Search results for: hospital factors
4908 Determining the Width and Depths of Cut in Milling on the Basis of a Multi-Dexel Model
Authors: Jens Friedrich, Matthias A. Gebele, Armin Lechler, Alexander Verl
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Chatter vibrations and process instabilities are the most important factors limiting the productivity of the milling process. Chatter can leads to damage of the tool, the part or the machine tool. Therefore, the estimation and prediction of the process stability is very important. The process stability depends on the spindle speed, the depth of cut and the width of cut. In milling, the process conditions are defined in the NC-program. While the spindle speed is directly coded in the NC-program, the depth and width of cut are unknown. This paper presents a new simulation based approach for the prediction of the depth and width of cut of a milling process. The prediction is based on a material removal simulation with an analytically represented tool shape and a multi-dexel approach for the work piece. The new calculation method allows the direct estimation of the depth and width of cut, which are the influencing parameters of the process stability, instead of the removed volume as existing approaches do. The knowledge can be used to predict the stability of new, unknown parts. Moreover with an additional vibration sensor, the stability lobe diagram of a milling process can be estimated and improved based on the estimated depth and width of cut.Keywords: dexel, process stability, material removal, milling
Procedia PDF Downloads 5264907 The Readiness of English Communication Skills for Travel Agents to Enter the ASEAN Economic Community
Authors: Bavornluck Kuosuwan
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The purpose of this research was to study the level of readiness of English communication skills for travel agents in the Silom road area of Bangkok in order to enter the ASEAN economic community in the year 2015. The multi-stage sampling method was utilized with 474 respondents from 79 travel agencies. An English Questionnaire was used to collect the data. Descriptive statistics included percentage, average, standard deviation and Pearson’s r coefficient. The findings revealed that the majority of respondents were not well prepared in terms of ASEAN knowledge including laws and regulations. The majority of respondents had not been well informed about the changes that will come with the coming of ASEAN economic community. Moreover, the level of English communication for most travel agents was between the poor and intermediate level and therefore improvement is needed, especially the speaking and listening skill. In other words, the majority of respondents needed more training in terms of communications skills. The correlation between the working environment and attitude of the staff was very positive. Moreover, the correlation between the background of staff and attitude of staff was also very positive and most of demographic factors had a positive correlation with attitude of staff, except gender.Keywords: ASEAN, communication skills, travel agents, media engineering
Procedia PDF Downloads 2564906 Variation of Base Width of a Typical Concrete Gravity Dam under Different Seismic Conditions Using Static Seismic Loading
Authors: Prasanna Kumar Khaund, Sukanya Talukdar
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A concrete gravity dam is a major hydraulic structure and it is very essential to consider the earthquake forces, to get a proper design base width, so that the entire weight of the dam resists the overturning moment due to earthquake and other forces. The main objective of this study is to obtain the design base width of a dam for different seismic conditions by varying the earthquake coefficients in both vertical and horizontal directions. This shall be done by equating the factor of safety against overturning, factor of safety against sliding and factor of safety against shear friction factor for a dam with their limiting values, under both tail water and no tail water condition. The shape of the Mettur dam in India is considered for the study. The study has been done taking a constant head of water at the reservoir, which is the maximum reservoir water level and a constant height of tail water. Using linear approximation method of Newton Raphson, the obtained equations against different factors of safety under different earthquake conditions are solved using a programme in C++ to get different values of base width of dam for varying earthquake conditions.Keywords: design base width, horizontal earthquake coefficient, tail water, vertical earthquake coefficient
Procedia PDF Downloads 2854905 The Sensitivity of Credit Defaults Swaps Premium to Global Risk Factor: Evidence from Emerging Markets
Authors: Oguzhan Cepni, Doruk Kucuksarac, M. Hasan Yilmaz
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Changes in the global risk appetite cause co-movement in emerging market risk premiums. However, the sensitivity of the changes in risk premium to the global risk appetite may vary across emerging markets. In this study, how the global risk appetite affects Credit Default Swap (CDS) premiums in emerging markets are analyzed using Principal Component Analysis (PCA) and rolling regressions. The PCA results indicate that the first common component derived by the PCA accounts for almost 76 percent of the common variation in CDS premiums. Additionally, the explanatory power of the first factor seems to be high over the sample period. However, the sensitivity to the global risk factor tends to change over time and across countries. In this regard, fixed effects panel regressions are used to identify the macroeconomic factors driving the heterogeneity across emerging markets. The panel regression results point to the significance of government debt to GDP and international reserves to GDP in explaining sensitivity. Accordingly, countries with lower government debt and higher reserves tend to be less subject to the variations in the global risk appetite.Keywords: credit default swaps, emerging markets, principal components analysis, sovereign risk
Procedia PDF Downloads 3834904 Digital Economy as an Alternative for Post-Pandemic Recovery in Latin America: A Literature Review
Authors: Armijos-Orellana Ana, González-Calle María, Maldonado-Matute Juan, Guerrero-Maxi Pedro
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Nowadays, the digital economy represents a fundamental element to guarantee economic and social development, whose importance increased significantly with the arrival of the COVID-19 pandemic. However, despite the benefits it offers, it can also be detrimental to those developing countries characterized by a wide digital divide. It is for this reason that the objective of this research was to identify and describe the main characteristics, benefits, and obstacles of the digital economy for Latin American countries. Through a bibliographic review, using the analytical-synthetic method in the period 1995-2021, it was determined that the digital economy could give way to structural changes, reduce inequality, and promote processes of social inclusion, as well as promote the construction and participatory development of organizational structures and institutional capacities in Latin American countries. However, the results showed that the digital economy is still incipient in the region and at least three factors are needed to establish it: joint work between academia, the business sector and the State, greater emphasis on learning and application of digital transformation and the creation of policies that encourage the creation of digital organizations.Keywords: developing countries, digital divide, digital economy, digital literacy, digital transformation
Procedia PDF Downloads 1434903 Modeling Sustainable Truck Rental Operations Using Closed-Loop Supply Chain Network
Authors: Khaled S. Abdallah, Abdel-Aziz M. Mohamed
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Moving industries consume numerous resources and dispose masses of used packaging materials. Proper sorting, recycling and disposing the packaging materials is necessary to avoid a sever pollution disaster. This research paper presents a conceptual model to propose sustainable truck rental operations instead of the regular one. An optimization model was developed to select the locations of truck rental centers, collection sites, maintenance and repair sites, and identify the rental fees to be charged for all routes that maximize the total closed supply chain profits. Fixed costs of vehicle purchasing, costs of constructing collection centers and repair centers, as well as the fixed costs paid to use disposal and recycling centers are considered. Operating costs include the truck maintenance, repair costs as well as the cost of recycling and disposing the packing materials, and the costs of relocating the truck are presented in the model. A mixed integer model is developed followed by a simulation model to examine the factors affecting the operation of the model.Keywords: modeling, truck rental, supply chains management.
Procedia PDF Downloads 2314902 The Effectiveness of Communication Skills Using Transactional Analysis on the Dimensions of Marital Intimacy: An Experimental Study
Authors: Mehravar Javid, James Sexton, S. Taridashti, Joseph Dorer
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Objective: Intimacy is among the most important factors in marital relationships and includes different aspects. Communication skills can enable couples to promote their intimacy. This experimental study was conducted to measure the effectiveness of communication skills using Transactional Analysis (TA) on various dimensions of marital intimacy. Method: The participants in this study were female teachers. Analysis of covariance was recruited in the experimental group (n =15) and control group (n =15) with pre-test and post-test. Random assignment was applied. The experimental group received the Transactional Analysis training program for 9 sessions of 2 hours each week. The instrument was the Marital Intimacy Questionnaire, with 87 items and 9 subscales. Result: The findings suggest that training in Transactional Analysis significantly increased the total score of intimacy except spiritual intimacy on the post-test. Discussion: According to the obtained data, it is concluded that communication skills using Transactional Analysis (TA) training could increase intimacy and improve marital relationships. The study highlights the differential effects on emotional, rational, sexual, and psychological intimacy compared to physical, social/recreational, and relational intimacy over a 9-week period.Keywords: communication skills, intimacy, marital relationships, transactional analysis
Procedia PDF Downloads 1024901 Problem, Policy and Polity in Agenda Setting: Analyzing Safe Motherhood Program in India
Authors: Vanita Singh
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In developing countries, there are conflicting political agendas; policy makers have to prioritize issues from a list of issues competing for the limited resources. Thus, it is imperative to understand how some issues gain attention, and others lose in the policy circles. Multiple-Streams Theory of Kingdon (1984) is among the influential theories that help to understand the public policy process and is utilitarian for health policy makers to understand how certain health issues emerge on the policy agendas. The issue of maternal mortality was long standing in India and was linked with high birth rate thus the focus of maternal health policy was on family planning since India’s independence. However, a paradigm shift was noted in the maternal health policy in the year 1992 with the launch of Safe Motherhood Programme and then in the year 2005, when the agenda of maternal health policy became universalizing institutional deliveries and phasing-out of Traditional Birth Attendants (TBAs) from the health system. There were many solutions proposed by policy communities other than universalizing of institutional deliveries, including training of TBAs and improving socio-economic conditions of pregnant women. However, Government of India favored medical community, which was advocating for the policy of universalizing institutional delivery, and neglected the solutions proposed by other policy communities. It took almost 15 years for the advocates of institutional delivery to transform their proposed solution into a program - the Janani Suraksha Yojana (JSY), a safe-motherhood program promoting institutional delivery through cash incentives to pregnant women. Thus, the case of safe motherhood policy in India is worth studying to understand how certain issues/problems gain political attention and how advocacy work in policy circles. This paper attempts to understand the factors that favored the agenda of safe-motherhood in the policy circle in India, using John Kingdon’s Multiple-Stream model of agenda-setting. Through document analysis and literature review, the paper traces the evolution of safe motherhood program and maternal health policy. The study has used open source documents available on the website of Ministry of Health and Family Welfare, media reports (Times of India Archive) and related research papers. The documents analyzed include National health policy-1983, National Health Policy-2002, written reports of Ministry of Health and Family Welfare Department, National Rural Health Mission (NRHM) document, documents related to Janani Suraksha Yojana and research articles related to maternal health programme in India. The study finds that focusing events and credible indicators coupled with media attention has the potential to recognize a problem. The political elites favor clearly defined and well-accepted solutions. The trans-national organizations affect the agenda-setting process in a country through conditional resource provision. The closely-knit policy communities and political entrepreneurship are required for advocating solutions high on agendas. The study has implications for health policy makers in identifying factors that have the potential to affect the agenda-setting process for a desired policy agenda and identify the challenges in generating political priorities.Keywords: agenda-setting, focusing events, Kingdon’s model, safe motherhood program India
Procedia PDF Downloads 1514900 Entrepreneurial Orientation and Customer Satisfaction: Evidences nearby Khao San Road
Authors: Vichada Chokesikarin
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The study aims to determine which factors account for customer satisfaction and to investigate the relationship between entrepreneurial orientation and business success, in particular, context of the information understanding of hostel business in Pranakorn district, Bangkok and the significant element of entrepreneurship in tourism industry. This study covers 352 hostels customers and 61 hostel owners/managers nearby Khao San Road. Data collection methods were used by survey questionnaire and a series of hypotheses were developed from services marketing literature. The findings suggest the customer satisfaction most influenced by image, service quality, room quality and price accordingly. Furthermore the findings revealed that significant relationships exist between entrepreneurial orientation and business success; while competitive aggressiveness was found unrelated. The ECSI model’s generic measuring customer satisfaction was found partially mediate the business success. A reconsideration of other variables applicable should be supported with the model of hostel business. The study provides context and overall view of hostel business while discussing from the entrepreneurial orientation to customer satisfaction, thereby reducing decision risk on hostel investment.Keywords: customer satisfaction, ECSI model, entrepreneurial orientation, small hotel, hostel, business performance
Procedia PDF Downloads 3394899 Constraints Women Academician's Participation at Administrative Positions in Higher Education of Developing Countries
Authors: Bahieh Mohajeri, Mohamad Sharif Mustaf, Mahani Mokhtar
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Purpose: This paper attempts to set the stage for the exploration of female participation in administrative positions within non-western countries by reviewing the studies on female in administrative positions within non-western countries and suggesting guidelines for future studies in this area in developing countries. Methodology: The paper is based on a systematic review of papers that have been published in journals. Findings: The review focuses on constraints to female’s participation in higher education of developing countries (e.g. strong family responsibility, low levels of women faculty members, social values and gendered cultural factors). Practical Implications: Further guidelines for future examination of this field of study are suggested (e.g. adopting a different theoretical view).Value: The article is an initial attempt to gather knowledge about constraints of female administrators in higher education of developing countries. The subject has received less attention in studies on administration and gender. In addition, the article provides suggestions for future studies in order to understand women administrators’ experiences in different educational and cultural settings.Keywords: administrative position, female administrator, developing countries, participation
Procedia PDF Downloads 2634898 Customer Adoption and Attitudes in Mobile Banking in Sri Lanka
Authors: Prasansha Kumari
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This paper intends to identify and analyze customer adoption and attitudes towards mobile banking facilities. The study uses six perceived characteristics of innovation that can be used to form a favorable or unfavorable attitude toward an innovation, namely: Relative advantage, compatibility, complexity, trailability, risk, and observability. Collected data were analyzed using Pearson Chi-Square test. The results showed that mobile bank users were predominantly males. There is a growing trend among young, educated customers towards converting to mobile banking in Sri Lanka. The research outcomes suggested that all the six factors are statistically highly significant in influencing mobile banking adoption and attitude formation towards mobile banking in Sri Lanka. The major reasons for adopting mobile banking services are the accessibility and availability of services regardless of time and place. Over the 75 percent of the respondents mentioned that savings in time and effort and low financial costs of conducting mobile banking were advantageous. Issue of security was found to be the most important factor that motivated consumer adoption and attitude formation towards mobile banking. Main barriers to mobile banking were the lack of technological skills, the traditional cash‐carry banking culture, and the lack of awareness and insufficient guidance to using mobile banking.Keywords: compatibility, complexity, mobile banking, observability, risk
Procedia PDF Downloads 2074897 Survey of Access Controls in Cloud Computing
Authors: Monirah Alkathiry, Hanan Aljarwan
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Cloud computing is one of the most significant technologies that the world deals with, in different sectors with different purposes and capabilities. The cloud faces various challenges in securing data from unauthorized access or modification. Consequently, security risks and levels have greatly increased. Therefore, cloud service providers (CSPs) and users need secure mechanisms that ensure that data are kept secret and safe from any disclosures or exploits. For this reason, CSPs need a number of techniques and technologies to manage and secure access to the cloud services to achieve security goals, such as confidentiality, integrity, identity access management (IAM), etc. Therefore, this paper will review and explore various access controls implemented in a cloud environment that achieve different security purposes. The methodology followed in this survey was conducting an assessment, evaluation, and comparison between those access controls mechanisms and technologies based on different factors, such as the security goals it achieves, usability, and cost-effectiveness. This assessment resulted in the fact that the technology used in an access control affects the security goals it achieves as well as there is no one access control method that achieves all security goals. Consequently, such a comparison would help decision-makers to choose properly the access controls that meet their requirements.Keywords: access controls, cloud computing, confidentiality, identity and access management
Procedia PDF Downloads 1334896 Understanding the Historical Consciousness of Children and Young People
Authors: Kay Carroll
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Creating historical consciousness in children and young people is critical to global inclusion and engagement. In a context of international and technological flux, children are confronted with shifting national identities. Within this quantitative study of Australian children and young people, the concept and development of historical consciousness are explored. The analysis reports on how children and young people are connected through national, collective, and personal narratives to understand historically significant events and changes, anchor themselves to universal and intergenerational traditions and norms, be open to divergent perspectives and resilient to perpetual socio-cultural shifts. This paper presents the development and factors that shape national historical consciousness in children and young people using established international frameworks and stages of historical consciousness. This research reports on quantitative surveys conducted with over 680 school children from ages 12 years to 19 years within Australian schools. Concepts of global citizenship, inclusion, and engagement with national historical memory and significance are explored. Findings identify the social benefits of collective and personal historical consciousness and consider the current barriers and enablers in developing a young person’s historical consciousness for the future.Keywords: curriculum, global citizenship, historical consciousness, significance
Procedia PDF Downloads 2024895 Determinants of Income Diversification among Support Zone Communities of National Parks in Nigeria
Authors: Daniel Etim Jacob, Samuel Onadeko, Edem A. Eniang, Imaobong Ufot Nelson
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This paper examined determinants of income diversification among households in support zones communities of national parks in Nigeria. This involved the use household data collected through questionnaires administered randomly among 1009 household heads in the study area. The data obtained were analyzed using probability and non-probability statistical analysis such as regression and analysis of variance to test for mean difference between parks. The result obtained indicates that majority of the household heads were male (92.57%0, between the age class of 21 – 40 years (44.90%), had non-formal education (38.16%), were farmers (65.21%), owned land (95.44%), with a household size of 1 – 5 (36.67%) and an annual income range of ₦401,000 - ₦600,000 (24.58%). Mean Simpson index of diversity showed a general low (0.375) level of income diversification among the households. Income, age, off-farm dependence, education, household size and occupation where significant (p<0.01) factors that affected households’ income diversification. The study recommends improvement in the existing infrastructures and social capital in the communities as avenues to improve the livelihood and ensure positive conservation behaviors in the study area.Keywords: income diversification, protected area, livelihood, poverty, Nigeria
Procedia PDF Downloads 1484894 Endometrial Ablation and Resection Versus Hysterectomy for Heavy Menstrual Bleeding: A Systematic Review and Meta-Analysis of Effectiveness and Complications
Authors: Iliana Georganta, Clare Deehan, Marysia Thomson, Miriam McDonald, Kerrie McNulty, Anna Strachan, Elizabeth Anderson, Alyaa Mostafa
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Context: A meta-analysis of randomized controlled trials (RCTs) comparing hysterectomy versus endometrial ablation and resection in the management of heavy menstrual bleeding. Objective: To evaluate the clinical efficacy, satisfaction rates and adverse events of hysterectomy compared to more minimally invasive techniques in the treatment of HMB. Evidence Acquisition: A literature search was performed for all RCTs and quasi-RCTs comparing hysterectomy with either endometrial ablation endometrial resection of both. The search had no language restrictions and was last updated in June 2020 using MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, PubMed, Google Scholar, PsycINFO, Clinicaltrials.gov and Clinical trials. EU. In addition, a manual search of the abstract databases of the European Haemophilia Conference on women's health was performed and further studies were identified from references of acquired papers. The primary outcomes were patient-reported and objective reduction in heavy menstrual bleeding up to 2 years and after 2 years. Secondary outcomes included satisfaction rates, pain, adverse events short and long term, quality of life and sexual function, further surgery, duration of surgery and hospital stay and time to return to work and normal activities. Data were analysed using RevMan software. Evidence synthesis: 12 studies and a total of 2028 women were included (hysterectomy: n = 977 women vs endometrial ablation or resection: n = 1051 women). Hysterectomy was compared with endometrial ablation only in five studies (Lin, Dickersin, Sesti, Jain, Cooper) and endometrial resection only in five studies (Gannon, Schulpher, O’Connor, Crosignani, Zupi) and a mixture of the Ablation and Resection in two studies (Elmantwe, Pinion). Of the 1² studies, 10 reported women’s perception of bleeding symptoms as improved. Meta-analysis showed that women in the hysterectomy group were more likely to show improvement in bleeding symptoms when compared with endometrial ablation or resection up to 2-year follow-up (RR 0.75, 95% CI 0.71 to 0.79, I² = 95%). Objective outcomes of improvement in bleeding also favored hysterectomy. Patient satisfaction was higher after hysterectomy within the 2 years follow-up (RR: 0.90, 95%CI: 0.86 to 0.94, I²:58%), however, there was no significant difference between the two groups at more than 2 years follow up. Sepsis (RR: 0.03, 95% CI 0.002 to 0.56; 1 study), wound infection (RR: 0.05, 95% CI: 0.01 to 0.28, I²: 0%, 3 studies) and Urinary tract infection (UTI) (RR: 0.20, 95% CI: 0.10 to 0.42, I²: 0%, 4 studies) all favoured hysteroscopic techniques. Fluid overload (RR: 7.80, 95% CI: 2.16 to 28.16, I² :0%, 4 studies) and perforation (RR: 5.42, 95% CI: 1.25 to 23.45, I²: 0%, 4 studies) however favoured hysterectomy in the short term. Conclusions: This meta-analysis has demonstrated that endometrial ablation and endometrial resection are both viable options when compared with hysterectomy for the treatment of heavy menstrual bleeding. Hysteroscopic procedures had better outcomes in the short term with fewer adverse events including wound infection, UTI and sepsis. The hysterectomy performed better when measuring more long-term impacts such as recurrence of symptoms, overall satisfaction at two years and the need for further treatment or surgery.Keywords: menorrhagia, hysterectomy, ablation, resection
Procedia PDF Downloads 1584893 Accelerating Sustainable Urban Transition Through Green Technology Innovation and Clean Energy to Achieve Net Zero Emissions
Authors: Emma Serwaa Obobisa
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Urbanization has become the focus for challenging goals relating to environmental performance, such as carbon neutrality. Green technological innovation and clean energy are considered the prominent factors in reducing emissions and achieving sustainable cities. Through the application of a fixed effect model, generalized method of moments, and quantile-on-quantile regression, this study explores the role of green technology innovation and clean energy in accelerating the sustainable urban transition towards net zero emissions in developing countries while controlling for nonrenewable energy consumption, and economic growth. The long-run results show that green technology innovation and renewable energy consumption reduce CO₂ emissions from urban residential buildings. In contrast, economic growth and nonrenewable energy consumption increase CO₂ emissions. This study proposes a consistent technique for encouraging green technological innovation and renewable energy projects in developing countries where the role of innovation in achieving carbon neutrality is still understudied.Keywords: green technology innovation, renewable energy, urbanization, net zero emissions
Procedia PDF Downloads 394892 Creation of a Trust-Wide, Cross-Speciality, Virtual Teaching Programme for Doctors, Nurses and Allied Healthcare Professionals
Authors: Nelomi Anandagoda, Leanne J. Eveson
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During the COVID-19 pandemic, the surge in in-patient admissions across the medical directorate of a district general hospital necessitated the implementation of an incident rota. Conscious of the impact on training and professional development, the idea of developing a virtual teaching programme was conceived. The programme initially aimed to provide junior doctors, specialist nurses, pharmacists, and allied healthcare professionals from medical specialties and those re-deployed from other specialties (e.g., ophthalmology, GP, surgery, psychiatry) the knowledge and skills to manage the deteriorating patient with COVID-19. The programme was later developed to incorporate the general internal medicine curriculum. To facilitate continuing medical education whilst maintaining social distancing during this period, a virtual platform was used to deliver teaching to junior doctors across two large district general hospitals and two community hospitals. Teaching sessions were recorded and uploaded to a common platform, providing a resource for participants to catch up on and re-watch teaching sessions, making strides towards reducing discrimination against the professional development of less than full-time trainees. Thus, creating a learning environment, which is inclusive and accessible to adult learners in a self-directed manner. The negative impact of the pandemic on the well-being of healthcare professionals is well documented. To support the multi-disciplinary team, the virtual teaching programme evolved to included sessions on well-being, resilience, and work-life balance. Providing teaching for learners across the multi-disciplinary team (MDT) has been an eye-opening experience. By challenging the concept that learners should only be taught within their own peer groups, the authors have fostered a greater appreciation of the strengths of the MDT and showcased the immense wealth of expertise available within the trust. The inclusive nature of the teaching and the ease of joining a virtual teaching session has facilitated the dissemination of knowledge across the MDT, thus improving patient care on the frontline. The weekly teaching programme has been running for over eight months, with ongoing engagement, interest, and participation. As described above, the teaching programme has evolved to accommodate the needs of its learners. It has received excellent feedback with an appreciation of its inclusive, multi-disciplinary, and holistic nature. The COVID-19 pandemic provided a catalyst to rapidly develop novel methods of working and training and widened access/exposure to the virtual technologies available to large organisations. By merging pedagogical expertise and technology, the authors have created an effective online learning environment. Although the authors do not propose to replace face-to-face teaching altogether, this model of virtual multidisciplinary team, cross-site teaching has proven to be a great leveler. It has made high-quality teaching accessible to learners of different confidence levels, grades, specialties, and working patterns.Keywords: cross-site, cross-speciality, inter-disciplinary, multidisciplinary, virtual teaching
Procedia PDF Downloads 1754891 Application of Discrete-Event Simulation in Health Technology Assessment: A Cost-Effectiveness Analysis of Alzheimer’s Disease Treatment Using Real-World Evidence in Thailand
Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk
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Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment
Procedia PDF Downloads 1324890 Study Mercapto-Nanoscavenger as a Promising Analytical Tool
Authors: Mohammed M. Algaradah
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A chelating mercapto- nanoscavenger has been developed exploiting the high surface area of monodisperse nano-sized mesoporous silica. The nanoscavenger acts as a solid phase trace metal extractant whilst suspended as a quasi-stable sol in aqueous samples. This mode of extraction requires no external agitation as the particles move naturally through the sample by Brownian motion, convection and slow sedimentation. Careful size selection enables the nanoscavenger to be easily recovered together with the extracted analyte by conventional filtration or centrifugation. The research describes the successful attachment of chelator mercapto to ca. 136 ± 15 nm high surface area (BET surface area = 1006 m2 g-1) mesoporous silica particles. The resulting material had a copper capacity of ca. 1.34 ± 0.10 mmol g-1 and was successfully applied to the collection of a trace element from water. Essentially complete recovery of Cu (II) has been achieved from freshwater samples giving typical preconcentration factors of 100 from 50 µg/l samples. Data obtained from a nanoscavenger-based extraction of copper from samples were not significantly different from those obtained by using a conventional colorimetric procedure employing complexation/solvent extraction.Keywords: nano scavenger, mesoporous silica, trace metal, preconcentration
Procedia PDF Downloads 914889 Mechanical Transmission of Parasites by Cockroaches’ Collected from Urban Environment of Lahore, Pakistan
Authors: Hafsa Memona, Farkhanda Manzoor
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Cockroaches are termed as medically important pests because of their wide distribution in human habitation including houses, hospitals, food industries and kitchens. They may harbor multiple drug resistant pathogenic bacteria and protozoan parasites on their external surfaces, disseminate on human food and cause serious diseases and allergies to human. Hence, they are regarded as mechanical vector in human habitation due to their nocturnal activity and nutritional behavior. Viable eggs and dormant cysts of parasites can hitch a ride on cockroaches. Ova and cysts of parasitic organism may settle into the crevices and cracks between thorax and head. There are so many fissures and clefts and crannies on a cockroach which provide site for these organisms. This study aimed with identifying role of cockroaches in mechanically transmitting and disseminating gastrointestinal parasites in two environmental settings; hospitals and houses in urban area of Lahore. Totally, 250 adult cockroaches were collected from houses and hospitals by sticky traps and food baited traps and screened for parasitic load. All cockroaches were captured during their feeding time in natural habitat. Direct wet smear, 1% lugols iodine and modified acid-fast bacilli staining were used to identify the parasites from the body surfaces of cockroaches. Among human habitation two common species of cockroaches were collected i.e. P. americana and B. germanica. The results showed that 112 (46.8%) cockroaches harbored at least one human intestinal parasite on their body surfaces. The cockroaches from hospital environment harboured more parasites than houses. 47 (33.57%) cockroaches from houses and 65 (59.09%) from hospitals were infected with parasitic organisms. Of these, 76 (67.85%) were parasitic protozoans and 36(32.15%) were pathogenic and non-pathogenic intestinal parasites. P. americana harboured more parasites as compared to B. germanica in both environment. Most common human intestinal parasites found on cockroaches include ova of Ascaris lumbricoides (giant roundworm), Trichuris trichura (whipworm), Anchylostoma deodunalae (hookworm), Enterobius vermicularis (pinworm), Taenia spp. and Strongyloides stercoralis (threadworm). The cysts of protozoans’ parasites including Balantidium coli, Entomoeba hystolitica, C. parvum, Isospora belli, Giardia duodenalis and C. cayetenensis were isolated and identified from cockroaches. Both experimental sites were significantly different in carriage of parasitic load on cockroaches. Difference in the hygienic condition of the environments, including human excrement disposal, variable habitat interacted, indoor and outdoor species, may account for the observed variation in the parasitic carriage rate of cockroaches among different experimental site. Thus a finding of this study is that Cockroaches are uniformly distributed in human habitation and act as a mechanical vector of pathogenic parasites that cause common illness such as diarrhea and bowel disorders. This fact contributes to epidemiological chain therefore control of cockroaches will significantly lessen the prevalence of illness in human. Effective control strategies will reduce the public health burden of the gastro-intestinal parasites in the developing countries.Keywords: cockroaches, health risks, hospitals, houses, parasites, protozoans, transmission
Procedia PDF Downloads 2874888 The Causes and Recommended Solutions of Burnout in Teaching Careers from the Perspective of University Professors
Authors: Narjes Tahmasbi
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Burnout is considered a work-related syndrome made from a person’s recognition of a gap between expecting success in professional performance and less satisfying reality. Teaching, as one of the most stressful jobs in the world, creates a sense of burnout that disturbs the competency of teachers’ personal and professional features, and it can be dangerous for themselves as well as their students. Recently, there has been growing research on the different effects of burnout; however, it is necessary to investigate the causes of this issue, especially in universities. This study aims to investigate the causes and recommended solutions to burnout in the teaching careers of university professors. The participants of the study were 5 EFL university professors from an institution of higher education in Shiraz, Iran. The current study used a qualitative design. Data were obtained from an interview with all participants. The participants were asked to answer 8 questions that were made through a semi-instructional interview. The results of the interview with the participants indicated that there were 4 main reasons that cause burnout in teachers: lack of student motivation, environmental factors, interpersonal problems, and financial problems. Recommended solutions were different according to the different personalities, creativity, and experiences of participants. The discussion of each of the causes of burnout represents how these categories cause burnout, and the discussion of each of the solutions shows how a teacher can handle burnout.Keywords: burnout, EFL teachers, reasons, solutions, work-related syndrome
Procedia PDF Downloads 854887 Genetic Evaluation of Locally Flock Sheep in Gabaraka Village
Authors: Salim Omar Raoof
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This study was conducted in a private local sheep herd at Gabaraka village-Kirkuk-Iraq. Analysis of 77 ewes recorded and 7 Rams of local sheep presented in Gabaraka village farm plain, the age of ewes ranged between (2-4) years. The aim of this study is to investigate the genetic and non-genetic factors (type of birth, sex, and age of dam) affecting daily milk yield (DMY), birth weight (BW), weaning weight (WW) and Gain characteristics of local sheep raised under Iraq conditions, and it also aims at estimating heritability’s, BLUP. The overall mean of daily milk yield, (BW), (WW), and gain. Was 444.15gm,4.92kg,43.08kg, and 38.16kg, respectively. The results showed there was a significant effect of the type of birth and sex on (BW) and (WW). Also, the age of the dam had a significant effect on daily milk yield (BW), (WW), and gain. Generally, the estimate of heritability of DMP, BWT, WWT, and Gain tend to be 0.22, 0.17, 0.27, and 0.22, respectively. The breeding value (BLUP) for rams ranged between (-0.1684 to 0.188), (-0.205 to 0.310), and ( -0.0171 to 0.029) according to growth traits of Lambs BW, WW, and Gain, respectively. It concluded that the selection of ewes and rams at the population level in planned selection schemes is based on BLUP value and heritability.Keywords: locally sheep, milk yield, Genetic parameters, BLUP value
Procedia PDF Downloads 834886 Personality, Coping, Quality of Life, and Distress in Persons with Hearing Loss: A Cross-Sectional Study of Patients Referred to an Audiological Service
Authors: Oyvind Nordvik, Peder O. L. Heggdal, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad
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Background: Hearing Loss (HL) is a condition that may affect people in all stages of life, but the prevalence increases with age, mostly because of age-related HL, generally referred to as presbyacusis. As human speech is related to relatively high frequencies, even a limited hearing loss at high frequencies may cause impaired speech intelligibility. Being diagnosed with, treated for and living with a chronic condition such as HL, must for many be a disabling and stressful condition that put ones coping resources to test. Stress is a natural part of life and most people will experience stressful events or periods. Chronic diseases, such as HL, are risk factor for distress in individuals, causing anxiety and lowered mood. How an individual cope with HL may be closely connected to the level of distress he or she is experiencing and to personality, which can be defined as those characteristics of a person that account for consistent patterns of feelings, thinking, and behavior. Thus, as to distress in life, such as illness or disease, available coping strategies may be more important than the challenge itself. The same line of arguments applies to level of experienced health-related quality of life (HRQoL). Aim: The aim of this study was to investigate the relationship between distress, HRQoL, reported hearing loss, personality and coping in patients with HL. Method: 158 adult (aged 18-78 years) patients with HL, referred for hearing aid (HA) fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals were included. First-time users had been pre-examined by an ENT-specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2, and 4 kHz) was determined for each ear. The Eysenck personality inventory, neuroticism and lie scales, the Theoretically Originated Measure of the Cognitive Activation Theory of Stress (TOMCATS) measuring active coping, hopelessness and helplessness, as well as distress (General Health Questionnaire (GHQ) - 12 items) and the EORTC Quality of Life Questionnaire general part were answered. In addition, we used a revised and shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) as a measure of patient-reported hearing loss. Results: Significant correlations were determined between APHAB (weak), HRQoL scores (strong), distress scores (strong) on the one side and personality and choice of coping scores on the other side. As measured by stepwise regression analyses, the distress and HRQoL scores were scored secondary to the obtained personality and coping scores. The APHAB scores were as determined by regression analyses scored secondary to PTA (best ear), level of neuroticism and lie score. Conclusion: We found that reported employed coping style, distress/HRQoL and personality are closely connected to each other in this patient group. Patient-reported HL was associated to hearing level and personality. There is need for further investigations on these questions, and how these associations may influence the clinical context.Keywords: coping, distress, hearing loss, personality
Procedia PDF Downloads 1474885 Construct the Fur Input Mixed Model with Activity-Based Benefit Assessment Approach of Leather Industry
Authors: M. F. Wu, F. T. Cheng
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Leather industry is the most important traditional industry to provide the leather products in the world for thousand years. The fierce global competitive environment and common awareness of global carbon reduction make livestock supply quantities falling, salt and wet blue leather material reduces and the price skyrockets significantly. Exchange rate fluctuation led sales revenue decreasing which due to the differences of export exchanges and compresses the overall profitability of leather industry. This paper applies activity-based benefit assessment approach to build up fitness fur input mixed model, fur is Wet Blue, which concerned with four key factors: the output rate of wet blue, unit cost of wet blue, yield rate and grade level of Wet Blue to achieve the low cost strategy under given unit price of leather product condition of the company. The research findings indicate that applying this model may improve the input cost structure, decrease numbers of leather product inventories and to raise the competitive advantages of the enterprise in the future.Keywords: activity-based benefit assessment approach, input mixed, output rate, wet blue
Procedia PDF Downloads 3794884 Fast Adjustable Threshold for Uniform Neural Network Quantization
Authors: Alexander Goncharenko, Andrey Denisov, Sergey Alyamkin, Evgeny Terentev
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The neural network quantization is highly desired procedure to perform before running neural networks on mobile devices. Quantization without fine-tuning leads to accuracy drop of the model, whereas commonly used training with quantization is done on the full set of the labeled data and therefore is both time- and resource-consuming. Real life applications require simplification and acceleration of quantization procedure that will maintain accuracy of full-precision neural network, especially for modern mobile neural network architectures like Mobilenet-v1, MobileNet-v2 and MNAS. Here we present a method to significantly optimize training with quantization procedure by introducing the trained scale factors for discretization thresholds that are separate for each filter. Using the proposed technique, we quantize the modern mobile architectures of neural networks with the set of train data of only ∼ 10% of the total ImageNet 2012 sample. Such reduction of train dataset size and small number of trainable parameters allow to fine-tune the network for several hours while maintaining the high accuracy of quantized model (accuracy drop was less than 0.5%). Ready-for-use models and code are available in the GitHub repository.Keywords: distillation, machine learning, neural networks, quantization
Procedia PDF Downloads 3324883 Sensitivity of Credit Default Swaps Premium to Global Risk Factor: Evidence from Emerging Markets
Authors: Oguzhan Cepni, Doruk Kucuksarac, M. Hasan Yilmaz
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Risk premium of emerging markets are moving altogether depending on the momentum and shifts in the global risk appetite. However, the magnitudes of these changes in the risk premium of emerging market economies might vary. In this paper, we focus on how global risk factor affects credit default swaps (CDS) premiums of emerging markets using principal component analysis (PCA) and rolling regressions. PCA results indicate that the first common component accounts for almost 76% of common variation in CDS premiums of emerging markets. Additionally, the explanatory power of the first factor seems to be high over sample period. However, the sensitivity to the global risk factor tends to change over time and across countries. In this regard, fixed effects panel regressions are employed to identify the macroeconomic factors driving the heterogeneity across emerging markets. There are two main macroeconomic variables that affect the sensitivity; government debt to GDP and international reserves to GDP. The countries with lower government debt and higher reserves tend to be less subject to the variations in the global risk appetite.Keywords: emerging markets, principal component analysis, credit default swaps, sovereign risk
Procedia PDF Downloads 3844882 Optimizing Resource Allocation and Indoor Location Using Bluetooth Low Energy
Authors: Néstor Álvarez-Díaz, Pino Caballero-Gil, Héctor Reboso-Morales, Francisco Martín-Fernández
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The recent tendency of "Internet of Things" (IoT) has developed in the last years, causing the emergence of innovative communication methods among multiple devices. The appearance of Bluetooth Low Energy (BLE) has allowed a push to IoT in relation to smartphones. In this moment, a set of new applications related to several topics like entertainment and advertisement has begun to be developed but not much has been done till now to take advantage of the potential that these technologies can offer on many business areas and in everyday tasks. In the present work, the application of BLE technology and smartphones is proposed on some business areas related to the optimization of resource allocation in huge facilities like airports. An indoor location system has been developed through triangulation methods with the use of BLE beacons. The described system can be used to locate all employees inside the building in such a way that any task can be automatically assigned to a group of employees. It should be noted that this system cannot only be used to link needs with employees according to distances, but it also takes into account other factors like occupation level or category. In addition, it has been endowed with a security system to manage business and personnel sensitive data. The efficiency of communications is another essential characteristic that has been taken into account in this work.Keywords: bluetooth low energy, indoor location, resource assignment, smartphones
Procedia PDF Downloads 3974881 Experience Level and Adoption of Interpretation Strategies by Iranian Interpreters
Authors: Niloofar Fathizaviyehkord
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Just as two hands cannot make a good boxer, knowing two or more languages cannot make a skillful interpreter. Interpreting, either consecutive or simultaneous, is a cognitively demanding task requiring not only linguistic and discourse knowledge but also strategic competence. Moreover, experience level can play a very crucial role in the strategies interpreters may employ since translation and interpretation quality is a matter of experience, besides other factors, as well. With regard to the significance of strategic competence, this study investigated what strategies are mainly employed by interpreters, what strategies are employed more frequently, and whether experience level can affect the choice of strategies by interpreters or not. To collect the necessary data, the first retrospective interviews were held with 20 interpreters experienced more or less in simultaneous and consecutive interpretation to see what strategies other than those classified in the literature are employed by interpreters. Then, several classifications of strategies in literature were merged with those emerging from the retrospective interviews to come up with a comprehensive questionnaire on interpreting strategies. After seeking five experts’ opinions regarding the wording/content of the questionnaire, it was given to 60 interpreters. The statistical analysis of the questionnaire data and experience level through ANOVA showed experience level could affect the choice of strategies. This study closes with the theoretical/practical implications of the findings for interpreter training.Keywords: experience level, consecutive and simultaneous, interpretation strategies, translation
Procedia PDF Downloads 1414880 Possibility Theory Based Multi-Attribute Decision-Making: Application in Facility Location-Selection Problem under Uncertain and Extreme Environment
Authors: Bezhan Ghvaberidze
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A fuzzy multi-objective facility location-selection problem (FLSP) under uncertain and extreme environments based on possibility theory is developed. The model’s uncertain parameters in the q-rung orthopair fuzzy values are presented and transformed in the Dempster-Shaper’s belief structure environment. An objective function – distribution centers’ selection ranking index as an extension of Dempster’s extremal expectations under discrimination q-rung orthopair fuzzy information is constructed. Experts evaluate each humanitarian aid from distribution centers (HADC) against each of the uncertain factors. HADCs location problem is reduced to the bicriteria problem of partitioning the set of customers by the set of centers: (1) – Minimization of transportation costs; (2) – Maximization of centers’ selection ranking indexes. Partitioning type constraints are also constructed. For an illustration of the obtained results, a numerical example is created from the facility location-selection problem.Keywords: FLSP, multi-objective combinatorial optimization problem, evidence theory, HADC, q-rung orthopair fuzzy set, possibility theory
Procedia PDF Downloads 1254879 Ecosystem Post-Wildfires Effects of Thasos Island
Authors: George D. Ranis, Valasia Iakovoglou, George N. Zaimes
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Fires are one of the main types of disturbances that shape ecosystems in the Mediterranean region. However nowadays, climate alterations towards higher temperature regimes results on the increased levels of the intensity, frequency and the spread of fires inducing obstacles for the natural regeneration. Thasos Island is one of the Greek islands that have experienced those problems. Since 1984, a series of wildfires led to the reduction of forest cover from 61.6% to almost 20%. The negative impacts were devastating in many different aspects for the island. The absence of plant cover, post-wildfire precipitation and steep slopes were the major factors that induced severe soil erosion and intense flooding events. That also resulted to serious economic problems to the local communities and the ability of the burnt areas to regenerate naturally. Despite the substantial amount of published work regarding Thasos wildfires, there is no information related to post-wildfire effects on the hydrology and soil erosion. More research related to post-fire effects should help to an overall assessment of the negative impacts of wildfires on land degradation through processes such as soil erosion and flooding.Keywords: erosion, land degradation, Mediterranean islands, regeneration, Thasos, wildfires
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