear and complete description of the experience: the management of a diabetic on hemodialysis is particularly difficult due to frequent hypoglycaemia and significant inter and perdialyticglycemic variability that is difficult to predict. The aim of our study is to describe the clinical-biological profile and to assess the cardiovascular risk of diabetics undergoing chronic hemodialysis, and compare them with non-diabetic hemodialysis patients. Methods: This cross-sectional, descriptive, and analytical study was carried out between January 01 and December 31, 2018, involving 309 hemodialysis patients spread over 4 centersThe data were collected prospectively then compiled and analyzed by the SPSS Version 10 software The FRAMINGHAM RISK SCORE has been used to assess cardiovascular risk in all hemodialysis patients Results: The survey involved 309 hemodialysis patients, including 83 diabetics, for a prevalence of 27% The average age 53 ± 10.2 years. The sex ratio is 1.5. 50% of diabetic hemodialysis patients retained residual diuresis against 32% in non-diabetics. In the group of diabetics, we noted more hypertension (70% versus 38% non-diabetics P 0.004), more intradialytichypoglycemia (15% versus 3% non-diabetics P 0.007), initially, vascular exhaustion was found in 4 diabetics versus 2 non-diabetics. 70% of diabetics with anuria had postdialytichyperglycemia. The study found a statistically significant difference between the different levels of cardiovascular risk according to the diabetic status. Conclusion: There are many challenges in the management of diabetics on hemodialysis, both to optimize glycemic control according to an individualized target and to coordinate comprehensive and effective care.

Keywords: hemodialysis, diabetes, chronic renal failure, glycemic control

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Authors: J. Ikome, M. Ndeley

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When a machine breakdown forces a Modified Flow Shop (MFS) out of the prescribed state, the proposed strategy reschedules part of the initial schedule to match up with the preschedule at some point. The objective is to create a new schedule that is consistent with the other production planning decisions like material flow, tooling and purchasing by utilizing the time critical decision making concept. We propose a new rescheduling strategy and a match-up point determination procedure through a feedback mechanism to increase both the schedule quality and stability. The proposed approach is compared with alternative reactive scheduling methods under different experimental settings.

Keywords: advanced critical task methods modified flow shop (MFS), Manufacturing, experiment, determination

Procedia PDF Downloads 409

Authors: Chalachew Kassaw, Henok Ababu, Bethelhem Sileshy, Lulu Abebe, Birhanie Mekuriaw

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Background: Psychological discomfort is a state of emotional distress caused by everyday stressors and obligations that are difficult to manage. Orthopedic trauma has a wide range of effects on survivors' physical health, as well as a variety of mental health concerns that impede recovery. Psychiatric and behavioral conditions are 3-5 times more common in people who have undergone physical trauma, and they are a predictor of poor outcomes. Despite the above facts, there is a shortage of research done on the subject. Therefore, this study aimed to determine the magnitude of psychological distress and associated factor among patients attending orthopedic treatment at Gedeo zone, South Ethiopia 2022. Methods: A cross-sectional study was undertaken at Dilla University Referral Hospital from October –November 2022. The data was collected via a face-to-face interview, and the Kessler psychological distress scale (K-10) was used to assess psychological distress. A total of 386 patients receiving outpatient and inpatient services at the orthopedic unit were chosen using a simple random selection technique. A Statistical Package for the Social Science version 21 (SPSS-21) was used to enter and evaluate the data. To find related factors, bivariate, and multivariate logistic regressions were used. Variables having a p-value of less than 0.05 were deemed statistically significant. Result: A total of 386 participants with a response rate of 94.8% were included in the study. Out of all respondents, 114 (31.4%) of the individuals have experienced psychological distress. Independent variables such as Females [Adjusted odds ratio (AOR)=5.8, 95%CI=(4.6-15.6)], Average monthly income of <3500 birrs [Adjusted odds ratio (AOR) =4.8, 95% CI=(2.4-9.8) ], Current history of substance use [Adjusted odds ratio (AOR) =2.6, 95% CI=(1.66-4.7)], Strong social support [Adjusted odds ratio (AOR)=0.4, 95% CI= 0.4(0.2-0.8)], and Poor sleep quality (PSQI score>5) [Adjusted odds ratio (AOR)=2.0, 95%CI= 2.0(1.2-2.8)] were significantly associated with psychological distress. Conclusion: The prevalence of psychological distress was high. Being female, having poor social support, and having a high PSQI score were significantly associated factors with psychological distress. It is good if clinicians emphasize orthopedic patients, especially females and those having poor social support and low sleep quality symptoms.

Keywords: psychological distress, orthopedic unit, Dilla University hospital, Dilla Town, Southern Ethiopia

Procedia PDF Downloads 93

Authors: Mohammed Alhawiti

Abstract:

Assessment of Learning Management Systems has been of less importance than its due share. This paper investigates the evaluation of learning management systems (LMS) within educational setting as both an online learning system as well as a helpful tool for multidisciplinary learning environment. This study suggests a theoretical e-learning evaluation model, studying a multi-dimensional methods for evaluation through LMS system, service and content quality, learner`s perspective and attitudes of the instructor. A survey was conducted among 105 e-learners. The sample consisted of students at both undergraduate and master’s levels. Content validity, reliability were tested through the instrument, Findings suggested the suitability of the proposed model in evaluation for the satisfaction of learners through LMS. The results of this study would be valuable for both instructors and users of e-learning systems.

Keywords: e-learning, LMS, higher education, management systems

Procedia PDF Downloads 407

Authors: Jitpisute Chunthorng-Orn, Thana Juckmeta, Onmanee Prajuabjinda, Arunporn Itharat

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Inflammation and oxidative stress work together to produce symptoms in cancer patients. The whole part of it is used as a preparation to treat cancer patients in Khampramong temple which has been a place of treatment and palliative care for cancer patients since 2005. Thus, the objective of this study was to investigate anti-inflammatory and antioxidant activities of Heliotropium indicum extracts. Dried plant materials were extracted in a similar manner to those practiced by the Khampramong Temple i.e. maceration in 95% ethanol and boiling in water. For anti-inflammation activity, both extracts were tested for suppression of nitric oxide (NO) production in LPS-induced RAW 264.7 cells. They were also tested for antioxidant activity by DPPH radical scavenging assay. This study found that the ethanolic extract of Heliotropium indicum exhibited higher inhibitory activity of NO release than Indomethacin as a positive control (IC50 value of 24.17±2.12 and 34.67±6.23 μg/mL, respectively). For DPPH radical scavenging assay, the ethanolic extract also exhibited antioxidant activity but less than BHT as a antioxidant compound (EC50 values = 28.91±4.26 and 13.08±0.29 μg/mL, respectively). In contrast, its water extract had no inhibitory activity on NO release (IC50 > 100 μg/mL) and no inhibitory activity on DPPH radicals (EC50 values > 100 μg/mL). The results showed correlation between anti-inflammation and antioxidant activity and these results also support using this plant to treat cancer patients.

Keywords: Heliotropium indicum, RAW 264.7, DPPH, Khampramong Temple

Procedia PDF Downloads 546