Search results for: federal hospitals

Authors: Katerine Moraes dos Satons, Gisele Massante Peixoto Tracera, Regina Célia Gollner Zeitoune

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To analyze the psychosocial risks related to the organization of nursing work in outpatient clinics of university hospitals. Cross-sectional epidemiological study developed in 11 outpatient units linked to the three public universities of the city of Rio de Janeiro, Brazil. Participants were 388 nursing professionals who worked in patient care at the time of the research. Data were collected from July to December 2018, using a self-applicable instrument. A questionnaire was used for sociodemographic, occupational and health characterization, and the Work Organization Scale. The bivariate analyses were performed using the odds ratio (OR), with a confidence interval of 95%, significance level of 5%. The organization of nursing work received an assessment of medium psychosocial risk by the professionals participating in the research, demanding interventions in the short and medium term. There was no association between sociodemographic, occupational and health characteristics and the organization of outpatient work. Interventional measures should be performed in the psychosocial risk factors presented in this research, with a view to improving the work environment, so that the importance of maintaining satisfactory material conditions is considered, as well as the adequate quantity of human resources. In addition, it aims to expand the spaces of nursing participation in decision- making, strengthening its autonomy as a profession.

Keywords: occupational risks, nursing, nursing team, worker’s health, psychosocial risks

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Authors: Rameesha Javaid

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Agriculture is the backbone of the economy of the province of Balochistan which is known as the ‘fruit basket’ of Pakistan. Its climate zones comprising highlands and plateaus, dependent on rain water, are more suited for the production of deciduous fruit. The vagaries of weather and more so the persistent droughts prompted the government to announce flat rates of electricity bills per month irrespective of the size of the farm, quantum or water used and the category of crop group. That has, no doubt, resulted in increased cropping intensity, more production and employment but has enormously burdened the official exchequer which picks up the residual bills in certain percentages amongst the federal and provincial governments and the local electricity company. This study tests the desirability of continuing the subsidy in the present mode. Optimization of social welfare of farmers has been the focus of the study with emphasis on the contribution of positive externalities and distortions caused in terms of negative externalities. By using the optimization technique with due allowance for distortions, it has been established that the subsidy calls for limiting policy distortions as they cause sub-optimal utilization of the tube well subsidy and improved policy programming. The sensitivity analysis with changed rankings of contributing variables towards social welfare does not significantly change the result. Therefore it leads to the net findings and policy recommendations of significantly reducing the subsidy size, correcting and curtailing policy distortions and targeting the subsidy grant more towards small farmers to generate more welfare by saving a sizeable amount from the subsidy for investment in the wellbeing of the farmers in rural Balochistan.

Keywords: distortion, policy distortion, socio-cultural distortion, social welfare, subsidy

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Authors: Sharifah Mousli, Sona Taheri, Jiayuan He

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Autism spectrum disorder (ASD) is a complex developmental condition involving persistent difficulties with social communication, restricted interests, and repetitive behavior. The challenges associated with ASD can interfere with an affected individual’s ability to function in social, academic, and employment settings. Although there is no effective medication known to treat ASD, to our best knowledge, early intervention can significantly improve an affected individual’s overall development. Hence, an accurate diagnosis of ASD at an early phase is essential. The use of machine learning approaches improves and speeds up the diagnosis of ASD. In this paper, we focus on the application of unsupervised clustering methods in ASD as a large volume of ASD data generated through hospitals, therapy centers, and mobile applications has no pre-existing labels. We conduct a comparative analysis using seven clustering approaches such as K-means, agglomerative hierarchical, model-based, fuzzy-C-means, affinity propagation, self organizing maps, linear vector quantisation – as well as the recently developed optimization-based clustering (COMSEP-Clust) approach. We evaluate the performances of the clustering methods extensively on real-world ASD datasets encompassing different age groups: toddlers, children, adolescents, and adults. Our experimental results suggest that the COMSEP-Clust approach outperforms the other seven methods in recognizing ASD with well-separated clusters.

Keywords: autism spectrum disorder, clustering, optimization, unsupervised machine learning

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Authors: Harinder Singh

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The paper sheds light on the perceptions of the uninsured workers employed in the urban informal sector of India, towards the health insurance. In addition to this, it also explores the association of the identified perceptions with household decisions to enroll for health insurance schemes in India. Firstly the data taken from the primary survey of the uninsured workers employed in the urban informal sector was analyzed using exploratory factor analysis to evaluate the perceptions. Thereafter, logistic regression was employed to determine the association of the identified perceptions regarding the enrollment. Our study identifies twelve perceptions related to the health insurance enrollment of the uninsured workers employed in the urban informal sector of India. The study demonstrates that perceptions have the strongest association with the voluntary enrollment. These specifically relate to the lack of awareness about the need to buy health insurance; comprehensive coverage; income constraint; future contingencies and social obligations; lack of information; availability of subsidized government health care; linkage with government hospitals and preference for government schemes. Conclusions: Along with the food security, health security has become a crying need of the workers employed in the informal sector and the time has come to scale up the health insurance schemes for them in the country. Policy makers or marketers of health insurance policies should recognize the household perceptions as a potential barrier and try to develop a health insurance package as per the actual needs of the informal sector (low income) in India.

Keywords: association, enrollment, health insurance, informal sector, perceptions, uninsured

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Authors: Sai Rajeev Reddy, Ishita Roy, M. Anji Reddy

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The paper describes the importance of preventive measures and immediate Emergency logistics during accidents and unfortunate Disasters for the Hyderabad Metro Rails in their various stages of construction. This is the need of the modern generation where accidents, explosions, attacks and sudden crisis are frequent casualties which take huge tolls of life in the present world. The paper utilizes the workflow and application of Geographical information System (GIS) to provide information about problems and crisis structures for efficient Metro Transportation in the city. The study analyzes the difficulties and problems which cause accidents during operation and maintenance stages of the Metro Rail. The paper focuses upon the intermediate and firsthand information of Crisis with the help of GIS technology to share Disaster data for effective measures by the Cyber Police stations, Emergency Responders, Hospitals and First Aid Centre to act immediately and save lives. The results and conclusions have nevertheless proved very informative and useful for the safety board authorities of the Hyderabad Metro Rail. The operation and Maintenance are integral stages in the development of any Multipurpose transportation Projects and are usually prone to various Disasters and tragedies. Hence, the GIS technologies help in distribution of information among the masses with the web Technologies and advanced software developed to prevent and manage crisis widely and in a cost-benefits manner.

Keywords: Geographical Information System, emergency assessment, accident zones, surveillance

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Authors: Ahmad Hamidi Mohamed, Jamaluddin Othman, Mashitah Suid, Mohd Zaim Mohd Shukri

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Floods are considered an annual natural disaster in Kelantan. However, the record-setting flood of 2014 was a 'tsunami-like disaster'. A study has been conducted with the objectives to assess the economic impact of the flood to the resident of Dabong area in Kelantan Darul Naim, Malaysia. This area was selected due to the severity during the flood. The impacts of flood on local people were done by conducting structured interviews with the use of questionnaires. The questionnaire was intended to acquire information on losses faced by Dabong residence. Questionnaires covered various areas of inconveniences suffered with respect to health effects, including illnesses suffered, their intensities, duration and their associated costs. Loss of productivity and quality of life was also assessed. Inquiries were made to Government agencies to obtain relevant statistical data regarding the loss due to the flood tragedy. The data collected by giving formal request to the governmental agencies and formal meetings were done. From the study a staggering amount of losses were calculated. This figure comes from losses of property, Farmers/Agriculture, Traders/Business, Health, Insurance and Governmental losses. Flood brings hardship to the people of Dabong and these losses of home will cause inconveniences to the society. The huge amount of economic loss extracted from this study shows that federal and state government of Kelantan need to find out the cause of the major flood in 2014. Fast and effective measures have to be planned and implemented in flood prone area to prevent same tragedy happens in the future.

Keywords: economic impact, flood tragedy, Malaysia, property losses

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Authors: Aliyu Damri

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This study analyzed the emergence of WhatsApp and how employees at the Federal Radio Corporation of Nigeria, Kaduna defined the concept base on their vast broadcasting experiences for over five decades and application of the phenomenon to the radio station. It also analyzed the nature, patterns, dimensions, features, challenges as well as the effects of WhatsApp as a social networking site with specific interest on the radio outlet. Also, the study identified how the radio organization responded to the challenges in an attempt to adapt to the new pattern of broadcasting characterized by many technological transformations. The study further explained in details such skills journalists need to function optimally using WhatsApp as well as the impacts of the WhatsApp on radio broadcasting. It used a combination of published materials, focus group discussion, in depth interviews and participant observation on the activities of the radio stations to address the research questions. The data generated provided insight to better understand the challenges posed to FRCN Kaduna as a result of WhatsApp application and how FRCN Kaduna responded to the challenges. It also provided information on the skills journalists need to function optimally in using WhatsApp application in the radio station. The interview and focus group discussion’s transcripts and the published materials were analyzed along thematic pattern related to the research questions in the study. The dominant response relied heavily on change in the radio station’s organizational and technical integration of newsrooms, the use of a multiskilled workforce, application of a flexible and user-friendly technology in all aspects of production, expansion of the station’s services in to new media such as internet and mobile phones as well as sharing of ideas across different units in the radio outfit.

Keywords: broadcasting, challenge, northern Nigeria, radio, WhatsApp application

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Authors: Jenny Ringblom, Marie Proczkowska, Laura Korhonen, Ingrid Wåhlin

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Background: Emergence delirium is a well-known behaviour of perceptual disturbances that may occur after general anaesthesia in children. Children with emergence delirium are often confused; they cry, are involuntarily physically active and are almost impossible to console. The prevalence varies considerably between about 13% and 53%. Research has mainly focused on how different medication accents affect the incidence of emergence delirium, but less is known about parents’ experiences of emergence delirium during the recovery process. Aim: The aim of this study was to describe parents’ experiences and reflections during their child's emergence delirium behaviour when recovering from anaesthesia. Method: The study has a qualitative design, and the data has been analyzed using thematic analysis. A total of 16 parents were interviewed at two county hospitals in Sweden. Results: When the parents reunited with their child at the recovering unit, they felt as if they were encountering an incomprehensible scenario. When watching their child demonstrating emergence delirium, they experienced fear and insecurity and had feelings of powerlessness and guilt. Information and previous experience turned out to offer relief and being seen by the healthcare staff when they, in their vulnerability, failed to reach or console their child gave hope and energy. Conclusion: Emergence delirium must be extensively considered in children undergoing general anaesthesia. Healthcare staff needs to be aware of the parental difficulties it may cause. There is also important to know what parents experience as relieving, such as receiving information and when staff members are being available, responsive and supportive during the wake-up period.

Keywords: emergence delirium, experiences, pediatrics, parents, postoperative care

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Authors: Maria T. Cruz, Scott N. Thompson

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In recent years, Canadian federal and provincial law enforcement organizations have implemented numerous mental health strategies in an attempt to address officers’ mental health and wellness needs. Despite these reforms, however, mental illness continues to persist in these populations. Whereas workplace stressors continue to be factored into the development of mental health initiatives, it is proposed that aspects of masculine culture have been overlooked as contributing to the prevalence of mental illness among Canadian officers. By drawing on Michel Foucault’s theory of discourse, this study was conducted to determine if elements of masculine discourse exist as a socio-cultural barrier for officers seeking mental health assistance. This research supported the above hypothesis, and furthermore, identified how masculine discourse works in competition with mental health-related help-seeking discourses. To answer the research question, semi-structured phone interviews with active and retired male officers from Western provincial and municipal policing organizations, and the Royal Canadian Mounted Police were employed. Through thematic analysis of the transcripts, the data revealed three themes: i) masculinity in law enforcement is a determinant of workplace competency; ii) the dominance of masculine culture in law enforcement is problematic for mental health, and iii) improved help-seeking policies complicate how masculinity is expressed in law enforcement organizations. These findings suggest that within the reviewed Canadian law enforcement organizations, aspects of masculinity act as a socio-cultural barrier to officers seeking mental health services, and that the two conflicting discourses of masculinity and mental health-related help-seeking appear to be in competition with each other.

Keywords: competing discourses, dominant discourses, Foucault’s theory of discourse, law enforcement, masculinity, mental health, police officers

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Authors: Elvira Loibl

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In Western countries, the demand for adoptable children, especially healthy babies, has been considerably high for several years. Rising infertility rates, liberal abortion politics, the widespread use of contraception, and the increasing acceptance of unmarried motherhood are factors that have decreased the number of infants available for domestic adoption in the U.S. and Europe. As a consequence, many involuntarily childless couples turn to intercountry adoption as a viable alternative to have a child of their own. However, the demand for children far outpaces the supply of orphans with the desired characteristics. The imbalance between the number of prospective adopters and the children available for intercountry adoption results in long waiting lists and high prices. The inordinate sums of money involved in the international adoption system have created a commercial ‘underbelly’ where unethical and illicit practices are employed to provide the adoption market with adoptable children. Children are being purchased or abducted from their families, hospitals or child care institutions and then trafficked to receiving countries as ‘orphans’. This paper aims to uncover and explain the factors of the German adoption system that are conducive to child trafficking for adoption purposes. It explains that the tension between money and integrity as experienced by German adoption agencies, blind trust in the authorities in the sending countries as well as a lenient control system encourage and facilitate the trafficking in children to Germany.

Keywords: child trafficking, intercountry adoption, market in adoptable babies, German adoption system

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Authors: Daniel Llanes, Alfredo Reyes, Sonia E. Ruiz, Federico Valenzuela Beltran

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Steel frames have been used in building construction for more than one hundred years. Beam-column may be connected to columns using either stiffened or unstiffened angles at the top and bottom beam flanges. Designers often assume that these assemblies acted as “pinned” connections for gravity loads and that the stiffened connections would act as “fixed” connections for lateral loads. Observation of damages sustained by buildings during the 1994 Northridge earthquake indicated that, contrary to the intended behavior, in many cases, brittle fractures initiated within the connections at very low levels of plastic demand, and in some cases, while the structures remained essentially elastic. Due to the damage presented in these buildings other type of alternative connections have been proposed. According to a research funded by the Federal Emergency Management Agency (FEMA), the screwed connections have better performance when they are subjected to cyclic loads, but at the same time, these connections have some degree of flexibility. Due to this situation, some researchers ventured into the study of semi-rigid connections. In the present study three steel buildings, constituted by regular frames are analyzed. Two types of connections are considered: pinned and semi-rigid connections. With the aim to estimate their structural capacity, a number of incremental dynamic analyzes are performed. 3D structural models are used for the analyses. The seismic ground motions were recorded on sites near Los Angeles, California, where the structures are supposed to be located. The vulnerability curves of the building are obtained in terms of maximum inter-story drifts. The vulnerability curves (which correspond to the models with two different types of connections) are compared, and its implications on its structural design and performance is discussed.

Keywords: steel frame Buildings, vulnerability curves, semi-rigid connections, pinned connections

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Authors: Daisy Saikia

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Long-term maternal health issues with Caesarean section deliveries are significant. Thus, this study aims to investigate the prevalence of caesarean section deliveries in India and to comprehend its associated predictors in light of the high caesarean section delivery rate. The study uses data from the fifth National Family Health Surveys (NFHS-5) round. Specifically, live births to women aged 15-49 in the 5 years preceding the survey. Binary logistic regression was used to check the adjusted effects of the predictor variables on caesarean section delivery. STATA/SE v16.0 was used for the data analysis with a 5% significance level. Twenty-two per cent of the live births to women were delivered by caesarean section. There was socio-economic, demographic and geographical variation in the prevalence of caesarean section delivery in India. Increasing age, body mass index, marital status, mother’s occupation and education, birth order, place of delivery, full ANC, non-tribal status, wealth quintile and region are significantly associated with caesarean section deliveries in India. Caesarean section deliveries should only be performed when essential from a medical perspective, and regions, where the rate is too high, should follow the guidelines. Additionally, it needs to be investigated whether private hospitals compel patients to have caesarean section deliveries to increase their revenue. Thus, these unnecessary deliveries must be examined immediately for safe childbirth and the wellness of both mother and child.

Keywords: caesarean section, delivery, maternal health, India

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Authors: Pia Moschall, Kathrin Sackmann

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Considering a purchasing volume of around two trillion Euros per year, which equals about 14% of the European Union’s gross domestic product, European public authorities have significant market power. Making use of this market power by prioritizing the procurement of green products and services offers a great potential to contribute to the Green New Deal. The market demand that is created by Green Public Procurement (GPP) sets incentives for European producers to design and develop Green Products and Eco-Innovations. However, most procurement still does not consider environmental criteria. The goal of the work is to encourage the adaptation of GPP in the European Union. To this end, the drivers for the adaptation were investigated over different case studies. The paper analyzes good-practice cases from European authorities from 2010 to 2020 that were provided by the European Commission. This analysis was guided by Philipp Mayring’s method of qualitative content analysis, whereby the inductively formed categories led to the identification of nine major drivers. The most important ones are ‘use of official guidelines and standards, ‘political support and requirements as well as ‘market research and involvement.’ Further, the paper discusses mutual dependencies between several drivers and how to exploit them. A supporting infrastructure was identified as a crucial factor for the successful adaption of green public procurement. In the next step, the work aims to examine on which administrative level the single drivers can be implemented most effectively. Practical implications of this research are recommendations on how to create a supporting structure on a municipal, federal and national level, including training for the responsible staff, support tools, as well as guidelines and standards for involved stakeholders.

Keywords: content analysis, green public procurement, public authorities, sustainable procurement

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Authors: Sonam Kelzang

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Background: Penetrating injuries as a result of traditional sports (Archery and Khuru) are commonly seen in Bhutan. To our knowledge, there is no study carried out looking into the data of penetrating injuries due to traditional sports. Aim: This is a retrospective analysis of cases of penetrating injuries as a result of traditional sports admitted to JDWNRH over the last 3 years to draw an inference on the pattern of injury and associated morbidity and mortality. Method: Data on penetrating injuries related to traditional sports (Archery and Khuru) were collected and reviewed over the period of 3 years. Assault cases were excluded. For each year we analysed age, sex, parts of the body affected, agent of injury and whether admission was required or not. Results: Out of the total 44 victims of penetrating injury by traditional sports (Archery and Khuru) between 2013 and 2015 (average of 15 cases of penetrating injuries per year). Eighty-five percent were male and 15% were female. Their age ranged from 4 yrs to 62 years. Sixty-one percent of the victims were in the working age group of 19-58 years; 30% of the victims were referred from various district hospitals; 38% of the victims needed admission; 42 % of the victims suffered injury to the head; and 54% of the injuries were caused by Khuru. Conclusion: Penetrating injuries due to traditional sports admitted to JDWNRH, Thimphu, remained same over the three years period despite safety regulations in place. Although there were no deaths during the last three years, morbidity still remains high.

Keywords: archery, Bhutan, Khuru, darts

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Authors: Abdullah Işıktaş, Kevser Dincer

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The use of HEPA filters for air conditioning systems in clean rooms tends to increase progressively in pharmaceutical, food stuff industries and in hospitals. There are two standards widely used for HEPA filters; the EN 1822 standards published by the European Union, CEN (European Committee for Standardization) and the US based IEST standard (Institute of Environmental Sciences and Technology. Both standards exhibit some differences in the definitions of efficiency and its measurement methods. While IEST standard defines efficiency at the grit diameter of 0.3 µm, the EN 1822 standard takes MPPS (Most Penetrating Particle Size) as the basis of its definition. That is, the most difficult grit size to catch up. On the other hand, while IEST suggests that photometer and grit counters be used for filter testing, in EN 1822 standard, only the grit (grain) counters are recommended for that purpose. In this study, powder holding capacities of H13 and H14 grade materials under the EN 779 standard are investigated experimentally by using activated carbon. Measurements were taken on an experimental set up based on the TS 932 standard. Filter efficiency was measured by injecting test powder at amounts predetermined in the standards into the filters at certain intervals. The data obtained showed that the powder holding capacities of the activated carbon filter are high enough to yield efficiency of around 90% and that the H13 and H14 filters exhibit high efficiency suitable for the standard used.

Keywords: activated carbon filters, HEPA filters, powder holding capacities, air conditioning systems

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Authors: Ganiyu Rasaq Omokeji

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The growing recognition of the pivotal role of universities in promoting socio-economic development has led to a focus upon the expansion of the sector around the world. As the economy and society become more ‘knowledge intensive’, the role of universities in development is more onerous than just teaching, research, and service. It is to help create the open society upon which the progress of ideas depends on. Driven to fulfill this role, universities are likely to become even more important in building regional networks of their host communities. Currently, there are about 129 universities in Nigeria, with a total number of 37 federal, 36 state, and 56 privately owned universities. Fountain University is among the private universities in Nigeria located in Osogbo, Osun State. The university is committed to the total development of men and women in an enabling environment, through appropriate teaching, research, and service to humanity, influenced by Islamic ethics and culture. The university focuses on educational development and growth that are relevant to the nation’s manpower needs and global competitiveness through a gradual but steady process. This paper examines the role of Private University in the socio-economic development of host community using Fountain University as a case study. The research methodology design for this paper has a total of 200 respondents. The research instrument of data collection was a questionnaire and in-depth interview (IDI). The finding reveals that Fountain University plays an important role in socio-economic and cultural development through their Islamic culture. The paper recommend that universities must bridge the gaps between creative individual with innovative ideas and the application of technology for economic progress and social betterment of their host communities. University also must serve as a bridge that carries the traffic of social and economic development.

Keywords: private university, socio-economic development, host communities, role of universities and community development

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Authors: Ephraim Ugwu, Christopher Ehinomen

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Despite efforts by the Nigerian government to harmonize the macroeconomic policy implementations by establishing various committees to resolve disputes between the fiscal and monetary authorities, it is still evident that the federal government had continued its expansionary policy by increasing spending, thus creating huge budget deficit. This study evaluates the effect of macroeconomic policy coordination on economic growth uncertainty in Nigeria from 1980 to 2020. Employing the Auto regressive distributed lag (ARDL) bound testing procedures, the empirical results shows that the error correction term, ECM(-1), indicates a negative sign and is significant statistically with the t-statistic value of (-5.612882 ). Therefore, the gap between long run equilibrium value and the actual value of the dependent variable is corrected with speed of adjustment equal to 77% yearly. The long run coefficient results showed that the estimated coefficients of the intercept term indicates that other things remains the same (ceteris paribus), the economics growth uncertainty will continue reduce by 7.32%. The coefficient of the fiscal policy variable, PUBEXP, indicates a positive sign and significant statistically. This implies that as the government expenditure increases by 1%, economic growth uncertainty will increase by 1.67%. The coefficient of monetary policy variable MS also indicates a positive sign and insignificant statistically. The coefficients of merchandise trade variable, TRADE and exchange rate EXR show negative signs and significant statistically. This indicate that as the country’s merchandise trade and the rate of exchange increases by 1%, the economic growth uncertainty reduces by 0.38% and 0.06%, respectively. This study, therefore, advocate for proper coordination of monetary, fiscal and exchange rate policies in order to actualize the goal of achieving a stable economic growth.

Keywords: macroeconomic, policy coordination, growth uncertainty, ARDL, Nigeria

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Authors: Anmol Patel

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Cardiopulmonary resuscitation is medical intervention which should be considered for all inpatients; with a patient centred approach, open communication and accurate documentation of clinical decisions. National enquiries have shown that in a significant number of cases CPR was attempted when it was considered inappropriate. In these circumstances attempting to prevent a natural death and subjecting a patient to trauma at the end of life would deprive them of a dignified death. Anticipatory “do not attempt CPR (DNACPR)” decisions aim to prevent this for those considered appropriate. As a legal document, these forms are required to be completed accurately and thoroughly. The aim of this study was to evaluate the difference in quality of DNACPR forms completed using electronic versus paper formats. A retrospective review of DNACPR forms and related documentation was completed in two District General Hospitals in South-East England, one of which uses electronic forms, while the other uses paper red forms. 50 completed forms from each hospital were analysed to assess for legibility, and quality of completion of all subsections of the form, including communications with family, relatives and the Multidisciplinary team. The hospital using paper forms showed a 40-44% rate of completion of sections relating to communication with patients and family, compared to 70% with the hospital using electronic forms. Similar trends were observed with other sections of the form. Conclusion: This study suggests that the implementation of electronic DNACPR forms significantly improves clinical practice and promotes better open communication with patients, family and the MDT.

Keywords: DNACPR, resuscitation, DNAR, patient communication

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Authors: Azadeh Yaraghchi, Reza Bagherian Sararoodi, Niknaz Salehi Moghadam, Mohammad Hossein Mandegar, Adis Kraskian Mujembari, Omid Rezaei

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Background: Quality of life is one of the most important consequences of disease in psychosomatic disorders. Many psychological factors are considered in predicting quality of life in patients with coronary artery bypass graft (CABG). The present study was aimed to determine the relationship between perceived social support and quality of life in patients with coronary artery bypass graft (CABG). Methods: The population included 82 patients who had undergone CABG from October 2014 to May 2015 in four different hospitals in Tehran. The patients were evaluated with Multi-dimension scale of perceived social support (MSPSS) and after three months follow up were evaluated by Short-Form quality of life questionnaire (SF-36). The obtained data were analyzed through Pearson correlation test and multiple variable regression models. Findings: A relationship between perceived social support and quality of life in patients with CABG was observed (r=0.374, p<0.01). The results showed that 22.4% of variation in quality of life is predicted by perceived social support components (p<0.01, R2 =0.224). Conclusion: Based on the results, perceived social support is one of the predictors of quality of life in patients with coronary artery bypass graft. Accordingly, these results can be useful in conceiving proactive policies, detecting high risk patients and planning for psychological interventions.

Keywords: coronary artery bypass graft, perceived social support, psychological factors, quality of life

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Authors: Sana Gul, Sheeba Murad, Aneela Javed

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Introduction: Human Papilloma Virus (HPV) is small DNA virus mostly infecting mucosa and cutaneous keratinocytes. So far, more than 200 Human papillomaviruses are known. HPV have been divided into high- and low-risk on the basis of their oncogenic potential. High risk HPV is considered to be the main etiological cause for cervical cancer. Objective: Current study was designed to screen the local cervical cancer patients from the twin cities of Pakistan for the occurance of high risk HPV. Methodology: A total of 67 formalin fixed paraffin-embedded samples of cervical cancer biopsies were obtained from the government hospitals in Islamabad and Rawalpindi. Cervical cancer biopsies were examined for the presence of HPV DNA. Polymerase chain reaction (PCR) was used for the amplification of a region in the HPV-L1 gene for the general detection of the Papilloma virus and for the genotype specific detection of high risk HPV 16 and 18 using the GP5/GP6 primers and genotype specific primers respectively. Results: HPV DNA was detected in 59 out of 67 samples analyzed. 30 samples showed the presence of HPV16 while 22 samples were positive for HPV 18 . HPV subtype could not be determined in 7 samples. Conclusion: Our results show a strong association between HPV infection and cervical cancer among women in twin cities of Pakistan. One way to minimize the disease burden in relation to HPV infection in Pakistani population is the use of prophylactic vaccines and routine screening. An early diagnosis of HPV infection will allow better health management to reduce the risk of developing cervical cancer.

Keywords: cervical cancer, Pakistan, human papillomavirus, HPV 16

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Authors: Rameesha Javaid

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Balochistan, the largest landmass named after and dominated by the 55% Baloch population, which has had a difficult anti-center history like their brothers the Kurds of Middle East, reluctantly acceded to Pakistan in 1947. The region, which attained the status of a province after two decades of accession, has lagged behind in social development and economic growth as compared to the other three federating units. The province has seen the least financial autonomy and administrative decentralization both in autocratic and democratic dispensations under geostrategic and security considerations. Significant corrections have been recently made in the policy framework through changing the formula for intra-provincial National Finance Award, curtailing the number of subjects under federal control, and reactivating the Council of Common Interests. Yet policymaking remains overwhelmingly bureaucratic under a weak parliamentary oversight. The provincial coalition governments are unwieldy and directionless. The government machinery has much less than the optimal capability, character, integrity, will, and opportunity to perform. Decentralization further loses its semblance in the absence of local governments for long intervals and with the hold of hereditary tribal chiefs. Increased allocations failed to make an impact in the highest per capita cost environment due to long distances and scattered settlements. Decentralization, the basic ingredient of federalism has remained mortgaged to geo-strategic factors, internal security perceptions, autocratic and individualistic styles of governments, bureaucratic policymaking structures, bad governance, non-existent local governments, and feudalistic tribal lords. This suboptimal federalism speaks for the present underdevelopment in Balochistan and will earmark the milestones in the future.

Keywords: Balochistan, economic development, federalism, political economy

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Authors: Mozhgan Bahadory, Gholam-Hossein Rostami

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Over the next quarter of a century, the US government and the private sector will spend billions of dollars annually to clean the contaminated sites from pollution such as petroleum products, heavy metals, and solvents organic compounds. During the past three decades, almost 750,000 sites that require remediation have been reported to the United States federal and state agencies. Out of these contamination sites, approximately 300,000 are still in need of remediation. In these sites, the most widespread forms of contamination are petroleum products and heavy metals. At least half of US Department of Defense, US Department of Energy, Superfund sites, and Resource Conservation and Recovery Act (RCRA) sites have been reported to contain heavy metals. Heavy metals most often found in the contaminated water are lead, mercury, chromium, cadmium, arsenic, and zinc. This investigation emphasizes the elimination of arsenic and cadmium from aqueous solution. During the past several years, we developed a novel material called Alkali-Activated fly ash Material Permeable Reactive Barrier (AAM-PRB), which includes fly ash, fine aggregates, coarse aggregates, activating chemicals, and water. AAM can be produced with high permeability, 10-1 cm/s, then crushed into pelletized form. Laboratory experiments showed that water containing 10 ppm, 100 ppm, and 1000 ppm of arsenic and cadmium ion passing through AAM-PRB reduced to less than 0.1 ppm. However, water containing 10,000 ppm arsenic ion passing through AAM- PRB shows that the breakthrough was achieved. The removal of the mixture of arsenic and cadmium from aqueous solutions was also tested by using AAM-PRB. The results indicate that the efficiency of AAM-PRB for simultaneous removal of arsenic and cadmium from 10 ppm, 100 ppm, and 1,000 ppm were marginally below that of arsenic alone. Still, it was significantly lower for cadmium from the aqueous solution. The basic science behind removing heavy metal and microstructural investigation AAM-PRB will be the focus of our future work.

Keywords: arsenic, cadmium, contaminated water, fly ash, permeability, reactive barrier

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Authors: Saima Akbar, Tahseen Ullah Khan

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The analysis of the climate change impact on flood frequency represents an important issue for water resource management and flood risk mitigation. This research was conducted to address the effects of climate change on flood incidents of Pakistan and find out gaps in existing policies to reducing the environmental aspects on floods and effects of global warming. The main objective of this research was to critically analyses the National Climate Change Policy (NCCP), National Disaster Management Authority (NDMA), Federal Flood Commission (FFC) and Vision 2025, as an effective policy document which is not only hitting the target of a climate resilient Pakistan but provides room for efficient and flexible policy implementation. The methodology integrates projected changes in monsoon patterns (since last 20 years and overall change in rainfall pattern since 1901 to 2015 from Pakistan Metrological Department), glacier melting, decreasing dam capacity and lacks in existing policies by using SWOT (Strength, Weakness, Opportunities, Threats) model in order to explore the relative impacts of global warming on the system performance. Results indicate the impacts of climate change are significant, but probably not large enough to justify a major effort for adapting the physical infrastructure to expected climatic conditions in Vision 2025 which is our shared destination to progress, ultimate aspiration to see Pakistan among the ten largest economies of the world by 2047– the centennial year of our independence. The conclusion of this research was to adapt sustainable measures to reduce flood impacts and make policies as neighboring countries are adapting for their sustainability.

Keywords: climatic factors, monsoon, Pakistan, sustainability

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Authors: Devin Simmons

Abstract:

At the USDOT’s Bureau of Transportation Statistics, a biannual census of ferry operators in the U.S. is conducted, with results such as route mileage used to determine federal funding levels for operators. AIS data allows for the possibility of using GIS software and geographical methods to confirm operator-reported mileage for individual ferry routes. As part of the USDOT’s work on the ferry census, an algorithm was developed that uses AIS data for ferry vessels in conjunction with known ferry terminal locations to model the average route travelled for use as both a cartographic product and confirmation of operator-reported mileage. AIS data from each vessel is first analyzed to determine individual journeys based on the vessel’s velocity, and changes in velocity over time. These trips are then converted to geographic linestring objects. Using the terminal locations, the algorithm then determines whether the trip represented a known ferry route. Given a large enough dataset, routes will be represented by multiple trip linestrings, which are then filtered by DBSCAN spatial clustering to remove outliers. Finally, these remaining trips are ready to be averaged into one route. The algorithm interpolates the point on each trip linestring that represents the start point. From these start points, a centroid is calculated, and the first point of the average route is determined. Each trip is interpolated again to find the point that represents one percent of the journey’s completion, and the centroid of those points is used as the next point in the average route, and so on until 100 points have been calculated. Routes created using this algorithm have shown demonstrable improvement over previous methods, which included the implementation of a LOESS model. Additionally, the algorithm greatly reduces the amount of manual digitizing needed to visualize ferry activity.

Keywords: ferry vessels, transportation, modeling, AIS data

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Authors: Tatiana Belmonte dos Santos Rodrigues

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This is a comparative study between the training process of teachers of English as a foreign language in a Brazilian institution and an Italian institution, analyzing the academic curriculum, which includes courses mandatory internship activities, among other curricular aspects, and investigating the motivations that lead pre-service teachers to pursue a teaching career. The two institutions involved in this research are considered the oldest in Brazil, the Federal University of Amazonas, created in 1909, and the oldest in Italy, the University of Bologna, created in 1088. The general problem, or guiding question of this research, therefore, is: What is the role of the academic curriculum in motivating and consolidating the teaching of English as a Foreign Language (EFL) as a professional career? The hypothesis be investigated is that the degree courses of the two institutions apply in their curricula the pedagogical contours described in Shulman (2005), essential for the consolidation of the specificities of professional teacher training, which would lead to the strengthening of motivation pre-service professors to remain in this professional career plan, both for those who have already entered the course with pre-established external or internal motivations and for those who entered without apparent motivation. This is qualitative research (CRESWELL, 2007), with the application of field research, where documental analysis of the academic curriculum was carried out together with interviews with preservice teachers of the two institutions and analysis through interpretivism (MERTENS, 2010). The curriculum was analyzed in the light of Shulman (2005) and the interviewees' motivational discourse were analyzed from the perspective of Lovely (2012)'s discoveries. At the end, the data was crossed to answer the guiding question of the research, generating the proposed comparative study.

Keywords: preservice teachers, academic curriculum, motivation, english as a foreign language

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Authors: Gamalath M. B. P. Abeysekara

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Primary objective of any organization is to enhance the bottom line profit. Strategic procurement is one of the prominent aspects in view of receiving this ultimate objective. Strategic procurement is an activity used in each and every organization in their operations. Pharmaceutical procurement is an especially significant task for any organizations, particularly state sector concerned. The whole pharmaceutical procurement requirement of the country is procured through the State Pharmaceutical Corporation (SPC) of Sri Lanka. They follow Pharmaceutical Procurement Guideline of 2006 as the procurement principle. The main objective of this project is to identify the importance of State Pharmaceutical Corporation supplier selection criteria and critical analysis of pharmaceutical procurement procedure. State Pharmaceutical Corporations applied net price, product quality, past performance, and delivery of suppliers’ as main criteria for the selection suppliers. Data collection for this study was taken place through a questionnaire, given to fifty doctors within the Colombo district attached to five main state hospitals. Data analysis is carried out with mean and standard deviation functions. The ultimate outcomes indicated product quality, net price, and delivery of suppliers’ are the most important criteria behind the selection of suppliers. Critical analysis proved State Pharmaceutical Corporation should focus on net price reduction, improving laboratory testing facilities and effective communication between up and down stream of supply chain.

Keywords: government procurement procedure, pharmaceutical procurement supplier selection criteria, importance of SPC supplier selection criteria

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Authors: Nkereke M. Essien

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The intention of this paper is to examine stress in the Educated Nigerian Accent of English (ENAE) with the aim of analyzing stress and rhythmic patterns of Nigerian English. Our aim also is to isolate differences and similarities in the stress patterns studied and also know what forms the accent of these Educated Nigerian English (ENE) which marks them off from other groups or English’s of the world, to ascertain and characterize it and to provide documented evidence for its existence. Nigerian stress and rhythmic patterns are significantly different from the British English stress and rhythmic patterns consequently, the educated Nigerian English (ENE) features more stressed syllables than the native speakers’ varieties. The excessive stressed of syllables causes a contiguous “Ss” in the rhythmic flow of ENE, and this brings about a “jerky rhythm’ which distorts communication. To ascertain this claim, ten (10) Nigerian speakers who are educated in the English Language were selected by a stratified Random Sampling technique from two Federal Universities in Nigeria. This classification belongs to the education to the educated class or standard variety. Their performance was compared to that of a Briton (control). The Metrical system of analysis was used. The respondents were made to read some words and utterance which was recorded and analyzed perceptually, statistically and acoustically using the one-way Analysis of Variance (ANOVA). The Turky-Kramer Post Hoc test, the Wilcoxon Matched Pairs Signed Ranks test, and the Praat analysis software were used in the analysis. It was revealed from our findings that the Educated Nigerian English speakers feature more stressed syllables in their productions by spending more time in pronouncing stressed syllables and sometimes lesser time in pronouncing the unstressed syllables. Their overall tempo was faster. The ENE speakers used tone to mark prominence while the native speaker used stress to mark pronounce, typified by the control. We concluded that the stress pattern of the ENE speakers was significantly different from the native speaker’s variety represented by the control’s performance.

Keywords: accent, Nigerian English, rhythm, stress

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Authors: Karthikeyan Srinivasan, Ranjana Singh, Yatin Talwar, Karthikeyan Srinivasan

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Healthcare services play a vital role in the life of human being. The Setup of Hospital varies in wide spectrum of cost, technology, and access. Hospital’s of Public sector satisfies need of a common man to poorer, which can differ at private owned hospitals on cost and treatment. Patient assessing hospital frequently assumes spending time at the hospital is miserable and not aware of what is happening around them. Mostly they are queued up round the clock waiting to be admitted on hospital beds. The idea here is to highlight the role in admitting patient population of Outdoor as well as Emergency entering the Post Graduate Institute of Medical Education and Research, Chandigarh with available hospital beds. This study emphasizes the trend forecasting and acquiring beds needed. The conception “if patient population increases’ likewise increasing hospital beds advertently perceived. If tend to increase the hospital beds, thereby exploring budget, Manpower, space, and infrastructure make compulsion. This survey ideally draws out planning and forecasting beds to cater patient population in and around neighboring state of Chandigarh for admission at territory healthcare and research institute on available hospital beds. Executing healthcare services for growing population needs to know Roemer’s law indicating "in an insured population, a hospital bed built is a filled bed".

Keywords: admissions, average length of stay, bed days, hospital beds, occupancy rates

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Authors: Ezeamagu M.U, Madu B.C

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This study was designed to investigate the efficacy of 5Es constructivist-based instructional model on students’ retention in primary Mathematics. 5Es stands for Engagement, Exploration, Explanation, Elaboration and Evaluation. The study adopted the pre test post test non-equivalent control group quasi-experimental research design. The sample size for the study was one hundred and thirty four pupils (134), seventy six male (76) and fifty eight female (58) from two primary schools in Nsukka education zone. Two intact classes in each of the sampled schools comprising all the primary four pupils were used. Each of the schools was given the opportunity of being assigned randomly to either experimental or control group. The Experimental group was taught using 5Es model while the control group was taught using the conventional method. Two research questions were formulated to guide the study and three hypotheses were tested at p ≤ 0. 05. A Fraction Achievement Test (FAT) of ten (10) questions were used to obtain data on pupils’ retention. Research questions were answered using mean and standard deviation while hypotheses were tested using analysis of covariance (ANCOVA). The result revealed that the 5Es model was more effective than the conventional method of teaching in enhancing pupils’ performance and retention in mathematics, secondly there is no significant difference in the mean retention scores of male and female students taught using 5Es instructional model. Based on the findings, it was recommended among other things, that the 5Es instructional model should be adopted in the teaching of mathematics in primary level of the educational system. Seminar, workshops and conferences should be mounted by professional bodies, federal and state ministries of education on the use of 5Es model. This will enable the mathematics educator, serving teachers, students and all to benefit from the approach.

Keywords: constructivist, education, mathematics, primary, retention

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Authors: Seyyed Mohammad Amin Mousavi Sagharchi, Alireza Mahmoudi Nasab, Tim Bakker

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Introduction: Mycobacterium tuberculosis (MTB) is the most intelligent bacterium that existed in the world to our best knowledge. This bacterium can cause tuberculosis (TB) which is responsible for its spread speed and murder of millions of people around the world. MTB has the practical function to escape from anti-tuberculosis drugs (AT), for this purpose, it handles some mutations in the main genes and creates new patterns for inhibited genes. Method and materials: Researchers have their best tries to safely isolate MTB from the sputum specimens of 35 patients in some hospitals in the Tehran province and detect MTB by culture on Löwenstein-Jensen (LJ) medium and microscopic examination. DNA was extracted from the established bacterial colony by enzymatic extraction method. It was amplified by the polymerase chain reaction (PCR) method, reverse hybridization, and evaluation for detection of resistance genes; generally, researchers apply GenoType MTBDRplus assay. Results: Investigations of results declare us that 21 of the isolated specimens (about 60%) have mutation in rpoB gene, which resisted to rifampicin (most prevalence), and 8 of them (about 22.8%) have mutation in katG or inhA genes which resisted to isoniazid. Also, 4 of them (about 11.4%) don't have any mutation, and 2 of them (about 5.7%) have mutation in every three genes, which makes them resistant to the two drugs mentioned above. Conclusion: Rifampicin and isoniazid are two essential AT that using in the first line of treatment. Resistance in rpoB, and katG, and inhA genes related to mentioned drugs lead to ineffective treatment.

Keywords: mycobacterium tuberculosis, tuberculosis, drug resistance, isoniazid, rifampicin

Procedia PDF Downloads 73