Search results for: outpatient department
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1843

Search results for: outpatient department

1183 Factorial Validity for the Morale Sprit Scale: The Case for Physical Education Faculty Members at Jordanian Universities

Authors: Abedalbasit M. Abedalhafiz, Aman Kasawneh, Zyad Altahynah, Ahmad Okor

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The purpose of this study was to determine the construct validity of the morale sprit scale (MSS). Ninety faculty members from colleges of physical education at Jordanian universities were chosen to participate in this study. The design of this study was an ex-post facto. The MSS consists of (48) items that measure different dimensions of morale spirit among faculty members. Principle axis factoring with oblique rotation was utilized to uncover the underlying structure of the instrument. The findings revealed eight factor solution explaining (72.825%). Seven factors were accepted according to the conditions of accepting factors. The seven factors were named morale as reflection of faculty and department's administration, regulations and instructions, working environment and conditions, promotions and incentives and salaries, relations between the faculty member's, the trend toward the college and university, the trend toward self factors.

Keywords: Factorial validity, morale sprit, faculty members, Jordanian Universities

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1182 The Valorisation of Dredged Sediment in the Self Compacting Concrete

Authors: N. Bouhamou, F. Mostefa, A. Mebrouki, N. Belas

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Every year, millions of cube meters are dredged from dams and restraints as an entertaining and prevention procedure all over the world. These dredged sediments are considered as natural waste leading to an environmental, ecological and even an economical problem in their processing and deposing. Nevertheless, in the context of the sustainable development policy, a way of management is opened aiming to the valorization of sediments as a building material and particularly as a new binder that can be industrially exploited and that improve the physical, chemical and mechanical characteristics of the concrete. This study is a part of the research works realized in the civil engineering department at the university of Mostaganem (Algeria), on the impact of the dredged mud of Fergoug dam on the behaviour of self-consolidating concrete in fresh and hardened state, such as the mechanical performance of SCC and its impact on the differed deformations (shrinkage). The work aims to valorize this mud in SCC and to show eventual interactions between constituents. The results obtained presents a good perspectives in order to perform SCC based in calcined mud.

Keywords: sediment, calcination, reuse, self-consolidating concrete, fresh state, hard state, shrinkage

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1181 Key Factors of Success and Deterrent of IT Projects, Case study: Islamic Azad University, Zahedan Branch

Authors: Mohammad Reza Abidi, Zahra Nourouz Pour, Mehdi Moudi

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In this research, firstly critical success factors and deterrent factors in implementing projects and also the factors those cause information technology productivity (IT) paradox in Islamic Azad University, Zahedan branch examined. Research method of this paper is descriptive. In fact, the researcher by using survey, proposed useful solutions. In this research, subjects’ responders to questionnaires items were based on Likert scale. In the questionnaire, economic, technical, organizational and cultural factors in the university have been assessed in order to obtain the necessary validity. We used masters and technicians of IT department’s advices to realize reliability and consistency. For the reliability test we used Cronbach’s reliability test and validity has been obtained using SPSS software. Because of the research questions and objectives, t-student test is used for hypothesis testing. Finally we analyze the findings, we offer conclusions and suggestions.

Keywords: IT projects, Islamic Azad University, success factors, deterrent factors

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1180 Genotyping of Rotaviruses in Pediatric Patients with Gastroenteritis by Using Real-Time Reverse Transcription Polymerase Chain Reaction

Authors: Recep Kesli, Cengiz Demir, Riza Durmaz, Zekiye Bakkaloglu, Aysegul Bukulmez

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Objective: Acute diarrhea disease in children is a major cause of morbidity worldwide and is a leading cause of mortality, and it is the most common agent responsible for acute gastroenteritis in developing countries. With hospitalized children suffering from acute enteric disease up to 50% of the analyzed specimen were positive for rotavirus. Further molecular surveillance could provide a sound basis for improving the response to epidemic gastroenteritis and could provide data needed for the introduction of vaccination programmes in the country. The aim of this study was to investigate the prevalence of viral etiology of the gastroenteritis in children aged 0-6 years with acute gastroenteritis and to determine predominant genotypes of rotaviruses in the province of Afyonkarahisar, Turkey. Methods: An epidemiological study on rotavirus was carried out during 2016. Fecal samples obtained from the 144 rotavirus positive children with 0-6 years of ages and applied to the Pediatric Diseases Outpatient of ANS Research and Practice Hospital, Afyon Kocatepe University with the complaint of diarrhea. Bacterial agents causing gastroenteritis were excluded by using bacteriological culture methods and finally, no growth observed. Rotavirus antigen was examined by both the immunochromatographic (One Step Rotavirus and Adenovirus Combo Test, China) and ELISA (Premier Rotaclone, USA) methods in stool samples. Rotavirus RNA was detected by using one step real-time reverse transcription-polymerase chain reaction (RT-PCR). G and P genotypes were determined using RT-PCR with consensus primers of VP7 and VP4 genes, followed by semi nested type-specific multiplex PCR. Results: Of the total 144 rotavirus antigen-positive samples with RT-PCR, 4 (2,8%) were rejected, 95 (66%) were examined, and 45 (31,2%) have not been examined for PCR yet. Ninety-one (95,8%) of the 95 examined samples were found to be rotavirus positive with RT-PCR. Rotavirus subgenotyping distributions in G, P and G/P genotype groups were determined as; G1:45%, G2:27%, G3:13%, G9:13%, G4:1% and G12:1% for G genotype, and P[4]:33%, P[8]:66%, P[10]:1% for P genotype, and G1P[8]:%37, G2P[4]:%21, G3P[8]:%10, G4P[8]:%1, G9P[8]:%8, G2P[8]:%3 for G/P genotype . Not common genotype combination were %20 in G/P genotype. Conclusions: This study subscribes to the global agreement of the molecular epidemiology of rotavirus which will be useful in guiding the alternative and application of rotavirus vaccines or effective control and interception. Determining the diversity and rates of rotavirus genotypes will definitely provide guidelines for developing the most suitable vaccine.

Keywords: gastroenteritis, genotyping, rotavirus, RT-PCR

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1179 The Experience of the Prosthetics Program in Palestine Arab American University as Model

Authors: Ahmad Dawabsheh

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The prosthetics program is an international program, found in honorable respectable universities. This program like other programs was found to serve several reasons, The most important reason is humanity, humanity free of conflict, religion, race, or war, but rather focuses on the humanitarian issue. This is what encouraged me to study this topic to help people, especially the poor in the world. The researcher will distribute a questionnaire to the faculty members and students of the department to measure the knowledge and importance of this program from the practical and theoretical sides of the local community. The researcher used the analytical method to study the subject. The research will attempt to answer the questions: What is the student's knowledge of this program? How important is this program to society?. The research aims to know the Palestinian society's need for this program. The research also aims to know the extent of students' knowledge of recent developments and new innovations in prosthetics around the world. What does the university offer to students in addition to theoretical courses?

Keywords: prosthetics, Arab American University, analytical method, questionnair

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1178 Evidence-Based in Telemonitoring of Users with Pacemakers at Five Years after Implant: The Poniente Study

Authors: Antonio Lopez-Villegas, Daniel Catalan-Matamoros, Remedios Lopez-Liria

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Objectives: The purpose of this study was to analyze clinical data, health-related quality of life (HRQoL) and functional capacity of patients using a telemonitoring follow-up system (TM) compared to patients followed-up through standard outpatient visits (HM) 5 years after the implantation of a pacemaker. Methods: This is a controlled, non-randomised, nonblinded clinical trial, with data collection carried out at 5 years after the pacemakers implant. The study was developed at Hospital de Poniente (Almeria, Spain), between October 2012 and November 2013. The same clinical outcomes were analyzed in both follow-up groups. Health-Related Quality of Life and Functional Capacity was assessed through EuroQol-5D (EQ-5D) questionnaire and Duke Activity Status Index (DASI) respectively. Sociodemographic characteristics and clinical data were also analyzed. Results: 5 years after pacemaker implant, 55 of 82 initial patients finished the study. Users with pacemakers were assigned to either a conventional follow-up group at hospital (HM=34, 50 initials) or a telemonitoring system group (TM=21, 32 initials). No significant differences were found between both groups according to sociodemographic characteristics, clinical data, Health-Related Quality of Life and Functional Capacity according to medical record and EQ5D and DASI questionnaires. In addition, conventional follow-up visits to hospital were reduced in 44,84% (p < 0,001) in the telemonitoring group in relation to hospital monitoring group. Conclusion: Results obtained in this study suggest that the telemonitoring of users with pacemakers is an equivalent option to conventional follow-up at hospital, in terms of Health-Related Quality of Life and Functional Capacity. Furthermore, it allows for the early detection of cardiovascular and pacemakers-related problem events and significantly reduces the number of in-hospital visits. Trial registration: ClinicalTrials.gov NCT02234245. The PONIENTE study has been funded by the General Secretariat for Research, Development and Innovation, Regional Government of Andalusia (Spain), project reference number PI/0256/2017, under the research call 'Development and Innovation Projects in the Field of Biomedicine and Health Sciences', 2017.

Keywords: cardiovascular diseases, health-related quality of life, pacemakers follow-up, remote monitoring, telemedicine

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1177 Heuristic Evaluation of Children’s Authoring Tool for Game Making

Authors: Laili Farhana Md Ibharim, Maizatul Hayati Mohamad Yatim

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The main purpose of this study is to evaluate the heuristic inspection of children’s authoring tools to develop games. The researcher has selected 15 authoring tools for making games specifically for educational purposes. Nine students from Diploma of Game Design and Development course and four lecturers from the computing department involved in this evaluation. A set of usability heuristic checklist used as a guideline for the students and lecturers to observe and test the authoring tools selected. The study found that there are just a few authoring tools that fulfill most of the heuristic requirement and suitable to apply to children. In this evaluation, only six out of fifteen authoring tools have passed above than five elements in the heuristic inspection checklist. The researcher identified that in order to develop a usable authoring tool developer has to emphasis children acceptance and interaction of the authoring tool. Furthermore, the authoring tool can be a tool to enhance their mental development especially in creativity and skill.

Keywords: authoring tool, children, game making, heuristic

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1176 Epidemiology of Healthcare-Associated Infections among Hematology/Oncology Patients: Results of a Prospective Incidence Survey in a Tunisian University Hospital

Authors: Ezzi Olfa, Bouafia Nabiha, Ammar Asma, Ben Cheikh Asma, Mahjoub Mohamed, Bannour Wadiaa, Achour Bechir, Khelif Abderrahim, Njah Mansour

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Background: In hematology/oncology, health care improvement has allowed increasingly aggressive management in diagnostic and therapeutic procedures. Nevertheless, these intensified procedures have been associated with higher risk of healthcare associated infections (HAIs). We undertook this study to estimate the burden of HAIs in the cancer patients in an onco -hematology unit in a Tunisian university hospital. Materials/Methods: A prospective, observational study, based on active surveillance for a period of 06 months from Mars through September 2016, was undertaken in the department of onco-hematology in a university hospital in Tunisia. Patients, who stayed in the unit for ≥ 48 h, were followed until hospital discharge. The Centers for Disease Control and Prevention criteria (CDC) for site-specific infections were used as standard definitions for HAIs. Results: One hundred fifty patients were included in the study. The gender distribution was 33.3% for girls and 66.6% boys. They have a mean age of 23.12 years (SD = 18.36 years). The main patient’s diagnosis is: Acute Lymphoblastic Leukemia (ALL): 48.7 %( n=73). The mean length of stay was 21 days +/- 18 days. Almost 8% of patients had an implantable port (n= 12), 34.9 % (n=52) had a lumber puncture and 42.7 % (n= 64) had a medullary puncture. Chemotherapy was instituted in 88% of patients (n=132). Eighty (53.3%) patients had neutropenia at admission. The incidence rate of HAIs was 32.66 % per patient; the incidence density was 15.73 per 1000 patient-days in the unit. Mortality rate was 9.3% (n= 14), and 50% of cases of death were caused by HAIs. The most frequent episodes of infection were: infection of skin and superficial mucosa (5.3%), pulmonary aspergillosis (4.6%), Healthcare associated pneumonia (HAP) (4%), Central venous catheter associated infection (4%), digestive infection (5%), and primary bloodstream infection (2.6%). Finally, fever of unknown origin (FUO) incidence rate was 14%. In case of skin and superficial infection (n= 8), 4 episodes were documented, and organisms implicated were Escherichia.coli, Geotricum capitatum and Proteus mirabilis. For pulmonary aspergillosis, 6 cases were diagnosed clinically and radiologically, and one was proved by positive aspergillus antigen in bronchial aspiration. Only one patient died due this infection. In HAP (6 cases), four episodes were diagnosed clinically and radiologically. No bacterial etiology was established in these cases. Two patients died due to HAP. For primary bloodstream infection (4 cases), implicated germs were Enterobacter cloacae, Geotricum capitatum, klebsiella pneumoniae, and Streptococcus pneumoniae. Conclusion: This type of prospective study is an indispensable tool for internal quality control. It is necessary to evaluate preventive measures and design control guides and strategies aimed to reduce the HAI’s rate and the morbidity and mortality associated with infection in a hematology/oncology unit.

Keywords: cohort prospective studies, healthcare associated infections, hematology oncology department, incidence

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1175 Application of Transportation Linear Programming Algorithms to Cost Reduction in Nigeria Soft Drinks Industry

Authors: Salami Akeem Olanrewaju

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The transportation models or problems are primarily concerned with the optimal (best possible) way in which a product produced at different factories or plants (called supply origins) can be transported to a number of warehouses or customers (called demand destinations). The objective in a transportation problem is to fully satisfy the destination requirements within the operating production capacity constraints at the minimum possible cost. The objective of this study is to determine ways of minimizing transport cost in order to maximum profit. Data were gathered from the records of the Distribution Department of 7-Up Bottling Company Plc. Ilorin, Kwara State, Nigeria. The data were analyzed using SPSS (Statistical Package for Social Sciences) while applying the three methods of solving a transportation problem. The three methods produced the same results; therefore, any of the method can be adopted by the company in transporting its final products to the wholesale dealers in order to minimize total production cost.

Keywords: cost minimization, resources utilization, distribution system, allocation problem

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1174 Identifying Characteristics of Slum in Palembang Riverbanks Area, Indonesia

Authors: Rhaptyalyani Herno Della, Nyimas Septi Rika Putri, Rika Nabila

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The growth of population and economic activities in urban areas needs support economic development, needs to be balanced with adequate environmental infrastructure development. Settlement can avoid from rundown condition and uninhabitable if the development of urban area accordance with healthy development. Identifying database of slum in this study reference to the Review of the Spatial Plan Development of Palembang City, Laws of Public Works Department about Technical Guidelines on the Quality Improvement Housing and Slum and Urban Spatial Global Report on Human Settlements 2003. A case study for identifying in Palembang riverbanks area are located in two districts; Ilir Timur I and Ilir Timur II. This study do the identification of slum areas based on several variables about physical and non physical aspect, then the result of identification are used to define a policy that can be used to improve the area.

Keywords: slum, riverbanks area, urban area, infrastructure

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1173 Malaria Vulnerability Mapping from the Space: A Case Study of Damaturu Town-Nigeria

Authors: Isa Muhammad Zumo

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Malaria is one of the worst illnesses that may affect humans. It is typically transmitted by the bite of a female Anopheles mosquito and is caused by parasitic protozoans from the Plasmodium parasite. Government and non-governmental organizations made numerous initiatives to combat the threat of malaria in communities. Nevertheless, the necessary attention was not paid to accurate and current information regarding the size and location of these favourable locations for mosquito development. Because mosquitoes can only reproduce in specific habitats with surface water, this study will locate and map those favourable sites that act as mosquito breeding grounds. Spatial and attribute data relating to favourable mosquito breeding places will be collected and analysed using Geographic Information Systems (GIS). The major findings will be in five classes, showing the vulnerable and risky areas for malaria cases. These risk categories are very high, high, moderate, low, and extremely low vulnerable areas. The maps produced by this study will be of great use to the health department in combating the malaria pandemic.

Keywords: Malaria, vulnerability, mapping, space, Damaturu

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1172 Evaluation of Groundwater Suitability for Irrigation Purposes: A Case Study for an Arid Region

Authors: Mustafa M. Bob, Norhan Rahman, Abdalla Elamin, Saud Taher

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The objective of this study was to assess the suitability of Madinah city groundwater for irrigation purposes. Of the twenty three wells that were drilled in different locations in the city for the purposes of this study, twenty wells were sampled for water quality analyses. The United States Department of Agriculture (USDA) classification of irrigation water that is based on Sodium hazard (SAR) and salinity hazard was used for suitability assessment. In addition, the residual sodium carbonate (RSC) was calculated for all samples and also used for irrigation suitability assessment. Results showed that all groundwater samples are in the acceptable quality range for irrigation based on RSC values. When SAR and salinity hazard were assessed, results showed that while all groundwater samples (except one) fell in the acceptable range of SAR, they were either in the high or very high salinity zone which indicates that care should be taken regarding the type of soil and crops in the study area.

Keywords: irrigation suitability, TDS, salinity, SAR

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1171 Meteorological Effect on Exergetic and Exergoeconomics Parameters of a Wind Turbine

Authors: Muhammad Abid

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In this study, we performed the comparative exergetic and exergoeconomic analyses of a wind turbine over a period of twelve months from 1st January to 30th December 2011. The turbine is part of a wind-PV hybrid system with hydrogen storage, located on the roof of Mechanical Engineering Department, King Saud University, Riyadh, Saudi Arabia. The rated power output from this turbine is 1.7 W with a rated wind speed of 12 m/s and cut-in/cut-out wind speeds of 3/14 m/s. We utilize a wide range of experimental data in the analysis and assessment. We determine exergy efficiencies and their relation with meteorological variables, such as temperature and density. We also calculate exergoeconomic parameter R ̇_ex and its dependence on the temperature, using the average values for twelve months of the year considered for comparison purposes. The exergy efficiency changes from 0.12 to 0.31 while the density varies between 1.31 and 1.2 kg/m3 for different temperature values. The R ̇_ex has minimum and maximum values of 0.02 and 0.81, respectively, while the temperature is in the range of 8-24°C for various wind velocity values.

Keywords: exergy, efficiency, renewable energy, wind energy, meteorological variables

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1170 Mindfulness among Educators in General and Special Education at Independent Schools in Qatar and Its Effects on Their Academic Performance and Self-Efficacy

Authors: Mohamed S. Osman, Mohamed R. Nosair

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The study aims to determine the effects of mindfulness on self-efficacy and professional success among educators of general and special education at Qatar Independent. The study sample will consist of 100 educators from the males and females divided to (50) educators of general education and (50) educators of Special Education in primary, and high schools. They will response to mindfulness scale and the scale of self-efficacy. In addition, use reports of the assessment by the Department of Education for their performance and assessments of their supervisors. The study will examine the effect of some variables such as differences between educators from general and special education, as well as the differences between males and females and years of experience. The study will use a statistic descriptive approach and Correlative analysis such as; means and the Pearson correlation coefficient. The study may predicts differences between educators in all variables study.

Keywords: mindfulness, educators, general education, special education, academic performance, self-efficacy

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1169 Toba Batak Education Stakeholders' Perspectives towards Education of Children with Disabilities in Toba Samosir North Sumatra Indonesia

Authors: Tryastuti I. B. Manullang, Juang Sunanto

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This study aimed to find the perspectives of the Toba Batak education stakeholders towards the education of children with disabilities in Toba Samosir North Sumatra Indonesia. The education stakeholders consist of a head of the education department in Toba Samosir, head of the H foundation, two principals and three teachers from the Special Primary Schools. This study uses qualitative a descriptive approach and research data obtained through interviews. The results of this study demonstrate that the education stakeholders knowledge about disabilities needs improvement in accordance with the development of science. The cultural views towards disability and its implications, and the education services available for children with disabilities, in addition, to encountered its problem in Toba Samosir are known. The education concept considered appropriate is the special school and the CBR (Community Based Rehabilitation) strategy, also inclusive education because it represents the Toba Batak philosophy.

Keywords: community based rehabilitation, education concept, education stakeholders, inclusive education

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1168 South Africa and U.S. AFRICOM: Reflections on a Lukewarm Relationship

Authors: Theo Neethling

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The United States Africa Command (AFRICOM) was established in 2007 as a military and diplomatic entity and is intended to assist African states and military actors to address their security needs. At the same time, AFRICOM is clearly an extension of US strategic interests on the African continent. The challenge for the US Department of Defence is to project AFRICOM as a cooperative and willing partner. This implies a partner that offers needed services and resources, and supports African security and military priorities with no presumption of having a privileged role in defining the African future. However, one of AFRICOM’s main challenges relates to the point that it has not been able to secure a firm partnership with South Africa as a key player on the continent: South Africa has continuously taken a lukewarm, if not cold, approach towards AFRICOM since its formation. The main aim of this article is to examine and discuss South Africa’s political-military relations with AFRICOM and to assess the underlying reasons currently inhibiting AFRICOM from achieving a fully productive relationship with the South African government.

Keywords: AFRICOM, South African foreign policy, US interests, defence capabilities in Africa, US-Africa relations

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1167 The Moderating Effects of Attachment Style on the Relationship between the Psychological Symptoms and Well-Being of Mental Health Practitioners in Rehabilitation Centers: A Preliminary Study

Authors: Amaba, Marinela C., Espino, Gianne Ericka S. J. Valencia, Zeia Beatriz C.

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This study aims to determine the moderating role of attachment style on the relationship between psychological symptoms and well-being of mental health practitioners in rehabilitation centers that are accredited of the Department of Health in Pampanga. Using the data gathered from 46 mental health practitioners, multiple regression models were conducted to test the main and moderating effects of attachment styles. The findings show that all three psychological symptoms namely depression, anxiety, and stress have main effects on their general well-being on a negative direction. However, attachment style did not moderate the relationship between the psychological symptoms and general well-being. On one hand, results about the relationship of psychological symptoms and well-being are consistent to previous findings of other studies while on the other hand, results in moderation were contradicting.

Keywords: attachment style, psychological symptoms, well-being, mental health practitioners, rehabilitation centers

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1166 Ethnobotanical Study of Medicinal Plants of Leguminosae in Kantharalak Community Forest, Si Sa Ket Province, Thailand

Authors: W. Promprom, W. Chatan

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Leguminosae is a large plant family and its members are important for local people utilization in the Northeast of Thailand. This research aimed to survey medicinal plants in this family in Kantharalak Community forest. The plant collection and exploration were made from October 2017 to September 2018. Folk medicinal uses were studied by interviewing villagers and folk medicine healers living around the community forest by asking about local names, using parts, preparation and properties. The results showed that 65 species belonging to 40 genera were found. Among these, 30 species were medicinal plant. The most used plant parts were leaf. Decoction and drinking were mostly preparation method and administration mode used. All medicinal plants could be categorized into 17 diseases/symptoms. Most plant (56.66%) were used for fever. The voucher specimens were deposited in Department of Biology, Faculty of Science, Mahasarakham University, Thailand. Therefore, the data from this study might be widely used by the local area and further scientific study.

Keywords: ethnobotany, ethnophamacology, medicinal plant, taxonomy, utilization

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1165 Compensation Analysis on Secondary Public Hospitals of Pudong New Area in Shanghai

Authors: Wei Fang, Jian Jun Gu, Di Xue

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Objective: To analyze the employee compensation status of secondary public hospitals of Pudong New Area in Shanghai in order to provide information for compensation reform of public hospitals in Shanghai and as well as in China. Methods: We surveyed all 15 secondary public hospitals of Pudong New Area in Shanghai to collect hospital annual compensation data for their employees and to investigate their suggestions for compensation reform in public hospitals in China. We also collected related annual compensation data of employees in Shanghai and of physicians in the USA from Shanghai statistical Yearbook 2013 and from Bureau of Labor Statistics, U.S. Department of Labor. Results: The average annual compensation for the employees in secondary public hospitals of Pudong New Area in Shanghai in 2012 was 2.65 times of that for overall employees in Shanghai. The physician’s compensation in these public hospitals was relatively lower than that in the USA. Conclusion: The physicians’ compensation in the secondary public hospitals of Pudong New Area in Shanghai should be increased rationally and new compensation reform in public hospitals in Shanghai should be carefully designed.

Keywords: human resource, compensation, public hospital, Shanghai

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1164 Development of an Improved Paradigm for the Tourism Sector in the Department of Huila, Colombia: A Theoretical and Empirical Approach

Authors: Laura N. Bolivar T.

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The tourism importance for regional development is mainly highlighted by the collaborative, cooperating and competitive relationships of the involved agents. The fostering of associativity processes, in particular, the cluster approach emphasizes the beneficial outcomes from the concentration of enterprises, where innovation and entrepreneurship flourish and shape the dynamics for tourism empowerment. Considering the department of Huila, it is located in the south-west of Colombia and holds the biggest coffee production in the country, although it barely contributes to the national GDP. Hence, its economic development strategy is looking for more dynamism and Huila could be consolidated as a leading destination for cultural, ecological and heritage tourism, if at least the public policy making processes for the tourism management of La Tatacoa Desert, San Agustin Park and Bambuco’s National Festival, were implemented in a more efficient manner. In this order of ideas, this study attempts to address the potential restrictions and beneficial factors for the consolidation of the tourism sector of Huila-Colombia as a cluster and how could it impact its regional development. Therefore, a set of theoretical frameworks such as the Tourism Routes Approach, the Tourism Breeding Environment, the Community-based Tourism Method, among others, but also a collection of international experiences describing tourism clustering processes and most outstanding problematics, is analyzed to draw up learning points, structure of proceedings and success-driven factors to be contrasted with the local characteristics in Huila, as the region under study. This characterization involves primary and secondary information collection methods and comprises the South American and Colombian context together with the identification of involved actors and their roles, main interactions among them, major tourism products and their infrastructure, the visitors’ perspective on the situation and a recap of the related needs and benefits regarding the host community. Considering the umbrella concepts, the theoretical and the empirical approaches, and their comparison with the local specificities of the tourism sector in Huila, an array of shortcomings is analytically constructed and a series of guidelines are proposed as a way to overcome them and simultaneously, raise economic development and positively impact Huila’s well-being. This non-exhaustive bundle of guidelines is focused on fostering cooperating linkages in the actors’ network, dealing with Information and Communication Technologies’ innovations, reinforcing the supporting infrastructure, promoting the destinations considering the less known places as well, designing an information system enabling the tourism network to assess the situation based on reliable data, increasing competitiveness, developing participative public policy-making processes and empowering the host community about the touristic richness. According to this, cluster dynamics would drive the tourism sector to meet articulation and joint effort, then involved agents and local particularities would be adequately assisted to cope with the current changing environment of globalization and competition.

Keywords: innovative strategy, local development, network of tourism actors, tourism cluster

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1163 Management of Myofascial Temporomandibular Disorder in Secondary Care: A Quality Improvement Project

Authors: Rishana Bilimoria, Selina Tang, Sajni Shah, Marianne Henien, Christopher Sproat

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Temporomandibular disorders (TMD) may affect up to a third of the general population, and there is evidence demonstrating the majority of Myofascial TMD cases improve after education and conservative measures. In 2015 our department implemented a modified care pathway for myofascial TMD patients in an attempt to improve the patient journey. This involved the use of an interactive group therapy approach to deliver education, reinforce conservative measures and promote self-management. Patient reported experience measures from the new group clinic revealed 71% patient satisfaction. This service is efficient in improving aspects of health status while reducing health-care costs and redistributing clinical time. Since its’ establishment, 52 hours of clinical time, resources and funding have been redirected effectively. This Quality Improvement Project was initiated because it was felt that this new service was being underutilised by our surgical teams. The ‘Plan-Do-Study-Act cycle’ (PDSA) framework was employed to analyse utilisation of the service: The ‘plan’ stage involved outlining our aims: to raise awareness amongst clinicians of the unified care pathway and to increase referral to this clinic. The ‘do’ stage involved collecting data from a sample of 96 patients over 4 month period to ascertain the proportion of Myofascial TMD patients who were correctly referred to the designated clinic. ‘Suitable’ patients who weren’t referred were identified. The ‘Study’ phase involved analysis of results, which revealed that 77% of suitable patients weren’t referred to the designated clinic. They were reviewed on other clinics, which are often overbooked, or managed by junior staff members. This correlated with our original prediction. Barriers to referral included: lack of awareness of the clinic, individual consultant treatment preferences and patient, reluctance to be referred to a ‘group’ clinic. The ‘Act’ stage involved presenting our findings to the team at a clinical governance meeting. This included demonstration of the clinical effectiveness of the care-pathway and explaining the referral route and criteria. In light of the evaluation results, it was decided to keep the group clinic and maximize utilisation. The second cycle of data collection following these changes revealed that of 66 Myofascial TMD patients over a 4 month period, only 9% of suitable patients were not seen via the designated pathway; therefore this QIP was successful in meeting the set objectives. Overall, employing the PDSA cycle in this QIP resulted in appropriate utilisation of the modified care pathway for patients with myofascial TMD in Guy’s Oral Surgery Department. In turn, this leads to high patient satisfaction with the service and effectively redirected 52 hours of clinical time. It permitted adoption of a collaborative working style with oral surgery colleagues to investigate problems, identify solutions, and collectively raise standards of clinical care to ensure we adopt a unified care pathway in secondary care management of Myofascial TMD patients.

Keywords: myofascial, quality Improvement, PDSA, TMD

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1162 Relationship with Immediate Superior, Leadership, and Career Success of Managers

Authors: L. N. A. Chandana Jayawardena, Ales Gregar

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Occupational Self Efficacy (OSE) reflects the conviction of a person’s ability to fulfill his job related behavior at a perfectly acceptable level to the employer. Transformational leadership improves followers’ commitment by influencing their needs, values, and self-esteem. Employees also develop a dyadic relationship with their immediate superiors. Study was conducted amongst one hundred and twenty two (122) bank managers in Sri Lanka. They were selected based on multi-stage (seniority in the hierarchy, gender, department-wise etc.) stratified random sampling. Major objectives of this study were to analyze the impact of transformational leadership style, and OSE along with socio-demographic factors, and career, job and organizational experience, to the career satisfaction of managers. SPSS software was used for parametric and non-parametric statistical analyses. Career satisfaction had positive impacts on their transformational leadership style, and their relationships with the immediate superior. Impact of socio-demographic factors, and career exposure to career satisfaction was assessed.

Keywords: career success, relationship with immediate superior, transformational leadership, occupational self efficacy (OSE)

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1161 Relationship of Internal Communication Channels Effecting to Job Satisfaction of Company Employees: in Rayong Province

Authors: Nititorn Ounpipat

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The objective of this study was to find the relationship between internal communication and job satisfaction, and to find out the best communication channel to contact employees for a quality working within the operation or organizational rules. The sample size of 100% who were working as a shop floor level employee in the company. The study used the quantitative research method by distributing a structured questionnaire to collect data from 150 employees as the sample size. Inferential statistics and forward multiple regression analysis were used to analyze the results of this research. The result shows that communication channel correlated with job satisfaction. Each channel has a correlation with the satisfaction of working with the Department Board Information and All Employee / Weekly Meeting Relevance high. Since there is a correlation coefficient equal. 851 and. 840, respectively. Company Board Information, Memo, Letter, Leader, Supervisor, Friends and Email Relevance moderate as well.

Keywords: internal communication channels, job satisfaction, personal feedback, Rayong province

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1160 An Assessment of Experiential Learning Outcomes of Study Abroad Programs in Hospitality: A Learning Style Perspective

Authors: Radesh Palakurthi

Abstract:

The purpose of this study was to determine the impact of experiential learning on learning outcomes in hospitality education. This paper presents the results of an online survey of students from the U.S. studying abroad and their self-reported change in learning outcomes as assessed using the Core Competencies Model for the Hospitality Industry developed by Employment and Training Development Office of the U.S. Department of Labor. The impact of student learning styles on learning outcomes is also evaluated in this study. Kolb’s Learning Styles Inventory Model was used to assess students’ learning style. The results show that students reported significant improvements in their learning outcomes because of engaging in study abroad experiential learning programs. The learning styles of the students had significant effect on one of core learning outcomes- personal effectiveness.

Keywords: hospitality competencies, hospitality education, Kolb’s learning style inventory, learning outcomes, study abroad

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1159 Dengue Death Review: A Tool to Adjudge the Cause of Dengue Mortality and Use of the Tool for Prevention of Dengue Deaths

Authors: Gagandeep Singh Grover, Vini Mahajan, Bhagmal, Priti Thaware, Jaspreet Takkar

Abstract:

Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The state of Punjab in India shows cyclical and seasonal variation in dengue cases. The Case Fatality Rate of Dengue has ranged from 0.6 to 1.0 in the past years. The department has initiated a review of the cases that have died due to dengue in order to know the exact cause of the death in a case of dengue. The study has been undertaken to know the other associated co-morbidities and factors causing death in a case of dengue. The study used the predesigned proforma on which the records (medical and Lab) were recorded and reviewed by the expert committee of the doctors. This study has revealed that cases of dengue having co-morbidities have a longer stay in the hospital. Fluid overload and co-morbidities have been found as major factors leading to death, however, in a confirmed case of dengue hepatorenal shutdown was found to be a major cause of mortality. The data obtained will help in sensitizing the treating physicians in order to decrease the mortality due to dengue in future.

Keywords: dengue, death, morbidities, DHF, DSS

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1158 A Rare Case Report of Non-Langerhans Cell Cutaneous Histiocytosis in a 6-Month Old Infant

Authors: Apoorva D. R.

Abstract:

INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.

Keywords: histiocytosis, non langerhans cell, case report, fatal, rare

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1157 Classification of Precipitation Types Detected in Malaysia

Authors: K. Badron, A. F. Ismail, A. L. Asnawi, N. F. A. Malik, S. Z. Abidin, S. Dzulkifly

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The occurrences of precipitation, also commonly referred as rain, in the form of "convective" and "stratiform" have been identified to exist worldwide. In this study, the radar return echoes or known as reflectivity values acquired from radar scans have been exploited in the process of classifying the type of rain endured. The investigation use radar data from Malaysian Meteorology Department (MMD). It is possible to discriminate the types of rain experienced in tropical region by observing the vertical characteristics of the rain structure. .Heavy rain in tropical region profoundly affects radiowave signals, causing transmission interference and signal fading. Required wireless system fade margin depends on the type of rain. Information relating to the two mentioned types of rain is critical for the system engineers and researchers in their endeavour to improve the reliability of communication links. This paper highlights the quantification of percentage occurrences over one year period in 2009.

Keywords: stratiform, convective, tropical region, attenuation radar reflectivity

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1156 Audit Management of Constipation According to National Institute for Health and Care Excellence Guideline

Authors: Areej Makeineldein Mustafa

Abstract:

The study evaluates the management processes and healthcare provider compliance with the National Institute for Health and Care Excellence recommendations for constipation management. We aimed to evaluate the adherence to National Institute for Health and Care Excellence guidelines in the management of constipation during the period from February to June 2023. We collected data from a random sample ( 51 patients) over 4 months with inclusion criteria for patients above 60 who were just admitted to the care of the elderly department during this period. Patient age, sex, medical records for constipation, acute or chronic constipation, or opioid-induced constipation, and treatment options were used to identify constipation and the type of treatment given. Our findings indicate that there is a gap between practice and National Institute for Health and Care Excellence guideline steps; only 3 patient was given medications according to National Institute for Health and Care Excellence guidelines in order of combination or steps of escalation. Addressing these gaps could potentially lead to enhanced patient outcomes and an overall improvement in the quality of care provided to individuals suffering from constipation.

Keywords: constipation, elderly, management, patient

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1155 Comparison of Nutritional Status of Asthmatic vs Non-asthmatic Adults

Authors: Ayesha Mushtaq

Abstract:

Asthma is a pulmonary disease in which blockade of the airway takes place due to inflammation as a response to certain allergens. Breathing troubles, cough, and dyspnea are one of the few symptoms. Several studies have indicated a significant effect on asthma due to changes in dietary routines. Certain food items, such as oily foods and other materials, are known to cause an increase in the symptoms of asthma. Low dietary intake of fruits and vegetables may be important in relation to asthma prevalence. The objective of this study is to assess and compare the nutritional status of asthmatic and non-asthmatic patients. The significance of this study lies in the factor that it will help nutritionists to arrange a feasible dietary routine for asthmatic patients. This research was conducted at the Pulmonology Department of the Pakistan Institute of Medical Science Islamabad. About thirty hundred thirty-four million people are affected by asthma worldwide. Pakistan is on the verge of being an uplifted urban population and asthma cases are increasingly high these days. Several studies suggest an increase in the Asthmatic patient population due to improper diet. Other studies conducted at different institutions have conducted research on similar topics. These studies have suggested that there is a substantial alteration in the nutritional status of asthmatic and non-Asthmatic patients. This is a cross-sectional study aimed at assessing the nutritious standing of Asthmatic and non-asthmatic patients. This research took place at the Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. The research included asthmatic and non-asthmatic patients coming to the pulmonology department clinic at the Pakistan Institute of Medical Sciences (PIMS). These patients were aged between 20-60 years. A questionnaire was developed for these patients to estimate their dietary plans in these patients. The methodology included four sections. The first section was the Socio-Demographic profile, which included age, gender, monthly income and occupation. The next section was anthropometric measurements which included the weight, height and body mass index (BMI) of the individual. The next section, section three, was about the biochemical attributes, such as for biochemical profiling, pulmonary function testing (PFT) was performed. In the next section, Dietary habits, which were assessed by using a food frequency questionnaire (FFQ) through food habits and consumption pattern, was assessed. The next section life style data, in which the person's level of physical activity, sleep and smoking habits were assessed. The next section was statistical analysis. All the data obtained from the study were statistically analyzed and assessed. Most of the asthma Patients were females, with weight more than normal or even obese. Body Mass Index (BMI) was higher in asthma Patients than those in non-Asthmatic ones. When the nutritional Values were assessed, we came to know that these patients were low on certain nutrients and their diet included more junk and oily food than healthy vegetables and fruits. Beverages intake was also included in the same assessment. It is evident from this study that nutritional status has a contributory effect on asthma. So, patients on the verge of developing asthma or those who have developed asthma should focus on their diet, maintain good eating habits and take healthy diets, including fruits and vegetables rather than oily foods. Proper sleep may also contribute to the control of asthma.

Keywords: NUTRI, BMI, asthma, food

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1154 Gross and Histological Studies on the Thymus of the Grasscutter (Thyronomys swinderianus)

Authors: R. M. Korzerzer, J. O. Hambolu, S. O. Salami, S. B. Oladele

Abstract:

Twelve apparently healthy grasscutters between the ages of three and seven months were used for this study. The animals were purchased from local breeders in Oturkpo, Benue state, Nigeria and transported to the research laboratory in the Department of Veterinary Anatomy, Ahmadu Bello University, Zaria by means of constructed cages. The animals were divided into three groups according to their ages and acclimatised. Sacrifice was done using chloroform gaseous inhalation anaesthesia. An incision was made at the neck region and the thymus located and identified by its prominent bilateral nature. Extirpated thymuses from each animal were immediately weighed and fixed in Bouin’s fluid for 48 hours. The tissues were then prepared using standard methods. Haematoxilin and eosin was used for routine histology and Rhodamine B aniline methylene blue was for studying the architecture of the elastic and reticular fibres of the thymus. Grossly, the thymus appeared as a bilateral organ on either side of the thoracic midline. The organ size decreased consistently as the animals advanced in age. Mean ± SEM values for thymic weights were 1.23 ± 0.048 g, 0.53 ± 0.019 g and 0.30 ± 0.042 g at three, five and seven months of age respectively.

Keywords: gross, histological, thymus, grasscutter

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