Search results for: provider recommendation

Authors: Rosni Lakandri

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With the development of science and technology, there has been a complete transformation in the domain of information technology. Particularly after the Second World War and Cold War period, the role of media and communication technology in shaping the political, economic, socio-cultural proceedings across the world has been tremendous. It performs as a channel between the governing bodies of the state and the general masses. As we have seen the international community constantly talking about the onset of Asian Century, India and China happens to be the major player in this. Both have the civilization history, both are neighboring countries, both are witnessing a huge economic growth and, important of all, both are considered the rising powers of Asia. Not negating the fact that both countries have gone to war with each other in 1962 and the common people and even the policy makers of both the sides view each other till now from this prism. A huge contribution to this perception of people goes to the media coverage of both sides, even if there are spaces of cooperation which they share, the negative impacts of media has tended to influence the people’s opinion and government’s perception about each other. Therefore, analysis of media’s impression in both the countries becomes important in order to know their effect on the larger implications of foreign policy towards each other. It is usually said that media not only acts as the information provider but also acts as ombudsman to the government. They provide a kind of check and balance to the governments in taking proper decisions for the people of the country but in attempting to answer this hypothesis we have to analyze does the media really helps in shaping the political landscape of any country? Therefore, this study rests on the following questions; 1.How do China and India depict each other through their respective News media? 2.How much and what influences they make on the policy making process of each country? How do they shape the public opinion in both the countries? In order to address these enquiries, the study employs both primary and secondary sources available, and in generating data and other statistical information, primary sources like reports, government documents, and cartography, agreements between the governments have been used. Secondary sources like books, articles and other writings collected from various sources and opinion from visual media sources like news clippings, videos in this topic are also included as a source of on ground information as this study is not based on field study. As the findings suggest in case of China and India, media has certainly affected people’s knowledge about the political and diplomatic issues at the same time has affected the foreign policy making of both the countries. They have considerable impact on the foreign policy formulation and we can say there is some mediatization happening in foreign policy issues in both the countries.

Keywords: China, foreign policy, India, media, public opinion

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Authors: Jeroen Rotteveel, Zeger De Groot

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The small satellite community is more and more aware of the need to start operating responsibly and sustainably in order to secure the use of outer space in the long run. On the technical side, many debris mitigation techniques have been investigated and demonstrated on board small satellites, showing that technically, a lot of things can be done to curb the growth of space debris and operate more responsible. However, in the absence of strict laws and constraints, one cannot help but wonder what the incentive is to incur significant costs (paying for debris mitigation systems and the launch mass of these systems) and to lose performance onboard resource limited small satellites (mass, volume, power)? Many small satellite developers are operating under tight budgets, either from their sponsors (in case of academic and research projects) or from their investors (in case of startups). As long as it is not mandatory to act more responsibly, we might need to consider the implementation of incentives to stimulate developers to accommodate deorbiting modules, etc. ISISPACE joined the NetZeroSpace initiative in 2021 with the aim to play its role in secure the use of low earth orbit for the next decades by facilitating more sustainable use of space. The company is in a good position as both a satellite builder, a rideshare launch provider, and a technology development company. ISISPACE operates under one of the stricter space laws in the world in terms of maximum orbital lifetime and has been active in various debris mitigation and debris removal in-orbit demonstration missions in the past 10 years. ISISPACE proposes to introduce together with launch partners and regulators an incentive scheme for CubeSat developers to baseline debris mitigation systems on board their CubeSats in such a way that is does not impose too many additional costs to the project. Much like incentives to switch to electric cars or install solar panels on your house, such an incentive can help to increase market uptake of behavior or solutions prior to legislation or bans of certain practices. This can be achieved by: Introducing an extended launch volume in CubeSat deployers to accommodate debris mitigation systems without compromising available payload space for the payload of the main mission Not charging the fee for the launch mass for the additional debris mitigation module Whenever possible, find ways to further co-fund the purchase price, or otherwise reduce the cost of flying debris mitigation modules onboard the CubeSats. The paper will outline the framework of such an incentive scheme and provides ISISPACE’s way forward to make this happen in the near future.

Keywords: netZerospace, cubesats, debris mitigation, small satellite community

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Authors: Cristina Fernandez, Felix Amparano, John Tumberger, Stephani Stancil, Sarah Hampl, Brooke Sweeney, Amy R. Beck, Helena H Laroche, Jared Tucker, Eileen Chaves, Sara Gould, Matthew Lindquist, Lora Edwards, Renee Arensberg, Meredith Dreyer, Jazmine Cedeno, Alleen Cummins, Jennifer Lisondra, Katie Cox, Kelsey Dean, Rachel Perera, Nicholas A. Clark

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Background: Adolescents with obesity are at higher risk of disordered eating than the general population. Detection of eating disorders (ED) is difficult. Screening questionnaires may aid in early detection of ED. Our team’s prior efforts focused on increasing ED screening rates to ≥90% using a validated 10-question adolescent binge eating disorder screening questionnaire (ADO-BED). This aim was achieved. We then aimed to improve treatment plan initiation of patients ≥12 years of age who screen positive for BED within our WMC from 33% to 70% within 12 months. Methods: Our WMC is within a tertiary-care, free-standing children’s hospital. A3, an improvement framework, was used. A multidisciplinary team (physicians, nurses, registered dietitians, psychologists, and exercise physiologists) was created. The outcome measure was documentation of treatment plan initiation of those who screen positive (goal 70%). The process measure was ADO-BED screening rate of WMC patients (goal ≥90%). Plan-Do-Study-Act (PDSA) cycle 1 included provider education on current literature and treatment plan initiation based upon ADO-BED responses. PDSA 2 involved increasing documentation of treatment plan and retrain process to providers. Pre-defined treatment plans were: 1) repeat screen in 3-6 months, 2) resources provided only, or 3) comprehensive multidisciplinary weight management team evaluation. Run charts monitored impact over time. Results: Within 9 months, 166 patients were seen in WMC. Process measure showed sustained performance above goal (mean 98%). Outcome measure showed special cause improvement from mean of 33% to 100% (n=31). Of treatment plans provided, 45% received Plan 1, 4% Plan 2, and 46% Plan 3. Conclusion: Through a multidisciplinary improvement team approach, we maintained sustained ADO-BED screening performance, and, prior to our 12-month timeline, achieved our project aim. Our efforts may serve as a model for other multidisciplinary WMCs. Next steps may include expanding project scope to other WM programs.

Keywords: obesity, pediatrics, clinic, eating disorder

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Authors: Chakkrit Poonpakdee, Jing-Hua Tzen, Ya-Zhen Huang, Yao-Tung Lin

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Potassium (K) is a known macro nutrient and essential element for plant growth. Single leaching and modified sequential extraction schemes have been developed to estimate the relative phase associations of soil samples. The sequential extraction process is a step in analyzing the partitioning of metals affected by environmental conditions, but it is not a tool for estimation of K bioavailability. While, traditional single leaching method has been used to classify K speciation for a long time, it depend on its availability to the plants and use for potash fertilizer recommendation rate. Clay mineral in soil is a factor for controlling soil fertility. The change of the micro-structure of clay minerals during various environment (i.e. swelling or shrinking) is characterized using Transmission X-Ray Microscopy (TXM). The objective of this study are to 1) compare the distribution of K speciation between single leaching and sequential extraction process 2) determined clay particle flocculation structure before/after suspension with K+ using TXM. Four tropical soil samples: farming without K fertilizer (10 years), long term applied K fertilizer (10 years; 168-240 kg K2O ha-1 year-1), red soil (450-500 kg K2O ha-1 year-1) and forest soil were selected. The results showed that the amount of K speciation by single leaching method were high in mineral K, HNO3 K, Non-exchangeable K, NH4OAc K, exchangeable K and water soluble K respectively. Sequential extraction process indicated that most K speciations in soil were associated with residual, organic matter, Fe or Mn oxide and exchangeable fractions and K associate fraction with carbonate was not detected in tropical soil samples. In farming long term applied K fertilizer and red soil were higher exchangeable K than farming long term without K fertilizer and forest soil. The results indicated that one way to increase the available K (water soluble K and exchangeable K) should apply K fertilizer and organic fertilizer for providing available K. The two-dimension of TXM image of clay particles suspension with K+ shows that the aggregation structure of clay mineral closed-void cellular networks. The porous cellular structure of soil aggregates in 1 M KCl solution had large and very larger empty voids than in 0.025 M KCl and deionized water respectively. TXM nanotomography is a new technique can be useful in the field as a tool for better understanding of clay mineral micro-structure.

Keywords: potassium, sequential extraction process, clay mineral, TXM

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Authors: Eakarat Boonreang, Anothai Harasarn

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The objectives of this study are to investigate the flood disaster management capacity of communities in Ubon Ratchathani province, Thailand, and to recommend the sustainable flood management approaches of communities in Ubon Ratchathani province, Thailand. The selected population consisted of the community leaders and committees, the executives of local administrative organizations, and the head of Ubon Ratchathani provincial office of disaster prevention and mitigation. The data was collected by in-depth interview, focus group, and observation. The data was analyzed and classified in order to determine the communities’ capacity in flood disaster management. The results revealed that communities’ capacity were as follows, before flood disaster, the community leaders held a meeting with the community committees in order to plan disaster response and determined evacuation routes, and the villagers moved their belongings to higher places and prepared vehicles for evacuation. During flood disaster, the communities arranged motorboats for transportation and villagers evacuated to a temporary evacuation center. Moreover, the communities asked for survival bags, motorboats, emergency toilets, and drinking water from the local administrative organizations and the 22nd Military Circle. After flood disaster, the villagers cleaned and fixed their houses and also collaborated in cleaning the temple, school, and other places in the community. The recommendation approaches for sustainable flood disaster management consisted of structural measures, such as the establishment of reservoirs and building higher houses, and non-structural measures such as raising awareness and fostering self-reliance, establishing disaster management plans, rehearsal of disaster response procedures every year, and transferring disaster knowledge among younger generations. Moreover, local administrative organizations should formulate strategic plans that focus on disaster management capacity building at the community level, particularly regarding non-structural measures. Ubon Ratchathani provincial offices of disaster prevention and mitigation should continually monitor and evaluate the outcomes of community based disaster risk management program, including allocating more flood disaster management-related resources among local administrative organizations and communities.

Keywords: capacity building, community based disaster risk management, flood disaster management, Thailand

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Authors: John Kosmeh

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Introduction – For years, senior health care and skilled nursing facilities have been plagued with the dilemma of not having the necessary tools and equipment to adequately care for senior residents in their communities. This has led to high transport rates to emergency departments and high 30-day readmission rates, costing billions of unnecessary dollars each year, as well as quality assurance issues. Our Senior care telemedicine program is designed to solve this issue. Methods – We conducted a 1-year pilot program using our technology coupled with our 24/7 telemedicine program with skilled nursing facilities in different parts of the United States. We then compared transports rates and 30-day readmission rates to previous years before the use of our program, as well as transport rates of other communities of similar size not using our program. This data was able to give us a clear and concise look at the success rate of reducing unnecessary transport and readmissions as well as cost savings. Results – A 94% reduction nationally of unnecessary out-of-facility transports, and to date, complete elimination of 30-day readmissions. Our virtual platform allowed us to instruct facility staff on the utilization of our tools and system as well as deliver treatment by our ER-trained providers. Delay waiting for PCP callbacks was eliminated. We were able to obtain lung, heart, and abdominal ultrasound imaging, 12 lead EKG, blood labs, auscultate lung and heart sounds, and collect other diagnostic tests at the bedside within minutes, providing immediate care and allowing us to treat residents within the SNF. Are virtual capabilities allowed for loved ones, family members, and others who had medical power of attorney to virtually connect with us at the time of visit, to speak directly with the medical provider, providing increased confidence in the decision to treat the resident in-house. The decline in transports and readmissions will greatly reduce governmental cost burdens, as well as fines imposed on SNF for high 30-day readmissions, reduce the cost of Medicare A readmissions, and significantly impact the number of patients visiting overcrowded ERs. Discussion – By utilizing our program, SNF can effectively reduce the number of unnecessary transports of residents, as well as create significant savings from loss of day rates, transportation costs, and high CMS fines. The cost saving is in the thousands monthly, but more importantly, these facilities can create a higher quality of life and medical care for residents by providing definitive care instantly with ER-trained personnel.

Keywords: senior care, long term care, telemedicine, technology, senior care communities

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Authors: Esther Gumboh

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While the definition of rape has evolved over the years and now differs from one jurisdiction to another, at the heart of the offence remains the absence of consent on the part of the victim. In simple terms, rape consists in non-consensual sexual intercourse. Therefore, the core issue is whether the accused acted with the consent of the victim. Once it is established that the act was consensual, a conviction of rape cannot be secured. Traditionally, rape within marriage was impossible because it was understood that a woman gave irrevocable consent to sex with her husband throughout the duration of the marriage. This position has since changed in most jurisdictions. Indeed, Malawian law now recognises the offence of marital rape. This is a victory for women’s rights and gender equality. Curiously, however, the definition of marital rape endorsed differs from the standard understanding of rape as non-consensual sex. Instead, the law has introduced the concept of unreasonableness of the refusal to engage in sex as a defence to an accused. This is an alarming position that undermines the protection sought to be derived from the criminalisation of rape within marriage. Moreover, in the Malawian context where rape remains an offence only men can commit against women, the current legal framework for marital rape perpetuates the societal misnomer that a married woman gives a once-off consent to sexual intercourse by virtue of marriage. This takes us back to the old common law position which many countries have moved away from. The present definition of marital rape under Malawian law also sits at odd with the nature of rape that is applicable to all other instances of non-consensual sexual intercourse. Consequently, the law fails to protect married women from unwanted sexual relations at the hands of their husbands. This paper critically examines the criminalisation of marital rape in Malawi. It commences with a historical account of the conceptualisation of rape and then looks at judgments that rejected the validity of marital rape. The discussion then moves to the debates that preceded the criminalisation of marital rape in Malawi and how the Law Commission reasoned to finally make a recommendation in its favour. Against this background, the paper analyses the legal framework for marital rape and what this means for the elements of the offence and defences that may be raised by an accused. In the final analysis, this contribution recommends that there is need to amend the definition of marital rape. Better still, the law should simply state that the fact of marriage is not a defence to a charge of rape, or, in other words, that there is no marital rape exemption. This would automatically mean that husbands are subjected to the same criminal law principles as their unmarried counterparts when it comes to non-consensual sexual intercourse with their wives.

Keywords: criminal law, gender, Malawi, marital rape, rape, sexual intercourse

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Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires was returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age range from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge. However, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non-significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: gene profiling, knowledge, Malaysia, physician

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Authors: Camilla Marini, Deborah Agostino

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Cultural institutions provide more than service-based offers; indeed, they are experience-based contexts. A cultural experience is a special event that encompasses a wide range of values which, for visitors, are primarily cultural rather than economic and financial. Cultural institutions have always been characterized by inclusivity and participatory practices, but the upcoming of digital technologies has put forward their interest in collaborative practices and the relationship with their audience. Indeed, digital technologies highly affected the cultural experience as it was conceived. Especially, museums, as traditional and authoritative cultural institutions, have been highly challenged by digital technologies. They shifted by a collection-oriented toward a visitor-centered approach, and digital technologies generated a highly interactive ecosystem in which visitors have an active role, shaping their own cultural experience. Most of the studies that investigate value co-creation in museums adopt a single perspective which is separately one of the museums or one of the users, but the analysis of the convergence/divergence of these perspectives is still emphasized. Additionally, many contributions focus on digital value co-creation as an outcome rather than as a process. The study aims to provide a joint perspective on digital value co-creation which include both museum and visitors. Also, it deepens the contribution of digital technologies in the value co-creation process, addressing the following research questions: (i) what are the convergence/divergence drivers on digital value co-creation and (ii) how digital technologies can be means of value co-creation? The study adopts an action research methodology that is based on the case of WORTHY, an educational project which involves cultural institutions and schools all around Europe, creating a virtual collaborative museum. It represents a valuable case for the aim of the study since it has digital technologies at its core, and the interaction through digital technologies is fundamental, all along with the experience. Action research has been identified as the most appropriate methodology for researchers to have direct contact with the field. Data have been collected through primary and secondary sources. Cultural mediators such as museums, teachers and students’ families have been interviewed, while a focus group has been designed to interact with students, investigating all the aspects of the cultural experience. Secondary sources encompassed project reports and website contents in order to deepen the perspective of cultural institutions. Preliminary findings highlight the dimensions of digital value co-creation in cultural institutions from a museum-visitor integrated perspective and the contribution of digital technologies in the value co-creation process. The study outlines a two-folded contribution that encompasses both an academic and a practitioner level. Indeed, it contributes to fulfilling the gap in cultural management literature about the convergence/divergence of service provider-user perspectives but it also provides cultural professionals with guidelines on how to evaluate the digital value co-creation process.

Keywords: co-creation, digital technologies, museum, value

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Authors: Ewa Kicko Walczak, Grazyna Rymarz

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In recent years, nanotechnology has been successfully applied for flame retardancy of polymers, in particular for construction materials. The consumption of thermoset resins as a construction polymers materials is approximately over one million tone word wide. Excellent mechanical, relatively high heat and thermal stability of their type of polymers are proven for variety applications, e.g. transportation, electrical, electronic, building part industry. Above applications in addition to the strength and thermal properties also requires -referring to the legal regulation or recommendation - an adequate level of flammability of the materials. This publication present the evaluation was made of effectiveness of flame retardancy of halogen-free hybrid flame retardants(FR) as compounds nitric/phosphorus modifiers that act with nanofillers (nano carbons, organ modified montmorillonite, nano silica, microsphere) in relation to unsaturated polyester/epoxy resins and glass-reinforced on base this resins laminates(GRP) as a final products. The analysis of the fire properties provided proof of effective flame retardancy of the tested composites by defining oxygen indices values (LOI), with the use of thermogravimetric methods (TGA) and combustion head (CH). An analysis of the combustion process with Cone Calorimeter (CC) method included in the first place N/P units and nanofillers with the observed phenomenon of synergic action of compounds. The fine-plates, phase morphology and rheology of composites were assessed by SEM/ TEM analysis. Polymer-matrix glass reinforced laminates with modified resins meet LOI over 30%, reduced in a decrease by 70% HRR (according to CC analysis), positive description of the curves TGA and values CH; no adverse negative impact on mechanical properties. The main objective of our current project is to contribute to the general understanding of the flame retardants mechanism and to investigate the corresponding structure/properties relationships. We confirm that nanotechnology systems are successfully concept for commercialized forms for non-flammable GRP pipe, concrete composites, and flame retardant tunnels constructions.

Keywords: fire retardants, FR, halogen-free FR nanofillers, non-flammable pipe/concrete, thermoset resins

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Authors: Ashi Gautam, Isha Shukla, Akhil Seghal

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Biosensors are analytical devices that use a biological sensing element to detect and measure a specific chemical substance or biomolecule in a sample. These devices are widely used in various fields, including medical diagnostics, environmental monitoring, and food analysis, due to their high specificity, sensitivity, and selectivity. In this research paper, a machine learning model is proposed for predicting the suitability of skin care products based on biosensor readings. The proposed model takes in features extracted from biosensor readings, such as biomarker concentration, skin hydration level, inflammation presence, sensitivity, and free radicals, and outputs the most appropriate skin care product for an individual. This model is trained on a dataset of biosensor readings and corresponding skin care product information. The model's performance is evaluated using several metrics, including accuracy, precision, recall, and F1 score. The aim of this research is to develop a personalised skin care product recommendation system using biosensor data. By leveraging the power of machine learning, the proposed model can accurately predict the most suitable skin care product for an individual based on their biosensor readings. This is particularly useful in the skin care industry, where personalised recommendations can lead to better outcomes for consumers. The developed model is based on supervised learning, which means that it is trained on a labeled dataset of biosensor readings and corresponding skin care product information. The model uses these labeled data to learn patterns and relationships between the biosensor readings and skin care products. Once trained, the model can predict the most suitable skin care product for an individual based on their biosensor readings. The results of this study show that the proposed machine learning model can accurately predict the most appropriate skin care product for an individual based on their biosensor readings. The evaluation metrics used in this study demonstrate the effectiveness of the model in predicting skin care products. This model has significant potential for practical use in the skin care industry for personalised skin care product recommendations. The proposed machine learning model for predicting the suitability of skin care products based on biosensor readings is a promising development in the skin care industry. The model's ability to accurately predict the most appropriate skin care product for an individual based on their biosensor readings can lead to better outcomes for consumers. Further research can be done to improve the model's accuracy and effectiveness.

Keywords: biosensors, data model, machine learning, skin care

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Authors: Mehmet Savsar

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Industrial Engineering is one of the engineering disciplines that deal with analysis, design, and improvement of systems, which include manufacturing, supply chain, healthcare, communication, and general service systems. Industrial engineers involve with comprehensive study of a given system, analysis of its interacting units, determination of problem areas, application of various optimization and operations research tools, and recommendation of solutions resulting in significant improvements. The Senior Design course in Industrial Engineering is the culmination of the Industrial Engineering Curriculum in a Capstone Design course, which fundamentally deals with systems analysis and design. The course at Kuwait University has been carefully designed with various course objectives and course outcomes in mind to achieve several program outcomes by practices and learning experiences, which are explicitly gained by systems analysis and design. The Senior Design Course is carried out in a selected industrial or service organization, with support from its engineering personnel, during a full semester by a team of students, who are usually in the last semester of their academic programs. A senior faculty member constantly administers the course to ensure that the students accomplish the prescribed objectives. Students work in groups to formulate issues and propose solutions and communicate, results in formal written and oral presentations. When the course is completed, they emerge as engineers that can be clearly identified as more mature, able to communicate better, able to participate in team work, able to see systems perspective in analysis and design, and more importantly, able to assume responsibility at entry level as engineers. The accomplishments are mainly due to real life experiences gained during the course of their design study. This paper presents methods, procedures, and experiences in teaching a Senior Design Course in Industrial Engineering Curriculum. A detailed description of the course, its role, its objectives, outcomes, learning practices, and assessments are explained in relation to other courses in Industrial Engineering Curriculum. The administration of the course, selected organizations where the course project is carried out, problems and solution tools utilized, student accomplishments and obstacles faced are presented. Issues discussed in this paper could help instructors in teaching the course as well as in clarifying the contribution of a design course to the industrial engineering education in general. In addition, the methods and teaching procedures presented could facilitate future improvements in industrial engineering curriculum.

Keywords: senior design course, industrial engineering, capstone design, education

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Authors: Luay Jum'a

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Many challenges are facing third-party logistics (3PL) providers in the domestic and global markets which create a volatile decision making environment. All these challenges such as managing changes in consumer behaviour, demanding expectations from customers and time compressions have turned into complex problems for 3PL providers. Since the movement towards increased outsourcing outpaces movement towards insourcing, the need to achieve a competitive advantage over competitors in 3PL market increases. This trend continues to grow over the years and as a result, areas of strengths and improvements are highlighted through the analysis of the LSQ factors that lead to B2B customers’ satisfaction which become a priority for 3PL companies. Consequently, 3PL companies are increasingly focusing on the most important issues from the perspective of their customers and relying more on this value of information in making their managerial decisions. Therefore, this study is concerned with providing guidance for improving logistics service quality (LSQ) levels in the context of 3PL industry in Jordan. The study focused on the most important factors in LSQ and used a managerial tool that guides 3PL companies in making LSQ improvements based on a quadrant analysis of two main dimensions: LSQ declared importance and LSQ inferred importance. Although, a considerable amount of research has been conducted to investigate the relationship between logistics service quality (LSQ) and customer satisfaction, there remains a lack of developing managerial tools to aid in the process of LSQ improvement decision-making. Moreover, the main advantage for the companies to use 3PL service providers as a trend is due to the realised percentage of cost reduction on the total cost of logistics operations and the incremental improvement in customer service. In this regard, having a managerial tool that help 3PL service providers in managing the LSQ factors portfolio effectively and efficiently would be a great investment for service providers. One way of suggesting LSQ improvement actions for 3PL service providers is via the adoption of analysis tools that perform attribute categorisation such as Importance–Performance matrix. In mind of the above, it can be stated that the use of quadrant analysis will provide a valuable opportunity for 3PL service providers to identify improvement opportunities as customer service attributes or factors importance are identified in two different techniques that complete each other. Moreover, the data were collected through conducting a survey and 293 questionnaires were returned from business-to-business (B2B) customers of 3PL companies in Jordan. The results showed that the LSQ factors vary in their importance and 3PL companies should focus on some LSQ factors more than other factors. Moreover, ordering procedures, timeliness/responsiveness LSQ factors considered being crucial in 3PL businesses and therefore they need to have more focus and development by 3PL service providers in the Jordanian market.

Keywords: logistics service quality, managerial decisions, quadrant analysis, third party logistics service provider

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: Hebah M. Musalem, Jeylan El-Mansoury, Lin M. Tuleimat, Selwa Alhazza, Abdul-Aziz A. Al Zoba

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Background: Amblyopia is a condition that affects the visual system triggering a decrease in visual acuity without a known underlying pathology. It is due to abnormal vision development in childhood or infancy. Most importantly, vision loss is preventable or reversible with the right kind of intervention in most of the cases. Strabismus, sensory defects, and anisometropia are all well-known causes of amblyopia. However, ocular misalignment in Strabismus is considered the most common form of amblyopia worldwide. The risk of developing amblyopia increases in premature children, developmentally delayed or children who had brain lesions affecting the visual pathway. The prevalence of amblyopia varies between 2 to 5 % in the world according to the literature. Objective: To determine the different causes of Amblyopia in pediatric patients seen in ophthalmology clinic of a tertiary care center, i.e. King Faisal Specialist Hospital and Research Center (KFSH&RC). Methods: This is a hospital based, random retrospective, based on reviewing patient’s files in the Ophthalmology Department of KFSH&RC in Riyadh city, Kingdom of Saudi Arabia. Inclusion criteria: amblyopic pediatric patients who attended the clinic from 2015 to 2016, who are between 6 months and 18 years old. Exclusion Criteria: patients above 18 years of age and any patient who is uncooperative to obtain an accurate vision or a proper refraction. Detailed ocular and medical history are recorded. The examination protocol includes a full ocular exam, full cycloplegic refraction, visual acuity measurement, ocular motility and strabismus evaluation. All data were organized in tables and graphs and analyzed by statistician. Results: Our preliminary results will be discussed on spot by our corresponding author. Conclusions: We focused on this study on utilizing various examination techniques which enhanced our results and highlighted a distinguished correlation between amblyopia and its’ causes. This paper recommendation emphasizes on critical testing protocols to be followed among amblyopic patient, especially in tertiary care centers.

Keywords: amblyopia, amblyopia causes, amblyopia diagnostic criterion, amblyopia prevalence, Saudi Arabia

Procedia PDF Downloads 152

Authors: Sk Ajim Ali

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The present study is an attempt to overview on the major environmental and health impacts due to hazardous waste generation and poor management. In present scenario, not only hazardous waste, but as a common term ‘Waste’ is one of the acceptable and thinkable environmental issues. With excessive increasing population, industrialization and standardization of human’s life style heap in extra waste generation which is directly or indirectly related with hazardous waste generation. Urbanization and population growth are solely responsible for establishing industrial sector and generating various Hazardous Waste (HW) and concomitantly poor management practice arising adverse effect on environment and human health. As compare to other Indian state, West Bengal is not too much former in HW generation. West Bengal makes a rank of 7th in HW generation followed by Maharashtra, Gujarat, Tamil Nadu, U.P, Punjab and Andhra Pradesh. During the last 30 years, the industrial sectors in W.B have quadrupled in size, during 1995 there were only 440 HW generating Units in West Bengal which produced 129826 MTA hazardous waste but in 2011, it rose up into 609 units and it produced about 259777 MTA hazardous waste. So, the notable thing is that during a 15 year interval there increased 169 waste generating units but it produced about 129951 MTA of hazardous waste. Major chemical industries are the main sources of HW and causes of adverse effect on the environment and human health. HW from industrial sectors contains heavy metals, cyanides, pesticides, complex aromatic compounds (i.e. PCB) and other chemical which are toxic, flammable, reactive, and corrosive and have explosive properties which highly affect the surrounding environment and human health in and around he disposal sites. The main objective of present study is to highlight on the sources and components of hazardous waste in West Bengal and impacts of improper HW management on health and environment. This study is carried out based on a secondary source of data and qualitative method of research. The secondary data has been collected annual report of WBPCB, WHO’s report, research paper, article, books and so on. It has been found that excessive HW generation from various sources and communities has serious health hazards that lead to the spreading of infectious disease and environmental change.

Keywords: environmental impacts, existing HW generation and management practice, hazardous waste (HW), health impacts, recommendation and planning

Procedia PDF Downloads 274

Authors: Magdalena Korytowska, Gunnar Lengstrand, Cecilia Larsson Wexell

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Background: Breast cancer (BC) is the most common cancer among women worldwide, and cases are continuing to increase in Sweden. Bone is the most common metastatic site in breast cancer patients, where > 65-75% of women with advanced breast cancer develop bone metastases during their disease. To prevent the skeletal-related events of metastases (e.g., pathological fractures, bone loss, cancer-induced bone pain, and hypercalcemia bone), two different classes of antiresorptive medications (AR), bisphosphonate and denosumab are typically administered every 3 to 4 weeks. Since 2015, adjuvant bisphosphonate treatment has been used every six months for three to five years in postmenopausal women for the prevention of skeletal metastases and improved survival. Methods: A case-control study was conducted to test the hypotheses that patients treated with high-dose AR are at higher risk of developing MRONJ than breast cancer patients with adjuvant bisphosphonate treatment at a lower dose. Medical and odontological data was collected between 2015-2020. Assessment of oral health and dental care before and during oncological treatment took place at the specialist clinic for Orofacial medicine linked to the specific hospital. Results: In total, 220 patients were included, 101 patients in the high-dose group and 119 patients in the adjuvant BP-treatment group. MRONJ was diagnosed in 13 patients (14%) in the high-dose group. The mandible was affected in most of the cases (84.6%), with a mean duration of high-dose treatment of 19.7 months. In 46.2% of cases, no dental cause of MRONJ could be identified. Overall, estrogen receptor-positive (ER+) BC was the most representative type in 172 patients (78.2%). However, this was 83.9% in the high-dose cases group. The most used drug was denosumab. Twenty-five patients (26.9%) switched their medication from ZOL to denosumab during their oncological treatment. Patients with ER+ breast cancer were reported in 88 patients (87.8%) in the adjuvant group that was treated with ZOL. Conclusions: MRONJ was diagnosed only in the high-dose AR group. Dental assessment and care of patients in the adjuvant group should be considered, with a recommendation to potentially prolong ZOL treatment from 3 to 5 years, with concomitant use of hormonal therapy in patients diagnosed with ER+ breast cancer to prevent bone loss induced by oncological treatment. A new referral for dental assessment is very important in the case of bone metastases when treatment with high dose AR will be required since it is associated with a higher risk of MRONJ.

Keywords: antiresorptive therapy, breast cancer, dental care, MRONJ

Procedia PDF Downloads 81

Authors: Tharwat Ibrahim Rushdy, Warda Youssef Mohammed Morsy, Hanaa Ali Ahmed Elfeky

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Background: Intra-aortic balloon pump (IABP) is the first and the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Therefore, critical care nurses not only have to know how to monitor and operate the IABP, but also to provide interventions for preventing possible complications. Aim of the study: To assess nurses' knowledge and practices regarding care of patients connected to IABP at the ICUs of Cairo University Hospitals. Research design: A descriptive exploratory design was utilized. Sample: Convenience samples of 40 nurses were included in the current study. Setting: This study was carried out at the Intensive Care Units of Cairo University Hospitals. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a- Nurses' personal background sheet, b- IABP nurses' knowledge self-administered questionnaire, and c- IABP Nurses' practice observational checklist. Results: The majority of the studied sample had unsatisfactory knowledge and practice level (88% & 95%) respectively with a mean of 9.45+2.94 and 30.5+8.7, respectively. Unsatisfactory knowledge was found regarding description and physiological effects, nursing care, indications, contraindications, complications, weaning, and removal of IABP in percentage of 95%, 90%, 72.5%, and 57.5%, respectively, with a mean total knowledge score of 9.45 +2.94. In addition, unsatisfactory practice was found regarding about preparation and initiation of IABP therapy, nursing practice during therapy, weaning, and removal of IABP in percentages of (97.5%, 97.5%, and 90%), respectively. Finally, knowledge level was found to differ significantly in relation to gender (t = 2.46 at P ≤ 0.018). However, gender didn't play a role in relation to practice (t = 0.086 at P≤ 0.932). Conclusion: In spite of having vital role in assessment and management of critically ill patients, critical care nurses in the current study had in general unsatisfactory knowledge and practice regarding care of patients connected to IABP. Recommendation: updating knowledge and practice of ICU nurses through carrying out continuing educational programs about IABP; strict observation of nurses' practice when caring for patients connected to IABP and provision of guidance to correct of poor practices and replication of this study on larger probability sample selected from different geographical locations.

Keywords: knowledge, practice, intra-aortic balloon pump (IABP), ICU nurses, intensive care unit (ICU), introduction

Procedia PDF Downloads 486

Authors: Mariam Tsitsagi, Ana Berdzenishvili

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Rainfall intensity change is one of the main indicators of climate change. It has a great influence on agriculture as one of the main factors causing soil erosion. Splash and sheet erosion are one of the most prevalence and harmful for agriculture. It is invisible for an eye at first stage, but the process will gradually move to stream cutting erosion. Our study provides the assessment of rainfall erosivity potential with the use of modern research methods in Kakheti region. The region is the major provider of wheat and wine in the country. Kakheti is located in the eastern part of Georgia and characterized quite a variety of natural conditions. The climate is dry subtropical. For assessment of the exact rate of rainfall erosion potential several year data of rainfall with short intervals are needed. Unfortunately, from 250 active metro stations running during the Soviet period only 55 of them are active now and 5 stations in Kakheti region respectively. Since 1936 we had data on rainfall intensity in this region, and rainfall erosive potential is assessed, in some old papers, but since 1990 we have no data about this factor, which in turn is a necessary parameter for determining the rainfall erosivity potential. On the other hand, researchers and local communities suppose that rainfall intensity has been changing and the number of haily days has also been increasing. However, finding a method that will allow us to determine rainfall erosivity potential as accurate as possible in Kakheti region is very important. The study period was divided into three sections: 1936-1963; 1963-1990 and 1990-2015. Rainfall erosivity potential was determined by the scientific literature and old meteorological stations’ data for the first two periods. And it is known that in eastern Georgia, at the boundary between steppe and forest zones, rainfall erosivity in 1963-1990 was 20-75% higher than that in 1936-1963. As for the third period (1990-2015), for which we do not have data of rainfall intensity. There are a variety of studies, where alternative ways of calculating the rainfall erosivity potential based on lack of data are discussed e.g.based on daily rainfall data, average annual rainfall data and the elevation of the area, etc. It should be noted that these methods give us a totally different results in case of different climatic conditions and sometimes huge errors in some cases. Three of the most common methods were selected for our research. Each of them was tested for the first two sections of the study period. According to the outcomes more suitable method for regional climatic conditions was selected, and after that, we determined rainfall erosivity potential for the third section of our study period with use of the most successful method. Outcome data like attribute tables and graphs was specially linked to the database of Kakheti, and appropriate thematic maps were created. The results allowed us to analyze the rainfall erosivity potential changes from 1936 to the present and make the future prospect. We have successfully implemented a method which can also be use for some another region of Georgia.

Keywords: erosivity potential, Georgia, GIS, Kakheti, rainfall

Procedia PDF Downloads 215

Authors: Marilou P. Angeles

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Seniors are a growing number of population all over the world, and they are getting sick with illnesses like diabetes, high blood, and high cholesterol. It is necessary to see the relationship of their physical illness and its effect on their quality of life. Having chronic illnesses also can affect the mood of the elderly; becoming cranky, lonely, not eating, etc. Therefore, there is a need to study the relationship of the quality of life of the elderly and the level of depression. Depression for elderly is known as late onset depression or vascular depression since it is tied to the vascular illnesses they are experiencing, although this is not homogeneous. There is heterogeneity in seniors. The purpose of the study is to determine how keep the satisfaction in life i.e., quality of life of seniors, as long as possible. This study was made in 4 barangays in Longos, Potrero, Tonsuya and Catmon, in Malabon, Metro Manila, Philippines. These Filipino seniors are availing of free medicines for their diabetes, high blood, and high cholesterol ailments in the barangay health centers, given freely by the Department of Health. Two instruments were used; quality of life (CASP-19) and patient health questionnaire(PHQ-19). The quality of life questionnaire was based on the theory of Abraham Maslow, human: beings are motivated to action by needs, starting from the lowest, physiological to the highest self-transcendence. Severity of depression is determined by PHQ-9, and according to the unified model of depression by Aaron Beck and Kurt B. Bredemeier, depression happens when a person cannot cope with life has not able to satisfy his needs as a person. The Pearson R correlation was used to determine the significance of the relationship between quality of life and depression. Finding is there is negative relationship between quality of life and depression. It means that a high value of quality of life lowers or minimizes depression. CASP-19 found that the Filipino elderly were in control, independent, enjoying their lives even if they are poor, and this is shown by the significant results. Self-transcendence, a need to give back to others, is important for Filipino elderly. Although the seniors have difficulty with money and they were affected by their illnesses, they are full of optimism, they are ignoring their physical pain because they are focusing on helping their loved ones (i.e., self-transcendence), their children and grandchildrenothers, and if problems come, they are resilient accepting of the challenges, because they have strong faith in God. They are also having pleasures interacting with their friends and neighbors who, like them, have the same health problems. And these two coping strategies for the elderlies allow them to live a meaningful life, a life high in quality. Thus, where there is high quality of life, there is none or minimal depression. Recommendation for future study is finding the relationship of spirituality to quality of life of seniors.

Keywords: CASP-19, depression, quality of life, PHQ-9, senior citizen

Procedia PDF Downloads 143

Authors: Oktia Woro Kasmini Handayani, Bambang Budi Raharjo, Efa Nugroho, Bertakalswa Hermawati

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Obesity prevalence and severe malnutrition in Indonesia has increased from 2007 to 2013. The utilization of local resources in nutritional program planning can be used to program efficiency and to reach the goal. The aim of this research is to plan a nutrition program based on local resources for urban fringe areas in a developing country. This research used a qualitative approach, with a focus on local resources including social capital, social system, cultural system. The study was conducted in Mijen, Central Java, as one of the urban fringe areas in Indonesia. Purposive and snowball sampling techniques are used to determine participants. A total of 16 participants took part in the study. Observation, interviews, focus group discussion, SWOT analysis, brainstorming and Miles and Huberman models were used to analyze the data. We have identified several local resources, such as the contributions from nutrition cadres, social organizations, social financial resources, as well as the cultural system and social system. The outstanding contribution of nutrition cadres is the participation and creativity to improve nutritional status. In addition, social organizations, like the role of the integrated health center for children (Pos Pelayanan Terpadu), can be engaged in the nutrition program planning. This center is supported by House of Nutrition to assist in nutrition program planning, and provide social support to families, neighbors and communities as social capitals. The study also reported that cultural systems that show appreciation for well-nourished children are a better way to improve the problem of balanced nutrition. Social systems such as teamwork and mutual cooperation can also be a potential resource to support nutritional programs and overcome associated problems. The impact of development in urban areas such as the introduction of more green areas which improve the perceived status of local people, as well as new health services facilitated by people and companies, can also be resources to support nutrition programs. Local resources in urban fringe areas can be used in the planning of nutrition programs. The expansion of partnership with all stakeholders, empowering the community through optimizing the roles of nutrition care centers for children as our recommendation with regard to nutrition program planning.

Keywords: developing country, local resources, nutrition program, urban fringe

Procedia PDF Downloads 244

Authors: Ella Sèdé Maforikan

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Accurate land cover mapping is essential for effective environmental monitoring and natural resources management. This study focuses on assessing the classification performance of two satellite datasets and evaluating the impact of different input feature combinations on classification accuracy in the Beterou catchment, situated in the northern part of Benin. Landsat-8 and Sentinel-2 images from June 1, 2020, to March 31, 2021, were utilized. Employing the Random Forest (RF) algorithm on Google Earth Engine (GEE), a supervised classification categorized the land into five classes: forest, savannas, cropland, settlement, and water bodies. GEE was chosen due to its high-performance computing capabilities, mitigating computational burdens associated with traditional land cover classification methods. By eliminating the need for individual satellite image downloads and providing access to an extensive archive of remote sensing data, GEE facilitated efficient model training on remote sensing data. The study achieved commendable overall accuracy (OA), ranging from 84% to 85%, even without incorporating spectral indices and terrain metrics into the model. Notably, the inclusion of additional input sources, specifically terrain features like slope and elevation, enhanced classification accuracy. The highest accuracy was achieved with Sentinel-2 (OA = 91%, Kappa = 0.88), slightly surpassing Landsat-8 (OA = 90%, Kappa = 0.87). This underscores the significance of combining diverse input sources for optimal accuracy in land cover mapping. The methodology presented herein not only enables the creation of precise, expeditious land cover maps but also demonstrates the prowess of cloud computing through GEE for large-scale land cover mapping with remarkable accuracy. The study emphasizes the synergy of different input sources to achieve superior accuracy. As a future recommendation, the application of Light Detection and Ranging (LiDAR) technology is proposed to enhance vegetation type differentiation in the Beterou catchment. Additionally, a cross-comparison between Sentinel-2 and Landsat-8 for assessing long-term land cover changes is suggested.

Keywords: land cover mapping, Google Earth Engine, random forest, Beterou catchment

Procedia PDF Downloads 56

Authors: Salma Akter, Md. Kamal Uddin

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Ashrayan (shelter) Prakalpa – a fully subsidized ‘integrated poverty eradication program’ through the provisioning of shelter of Bangladesh Government (GoB) targeting the internally displaced and homeless. In spite of the inclusiveness (poverty alleviation, employment opportunity, Tenure ship and training) of the shelter policy, dwellers are not merely questioned by the issue of 'the quality of life' .This study demonstrates how top-down policies, ambiguous ownership status of land and dwelling environments lead to ‘everyday compromise’ by the grassroots in both subjective (satisfaction, comfort and safety) and objective (physical design elements and physical environmental elements) issues in three respective scale macro (neighborhood) meso (shelter /built environment) and micro(family). It shows that by becoming subject to Government’s resettlements policies and after becoming user of its shelter units (although locally known as ‘barracks’ rather shelter or housing), the once displaced settlers assume a curious form of spatial practice where both social and spatial often bear slippery meanings. Thus, Policy-based shelter force the dwellers frequently compromise with their provided built environments and spaces within the settlements both in overtly and covertly. Compromises are made during the production of space and forms, whereas interesting new spaces and space-making practices emerge. The settlements under study are Dakshin Chandani Mahal Ashrayan Prakalpa located at the Eastern fringe area of Khulna, Bangladesh. In terms of methodology, this research is primarily exploratory and assumes a qualitative approach. Key tools used to obtain information are policy analysis, literature review, key informant interview, focus group discussion and participant observation at the level of dwelling and settlements. Necessary drawings and photographs have been taken to promote the study objective. Findings revealed that various shortages, inadequacies and negligence of policymakers make a compromising character of displaced by the means of 'quality of life' both in objective and subjective ground. Thus the study ends up with a recommendation to the policymakers to take an initiative to ensure the quality of life of the dwellers.

Keywords: Ashrayan, compromise, displaced people, quality of life

Procedia PDF Downloads 335

Authors: Etsuko Sakairi

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In 2016 Japan started to enforce domestic legislation in the form of the Act of Elimination of Discrimination against Persons with Disability, along with ratifying the United Nations Convention on the Rights of Persons with Disabilities (CRPD) in 2014. However, it is not clear what kind of situations would be considered cases of discrimination in relation to issues of sexuality according to this legislation. Furthermore, in March 2016, the United Nations Committee on the Elimination of Discrimination against Women (CEDAW) made a recommendation to the Japanese government to conduct a study of the forced sterilization of women under the Eugenic Protection Act. This research is carried out against this background in which the experiences of people with disabilities have often been restricted by caregivers and family members—as evidenced by the high number of eugenics surgeries performed on people with disabilities without their consent. This research contributes to this topic by presenting voices and perspectives of key people, especially focusing on the voices of carers who are working with people with physical disabilities in a Non-Western country, Japan. Furthermore, since 90% of the research on the topic of sexuality of people with disabilities is conducted in Western countries, the voices from Non-Western countries in this regard are greatly lacking. In the part of the research presented here, the researcher has employed a feminist disability theory to understand the circumstances surrounding people with physical disabilities. She has gathered voices from 58 carers by using an on-line questionnaire (55) and by conducting face-to-face interviews (3). In this presentation, the researcher will introduce experiences and thoughts regarding sexuality and people with disabilities by using carers’ own words. One of the major findings was carers’ concern about a boundary issue. Although each carer has had unique experiences depending on their professional or personal relationship with people with physical disabilities, many of them shared some similar viewpoints. This included a concern that assisting with the meeting of some forms of sexual needs 9e.g. assisted masturbation) would result in the possibility of transgressing the boundary between the carer and the person with physical disability. Most of the carer did not have any opportunity to receive any trainings regarding to sexuality of people with disabilities. Furthermore, most of the carers conceptualized that ‘Keeping a sexual dignity of people with disabilities’ means practicing a ‘Principle of same sex assistance’. The researcher hopes that this presentation provides an opportunity for audiences to look back at their own community and to think about what sexuality of people with physical disabilities means to their carers as well as to look back at their own practice in relation to this issue.

Keywords: Carer, Japan, physical disabilities, sexuality

Procedia PDF Downloads 166

Authors: Muhammad Fatahillah Akbar

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Criminal Procedural Law is established to protect the society from the abuse of authority. To achieve that purpose, the criminal procedural law shall be established in accordance with the laws of human right and the protection of the society. One of the mechanisms to protect human rights and to ensure the compliance of authorities in criminal procedural law is pre-trial mechanism. In many countries, there are various mechanisms of pre-trial. In the recent cases in Indonesia, pre-trial has been an interesting issue. The issue is also addressed by the Constitutional Court Decision Number 21/PUU-XII/2014 which enhance the competence of pre-trial which includes the suspect determination and the legality of seizure and search. Before that decision, some pre-trial decisions have made landmark decision by enhancing the competence of pre-trial, such as the suspect determination case in Budi Gunawan Case and legality of the investigation in Hadi Purnomo Case. These pre-trial cases occurred because the society needs protection even though it is not provided by written legislations, in this matter, The Indonesian Criminal Procedural Code (KUHAP). For instance, a person can be a suspect for unlimited time because the Criminal Procedural Code does not regulate the limit of investigation, so the suspect enactment shall be able to be challenged to protect human rights. Before the Constitutional Court Decision Suspect Determination cannot be challenged so that the society is not fully protected. The Constitutional Court Decision has provided more protections. Nowadays, investigators shall be more careful in conducting the investigation. However, those decisions, including the Constitutional Court Decision are not sufficient for society to be protected by abuse of authority. For example, on 7 March 2017, a single judge, in a Pre-Trial, at the Surabaya District Court, decided that the investigation was unlawful and shall be terminated. This is not regulated according to the Code and also any decisions in pre-trial. It can be seen that the reform of pre-trial is necessary. Hence, this paper aims to examine how pre-trial shall be developed in the future to provide wide access for society to have social justice in criminal justice system. The question will be answered by normative, historical, and comparative approaches. Firstly, the paper will examine the history of pre-trial in Indonesia and also landmark decisions on pre-trial. Then, the lessons learned from other countries regarding to the pre-trial mechanism will be elaborated to show how pre-trial shall be developed and what the competences of a pre-trial are. The focus of all discussions shall be on how the society is protected and provided access to legally complain to the authority. At the end of the paper, the recommendation to reform the pre-trial mechanism will be suggested.

Keywords: pre-trial, criminal procedural law, society

Procedia PDF Downloads 161

Authors: Gabriel Ugalahi, Dominic S. Nyitamen

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This project seeks to improve Wi-Fi reception by utilizing the properties of directional microstrip patch antennae. Where there is a dense population of Wi-Fi signal, several signal sources transmitting on the same frequency band and indeed channel constitutes interference to each other. The time it takes for request to be received, resolved and response given between a user and the resource provider is increased considerably. By deploying a directional patch antenna with a narrow bandwidth, the range of frequency received is reduced and should help in limiting the reception of signal from unwanted sources. A rectangular microstrip patch antenna (RMPA) is designed to operate at the Industrial Scientific and Medical (ISM) band (2.4GHz) commonly used in Wi-Fi network deployment. The dimensions of the antenna are calculated and these dimensions are used to generate a model on Advanced Design System (ADS), a microwave simulator. Simulation results are then analyzed and necessary optimization is carried out to further enhance the radiation quality so as to achieve desired results. Impedance matching at 50Ω is also obtained by using the inset feed method. Final antenna dimensions obtained after simulation and optimization are then used to implement practical construction on an FR-4 double sided copper clad printed circuit board (PCB) through a chemical etching process using ferric chloride (Fe2Cl). Simulation results show an RMPA operating at a centre frequency of 2.4GHz with a bandwidth of 40MHz. A voltage standing wave ratio (VSWR) of 1.0725 is recorded on a return loss of -29.112dB at input port showing an appreciable match in impedance to a source of 50Ω. In addition, a gain of 3.23dBi and directivity of 6.4dBi is observed during far-field analysis. On deployment, signal reception from wireless devices is improved due to antenna gain. A test source with a received signal strength indication (RSSI) of -80dBm without antenna installed on the receiver was improved to an RSSI of -61dBm. In addition, the directional radiation property of the RMPA prioritizes signals by pointing in the direction of a preferred signal source thus, reducing interference from undesired signal sources. This was observed during testing as rotation of the antenna on its axis resulted to the gain of signal in-front of the patch and fading of signals away from the front.

Keywords: advanced design system (ADS), inset feed, received signal strength indicator (RSSI), rectangular microstrip patch antenna (RMPA), voltage standing wave ratio (VSWR), wireless fidelity (Wi-Fi)

Procedia PDF Downloads 214

Authors: Arsalan Jabbar, Wajiha Javed, Nelofer Mehboob, Zahid Memon

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Introduction: There are multiple social, individual and cultural factors that influence an individual’s decision to adopt family planning methods especially among non-users in patriarchal societies like Pakistan.Non-users, if targeted efficiently, can contribute significantly to country’s CPR. A research study showed that non-users if convinced to adopt lactational amenorrhea method can shift to long-term methods in future. Research shows that if non-users are targeted efficiently a 59% reduction in unintended pregnancies in Saharan Africa and South-Central and South-East Asia is anticipated. Methods: We did secondary data analysis on Pakistan Demographic Heath Survey (2012-13) dataset. Use of contraception (never-use/ever-use) was the outcome variable. At univariate level Chi-square/Fisher Exact test was used to assess relationship of baseline covariates with contraception use. Then variables to be incorporated in the model were checked for multi-collinearity, confounding, and interaction. Then binary logistic regression (with an urban-rural stratification) was done to find the relationship between contraception use and baseline demographic and social variables. Results: The multivariate analyses of the study showed that younger women (≤ 29 years) were more prone to be never users as compared to those who were > 30 years and this trend was seen in urban areas (AOR 1.92, CI 1.453-2.536) as well as rural areas (AOR 1.809, CI 1.421-2.303). While looking at regional variation, women from urban Sindh (AOR 1.548, CI 1.142-2.099) and urban Balochistan (AOR 2.403, CI 1.504-3.839) had more never users as compared to other urban regions. Women in the rich wealth quintile were more never users and this was seen both in urban and rural localities (urban (AOR 1.106 CI .753-1.624); rural areas (AOR 1.162, CI .887-1.524)) even though these were not statistically significant. Women idealizing more children(> 4) are more never users as compared to those idealizing less children in both urban (AOR 1.854, CI 1.275-2.697) and rural areas (AOR 2.101, CI 1.514-2.916). Women who never lost a pregnancy were more inclined to be non-users in rural areas (AOR 1.394, CI 1.127-1.723) .Women familiar with only traditional or no method had more never users in rural areas (AOR 1.717, CI 1.127-1.723) but in urban areas it wasn’t significant. Women unaware of Lady Health Worker’s presence in their area were more never users especially in rural areas (AOR 1.276, CI 1.014-1.607). Women who did not visit any care provider were more never users (urban (AOR 11.738, CI 9.112-15.121) rural areas (AOR 7.832, CI 6.243-9.826)). Discussion/Conclusion: This study concluded that government, policy makers and private sector family planning programs should focus on the untapped pool of never users (younger women from underserved provinces, in higher wealth quintiles, who desire more children.). We need to make sure to cover catchment areas where there are less LHWs and less providers as ignorance to modern methods and never been visited by an LHW are important determinants of never use. This all is in sync with previous literate from similar developing countries.

Keywords: contraception, demographic and health survey, family planning, never users

Procedia PDF Downloads 402

Authors: Tsedekech Gebremeskel Weldmichael, Tamas Szegi, Lubangakene Denish, Ravi Kumar Gangwar, Erika Micheli, Barbara Simon

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Following the 1992 Earth Summit in Rio de Janeiro, soil biodiversity has been recognized globally as a crucial player in guaranteeing the functioning of soil and a provider of several ecosystem services essential for human well-being. The microbial fraction of the soil is a vital component of soil fertility as soil microbes play key roles in soil aggregate formation, nutrient cycling, humification, and degradation of pollutants. Soil fauna, such as earthworms, have huge impacts on soil organic matter dynamics, nutrient cycling, and infiltration and distribution of water in the soil. Currently, land-use change has been a global concern as evidence accumulates that it adversely affects soil biodiversity and the associated ecosystem goods and services. In this study, we examined the patterns of soil microbial respiration (SMR) and earthworm (abundance, biomass, and species richness) across three land-use types (grassland, arable land, and forest) in Hungary. The objectives were i) to investigate whether there is a significant difference in SMR and earthworm (abundance, biomass, and species richness) among land-use types. ii) to determine the key soil properties that best predict the variation in SMR and earthworm communities. Soil samples, to a depth of 25 cm, were collected from the surrounding areas of seven soil profiles. For physicochemical parameters, soil organic matter (SOM), pH, CaCO₃, E₄/E₆, available nitrogen (NH₄⁺-N and NO₃⁻-N), potassium (K₂O), phosphorus (P₂O₅), exchangeable Ca²⁺, Mg²⁺, soil moisture content (MC) and bulk density were measured. The analysis of SMR was determined by basal respiration method, and the extraction of earthworms was carried out by hand sorting method as described by ISO guideline. The results showed that there was no statistically significant difference among land-use types in SMR (p > 0.05). However, the highest SMR was observed in grassland soils (11.77 mgCO₂ 50g⁻¹ soil 10 days⁻¹) and lowest in forest soils (8.61 mgCO₂ 50g⁻¹ soil 10 days⁻¹). SMR had strong positive correlations with exchangeable Ca²⁺ (r = 0.80), MC (r = 0.72), and exchangeable Mg²⁺(r = 0.69). We found a pronounced variation in SMR among soil texture classes (p < 0.001), where the highest value in silty clay loam soils and the lowest in sandy soils. This study provides evidence that agricultural activities can negatively influence earthworm communities, in which the arable land had significantly lower earthworm communities compared to forest and grassland respectively. Overall, in our study, land use type had minimal effects on SMR whereas, earthworm communities were profoundly influenced by land-use type particularly agricultural activities related to tillage. Exchangeable Ca²⁺, MC, and texture were found to be the key drivers of the variation in SMR.

Keywords: earthworm community, land use, soil biodiversity, soil microbial respiration, soil property

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Authors: D. Tedesco, G. Feletti, P. Trucco

Abstract:

The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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Authors: Alexandra McKinzie, Lucy Brown, Sarah Komanapalli, Sarah Swiezy, Caitlin Bernard

Abstract:

Background: While 25% of US women will seek an abortion before age 45, targeted laws have led to a decline in abortion clinics, subsequently leaving 96% of Indiana counties and the 70% of Hoosier women residing in these counties without access to services they desperately need.1,2 Despite the need for a physician workforce that is educated and able to provide full-spectrum reproductive health care, few medical institutions have a standardized family planning and abortion pre-clinical curriculum. Methods: A Qualtrics survey was disseminated to students from Indiana University School of Medicine (IUSM) to evaluate (1) student interest in curriculum reform, (2) self-assessed preparedness to counsel on contraceptive and pregnancy options, and (3) preferred modality of instruction for family planning and abortion topics. Based on the pre-panel survey feedback, a case-based pregnancy options counseling panel will be implemented in the students’ pre-clinical, didactic course Endocrine, Reproductive, Musculoskeletal, Dermatologic Systems (ERMD) in February 2022. A Qualtrics post-panel survey will be disseminated to evaluate students’ perceived efficacy and quality of the panel, as well as their self-assessed preparedness to counsel on pregnancy options. Results: Participants in the pre-panel survey (n=303) were primarily female (61.72%) and White (74.43%). Across all class levels, many (60.80%) students expected to learn about family planning and abortion in their pre-clinical education. While most (84-88%) participants felt prepared to counsel about common, non-controversial pharmacotherapies (e.g. beta-blockers and diuretics), only 20% of students felt prepared to counsel on abortion options. Overall, 85.67% of students believed that IUSM should enhance its reproductive health coverage in pre-clinical, didactic courses. Traditional lectures, panels, and direct clinical exposure were the most popular instructional modalities. Expected Results: The authors predict that following the panel, students will indicate improved confidence in providing pregnancy options counseling. Additionally, students will provide constructive feedback on the structure and content of the panel for incorporation into future years’ curriculum. Conclusions: IUSM students overwhelmingly expressed interest in expanding their pre-clinical curriculum’s coverage of family planning and abortion topics. To specifically improve students’ self-assessed preparedness to provide pregnancy options counseling and address students’ self-cited learning gaps, a case-based provider panel session will be implemented in response to students’ preferred modality feedback.

Keywords: options counseling, family planning, abortion, curriculum reform, case-based panel

Procedia PDF Downloads 138