Search results for: emergency service

Authors: Fatima Z. Cherhabil, Mammar Sedrati, Sonia-Sabrina Bendib‎

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In order to support the continued growth, critical latency of ‎IoT ‎applications, and ‎various obstacles of traditional data centers, ‎mobile edge ‎computing (MEC) has ‎emerged as a promising solution that extends cloud data-processing and decision-making to edge devices. ‎By adopting a MEC structure, IoT applications could be executed ‎locally, on ‎an edge server, different fog nodes, or distant cloud ‎data centers. However, we are ‎often ‎faced with wanting to optimize conflicting criteria such as ‎minimizing energy ‎consumption of limited local capabilities (in terms of CPU, RAM, storage, bandwidth) of mobile edge ‎devices and trying to ‎keep ‎high performance (reducing ‎response time, increasing throughput and service availability) ‎at the same ‎time‎. Achieving one goal may affect the other, making task offloading (TO), ‎resource allocation (RA), and service placement (SP) complex ‎processes. ‎It is a nontrivial multi-objective optimization ‎problem ‎to study the trade-off between conflicting criteria. ‎The paper provides a survey on different TO, SP, and RA recent multi-‎objective optimization (MOO) approaches used in edge computing environments, particularly artificial intelligent (AI) ones, to satisfy various objectives, constraints, and dynamic conditions related to IoT applications‎.

Keywords: mobile edge computing, multi-objective optimization, artificial ‎intelligence ‎approaches, task offloading, resource allocation, ‎ service placement

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Authors: Alisher Agzamov, Hanan Al Harbi

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BACKGROUND: The timely assessment and treatment of ICU Surgical and Medical Oncology patients is important for Oncology surgeons and Medical Oncologists and Intensivists (1). We hypothesized that the use of Robot Physician’s (RP - 7) ICU management and care in ICU can improve ICU physician rapid response to unstable ICU Oncology patients. METHODS: This is a prospective study of 1501 oncology patients using a before-after, cohort-control design to test the effectiveness of RP. We have used RP to make multidisciplinary ICU rounds in the ICU and for Emergency cases. Data concerning several aspects of the RP interaction, including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RP, were documented. The effect of RP on ICU length of stay and cost was assessed. RESULTS: The use of RP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RP: 10.2 +/- 3.3 minutes vs conventional: 210 +/- 40 minutes). The response latencies to Oncology Emergency (8.0 +/- 2.8 vs 140 +/- 35 minutes) and for Respiratory Failure (12 +/- 04 vs 110 +/- 45 minutes) were reduced (P < .001), as was the LOS for oncology patients (5 days) and ARDS (10 day). There was an increase in ICU occupancy by 29 % compared with the prerobot era, and there was an ICU cost savings of KD2.2 million attributable to the use of RP. CONCLUSION: The use of RP enabled rapid face-to-face ICU Intensivist - physician response to unstable ICU Oncology patients and resulted in decreased ICU cost and LOS.

Keywords: robot physician, oncology patients, icu management and care, cost and icu occupancy

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Authors: Byeongju Choi, Sanggil Lee, Kyung-Eun Lee

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Introduction: In the republic of Korea, the number of workers in the beauty industry has been increasing. Because the prevalence of hepatitis B carriers in Korea is higher than in other countries, the risk of blood-borne infection including viral hepatitis B and C, among the workers by using the sharp and contaminated instruments during procedure can be expected among beauty salon workers. However, the health care policies for the workers to prevent the blood-borne infection are not established due to the lack of evidences. Moreover, the workers in hair and nail salon were mostly employed at small businesses, where national mandatory systems or policies for workers’ health management are not applied. In this study, the risk of the viral hepatitis B and C from the job experiencing the hair and nail procedures in the mortality was assessed. Method: We conducted a retrospective review of the job histories and causes of death in the female deaths from 2006-2016. 132,744 of female deaths who had one more job experiences during their lifetime were included in this study. Job histories were assessed using the employment insurance database in Korea Employment Information Service (KEIS) and the causes of death were in death statistics produced by Statistics Korea. Case group (n= 666) who died from viral hepatitis was classified the death having record involved in ‘B15-B19’ as a cause of deaths based on Korean Standard Classification of Diseases(KCD) with the deaths from other causes, control group (n=132,078). The group of the workers in the beauty service industry were defined as the employees who had ever worked in the industry coded as ‘9611’ based on Korea Standard Industry Classification (KSIC) and others were others. Other than job histories, birth year, marital status, education level were investigated from the death statistics. Multiple logistic regression analysis were used to assess the risk of deaths from viral hepatitis in the case and control group. Result: The number of the deaths having ever job experiences at the hair and nail salon was 255. After adjusting confounders of age, marital status and education, the odds ratio(OR) for deaths from viral hepatitis was quite high in the group having experiences with working in the beauty service industry with 3.14(95% confidence interval(CI) 1.00-9.87). Other associated factors with increasing the risk of deaths from viral hepatitis were low education level(OR=1.34, 95% CI 1.04-1.73), married women (OR=1.42, 95% CI 1.02-1.97). Conclusion: The risk of deaths from viral hepatitis were high in the workers in the beauty service industry but not statistically significant, which might attributed from the small number of workers in beauty service industry. It was likely that the number of workers in beauty service industry could be underestimated due to their temporary job position. Further studies evaluating the status and the incidence of viral infection among the workers with consideration of the vertical transmission would be required.

Keywords: beauty service, viral hepatitis, blood-borne infection, viral infection

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Authors: Sai-Kit Choi

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While traditional social services heavily depended on Government funding and support, there were always time lag, and resources mismatch with the fast growing and changing social needs. This study aims at investigating the effectiveness of implementing Circular Economy concept in a social service setting with comparison to Government Policy in response to social needs in 3 areas: response time, suitability, and community participation. To investigate the effectiveness of implementing Circular Economy concept in a social service setting, a real service model, a community resources sharing platform, was set up and statistics of the first 6 months’ operation data were used as comparison with traditional social services. Literature review was conducted as a reference basis of traditional social services under Government Policy. Case studies were conducted to provide the qualitative perspectives of the innovative approach. The results suggest that the Circular Economy model showed extraordinarily high level of community participation. In addition, it could utilize community resources in response precisely to the burning social needs. On the other hand, the available resources were unstable when comparing to those services supported by Government funding. The research team concluded that Circular Economy has high potential in applications in social service, especially in certain areas, such as resources sharing platform. Notwithstanding, it should be aware of the stability of resources when the services targeted to support some crucial needs.

Keywords: circular economy, social innovation, community participation, sharing economy, social response

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Authors: Rui Liu, Pengyu Cui, Nan Jiang

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At present, there is much research on the application of centralized management and cross-integration application of basic geographic information. However, the idea of information integration and sharing between land, sea, and air navigation targets is not deeply applied into the research of navigation information service, especially in the information expression. Targeting at this problem, the paper carries out works about the expression pattern of navigation electronic map for ground vehicles under air and land united navigation mechanism. At first, with the support from multi-source information fusion of GIS vector data, RS data, GPS data, etc., an air and land united information expression pattern is designed aiming at specific navigation task of emergency rescue in the earthquake. And then, the characteristics and specifications of the united expression of air and land navigation information under the constraints of map load are summarized and transferred into expression rules in the rule bank. At last, the related navigation experiment is implemented to evaluate the effect of the expression pattern. The experiment selects evaluation factors of the navigation task accomplishment time and the navigation error rate as the main index, and make comparisons with the traditional single information expression pattern. To sum up, the research improved the theory of navigation electronic map and laid a certain foundation for the design and realization of united navigation system in the aspect of real-time navigation information delivery.

Keywords: navigation electronic map, united navigation, multi-element expression pattern, multi-source information fusion

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Authors: A. Metioui

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Research related to the student’s conceptual difficulties in sciences, particularly in the field of physics, are relatively numerous. In this work, we will analyze the results of qualitative research conducted with 80 elementary preservice teachers from Quebec in Canada on their understandings after studying the free fall bodies. First, we will illustrate the paper-pencil questionnaire built for this purpose. Then we will give the analysis of the experimental data. The results show that, even though there is a continuing physics education, many misconceptions persist despite the teaching provided.

Keywords: pre-service teachers, elementary school, conceptual difficulties, free fall bodies

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Authors: Shahram Keshavarzi

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Today, getting good service, having a good time, and leaving the company with good feelings are importanttforbothcustomers and businesses. It has been observed that when customersareexposedtopleasantsmells, their visit times increase by 26%, and theyvisittheaislesfor 3 times longer. Byusingtheeffect of scents on people, it is toensurethatcustomersshopmore, benefit from the service and be satisfied. Intoday'sresearch, visual memory can be 40% effective after a period of 4 months, whileolfactorymemory is 60% moreeffectiveevenafter 1 year. The purpose of the research is thehiddenandeffectivepower of skepticism in the behavior of consumersandtheeffectivestrategy of modern marketing. Special scentsdirectlyaffecttheincrease in sales by influencing the customer's-decision mechanism in purchasing products.

Keywords: modern marketing strategy, scent, scent marketing, consumer behavior

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Authors: Arne Koschel

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This article discusses event monitoring options for heterogeneous event sources as they are given in nowadays heterogeneous distributed information systems. It follows the central assumption, that a fully generic event monitoring solution cannot provide complete support for event monitoring; instead, event source specific semantics such as certain event types or support for certain event monitoring techniques have to be taken into account. Following from this, the core result of the work presented here is the extension of a configurable event monitoring (Web) service for a variety of event sources. A service approach allows us to trade genericity for the exploitation of source specific characteristics. It thus delivers results for the areas of SOA, Web services, CEP and EDA.

Keywords: event monitoring, ECA, CEP, SOA, web services

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Authors: Michelangelo Liban, Debbie Liquete

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A case of a 93-year-old Filipina who experienced a sudden onset of left-sided hemichorea hemiballismus after falling from a standing height due to dizziness and then sought consult at the Emergency Room. She was not known to have diabetes mellitus nor experienced any symptoms of diabetes aside from its rare neurological manifestation of hemichorea-hemiballismus prior to this consult. On further workup, her baseline laboratory tests at the Emergency Room Department showed a CBG of 340mg/dL, an HbA1c of 15%, no ketones were detected in her urine but a hyperdensity with a Hounsfeld unit of 38 on CT, and hyperintensity on T1 weighted MRI on her right striatum with an incidental finding of a subdural hematoma measured as a 0.7cm hyperdensity on her right temporoparietal area with no midline shift. She was then treated with Clonazepam 2mg ¼ tab twice a day before bedtime and insulin 70/30 16 units in the morning and eight units in the evening, which provided good glycemic control maintained at 140-180 mg/dL, complete cessation of the left-sided hemichorea hemiballismus was also observed. The subdural hematoma was deemed non-surgical, and she refused admission into our institution; hence observation on an outpatient basis was done. This is a case of a rare neurological manifestation of diabetes mellitus but with good treatment response to anti-chorea medications combined with diabetes medications.

Keywords: hemichorea, hemiballismus, striatopathy, diabetes

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Authors: Veronica Basilio, Shuting Palomo

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This research paper explores the psychological concept of coherence and wellbeing. In particular, we focus on the relationship between individual well-being and community development. The focus setting for the research is Bali, Indonesia. The major finding of our research is: a coherent life can be achieved through living a life motivated by service to others, which contributes to community development and wellbeing. Coherence occurs when values are consistent with one’s thoughts, words, and actions. According to Antonovsky’s salutogenic theory, a sense of coherence is significant to psychological well-being. The ability to cope with life’s stressors is based on how comprehensive, manageable, and meaningful one’s sense of coherence is. The methodology for the research draws on an ethnographic approach with particular attention to participant observation and in-depth interviews within the context of village and family life in Bali. The research highlights Viktor Frankl’s ideas on self-actualization that is achieved through a life of service to others. The research also focuses on the individual’s ability to shift their perspective in the face of adversity, which contributes to individual development. Through personal transformation, one can be committed to serving others, which in the end, is the foundation of a coherent life and community development.

Keywords: psychology, bali, coherence, well-being, sociology

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Authors: Omur F. Karakullukcu, Bilal Okudan, Yusuf Can

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The aim of this study is to analyze sports managers’ managerial competence levels and job satisfaction’s correlation with career satisfaction. In the study, it has also been analyzed if there is any significant difference in sports managers’ managerial competence, job and career satisfaction in terms of gender, age, duty status, year of service and level of education. 256 sports managers, who work at department of sports service’s central and field organization at least as a chief in the manager position, have been chosen with random sampling method and they have voluntarily participated in the study. In the study, the managerial competence scale which was developed by Cetinkaya (2009), job satisfaction scale developed by Weiss at al.(1967) and Career Satisfaction Scale developed by Vatansever (2008) have been used as a data collection tool. The questionnaire form used as a data collection tool in the study includes a personal information form consisting of 5 questions; questioning gender, age, duty status, years of service and level of education. In the study, pearson correlation analysis has been used for defining the correlation of managerial competence levels, job satisfaction, and career satisfaction levels of sports managers. T-test analysis for binary grouping and anova analysis for more than binary groups have been used in the level of self-efficacy, collective and managerial competence in terms of the participants’ duty status, year of service and level of education. According to the research results, it has been found that there is a positive correlation between sports managers’ managerial competence levels, job satisfaction, and career satisfaction levels. Also, the results show that there is a significant difference in managerial competence levels, job satisfaction and career satisfaction of sports managers in terms of duty status, year of service and level of education; however, the results reveal that there is no significant difference in terms of age groups and gender.

Keywords: sports manager, managerial competence, job satisfaction, career satisfaction

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Authors: Mona Misfer Alshardan, Djamal Ziani

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Enterprise resource planning (ERP) systems are the organizations tickets to the global market. With the implementation of ERP, organizations can manage and coordinate all functions, processes, resources and data from different departments by a single software. However, many organizations consider the cost of traditional ERP to be expensive and look for alternative affordable solutions within their budget. One of these alternative solutions is providing ERP over a software as a service (SaaS) model. This alternative could be considered as a cost effective solution compared to the traditional ERP system. A key feature of any SaaS system is the multi-tenancy architecture where multiple customers (tenants) share the system software. However, different organizations have different requirements. Thus, the SaaS developers accommodate each tenant’s unique requirements by allowing tenant-level customization or configuration. While customization requires source code changes and in most cases a programming experience, the configuration process allows users to change many features within a predefined scope in an easy and controlled manner. The literature provides many techniques to accomplish the configuration process in different SaaS systems. However, the nature and complexity of SaaS ERP needs more attention to the details regarding the configuration process which is merely described in previous researches. Thus, this research is built on strong knowledge regarding the configuration in SaaS to define specifically the configuration borders in SaaS ERP and to design a configuration service with the consideration of the different configuration aspects. The proposed architecture will ensure the easiness of the configuration process by using wizard technology. Also, the privacy and performance are guaranteed by adopting the databases isolation technique.

Keywords: configuration, software as a service, multi-tenancy, ERP

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Authors: Tsegahun Manyazewal, Francesco Marinucci, Getachew Belay, Abraham Tesfaye, Gonfa Ayana, Amaha Kebede, Tsegahun Manyazewal, Francesco Marinucci, Getachew Belay, Abraham Tesfaye, Gonfa Ayana, Amaha Kebede, Yewondwossen Tadesse, Susan Lehman, Zelalem Temesgen

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In-service health trainings in Sub-Saharan Africa are mostly content-centered with higher disconnection with the real practice in the facility. This study intended to evaluate in-service training approach aimed to strengthen health care human resources. A combined web-based and face-to-face training was designed and piloted in Ethiopia with the diagnosis of tuberculosis. During the first part, which lasted 43 days, trainees accessed web-based material and read without leaving their work; while the second part comprised a one-day hands-on evaluation. Trainee’s competency was measured using multiple-choice questions, written-assignments, exercises and hands-on evaluation. Of 108 participants invited, 81 (75%) attended the course and 71 (88%) of them successfully completed. Of those completed, 73 (90%) scored a grade from A to C. The approach was effective to transfer knowledge and turn it into practical skills. In-service health training should transform from a passive one-time-event to a continuous behavioral change of participants and improvements on their actual work.

Keywords: Ethiopia, health care, Mycobacterium tuberculosis, training

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Authors: P. S. Jagadeesh Kumar, S. Meenakshi Sundaram

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With the increase of prevailing non-traditional rivalry, mobile banking experiences an ever changing commercial backdrop. Substantial customer demands have established to be more intricate as customers request more expediency and superintend over their banking services. To enterprise advance and modernization in mobile banking applications, it is gradually obligatory to deeply leapfrog the scuffle using business model transformation. The dramaturgical vicissitudes taking place in mobile banking entail advanced traditions to exploit security. By reforming and transforming older back office into integrated mobile banking applications, banks can engender a supple and nimble banking environment that can rapidly respond to new business requirements over cloud computing. Cloud computing is transfiguring ecosystems in numerous industries, and mobile banking is no exemption providing services innovation, greater flexibility to respond to improved security and enhanced business intelligence with less cost. Cloud technology offer secure deployment possibilities that can provision banks in developing new customer experiences, empower operative relationship and advance speed to efficient banking transaction. Cloud adoption is escalating quickly since it can be made secured for commercial mobile banking transaction through backend as a service in scrutinizing the security strategies of the cloud service provider along with the antiquity of transaction details and their security related practices.

Keywords: cloud adoption, backend as a service, business intelligence, secured mobile banking

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Authors: Debalkie Demissie Addisu, Ejigu Alemu Abebe, Tsegay Tensay Assefa

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This study examines the indirect effect of servant leadership on organizational citizenship behavior through perceptions of organizational politics moderated by political skill. This study reports the responses of 321 respondents from six federal public service organizations in Ethiopia. A multi-stage random sampling procedure was employed to select the sampled federal public service organizations. To test hypotheses, the study employed structural equation modeling using AMOS version-26 software. The result revealed that all direct effects have a significant effect. Specifically, servant leadership has a positive effect on organizational citizenship behavior. Likewise, servant leadership has a negative effect on perceptions of organizational politics. Also, a perception of organizational politics has a negative effect on organizational citizenship behavior. Moreover, perceptions of organizational politics competitively mediated the effect of servant leadership on organizational citizenship behavior. As well, political skill moderated the effect of perceptions of organizational politics on organizational citizenship behavior but not the indirect effect. To the best of our knowledge, no one else employs perceptions of organizational politics as a mediating effect between servant leadership and organizational citizenship behavior. Furthermore, we are not aware of anyone else employing political skill as a moderating role in the indirect effect of servant leadership on organizational citizenship behavior through perceptions of organizational politics.

Keywords: servant leadership, organizational citizenship behavior, perceptions of organizational politics, political skill, public service organization, Ethiopia

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Authors: Tugce Duygu Koksal

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In recent years, given the fact that the acts of terrorism and the threat of the latter are taking place without any border and distinction, it has led the states to deal with the terrorism as a priority issue. More recently, as seen in different countries during state of emergency, the adoption of anti-terrorism measures motivated by the sole need of the prevention of terrorism targets directly the fundamental rights of individuals. Therefore, a contribution to the understanding of the value of the principle of legality is becoming more and more important nowadays. This paper aims to reflect the probable effects of the adoption of anti-terrorism measures regardless of the principle of legality, on the fundamental rights. In this respect, this paper will first discuss the margin of appreciation of the national authorities by countering terrorism, and then, the importance of the respect of the legality of the anti-terrorism measures will be examined in the light of actual examples. Indeed, one of the major findings of this study is the fact that the anti-terrorism laws and measures were taken in this framework must be subject to close scrutiny in democracies, which adopted the principle of the rule of law and respect human rights. Although the state's margin of appreciation in the field of counter-terrorism is broad, these measures which are based on the legitimate aim of a democracies’ legitimate right to protect itself against the activities of terrorist organizations should have the legal basis and be strictly required by the exigencies of the fight against terrorism. While combating terrorism, the legal basis shall only be achieved if the legal consequences of an individuals’ actions related to terrorism shall be clear and foreseeable by the individuals of a society. On the other hand, particularly during the state of emergency, the ambiguity of the law might be used to include a wide range of actions under acts of terrorism. This is becoming more dangerous where freedom of expression, freedom of the press, freedom of association and the right to information is in the substance of these actions. Disregarding the principle of legality is susceptible to create a chilling effect on the exercise of human rights, and therefore, the fight against terrorism can be transformed into a repressive regime on opponents. As a result, the efforts to counter terrorism of the national authorities irrespective of the principle of legality are susceptible to cause a transformation of the rule of law to a state of law which cannot be appreciated in a democratic society.

Keywords: anti-terrorism measures, chilling effect, predictability, the principle of legality, state of emergency

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Authors: Ahmed Al Khamisi

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The Disaster Preparedness Standard (DPS) is one of the elements that is evaluated by the Accreditation Canada International (ACI). ACI emphasizes to train and educate all staff, including service providers and senior leaders, on emergency and disaster preparedness upon the orientation and annually thereafter. Lack of awareness and deficit of knowledge among the healthcare providers about DPS have been noticed in a tertiary hospital where ACI standards were implemented. Therefore, this paper aims to introduce a video-based e-learning (VB-EL) module that explains the hospital’s disaster plan in a simple language which will be easily accessible to all healthcare providers through the hospital’s website. The healthcare disaster preparedness coordinator in the targeted hospital will be responsible to ensure that VB-EL is ready by 25 April 2019. This module will be developed based on the Kirkpatrick evaluation method. In fact, VB-EL combines different data forms such as images, motion, sounds, text in a complementary fashion which will suit diverse learning styles and individual learning pace of healthcare providers. Moreover, the module can be adjusted easily than other tools to control the information that healthcare providers receive. It will enable healthcare providers to stop, rewind, fast-forward, and replay content as many times as needed. Some anticipated limitations in the development of this module include challenges of preparing VB-EL content and resistance from healthcare providers.

Keywords: Accreditation Canada International, Disaster Preparedness Standard, Kirkpatrick evaluation method, video-based e-learning

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Authors: Mahadzirah Mohamad, Nur Izzati Ab Ghani

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Worldwide, tourism sustained growth and remained to be one of the fast-growing sectors. Malaysia tourism industry experienced an unstable and declining pattern of international tourist arrival’s growth rate. The situation suggested that the industry was competitive and denoted the need to study factors that influence tourist loyalty. The primary purpose of this study was to develop a model that examined how destination image, perceived value, service quality and tourist satisfaction affect destination loyalty. The study was conducted at the Kuala Lumpur International Airport and Kota Kinabalu International Airport. The respondents were international tourists from United Kingdom and Australia and they were selected using simple random sampling method. A total of 337 respondents were subjected to data analysis using structural equation modelling. The study uncovered that perceived value and destination image was highly correlated and the model suggested that these constructs should be treated as one construct. The construct was labelled as overall destination image. Overall image had significant direct effect on service quality, satisfaction and loyalty. Service quality had a significant indirect effect on loyalty through satisfaction as a moderating variable. However, satisfaction had no mediating effect on the relationship between overall destination image and loyalty. The study suggested that more efforts should be focused on portraying the image of experiencing joy with many interesting natural scenic places to see whilst on a holiday to Malaysia. In addition, the destination management office should promote tourist visiting to Malaysia would enjoy quality service related to accommodation, information facilities, health, and shopping. Tourist satisfaction empirically proved to be an important construct that influenced destination loyalty. This study contributed to the extended knowledge that postulated overall image of a destination was measured by perceived value and destination image.

Keywords: destination image, destination loyalty, structural equation modelling, tourist satisfaction

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Authors: Md. Rashed Aalm, Md. Nuruzzaman Khan, Yothin Sawangdee

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Background: Around 47% of the total pregnancies are unintended in Bangladesh, which lead to several adverse consequences, including maternal and child mortality. Use of menstrual regulation (MR) can help women to reduce unintended pregnancy related adverse consequences. We explored the prevalence and determinants of MR services among ever-married women in Bangladesh. Methods: Total of 14,346 ever-married women data were analysed from the 2017 Bangladesh Demographic and Health Survey. Our study variable was use or non-use of MR services. Individual, household, and community level factors were the explanatory factors. Multilevel mixed-effect Poisson regression model was used to determine the factors associated with MR services in Bangladesh. Results: Nearly 7% of the total women in Bangladesh use MR services. Use of MR services was found higher among women who were aged 20-30 ages (IRR 1.60, 95% CI: 1.17–2.17), who were overweight (IRR 1.43, 95% CI: 1.13–1.81), had at least 1 child (IRR 2.97, 95% CI: 2.34– 3.77) or > 2 children (IRR 3.22, 95% CI: 2.45–4.20), and the birth preceding birth interval was(2 – 4) years (IRR 1.56, 95% CI: 1.13–2.15). Around 1.39 times (95% CI: 1.11–1.73) higher likelihood of MR was found among women whose husbands were engage with business. At the community level, MR service was found lower among the women who resided in the community with higherilliteracy (IRR 0.67, 95% CI: 0.42–0.96) and the Mymensingh division (IRR 0.39, 95% CI: 0.31–0.91). Conclusion: Use of MR service is comparatively low, which indicate a significant proportion of unintended pregnancy continued toward life-birth. This could be responsible for higher adverse maternal and child health outcomes in Bangladesh. Initiatives should be taken to ensure MR services is available when women need this service.

Keywords: menstrual regulation, pattern, risk, maternal health, Bangladesh

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Authors: Hiromi Takafuji

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It is a well-known fact that health care and welfare are the foundation of human activities, and human service professionals such as nurses and child care workers support these activities. COVID-19 pandemic has made the severity of the working environment in these fields even more known. It is high time to discuss the work of human service workers for the sustainable development of the human environment. Early turnover has been recognized as a long-standing issue in these fields. In Japan, the attrition rate within three years of graduation for these occupations has remained high at about 40% for more than 20 years. One of the reasons for this is Reality Shock: RS, which refers to the stress caused by the gap between pre-employment expectations and the post-employment reality experienced by new workers. The purpose of this study was to academically elucidate the mechanism of RS among human service professionals and to contribute to countermeasures against it. Firstly, to explore the structure of the relationship between professionalism and workers' RS, an exploratory interview survey was conducted and analyzed by text mining and content analysis. The results showed that the expectation of professionalism influences RS as a pre-employment job expectation. Next, the expectations of professionalism were quantified and categorized, and the responses of a total of 282 human service work professionals, nurses, child care workers, and caregivers; were finalized for data analysis. The data were analyzed using exploratory factor analysis, confirmatory factor analysis, multiple regression analysis, and structural equation modeling techniques. The results revealed that self-control orientation and authority orientation by qualification had a direct positive significant impact on RS. On the other hand, interpersonal helping orientation and altruistic orientation were found to have a direct negative significant impact and an indirect positive significant impact on RS.; we were able to clarify the structure of work expectations that affect the RS of welfare professionals, which had not been clarified in previous studies. We also explained the limitations, practical implications, and directions for future research.

Keywords: human service professional, new hire turnover, SEM, reality shock

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Authors: Harley Bray, Helen Pymar, Michelle Liu, Chau Pham, Tomislav Jelic, Fran Mulhall

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Background: Our study assesses the impact of the COVID-19 pandemic on early pregnancy assessment clinic (EPAC) referrals and the use of virtual consultation in Winnipeg, Manitoba. Our clinic expanded to accept referrals from all Winnipeg Emergency Department (ED)/Urgent Care (UC) sites beginning November 2019 to April 2020. By May 2020, the COVID-19 pandemic reached Manitoba and EPAC virtual care was expanded by performing hCG remotely and reviewing blood and ED/UC ultrasound results by phone. Methods: Emergency Department Information Systems (EDIS) and EPAC data reviewed ED/UC visits for pregnancy <20 weeks and vaginal bleeding 1-year pre-COVID (March 12, 2019, to March 11, 2020) and during COVID (March 12, 2020 (first case in Manitoba) to March 11, 2021). Results: There were fewer patient visits for vaginal bleeding or pregnancy of <20 weeks (4264 vs. 5180), diagnoses of threatened abortion (1895 vs. 2283), and ectopic pregnancy (78 vs. 97) during COVID compared with pre-COVID, respectively. ICD 10 codes were missing in 849 (20%) and 1183 (23%) of patients during COVID and pre-COVID, respectively. Wait times for all patient visits improved during COVID-19 compared to pre-COVID (5.1 ± 4.4 hours vs. 5.5 ± 3.8 hours), more patients received obstetrical ultrasounds, 761 (18%) vs. 787 (15%), and fewer patients returned within 30 days (1360 (32%) vs. 1848 (36%); p<0.01). EPAC saw 708 patients (218; 31% new ED/UC) during COVID-19 compared to 552 (37; 7% new ED/UC) pre-COVID. Fewer operative interventions for pregnancy loss (346 vs. 456) and retained products (236 vs. 272) were noted. Surgeries to treat ectopic pregnancy (106 vs 113) remained stable during the study time interval. Conclusion: Accurate identification of pregnancy complications was difficult, with over 20% missing ICD-10 diagnostic codes. There were fewer ED/UC visits and surgical management for threatened abortion during COVID-19, but ectopic pregnancy operative management remained unchanged.

Keywords: early pregnancy, ultrasound, COVID-19, obstetrics

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Authors: Iseoluwa Bukunmi Kolawole, Omowunmi Precious Isreal

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Social media has completely revolutionized the ways communication used to take place even a decade ago. It makes use of computer mediated technologies which helps in the creation of information and sharing. Social media may be defined as the production, consumption and exchange of information across platforms for social interaction. The social media has become a forum in which customer’s look for information about companies to do business with and request answers to questions about their products and services. Customer service may be termed as a process of ensuring customer’s satisfaction by meeting and exceeding their wants. In delivering excellent customer service, knowing customer’s expectations and where they are reaching out is important in meeting and exceeding customer’s want. Facebook is one of the most used social media platforms among others which also include Twitter, Instagram, Whatsapp and LinkedIn. This indicates customers are spending more time on social media platforms, therefore calls for improvement in customer service delivery over the social media pages. Millions of people channel their issues, complaints, complements and inquiries through social media. This study have being able to identify what social media customers want, their expectations and how they want to be responded to by brands and companies. However, the applied research methodology used in this paper was a mixed methods approach. The authors of d paper used qualitative method such as gathering critical views of experts on social media and customer relationship management to analyse the impacts of social media on customer's satisfaction through interviews. The authors also used quantitative such as online survey methods to address issues at different stages and to have insight about different aspects of the platforms i.e. customer’s and company’s perception about the effects of social media. Thereby exploring and gaining better understanding of how brands make use of social media as a customer relationship management tool. And an exploratory research approach strategy was applied analysing how companies need to create good customer support using social media in order to improve good customer service delivery, customer retention and referrals. Therefore many companies have preferred social media platform application as a medium of handling customer’s queries and ensuring their satisfaction, this is because social media tools are considered more transparent and effective in its operations when dealing with customer relationship management.

Keywords: brands, customer service, information, social media

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Authors: Darma Putra Sitepu, Dewi Larasati, Yohanes Wolter Hendrik George

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Sepsis is a life-threatening medical emergency frequently observed in intensive care unit (ICU). Surviving Sepsis Campaign in 2018 has recommended the administration of early vasopressor in the first hour of sepsis or septic shock but has not yet included de-resuscitation protocol. De-resuscitation in acute management of septic shock is where patient received active removal of accumulated fluid. It has been proposed by some studies and ongoing clinical trials. Here we present a case with early vasopressor and de-resuscitation. Male, 27 years old presenting to the emergency room with shortness of breath, altered mental status, and widespread blisters on his body and lips started a few hours prior, after receiving non-steroidal anti-inflammatory drug through intravenous injection. Patient was hypotensive, tachycardic, and tachypneic at admission, diagnosed with Steven Johnson Syndrome with Septic Shock. Patient received fluid resuscitation, early vasopressor, and diuresis agent aimed to actively remove fluid after the initial phase of resuscitation. Patient was admitted to ICU and progressively recovering. At day-10, patient was stabilized and was transferred to general ward. Early vasopressor and de-resuscitation are beneficial for the patient.

Keywords: sepsis, shock, de-resuscitation, vasopressor, fluid, case report

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Authors: Tiffany Riggleman, Andrea Schultheis, Kalyn Jannace, Jerika Taylor, Michelle Nordstrom, Paul F. Pasquina

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Introduction: Posttraumatic Stress (PTS) and Posttraumatic Stress Disorder (PTSD) remain significant problems for military and veteran communities. Symptoms of PTSD often include poor sleep, intrusive thoughts, difficulty concentrating, and trouble with emotional regulation. Unfortunately, despite its high prevalence, service members diagnosed with PTSD often do not seek help, usually because of the perceived stigma surrounding behavioral health care. To help address these challenges, non-pharmacological, therapeutic approaches are being developed to help improve care and enhance compliance. The Service Dog Training Program (SDTP), which involves teaching patients how to train puppies to become mobility service dogs, has been successfully implemented into PTS/PTSD care programs with anecdotal reports of improved outcomes. This study was designed to assess the biopsychosocial effects of SDTP from military beneficiaries with PTS symptoms. Methods: Individuals between the ages of 18 and 65 with PTS symptom were recruited to participate in this prospective study. Each subject completes 4 weeks of baseline testing, followed by 6 weeks of active service dog training (twice per week for one hour sessions) with a professional service dog trainer. Outcome measures included the Posttraumatic Stress Checklist for the DSM-5 (PCL-5), Generalized Anxiety Disorder questionnaire-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), social support/interaction, anthropometrics, blood/serum biomarkers, and qualitative interviews. Preliminary analysis of 17 participants examined mean scores on the GAD-7, PCL-5, and PHQ-9, pre- and post-SDTP, and changes were assessed using Wilcoxon Signed-Rank tests. Results: Post-SDTP, there was a statistically significant mean decrease in PCL-5 scores of 13.5 on an 80-point scale (p=0.03) and a significant mean decrease of 2.2 in PHQ-9 scores on a 27 point scale (p=0.04), suggestive of decreased PTSD and depression symptoms. While there was a decrease in mean GAD-7 scores post-SDTP, the difference was not significant (p=0.20). Recurring themes among results from the qualitative interviews include decreased pain, forgetting about stressors, improved sense of calm, increased confidence, improved communication, and establishing a connection with the service dog. Conclusion: Preliminary results of the first 17 participants in this study suggest that individuals who received SDTP had a statistically significant decrease in PTS symptom, as measured by the PCL-5 and PHQ-9. This ongoing study seeks to enroll a total of 156 military beneficiaries with PTS symptoms. Future analyses will include additional psychological outcomes, pain scores, blood/serum biomarkers, and other measures of the social aspects of PTSD, such as relationship satisfaction and sleep hygiene.

Keywords: post-concussive syndrome, posttraumatic stress, service dog, service dog training program, traumatic brain injury

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Authors: Nuhi Arslani, Aleks Brumec

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Adhesive small bowel obstruction (ASBO) accounts for 20% of emergency surgical procedures and intraabdominal adhesions account for 65% of such cases. In a 10-year post-operative period of abdominal surgery patients, around 35% of them will be readmitted because of ASBO. The first step in approaching ASBOs is using the Bologna guidelines, which include a thorough initial evaluation to diagnose or rule out an ASBO and then proceed with either further imaging studies or emergency surgery, which can be either open or laparoscopic. The contraindications for a laparoscopic approach include hemodynamic instability of the patient and infections in the peritoneum or port sites. Studies have shown that a laparoscopic approach to adhesiolysis is linked with a significantly smaller risk of readmissions and reoperations as well as with faster recovery time and fewer postoperative infections, but has a higher risk of bowel injuries, so a careful selection of patients is required. Although studies favor a laparoscopic approach, many countries still prefer a laparotomy, often because a laparoscopic approach requires surgeons to be highly skilled in the procedure. In the US and UK, between 50 and 60% of surgeons would approach an ASBO with laparoscopy, while in Italy, this number is around 15% and it is most likely similar in Slovenia. We believe that in the right cases and in the right patients, a laparoscopic approach can be equally feasible for treating ASBOs and is associated with fewer intraoperative and postoperative complications.

Keywords: adhesive small bowel obstruction, laparoscopy, adhesions, adhesiolysis

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Authors: Roongtiwa Chobchuen, Siriporn Mongkholthawornchai, Boonsong Hatawaikarn, Uriwan Chaichangreet, Kobkaew Thongtid, Pusda Pukdeekumjorn, Panita Limpawattana

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Background: Age-friendly nursing service system in Srinagarind Hospital has been developed continuously based on the value and cultural background of Thailand which corporates with the modified WHO’s Age friendly Primary Care Service System. It consists of 3 issues; 1) development of staff training, 2) age-friendly service and 3) appropriate physical environment. Objective: To evaluate the efficacy of Age-friendly Nursing Service System: KKU (AFNS:KKU) model and to evaluate factors associated with nursing perception with AFN:KKU. Study design: Descriptive study Setting: 31 wards that served older patients in Srinagarind Hospital Populations: Nursing staff from 11 departments (31 wards) Instrument: Age-friendly nursing care scale as perceived by hospitalized older person Procedure and statistical analysis: All participants were asked questions using age-friendly nursing care scale as perceived by hospitalized older person questionnaires. Descriptive statistics and multiple logistic regression analyses were used to analyse the outcomes. Results: There were 337 participants recruited in this study. The majority of them were women (92%) with the mean ages of 29 years and 77.45% were nurse practitioners. They had average nursing experiences of 5 years. The average scores of age-friendly nursing care scale were high and highest in the area of attitude and communication. Age, sex, educational level, duration of work among, and having experience in aging training were not associated with nursing perception where type of department was an independent factor. Nurses from department of Surgery and Orthopedic, Eye and ENT, special ward and Obstetrics and Gynecological had significant greater perception than nurses from Internal Medicine Department (p < 0.05). Conclusion: Nurses had high scores in all dimensions of age-friendly concept. The result indicates that nurses have good attitude to aging care which can lead to improve quality of care. Organization should support other domains of ageing care to achieve greater effectiveness in geriatric care.

Keywords: age-friendly, nursing service system, excellence model, geriatric care

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Authors: Fazli Idris, Jihad Mohammad

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The study aims to determine the impact of technology and service operations flexibility, which is divided into external flexibility and internal robustness, on operations costs. A mediation model is proposed that links technology to operations costs via operation flexibility. Drawing on a sample of 475 of operations managers of various service sectors in Malaysia and South Africa, Structural Equation Modeling (SEM) was employed to test the relationship using Smart-PLS procedures. It was found that a significant relationship was established between technologies to operations costs via both operations flexibility dimensions. Theoretical and managerial implications are offered to explain the results.

Keywords: Operations flexibility, technology, costs, mediation

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Authors: Reem Osama Yousif Ali, Osama Yousif Ali Al Gibali

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Introduction: Balanced nutrition is undeniably essential for maintaining health, body functions, and integrity of cell metabolism; however, some sick patients cannot tolerate oral or enteral feeding to meet their nutritional needs, so partial or total parenteral nutrition (PN) may be the most suitable alternative route in such situations. Dietitians are fundamental personnel among the medical team to ensure the proper provision of PN service, which was introduced in Sudan in the 1980s. Objective: The study aimed to recognize the dietitians' awareness of parenteral nutrition and their role in providing this service in Sudan – Khartoum State. Methodology: Formulated questionnaire forms composed of twelve questions were distributed to the dietitians working in four tertiary level hospitals. Results: The majority (75%) of the responded dietitians had reasonable knowledge about the importance of PN, its advantages, and its indications. Sixty percent of them were mindful of the PN side effects. Most of the dietitians were aware of the different assessment measurements and PN calculations and were exposed in their clinical practice to patients who were in need of PN, but only a few of them (about 30%) had the actual chance to participate in the formulation and application of PN therapy. The unavailability of the multidisciplinary team, lack of the required equipment and financial support, and associated complications were basic obstacles to the provision of long-term PN service in Khartoum state hospitals. Conclusion: Although dietitians in Khartoum state hospitals have good information about PN definition, indications, accesses, and assessment measures, they do not have enough knowledge and clinical exposure that make them confident to provide the PN service. Establishing a few models of parenteral nutrition units in tertiary hospitals will be of great help, as well as providing the dietitian's training in the area of parenteral nutrition. Further study can explore more requirements to run this service.

Keywords: nutrition support, dietitian, Sudan, parenteral nutrition, nutrition support team

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Authors: Mawong R., Bussracumpakorn C.

Abstract:

Millions of young people around the world have been affected by COVID-19 to their psychological and social effects. Millennials’ stresses have been shaped by a few global issues, including climate change, political instability, and financial crisis. In particular, the spread of COVID-19 has become laying psychological and socioeconomic scars on them. When end-of-life planning turns into more widely discussed, the stigma and taboos around this issue are greatly lessened. End-of-life planning is defined as a future life plan, such as financial, legacy, funeral, and memorial planning. This plan would help millennials to discover the value and meaning of life. This study explores the attitudes of Thai Millennials toward end-of-life planning as a new normal awareness of life in order to initiate an innovative service concept to fit with their value and meaning. The study conducts an in-depth interview with 12 potential participants who have awareness or action on the plan. The framework of the customer journey map is used to analyze the responses to examine trigger points, barriers, beliefs, and expectations. The findings pointed to a service concept that is suggested for a new end-of-life planning service that is suited to Thai Millennials in 4 different groups, which are 1. Social -Conscious as a socially aware who to donate time and riches to make the world and society a better place, their end-of-life planning value is inspired by the social impact of giving something or some action that they will be able to do after life or during life which provides a variety of choice based on their preference to give to society, 2. Life Fulfillment who make a life goal for themselves and attempt to achieve it before the time comes to their value will be to inspire life value with a customized plan and provide guidance to suggest, 3. Prevention of the After-Death Effect who want to plan to avoid the effects of their death as patriarch, head of the family, and anchor of someone, so they want to have a plan that brings confidence and feel relief while they are still alive and they want to find some reliable service that they can leave the death will or asset, and 4. No Guilty Planning who plan for when they wish to be worry-free as a self-responsible they want to have the plan which is easy to understand and easy to access. The overall finding of the study is to understand the new service concept of end-of-life planning which to improve knowledge of significant life worth rather than death planning, encouraging people to reassess their lives in a positive way, leading to higher self-esteem and intrinsic motivation for this generation in this time of global crisis.

Keywords: design management, end-of-life planning, millennial generation, service design solution

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Authors: Rafi Ullah, Shah Muhammad Emaduddin, Taha Jilani

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Vehicle Adhoc Networks (VANET) belongs to a special class of Mobile Adhoc Network (MANET) with high mobility. Network is created by road side vehicles equipped with communication devices like GPS and Wifi etc. Since the environment is highly dynamic due to difference in speed and high mobility of vehicles and weak stability of the network connection, it is a challenging task to design an efficient routing protocol for such an unstable environment. Our proposed algorithm uses heuristic for the calculation of optimal path for routing the packet efficiently in collaboration with several other parameters like geographical location, speed, priority, the distance among the vehicles, communication range, and networks congestion. We have incorporated probabilistic, heuristic and machine learning based approach inconsistency with the relay function of the memory buffer to keep the packet moving towards the destination. These parameters when used in collaboration provide us a very strong and admissible heuristics. We have mathematically proved that the proposed technique is efficient for the routing of packets, especially in a medical emergency situation. These networks can be used for medical emergency, security, entertainment and routing purposes.

Keywords: heuristics routing, intelligent routing, VANET, route optimization

Procedia PDF Downloads 176