Search results for: continuous improvement programs

Authors: Tammy Wee, Detlev Remy, Arif Perdana

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In the recent years, data analytics has become the buzzword in the hospitality industry. The hospitality industry is another example of a data-rich industry that has yet fully benefited from the insights of data analytics. Effective use of data analytics can change how hotels operate, market and position themselves competitively in the hospitality industry. However, at the moment, the data obtained by individual hotels remain under-utilized. This research is a preliminary research on data analytics in the hospitality industry, using an in-depth face-to-face interview on one hotel as a start to a multi-level research. The main case study of this research, hotel A, is a chain brand of international hotel that has been systematically gathering and collecting data on its own customer for the past five years. The data collection points begin from the moment a guest book a room until the guest leave the hotel premises, which includes room reservation, spa booking, and catering. Although hotel A has been gathering data intelligence on its customer for some time, they have yet utilized the data to its fullest potential, and they are aware of their limitation as well as the potential of data analytics. Currently, the utilization of data analytics in hotel A is limited in the area of customer service improvement, namely to enhance the personalization of service for each individual customer. Hotel A is able to utilize the data to improve and enhance their service which in turn, encourage repeated customers. According to hotel A, 50% of their guests returned to their hotel, and 70% extended nights because of the personalized service. Apart from using the data analytics for enhancing customer service, hotel A also uses the data in marketing. Hotel A uses the data analytics to predict or forecast the change in consumer behavior and demand, by tracking their guest’s booking preference, payment preference and demand shift between properties. However, hotel A admitted that the data they have been collecting was not fully utilized due to two challenges. The first challenge of using data analytics in hotel A is the data is not clean. At the moment, the data collection of one guest profile is meaningful only for one department in the hotel but meaningless for another department. Cleaning up the data and getting standards correctly for usage by different departments are some of the main concerns of hotel A. The second challenge of using data analytics in hotel A is the non-integral internal system. At the moment, the internal system used by hotel A do not integrate with each other well, limiting the ability to collect data systematically. Hotel A is considering another system to replace the current one for more comprehensive data collection. Hotel proprietors recognized the potential of data analytics as reported in this research, however, the current challenges of implementing a system to collect data come with a cost. This research has identified the current utilization of data analytics and the challenges faced when it comes to implementing data analytics.

Keywords: data analytics, hospitality industry, customer relationship management, hotel marketing

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Authors: Dibyendu Rakshit, Santosh K. Sarkar

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The study illustrates a comprehensive account of large-scale changes plankton community structure in relevance to water quality characteristics due to anthropogenic stresses, mainly concerned for Annual Gangasagar Festival (AGF) at the southern tip of Sagar Island of Indian Sundarban wetland for 3-year duration (2012-2014; n=36). This prograding, vulnerable and tide-dominated megadelta has been formed in the estuarine phase of the Hooghly Estuary infested by largest continuous tract of luxurious mangrove forest, enriched with high native flora and fauna. The sampling strategy was designed to characterize the changes in plankton community and water quality considering three diverse phases, namely during festival period (January) and its pre - (December) as well as post (February) events. Surface water samples were collected for estimation of different environmental variables as well as for phytoplankton and microzooplankton biodiversity measurement. The preservation and identification techniques of both biotic and abiotic parameters were carried out by standard chemical and biological methods. The intensive human activities lead to sharp ecological changes in the context of poor water quality index (WQI) due to high turbidity (14.02±2.34 NTU) coupled with low chlorophyll a (1.02±0.21 mg m-3) and dissolved oxygen (3.94±1.1 mg l-1), comparing to pre- and post-festival periods. Sharp reduction in abundance (4140 to 2997 cells l-1) and diversity (H′=2.72 to 1.33) of phytoplankton and microzooplankton tintinnids (450 to 328 ind l-1; H′=4.31 to 2.21) was very much pronounced. The small size tintinnid (average lorica length=29.4 µm; average LOD=10.5 µm) composed of Tintinnopsis minuta, T. lobiancoi, T. nucula, T. gracilis are predominant and reached some of the greatest abundances during the festival period. Results of ANOVA revealed a significant variation in different festival periods with phytoplankton (F= 1.77; p=0.006) and tintinnid abundance (F= 2.41; P=0.022). RELATE analyses revealed a significant correlation between the variations of planktonic communities with the environmental data (R= 0.107; p= 0.005). Three distinct groups were delineated from principal component analysis, in which a set of hydrological parameters acted as the causative factor(s) for maintaining diversity and distribution of the planktonic organisms. The pronounced adverse impact of anthropogenic stresses on plankton community could lead to environmental deterioration, disrupting the productivity of benthic and pelagic ecosystems as well as fishery potentialities which directly related to livelihood services. The festival can be considered as multiple drivers of changes in relevance to beach erosion, shoreline changes, pollution from discarded plastic and electronic wastes and destruction of natural habitats resulting loss of biodiversity. In addition, deterioration in water quality was also evident from immersion of idols, causing detrimental effects on aquatic biota. The authors strongly recommend for adopting integrated scientific and administrative strategies for resilience, sustainability and conservation of this megadelta.

Keywords: Gangasagar festival, phytoplankton, Sundarban megadelta, tintinnid

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Authors: Chen Guo, Heng Tang, Ben Niu

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Clustering splits objects into different groups based on similarity, making the objects have higher similarity in the same group and lower similarity in different groups. Thus, clustering can be treated as an optimization problem to maximize the intra-cluster similarity or inter-cluster dissimilarity. In real-world applications, the datasets often have some complex characteristics: sparse, overlap, high dimensionality, etc. When facing these datasets, simultaneously optimizing two or more objectives can obtain better clustering results than optimizing one objective. However, except for the objectives weighting methods, traditional clustering approaches have difficulty in solving multi-objective data clustering problems. Due to this, evolutionary multi-objective optimization algorithms are investigated by researchers to optimize multiple clustering objectives. In this paper, the Data Clustering algorithm based on Multi-objective Periodic Bacterial Foraging Optimization with two Learning Archives (DC-MPBFOLA) is proposed. Specifically, first, to reduce the high computing complexity of the original BFO, periodic BFO is employed as the basic algorithmic framework. Then transfer the periodic BFO into a multi-objective type. Second, two learning strategies are proposed based on the two learning archives to guide the bacterial swarm to move in a better direction. On the one hand, the global best is selected from the global learning archive according to the convergence index and diversity index. On the other hand, the personal best is selected from the personal learning archive according to the sum of weighted objectives. According to the aforementioned learning strategies, a chemotaxis operation is designed. Third, an elite learning strategy is designed to provide fresh power to the objects in two learning archives. When the objects in these two archives do not change for two consecutive times, randomly initializing one dimension of objects can prevent the proposed algorithm from falling into local optima. Fourth, to validate the performance of the proposed algorithm, DC-MPBFOLA is compared with four state-of-art evolutionary multi-objective optimization algorithms and one classical clustering algorithm on evaluation indexes of datasets. To further verify the effectiveness and feasibility of designed strategies in DC-MPBFOLA, variants of DC-MPBFOLA are also proposed. Experimental results demonstrate that DC-MPBFOLA outperforms its competitors regarding all evaluation indexes and clustering partitions. These results also indicate that the designed strategies positively influence the performance improvement of the original BFO.

Keywords: data clustering, multi-objective optimization, bacterial foraging optimization, learning archives

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Authors: Alexis D'Agostino, Celeste Sununtunasuk, Jack Fiedler

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Background: Iron-folic acid (IFA) supplementation during antenatal care (ANC) has existed in many countries for decades. Despite this, low national coverage persists and women do not often consume appropriate amounts during pregnancy. USAID’s SPRING Project investigated pregnant women’s access to, and consumption of, IFA tablets through ANC. Cross-country analysis provided a global picture of the state of IFA-supplementation, while country-specific results noted key contextual issues, including geography, wealth, and ANC attendance. The analysis can help countries prioritize strategies for systematic performance improvements within one of the most common micronutrient supplementation programs aimed at reducing maternal anemia. Methodology: Using falter point analysis on Demographic and Health Survey (DHS) data collected from 162,958 women across 22 countries, SPRING identified four sequential falter points (ANC attendance, IFA receipt or purchase, IFA consumption, and number of tablets taken) where pregnant women fell out of the IFA distribution structure. SPRING analyzed data on IFA intake from DHS surveys with women of reproductive age. SPRING disaggregated these data by ANC participation during the most recent pregnancy, residency, and women’s socio-economic status. Results: Average sufficient IFA tablet use across all countries was only eight percent. Even in the best performing countries, only about one-third of pregnant women consumed 180 or more IFA tablets during their most recent pregnancy. ANC attendance was an important falter point for a quarter of women across all countries (with highest falter rates in Democratic Republic of the Congo, Nigeria, and Niger). Further analysis reveals patterns, with some countries having high ANC coverage but low IFA provision during ANC (DRC and Haiti), others having high ANC coverage and IFA provision but few women taking any tablets (Nigeria and Liberia), and countries that perform well in ANC, supplies, and initial consumption but where very few women consume the recommended 180 tablets (Malawi and Cambodia). Country-level analysis identifies further patterns of supplementation. In Indonesia, for example, only 62% of women in the poorest quintile took even one IFA tablet, while 86% of the wealthiest women did. This association between socioeconomic status and IFA intake held across nearly all countries where these data are available and was also visible in rural/urban comparisons. Analysis of ANC attendance data also suggests that higher numbers of ANC visits are associated with higher tablet intake. Conclusions: While it is difficult to disentangle which specific aspects of supply or demand cause the low rates of consumption, this tool allows policy-makers to identify major bottlenecks to scaling-up IFA supplementation during ANC. In turn, each falter point provides possible explanations of program performance and helps strategically identify areas for improved IFA supplementation. For example, improving the delivery of IFA supplementation in Ethiopia relies on increasing access to ANC, but also on identifying and addressing program gaps in IFA supply management and health workers’ practices in order to provide quality ANC services. While every country requires a customized approach to improving IFA supplementation, the multi-country analysis conducted by SPRING is a helpful first step in identifying country bottlenecks and prioritizing interventions.

Keywords: iron and folic acid, supplementation, antenatal care, micronutrient

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Authors: Jane Oliver, Angeline Ferdinand, Jessica Kaufman, Peta Edler, Nicole Allard, Margie Danchin, Katherine B. Gibney

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Background: The cohealth Health Concierge program operated in Melbourne, Australia, from July 2020 to 30 June 2022. The program was designed to provide place-based peer-to-peer COVID-19 education and support to culturally and linguistically diverse residents of high-rise public housing estates. During this time, the COVID-19 public health response changed frequently. We conducted a mixed-methods evaluation to determine the program’s impact on residents’ trust, engagement and communication with health services and public health activities. Methods: The RE-AIM model was used to assess program reach, effectiveness, adoption, implementation and maintenance and the evaluation was informed by a Project Reference Group including end-users. Data were collected between March and May 2022 in four estates where the program operated. We surveyed 301 residents, conducted qualitative interviews with 32 stakeholders and analyzed data from 20,901 forms reporting interactions between Health Concierges and residents collected from August 2021 to May 2022. These forms outlined the support provided by Health Concierges during each interaction. Results: Overall, the program was effective in guiding residents to testing and vaccination services and facilitating COVID-19 safe practices. Nearly two-thirds (191; 63.5%) of the 301 surveyed participants reported speaking with a Health Concierge in the previous six months, and some described having meaningful conversations with them. Despite this, many of the interactions residents described having with Health Concierges were superficial. When considering surveyed participants’ responses to the adapted Public Health Disaster Trust Scale, the mean score across all estates was 2.3 (or slightly more than ‘somewhat confident’) in public health authorities’ ability to respond to a localized infectious disease outbreak. While the program was valued during the rapidly changing public health response, many felt it had failed to evolve in the ‘living with COVID’ phase. Some residents expressed frustration with Health Concierges’ having perceived inactive, passive roles - although other residents felt Health Concierges were helpful and appreciated them. A perception that the true impact of Health Concierges’ work was underrecognized was widely voiced by health staff. All 20,901 Interaction Forms identified COVID-19-related supports provided to residents; almost all included provision of facemasks and/or hand sanitiser and 78% identified additional supports that were also provided, most frequently provision of other health information. Conclusions: The program disseminated up-to-date information to a diverse population within a rapidly changing public health setting. Health Concierges were able promote COVID-19-safe behaviours, including vaccine uptake, and link residents with support services. We recommend the program be revised and continued. New programs that draw on the Health Concierge model may be valuable in supporting future pandemic responses and should be considered in preparedness planning.

Keywords: community health, COVID-19 pandemic, infectious diseases, public health, community health workers

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Authors: Sanaa Riaz

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The free people, Amazigh (plural Imazighen), often known by the more popular exonym, Berber, are spread across several North African countries with the highest population in Morocco have been substantially misunderstood and differentially showcased by entities from western-school educated scholars to human, health and women’s rights organizations, to the State to the international community. This paper is an examination of the various conceptualization of the Imazighen. With the popularity of the Arab Spring movement to oust monarchical and dictatorial rulers across the Middle East and North Africa in Morocco, the Moroccan monarchy introduced various reform programs to win public favor. These included social, economic and educational reforms to incorporate marginalized groups such as the Imazighen. The monarchy has ushered Amazigh representation in public offices and landscape through Amazigh script, even though theirs has been an oral culture. After the Arab Spring, the Justice and Development party, an Islamist party took over in Morocco due to its accessibility to the masses, In Sept. 2021, unlike the case of Egypt and Tunisia where military and constitutional means were sought, Morocco successfully removed it from power through the ballot, resulting in a real victory for the neutral monarchy and its representation as a moderate, secular and liberal force for the nation. As a result, supporting the perpetuation of Amazigh linguistic identity also became synonymous to making a secular statement as a Muslim. It has led to the telling of Amazigh identity at state museums as one representing the indigenous, pure, diverse, culturally-rich and united Morocco. Reform efforts have also prioritized an amiable look towards the economic and familial links of Moroccan Jews with the few thousand families still left in the country and a showcasing through museums and cultural centers of the Jewish identity as Moroccan first. In that endeavor, it is interesting to note the coverage of Jews as the indigenous of Morocco through the embracing of their “folk” cultural and religious practices, those that are not continued outside Morocco. In this epistemology, the concept of the Moroccan Jew becomes similar to the indigenous Amazigh, both cherished as the oldest peoples of Morocco and symbols of its unity and resilience. In the urban discourse, Amazigh identity is a concept that continues to be part of the deliberations of elites and scholars graduating from French schools on the incorporation of rural and illiterate Morocco in economic and educational advancement. Yet, with the constant influx of migrants from Western Sahara into cities like Fez and Marrakesh, Amazigh has often been described as the umbrella term of those of “mixed” ethnic ancestry who constitute the country’s free population. In sum, Amazigh identity highlights the changing discourse on marginalized communities, human rights, representation, Moroccan nationhood, and regional and transnational politics. The aim of this paper is to analyze perceptions of Amazigh identity in Morocco post-2021 ousting of the Islamist party using data from state-sponsored museum displays and cultural centers collected in Summer 2022 and scholarly analyses of Amazigh identity, representation and rights in Morocco.

Keywords: Amazigh identity, Morocco, representation, state politics

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Authors: Alexander Street, Nina Wollersberger, Paul Fernie, Leonardo Muller, Ming Hung HSU, Helen Odell-Miller, Jorg Fachner, Patrizia Di Campli San Vito, Stephen Brewster, Hari Shaji, Satvik Venkatesh, Paolo Itaborai, Nicolas Farina, Alexis Kirke, Sube Banerjee, Eduardo Reck Miranda

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Escalating neuropsychiatric symptoms (NPS) in people with dementia may lead to earlier care home admission. Music listening has been reported to stimulate cognitive function, potentially reducing agitation in this population. We present a scoping review, reporting on current developments and discussing the potential for music listening with related technology in managing agitation in dementia care. Of two searches for music listening studies, one focused on older people or people living with dementia where music listening interventions, including technology, were delivered in participants’ homes or in institutions to address neuropsychiatric symptoms, quality of life and independence. The second included any population focusing on the use of music technology for health and wellbeing. In search one 70/251 full texts were included. The majority reported either statistical significance (6, 8.5%), significance (17, 24.2%) or improvements (26, 37.1%). Agitation was specifically reported in 36 (51.4%). The second search included 51/99 full texts, reporting improvement (28, 54.9%), significance (11, 21.5%), statistical significance (1, 1.9%) and no difference compared to the control (6, 11.7%). The majority in the first focused on mood and agitation, and the second on mood and psychophysiological responses. Five studies used AI or machine learning systems to select music, all involving healthy controls and reporting benefits. Most studies in both reviews were not conducted in a home environment (review 1 = 12; 17.1%; review 2 = 11; 21.5%). Preferred music listening may help manage NPS in the care home settings. Based on these and other data extracted in the review, a reasonable progression would be to co-design and test music listening systems and protocols for NPS in all settings, including people’s homes. Machine learning and automated technology for music selection and arousal adjustment, driven by live biodata, have not been explored in dementia care. Such approaches may help deliver the right music at the appropriate time in the required dosage, reducing the use of medication and improving quality of life.

Keywords: music listening, dementia, agitation, scoping review, technology

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Authors: Hong Je Kang, Young Chae Choi, Jin Sung Park, Isac Kim

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Purpose: Osteoporotic fractures are an important among postmenopausal women. When osteoporotic distal radial fractures occur, osteoporosis must be treated to prevent the hip and spine fractures. Intravenous injection of Zoledronic acid is expected to improve preventing osteoporotic fractures. Many articles reported the effect of intravenous Zoledronic acid to BMD of the hip and spine fracture or non-fracture patients with low BMD. However, that with distal radial fractures has rarely been reported. Therefore, the authors decided to study the effect of Zoledronic acid in BMD score, bone union, and bone turnover markers in the patients who underwent volar plating due to osteoporotic distal radial fractures. Materials: From April 2018 to May 2022, postmenopausal women aged 55 years or older who had osteoporotic distal radial fractures and who underwent surgical treatment using volar plate fixation were included. Zoledronic acid (5mg) was injected intravenously between 3 and 5 days after surgery. BMD scores after 1 year of operation were compared with the initial scores. Bone turnover markers were measured before surgery, after 3 months, and after 1 year. Radiological follow-up was performed every 2 weeks until the bone union and at 1 year postoperatively. Clinical outcome indicators were measured one year after surgery, and the occurrence of side effects was observed. Result: Total of 23 patients were included, with a lumbar BMD T score of -2.89±0.2 before surgery to -2.27±0.3 one year after surgery (p=0.012) and a femoral neck BMD T score of -2.45±0.3 before surgery to -2.36±0.3 (p=0.041) after one year, and all were statistically significant. Measured as bone resorption markers, serum CTX-1 was 337.43±10.4 pg/mL before surgery, 160.86±8.7 pg/mL (p=0.022) after three months, and 250.12±12.7 pg/mL (p=0.031) after one year. Urinary NTX-1 was 39.24±2.2 ng/mL before surgery, 24.46±1.2 ng/mL (p=0.014) after three months and 30.35±1.6 ng/mL (p=0.042) after one year. Measured as bone formation markers, serum osteocalcin was 13.04±1.1 ng/mL before surgery, 8.84±0.7 ng/mL (p=0.037) after 3 months and 11.1±0.4 ng/mL (p=0.026) after one year. Serum bone-specific ALP was 11.24±0.9 IU/L before surgery, 8.25±0.9 IU/L (p=0.036) after three months, and 10.2±0.9 IU/L (p=0.027) after one year. All were statistically significant. All cases showed bone union within an average of 6.91±0.3 weeks without any signs of failure. Complications were found in 5 out of 23 cases (21.7%), such as headache, nausea, muscle pain, and fever. Conclusion: When Zoledronic acid was used, BMD was improved in both the spine and femoral neck. This may reduce the likelihood and subsequent morbidity of additional osteoporotic fractures. This study is meaningful in that there was no difference in the duration of bone union and radiological characteristics in patients with distal radial fractures administrated with intravenous BP early after the fractures, and improvement in BMD and bone turnover indicators was measured.

Keywords: zeoldreonic acid, BMD, osteoporosis, distal radius

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Authors: Aurela Jahja, Katarzyna Wątor, Arjan Beqiraj, Piotr Rusiniak, Nevton Kodhelaj

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Albanian geological terrains represent an important node of the Alpine – Mediterranean mountain belt and are divided into several predominantly NNW - SSE striking geotectonic units, which, based on the presence or lack of Cretaceous transgression and magmatic rocks, belong to Internal or External Albanides. The internal (Korabi, Mirdita and Gashi) units are characterized by the Lower Cretaceous discordance and the presence of abundant magmatic rocks whereas in the external (Alps, Krasta-Cukali, Kruja, Ionian, Sazani and Peri Adriatic Depression) units an almost continuous sedimentation from Triassic to Paleogene is evidenced. The internal and external units show relevant differences in both geothermal and heat flow density values. The gradient values vary from 15-21.3 to 36 mK/m, while the heat flow density ranges from 42 to 60 mW/m2, in the external (Preadriatic Depression) and internal (ophiolitic belt) units, respectively. The geothermal fluids, which are found in natural springs and deep oil wells of Albania, are located in four thermo-mineral provinces: a) Peshkopi (Korabi) province; b) Kruja province; c) Preadriatic basin province, and d) South Ionian province. Thirteen geothermal waters were sampled from 11 natural springs and 2 deep wells, of which 6 springs and 2 wells from Kruja, 1 spring from Peshkopia, 2 springs from Preadriatic basin and 2 springs South Ionian province. Temperature, pH and Electrical Conductivity were measured in situ, while in laboratory were analyzed by ICP method major anions and cations and several trace elements (B, Li, Sr, Rb, I, Br, etc.). The measured values of temperature, pH and electrical conductivity range within 17-63°C, 6.26-7.92 and 724- 26856µS/cm intervals, respectively. The chemical type of the Albania thermal waters is variable. In the Kruja province prevail the Cl-SO4-NaCa and Cl-Na-Ca water types; while SO4-Ca, HCO3-Ca and Cl-HCO3-Na-Ca, and Cl-Na are found in the provinces of Peshkopi, Ionian and Preadriatic basin, respectively. In the Cl-SO4-HCO3 triangular diagram most of the geothermal waters are close to the chloride corner that belong to “mature waters”, typical of geothermal deep and hot fluids. Only samples from the Ionian province are located within the region of high bicarbonate concentration and they can be classified as peripheral waters that may have mixed with cold groundwater. In the Na-Ca-Mg and Na-K-Mg triangular diagram the majority of waters fall in the corner of sodium, suggesting that their cation ratios are controlled by mineral-solution equilibrium. There is a linear relationship between Cl and B which indicates the mixing of geothermal water with cold water, where the low-chlorine thermal waters from Ionian basin and Preadriatic depression provinces are distinguished by high-chlorine thermal waters from Kruja province. The Cl/Br molar ration of the thermal waters from Kruja province ranges from 1000 to 2660 and separates them from the thermal waters of Ionian basin and Preadriatic depression provinces having Cl/Br molar ratio lower than 650. The apparent increase of Cl/Br molar ratio that correlates with the increasing of the chloride, is probably related with dissolution of the Halite.

Keywords: geothermal fluids, geotectonic units, natural springs, deep wells, mature waters, peripheral waters

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Authors: Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta

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Background: Existing shortcomings of current health-service delivery include poor teamwork, competencies that do not address consumer needs, and episodic rather than continuous care. Brazil’s Sistema Único de Saúde (Unified Health System, UHS) is acknowledged worldwide as a model for delivering community-based care through Estratégia Saúde da Família (FHS; Family Health Strategy) interdisciplinary teams, comprised of Community Health Agents (in Portuguese, Agentes Comunitário de Saude, ACS), nurses, and physicians. FHS teams are mandated to collectively offer clinical care, disease prevention services, vector control, health surveillance and social services. Our study compares medical providers (nurses and physicians) and community-based providers (ACS) on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on similarities and differences across care providers to develop interprofessional training for community-based primary care. Methods: Cross-sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Brazil. We compared providers’ demographic characteristics (age, race, and gender) and job context variables (caseload, work experience, work proximity to community, the length of commute, and familiarity with the community). Providers perceptions were compared to their work environment (work conditions and work resources), professional skills (consumer-input, interdisciplinary collaboration, efficacy of FHS teams, work-methods and decision-making autonomy), and cognitive capacities (knowledge and skills, skill variety, confidence and perseverance). Descriptive and bi-variate analysis, such as Pearson Chi-square and Analysis of Variance (ANOVA) F-tests, were performed to draw comparisons across providers. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Majority of nurses and ACS identified as mixed races (ACS, n=85; nurses, n=27); most physicians identified as males (n=16; 52%), and white (n=18; 58%). Physicians were less likely to incorporate consumer-input and demonstrated greater decision-making autonomy than nurses and ACS. ACS reported the highest levels of knowledge and skills but the least confidence compared to nurses and physicians. ACS, nurses, and physicians were efficacious that FHS teams improved the quality of health in their catchment areas, though nurses tend to disagree that interdisciplinary collaboration facilitated their work. Conclusion: To our knowledge, there has been no study comparing key demographic and cognitive variables across ACS, nurses and physicians in the context of their work environment and professional training. We suggest that global health systems can leverage upon the diverse perspectives of providers to implement a community-based primary care model grounded in interprofessional training. Our study underscores the need for in-service trainings to instill reflective skills of providers, improve communication skills of medical providers and curative skills of ACS. Greater autonomy needs to be extended to community based providers to offer care integral to addressing consumer and community needs.

Keywords: global health systems, interdisciplinary health teams, community health agents, community-based care

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Authors: Rizwana Tabassum

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Introductive Statement: Delay in budget releases is often cited as one of the biggest bottlenecks to smooth and efficient service delivery. While budget release from the ministry of finance to the line ministries has been expedited by simplifying the procedure, budget distribution within the line ministries remains one of the major causes of slow budget utilization. While the budget preparation is a bottom-up process where all DDOs submit their proposals to their controlling officers (such as Upazila Civil Surgeon sends it to Director General Health), who consolidate the budget proposals in iBAS++ budget preparation module, the approved budget is not disaggregated by all DDOs. Instead, it is left to the discretion of the controlling officers to distribute the approved budget to their sub-ordinate offices over the course of the year. Though there are some need-based criteria/formulae to distribute the approved budget among DDOs in some sectors, there is little evidence that these criteria are actually used. This means that majority of the DDOs don’t know their yearly allocations upfront to enable yearly planning of activities and expenditures. This delays the implementation of critical activities and the payment to the suppliers of goods and services and sometimes leads to undocumented arrears to suppliers for essential goods/services. In addition, social sector budgets are fragmented because of the vertical programs and externally financed interventions that pose several management challenges at the level of the budget holders and frontline service providers. Slow procurement processes further delay the provision of necessary goods and services. For example, it takes an average of 15–18 months for drugs to reach the Upazila Health Complex and below, while it should not take more than 9 months in procuring and distributing these. Aim of the Study: This paper aims to investigate the budget distribution practices of an emerging economy, Bangladesh. The paper identifies challenges of timely distribution and ways to deal with problems as well. Methodology: The study draws conclusions on the basis of document analysis which is a branch of the qualitative research method. Major Findings: Upon approval of the National Budget, the Ministry of Finance is required to distribute the budget to budget holders at the department level; however, budget is distributed to drawing and disbursing officers much later. Conclusions: Timely and predictable budget releases assist completion of development schemes on time and on budget, with sufficient recurrent resources for effective operation. ADP implementation is usually very low at the beginning of the fiscal year and expedited dramatically during the last few months, leading to inefficient use of resources. The timely budget release will resolve this issue and deliver economic benefits faster, better, and more reliably. This will also give the project directors/DDOs the freedom to think and plan the budget execution in a predictable manner, thereby ensuring value for money by reducing time overrun and expediting the completion of capital investments, and improving infrastructure utilization through timely payment of recurrent costs.

Keywords: budget distribution, challenges, digitization, emerging economy, service delivery

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Authors: Abejide Dorcas Ropo, Falusi Olamide Ahmed, Daudu Oladipupo Abdulazeez Yusuf, Muhammad Liman Muhammad, Gado Aishatu Adamu

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Bambara groundnut is an indigenous African legume with great potential to tackle the problem of food insecurity in Nigeria. A germplasm collection mission was carried out in collaboration with the Agricultural Developments Project (ADP) Extension officers of Nigeria between October and December 2014. Bambara groundnut seeds were collected from farmers in different States in Nigeria, such as Kaduna, Niger, Kogi, Benue, Plateau, Adamawa, Nasarawa, Jigawa, Enugu, and Federal Capital Territoy (FCT) Abuja. Some seeds were also collected from National Centre for Genetic Resources and Biotechnology (NACGRAB). The seeds were phenotyped using the descriptor list of Vigna subterranea produced by the International Plant Genetic Resource Institute. A total of 45 original seed lots were collected, which comprised of mixed seeds having different seed coat colours (15) and pure seeded accessions having the same seed coat and eye colour (30). After sorting, a total of 83 accessions were derived from the 45 original seed lots collected, and a total of 24 distinct seed morphotypes with varying seed coat colours and eye colours were identified from the collections. They include cream ( cream ash eye, cream plain eye, and cream black eye), cream purplish spots, cream brown spots/stripe, cream black stripe, cream dark brown patches, cream light grey spots, cream black patches, black, red, light red, dark red, brownish red, brown speckled with black, red speckled with black, brown, brown with brown pattern below hilum, brown with black pattern below hilum, cream black, grey brown, grey black and variegated red. The highest number of accessions were collected from NACGRAB (11), followed by Niger State (10), and the lowest from Benue, Jigawa, and Adamawa States (2). Niger State also had the highest number of mixed seeds. The different seed phenotypes observed in the study are important for the field production of true-to-type lines and can be exploited for the genetic improvement of the Bambara groundnut.

Keywords: Bambara groundnut, characterization, collection, germplasm, phenotypic

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Authors: Gela Gelashvili, David Gelenidze, Sulkhan Nanobashvili, Irakli Nanobashvili, George Tavkhelidze, Tsiuri Sitchinava

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Development of new highly efficient plasma arc combustion system of pulverized coal is presented. As it is well-known, coal is one of the main energy carriers by means of which electric and heat energy is produced in thermal power stations. The quality of the extracted coal decreases very rapidly. Therefore, the difficulties associated with its firing and complete combustion arise and thermo-chemical preparation of pulverized coal becomes necessary. Usually, other organic fuels (mazut-fuel oil or natural gas) are added to low-quality coal for this purpose. The fraction of additional organic fuels varies within 35-40% range. This decreases dramatically the economic efficiency of such systems. At the same time, emission of noxious substances in the environment increases. Because of all these, intense development of plasma combustion systems of pulverized coal takes place in whole world. These systems are equipped with Non-Transferred Plasma Arc Torches. They allow practically complete combustion of pulverized coal (without organic additives) in boilers, increase of energetic and financial efficiency. At the same time, emission of noxious substances in the environment decreases dramatically. But, the non-transferred plasma torches have numerous drawbacks, e.g. complicated construction, low service life (especially in the case of high power), instability of plasma arc and most important – up to 30% of energy loss due to anode cooling. Due to these reasons, intense development of new plasma technologies that are free from these shortcomings takes place. In our proposed system, pulverized coal-air mixture passes through plasma arc area that burns between to carbon electrodes directly in pulverized coal muffler burner. Consumption of the carbon electrodes is low and does not need a cooling system, but the main advantage of this method is that radiation of plasma arc directly impacts on coal-air mixture that accelerates the process of thermo-chemical preparation of coal to burn. To ensure the stability of the plasma arc in such difficult conditions, we have developed a power source that provides fixed current during fluctuations in the arc resistance automatically compensated by the voltage change as well as regulation of plasma arc length over a wide range. Our combustion system where plasma arc acts directly on pulverized coal-air mixture is simple. This should allow a significant improvement of pulverized coal combustion (especially low-quality coal) and its economic efficiency. Preliminary experiments demonstrated the successful functioning of the system.

Keywords: coal combustion, plasma arc, plasma torches, pulverized coal

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Authors: Carolina Beltran, Carlos De Los Reyes

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Acquired brain injury (ABI) is any physical and functional injury secondary to events that affect the brain tissue. It is one of the biggest causes of disability in the world and it has a high annual incidence in the pediatric population. There are several causes of ABI such as traumatic brain injury, central nervous system infection, stroke, hypoxia, tumors and others. The consequences can be cognitive, behavioral, emotional and functional. The cognitive rehabilitation is necessary to achieve the best outcomes for pediatric people with ABI. Cognitive orientation to daily occupational performance (CO-OP) is an individualized client-centered, performance-based, problem-solving approach that focuses on the strategy used to support the acquisition of three client-chosen goals. It has demonstrated improvements in the pediatric population with other neurological disorder but not in Spanish speakers with ABI. Aim: The main objective of this study was to determine the efficacy of cognitive orientation to daily occupational performances (CO-OP) adapted to Spanish speakers, in the level of independence and behavior in a pediatric population with ABI. Methods: Case studies with measure pre/post-treatment were used in three children with ABI, sustained at least before 6 months assessment, in school, aged 8 to 16 years, age ABI after 6 years old and above average intellectual ability. Twelve sessions of CO-OP adapted to Spanish speakers were used and videotaped. The outcomes were based on cognitive, behavior and functional independence measurements such as Child Behavior Checklist (CBCL), Behavior Rating Inventory of Executive Function (BRIEF), The Vineland Adaptive Behavior Scales (VINELAND, Social Support Scale (MOS-SSS) and others neuropsychological measures. This study was approved by the ethics committee of Universidad del Norte in Colombia. Informed parental written consent was obtained for all participants. Results: children were able to identify three goals and use the global strategy ‘goal-plan-do-check’ during each session. Verbal self-instruction was used by all children. CO-OP showed a clinically significant improvement in goals regarding with independence level and behavior according to parents and teachers. Conclusion: The results indicated that CO-OP and the use of a global strategy such as ‘goal-plan-do-check’ can be used in children with ABI in order to improve their specific goals. This is a preliminary version of a big study carrying in Colombia as part of the experimental design.

Keywords: cognitive rehabilitation, acquired brain injury, pediatric population, cognitive orientation to daily occupational performance

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Authors: Mei Lin, Chang Liu

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Argumentative writing is the most prevalent genre in diverse writing tests. How to construct academic arguments is often regarded as a difficult task by most English as a foreign language (EFL) learners. A failure to generate enough ideas and organise them coherently and logically as well as a lack of competence in supporting their arguments with relevant evidence are frequent problems faced by EFL learners when approaching an English argumentative writing task. Overall, these problems are closely related to planning, and planning an argumentative writing at pre-writing stage plays a vital role in a good academic essay. However, how teachers can effectively guide students to generate ideas is rarely discussed in planning English argumentative writing, apart from brainstorming. Brainstorming has been a common practice used by teachers to help students generate ideas. However, some limitations of brainstorming suggest that it can help students generate many ideas, but ideas might not necessarily be coherent and logic, and could sometimes impede production. It calls for a need to explore effective instructional strategies at pre-writing stage of English argumentative writing. This paper will first examine how a Six Thinking Hats approach can be used to provide a dialogic space for EFL learners to experience and collaboratively generate ideas from multiple perspectives at pre-writing stage. Part of the findings of the impact of a twelve-week intervention (from March to July 2021) on students learning to generate ideas through engaging in group discussions of using Six Thinking Hats will then be reported. The research design is based on the sociocultural theory. The findings present evidence from a mixed-methods approach and fifty-nine participants from two first-year undergraduate natural classes in a Chinese university. Analysis of pre- and post- questionnaires suggests that participants had a positive attitude toward the Six Thinking Hats approach. It fosters their understanding of prewriting and argumentative writing, helps them to generate more ideas not only from multiple perspectives but also in a systematic way. A comparison of participants writing plans confirms an improvement in generating counterarguments and rebuttals to support their arguments. Above all, visual and transcripts data of group discussion collected from different weeks throughout the intervention enable teachers and researchers to ‘see’ the hidden process of learning to generate ideas in action.

Keywords: argumentative writing, innovative pedagogy, six thinking hats, dialogic space, prewriting, higher education

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Authors: Lenka Krsnakova, Petr Jirsak

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Prior research on facility location in supply chain is mostly focused on improvement of mathematical models. It is due to the fact that supply chain design has been for the long time the area of operational research that underscores mainly quantitative criteria. Qualitative criteria are still highly neglected within the supply chain design research. Facility location in the supply chain has become multi-criteria decision-making problem rather than single criteria decision due to changes of market conditions. Thus, both qualitative and quantitative criteria have to be included in the decision making process. The aim of this study is to emphasize the importance of qualitative criteria as key parameters of relevant mathematical models. We examine which criteria are taken into consideration when Czech companies decide about their facility location. A literature review on criteria being used in facility location decision making process creates a theoretical background for the study. The data collection was conducted through questionnaire survey. Questionnaire was sent to manufacturing and business companies of all sizes (small, medium and large enterprises) with the representation in the Czech Republic within following sectors: automotive, toys, clothing industry, electronics and pharmaceutical industry. Comparison of which criteria prevail in the current research and which are considered important by companies in the Czech Republic is made. Despite the number of articles focused on supply chain design, only minority of them consider qualitative criteria and rarely process supply chain design as a multi-criteria decision making problem. Preliminary results of the questionnaire survey outlines that companies in the Czech Republic see the qualitative criteria and their impact on facility location decision as crucial. Qualitative criteria as company strategy, quality of working environment or future development expectations are confirmed to be considered by Czech companies. This study confirms that the qualitative criteria can significantly influence whether a particular location could or could not be right place for a logistic facility. The research has two major limitations: researchers who focus on improving of mathematical models mostly do not mention criteria that enter the model. Czech supply chain managers selected important criteria from the group of 18 available criteria and assign them importance weights. It does not necessarily mean that these criteria were taken into consideration when the last facility location was chosen, but how they perceive that today. Since the study confirmed the necessity of future research on how qualitative criteria influence decision making process about facility location, the authors have already started in-depth interviews with participating companies to reveal how the inclusion of qualitative criteria into decision making process about facility location influence the company´s performance.

Keywords: criteria influencing facility location, Czech Republic, facility location decision-making, qualitative criteria

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Authors: J. Vveinhardt, V. B. Fominiene, L. Jeseviciute-Ufartiene

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Relevance of Research: Qualitative research is still regarded as highly subjective and not sufficiently scientific in order to achieve objective research results. However, it is agreed that a qualitative study allows revealing the hidden motives of the research participants, creating new theories, and highlighting the field of problem. There is enough research done to reveal these qualitative research aspects. However, each research area has its own specificity, and sport is unique due to the image of its participants, who are understood as strong and invincible. Therefore, a sport participant might have personal issues to recognize himself as a victim in the context of bullying and harassment. Accordingly, researcher has a dilemma in general making to speak a victim in sport. Thus, ethical aspects of qualitative research become relevant. The plenty fields of sport make a problem determining the sample size of research. Thus, the corresponding problem of this research is which and why qualitative research strategies are the most suitable revealing the phenomenon of bullying and harassment in sport. Object of research is qualitative research strategy for bullying and harassment in sport. Purpose of the research is to analyze strategies of qualitative research selecting suitable one for bullying and harassment in sport. Methods of research were scientific research analyses of qualitative research application for bullying and harassment research. Research Results: Four mane strategies are applied in the qualitative research; inductive, deductive, retroductive, and abductive. Inductive and deductive strategies are commonly used researching bullying and harassment in sport. The inductive strategy is applied as quantitative research in order to reveal and describe the prevalence of bullying and harassment in sport. The deductive strategy is used through qualitative methods in order to explain the causes of bullying and harassment and to predict the actions of the participants of bullying and harassment in sport and the possible consequences of these actions. The most commonly used qualitative method for the research of bullying and harassment in sports is semi-structured interviews in speech and in written. However, these methods may restrict the openness of the participants in the study when recording on the dictator or collecting incomplete answers when the participant in the survey responds in writing because it is not possible to refine the answers. Qualitative researches are more prevalent in terms of technology-defined research data. For example, focus group research in a closed forum allows participants freely interact with each other because of the confidentiality of the selected participants in the study. The moderator can purposefully formulate and submit problem-solving questions to the participants. Hence, the application of intelligent technology through in-depth qualitative research can help discover new and specific information on bullying and harassment in sport. Acknowledgement: This research is funded by the European Social Fund according to the activity ‘Improvement of researchers’ qualification by implementing world-class R&D projects of Measure No. 09.3.3-LMT-K-712.

Keywords: bullying, focus group, harassment, narrative, sport, qualitative research

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Authors: Sushil Kumar Singh, Kumar Rahul, Vivek Tewarson, Sarvesh Kumar, Shobhit Kumar

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Objective: Rheumatic mitral stenosis continues to be a major public health problem in developing countries. When the left atrium (LA) is unable to fill the left ventricle (LV) at normal LA pressures due to impaired relaxation and impaired compliance, diastolic dysfunction occurs. The assessment of left ventricular (LV) diastolic function and filling pressures is of clinical importance to identify underlying cardiac disease, its treatment, and to assess prognosis. 2D echocardiography can detect diastolic dysfunction with excellent sensitivity and minimal risk when compared to the gold standard of invasive pressure-volume measurements. Material and Method: This was a one-year study consisting of twenty-nine patients of isolated rheumatic severe mitral stenosis. Data was analyzed preoperative and post operative (at one month follow-up). Transthoracic 2D echocardiographic parameters of the diastolic function are transmitral flow, pulmonary venous flow, mitral annular tissue doppler, and color M-mode doppler. In our study, mitral valve orifice area, ejection fraction, deceleration time, E/A-wave, E/E’-wave, myocardial performance index of left ventricle (Tei index ), and Mitral inflow propagation velocity were included for echocardiographic evaluation. The statistical analysis was performed on SPSS Version 15.0 statistical analysis software. Result: Twenty-nine patients underwent successful closed mitral commissurotomy for isolated mitral stenosis. The outcome measures were observed pre-operatively and at one-month follow-up. The majority of patients were in NYHA grade III (69.0%) in the preoperative period, which improved to NYHA grade I (48.3%) after closed mitral commissurotomy. Post-surgery mitral valve area increased from 0.77 ± 0.13 to 2.32 ± 0.26 cm, ejection fraction increased from 61.38 ± 4.61 to 64.79 ± 3.22. There was a decrease in deceleration time from 231.55 ± 49.31 to 168.28 ± 14.30 ms, E/A ratio from 1.70 ± 0.54 from 0.89 ± 0.39, E/E’ ratio from 14.59 ± 3.34 to 8.86 ± 3.03. In addition, there was improvement in TIE index from 0.50 ± 0.03 to 0.39 ± 0.06 and mitral inflow propagation velocity from 47.28 ± 3.71 to 57.86 ± 3.19 cm/sec. In peri-operative and follow-up, there was no incidence of severe mitral regurgitation (MR). There was no thromboembolic incident and no mortality.

Keywords: closed mitral valvotomy, mitral stenosis, open mitral commissurotomy, balloon mitral valvotomy

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Authors: Maria Fonseca, Ana Branco, Joao Graca, Rui Mendes, Pedro Mimoso

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The present work is focused on the production of a carbon composite element for cycling through different techniques, namely, blow-molding and high-pressure resin transfer injection (HP-RTM). The main objective of this work is to compare both processes to produce carbon composite elements for the cycling industry. It is well known that the carbon composite components for cycling are produced mainly through blow-molding; however, this technique depends strongly on manual labour, resulting in a time-consuming production process. Comparatively, HP-RTM offers a more automated process which should lead to higher production rates. Nevertheless, a comparison of the elements produced through both techniques must be done, in order to assess if the final products comply with the required standards of the industry. The main difference between said techniques lies in the used material. Blow-moulding uses carbon prepreg (carbon fibres pre-impregnated with a resin system), and the material is laid up by hand, piece by piece, on a mould or on a hard male. After that, the material is cured at a high temperature. On the other hand, in the HP-RTM technique, dry carbon fibres are placed on a mould, and then resin is injected at high pressure. After some research regarding the best material systems (prepregs and braids) and suppliers, an element was designed (similar to a handlebar) to be constructed. The next step was to perform FEM simulations in order to determine what the best layup of the composite material was. The simulations were done for the prepreg material, and the obtained layup was transposed to the braids. The selected material was a prepreg with T700 carbon fibre (24K) and an epoxy resin system, for the blow-molding technique. For HP-RTM, carbon fibre elastic UD tubes and ± 45º braids were used, with both 3K and 6K filaments per tow, and the resin system was an epoxy as well. After the simulations for the prepreg material, the optimized layup was: [45°, -45°,45°, -45°,0°,0°]. For HP-RTM, the transposed layup was [ ± 45° (6k); 0° (6k); partial ± 45° (6k); partial ± 45° (6k); ± 45° (3k); ± 45° (3k)]. The mechanical tests showed that both elements can withstand the maximum load (in this case, 1000 N); however, the one produced through blow-molding can support higher loads (≈1300N against 1100N from HP-RTM). In what concerns to the fibre volume fraction (FVF), the HP-RTM element has a slightly higher value ( > 61% compared to 59% of the blow-molding technique). The optical microscopy has shown that both elements have a low void content. In conclusion, the elements produced using HP-RTM can compare to the ones produced through blow-molding, both in mechanical testing and in the visual aspect. Nevertheless, there is still space for improvement in the HP-RTM elements since the layup of the braids, and UD tubes could be optimized.

Keywords: HP-RTM, carbon composites, cycling, FEM

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Authors: Meng-Fei Cheng, Wei-Lun Chen, Han-Chang Ma, Chi-Che Tsai

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Recent K–12 Taiwan Science Education Curriculum Guideline emphasize the essential role of modeling curriculum in science learning; however, few modeling curricula have been designed and adopted in current science teaching. Therefore, this study aims to develop modeling curriculum on electric circuits to investigate any learning difficulties students have with modeling curriculum and further enhance modeling teaching. This study was conducted with 44 10th-grade students in Central Taiwan. Data collection included a students’ understanding of models in science (SUMS) survey that explored the students' epistemology of scientific models and modeling and a complex circuit problem to investigate the students’ modeling abilities. Data analysis included the following: (1) Paired sample t-tests were used to examine the improvement of students’ modeling abilities and conceptual understanding before and after the curriculum was taught. (2) Paired sample t-tests were also utilized to determine the students’ modeling abilities before and after the modeling activities, and a Pearson correlation was used to understand the relationship between students’ modeling abilities during the activities and on the posttest. (3) ANOVA analysis was used during different stages of the modeling curriculum to investigate the differences between the students’ who developed microscopic models and macroscopic models after the modeling curriculum was taught. (4) Independent sample t-tests were employed to determine whether the students who changed their models had significantly different understandings of scientific models than the students who did not change their models. The results revealed the following: (1) After the modeling curriculum was taught, the students had made significant progress in both their understanding of the science concept and their modeling abilities. In terms of science concepts, this modeling curriculum helped the students overcome the misconception that electric currents reduce after flowing through light bulbs. In terms of modeling abilities, this modeling curriculum helped students employ macroscopic or microscopic models to explain their observed phenomena. (2) Encouraging the students to explain scientific phenomena in different context prompts during the modeling process allowed them to convert their models to microscopic models, but it did not help them continuously employ microscopic models throughout the whole curriculum. The students finally consistently employed microscopic models when they had help visualizing the microscopic models. (3) During the modeling process, the students who revised their own models better understood that models can be changed than the students who did not revise their own models. Also, the students who revised their models to explain different scientific phenomena tended to regard models as explanatory tools. In short, this study explored different strategies to facilitate students’ modeling processes as well as their difficulties with the modeling process. The findings can be used to design and teach modeling curricula and help students enhance their modeling abilities.

Keywords: electric circuits, modeling curriculum, science learning, scientific model

Procedia PDF Downloads 443

Authors: Yaser S. Kishawi, Sadi R. Ali

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Part of Palestine, Gaza Strip (365 km2 and 1.8 million habitants) is considered a semi-arid zone relies solely on the Coastal Aquifer. The coastal aquifer is only source of water with only 5-10% suitable for human use. This barely covers the domestic and agricultural needs of Gaza Strip. Palestinian Water Authority Strategy is finding non-conventional water resource from treated wastewater to cover agricultural requirements and serve the population. A new WWTP project is to replace the old-overloaded Biet Lahia WWTP. The project consists of three parts; phase A (pressure line and infiltration basins-IBs), phase B (a new WWTP) and phase C (Recovery and Reuse Scheme–RRS– to capture the spreading plume). Currently, only phase A is functioning. Nearly 23 Mm3 of partially treated wastewater were infiltrated into the aquifer. Phase B and phase C witnessed many delays and this forced a reassessment of the RRS original design. An Environmental Management Plan was conducted from Jul 2013 to Jun 2014 on 13 existing monitoring wells surrounding the project location. This is to measure the efficiency of the SAT system and the spread of the contamination plume with relation to the efficiency of the proposed RRS. Along with the proposed location of the 27 recovery wells as part of the proposed RRS. The results of monitored wells were assessed compared with PWA baseline data. This was put into a groundwater model to simulate the plume to propose the best suitable solution to the delays. The redesign mainly manipulated the pumping rate of wells, proposed locations and functioning schedules (including wells groupings). The proposed simulations were examined using visual MODFLOW V4.2 to simulate the results. The results of monitored wells were assessed based on the location of the monitoring wells related to the proposed recovery wells locations (200m, 500m, and 750m away from the IBs). Near the 500m line (the first row of proposed recovery wells), an increase of nitrate (from 30 to 70mg/L) compare to a decrease in Chloride (1500 to below 900mg/L) was found during the monitoring period which indicated an expansion of plume to this distance. On this rate with the required time to construct the recovery scheme, keeping the original design the RRS will fail to capture the plume. Based on that many simulations were conducted leading into three main scenarios. The scenarios manipulated the starting dates, the pumping rate and the locations of recovery wells. A simulation of plume expansion and path-lines were extracted from the model monitoring how to prevent the expansion towards the nearby municipal wells. It was concluded that the location is the most important factor in determining the RRS efficiency. Scenario III was adopted and showed effective results even with a reduced pumping rates. This scenario proposed adding two additional recovery wells in a location beyond the 750m line to compensate the delays and effectively capture the plume. A continuous monitoring program for current and future monitoring wells should be in place to support the proposed scenario and ensure maximum protection.

Keywords: soil aquifer treatment, recovery reuse scheme, infiltration basins, North Gaza

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Authors: Marcio Freire Cruz, Naoaki Ono, Shigehiko Kanaya, Carlos Arthur Mattos Teixeira Cavalcante

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The systems that record patient care information, known as Electronic Medical Record (EMR) and those that monitor vital signs of patients, such as heart rate, body temperature, and blood pressure have been extremely valuable for the effectiveness of the patient’s treatment. Several kinds of research have been using data from EMRs and vital signs of patients to predict illnesses. Among them, we highlight those that intend to predict, classify, or, at least identify patterns, of sepsis illness in patients under vital signs monitoring. Sepsis is an organic dysfunction caused by a dysregulated patient's response to an infection that affects millions of people worldwide. Early detection of sepsis is expected to provide a significant improvement in its treatment. Preceding works usually combined medical, statistical, mathematical and computational models to develop detection methods for early prediction, getting higher accuracies, and using the smallest number of variables. Among other techniques, we could find researches using survival analysis, specialist systems, machine learning and deep learning that reached great results. In our research, patients are modeled as points moving each hour in an n-dimensional space where n is the number of vital signs (variables). These points can reach a sepsis target point after some time. For now, the sepsis target point was calculated using the median of all patients’ variables on the sepsis onset. From these points, we calculate for each hour the position vector, the first derivative (velocity vector) and the second derivative (acceleration vector) of the variables to evaluate their behavior. And we construct a prediction model based on a Long Short-Term Memory (LSTM) Network, including these derivatives as explanatory variables. The accuracy of the prediction 6 hours before the time of sepsis, considering only the vital signs reached 83.24% and by including the vectors position, speed, and acceleration, we obtained 94.96%. The data are being collected from Medical Information Mart for Intensive Care (MIMIC) Database, a public database that contains vital signs, laboratory test results, observations, notes, and so on, from more than 60.000 patients.

Keywords: dynamic analysis, long short-term memory, prediction, sepsis

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Authors: T. Pradhan, P. Rijal, M. C. Regmi

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Background: Eclampsia is a multisystem disorder that involves vital organs and failure of these may lead to deterioration of maternal condition and hypoxia and acidosis of fetus resulting in high maternal and perinatal mortality and morbidity. Thus, evaluation of the contributing factors for this condition and its complications leading to maternal deaths should be the priority. Formulating the plan and protocol to decrease these losses should be our goal. Aims and Objectives: To evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia and to correlate the risk factors associated with maternal and fetal morbidity and mortality. Methods: All patients with eclampsia admitted in Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to patients, and attendants like Antenatal clinic visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate and the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition like maternal Intensive Care Unit admission, neurological impairment and mortality were noted before discharge. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS 11). Mean and percentage were calculated for demographic variables. Pearson’s correlation test and chi-square test were applied to find the relation between the risk factors and the outcomes. P value less than 0.05 was considered significant. Results: There were 10,000 antenatal deliveries during the study period. Fifty-two patients with eclampsia were admitted. All of the patients were unbooked for our institute. Thirty-nine patients were antepartum eclampsia. Thirty-one patients required mechanical ventilator support. Twenty-four patients were delivered by emergency c-section and 21 babies were Low Birth Weight and there were 9 stillbirths. There was one maternal mortality and 45 patients were discharged with improvement but 3 patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate. Conclusion: Early detection and management of hypertensive complicating pregnancy during antenatal clinic check up. Early hospitalization and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes.

Keywords: eclampsia, maternal mortality, perinatal mortality, risk factors

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Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Doris F. Rabelo

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Introduction: Endotracheal Intubation (ETI) is a procedure for clinical management of patients with severe clinical presentation of COVID-19 disease. Realistic simulation (RS) is an active learning methodology utilized for clinical skill's improvement. To improve ETI skills of public health network's physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was planned and carried out. Training scenario included the Nasco Lifeform realistic simulator, and three actions were simulated: ETI procedure, sedative drugs management, and bougie guide utilization. Training intervention occurred between May and June 2020, as an interinstitutional cooperation between the Health's Department of Bahia State and the Federal University from Recôncavo da Bahia. Objective: The main objective is to report the effects on participants' self-confidence perception for ETI procedure after RS based training. Methods: This is a descriptive study, with secondary data extracted from questionnaires applied throughout RS training. Priority workplace, time from last intubation, and knowledge about bougie were reported on a preparticipation questionnaire. Additionally, participants completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding self-confidence perception in performing each of simulated actions. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's Exact Test. Results: 36 physicians participated of training, 25 (69%) from primary care setting, 25 (69%) performed ETI over a year ago, and only 4 (11%) had previous knowledge about the bougie guide utilization. There was an increase in self-confidence medians for all three simulated actions. Medians (variation) for self-confidence before and after training, for each simulated action were as follows: ETI [5 (1-9) vs. 8 (6-10) (p < 0.0001)]; Sedative drug management [5 (1-9) vs. 8 (4-10) (p < 0.0001)]; Bougie guide utilization [2.5 (1-7) vs. 8 (4-10) (p < 0.0001)]. Among those who performed ETI over a year ago (n = 25), an increase in self-confidence greater than 3 points for ETI was reported by 23 vs. 2 physicians (p = 0.0002), and by 21 vs. 4 (p = 0.03) for sedative drugs management. Conclusions: RS training contributed to self-confidence increase in performing ETI. Among participants who performed ETI over a year, there was a significant association between RS training and increase of more than 3 points in self-confidence, both for ETI and sedative drug management. Training with RS methodology is suitable for ETI confidence enhancement during COVID-19 outbreak.

Keywords: confidence, COVID-19, endotracheal intubation, realistic simulation

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Authors: Karen Trimmer, Raelene Ward, Linda Wondunna-Foley

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Within Australian tertiary institutions, the subject of Aboriginal and Torres Strait Islander education has been a major concern for many years. Aboriginal and Torres Strait Islander teachers are significantly under-represented in Australian schools and universities. High attrition rates in teacher education and in the teaching industry have contributed to a minimal growth rate in the numbers of Aboriginal and Torres Strait Islander teachers in previous years. There was an increase of 500 Indigenous teachers between 2001 and 2008 but these numbers still only account for one percent of teaching staff in government schools who identified as Aboriginal and Torres Strait Islander Australians (Ministerial Council for Education, Early Childhood Development and Youth Affairs 2010). Aboriginal and Torres Strait Islander teachers are paramount in fostering student engagement and improving educational outcomes for Indigenous students. Increasing the numbers of Aboriginal and Torres Strait Islander teachers is also a key factor in enabling all students to develop understanding of and respect for Aboriginal and Torres Strait Islander histories, cultures, and language. An ambitious reform agenda to improve the recruitment and retention of Aboriginal and Torres Strait Islander teachers will be effective only through national collaborative action and co-investment by schools and school authorities, university schools of education, professional associations, and Indigenous leaders and community networks. Whilst the University of Southern Queensland currently attracts Indigenous students to its teacher education programs (61 students in 2013 with an average of 48 enrollments each year since 2010) there is significant attrition during pre-service training. The annual rate of exiting before graduation remains high at 22% in 2012 and was 39% for the previous two years. These participation and retention rates are consistent with other universities across Australia. Whilst aspirations for a growing number of Indigenous people to be trained as teachers is present, there is a significant loss of students during their pre-service training and within the first five years of employment as a teacher. These trends also reflect the situation where Aboriginal and Torres Strait Islander teachers are significantly under-represented, making up less than 1% of teachers in schools across Australia. Through a project conducted as part the nationally funded More Aboriginal and Torres Strait Islander Teachers Initiative (MATSITI) we aim to gain an insight into the reasons that impact Aboriginal and Torres Strait Islander student’s decisions to exit their program. Through the conduct of focus groups and interviews with two graduating cohorts of self-identified Aboriginal and Torres Strait Islander students, rich data has been gathered to gain an understanding of the barriers and enhancers to the completion of pre-service qualification and transition to teaching. Having a greater understanding of these reasons then allows the development of collaborative processes and procedures to increase retention and completion rates of new Indigenous teachers. Analysis of factors impacting on exit decisions and transitions has provided evidence to support change of practice, redesign and enhancement of relevant courses and development of policy/procedures to address identified issues.

Keywords: graduation, indigenous, pre-service teacher education, retention

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Authors: Mishak Rahul, Naveen Kumar, Bharath Kumar

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Conceived as a high-end engine to revolutionise sustainable agri-food production, the intelligent crop circle (ICC) aims to incorporate the Internet of Things (IoT), blockchain technology and artificial intelligence (AI) to bolster resource efficiency and prevent waste, increase the volume of production and bring about sustainable solutions with long-term ecosystem conservation as the guiding principle. The operating principle of the ICC relies on bringing together multidisciplinary bottom-up collaborations between producers, researchers and consumers. Key elements of the framework include IoT-based smart sensors for sensing soil moisture, temperature, humidity, nutrient and air quality, which provide short-interval and timely data; blockchain technology for data storage on a private chain, which maintains data integrity, traceability and transparency; and AI-based predictive analysis, which actively predicts resource utilisation, plant growth and environment. This data and AI insights are built into the ICC platform, which uses the resulting DSS (Decision Support System) outlined as help in decision making, delivered through an easy-touse mobile app or web-based interface. Farmers are assumed to use such a decision-making aid behind the power of the logic informed by the data pool. Building on existing data available in the farm management systems, the ICC platform is easily interoperable with other IoT devices. ICC facilitates connections and information sharing in real-time between users, including farmers, researchers and industrial partners, enabling them to cooperate in farming innovation and knowledge exchange. Moreover, ICC supports sustainable practice in agriculture by integrating gamification techniques to stimulate farm adopters, deploying VR technologies to model and visualise 3D farm environments and farm conditions, framing the field scenarios using VR headsets and Real-Time 3D engines, and leveraging edge technologies to facilitate secure and fast communication and collaboration between users involved. And through allowing blockchain-based marketplaces, ICC offers traceability from farm to fork – that is: from producer to consumer. It empowers informed decision-making through tailor-made recommendations generated by means of AI-driven analysis and technology democratisation, enabling small-scale and resource-limited farmers to get their voice heard. It connects with traditional knowledge, brings together multi-stakeholder interactions as well as establishes a participatory ecosystem to incentivise continuous growth and development towards more sustainable agro-ecological food systems. This integrated approach leverages the power of emerging technologies to provide sustainable solutions for a resilient food system, ensuring sustainable agriculture worldwide.

Keywords: blockchain, internet of things, artificial intelligence, decision support system, virtual reality, gamification, traceability, sustainable agriculture

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Authors: Moustafa Osman Mohammed

Abstract:

The photocurrent generations are influencing ultra-high efficiency solar cells based on self-assembled quantum dot (QD) nanostructures. Nanocrystal quantum dots (QD) provide a great enhancement toward solar cell efficiencies through the use of quantum confinement to tune absorbance across the solar spectrum enabled multi-exciton generation. Based on theoretical predictions, QDs have potential to improve systems efficiency in approximate regular electrons excitation intensity greater than 50%. In solar cell devices, an intermediate band formed by the electron levels in quantum dot systems. The spatial architecture is exploring how can solar cell integrate and produce not only high open circuit voltage (> 1.7 eV) but also large short-circuit currents due to the efficient absorption of sub-bandgap photons. In the proposed QD system, the structure allows barrier material to absorb wavelengths below 700 nm while multi-photon processes in the used quantum dots to absorb wavelengths up to 2 µm. The assembly of the electronic model is flexible to demonstrate the atoms and molecules structure and material properties to tune control energy bandgap of the barrier quantum dot to their respective optimum values. In terms of energy virtual conversion, the efficiency and cost of the electronic structure are unified outperform a pair of multi-junction solar cell that obtained in the rigorous test to quantify the errors. The milestone toward achieving the claimed high-efficiency solar cell device is controlling the edge causes of energy bandgap between the barrier material and quantum dot systems according to the media design limits. Despite this remarkable potential for high photocurrent generation, the achievable open-circuit voltage (Voc) is fundamentally limited due to non-radiative recombination processes in QD solar cells. The orientation of voltage recovery system is compared theoretically with experimental Voc variation in mediation upper–limit obtained one diode modeling form at the cells with different bandgap (Eg) as classified in the proposed spatial architecture. The opportunity for improvement Voc is valued approximately greater than 1V by using smaller QDs through QD solar cell recovery systems as confined to other micro and nano operations states.

Keywords: nanotechnology, photovoltaic solar cell, quantum systems, renewable energy, environmental modeling

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Authors: Jade V. Rushby, Tony Loughland, Tracy L. Durksen, Hoa Nguyen, Robert M. Klassen

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This paper reports a study investigating the development and implementation of an online multi-session ‘scenario-based learning’ (SBL) program administered to preservice teachers in Australia. The transition from initial teacher education to the teaching profession can present numerous cognitive and psychological challenges for early career teachers. Therefore, the identification of additional supports, such as scenario-based learning, that can supplement existing teacher education programs may help preservice teachers to feel more confident and prepared for the realities and complexities of teaching. Scenario-based learning is grounded in situated learning theory which holds that learning is most powerful when it is embedded within its authentic context. SBL exposes participants to complex and realistic workplace situations in a supportive environment and has been used extensively to help prepare students in other professions, such as legal and medical education. However, comparatively limited attention has been paid to investigating the effects of SBL in teacher education. In the present study, the SBL intervention provided participants with the opportunity to virtually engage with school-based scenarios, reflect on how they might respond to a series of plausible response options, and receive real-time feedback from experienced educators. The development process involved several stages, including collaboration with experienced educators to determine the scenario content based on ‘critical incidents’ they had encountered during their teaching careers, the establishment of the scoring key, the development of the expert feedback, and an extensive review process to refine the program content. The 4-part SBL program focused on areas that can be challenging in the beginning stages of a teaching career, including managing student behaviour and workload, differentiating the curriculum, and building relationships with colleagues, parents, and the community. Results from prior studies implemented by the research group using a similar 4-part format have shown a statistically significant increase in preservice teachers’ self-efficacy and classroom readiness from the pre-test to the final post-test. In the current research, professional teaching identity - incorporating self-efficacy, motivation, self-image, satisfaction, and commitment to teaching - was measured over six weeks at multiple time points: before, during, and after the 4-part scenario-based learning program. Analyses included latent growth curve modelling to assess the trajectory of change in the outcome variables throughout the intervention. The paper outlines (1) the theoretical underpinnings of SBL, (2) the development of the SBL program and methodology, and (3) the results from the study, including the impact of the SBL program on aspects of participating preservice teachers’ professional identity. The study shows how SBL interventions can be implemented alongside the initial teacher education curriculum to help prepare preservice teachers for the transition from student to teacher.

Keywords: classroom simulations, e-learning, initial teacher education, preservice teachers, professional learning, professional teaching identity, scenario-based learning, teacher development

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Authors: A. Sottomayor, M. Perez Duque, M. C. Henriques

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Introduction: Migration is not a new phenomenon; nomads often traveled, seeking better living conditions, including food and water. The increase of migrations affects all countries, rising health-related challenges. In Portugal, we have had migrant movements in the last decades, pairing with economic behavior. Irregular immigrants are detained in Santo António detention center from Portuguese Immigration and Borders Service (USHA-SEF) in Porto until court decision for a maximum of 60 days. It is the only long stay officially designated detention center for immigrants in Portugal. Immigrant health is important for public health (PH). It affects and is affected by the community. The XXVII Portuguese Government considered immigrant integration, including access to health, health promotion, protection and reduction of inequities a political priority. Many curative, psychological and legal services are provided for detainees, but until 2015, no structured health promotion or prevention actions were being held at USHA-SEF. That year, Porto Occidental PH Local Unit started to provide vaccination and health literacy on this theme for detainees and SEF workers. Our activities include a vaccine lecture, a medical consultation with vaccine prescription and administration, along with documented proof of vaccination. All vaccines are volunteer and free of charge. This action reduces the risk of importation and transmission of diseases, contributing to world eradication and elimination programs. We aimed to characterize the demography of irregular immigrant detained at UHSA-SEF and describe our activity. Methods: All data was provided by Porto Occidental Public Health Unit. All paper registers of vaccination were uploaded to MicrosoftExcel®. We included all registers and collected demographic variables, nationality, vaccination date, category, and administered vaccines. Descriptive analysis was performed using MicrosoftExcel®. Results: From 2015 to 2018, we delivered care to 256 individuals (179 immigrants; 77 workers). Considering immigrants, 72% were male, and 8 (16%) women were pregnant. 85% were between 20-54 years (ᵡ=30,8y; 2-71y), and 11 didn’t report any age. Migrants came from 48 countries, and India had the highest number (9%). MMR and Tetanus vaccines had > 90% vaccination rate and Poliomyelitis, hepatitis B and flu vaccines had around 85% vaccination rates. We had a consistent number of refusals. Conclusion: Our irregular migrant population comes from many different countries, which increases the risk of disease importation. Pregnant women are present as a particular subset of irregular migrants, and vaccination protects them and the baby. Vaccination of migrant is valuable for them and for the countries in which they pass. It contributes to universal health coverage, for eradication programmes and accomplishment of the Sustainable Development Goals. Peer influence may present as a determinant of refusals so we must consistently educate migrants before vaccination. More studies would be valuable, particularly on the migrant trajectory, duration of stay, destiny after court decision and health impact.

Keywords: migrants, public health, universal health coverage, vaccination

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Authors: Eitedal Daoud, Reda M.Daoud, Khaled Abdel-Wahhab, Maha M.Saber, Lobna Saber

Abstract:

Background: Cis-platin is a widely used chemotherapeutic drug to treat many malignant disorders including head and neck malignancies. Oto-nephrotxicity is an important and dose - limiting side effect of cis - platin therapy. Nowadays, more attention had been paid to oto-toxicity caused with cis-platin. Aim of the Work: This study was designed to investigate the potential protective effect of Whey protein (WP) against cis-platin induced ototoxicity compared to the effect of N-acetylcysteine (NAC) in rats. Methodology: Male albino rats were randomly divided into 6 groups: untreated rats (control), rats orally treated with whey protein (1g/kg b.w/day) for seven executive days, rats treated orally with N-acetylcysteine (500 mg/kgb.w /day) for seven executive days, rates intoxicated intraperitoneal (ip) with cis- platin (10 mg/kgb.w. once), rats treated with whey protein (1g/kgb.w./day) for seven executive days) followed by one injection (ip) of cis-platin(10 mg/kg b.w.) one hour after the last oral administration of whey protein, rats treated with N- acetylcysteine (for seven executive days followed by one injection (ip) of cis-platin (10 mg/kgb.w) one hour after the last oral administration of N-acetylcysteine. The organ of Corti, the stria vascularis and spiral ganglia were visualized by light microscopy at different magnifications. Results: Cis-platin intoxicated animals showed a significant decrease in serum level of total antioxidant capacity (TAC),with inhibition in the activity of serum glutathione-s transferase(GST) and paraoxonnase-1 (PON-1) in comparison with control. Group treated with either NAC or WP with cis-platin showed significant elevation in the activity of both GST & PON-1 with increased serum level of TAC when compared with cis-platin intoxicated rats. Animals treated with NAC or WP with cis-platin compared to those treated with cis-platin alone showed marked degree of improvement towards control rats as there was significant drop in the serum level of cortecosterone, nitric oxide (NO), and melandialdehyde (MDA).Histopathologic, in NAC pretreated group there was no changes in stria vascularis or spiral ganglia. In group pretreated with WP, there was no histopathologic alteration detected in the organ of Corti and Reissers membrane but oedema and haemorrhage were founded in the stria vascularis in small focal manner. Conclusion: Our finding showed that Whey protein is a natural dietary supplement product proved its ability of protection of anti-oxidant system and the cochlea against cis-platin induced ototoxicity.

Keywords: anti-oxidant, cis-platin, N-acetylcysteine, ototoxicity, whey protein

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