Search results for: levels of care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10409

Search results for: levels of care

3209 Assessment of Utilization of Provider Initiated HIV Testing and Counseling and Associated Factors among Adult out Patient Department Patients in Wonchi Woreda, South West Shoa Zone, Central Ethiopia

Authors: Dinka Fikadu, Mulugeta Shegaze

Abstract:

Background: Currently in health facility, provider-initiated human immunodeficiency virus testing is the key entry point to prevention, care, treatment and support services, but most people remains unaware of their HIV status due to various reasons. In many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome, "has become one of the world’s most serious health and development challenges. Reaching individuals with HIV who do not know their serostatus is a global public health priority. Objective: To assess utilization of provider initiated HIV testing and counseling and associated factors among adult outpatient department patients. Methods: Health facility based cross sectional study was conducted among 392 adult outpatient department patients in Wonchi woreda from February 24 to March 24 /2013. The study participant was recruited patients from all adult outpatient department patients of all four public health facilities of wonchi woreda using systematic sampling. A structured interviewer administered questionnaire was used to elicit all important variables from the study participants and multiple logistic regression analysis was used. Result: A total of 371 adult outpatient department patients aged between 15 to 64 years were actively participated in the study and 291(78.4%) of them utilized provider initiated HIV testing and counseling and 80(21.6%) of them refused. Knowledge on HIV is low in the study population; majority of the participants didn’t have comprehensive knowledge (64.7%) and (35.3%) fail to reject misconception about means of HIV transmission and prevention. Utilization of provider-initiated HIV testing and counseling were associated with divorced/widowed marital status[AOR (95%CI) = 0.32(0.15, 0.69)], being male sex [AOR (95%CI) =1.81(1.01, 3.24)], having comprehensive knowledge on HIV [AOR (95%CI) =0.408(0.220,0.759)],having awareness about provider initiated HIV testing and counseling [AOR(95%CI) =2.89(1.48,5.66)] and receiving test on HIV before[AOR (95%CI)=4.15(2.30, 7.47)]. Conclusion: Utilization of provider initiated HIV testing and counseling among adult outpatient departments in wonchi woreda public health facility was [(78.4%)].Strengthening health information through mass media and peer education on HIV to address barrier to testing in the community such as low awareness on PITC, to increase up take of PITC among adult OPD patients.

Keywords: utilization, human immune deficiency, testing, provider, initiate

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3208 Improving the Growth, Biochemical Parameters and Content and Composition of Essential Oil of Mentha piperita L. through Soil-Applied N, P, and K

Authors: Bilal Bhat, M. Masroor A. Khan, Moin Uddin, M. Naeem

Abstract:

Aromatic herb, peppermint (Mentha piperita L.), is a natural hybrid (M. aquatica × M. spicata) with immense therapeutic uses, apart from other potential uses. Peppermint oil is one of the most popular and widely used essential oil (EO), because of its main components menthol and menthone. In view of enhancing growth, yield and quality of this medicinally important herb, a pot experiment was conducted in the net-house of the department. The experiment was aimed at studying the effect of graded levels of N, P, and K on growth, biochemical characteristics, and content and composition of EO in Mentha piperita L. Six NPK treatments (viz. N0P0K0, N20P20K20, N40P40K40, N20+20 P20+20 K20+20, N60P60K60, and N30+30 P30+30 K30+30) were tested. The plants were harvested 150 days after transplanting. The crop performance was assessed in terms of growth attributes, physiological activities, herbage yield and content as well as yield of active constituents of Mentha piperita L. Biochemical parameters were analyzed spectrophotometrically. The EO was extracted using Clevenger’s apparatus and the active constituents of the oil were determined using Gas Chromatography. Split-dose application of N, P and K (N30+30 P30+30 K30+30) ameliorated most of the parameters significantly including, fresh and dry weight of plant, NPK content, chlorophyll and carotenoids content, and the activities of carbonic anhydrase and nitrate reductase in the leaves. It also enhanced the EO content (44.0%), EO yield (91.0%), menthol content (14.1%), menthone content (34.0%), menthyl acetate content (16.9%) and 1, 8-cineole content (43.7%) but decreased the pulegone content (36.8%). Conclusively, the fertilization proved useful in enhancing the EO content, yield and other EO components of the plant. Thus, the yield and quality of EO of peppermint may be improved by this agricultural strategy.

Keywords: mentha piperita, menthol, menthone, EO

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3207 Probabilistic Damage Tolerance Methodology for Solid Fan Blades and Discs

Authors: Andrej Golowin, Viktor Denk, Axel Riepe

Abstract:

Solid fan blades and discs in aero engines are subjected to high combined low and high cycle fatigue loads especially around the contact areas between blade and disc. Therefore, special coatings (e.g. dry film lubricant) and surface treatments (e.g. shot peening or laser shock peening) are applied to increase the strength with respect to combined cyclic fatigue and fretting fatigue, but also to improve damage tolerance capability. The traditional deterministic damage tolerance assessment based on fracture mechanics analysis, which treats service damage as an initial crack, often gives overly conservative results especially in the presence of vibratory stresses. A probabilistic damage tolerance methodology using crack initiation data has been developed for fan discs exposed to relatively high vibratory stresses in cross- and tail-wind conditions at certain resonance speeds for limited time periods. This Monte-Carlo based method uses a damage databank from similar designs, measured vibration levels at typical aircraft operations and wind conditions and experimental crack initiation data derived from testing of artificially damaged specimens with representative surface treatment under combined fatigue conditions. The proposed methodology leads to a more realistic prediction of the minimum damage tolerance life for the most critical locations applicable to modern fan disc designs.

Keywords: combined fatigue, damage tolerance, engine, surface treatment

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3206 Transforming ESL Teaching and Learning with ICT

Authors: Helena Sit

Abstract:

Developing skills in using ICT in the language classroom has been discussed at all educational levels. Digital tools and learning management systems enable teachers to transform their instructional activities while giving learners the opportunity to engage with virtual communities. In the field of English as a second language (ESL) teaching and learning, the use of technology-enhanced learning and diverse pedagogical practices continues to grow. Whilst technology and multimodal learning is a way of the future for education, second language teachers now face the predicament as to whether implementing these newer ways of learning is, in fact, beneficial or disadvantageous to learners. Research has shown that integrating multimodality and technology can improve students’ engagement and participation in their English language learning. However, students can experience anxiety or misunderstanding when engaging with E-learning or digital-mediated learning. This paper aims to explore how ESL teaching and learning are transformed via the use of educational technology and what impact it has had on student teachers. Case study is employed in this research. The study reviews the growing presence of technology and multimodality in university language classrooms, discusses their impact on teachers’ pedagogical practices, and proposes scaffolding strategies to help design effective English language courses in the Australian education context. The study sheds light on how pedagogical integration today may offer a way forward for language teachers of tomorrow and provides implications to implement an evidence-informed approach that blends knowledge from research, practice and people experiencing the practice in the digital era.

Keywords: educational technology, ICT in higher education, curriculum design and innovation, teacher education, multiliteracies pedagogy

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3205 Inhibitory Effect of Lactic Acid Bacteria on Uropathogenic Escherichia coli-Induced Urinary Tract Infections

Authors: Cheng-Chih Tsai, Yu-Hsuan Liu, Cheng-Ying Ho, Chun-Chin Huang

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The aim of this study evaluated the in vitro and in vivo antimicrobial activity of selected lactic acid bacteria (LAB) against Uropathogenic Escherichia coli (UPEC) for prevention and amelioration of UTIs. We screened LAB strains with antimicrobial effects on UPEC using a well-diffusion assay, bacterial adherence to the uroepithelium cell line SV-HUC-1 (BCRC 60358), and a coculture inhibition assay. The results showed that the 7 LAB strains (Lactobacillus paracasei, L. salivarius, two Pediococcus pentosaceus strains, two L. plantarum strains, and L. crispatus) and the fermented probiotic products produced by these multi-LAB strains exhibited potent zones of inhibition against UPEC. Moreover, the LAB strains and probiotic products adhered strongly to the uroepithelium SV-HUC-1 cell line. The growth of UPEC strains was also markedly inhibited after co-culture with the LAB strains and probiotic products in human urine. In addition, the enhanced levels of IL-6, IL-8 and lactic acid dehydrogenase were significantly decreased by treatments with the LAB strains and probiotic products in UPEC-induced SV-HUC-1 cells. Furthermore, oral administration of probiotic products reduced the number of viable UPEC in the urine of UPEC-challenged BALB/c mice. Taken together, this study demonstrates that probiotic supplementation may be useful as an adjuvant therapy for the treatment of bacterial-induced urinary tract infections.

Keywords: lactic acid bacterium, SV-HUC-1 uroepithelium, urinary tract infection, uropathogenic Escherichia coli, BALB/c mice

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3204 Numerical Investigation of Material Behavior During Non-Equal Channel Multi Angular Extrusion

Authors: Mohamed S. El-Asfoury, Ahmed Abdel-Moneim, Mohamed N. A. Nasr

Abstract:

The current study uses finite element modeling to investigate and analyze a modified form of the from the conventional equal channel multi-angular pressing (ECMAP), using non-equal channels, on the workpiece material plastic deformation. The modified process non-equal channel multi-angular extrusion (NECMAE) is modeled using two-dimensional plane strain finite element model built using the commercial software ABAQUS. The workpiece material used is pure aluminum. The model was first validated by comparing its results to analytical solutions for single-pass equal channel angular extrusion (ECAP), as well as previously published data. After that, the model was used to examine the effects of different % of reductions of the area (for the second stage) on material plastic deformation, corner gap, and required the load. Three levels of reduction in the area were modeled; 10%, 30%, and 50%, and compared to single-pass and double-pass ECAP. Cases with a higher reduction in the area were found to have smaller corner gaps, higher and much uniform plastic deformation, as well as higher required loads. The current results are mainly attributed to the back pressure effects exerted by the second stage, as well as strain hardening effects experienced during the first stage.

Keywords: non-equal channel angular extrusion, multi-pass, sever plastic deformation, back pressure, Finite Element Modelling (FEM)

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3203 Effectiveness of Psychosocial Interventions in Preventing Postpartum Depression among Teenage Mothers: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Lebeza Alemu Tenaw, Fei Wan Ngai

Abstract:

Background: Postpartum depression is the most common mental health disorder that occurs after childbirth, and it is more prevalent among teenage mothers compared to adults. Although there is emerging evidence suggesting psychosocial interventions can decrease postpartum depression, there are no consistent findings regarding the effectiveness of these interventions, especially for teenage mothers. The current review aimed to investigate the effectiveness of psychosocial interventions in preventing postpartum depression among teenage mothers. Methods: The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) manual was implemented to select articles from online databases. The articles were searched using the Population, Intervention, Control, and Outcome (PICO) model. The quality of the articles was assessed using the Cochrane Collaboration Risk of Bias assessment tool. The statistical analyses were performed using Stata 17, and the effect size was estimated using the standard mean difference score of depression between the intervention and control groups. Heterogeneity between the studies was assessed through the I2 statistic and Q statistic, while the publication bias was evaluated using the asymmetry of the funnel plot and Egger's test. Results: In this systematic review, a total of nine articles were included. While psychosocial interventions demonstrated in reducing the risk of postpartum depression compared to usual maternal care, it is important to note that the mean difference score of depression was significant in only three of the included studies. The overall meta-analysis finding revealed that psychosocial interventions were effective in preventing postpartum depression, with a pooled effect size of -0.5 (95% CI: -0.95, -0.06) during the final time postpartum depression assessment. The heterogeneity level was found to be substantial, with an I2 value of 82.3%. However, no publication bias was observed. Conclusion: The review findings suggest that psychosocial interventions initiated during the late antenatal and early postnatal periods effectively prevent postpartum depression. The interventions were found to be more beneficial during the first three months of the postpartum period. However, this review also highlighted that there is a scarcity of interventional studies conducted in low-income countries, indicating the need for further studies in diverse communities.

Keywords: teenage pregnancy, postpartum depression, review

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3202 A Single-Use Endoscopy System for Identification of Abnormalities in the Distal Oesophagus of Individuals with Chronic Reflux

Authors: Nafiseh Mirabdolhosseini, Jerry Zhou, Vincent Ho

Abstract:

The dramatic global rise in acid reflux has also led to oesophageal adenocarcinoma (OAC) becoming the fastest-growing cancer in developed countries. While gastroscopy with biopsy is used to diagnose OAC patients, this labour-intensive and expensive process is not suitable for population screening. This study aims to design, develop, and implement a minimally invasive system to capture optical data of the distal oesophagus for rapid screening of potential abnormalities. To develop the system and understand user requirements, a user-centric approach was employed by utilising co-design strategies. Target users’ segments were identified, and 38 patients and 14 health providers were interviewed. Next, the technical requirements were developed based on consultations with the industry. A minimally invasive optical system was designed and developed considering patient comfort. This system consists of the sensing catheter, controller unit, and analysis program. Its procedure only takes 10 minutes to perform and does not require cleaning afterward since it has a single-use catheter. A prototype system was evaluated for safety and efficacy for both laboratory and clinical performance. This prototype performed successfully when submerged in simulated gastric fluid without showing evidence of erosion after 24 hours. The system effectively recorded a video of the mid-distal oesophagus of a healthy volunteer (34-year-old male). The recorded images were used to develop an automated program to identify abnormalities in the distal oesophagus. Further data from a larger clinical study will be used to train the automated program. This system allows for quick visual assessment of the lower oesophagus in primary care settings and can serve as a screening tool for oesophageal adenocarcinoma. In addition, this system is able to be coupled with 24hr ambulatory pH monitoring to better correlate oesophageal physiological changes with reflux symptoms. It also can provide additional information on lower oesophageal sphincter functions such as opening times and bolus retention.

Keywords: endoscopy, MedTech, oesophageal adenocarcinoma, optical system, screening tool

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3201 Application of Nonparametric Geographically Weighted Regression to Evaluate the Unemployment Rate in East Java

Authors: Sifriyani Sifriyani, I Nyoman Budiantara, Sri Haryatmi, Gunardi Gunardi

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East Java Province has a first rank as a province that has the most counties and cities in Indonesia and has the largest population. In 2015, the population reached 38.847.561 million, this figure showed a very high population growth. High population growth is feared to lead to increase the levels of unemployment. In this study, the researchers mapped and modeled the unemployment rate with 6 variables that were supposed to influence. Modeling was done by nonparametric geographically weighted regression methods with truncated spline approach. This method was chosen because spline method is a flexible method, these models tend to look for its own estimation. In this modeling, there were point knots, the point that showed the changes of data. The selection of the optimum point knots was done by selecting the most minimun value of Generalized Cross Validation (GCV). Based on the research, 6 variables were declared to affect the level of unemployment in eastern Java. They were the percentage of population that is educated above high school, the rate of economic growth, the population density, the investment ratio of total labor force, the regional minimum wage and the ratio of the number of big industry and medium scale industry from the work force. The nonparametric geographically weighted regression models with truncated spline approach had a coefficient of determination 98.95% and the value of MSE equal to 0.0047.

Keywords: East Java, nonparametric geographically weighted regression, spatial, spline approach, unemployed rate

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3200 Service Delivery Disparity Conundrum at Winnie Madikizela Mandela Local Municipality: Exploration of the Enhanced Future

Authors: Mandisi Matyana

Abstract:

Although the South African local government is doing all the best in ensuring improved service delivery for the citizens, service delivery disparity still remains the real challenge for other municipalities. The unequal distribution of services within municipal wards is causing unequal happiness among the citizens; hence others do enjoy different provided municipal services, while others do not. It is acknowledged that less access to municipal services infringes one’s rights, such as the right to human dignity and the right to life. Some of the municipal services are basic services and they are the mainstay of human survival, such as water, housing, etc. It is quite evident that the service delivery disparity could be caused by the various factors within the local municipality affairs, including both administrative and political factors. Therefore, this study is undertaken to check and evaluate the main foundations of service delivery disparity in ensuring equal development of the state, particularly for local communities. The study used the qualitative method to collect the data from the citizens of Winnie Madikizela Mandela Local Municipality. An extensive literature was also conducted in understanding the causes of service delivery disparity. Study findings prove that the service delivery disparity could be caused by factors such as political interference in administration, corruption and fraud, elevated unemployment levels, inadequate institutional capacity, etc. Therefore, the study recommends strong community participation and constant external supervision in the local government so as to encourage openness in local government to ensure fair administration towards services to be provided.

Keywords: administration, development, municipal services, service delivery disparity, Winnie Madikizela Mandela local municipality

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3199 Hindi Speech Synthesis by Concatenation of Recognized Hand Written Devnagri Script Using Support Vector Machines Classifier

Authors: Saurabh Farkya, Govinda Surampudi

Abstract:

Optical Character Recognition is one of the current major research areas. This paper is focussed on recognition of Devanagari script and its sound generation. This Paper consists of two parts. First, Optical Character Recognition of Devnagari handwritten Script. Second, speech synthesis of the recognized text. This paper shows an implementation of support vector machines for the purpose of Devnagari Script recognition. The Support Vector Machines was trained with Multi Domain features; Transform Domain and Spatial Domain or Structural Domain feature. Transform Domain includes the wavelet feature of the character. Structural Domain consists of Distance Profile feature and Gradient feature. The Segmentation of the text document has been done in 3 levels-Line Segmentation, Word Segmentation, and Character Segmentation. The pre-processing of the characters has been done with the help of various Morphological operations-Otsu's Algorithm, Erosion, Dilation, Filtration and Thinning techniques. The Algorithm was tested on the self-prepared database, a collection of various handwriting. Further, Unicode was used to convert recognized Devnagari text into understandable computer document. The document so obtained is an array of codes which was used to generate digitized text and to synthesize Hindi speech. Phonemes from the self-prepared database were used to generate the speech of the scanned document using concatenation technique.

Keywords: Character Recognition (OCR), Text to Speech (TTS), Support Vector Machines (SVM), Library of Support Vector Machines (LIBSVM)

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3198 Synthesis, Structural, Spectroscopic and Nonlinear Optical Properties of New Picolinate Complex of Manganese (II) Ion

Authors: Ömer Tamer, Davut Avcı, Yusuf Atalay

Abstract:

Novel picolinate complex of manganese(II) ion, [Mn(pic)2] [pic: picolinate or 2-pyridinecarboxylate], was prepared and fully characterized by single crystal X-ray structure determination. The manganese(II) complex was characterized by FT-IR, FT-Raman and UV–Vis spectroscopic techniques. The C=O, C=N and C=C stretching vibrations were found to be strong and simultaneously active in IR and spectra. In order to support these experimental techniques, density functional theory (DFT) calculations were performed at Gaussian 09W. Although the supramolecular interactions have some influences on the molecular geometry in solid state phase, the calculated data show that the predicted geometries can reproduce the structural parameters. The molecular modeling and calculations of IR, Raman and UV-vis spectra were performed by using DFT levels. Nonlinear optical (NLO) properties of synthesized complex were evaluated by the determining of dipole moment (µ), polarizability (α) and hyperpolarizability (β). Obtained results demonstrated that the manganese(II) complex is a good candidate for NLO material. Stability of the molecule arising from hyperconjugative interactions and charge delocalization was analyzed using natural bond orbital (NBO) analysis. The highest occupied and the lowest unoccupied molecular orbitals (HOMO and LUMO) which is also known the frontier molecular orbitals were simulated, and obtained energy gap confirmed that charge transfer occurs within manganese(II) complex. Molecular electrostatic potential (MEP) for synthesized manganese(II) complex displays the electrophilic and nucleophilic regions. From MEP, the the most negative region is located over carboxyl O atoms while positive region is located over H atoms.

Keywords: DFT, picolinate, IR, Raman, nonlinear optic

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3197 Changes in Serum Neopterin in Workers Exposed to Different Mineral Dust

Authors: Gospodinka Prakova, Pavlina Gidikova, Gergana Sandeva, Kamelia Haracherova, Emil Slavov

Abstract:

Neopterin was demonstrated to be a sensitive marker of cell-mediated immune reactions which plays a key role in the interaction of monocyte / macrophage activation. The purpose of this work was to investigate changes in serum neopterin in workers exposed to different composition of mineral dust. Material and Methods: Serum neopterin was studied in 193 exposed workers, divided into three groups, depending on the mineral dust and content of the quartz in the respirable fraction. The I-st group-coal dust containing less than 2% free crystalline silica (n=44), II-nd group-coal dust containing over 2% free crystalline silica (n=94) and the III-rd group-mixed dust with corundum and carborundum (n=55). The control group was composed of 21 individuals without exposure to dust. Serum neopterin was investigated by Elisa method in ng/ml according to the instructions of the manufacturer. Results and Discussion: It was found significantly higher level of serum neopterin in exposed workers of mineral dust (2,10 ± 0,62 ng / ml), compared with that of the control group (1,10 ± 0,85 ng/ml; p < 0,05). Neopterin levels in workers exposed to coal dust (1,87 ± 0,42 ng / ml-I-st and 3,32 ± 0,77 ng / ml-II-nd group) were significantly higher compared with those exposed to a mixed dust (1,31±0,68 mg / ml-third) and control group (p < 0,05). No significant difference in serum neopterin when exposed to a mixed dust composed of corundum and carborundum (III-rd) and a control group. Conclusion: The results of this study indicate activates a cell-mediated immune response when exposed to a mineral dust. The level of that activation depends mainly on the composition of the dust and is significantly highest in workers exposed to coal dust.

Keywords: mineral dust, neopterin, occupational exposure, respirable crystalline silica

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3196 PM Air Quality of Windsor Regional Scale Transport’s Impact and Climate Change

Authors: Moustafa Osman Mohammed

Abstract:

This paper is mapping air quality model to engineering the industrial system that ultimately utilized in extensive range of energy systems, distribution resources, and end-user technologies. The model is determining long-range transport patterns contribution as area source can either traced from 48 hrs backward trajectory model or remotely described from background measurements data in those days. The trajectory model will be run within stable conditions and quite constant parameters of the atmospheric pressure at the most time of the year. Air parcel trajectory is necessary for estimating the long-range transport of pollutants and other chemical species. It provides a better understanding of airflow patterns. Since a large amount of meteorological data and a great number of calculations are required to drive trajectory, it will be very useful to apply HYPSLIT model to locate areas and boundaries influence air quality at regional location of Windsor. 2–days backward trajectories model at high and low concentration measurements below and upward the benchmark which was areas influence air quality measurement levels. The benchmark level will be considered as 30 (μg/m3) as the moderate level for Ontario region. Thereby, air quality model is incorporating a midpoint concept between biotic and abiotic components to broaden the scope of quantification impact. The later outcomes’ theories of environmental obligation suggest either a recommendation or a decision of what is a legislative should be achieved in mitigation measures of air emission impact ultimately.

Keywords: air quality, management systems, environmental impact assessment, industrial ecology, climate change

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3195 The Reasons and the Practical Benefits Behind the Motivation of Businesses to Participate in the Dual Education System (DLS)

Authors: Ainur Bulasheva

Abstract:

During the last decade, the dual learning system (DLS) has been actively introduced in various industries in Kazakhstan, including both vocational, post-secondary, and higher education levels. It is a relatively new practice-oriented approach to training qualified personnel in Kazakhstan, officially introduced in 2012. Dual learning was integrated from the German vocational education and training system, combining practical training with part-time work in production and training in an educational institution. The policy of DLS has increasingly focused on decreasing youth unemployment and the shortage of mid-level professionals by providing incentives for employers to involve in this system. By participating directly in the educational process, the enterprise strives to train its future personnel to meet fast-changing market demands. This study examines the effectiveness of DLS from the perspective of employers to understand the motivations of businesses to participate (invest) in this program. The human capital theory of Backer, which predicts that employers will invest in training their workers (in our case, dual students) when they expect that the return on investment will be greater than the cost - acts as a starting point. Further extensionists of this theory will be considered to understand investing intentions of businesses. By comparing perceptions of DLS employers and non-dual practices, this study determines the efficiency of promoted training approach for enterprises in the Kazakhstan agri-food industry.

Keywords: vocational and technical education, dualeducation, human capital theory, argi-food industry

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3194 Effects of Mindfulness Practice on Clinician Burnout: A Scoping Review

Authors: Hani Malik

Abstract:

Background: Clinician burnout is a growing phenomenon in current health systems worldwide. Increasing emotional exhaustion, depersonalisation, and reduced personal accomplishment threaten the effective delivery of healthcare. This can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in clinicians. Objectives: To conduct a scoping review and identify high-quality studies on mindfulness practice in clinician burnout, synthesize themes that emerge from these studies, and discuss the implications of the results to healthcare leadership and innovation. Methodology: A focused scoping review was carried out to investigate the effects of mindfulness practice on clinician burnout. High-ranking journals were targeted to analyse high-quality studies and synthesize common themes in the literature. Studies conducted on current, practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Grey literature and studies conducted only on allied health personnel were excluded from this review. Analysis:31 studies were included in this scoping review. Mindfulness practice was found to decrease emotional exhaustion and depersonalisation while improving mood, responses to stress, and vigour. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged which include: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to clinician mindfulness practice. Conclusion: Mindfulness had widely been reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate clinician leader will play a crucial role in addressing gaps in current practice, prioritise staff mental health, and provide a supportive platform for innovation.

Keywords: mindfulness practice, clinician burnout, healthcare leadership, COVID-19

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3193 Importance of Developing a Decision Support System for Diagnosis of Glaucoma

Authors: Murat Durucu

Abstract:

Glaucoma is a condition of irreversible blindness, early diagnosis and appropriate interventions to make the patients able to see longer time. In this study, it addressed that the importance of developing a decision support system for glaucoma diagnosis. Glaucoma occurs when pressure happens around the eyes it causes some damage to the optic nerves and deterioration of vision. There are different levels ranging blindness of glaucoma disease. The diagnosis at an early stage allows a chance for therapies that slows the progression of the disease. In recent years, imaging technology from Heidelberg Retinal Tomography (HRT), Stereoscopic Disc Photo (SDP) and Optical Coherence Tomography (OCT) have been used for the diagnosis of glaucoma. This better accuracy and faster imaging techniques in response technique of OCT have become the most common method used by experts. Although OCT images or HRT precision and quickness, especially in the early stages, there are still difficulties and mistakes are occurred in diagnosis of glaucoma. It is difficult to obtain objective results on diagnosis and placement process of the doctor's. It seems very important to develop an objective decision support system for diagnosis and level the glaucoma disease for patients. By using OCT images and pattern recognition systems, it is possible to develop a support system for doctors to make their decisions on glaucoma. Thus, in this recent study, we develop an evaluation and support system to the usage of doctors. Pattern recognition system based computer software would help the doctors to make an objective evaluation for their patients. It is intended that after development and evaluation processes of the software, the system is planning to be serve for the usage of doctors in different hospitals.

Keywords: decision support system, glaucoma, image processing, pattern recognition

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3192 Pharmacokinetic and Tissue Distribution of Etoposide Loaded Modified Glycol Chitosan Nanoparticles

Authors: Akhtar Aman, Abida Raza, Shumaila Bashir, Mehboob Alam

Abstract:

The development of efficient delivery systems remains a major concern in cancer chemotherapy as many efficacious anticancer drugs are hydrophobic and difficult to formulate. Nanomedicines based on drug-loaded amphiphilic glycol chitosan micelles offer potential advantages for the formulation of drugs such as etoposide that may improve the pharmacokinetics and reduce the formulation-related adverse effects observed with current formulations. Amphiphilic derivatives of glycol chitosan were synthesized by chemical grafting of palmitic acid N-hydroxysuccinimide and quaternization to glycol chitosan backbone. To this end, a 7.9 kDa glycol chitosan was modified by palmitoylation and quaternization, yielding a 13 kDa amphiphilic polymer. Micelles prepared from this amphiphilic polymer had a size of 162nm and were able to encapsulate up to 3 mg/ml etoposide. Pharmacokinetic results indicated that the GCPQ micelles transformed the biodistribution pattern and increased etoposide concentration in the brain significantly compared to free drugs after intravenous administration. AUC 0.5-24h showed statistically significant difference in ETP-GCPQ vs. Commercial preparation in liver (25 vs.70, p<0.001), spleen (27 vs.36, p<0.05), lungs (42 vs.136,p<0.001),kidneys(25 vs.70,p< 0.05),and brain(19 vs.9,p<0.001). ETP-GCPQ crossed the blood-brain barrier, and 4, 3.5, 2.6, 1.8, 1.7, 1.5, and 2.5 fold higher levels of etoposide were observed at 0.5, 1, 2, 4, 6, 12, and 24hrs; respectively suggesting these systems could deliver hydrophobic anticancer drugs such as etoposide to tumors but also increased their transport through the biological barriers, thus making it a good delivery system

Keywords: glycol chitosan, micelles, pharmacokinetics, tissue distribution

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3191 Urban Dust Influence on the Foliar Surface and Biochemical Constituents of Selected Plants in the National Capital Region of Delhi, India

Authors: G. P. Gupta, B. Kumar, S. Singh, U. C. Kulshrestha

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Very high loadings of atmospheric dust in the Indian region contribute to remarkably higher levels of particulate matter. During dry weather conditions which prevail most of the year, dustfall is deposited onto the foliar surfaces affecting their morphology, stomata and biochemical constituents. This study reports chemical characteristics of dustfall, its effect on foliar morphology and biochemical constituents of two medicinal plants i.e. Morus (Morus alba) and Arjun (Terminalia arjuna) in the urban environment of National Capital Region (NCR) of Delhi at two sites i.e. Jawaharlal Nehru University (residential) and Sahibabad (industrial). Atmospheric dust was characterized for major anions (F-, Cl-, NO3-, SO4--) and cations (Na+, NH4+, K+, Mg++, Ca++) along with the biochemical parameters Chl a, Chl b, total chlorophyll, carotenoid, total soluble sugar, relative water content (RWC), pH, and ascorbic acid. The results showed that the concentrations of major ions in dustfall were higher at the industrial site as compared to the residential site due to the higher level of anthropogenic activities. Both the plant species grown at industrial site had significantly lower values of chlorophyll ‘a’, chlorophyll ‘b’, total chlorophyll, carotenoid but relatively higher values of total soluble sugar and ascorbic acid indicating stressful conditions due to industrial and vehicular emissions.

Keywords: dustfall, urban environment, biochemical constituents, atmospheric dust

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3190 Economic Integration in Eurasia: Modeling of the Current and Future Architecture

Authors: M. G. Shilina

Abstract:

The prospects for political and economic development of the Eurasian space are currently discussed at both governmental and expert levels. New concepts actively proposed by the Eurasian governments require the analysis and search for effective implementation options. In the paper, an attempt to identify effective solutions to the problems surrounding the current economic integration of the Eurasian states is given on the basis of an interdisciplinary, comprehensive, structured analysis. The phenomenon is considered through the prism of the international law, world economy and politics, combined with the study of existing intergovernmental practice. The modeling method was taken as the basis for the research and is supplemented by legal and empirical methods. The detailed multi-level model of practical construction the 'Great Eurasia' (the GE) concept is proposed, the option for building a phased interaction in Eurasia is given through the prism of construction by the Eurasian Economic Union (the EAEU) as the main tool. The Shanghai Cooperation Organization (the SCO) is seen as the most promising element of the model. The SCO is capable of streamlining the formation of the GE and determine the transformation of Eurasia into a common economic space. Effective development of the economic integration between Eurasian states on the framework of the SCO is optimal. The SCO+ could be used as a platform for integration-integration processes formation. The creation of stable financial ties could become the basis for the possible formation of an expanded transregional integration platform. The paper concludes that the implementation of the proposed model could entail a gradual economic rapprochement of Eurasia and beyond.

Keywords: economic integration, The Eurasian Economic Union, The European Union, The Shanghai Cooperation Organization, the silk road economic belt

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3189 Back to Basics: Redefining Quality Measurement for Hybrid Software Development Organizations

Authors: Satya Pradhan, Venky Nanniyur

Abstract:

As the software industry transitions from a license-based model to a subscription-based Software-as-a-Service (SaaS) model, many software development groups are using a hybrid development model that incorporates Agile and Waterfall methodologies in different parts of the organization. The traditional metrics used for measuring software quality in Waterfall or Agile paradigms do not apply to this new hybrid methodology. In addition, to respond to higher quality demands from customers and to gain a competitive advantage in the market, many companies are starting to prioritize quality as a strategic differentiator. As a result, quality metrics are included in the decision-making activities all the way up to the executive level, including board of director reviews. This paper presents key challenges associated with measuring software quality in organizations using the hybrid development model. We introduce a framework called Prevention-Inspection-Evaluation-Removal (PIER) to provide a comprehensive metric definition for hybrid organizations. The framework includes quality measurements, quality enforcement, and quality decision points at different organizational levels and project milestones. The metrics framework defined in this paper is being used for all Cisco systems products used in customer premises. We present several field metrics for one product portfolio (enterprise networking) to show the effectiveness of the proposed measurement system. As the results show, this metrics framework has significantly improved in-process defect management as well as field quality.

Keywords: quality management system, quality metrics framework, quality metrics, agile, waterfall, hybrid development system

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3188 Psychological Skills Training for Severely Injured Athletes to Enhance Recovery and Return to Sport

Authors: John E Coumbe-Lilley

Abstract:

This IRB-approved study explored athletes' emotional recovery experiences following a severe sports injury keeping them out of their sport for six months or longer. A realistic thematic analytical approach was used to interpret the findings of 44 semi-structured interviews of athletes who competed at high school, college, and professional levels of competition. Thematic analysis validated by a self-rating scale demonstrated athletes cross a series of emotional thresholds during their injury rehabilitation process. Results showed athletes crossed two to six emotional thresholds before positive emotion and coping were consistently experienced following their injury. Athletes reported being unequipped to cope with negative emotional intensity, the longevity of recovery, and enduring depression during long-term rehabilitation. Positive emotional recovery was expected no sooner than nine months and up to 2.5 years following a sports injury. In addition, 100% of athletes received no psychological skills training (PST) for coping and recovery, and 93% of athletes indicated passive psychological coping strategies in the first month following injury, which extended their time to recover. Athletes recommended immediate, realistic, and evidence-based strategies benefitting the emotional recovery of severely injured athletes emotional recovery to improve athletes' emotional well-being during long-term rehabilitation and enhance their return to sport. Future experimental research might compare the post-PST program that emerged from this study to determine its efficacy in improving the recovery of severely injured athletes.

Keywords: sports, injury, rehabilitation, psychological skills training, coping

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3187 Applied of LAWA Classification for Assessment of the Water by Nutrients Elements: Case Oran Sebkha Basin

Authors: Boualla Nabila

Abstract:

The increasing demand on water, either for the drinkable water supply, or for the agricultural and industrial custom, requires a very thorough hydrochemical study to protect better and manage this resource. Oran is relatively a city with the worst quality of the water. Recently, the growing populations may put stress on natural waters by impairing the quality of the water. Campaign of water sampling of 55 points capturing different levels of the aquifer system was done for chemical analyzes of nutriments elements. The results allowed us to approach the problem of contamination based on the largely uniform nationwide approach LAWA (LänderarbeitsgruppeWasser), based on the EU CIS guidance, has been applied for the identification of pressures and impacts, allowing for easy comparison. Groundwater samples were analyzed, also, for physico-chemical parameters such as pH, sodium, potassium, calcium, magnesium, chloride, sulphate, carbonate and bicarbonate. The analytical results obtained in this hydrochemistry study were interpreted using Durov diagram. Based on these representations, the anomaly of high groundwater salinity observed in Oran Sebkha basin was explained by the high chloride concentration and to the presence of inverse cation exchange reaction. Durov diagram plot revealed that the groundwater has been evolved from Ca-HCO3 recharge water through mixing with the pre-existing groundwater to give mixed water of Mg-SO4 and Mg-Cl types that eventually reached a final stage of evolution represented by a Na-Cl water type.

Keywords: contamination, water quality, nutrients elements, approach LAWA, durov diagram

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3186 The Need for a One Health and Welfare Approach to Animal Welfare in Industrial Animal Farming

Authors: Clinton Adas

Abstract:

Antibiotic resistance has been identified by the World Health Organisation as a real possibility for the 21st Century. While many factors contribute to this, one of the more significant is industrial animal farming and its effect on the food chain and environment. Livestock consumes a significant portion of antibiotics sold globally, and these are used to make animals grow faster for profit purposes, to prevent illness caused by inhumane living conditions, and to treat disease when it breaks out. Many of these antibiotics provide little benefit to animals, and most are the same as those used by humans - including those deemed critical to human health that should therefore be used sparingly. Antibiotic resistance contributes to growing numbers of illnesses and death in humans, and the excess usage of these medications results in waste that enters the environment and is harmful to many ecological processes. This combination of antimicrobial resistance and environmental degradation furthermore harms the economic well-being and prospects of many. Using an interdisciplinary approach including medical, environmental, economic, and legal studies, the paper evaluates the dynamic between animal welfare and commerce and argues that while animal welfare is not of great concern to many, this approach is ultimately harming human welfare too. It is, however, proposed that both could be addressed under a One Health and Welfare approach, as we cannot continue to ignore the linkages between animals, the environment, and people. The evaluation of industrial animal farming is therefore considered through three aspects – the environmental impact, which is measured by pollution that causes environmental degradation; the human impact, which is measured by the rise of illnesses from pollution and antibiotics resistance; and the economic impact, which is measured through costs to the health care system and the financial implications of industrial farming on the economic well-being of many. These three aspects are considered in light of the Sustainable Development Goals that provide additional tangible metrics to evidence the negative impacts. While the research addresses the welfare of farmed animals, there is potential for these principles to be extrapolated into other contexts, including wildlife and habitat protection. It must be noted that while the question of animal rights in industrial animal farming is acknowledged and of importance, this is a separate matter that is not addressed here.

Keywords: animal and human welfare, industrial animal farming, one health and welfare, sustainable development goals

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3185 Optical Emission Studies of Laser Produced Lead Plasma: Measurements of Transition Probabilities of the 6P7S → 6P2 Transitions Array

Authors: Javed Iqbal, R. Ahmed, M. A. Baig

Abstract:

We present new data on the optical emission spectra of the laser produced lead plasma using a pulsed Nd:YAG laser at 1064 nm (pulse energy 400 mJ, pulse width 5 ns, 10 Hz repetition rate) in conjunction with a set of miniature spectrometers covering the spectral range from 200 nm to 720 nm. Well resolved structure due to the 6p7s → 6p2 transition array of neutral lead and a few multiplets of singly ionized lead have been observed. The electron temperatures have been calculated in the range (9000 - 10800) ± 500 K using four methods; two line ratio, Boltzmann plot, Saha-Boltzmann plot and Morrata method whereas, the electron number densities have been determined in the range (2.0 – 8.0) ± 0.6 ×1016 cm-3 using the Stark broadened line profiles of neutral lead lines, singly ionized lead lines and hydrogen Hα-line. Full width at half maximum (FWHM) of a number of neutral and singly ionized lead lines have been extracted by the Lorentzian fit to the experimentally observed line profiles. Furthermore, branching fractions have been deduced for eleven lines of the 6p7s → 6p2 transition array in lead whereas the absolute values of the transition probabilities have been calculated by combining the experimental branching fractions with the life times of the excited levels The new results are compared with the existing data showing a good agreement.

Keywords: LIBS, plasma parameters, transition probabilities, branching fractions, stark width

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3184 Effect of Project Control Practices on the Performance of Building Construction Companies in Uganda: A Case Study of Kampala City

Authors: Tukundane Hillary

Abstract:

This research paper analytically evaluates the project control practice levels used by the building construction companies within Kampala, Uganda. The research also assesses the outcome of project control practices on the productivity of the companies. The research was performed to ascertain the current control practices among 160 respondents from various construction companies registered with the Uganda Registration Services Bureau. This research used amalgamation from multiple literature to obtain the variables. The research adopts 34 standard control practices from four vital project control duties: planning, monitoring, analyzing, and reporting. These project control tasks were organized using mean response ratings grounded on their relevance to the construction companies. Results showed that evaluating performance with the use of curves (4.32), timely access to information and encouragement (4.55), report representation using quantitative tools 4.75, and cost value comparison application during analysis (4.76) were rated least among the control practices. On the other hand, the top project control practices included formulation of the project schedule (8.88), Project feasibility validation (8.86), Budgeting for each activity (8.84), Key project route definition (8.81), Team awareness of the budget (8.77), Setting realistic targets for projects (8.50) and Consultation from subcontractors (8.74). From the results obtained by the sample respondents specified, it can be concluded that planning is the most vital project control task practiced in the building construction industry in Uganda. In addition, this research ascertained a substantial relationship between project control practices and the performance of building construction companies. Accordingly, this research recommends that project control practices be effectively observed by both contracting and consulting companies to enhance their overall performance and governance.

Keywords: cost value, project control, cost control, time control, project performance, control practices

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3183 Relationship Building Between Peer Support Worker and Person in Recovery in the Community-based One-to-One Peer Support Service of Mental Health Setting

Authors: Yuen Man Yan

Abstract:

Peer support has been a rising prevalent mental health service in the globe. The community-based mental health services employ persons with lived experience of mental illness to be peer support workers (PSWs) to provide peer support service to those who are in the progress of recovery (PIRs). It represents the transformation of mental health service system to a recovery-oriented and person-centered care. Literatures proved the feasibility and effectiveness of the peer support service. Researchers have attempted to explore the unique good qualities of peer support service that benefit the PIRs. Empirical researches found that the strength of the relationship between those who sought for change and the change agents positively related to the outcomes in one-to-one therapies across theoretical orientations. However, there is lack of literature on investigating the relationship building between the PSWs and PIRs in the one-to-one community-based peer support service. This study aims to identify and characterise the relationship in the community-based one-to-one peer support service from the perspectives of PSWs and PIRs; and to conceptualize the components of relationship building between PSWs and PIRs in the community-based one-to-one peer support service. The study adopted the constructivist grounded theory approach. 10 pairs of the PSWs and PIRs participated in the study. Data were collected through multiple qualitative methods, including observation of the interaction and exchange of the PSWs and PIRs in the 1ₛₜ, 3ᵣ𝒹 and 9th sessions of the community-based one-to-one peer support service; and semi-structural interview with the PSWs and PIRs separately after the 3ᵣ𝒹and 9ₜₕ session of the peer support service. This presentation is going to report the preliminary findings of the study. PSWs and PIRs identified their relationship as “life alliance”. Empathy was found to be one of key components of the relationship between the PSWs and the PIRs. Unlike the empathy, as explained by Carl Roger, in which the service provider was able to put themselves into the shoes of the service recipients as if he was the service recipients, the intensity of the empathy was much greater in the relationship between PSWs and PIRs because PSWs had the lived experience of mental illness and recovery. The dimensions of the empathy in the relationship between PSWs and PIRs was found to be multiple, not only related to the mental illness but also related to various aspects in life, like family relationship, employment, interest of life, self-esteem and etc.

Keywords: person with lived experience, peer support worker, peer support service, relationship building, therapeutic alliance, community-based mental health setting

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3182 Improving Climate Awareness and the Knowledge Related to Climate Change's Health Impacts on Medical Schools

Authors: Abram Zoltan

Abstract:

Over the past hundred years, human activities, particularly the burning of fossil fuels, have released enough carbon dioxide and other greenhouse gases to dissipate additional heat into the lower atmosphere and affect the global climate. Climate change affects many social and environmental determinants of health: clean air, safe drinking water, and adequate food. Our aim is to draw attention to the effects of climate change on the health and health care system. Improving climate awareness and the knowledge related to climate change's health impacts are essential among medical students and practicing medical doctors. Therefore, in their everyday practice, they also need some assistance and up-to-date knowledge of how climate change can endanger human health and deal with these novel health problems. Our activity, based on the cooperation of more universities, aims to develop new curriculum outlines and learning materials on climate change's health impacts for medical schools. Special attention is intended to pay to the possible preventative measures against these impacts. For all of this, the project plans to create new curriculum outlines and learning materials for medical students, elaborate methodological guidelines and create training materials for medical doctors' postgraduate learning programs. The target groups of the project are medical students, educational staff of medical schools and universities, practicing medical doctors with special attention to the general practitioners and family doctors. We had searched various surveys, domestic and international studies about the effects of climate change and statistical estimation of the possible consequences. The health effects of climate change can be measured only approximately by considering only a fraction of the potential health effects and assuming continued economic growth and health progress. We can estimate that climate change is expected to cause about 250,000 more deaths. We conclude that climate change is one of the most serious problems of the 21st century, affecting all populations. In the short- to medium-term, the health effects of climate change will be determined mainly by human vulnerability. In the longer term, the effects depend increasingly on the extent to which transformational action is taken now to reduce emissions. We can contribute to reducing environmental pollution by raising awareness and by educating the population.

Keywords: climate change, health impacts, medical students, education

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3181 Bi-Criteria Vehicle Routing Problem for Possibility Environment

Authors: Bezhan Ghvaberidze

Abstract:

A multiple criteria optimization approach for the solution of the Fuzzy Vehicle Routing Problem (FVRP) is proposed. For the possibility environment the levels of movements between customers are calculated by the constructed simulation interactive algorithm. The first criterion of the bi-criteria optimization problem - minimization of the expectation of total fuzzy travel time on closed routes is constructed for the FVRP. A new, second criterion – maximization of feasibility of movement on the closed routes is constructed by the Choquet finite averaging operator. The FVRP is reduced to the bi-criteria partitioning problem for the so called “promising” routes which were selected from the all admissible closed routes. The convenient selection of the “promising” routes allows us to solve the reduced problem in the real-time computing. For the numerical solution of the bi-criteria partitioning problem the -constraint approach is used. An exact algorithm is implemented based on D. Knuth’s Dancing Links technique and the algorithm DLX. The Main objective was to present the new approach for FVRP, when there are some difficulties while moving on the roads. This approach is called FVRP for extreme conditions (FVRP-EC) on the roads. Also, the aim of this paper was to construct the solving model of the constructed FVRP. Results are illustrated on the numerical example where all Pareto-optimal solutions are found. Also, an approach for more complex model FVRP with time windows was developed. A numerical example is presented in which optimal routes are constructed for extreme conditions on the roads.

Keywords: combinatorial optimization, Fuzzy Vehicle routing problem, multiple objective programming, possibility theory

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3180 The Effect of Bihemisferic Transcranial Direct Current Stimulation Therapy on Upper Extremity Motor Functions in Stroke Patients

Authors: Dilek Cetin Alisar, Oya Umit Yemisci, Selin Ozen, Seyhan Sozay

Abstract:

New approaches and treatment modalities are being developed to make patients more functional and independent in stroke rehabilitation. One of these approaches is transcranial direct stimulation therapy (tDCS), which aims to improve the hemiplegic upper limb function of stroke patients. tDCS therapy is not in the routine rehabilitation program; however, the studies about tDCS therapy on stroke rehabilitation was increased in recent years. Evaluate the effect of tDCS treatment on upper extremity motor function in patients with subacute stroke was aimed in our study. 32 stroke patients (16 tDCS group, 16 sham groups) who were hospitalized for rehabilitation in Başkent University Physical Medicine and Rehabilitation Clinic between 01.08.2016-20.01-2018 were included in the study. The conventional upper limb rehabilitation program was used for both tDCS and control group patients for 3 weeks, 5 days a week, for 60-120 minutes a day. In addition to the conventional stroke rehabilitation program in the tDAS group, bihemispheric tDCS was administered for 30 minutes daily. Patients were evaluated before treatment and after 1 week of treatment. Functional independence measure self-care score (FIM), Brunnstorm Recovery Stage (BRS), and Fugl-Meyer (FM) upper extremity motor function scale were used. There was no difference in demographic characteristics between the groups. There were no significant differences between BRS and FM scores in two groups, but there was a significant difference FIM score (p=0.05. FIM, BRS, and FM scores are significantly in the tDCS group, when before therapy and after 1 week of therapy, however, no difference is found in the shame group (p < 0,001). When FBS and FM scores were compared, there were statistical significant differences in tDCS group (p < 0,001). In conclusion, this randomized double-blind study showed that bihemispheric tDCS treatment was found to be superior to upper extremity motor and functional enhancement in addition to conventional rehabilitation methods in subacute stroke patients. In order for tDCS therapy to be used routinely in stroke rehabilitation, there is a need for more comprehensive, long-termed, randomized controlled clinical trials in order to find answers to many questions, such as the duration and intensity of treatment.

Keywords: cortical stimulation, motor function, rehabilitation, stroke

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