Search results for: evidence based nursing

Authors: Louise Fitzgerald, John Allman

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Introduction: Having previously engaged in a meditation-based programme (MBP) for staff in general practice, we explore the evidence and extent to which MBPs are employed in the workplace. Aim of the study: We aim to understand the current workplace MBP intervention literature, which will help inform the suitability of these interventions within the workplace domain. Objectives: Uptake of MBPs in the workplace has grown as organizations look to support employee health, wellbeing, and performance. We will discuss the current MBP literature, including the large variability across MBPs and the associated difficulties in evaluating their efficacy. Learning points: 1) MBPs have a positive impact on cognitive function including concentration and memory and as such job performance. MBPs appear to have a positive impact on objective and subjective job satisfaction, productivity, motivation and work engagement. Meditation in the workplace may have positive impacts on mental health issues - including stress reduction and depression. 2) From our review MBPs appear to be implementable in a wide range of professions and work contexts - regardless of individual factors. Given many companies are focusing on health and wellbeing of employees, this could be included in employee wellbeing programmes. 3) Despite the benefits of mindfulness and meditation interventions in psychosocial workplace health and work performance the long-term efficacy has yet to be fully determined.

Keywords: meditation-based programmes, mindfulness, meditation, well-being

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Authors: Masih Nikgou

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ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

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Authors: Ho-Hsin Lee, Yue-Min Jiang, Shu-Hui Tsai, Jian-Ren Chen, Mei-Yu XU, Wen-Tien Wu

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This project presents an AI-based method and system for wound status analysis. The system uses a three-in-one sensor device to analyze wound status, including color, temperature, and a 3D sensor to provide wound information up to 2mm below the surface, such as redness, heat, and blood circulation information. The system has a 90% accuracy rate, requiring only one manual correction in 70% of cases, with a one-second delay. The system also provides an offline application that allows for manual correction of the wound bed range using color-based guidance to estimate wound bed size with 96% accuracy and a maximum of one manual correction in 96% of cases, with a one-second delay. Additionally, AI-assisted wound bed range selection achieves 100% of cases without manual intervention, with an accuracy rate of 76%, while AI-based wound tissue type classification achieves an 85.3% accuracy rate for five categories. The AI system also includes similar case search and expert recommendation capabilities. For AI-assisted wound range selection, the system uses WIFI6 technology, increasing data transmission speeds by 22 times. The project aims to save up to 64% of the time required for human wound record keeping and reduce the estimated time to assess wound status by 96%, with an 80% accuracy rate. Overall, the proposed AI method and system integrate multiple sensors to provide accurate wound information and offer offline and online AI-assisted wound bed size estimation and wound tissue type classification. The system decreases delay time to one second, reduces the number of manual corrections required, saves time on wound record keeping, and increases data transmission speed, all of which have the potential to significantly improve wound care and management efficiency and accuracy.

Keywords: wound status analysis, AI-based system, multi-sensor integration, color-based guidance

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Authors: Seyed Reza Mirmahdi, Seyedeh Maryam Hashemi Jabali

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This research was conducted to evaluate the effects of group spiritual therapy on increasing the life expectancy and mental health among the elderlies. This was a quasi-experimental research using a pretest-posttest design with a control group conducted over a population including all the elderly people of Tehran in 2012-13. A randomized sampling method was used to select 30 elderly people living in Parham nursing home that were then randomly assigned into two control and experimental groups of 15 people each. The instruments used were Miller’s life expectancy and mental health test (SCL.90.R) standard questionnaires. Individuals in experimental group received 12 sessions of group spiritual therapy while those in control group did not receive any kind of therapy. The tests were performed again for all the subjects (30 individuals) at the end of the experiment. To test the hypotheses, the data collected by questionnaires were analyzed using descriptive methods through relevant tables and charts and also inferential methods through the analysis of covariance using the SPSS software. Results showed that group spiritual therapy leads to a significant increase in both mental health and life expectancy in the experimental group of elderlies living in Parham nursing home compared to those in the control group.

Keywords: spiritual therapy, life expectancy, mental health, elderlies

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Authors: R. Cooper, M. Kurien

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Background: Coeliac Disease affects around 1 in 100 people. Untreated, it can result in serious morbidity such as malabsorption and cancers. The only treatment is to adhere to a gluten free diet (GFD). International guidelines recommend that people with the coeliac disease receive follow-up healthcare annually to detect complications early and support their adherence to a GFD. However, there is a finite amount of healthcare in the UK, and as such, not all patients receive follow-up care as recommended by the guidelines. Furthermore, there is an increasing number of patients being diagnosed with coeliac disease. Given the potential severe morbidity that non-adherence to a GFD could result in, alongside reports that the rate of non- GFD adherence could be as high as 91%, it is imperative that action is taken. One potential solution to this would be to provide follow-up care digitally through utilising technology. This abstract reports on a rapid review undertaken to explore the existing evidence in this area. Methods: In June 2020, 11 bibliographic databases were searched to find any pertinent studies. The inclusion criteria required the study to be written in the English language and report on the use of digital healthcare interventions for people with Coeliac Disease. Results: A small amount of evidence (n=8) was found which met our inclusion criteria and pertained to the provision of CD follow-up digitally. These studies focussed either on educating and supporting patients to adhere to a GFD or providing consultation remotely with a focus on detecting complications early. These studies showed that there is potential for digital healthcare interventions to positively impact people with coeliac disease. However, it is suggested that the effectiveness of these interventions may depend on local circumstances, individual knowledge of CD and general attitudes. Conclusion: The above studies suggest that providing follow-up care digitally may offer a potential solution; however, the evidence about how this should be done and in what circumstances this will work for individuals is scarce. In the light of the COVID-19 pandemic, the introduction of digital healthcare interventions appears to be highly topical, and as such, this review may benefit from being refreshed in the future.

Keywords: coeliac disease, follow-up, gluten free diet, digital healthcare interventions

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Authors: Ademola Ajibade

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Previous studies have explored several rationales for hedging strategies, but the evidence provided by these studies remains ambiguous. Using a hand-collected dataset of 2460 observations of non-financial firms in eight African countries covering 2013-2022, this paper investigates the determinants and extent of corporate hedge use. In particular, this paper focuses on the link between country-specific conditions and the corporate hedging behaviour of firms. To our knowledge, this represents the first African studies investigating the association between country-specific factors and corporate hedging policy. The evidence based on both univariate and multivariate reveal that country-level corruption and government quality are important indicators of the decisions and extent of hedge use among African firms. However, the connection between country-specific factors as a rationale for corporate hedge use is stronger for firms located in highly corrupt countries. This suggest that firms located in corrupt countries are more motivated to hedge due to the large exposure they face. In addition, we test the risk management theories and observe that CEOs educational qualification and experience shape corporate hedge behaviour. We implement a lagged variables in a panel data setting to address endogeneity concern and implement an interaction term between governance indices and firm-specific variables to test for robustness. Generally, our findings reveal that institutional factors shape risk management decisions and have a predictive power in explaining corporate hedging strategy.

Keywords: corporate hedging, governance quality, corruption, derivatives

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Authors: Nguyen Quynh Trang, Nguyễn Thị Hông Nhung

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The study aimed to identify the effectiveness of using the mind map technique to enhance students’ medical vocabulary retention among a group of students at a higher education institution - Thai Nguyen University of Medicine and Pharmacy during the first semester of the school year 2022-2023. The research employed a quasi-experimental method, exploring primary sources such as questionnaires and the analyzed results of pre-and-post tests. Almost teachers and students showed high preferences for the implementation of the mind map technique in language teaching and learning. Furthermore, results from the pre-and-post tests between the experimental group and control one pointed out that this technique brought back positive academic performance in teaching and learning English. The research findings revealed that there should be more supportive policies to evoke the use of the mind map technique in a pedagogical context. Aim of the Study: The purpose of this research was to investigate whether using mind mapping can help students to enhance nursing students’ medical vocabulary retention and to assess the students’ attitudes toward using mind mapping as a tool to improve their vocabulary. The methodology of the study: The research employed a quasi-experimental method, exploring primary sources such as questionnaires and the analyzed results of pre-and-post tests. The contribution of the study: The research contributed to the innovation of teaching vocabulary methods for English teachers at a higher education institution. Moreover, the research helped the English teachers and the administrators at a university evoke and maintain the motivation of students not only in English classes but also in other subjects. The findings of this research were beneficial to teachers, students, and researchers interested in using mind mapping to teach and learn English vocabulary. The research explored and proved the effectiveness of applying mind mapping in teaching and learning English vocabulary. Therefore, teaching and learning activities were conducted more and more effectively and helped students overcome challenges in remembering vocabulary and creating motivation to learn English vocabulary.

Keywords: medical vocabulary retention, mind map technique, nursing students, medical vocabulary

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Authors: Asnakech Zekiwos

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Background: Stress in nursing refers to the reactions nurses experience when faced with work demands that exceed their knowledge, skills, or ability to cope. Nursing, as a profession, is particularly susceptible to work-related stress. Methods: A cross-sectional study was conducted among 405 randomly selected nurses working in Hadiya Zone Public Hospitals from March 1 to 30, 2023. Data were collected using a pre-tested self-administered questionnaire. The data were entered using Epi-data version 3.1 and analyzed using SPSS version 20.0. Multivariable logistic regression analysis was performed to identify factors associated with the level of work stress. Variables with a p-value <0.05 were considered statistically significant. Results: In this study, 56% (95% CI 50.9-61.2) of the participants reported being stressed in their work. Several factors were found to be associated with work stress, including being female (AOR=1.94, 95% CI 1.19-3.16), rotating shifts (AOR=2.06, 95% CI 1.31-3.25), working in the intensive care unit (AOR=3.42, 95% CI 1.20-9.73), and having post-basic training (AOR=0.55, 95% CI 0.34-0.92). Conclusion: The study revealed a high level of work stress among nurses in the study area. The zonal health unit takes measures to address work stress by providing job orientation during the hiring process, rotation, and on-the-job training to help nurses cope with and manage stressful events. Stress in public hospitals and among nurses is an important issue that needs attention.

Keywords: stress, nurses, public hospitals, expanded stress scale

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Authors: Tasawar Nawaz

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Migration has once again become a lively topic in Europe and UK, in particular. A burgeoning concern in the public debate, however, is driven by the fear that migrants are fiscal burden because they drain public resources by drawing on the generous social transfers introduced in Europe to prevent social exclusion. This study challenges these beliefs by gathering empirical evidence through a qualitative research approach on the subject matter. The analysis suggests that UK provides a rich social and economic environment for intellectual profiles especially, human intellectual capital of migrants to flourish and add value to the exchequer. Contrary to the beliefs held by politicians and general public, the empirical evidence suggests that migrants add higher fiscal contribution by working longer hours, paying consistent taxes, and bringing skills which UK may lack thus, are not fiscal burdens on the UK exchequer.

Keywords: austerity, European union, human intellectual capital, migrants, social welfare, United Kingdom

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Authors: Yvonne Howard

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This project currently under development is centered around current learning processes, including a thorough literature review and ongoing practical experiences gained as a deputy head in a school. These daily experiences with students engaging in animal-assisted interventions and the school therapy dog form a strong base for this research. The primary objective of this research is to comprehensively explore the impact of dog-assisted well-being interventions on student motivation and affective engagement within primary and secondary school settings. The educational domain currently encounters a significant challenge due to the lack of substantial research in this area. Despite the perceived positive outcomes of such interventions being acknowledged and shared in various settings, the evidence supporting their effectiveness in an educational context remains limited. This study aims to bridge the gap in the research and shed light on the potential benefits of dog-assisted well-being interventions in promoting student motivation and affective engagement. The significance of this topic recognizes that education is not solely confined to academic achievement but encompasses the overall well-being and emotional development of students. Over recent years, there has been a growing interest in animal-assisted interventions, particularly in healthcare settings. This interest has extended to the educational context. While the effectiveness of these interventions in these areas has been explored in other fields, the educational sector lacks comprehensive research in this regard. Through a systematic and thorough research methodology, this study seeks to contribute valuable empirical data to the field, providing evidence to support informed decision-making regarding the implementation of dog-assisted well-being interventions in schools. This research will utilize a mixed-methods design, combining qualitative and quantitative measures to assess the research objectives. The quantitative phase will include surveys and standardized scales to measure student motivation and affective engagement, while the qualitative phase will involve interviews and observations to gain in-depth insights from students, teachers, and other stakeholders. The findings will contribute evidence-based insights, best practices, and practical guidelines for schools seeking to incorporate dog-assisted interventions, ultimately enhancing student well-being and improving educational outcomes.

Keywords: therapy dog, wellbeing, engagement, motivation, AAI, intervention, school

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Authors: Hoyoung Lee, Dong-Kyu Kim, Seung-Young Kho, R. Eddie Wilson

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This study quantifies a decrement in freeway capacity during rainfall. Traffic and rainfall data were gathered from Highway Agencies and Wunderground weather service. Three inter-urban freeway sections and its nearest weather stations were selected as experimental sites. Capacity analysis found reductions of maximum and mean pre-breakdown flow rates due to rainfall. The Kruskal-Wallis test also provided some evidence to suggest that the variance in the pre-breakdown flow rate is statistically insignificant. Potential application of this study lies in the operation of real time traffic management schemes such as Variable Speed Limits (VSL), Hard Shoulder Running (HSR), and Ramp Metering System (RMS), where speed or flow limits could be set based on a number of factors, including rainfall events and their intensities.

Keywords: capacity randomness, flow breakdown, freeway capacity, rainfall

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Authors: Irina Belozerova

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In the recent years, the number of crimes against peace and humanity has constantly been increasing. The development of the international community is inseparably connected to the compliance with the law which protects the rights and interests of citizens in all of their manifestations. The provisions of the law of criminal procedure are no exception. The rights of the victims of genocide, of the war crimes and the crimes against humanity, require particular attention. These crimes fall within the jurisdiction of the International Criminal Court governed by the Rome Statute of the International Criminal Court. These crimes have the following features. First, any such crime has a mass character and therefore requires specific regulation in the international criminal law and procedure and the national criminal law and procedure of different countries. Second, the victims of such crimes are usually children, women and old people; the entire national, ethnic, racial or religious groups are destroyed. These features influence the classification of victims by the age criterion. Article 68 of the Rome Statute provides for protection of the safety, physical and psychological well-being, dignity and privacy of victims and witnesses and thus determines the procedural status of these persons. However, not all the persons whose rights have been violated by the commission of these crimes acquire the status of victims. This is due to the fact that such crimes affect a huge number of persons and it is impossible to mention them all by name. It is also difficult to assess the entire damage suffered by the victims. While assessing the amount of damages it is essential to take into account physical and moral harm, as well as property damage. The procedural status of victims thus gains an exclusive character. In order to determine the full extent of the damage suffered by the victims it is necessary to collect sufficient evidence. However, it is extremely difficult to collect the evidence that would ensure the full and objective protection of the victims’ rights. While making requests for the collection of evidence, the International Criminal Court faces the problem of protection of national security information. Religious beliefs and the family life of victims are of great importance. In some Islamic countries, it is impossible to question a woman without her husband’s consent which affects the objectivity of her testimony. Finally, the number of victims is quantified by hundreds and thousands. The assessment of these elements demands time and highly qualified work. These factors justify the creation of a mechanism that would help to collect the evidence and establish the truth in the international criminal proceedings. This mechanism will help to impose a just and appropriate punishment for the persons accused of having committed a crime, since, committing the crime, criminals could not misunderstand the outcome of their criminal intent.

Keywords: crimes against humanity, evidence in international criminal proceedings, international criminal proceedings, protection of victims

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Authors: Rahy Farooq, Maria Ahmad Khan, Ayesha Isani Majeed

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Objective: The main aim of this research is to assess the knowledge, attitude and practices of female nursing staff and nursing students regarding breast cancer, to provide a baseline for monitoring trends of breast cancer awareness in them. Background: Healthcare professionals are a direct source of information for the patients and the general public as a whole. It is, therefore, essential that the information they convey be accurate and helps in building additional awareness. However, clinical experience does not influence the knowledge, attitude and practices regarding breast cancer. Nurses, being the prime part of the healthcare professionals, play a significant role and hence, their awareness regarding this pressing issue is pertinent. Lack of awareness regarding common presenting symptoms or breast cancer risk factors translates to poor breast cancer screening practices and late diagnosis. Methodology: A cross-sectional study of 280 female nurses was conducted at a tertiary care hospital in Islamabad, Pakistan. A pre-tested structured questionnaire with additional variables like cultural barriers to seeking medical help was used. The scores for outcome variables including knowledge, attitude and practices were pre-defined. Data was analyzed using SPSSv23. Results: Of the 280 participants with a mean age of 28.99±9.98 years, 142 (50.7%) were married, and 138 (49.3%) were unmarried. Mean scores were computed to be 6.14±2.93 (out of 12), 0.30±0.7 (out of 3) and 9.53±1.92 (out of 16) for knowledge, attitude and practice respectively. Using independent sample T-test, a statistically significant correlation was found when means for the score of Attitude was compared with age. With a p-value of 0.018, 117 nurses of age more than 30 years, faced more practical, financial, emotional and service barriers as compared to 163 women younger than 30 years of age. Knowledge of age-related lifetime risks was also significantly poor more in single women; with a p-value of 0.006 for identification of correct age as a risk factor and a p-value of 0.005 for correct identification of risk for development of breast cancer in the lifetime of women. By application of Chi-square test, there was a significant correlation between marital status and cultural barriers to seeking medical help, showing that single women (58.7%) shy away from talking about breast cancer considering it a taboo (p-value 0.028) whereas, more married nurses (59.2%) were apprehensive that they might be considered at fault by the society, as compared to 40.8% of single nurses. (p-value 0.038). Conclusion: Owing to the scarcity of awareness among nurses, this study recognizes the need for delivering effective information to the female nurses regarding breast cancer. Educating patients is likely to be effective if the female nurses play their part and have correct attitudes towards breast cancer practices. A better understanding of the knowledge and practices regarding breast cancer among the nursing population will enable high-risk patients to be recognized early. Therefore, we recommend arrangement of special courses and seminars for all healthcare professionals including the nursing staff.

Keywords: breast cancer, cultural barriers, kap, nurses

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Authors: Hao-Jun Hong, Jung-Tang Huang

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The world is gradually becoming an aging society, and with the lack of laboring forces, this phenomenon is affecting the nation’s economy growth. Although nursing centers are booming in recent years, the lack of medical resources are yet to be resolved, thus creating an innovative wearable medical device could be a vital solution. This research is focused on the design and development of a wearable device which obtains a more precise heart failure measurement than products on the market. The method used by the device is based on the sensor fusion and big data algorithm. From the test result, the modified structure of wearable device can significantly decrease the MA (Motion Artifact) and provide users a more cozy and accurate physical monitor experience.

Keywords: big data, heart failure, motion artifact, sensor fusion, wearable medical device

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Authors: Patrick Ho

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Bloodstain Pattern Analysis (BPA) forensic evidence can be complex, requiring effective courtroom presentation to ensure clear and comprehensive understanding of the analyst’s findings. BPA witness statements can often involve reference to spatial information (such as location of rooms, objects, walls) which, when coupled with classified blood patterns, may illustrate the reconstructed movements of suspects and injured parties. However, it may be difficult to communicate this information through photography alone, despite this remaining the UK’s established method for presenting BPA evidence. Through an academic-police partnership between the University of Warwick and West Midlands Police (WMP), an integrated 3D scanning and HDR photography workflow for BPA was developed. Homicide scenes were laser scanned and, after processing, the 3D models were utilised in the BPA peer-review process. The same 3D models were made available for court but were not always utilised. This workflow has improved the ease of presentation for analysts and provided 3D scene models that assist with the investigation. However, the effects of incorporating 3D scene models in judicial processes may need to be studied before they are adopted more widely. 3D models from a simulated crime scene and West Midlands Police cases approved for conference disclosure are presented. We describe how the workflow was developed and integrated into established practices at WMP, including peer-review processes and witness statement delivery in court, and explain the impact the work has had on the Criminal Justice System in the West Midlands.

Keywords: bloodstain pattern analysis, forensic science, criminal justice, 3D scanning

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Authors: Debi Konukcu Onal, Tarkan Cavusoglu

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In modern societies, the costs of public goods and services are shared through taxes paid by citizens. However, taxation has always been a frictional issue, as tax obligations are perceived to be a financial burden for taxpayers rather than being merit that fulfills the redistribution, regulation and stabilization functions of the welfare state. The tax compliance literature evolves into discussing why people still pay taxes in systems with low costs of legal enforcement. Related empirical and theoretical works show that a wide range of socially oriented behavioral factors can stimulate voluntary compliance and subversive effects as well. These behavioral motivations are argued to be driven by self-enforcing rules of informal institutions, either independently or through interactions with legal orders set by formal institutions. The main focus of this study is to investigate empirically whether institutional particularities have a significant role in explaining the cross-country differences in the tax noncompliance levels. A part of the controversy about the driving forces behind tax noncompliance may be attributed to the lack of empirical evidence. Thus, this study aims to fill this gap through regression estimates, which help to trace the link between institutional quality and noncompliance on a cross-country basis. Tax evasion estimates of Buehn and Schneider is used as the proxy measure for the tax noncompliance levels. Institutional quality is quantified by three different indicators (percentile ranks of Worldwide Governance Indicators, ratings of the International Country Risk Guide, and the country ratings of the Freedom in the World). Robust Least Squares and Threshold Regression estimates based on the sample of the Organization for Economic Co-operation and Development (OECD) countries imply that tax compliance increases with institutional quality. Moreover, a threshold-based asymmetry is detected in the effect of institutional quality on tax noncompliance. That is, the negative effects of tax burdens on compliance are found to be more pronounced in countries with institutional quality below a certain threshold. These findings are robust to all alternative indicators of institutional quality, supporting the significant interaction of societal values with the individual taxpayer decisions.

Keywords: institutional quality, OECD economies, tax compliance, tax evasion

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Authors: Annabelle Onyefulu-Kingston

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One of the major purposes of AI today is to evaluate and analyze millions of micro and macro data in order to determine what is relevant in a particular case and proffer it in an adequate manner. Microdata, as far as it relates to AI in international arbitration, is the millions of key issues specifically mentioned by either one or both parties or by their counsels, arbitrators, or arbitral tribunals in arbitral proceedings. This can be qualifications of expert witness and admissibility of evidence, amongst others. Macro data, on the other hand, refers to data derived from the resolution of the dispute and, consequently, the final and binding award. A notable example of this includes the rationale of the award and specific and general damages awarded, amongst others. This paper aims to critically evaluate and analyze the possibility of technological inclusion in international arbitration. This research will be imploring the qualitative method by evaluating existing literature on the consequence of applying AI to both micro and macro data in international arbitration, and how this can be of assistance to parties, counsels, and arbitrators.

Keywords: AI-based technologies, algorithms, arbitrators, international arbitration

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Authors: Md. Ashikur Rahman

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Optimal breastfeeding practice is essential to reducing childhood morbidity and mortality and helps to achieve Millennium Development Goal (MDG). A cross-sectional study was conducted in a rural area in Dhaka district to explore the barrier to optimal breastfeeding practices. The population of this study constitutes all nursing mothers having children aged 0-6 months, and they were selected purposively. The study adopted a structured and in-depth interview procedure consisting of open and closed-ended questions. Four hundred rural nursing mothers constituted the sample of the structured interview, while 15 were involved in the in-depth interview. Among the respondent's majority (67%) were in the age group 17-25 years, with a mean age of 24.44 years. Most (39.5%) of the mothers were housewives with a secondary level of education (46.5%). About 32% of mothers started breastfeeding within one hour after birth. But delayed initiation was reported in 31.5% of mothers, whereas 36.8% of mothers forgot the exact time of initiation of breastfeeding. The main reason not to practice colostrum was mothers tried to breastfeed, but there was no milk, stated 13.8% of mothers. In addition, about one-third (34.3%) of the respondents practiced pre-lacteal feeding, and among them, 12.8% introduced sugar with water. Reasons given by the mothers for bottle-feeding was that baby was not satisfied with breast milk only; 22.0% of mothers indicated this cause. The main influence to take formula milk by their mother and mothers-in-law was stated by 18.8% of mothers. Some mothers stated that major constraints to EBF were the perception of not having enough milk (25.5 %) and babies crying seems to be hungry (8.8%). One-third of the mothers (31.5%) felt uncomfortable during breastfeeding. Access to antenatal and postnatal counseling in the study area also was a key obstacle to optimal breastfeeding practices. In a qualitative survey, some mothers believed that there was no difference between breast milk and formula milk. Colostrum feeding, pre-lacteal feeding, early initiation of breastfeeding, and exclusive breastfeeding were strongly associated with family type, family member, birth order, religion, husbands' occupation, delivery attendants and delivery type, postnatal care, and health care facilities. To reduce the barriers to the successful practice of exclusive breastfeeding, there is a need for a grass-roots approach to educating and counseling nursing mothers with identifying factors influencing or discouraging the optimal practice.

Keywords: exclusive, breast feeding, practices, Bangladesh

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Authors: Flavia Oliveira de A. M. Cruz, Edison Tostes Faria, Paula Elaine D. Reis

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When the breast is submitted to radiation therapy (RT), the most common effects are pain, skin changes, mobility restrictions, local sensory alteration, and fatigue. These effects, if not managed properly, may reduce the quality of life of cancer patients and may lead to the treatment discontinuation. Therefore, promoting knowledge and guidelines for symptom management remain a high priority for patients and a challenge for health professionals, due to the need to handle side effects in a population with a life-threatening disease. Printed materials are important strategies for supporting educative activities since they help the individual to assimilate and understand the amount of information transmitted. Nurses' behavior can be systematized through the use of an educative manual, which may be effective in promoting information regarding the treatment, self-care and how to control the effects of RT at home. In view of the importance of guaranteeing the validity of the material before its use, the objective of this research was to validate the content and appearance of an educative manual for breast cancer patients undergoing RT. The Theory of Psychometrics was used for the validation process in this descriptive methodological research. A minimum agreement rate (AR) of 80% was considered to guarantee the validity of the material. The data were collected from October to December 2017, by means of two assessments tools, constructed in the form of a Likert scale, with five levels of understanding. These instruments addressed different aspects of the evaluation, in view of two different groups of participants; 17 experts in the theme area of the educative manual, and 12 women that received RT previously to treat breast cancer. The manual was titled 'Orientation Manual: radiation therapy in breast', and was focused on breast cancer patients attended at the Department of Oncology of the Brasília University Hospital (UNACON/HUB). The research project was submitted to the Research Ethics Committee at the School of Health Sciences of the University of Brasília (CAAE: 24592213.1.0000.0030). Only two items of the assessment tool for the experts, one related to the manual's ability to promote behavioral and attitude changes and the other related to the extent of its use for other health services, obtained AR < 80% and were reformulated based on the participants' suggestions and in the literature. All other items were considered appropriate and/or complete appropriate in the three blocks proposed for the experts: objectives - 89%, structure and form - 93%, and relevance - 93%; and good and/or very good in the five blocks of analysis proposed for patients: objectives - 100%, organization - 100%, writing style - 100%, appearance - 100%, and motivation. The appearance and content validation of the educative manual proposed were attended to. The educative manual was considered relevant and pertinent and may contribute to the understanding of the therapeutic process by breast cancer patients during RT, as well as support clinical practice through the nursing consultation.

Keywords: oncology nursing, nursing care, validation studies, educational technology

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Authors: Aymen Gammoudi, Hamza Labbaci, Nizar Messai, Yacine Sam

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Web Service Composition (Mash-up) has been considered as a new approach used to offer the user a set of Web Services responding to his request. These approaches can return a set of similar Mash-ups in a given context that makes users unable to select the perfect one. Recent approaches focus on computing the skyline over a set of Quality of Service (QoS) attributes. However, these approaches are not sufficient in a dynamic web service environment where the delivered QoS by a Web service is inherently uncertain. In this paper, we treat the problem of computing the skyline over a set of similar Mash-ups under certain dimension values. We generate dimensions for each Mash-up using aggregation operations applied to the QoS attributes. We then tackle the problem of computing the skyline under uncertain dimensions. We present each dimension value of mash-up using a frame of discernment and introduce the d-dominance using the Evidence Theory. Finally, we propose our experimental results that show both the effectiveness of the introduced skyline extensions and the efficiency of the proposed approaches.

Keywords: web services, uncertain QoS, mash-ups, uncertain dimensions, skyline, evidence theory, d-dominance

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Authors: Jutamas Wisansing, Thanakarn Vongvisitsin, Udom Hongchatikul

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Designated Areas for Sustainable Tourism Administration (DASTA) is a public organization, dedicating to sustainable tourism development in 6 designated areas in Thailand. This paper provides rich reflections from a decade of DASTA, formulating an advanced model to deepen our understanding of 2 key intertwining issues; 1) what are the new landscapes of actors for community based tourism and 2) who are the benefactors and beneficiaries of tourism development within the community? An action research approach was used, enabling the process and evidence-based cases to be better captured. The aim is to build theoretical foundation through 13 communities/cases, which have engaged in community based tourism pilot projects. Drawing from emic and qualitative research, specific and contextual phenomenon provides succinct patterns of ‘Community Benefitting through Tourism (CbtT)’ model. The re-definition of the 2 key issues helps shape the interlinking of actors; practicalities of inclusive tourism and inter-sectoral framework and its value chain will also be set forth. In tourism sector, community members could be active primarily on the supply side as employees, entrepreneurs and local heritage experts. CbtT when well defined stimulates the entire value chain of local economy while promoting social innovation through positive dialogue with wider actors. Collaboration with a new set of actors who are from the tourism-related businesses and non-tourism related businesses create better impacts on mutual benefits.

Keywords: community based tourism, community benefitting through tourism -CbtT DASTA model, sustainable tourism in thailand, value chain and inclusive business

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Authors: Kristin Thooft

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— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

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Authors: Jung Yoon Kim

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Introduction: Wounds inevitably cause patients to experience discomfort, distress, and consequentially reduced quality of life due to entailed pain, maceration, and foul odor. The dressing has been a universal wound care method in which wounds are covered and protected, and an optimum environment for healing is provided. This study aimed to investigate Korean nurses’ level of awareness of pain and skin tearing in wound beds and/or peri-wound skin at dressing change. Methods: A descriptive study was performed. Convenience sampling was employed, and registered nurses were recruited from attendees of continuing education program. A total of 399 participants (RN) completed the questionnaire. Data were collected from September to November 2022. Results: Many of them perceived skin tearing and wound-related pain associated with dressing changes, but most of them did not assess and record pain and skin tearing at dressing change. More than half of the respondents reported that they did not provide nursing intervention to prevent pain and skin tearing. Many of them reported that a systematic educational program for preventing pain and skin tearing at dressing changes was needed. Discussion: Many of the respondents were aware of pain and skin tearing at dressing change but did not take any further necessary measures, including nursing intervention, for the most appropriate, systematic pain and skin tearing management. Therefore, this study suggested that a systematic and comprehensive educational program for Korean healthcare professionals needs to be developed and implemented in Korea’s hospital settings.

Keywords: skin tearing, pain, dressing change, nurses

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Authors: Fernanda Ludmilla Rossi Rocha, Thamiris Cavazzani Vegro, Silvia Helena Henriques Camelo, Carmen Silvia Gabriel, Andrea Bernardes

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Introduction: Organizations are cultural, symbolic and imaginary systems composed by values and norms. These values and norms represent the organizational culture, which determines the behavior of the workers, guides the work practices and impacts the quality of care and the safety culture of health services worldwide. Objective: To analyze the organizational culture of a public and a private hospital in Brazil. Method: Descriptive study with quantitative approach developed in a public and in a private hospital of Brazil. Sample was composed by 281 nursing workers, of which 73 nurses and 208 nursing auxiliaries and technicians. The data collection instrument comprised the Brazilian Instrument for Assessing Organizational Culture. Data were collected from March to December 2013. Results: At the public hospital, the results showed an average score of 2.85 for the values concerning cooperative professionalism (CP); 3.02 for values related to hierarchical rigidity and the centralization of power (HR); 2.23 for individualistic professionalism and competition at work (IP); 2.22 for values related to satisfaction, well-being and motivation of workers (SW); 3.47 for external integration (EI); 2.03 for rewarding and training practices (RT); 2.75 for practices related to the promotion of interpersonal relationships (IR) About the private hospital, the results showed an average score of 3.24 for the CP; 2.83 for HR; 2.69 for IP; 2.71 for SW; 3.73 for EI; 2.56 for RT; 2.83 for IR at the hospital. Discussion: The analysis of organizational values of the studied hospitals shows that workers find the existence of hierarchical rigidity and the centralization of power in the institutions; believed there was cooperation at workplace, though they perceived individualism and competition; believed that values associated with the workers’ well-being, satisfaction and motivation were seldom acknowledged by the hospital; believed in the adoption of strategic planning actions within the institution, but considered interpersonal relationship promotion, continuous education and the rewarding of workers to be little valued by the institution. Conclusion: This work context can lead to professional dissatisfaction, compromising the quality of care and contributing to the occurrence of occupational diseases.

Keywords: nursing management, organizational culture, quality of care, interpersonal relationships

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Authors: Sheheryar Khan, Weidong Li, Fanqian Meng

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The Urban Heat Island (UHI) effect is one of the foremost problems out of other ecological and socioeconomic issues in urbanization. Due to this phenomenon that human-made urban areas have replaced the rural landscape with the surface that increases thermal conductivity and urban warmth; as a result, the temperature in the city is higher than in the surrounding rural areas. To affect the evidence of this phenomenon in the Zhengzhou city area, an observation of the temperature variations in the urban area is done through a scientific method that has been followed. Landsat 8 satellite images were taken from 2013 to 2015 to calculate the effect of Urban Heat Island (UHI) along with the NPP-VRRIS night-time remote sensing data to analyze the result for a better understanding of the center of the built-up area. To further support the evidence, the correlation between land surface temperatures and the normalized difference vegetation index (NDVI) was calculated using the Red band 4 and Near-infrared band 5 of the Landsat 8 data. Mono-window algorithm was applied to retrieve the land surface temperature (LST) distribution from the Landsat 8 data using Band 10 and 11 accordingly to convert the top-of-atmosphere radiance (TOA) and to convert the satellite brightness temperature. Along with Landsat 8 data, NPP-VIIRS night-light data is preprocessed to get the research area data. The analysis between Landsat 8 data and NPP night-light data was taken to compare the output center of the Built-up area of Zhengzhou city.

Keywords: built-up area, land surface temperature, mono-window algorithm, NDVI, remote sensing, threshold method, Zhengzhou

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Authors: Jonathan A. Sánchez Muñoz, Gustavo Flores Eraña, Juan M. Silva

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Mexican Mezcal industry has reached attention during the last decade due to it has been a popular beverage demanded by North American and European markets, reaching popularity due to its crafty character. Despite its wide demand, productive processes are still made with rudimentary equipment, and there is a lack of evidence to improve kiln energy efficiency. Tec21 is a challenge-based learning curricular model implemented by Tecnológico de Monterrey since 2019, where each formation unit requires an industrial partner. “Problem processes solution” is a formation unity designed for mechatronics engineers, where students apply the acquired knowledge in thermofluids and apply electronic. During five weeks, students are immersed in an industrial problem to obtain a proper level of competencies according to formation unit designers. This work evaluates the competencies acquired by the student through qualitative research methodology. Several evaluation instruments (report, essay, and poster) were selected to evaluate etic argumentation, principles of sustainability, implemented actions, process modelling, and redesign feasibility.

Keywords: applied electronic, challenge based learning, competencies, mezcal industry, thermofluids

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Authors: Rizwan Arshad, Alessio Panza, Nimra Inayat, Syeda Mariam Batool Kazmi, Shawana Azmat

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The rapidly expanding use of immunotherapy for a wide range of cancers from late to early stages has, predictably, been accompanied by evidence of inequities in access to these highly effective but costly treatments. In this survey-based case study, we aimed to develop a One-window services model (OWSM) based on Anderson’s behavioral model to enhance competence in accessing cancer medications, particularly immunotherapies, through the analysis of 20 patient surveys conducted in the Armed forces bone marrow transplant center of the district, Rawalpindi from November to December 2022. The purposive sampling technique was used. Cronbach’s alpha coefficient was found to be 0.71. It was analyzed using SPSS version 26 with descriptive analysis, and results showed that the majority of the cancer patients were non-competent to access their prescribed cancer immunotherapy because of individual-level, socioeconomic, and organizational barriers.

Keywords: cancer immunotherapy, one-window services model, accessibility, competence

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Authors: Syed Jawad Hussain Shahzad, Muhammad Zakaria, Mobeen Ur Rehman, Saniya Khaild

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This study examines the co-movement between the Pakistan, Indian, S&P 500 and Nikkei 225 stock markets using weekly data from 1998 to 2013. The time-frequency relationship between the selected stock markets is conducted by using measures of continuous wavelet power spectrum, cross-wavelet transform and cross (squared) wavelet coherency. The empirical evidence suggests strong dependence between Pakistan and Indian stock markets. The co-movement of Pakistani index with U.S and Japanese, the developed markets, varies over time and frequency where the long-run relationship is dominant. The results of cross wavelet and wavelet coherence analysis indicate moderate covariance and correlation between stock indexes and the markets are in phase (i.e. cyclical in nature) over varying durations. Pakistan stock market was lagging during the entire period in relation to Indian stock market, corresponding to the 8~32 and then 64~256 weeks scale. Similar findings are evident for S&P 500 and Nikkei 225 indexes, however, the relationship occurs during the later period of study. All three wavelet indicators suggest strong evidence of higher co-movement during 2008-09 global financial crises. The empirical analysis reveals a strong evidence that the portfolio diversification benefits vary across frequencies and time. This analysis is unique and have several practical implications for regional and international investors while assigning the optimal weightage of different assets in portfolio formulation.

Keywords: co-movement, Pakistan stock exchange, S&P 500, Nikkei 225, wavelet analysis

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Authors: Modreck Gomo

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Although the dolomite and calcite carbonates can neutralize Acid Mine Drainage (AMD) and prevent leaching of metals, salinity still remains a huge problem. The study presents a conceptual discussion of geochemical controls of salinity in a typical calcite and dolomite AMD neutralised groundwater systems. Thereafter field evidence is presented to support the conceptual discussions. 1020 field data sets of from a groundwater system reported to be under circumneutral conditions from the neutralization effect of calcite and dolomite is analysed using correlation analysis and bivariate plots. Field evidence indicates that sulphate, calcium and magnesium are strongly and positively correlated to Total Dissolved Solids (TDS) which is used as measure of salinity. In this, a hydrogeochemical system, the dissolution of sulphate, calcium and magnesium form AMD neutralization process contributed 50%, 10% and 5% of the salinity.

Keywords: acid mine drainage, carbonates, neutralization, salinity

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Authors: Mourad Zmami Oussema BenSalha

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The current research aims to assess empirically the reaction of private investment to exchange rate fluctuations in Tunisia using a sample of 548 firms operating in manufacturing industries between 1997 and 2002. The micro-econometric model we estimate is based on an accelerator-profit specification investment model increased by two variables that measure the variation and the volatility of exchange rates. Estimates using the system the GMM method reveal that the effects of the exchange rate depreciation on investment are negative since it increases the cost of imported capital goods. Turning to the exchange rate volatility, as measured by the GARCH (1,1) model, our findings assign a significant role to the exchange rate uncertainty in explaining the sluggishness of private investment in Tunisia in the full sample of firms. Other estimation attempts based on various sub samples indicate that the elasticities of investment relative to the exchange rate volatility depend upon many firms’ specific characteristics such as the size and the ownership structure.

Keywords: investment, exchange rate volatility, manufacturing firms, system GMM, Tunisia

Procedia PDF Downloads 387