Search results for: health care services

Authors: Debi Konukcu Onal, Tarkan Cavusoglu

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In modern societies, the costs of public goods and services are shared through taxes paid by citizens. However, taxation has always been a frictional issue, as tax obligations are perceived to be a financial burden for taxpayers rather than being merit that fulfills the redistribution, regulation and stabilization functions of the welfare state. The tax compliance literature evolves into discussing why people still pay taxes in systems with low costs of legal enforcement. Related empirical and theoretical works show that a wide range of socially oriented behavioral factors can stimulate voluntary compliance and subversive effects as well. These behavioral motivations are argued to be driven by self-enforcing rules of informal institutions, either independently or through interactions with legal orders set by formal institutions. The main focus of this study is to investigate empirically whether institutional particularities have a significant role in explaining the cross-country differences in the tax noncompliance levels. A part of the controversy about the driving forces behind tax noncompliance may be attributed to the lack of empirical evidence. Thus, this study aims to fill this gap through regression estimates, which help to trace the link between institutional quality and noncompliance on a cross-country basis. Tax evasion estimates of Buehn and Schneider is used as the proxy measure for the tax noncompliance levels. Institutional quality is quantified by three different indicators (percentile ranks of Worldwide Governance Indicators, ratings of the International Country Risk Guide, and the country ratings of the Freedom in the World). Robust Least Squares and Threshold Regression estimates based on the sample of the Organization for Economic Co-operation and Development (OECD) countries imply that tax compliance increases with institutional quality. Moreover, a threshold-based asymmetry is detected in the effect of institutional quality on tax noncompliance. That is, the negative effects of tax burdens on compliance are found to be more pronounced in countries with institutional quality below a certain threshold. These findings are robust to all alternative indicators of institutional quality, supporting the significant interaction of societal values with the individual taxpayer decisions.

Keywords: institutional quality, OECD economies, tax compliance, tax evasion

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Authors: S. Abdolvahab Samavi, Kobra Hajializadeh, S. Abdolhadi Samavi

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Nursing is a critical work that that can effect on the health of the society. A parenting style is a psychological construct demonstrating standard policies that parents use in their child rearing. The quality of parenting is more critical than the quantity spend with the child. Also, marital Conflict resolution is conceptualized as the methods and processes involved in facilitating the peaceful ending of conflict between couples. Both of these variables were affected by job status in nurses. Aim of this study was to compare the Marital Conflict Resolution and Parenting Styles between Nurses with fixed and rotating shifts in public hospitals of Bandar Abbas, Iran. Statistical population includes all married Nurses in hospitals of Bandar Abbas (900 Persons). For sample size estimation, the Morgan table was used, 270 people were selected by random sampling method. Conflict solution styles and Baumrind parenting styles questionnaire were used for collecting data about study variables. For analysis of data, descriptive and inferential statistics were used. Results showed there was significant difference between both groups in conflict solution styles. According to study results, nurses with fixed shifts had an effective conflict solution styles. Also, there was significant difference between both groups in Parenting Styles. According to study results, nurses with fixed shifts had an effective parenting style. Totally, results of this study showed that job status of nurses affected on Marital Conflict Resolution and Parenting Styles of nurses. Managers of health system should be consider these issues about work of nurses and if possible, married nurses employed at fixed day (vs. rotating) shift.

Keywords: marital conflict resolution procedures, parenting styles, nurses with fixed and rotating shifts, public hospitals

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Authors: Rahmi Kafadar, Levent Genc

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In present study, it was aimed to determine potential agricultural lands (PALs) in Gokceada (Imroz) Island of Canakkale province, Turkey. Seven-band Landsat 8 OLI images acquired on July 12 and August 13, 2013, and their 14-band combination image were used to identify current Land Use Land Cover (LULC) status. Principal Component Analysis (PCA) was applied to three Landsat datasets in order to reduce the correlation between the bands. A total of six Original and PCA images were classified using supervised classification method to obtain the LULC maps including 6 main classes (“Forest”, “Agriculture”, “Water Surface”, “Residential Area-Bare Soil”, “Reforestation” and “Other”). Accuracy assessment was performed by checking the accuracy of 120 randomized points for each LULC maps. The best overall accuracy and Kappa statistic values (90.83%, 0.8791% respectively) were found for PCA images which were generated from 14-bands combined images called 3-B/JA. Digital Elevation Model (DEM) with 15 m spatial resolution (ASTER) was used to consider topographical characteristics. Soil properties were obtained by digitizing 1:25000 scaled soil maps of rural services directorate general. Potential Agricultural Lands (PALs) were determined using Geographic information Systems (GIS). Procedure was applied considering that “Other” class of LULC map may be used for agricultural purposes in the future properties. Overlaying analysis was conducted using Slope (S), Land Use Capability Class (LUCC), Other Soil Properties (OSP) and Land Use Capability Sub-Class (SUBC) properties. A total of 901.62 ha areas within “Other” class (15798.2 ha) of LULC map were determined as PALs. These lands were ranked as “Very Suitable”, “Suitable”, “Moderate Suitable” and “Low Suitable”. It was determined that the 8.03 ha were classified as “Very Suitable” while 18.59 ha as suitable and 11.44 ha as “Moderate Suitable” for PALs. In addition, 756.56 ha were found to be “Low Suitable”. The results obtained from this preliminary study can serve as basis for further studies.

Keywords: digital elevation model (DEM), geographic information systems (GIS), gokceada (Imroz), lANDSAT 8 OLI-TIRS, land use land cover (LULC)

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Authors: Mohammad Rahim Rahnama, Amir Ali Kharazmi, Safiye Rokni

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The tourism industry will be the most important unlimited, sustainable source of income after the oil and automotive industries by 2020 and not only countries, but cities are striving to apprehend its various facets. In line with this objective, the present descriptive-analytical study, through survey and using a questionnaire, seeks to evaluate the probability of tourists’ return and their recommendation to their countrymen to travel to Mashhad, Iran. The population under study is a sample of 384 foreign tourists who, in 2016, arrived at Mashhad, the second metropolis in Iran and its biggest religious city. The Kaplan-Meier estimator was used to analyze the data. Twenty-six percent of the tourists are female and 74% are male. On average, each tourist has had 3.02 trips abroad and 2.1 trips to Mashhad. Tourists from 14 different countries have arrived at Mashhad. Kuwait (15.9%), Armenia (15.6%), and Iraq (10.9%) were the countries where most tourists originated. Seventy-six percent of the tourists traveled with family and 90% of the tourists arrived at Mashhad via airplane. Major purposes of tourists’ trip include pilgrimage (27.9%), treatment (22.1%) followed by pilgrimage and treatment combined (35.4%). Major issues for tourists, in the order of priority, include quality of goods and services (30.2%), shopping (18%), and inhabitants’ treatment of foreigners (15.9%). Main tourist attractions, in addition to the Holy Shrine of Imam Reza, include Torqabeh and Shandiz (Torqabeh 40.9% and Shandiz 29.9%), Neyshabour (18.2%) followed by Kalat, 4.4%. The average willingness to return among tourists is 3.13, which is higher than the mean 3, indicating satisfaction with the stay in Mashhad. Similarly, the average for tourists’ recommending to their countrymen to visit Mashhad is 3.42, which is also an indicator of tourists’ satisfaction with their presence in Mashhad. According to the findings of the Kaplan-Meier estimator, an increase in the number of tourists’ trips to Mashhad, and an increase in the number of tourists’ foreign trips, reduces the probability of recommending a trip to Mashhad by tourists. Similarly, willingness to return is higher among those who stayed at a relatives’ home compared with other patterns of residence (hotels, self-catering accommodation, and pilgrim houses). Therefore, addressing the issues raised by tourists is essential for their return and their recommendation to others to travel to Mashhad.

Keywords: international tourist, probability of return, satisfaction, Mashhad

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Authors: Hansraj Bookun, Angela Tan, Rachel Xuan, Linheng Zhao, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos

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Introduction: Incisional wound complications in vascular surgery patients represent a significant clinical and econometric burden of morbidity and mortality. The objective of this study was to trial the feasibility of applying the Prevena negative pressure incision management system as a routine dressing in patients who had undergone arterial surgery. Conventionally, Prevena has been applied to groin incisions, but this study features applications on multiple wound sites such as the thigh or major amputation stumps. Method: This was a cross-sectional observational, single-centre case series of 12 patients who had undergone major vascular surgery. Their wounds were managed with the Prevena system being applied either intra-operatively or on the first post-operative day. Demographic and operative details were collated as well as the length of stay and complication rates. Results: There were 9 males (75%) with mean age of 66 years and the comorbid burden was as follows: ischaemic heart disease (92%), diabetes (42%), hypertension (100%), stage 4 or greater kidney impairment (17%) and current or ex-smoking (83%). The main indications were acute ischaemia (33%), claudication (25%), and gangrene (17%). There were single instances of an occluded popliteal artery aneurysm, diabetic foot infection, and rest pain. The majority of patients (50%) had hybrid operations with iliofemoral endarterectomies, patch arterioplasties, and further peripheral endovascular treatment. There were 4 complex arterial bypass operations and 2 major amputations. The mean length of stay was 17 ± 10 days, with a range of 4 to 35 days. A single complication, in the form of a lymphocoele, was encountered in the context of an iliofemoral endarterectomy and patch arterioplasty. This was managed conservatively. There were no deaths. Discussion: The Prevena wound management system shows that in conjunction with safe vascular surgery, absolute wound complication rates remain low and that it remains a valuable adjunct in the treatment of vasculopaths.

Keywords: wound care, negative pressure, vascular surgery, closed incision

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Authors: Rebecca E. Dalli Gonzi, Joseph Falzon

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Background: Islands in the Mediterranean region offer opportunities for various industries to take advantage of the facilitation and use of versatile floating structures in coastal areas. In the context of dense land use, marine structures can contribute to ensure both terrestrial and marine resource sustainability. Objective: The aim of this paper is to present and critically discuss an array of issues that characterize the design process of a floating structure for coastal areas and to present the challenges and opportunities of providing such multifunctional and versatile structures around the Maltese coastline. Research Design: A three-tier research design commenced with a systematic literature review. Semi-structured interviews with stakeholders including a naval architect, a marine engineer and civil designers were conducted. A second stage preceded a focus group with stakeholders in design and construction of marine lightweight structures. The three tier research design ensured triangulation of issues. All phases of the study were governed by research ethics. Findings: Findings were grouped into three main themes: excellence, impact and implementation. These included design considerations, applications and potential impacts on local industry. Literature for the design and construction of marine structures in the Maltese Islands presented multiple gaps in the application of marine structures for local industries. Weather conditions, depth of sea bed and wave actions presented limitations on the design capabilities of the structure. Conclusion: Water structures offer great potential and conclusions demonstrate the applicability of such designs for Maltese waters. There is still no such provision within Maltese coastal areas for multi-purpose use. The introduction of such facilities presents a range of benefits for visiting tourists and locals thereby offering wide range of services to tourism and marine industry. Costs for construction and adverse weather conditions were amongst the main limitations that shaped design capacities of the water structures.

Keywords: coastal areas, lightweight, marine structure, multi purpose, versatile, floating device

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Authors: Waseem Akram, Hafiz Azhar Ali Khan

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Unplanned urbanization together with change in life from simple to more technologically advanced style with flow of rural masses to urban areas has played a vital role in pilling loads of solid wastes in our environment. The cities and towns have expanded beyond boundaries. Even the uncontrolled population expansion has caused the overall environmental burden. Thus, today the indifference remains as one of the biggest trash that has come up due to the non-responsive behavior of the people. Everyday huge amount of solid waste is thrown in the streets, on the roads, parks, and in all those places that are frequently and often visited by the human beings. This behavior based response in many countries of the world has led to serious health concerns and environmental issues. Over 80% of our products that are sold in the market are packed in plastic bags. None of the bags are later recycled but simply become a permanent environment concern that flies, choke lines or are burnt and release toxic gases in the environment or form dumps of heaps. Lack of classification of the daily waste generated from houses and other places lead to worst clogging of the sewerage lines and formation of ponding areas which ultimately favor vector borne disease and sometimes become a cause of transmission of polio virus. Solid waste heaps were checked at different places of the cities. All of the wastes on visual assessments were classified into plastic bags, papers, broken plastic pots, clay pots, steel boxes, wrappers etc. All solid waste dumping sites in the cities and wastes that were thrown outside of the trash containers usually contained wrappers, plastic bags, and unconsumed food products. Insect populations seen in these sites included the house flies, bugs, cockroaches and mosquito larvae breeding in water filled wrappers, containers or plastic bags. The population of the mosquitoes, cockroaches and houseflies were relatively very high in dumping sites close to human population. This population has been associated with cases like dengue, malaria, dysentery, gastro and also to skin allergies during the monsoon and summer season. Thus, dumping of the huge amount of solid wastes in and near the residential areas results into serious environmental concerns, bad smell circulation, and health related issues. In some places, the same waste is burnt to get rid of mosquitoes through smoke which ultimately releases toxic material in the atmosphere. Therefore, a proper environmental strategy is needed to minimize environmental burden and promote concepts of recycled products and thus, reduce the disease burden.

Keywords: solid waste accumulation, disease burden, mosquitoes, vector borne diseases

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Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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Authors: Deborah Zelinsky

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The retina filters millions of incoming signals into a smaller amount of exiting optic nerve fibers that travel to different portions of the brain. Most of the signals are for eyesight (called "image-forming" signals). However, there are other faster signals that travel "elsewhere" and are not directly involved with eyesight (called "non-image-forming" signals). This article centers on the neurons of the optic nerve connecting to parts of the limbic system. Eye care providers are currently looking at parvocellular and magnocellular processing pathways without realizing that those are part of an enormous "galaxy" of all the body systems. Lenses are modifying both non-image and image-forming pathways, taking A.M. Skeffington's seminal work one step further. Almost 100 years ago, he described the Where am I (orientation), Where is It (localization), and What is It (identification) pathways. Now, among others, there is a How am I (animation) and a Who am I (inclination, motivation, imagination) pathway. Classic eye testing considers pupils and often assesses posture and motion awareness, but classical prescriptions often overlook limbic involvement in visual processing. The limbic system is composed of the hippocampus, amygdala, hypothalamus, and anterior nuclei of the thalamus. The optic nerve's limbic connections arise from the intrinsically photosensitive retinal ganglion cells (ipRGC) through the "retinohypothalamic tract" (RHT). There are two main hypothalamic nuclei with direct photic inputs. These are the suprachiasmatic nucleus and the paraventricular nucleus. Other hypothalamic nuclei connected with retinal function, including mood regulation, appetite, and glucose regulation, are the supraoptic nucleus and the arcuate nucleus. The retino-hypothalamic tract is often overlooked when we prescribe eyeglasses. Each person is different, but the lenses we choose are influencing this fast processing, which affects each patient's aiming and focusing abilities. These signals arise from the ipRGC cells that were only discovered 20+ years ago and do not address the campana retinal interneurons that were only discovered 2 years ago. As eyecare providers, we are unknowingly altering such factors as lymph flow, glucose metabolism, appetite, and sleep cycles in our patients. It is important to know what we are prescribing as the visual processing evaluations expand past the 20/20 central eyesight.

Keywords: neuromodulation, retinal processing, retinohypothalamic tract, limbic system, visual processing

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Authors: Evelyn Bilias-Lolis, Emily Louise Winter

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Schools have a responsibility to implement school-wide frameworks that actively prevent, detect, and support all aspects of child development and learning. Such efforts can range from individual or classroom-level supports to school-wide primary prevention practices for the school’s infrastructure or climate. This study assessed the perceptions of educators across a variety of disciplines in Connecticut (i.e., elementary and secondary education, special education, school psychology, and school social work) on the perceived impact of their beliefs, language, and behavior about food and body consciousness on student self-image and school climate. Participants (N=50) completed a short electronic questionnaire measuring perceptions of how their behavior can influence their students’ opinions about themselves, their emerging self-image, and the overall climate of the school community. Secondly, the beliefs that were directly assessed in the first portion of the survey were further measured through the use of applied social vignettes involving students directly or as bystanders. Preliminary findings are intriguing. When asked directly, 100% of the respondents reported that what they say to students directly could influence student opinions about themselves and 98% of participants further agreed that their behavior both to and in front of students could impact a student’s developing self-image. Likewise, 82% of the sample agreed that their personal language and behavior affect the overall climate of a school building. However, when the above beliefs were assessed via applied social vignettes depicting routine social exchanges, results were significantly more widespread (i.e., results were evenly dispersed among levels of agreement and disagreement across participants in all areas). These preliminary findings offer humble but critical implications for informing integrated school wellness frameworks that aim to create body-sensitive school communities. Research indicates that perceptions about body image, attitudes about eating, and the onset of disordered eating practices surface in school-aged years. Schools provide a natural setting for instilling foundations for child wellness as a natural extension of existing school climate reform efforts. These measures do not always need to be expansive or extreme. Rather, educators have a ripe opportunity to become champions for health and wellness through increased self-awareness and subtle shifts in language and behavior. Future psychological research needs to continue to explore this line of inquiry using larger and more varied samples of educators in order to identify needs in teacher training and development that can yield positive and preventative health outcomes for children.

Keywords: body-sensitive schools, integrated school health, school climate reform, teacher awareness

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Authors: Atitallah Sofien, Bouyahia Olfa, Attar Souleima, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Ciliopathies are a spectrum of diseases that have in common a defect in the synthesis of ciliary proteins. It is a rare cause of neonatal cholestasis. Clinical presentation varies extremely, and the main affected organs are the kidneys, liver, and pancreas. Methodology: This is a descriptive case report of a newborn who was admitted for exploration of neonatal cholestasis in the Paediatric Department C at the Children’s Hospital of Tunis, where the investigations concluded with a rare genetic mutation. Results: This is the case of a newborn male with no family history of hepatic and renal diseases, born to consanguineous parents, and from a well-monitored uneventful pregnancy. He developed jaundice on the second day of life, for which he received conventional phototherapy in the neonatal intensive care unit. He was admitted at 15 days for mild bronchiolitis. On clinical examination, intense jaundice was noted with normal stool and urine colour. Initial blood work showed an elevation in conjugated bilirubin and a high gamma-glutamyl transferase level. Transaminases and prothrombin time were normal. Abdominal sonography revealed hepatomegaly, splenomegaly, and undifferentiated renal cortex with bilateral medullar micro-cysts. Kidney function tests were normal. The infant received ursodeoxycholic acid and vitamin therapy. Genetic testing showed a homozygous mutation in the DCDC2 gene that hadn’t been documented before confirming the diagnosis of renal-hepatic ciliopathy. The patient has regular follow-ups, and his conjugated bilirubin and gamma-glutamyl transferase levels have been decreasing. Conclusion: Genetic testing has revolutionized the approach to etiological diagnosis in pediatric cholestasis. It enables personalised treatment strategies to better enhance the quality of life of patients and prevent potential complications following adequate long-term monitoring.

Keywords: cholestasis, newborn, ciliopathy, DCDC2, genetic

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Authors: Nayomi Ranathunga, Priyantha Perera, Sumal Nandasena, Nalini Sathiakumar, Anuradhini Kasthuriratne, Rajitha Wikremasinghe

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Solid fuel combustion is an important source of indoor air pollution (IAP) in developing countries that has adverse health impacts particularly in children. This study was conducted to determine the effect of IAP due to solid fuel combustion on physical growth of children under five in a Sri Lankan setting. A prospective study was conducted in a mixed population comprising urban and semi urban residents. The study included 240 children under 5 who were permanent residents of the area. Physical growth was assessed by measuring anthropometric indices based on the World Health Organization (WHO) guidelines and standards. Exposure levels were defined according to the main type of fuel used for cooking at home: children residing in households using biomass fuel or kerosene as the main type of fuel for cooking were classified as the “high exposure” group and children resident in households using liquefied petroleum gas (LPG) or electricity for cooking were classified as the “low exposure” group. Sixty percent of the children were classified as from the “high” exposure group and 40% of the children were classified as from the “low” exposure group; 54% of the children were male. At baseline, the prevalence of wasting was 17.1% and the prevalence of stunting was 10.4%; the mean z-score for weight for height was - 0.85, weight for age was - 0.46 and height for age was -0.38. At baseline, children from the “high” exposure group had a significantly lower mean weight for height z-score (p=0.02) and a mean height for age z-score (p=0.001) as compared to children from the “low” exposure group after adjusting for confounding factors such as father’s education, mother’s education and family income. Poor maternal education was significantly associated with lower height for age z-scores (p=0.04) after adjusting for exposure status. IAP due to combustion of biomass fuel leads to chronic malnutrition.

Keywords: children, growth, indoor air pollution, solid fuel

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Authors: Abhimanyu Behera

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Over the past few years, energy security and sustainable development have moved rapidly into the global agenda. There are two main reasons: first, the impact of high and often volatile energy prices; second, concerns over environmental sustainability particularly about the global climate. Both issues are critically important in which impressive economic growth has boosted the demand for energy and put corresponding strains on the environment. Energy security is a broad concept that focuses on energy availability and pricing. Specifically, it refers to the ability of the energy supply system i.e. suppliers, transporters, distributors and regulatory, financial and R&D institutions to deliver the amount of competitively priced energy that customers demand, within accepted standards of reliability, timeliness, quality, safety. Traditionally, energy security has been defined in the context of the geopolitical risks to external oil supplies but today it is encompassing all energy forms, all the external and internal links bringing the energy to the final consumer, and all the many ways energy supplies can be disrupted including equipment malfunctions, system design flaws, operator errors, malicious computer activities, deficient market and regulatory frameworks, corporate financial problems, labour actions, severe weather and natural events, aggressive acts (e.g. war, terrorism and sabotage), and geopolitical disruptions. In practice, the most challenging disruptions are those linked to: 1) extreme weather events; 2) mismatched electricity supply and demand; 3) regulatory failures; and 4) concentration of oil and gas resources in certain regions of the world. However, insecure energy supplies inhibit development by raising energy costs and imposing expensive cuts in services when disruptions actually occur. The energy supply sector can best advance sustainable development by producing and delivering secure and environmentally-friendly sources of energy and by increasing the efficiency of energy use. With this objective, this paper seeks to highlight the significance of energy security and sustainable development in today’s world. Moreover, it critically overhauls the major challenges towards sustainability of energy security and what are the major policies are taken to overcome these challenges by Government is lucidly explicated in this paper.

Keywords: energy, policies, security, sustainability

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Authors: Dipankar Deka

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Exploration and production of Oil & Gas is a very challenging business on which a nation’s energy security depends on. The exploration and Production of hydrocarbon is a very precise and time-bound process. The striking rate of hydrocarbon in a drilled well is so uncertain that the success rate is only 31% in 2021 as per Rigzone. Huge cost is involved in drilling as well as the production of hydrocarbon from a well. Due to this very reason, no one can effort to lose a well because of faulty machines, which increases the non-productive time (NPT). Numerous activities that include manpower and machines synchronized together works in a precise way to complete the full cycle of exploration, rig movement, drilling and production of crude oil. There are several machines, both fixed and mobile, are used in the complete cycle. Most of these machines have a tight schedule of work operating in various drilling sites that are simultaneously being drilled, providing a very narrow window for maintenance. The shutdown of any of these machines for even a small period of time delays the whole project and increases the cost of production of hydrocarbon by manifolds. Moreover, these machines are custom designed exclusively for oil field operations to be only used in Mining Exploration Licensed area (MEL) earmarked by the government and are imported and very costly in nature. The cost of some of these mobile units like Well Logging Units, Coil Tubing units, Nitrogen pumping units etc. that are used for Well stimulation and activation process exceeds more than 1 million USD per unit. So the increase of self-life of these units also generates huge revenues during the extended duration of their services. In this paper we are considering the very critical mobile oil field equipment like Well Logging Unit, Coil Tubing unit, well-killing unit, Nitrogen pumping unit, MOL Oil Field Truck, Hot Oil Circulation Unit etc., and their extensive preventive maintenance in our auto workshop. This paper is the outcome of 10 years of structured automobile maintenance and minute documentation of each associated event that allowed us to perform the comparative study between the new practices of preventive maintenance over the age-old practice of system-based corrective maintenance and its impact on the self-life of the equipment.

Keywords: automobile maintenance, preventive maintenance, symptom based maintenance, workshop technologies

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Authors: Usha Barahmand, Ruhollah Heydari Sheikh Ahmad, Sara Alaie Khoraem

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Introduction: The association of epilepsy with several psychological disorders and reduced quality of life has long been recognized. The present study aimed at comparing the personality profiles, quality of life and symptomatology of anxiety and depression in patients with epilepsy and healthy controls. Materials and Methods: Forty seven patients (29 men and 18 women) with diagnosed epilepsy participated in this study. Forty seven healthy controls who matched the patients in age and gender were also recruited. The participants’ personality and psychological profiles were assessed using the Depression, Anxiety, and Stress Scale (DASS-21), the Short-Form Health Survey (SF-36) and the HEXACO Personality Inventory (HEXACO-PI). Scoring algorithms were applied to the SF-36 produce the physical and mental component scores (PCS and MCS). Results: There were statistically significant differences in the total SF-36 score, anxiety, depression and stress scores of the DASS-21 between patients and controls. Anxiety, stress and depression scores significantly correlated inversely with the PCS and MCS. Data analysis showed that females had higher depression scores than males in both patients and controls, while males in both groups scored higher on stress. Patients’ personality scores were also different from those reported by controls on emotional, agreeableness and extroversion. Patients scored higher on emotionality, and lower on agreeableness and extraversion. Patients also scored lower on indices of quality of life. Regression analysis revealed that emotionality, anxiety, stress and MCS accounted for a significant proportion of the variance in severity of epileptic seizures. Conclusion: Stressful situations and psychological conditions as well as the personality trait of neuroticism were related to the occurrence of recurrent epileptic seizures.

Keywords: anxiety, depression, epilepsy, neuroticism, personality, quality of life, stress

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Authors: Mahta Mohamadkashi

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The family is the most important source of security and health for the people of the society, and at the same time, it is the main field of creating all kinds of social and psychological problems. On the one hand, a family is a natural group with many goals and roles that are important and necessary for all family members. On the other hand, the family is a strong and organized group that recruits the therapist because of the goals that are concealed in its policy and procedures. The relationship between the environment and the family background with mental illnesses has been the focus of various researchers for a long time, and the research and experiments that have been conducted to show that the functioning of the family is related to the mental health of the members of the family. Currently, several theoretical perspectives with different approaches seek to explain and resolve psychological problems and family conflicts that can be mentioned. This research aims to investigate "cognitive-behavioral family therapy" by using the "family therapy" research method which is included the descriptive-analytical method and the method of collecting library information, with special reliance on Persian and Latin books and articles. for considering one of the important approaches of family therapy that we are going which have been known as data and its conditions that also includes requirements and limitations. For this purpose, in the beginning, brief background and introduction about family and family therapy are going to describe, and then the basics of cognitive-behavioral family therapy and the implementation process and various techniques of this approach can go through a big discussion. After that, we will apply this approach in the treatment of various physical and mental diseases in the form of related research, and we will examine the ups and downs of the implementation procedures, limitations, and future directions in this field. In general, This study emphasizes the role of the family system in the occurrence of psychological diseases and disorders and also validates the role of the family system in the treatment of those diseases and disorders. Also, cognitive-behavioral family therapy has been approved as an effective treatment approach for a variety of mental disorders.

Keywords: cognitive-behavioral, family, family therapy, cognitive-behavioral family therapy

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Authors: Pirjo Kaakinen, Helvi Kyngäs, Danica Železnik

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People live longer than earlier and healthy lifestyle is one of the important issue to prevent functional inability and chronic disease. Aim of this study was describe the lifestyle changes of Carintia region’s people. The study was cross-sectional study. Data were collected by questionnaire in two period, first May 2013 (N=63) and on March 2014 (N=77) at the University of College of ‘Health Sciences Slovenj Gradec’. The study was part of project ‘Choose a healthy lifestyle - an investment for the future’. The questionnaire included self-estimated questions about physical activity, nutrition, grocery habit, smoking habit and alcohol use. Participants were measured clinical parameters such as blood pressure, blood glucose, BMI. Most of participants were women (61%) and they were over 60 years old (64%). Participants have a high BMI (75%) and elevated blood pressure (64%). However, almost all participants (89%) had normal blood glucose level. Slightly more than half of participants (54%) have normal cholesterol level. Participants (83%) eat breakfast in the morning and most of them have three or four daily meals. Fruit and vegetable consumption decrease during this study. Half of participants (51%) drank a litre of water per day and popular beverage was coffee or tea. To drink carbonate beverages was not so popular over 60 year’s old participants than younger one. There was less smokers in 2014 than 2013. Intensity of daily physical activity increased during healthy lifestyle project. The most popular form of physical activity was hiking. This study showed that the project can be effective in the Carintia region’s people lifestyle changes even it was short time. People did changes in their daily life and there were a positive influence physical activity, meal frequency, fruit, vegetable and alcohol consumption. In the future is needed the follow up study to get out longitudinal lifestyle changes.

Keywords: adults, healthy lifestyle, health education, quality of life

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Authors: Charles Chijioke Dike, Hugh Clifford Chima Maduka, Chinwe A. Isibor

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Fish is among the products consumed at a very high rate. In most countries of the world, fish are used as part of the daily meal. The high cost of commercial fish feeds in Africa has made it necessary the development of an alternative source of fish feed processing from organic waste. The objective of this research is to investigate the efficacy of fish feeds processed from various animal wastes in order to know whether those feeds shall be alternatives to commercial feeds. This work shall be carried out at the Research Laboratory Unit of the Department of Human Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, Nnamdi Azikiwe University (NAU), Nnewi Campus, Anambra State. The fingerlings to be used shall be gotten from the Agricultural Department of NAU, Awka, Anambra State, and allowed to acclimatize for 14 d. Animal and food wastes shall be gotten from Nnewi. The fish shall be grouped into 1-13 (Chicken manure only, cow dung only, pig manure only, chicken manure + yeast, cow dung + yeast, pig manure + yeast, chicken manure + other wastes + yeast, cow dung + other wastes + yeast, and pig manure + other wastes + yeast. Feed assessment shall be carried out by determining bulk density, feed water absorption, feed hardness, feed oil absorption, and feed water stability. The nutritional analysis shall be carried out on the feeds processed. The risk assessment shall be done on the fish by determining methylmercury (MeHg), polycyclic aromatic hydrocarbons (PAHs), and dichloro-diphenyl-trichloroethane (DDT) in the fish. The results from this study shall be analyzed statistically using SPSS statistical software, version 25. The hypothesis is that fish feeds processed from animal wastes are efficient in raising catfish. The outcome of this study shall provide the basis for the formulation of fish feeds from organic wastes.

Keywords: assessment, feeds, health risk, wastes

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Authors: Moses Ikechukwu Benjamin

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The continued increase in methicillin-resistant Staphylococcuspseudintermedius (MRSP) among dogs and the zoonotic transmission event of MRSP from dogs to humans threaten veterinary medicine and public health. The cardinal objective of this study was to determine the antibiogram and frequency of toxingenes in MRSP obtained from shelter dogs with skin infections and dog owners in Abakaliki, Eastern Nigeria. Skinswabs from 61 shelter dogs with skin infections and 33 nasal swabs from dog owners were processed and analyzed using standard microbiological techniques. Susceptibility to antibiotics was determined by Kirby Bauer disc diffusion technique. The screening for Seccanine, lukD, siet, and exitoxin genes was carried out by PCR. A total of 23 (37.7 %) and 1 (3 %) MRSP strains were obtained from shelter dogs and dog owners, respectively. Generally, isolates exhibited high resistance to amoxicillin-clavulanic acid, ceftazidime, and cefepime (100 % - 66.7 %) but were very susceptible (100 % - 70.7 %) to chloramphenicol and doripenem. The only isolate from dog owners harbouredseccanine, lukD, and siet toxin genes while solatesfrom shelter dogs harbouredseccanine16 (69.6 %), lukD 17 (73.9 %), siet 20 (87 %), and exi1 (4.4 %) toxin genes. Isolates were generally observed to be more resistant than other reports from the literature. Interesting, there was a similarity in the resistance antibiotypes and frequency of toxin genes harboured by MRSP isolates between shelter dogs with skin infections and their owner in a sampled household, thus suggesting a likely zoonotic transmission event. This report of the occurrence of MRSP and high frequency of toxin genes (Seccanine,lukD, and siet) in shelter dogs and dog owners represent a major challenge, especially in terms of antibiotic therapy, and is a serious concern for both animal and public health.

Keywords: methicillin-resistant S. pseudintermedius, zoonotic transmission, antibiotic resistance, companion dogs, toxin genes

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Authors: B. Suresh Reddy

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The over dependence on chemical fertilizers for nutrient management in crop production for the last few decades has led to several problems affecting soil health, environment and farmers themselves. Based on the field work done in 2012-13 with 1080 farmers of different size-classes in semi-arid regions of Uttar Pradesh, Jharkhand and Madhya Pradesh states of India, this paper reveals that the farmers in semi-arid regions of India are actively managing soil fertility and other soil properties through a wide range of practices that are based on local resources and knowledge. It also highlights the socio-economic web woven around these soil fertility management practices. This study highlights the contribution of organic matter by traditional soil fertility management practices in maintaining the soil health. Livestock has profound influence on the soil fertility enhancement through supply of organic manure. Empirical data of this study has clearly revealed how farmers’ soil fertility management options are being undermined by government policies that give more priority to chemical fertiliser-based strategies. Based on the findings it is argued that there should be a 'level playing field' for both organic and inorganic soil fertility management methods by promoting and supporting farmers in using organic methods. There is a need to provide credit to farmers for adopting his choice of soil fertility management methods which suits his socio-economic conditions and that best suits the long term productivity of soils. The study suggests that the government policies related to soil fertility management must be enabling, creating the conditions for development based more on locally available resources and local skills and knowledge. This will not only keep Indian soils in healthy condition but also support the livelihoods of millions of people, especially the small and marginal farmers.

Keywords: livestock, organic matter, small farmers, soil fertility

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Authors: Pei-Ru Yang, Yu-Chen Lin, Jia-Min Wu

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Background: A 58-year-old man with a history of osteoporosis and diabetes presented with chronic pain in his left knee due to severe knee joint degeneration. The knee replacement surgery was recommended by the doctor. But the patient suffered from low pain tolerance and wondered if virtual reality could relieve acute postoperative wound pain. Methods: We used the PICO (patient, intervention, comparison, and outcome) approach to generate indexed keywords and searched systematic review articles from 2017 to 2021 on the Cochran Library, PubMed, and Clinical Key databases. Results: The initial literature results included 38 articles, including 12 Cochrane library articles and 26 PubMed articles. One article was selected for further analysis after removing duplicates and off-topic articles. The eight trials included in this article were published between 2013 and 2019 and recruited a total of 723 participants. The studies, conducted in India, Lebanon, Iran, South Korea, Spain, and China, included adults who underwent hemorrhoidectomy, dental surgery, craniotomy or spine surgery, episiotomy repair, and knee surgery, with a mean age (24.1 ± 4.1 to 73.3 ± 6.5). Virtual reality is an emerging non-drug postoperative analgesia method. The findings showed that pain control was reduced by a mean of 1.48 points (95% CI: -2.02 to -0.95, p-value < 0.0001) in minor surgery and 0.32 points in major surgery (95% CI: -0.53 to -0.11, p-value < 0.03), and the overall postoperative satisfaction has improved. Discussion: Postoperative pain is a common clinical problem in surgical patients. Research has confirmed that virtual reality can create an immersive interactive environment, communicate with patients, and effectively relieve postoperative pain. However, virtual reality requires the purchase of hardware and software and other related computer equipment, and its high cost is a disadvantage. We selected the best literature based on clinical questions to answer the patient's question and used share decision making (SDM) to help the patient make decisions based on the clinical situation after knee replacement surgery to improve the quality of patient-centered care.

Keywords: knee replacement surgery, postoperative pain, share decision making, virtual reality

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Authors: Isara Muangthai, Lin Sue Jane

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Electricity is vital to every country’s economy in the world. For Thailand, the electricity generation sector plays an important role in the economic system, and it is the largest source of CO2 emissions. The aim of this paper is to use the decomposition analysis to investigate the key factors contributing to the changes of CO2 emissions from the electricity sector. The decomposition analysis has been widely used to identify and assess the contributors to the changes in emission trends. Our study adopted the Divisia index decomposition to identify the key factors affecting the evolution of CO2 emissions from Thailand’s thermal power sector during 2000-2011. The change of CO2 emissions were decomposed into five factors, including: Emission coefficient, heat rate, fuel intensity, electricity intensity, and economic growth. Results have shown that CO2 emission in Thailand’s thermal power sector increased 29,173 thousand tons during 2000-2011. Economic growth was found to be the primary factor for increasing CO2 emissions, while the electricity intensity played a dominant role in decreasing CO2 emissions. The increasing effect of economic growth was up to 55,924 million tons of CO2 emissions because the growth and development of the economy relied on a large electricity supply. On the other hand, the shifting of fuel structure towards a lower-carbon content resulted in CO2 emission decline. Since the CO2 emissions released from Thailand’s electricity generation are rapidly increasing, the Thailand government will be required to implement a CO2 reduction plan in the future. In order to cope with the impact of CO2 emissions related to the power sector and to achieve sustainable development, this study suggests that Thailand’s government should focus on restructuring the fuel supply in power generation towards low carbon fuels by promoting the use of renewable energy for electricity, improving the efficiency of electricity use by reducing electricity transmission and the distribution of line losses, implementing energy conservation strategies by enhancing the purchase of energy-saving products, substituting the new power plant technology in the old power plants, promoting a shift of economic structure towards less energy-intensive services and orienting Thailand’s power industry towards low carbon electricity generation.

Keywords: co2 emission, decomposition analysis, electricity generation, energy consumption

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Authors: Tania M. Guerrero, Ileana Cortes Santiago

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Estamos Unidos Asylum Project has served more than 2,000 asylum seekers and migrants who are under the Migrant Protection Protocols (MPP) policy in Ciudad Juarez, Mexico. The U.S. policy, implemented in January 2019, has stripped asylum seekers of their rights—forcing people fleeing violence and discrimination to wait in similar or worse conditions from which they fled and navigate their entire asylum process in a different country. Several civil rights groups, including the American Civil Liberties Union (ACLU), challenged MPP in U.S. federal courts in February 2019, arguing a violation of international U.S. obligations towards refugees and asylum-seekers under the 1951 Refugee Convention and the Refugee Act of 1980 in regards to the non-refoulement principle. MPP has influenced Mexico's policies, enforcement, and prioritization of the presence of asylum seekers and migrants; it has also altered the way international non-governmental organizations work at the Mexican Northern border. Estamos Unidos is a project situated in a logistical conundrum, as it provides needed legal services to a population in a legal and humanitarian void, i.e., a liminal space. The liminal space occupied by asylum seekers living under MPP is one that, in today's world, should not be overlooked; it dilutes asylum law and U.S. commitments to international protections. This paper provides analysis of and broader implications from a project whose main goal is to uphold the protections of asylum seekers and international refugee law. The authors identified and analyzed four critical points based on field work conducted since August 2019: (1) strategic coalition building with international, local, and national organizations; (2) brokering between domestic and international contexts and critical legal constraints; (3) flexibility to sudden policy changes and the diverse needs of the multiethnic groups of migrants and asylum seekers served by the project; and (4) the complexity of providing legal assistance to asylum seekers who are survivors of trauma. The authors concur with scholarship when highlighting the erosion of protections of asylum seekers and migrants as a dangerous and unjust global phenomenon.

Keywords: asylum, human rights, migrant protection protocols, refugees law

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Authors: Maressa Aires de Proenca

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The inclusion of a gender perspective in peace operations is based on a series of conventions, treaties, and resolutions designed to protect and include women addressing gender mainstreaming. The UN Security Council recognizes that women's participation and gender equality within peace operations are indispensable for achieving sustainable development and peace. However, the participation of women in the field of peace and security is still embryonic. There are gaps when we think about female participation in conflict resolution and peace promotion spaces, and it does not seem clear how women are present in these spaces. This absence may correspond to silence about representation and the guarantee of the female perspective within the context of peace promotion. Thus, the present research aimed to describe the panorama of the participation of women who are currently active in the 14 active UN peace operations, which are: 1) MINUJUSTH, Haiti, 2) MINURSO, Western Sahara, 3) MINUSCA, Central African Republic, 4) MINUSMA, Mali, 5) MONUSCO, the Democratic Republic of the Congo, 6) UNAMID, Darfur, 7) UNDOF, Golan, 8) UNFICYP, Cyprus, 9) UNIFIL, Lebanon, 10) UNISFA, Abyei, 11) UNMIK, Kosovo, 12) UNMISS, South Sudan, 13) UNMOGIP, India, and Pakistan, and 14) UNTSO, Middle East. A database was constructed that reported: (1) position held by the woman in the peace operation, (2) her profession, (3) educational level, (4) marital status, (5) religion, (6) nationality, (8) number of years working with peace operations, (9) whether the operation in which it operates has provided training on gender issues. For the construction of this database, official reports and statistics accessed through the UN Peacekeeping Resource Hub were used; The United Nations Statistical Commission, Peacekeeping Master Open Datasets, The Armed Conflict Database (ACD), The International Institute for Strategic Studies (IISS) database; Armed Conflict Location & Event Data Project (ACLED) database; from the Evidence and Data for Gender Equality (EDGE) database. In addition to access to databases, peacekeeping operations will be contacted directly, and data requested individually. The database showed that the presence of women in these peace operations is still incipient, but growing. There are few women in command positions, and most of them occupy administrative or human-care positions.

Keywords: women, peace and security, peacekeeping operations, peace studies

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Authors: Jerome E. Abiemo, Takeshi Mizunoya

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The Aveyime community in the Volta region of Ghana is one of the major hubs for rice production. In the past, rice farmers applied organic pesticides to control pests, and compost as a soil amendment to improve fertility and productivity. However, the introduction of chemical pesticides and fertilizers have led many farmers to convert to inorganic system of rice production, without considering the social costs (e.g. groundwater contamination and health costs) related to the use of pesticides. The study estimates and compares the private and social BCRs of organic and inorganic systems of rice production. Both stratified and simple random sampling techniques were employed to select 300 organic and inorganic rice farmers and 50 pesticide applicators. The respondents were interviewed with pre-tested questionnaires. The Contingent Valuation Method (CVM) which elucidates organic farmers` Willingness-to-Pay (WTP) was employed to estimate the cost of groundwater contamination. The Cost of Illness (COI) analysis was used to estimate the health cost of pesticide-induced poisoning of applicators. The data collated, was analyzed with the aid of Microsoft excel. The study found that high private benefit (e.g. increase in farm yield and income) was the most influential factor for the rapid adoption of pesticides among rice farmers. The study also shows that the social costs of inorganic rice production were high. As such the social BCR of inorganic farming (0.2) was low as compared to organic farming (0.7). Based on the results, it was recommended that government should impose pesticide environmental tax, review current agricultural policies to favour organic farming and promote extension education to farmers on pesticide risk, to ensure agricultural and environmental sustainability.

Keywords: benefit-cost-ratio (BCR), inorganic farming, pesticides, social cost

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Authors: Hannah Rosenqvist, Fanny Guay

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Critical infrastructure protection has been an important topic for several years. Programmes such as the European Programme for Critical Infrastructure Protection (EPCIP), Critical Infrastructure Warning Information Network (CIWIN) and the European Reference Network for Critical Infrastructure Protection (ENR-CIP) have been the pillars to the work done since 2006. However, measuring critical infrastructure resilience has not been an easy task. This has to do with the fact that the concept of resilience has several definitions and is applied in different domains such as engineering and social sciences. Since June 2015, the EU project IMPROVER has been focusing on developing a methodology for implementing a combination of societal, organizational and technological resilience concepts, in the hope to increase critical infrastructure resilience. For this paper, we performed research on how to include societal resilience as a form of measurement of the context of critical infrastructure resilience. Because one of the main purposes of critical infrastructure (CI) is to deliver services to the society, we believe that societal resilience is an important factor that should be considered when assessing the overall CI resilience. We found that existing methods for CI resilience assessment focus mainly on technical aspects and therefore that is was necessary to develop a resilience model that take social factors into account. The model developed within the project IMPROVER aims to include the community’s expectations of infrastructure operators as well as information sharing with the public and planning processes. By considering such aspects, the IMPROVER framework not only helps operators to increase the resilience of their infrastructures on the technical or organizational side, but aims to strengthen community resilience as a whole. This will further be achieved by taking interdependencies between critical infrastructures into consideration. The knowledge gained during this project will enrich current European policies and practices for improved disaster risk management. The framework for societal resilience analysis is based on three dimensions for societal resilience; coping capacity, adaptive capacity and transformative capacity which are capacities that have been recognized throughout a widespread literature review in the field. A set of indicators have been defined that describe a community’s maturity within these resilience dimensions. Further, the indicators are categorized into six community assets that need to be accessible and utilized in such a way that they allow responding to changes and unforeseen circumstances. We conclude that the societal resilience model developed within the project IMPROVER can give a good indication of the level of societal resilience to critical infrastructure operators.

Keywords: community resilience, critical infrastructure protection, critical infrastructure resilience, societal resilience

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Authors: Gaurav Kumar Mishra, Sanjeeva Nayaka, Dalip Kumar Upreti

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Our nature exhibited presence of a number of unique plants which can be used as indicator of environmental condition of particular place. Lichens are unique plant which has an ability to absorb not only organic, inorganic and metaloties but also absorb radioactive nuclide substances present in the environment. In the present study pyrenocarpous lichens will used as indicator of good forest health in a particular place. The Pyrenocarpous lichens are simple crust forming with black dot like perithecia have few characters for their taxonomical segregation as compared to their foliose and fruticose brethrean. The thallus colour and nature, presence and absence of hypothallus are only few characters of thallus are used to segregate the pyrenocarpous taxa. The fruiting bodies of pyrenolichens i.e. ascocarps are perithecia. The perithecia and the contents found within them posses many important criteria for the segregation of pyrenocarpous lichen taxa. The ascocarp morphology, ascocarp arrangement, the perithecial wall, ascocarp shape and colour, ostiole shape and position, ostiole colour, ascocarp anatomy including type of paraphyses, asci shape and size, ascospores septation, ascospores wall and periphyses are the valuable charcters used for segregation of different pyrenocarpous lichen taxa. India is represented by the occurrence of the 350 species of 44 genera and eleven families. Among the different genera Pyrenula is dominant with 82 species followed by the Porina with 70 species. Recently, systematic of the pyrenocarpous lichens have been revised by American and European lichenologists using phylogenetic methods. Still the taxonomy of pyrenocarpous lichens is in flux and information generated after the completion of this study will play vital role in settlement of the taxonomy of this peculiar group of lichens worldwide. The Indian Himalayan region exhibit rich diversity of pyrenocarpous lichens in India. The western Himalayan region has luxuriance of pyrenocarpous lichens due to its unique topography and climate condition. However, the eastern Himalayan region has rich diversity of pyrenocarpous lichens due to its warmer and moist climate condition. The rich moist and warmer climate in eastern Himalayan region supports forest with dominance of evergreen tree vegetation. The pyrenocarpous lichens communities are good indicator of young and regenerated forest type. The rich diversity of lichens clearly indicates that moist of the forest within the eastern Himalayan region has good health of forest. Due to fast pace of urbanization and other developmental activities will defiantly have adverse effects on the diversity and distribution of pyrenocarpous lichens in different forest type and the present distribution pattern will act as baseline data for carried out future biomonitoring studies in the area.

Keywords: lichen diversity, indicator species, environmental factors, pyrenocarpous

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Authors: Dale Dzemydiene, Aurelija Burinskiene, Arunas Miliauskas, Kristina Ciziuniene

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Data flow and the purpose of reporting the data are different and dependent on business needs. Different parameters are reported and transferred regularly during freight delivery. This business practices form the dataset constructed for each time point and contain all required information for freight moving decisions. As a significant amount of these data is used for various purposes, an integrating methodological approach must be developed to respond to the indicated problem. The proposed methodology contains several steps: (1) collecting context data sets and data validation; (2) multi-objective analysis for optimizing freight transfer services. For data validation, the study involves Grubbs outliers analysis, particularly for data cleaning and the identification of statistical significance of data reporting event cases. The Grubbs test is often used as it measures one external value at a time exceeding the boundaries of standard normal distribution. In the study area, the test was not widely applied by authors, except when the Grubbs test for outlier detection was used to identify outsiders in fuel consumption data. In the study, the authors applied the method with a confidence level of 99%. For the multi-objective analysis, the authors would like to select the forms of construction of the genetic algorithms, which have more possibilities to extract the best solution. For freight delivery management, the schemas of genetic algorithms' structure are used as a more effective technique. Due to that, the adaptable genetic algorithm is applied for the description of choosing process of the effective transportation corridor. In this study, the multi-objective genetic algorithm methods are used to optimize the data evaluation and select the appropriate transport corridor. The authors suggest a methodology for the multi-objective analysis, which evaluates collected context data sets and uses this evaluation to determine a delivery corridor for freight transfer service in the multi-modal transportation network. In the multi-objective analysis, authors include safety components, the number of accidents a year, and freight delivery time in the multi-modal transportation network. The proposed methodology has practical value in the management of multi-modal transportation processes.

Keywords: multi-objective, analysis, data flow, freight delivery, methodology

Procedia PDF Downloads 182

Authors: Sanjay Dhiraaj, Puneet Goyal, Aditya Kapoor, Gaurav Misra

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In electrocardiography, an ECG artefact is used to indicate something that is not heart-made. Although technological advancements have produced monitors with the potential of providing accurate information and reliable heart rate alarms, despite this, interference of the displayed electrocardiogram still occurs. These interferences can be from the various electrical gadgets present in the operating room or electrical signals from other parts of the body. Artefacts may also occur due to poor electrode contact with the body or due to machine malfunction. Knowing these artefacts is of utmost importance so as to avoid unnecessary and unwarranted diagnostic as well as interventional procedures. We report a case of ECG artefacts occurring due to patient warming blanket and its consequences. A 20-year-old male with a preoperative diagnosis of exstrophy epispadias complex was posted for surgery under epidural and general anaesthesia. Just after endotracheal intubation, we observed nonspecific ECG changes on the monitor. At a first glance, the monitor strip revealed broad QRs complexes suggesting a ventricular bigeminal rhythm. Closer analysis revealed these to be artefacts because although the complexes were looking broad on the first glance there was clear presence of normal sinus complexes which were immediately followed by 'broad complexes' or artefacts produced by some device or connection. These broad complexes were labeled as artefacts as they were originating in the absolute refractory period of the previous normal sinus beat. It would be physiologically impossible for the myocardium to depolarize so rapidly as to produce a second QRS complex. A search for the possible reason for the artefacts was made and after deepening the plane of anaesthesia, ruling out any possible electrolyte abnormalities, checking of ECG leads and its connections, changing monitors, checking all other monitoring connections, checking for proper grounding of anaesthesia machine and OT table, we found that after switching off the patient’s warming apparatus the rhythm returned to a normal sinus one and the 'broad complexes' or artefacts disappeared. As misdiagnosis of ECG artefacts may subject patients to unnecessary diagnostic and therapeutic interventions so a thorough knowledge of the patient and monitors allow for a quick interpretation and resolution of the problem.

Keywords: ECG artefacts, patient warming blanket, peri-operative arrhythmias, mobile messaging services

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Authors: Junaid Mahmood Alam, Sana Anwar, Sarah Sughra Asghar

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Chronic hepatitis or Hepatitis C viral (HCV) infection has been identified as one of the factors that could elicit autoimmune disease resulting in the development of auto-antibodies. Furthermore, HCV is implicated in contravening of forbearance to antigens, therefore, inciting auto-reactivity. In this regard, several near and past studies noted the prevalence of thyroid dysfunction and production of anti-thyroid antibodies (ATAb) such as anti-thyroid peroxidase (AntiTPO) and anti-thyroglobulin (AntiTG) in patients with HCV. Likewise, one of the etiologies of augmentation of thyroid disease is basically interferon therapy for HCV infections, for which a number of autoimmune diseases have been noted including Grave’s disease, Hishimoto thyroiditis. A prospectively case-control study was therefore carried out at department of clinical biochemistry lab services and chemical pathology in collaboration with department of clinical microbiology, at Liaquat National Hospital and Medical College, Karachi Pakistan for the period January 2015 to December 2017. Two control groups were inducted for comparison purpose, control group 1 = without HCV infection and with thyroid disorders (n = 20), control group 2 = with HCV infection and without thyroid disorders (n = 20), whereas HCV infected were n = 40 where more than half were noted to be positive for either of HCV IgG and Ag. In HCV group, patients with existing sub-clinical hypothyroidism and clinical hyperthyroidism were less than 5%. Analysis showed the presence of AntiTG in 12 HCV patients (30%), AntiTPO in 15 (37.5%) and both AntiTG and antiTPO in 10 patients (25%). Only 3 patients were found with the history of anti-thyroid auto-antibodies (7.5%) and one with parents and relatives with auto-immune disorders (2.5%). Patients that remained untreated were 12 (30%), under treatment 18 (45%) and with complete-course of treatment 10 (25%). As per review of the literature, meta-analysis of evident data and cross-sectional studies of selective cohorts (as studied in presented research), thyroid connection is designated as one of the most recurrent endocrine ailment associated with chronic HCV infection. Moreover, it also represents an extrahepatic disease in the continuum of HCV syndrome. In conclusion, HCV patients were more likely to encompass thyroid disorders especially related to development of either of ATAb or both antiTG and AntiTPO.

Keywords: Hepatitis C viral (HCV) infection, anti-thyroid antibodies, anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies

Procedia PDF Downloads 160