Search results for: logistics providers

Authors: Ivan Sosa Gomez

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Digitalization has impacted the entire insurance value chain, and the growing movement towards P2P platforms and the collaborative economy is also beginning to have a significant impact. P2P insurance is defined as innovation, enabling policyholders to pool their capital, self-organize, and self-manage their own insurance. In this context, new InsurTech start-ups are emerging as peer-to-peer (P2P) providers, based on a model that differs from traditional insurance. As a result, although P2P platforms do not change the fundamental basis of insurance, they do enable potentially more efficient business models to be established in terms of ensuring the coverage of risk. It is therefore relevant to determine whether p2p innovation can have substantial effects on the future of the insurance sector. For this purpose, it is considered necessary to develop P2P innovation from a business perspective, as well as to build a comparison between a traditional model and a P2P model from an actuarial perspective. Objectives: The objectives are (1) to represent P2P innovation in the business model compared to the traditional insurance model and (2) to establish a comparison between a traditional model and a P2P model from an actuarial perspective. Methodology: The research design is defined as action research in terms of understanding and solving the problems of a collectivity linked to an environment, applying theory and best practices according to the approach. For this purpose, the study is carried out through the participatory variant, which involves the collaboration of the participants, given that in this design, participants are considered experts. For this purpose, prolonged immersion in the field is carried out as the main instrument for data collection. Finally, an actuarial model is developed relating to the calculation of premiums that allows for the establishment of projections of future scenarios and the generation of conclusions between the two models. Main Contributions: From an actuarial and business perspective, we aim to contribute by developing a comparison of the two models in the coverage of risk in order to determine whether P2P innovation can have substantial effects on the future of the insurance sector.

Keywords: Insurtech, innovation, business model, P2P, insurance

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Authors: Andrew Fox, Tao Zhang, Yuanhong Zhao, Qingping Yang

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The furniture manufacturing industry has been slow in general to adopt the latest manufacturing technologies, historically relying heavily upon specialised conventional machinery. This approach not only requires high levels of specialist process knowledge, training, and capital investment but also suffers from significant subtractive manufacturing waste and high logistics costs due to the requirement for centralised manufacturing, with high levels of furniture product not re-cycled or re-used. This paper aims to address the problems by introducing suitable digital manufacturing technologies to create step changes in furniture manufacturing design, as the traditional design practices have been reported as building in 80% of environmental impact. In this paper, a 3D printing robot for furniture manufacturing is reported. The 3D printing robot mainly comprises a KUKA industrial robot, an Arduino microprocessor, and a self-assembled screw fed extruder. Compared to traditional 3D printer, the 3D printing robot has larger motion range and can be easily upgraded to enlarge the maximum size of the printed object. Generative design is also investigated in this paper, aiming to establish a combined design methodology that allows assessment of goals, constraints, materials, and manufacturing processes simultaneously. ‘Matrixing’ for part amalgamation and product performance optimisation is enabled. The generative design goals of integrated waste reduction increased manufacturing efficiency, optimised product performance, and reduced environmental impact institute a truly lean and innovative future design methodology. In addition, there is massive future potential to leverage Single Minute Exchange of Die (SMED) theory through generative design post-processing of geometry for robot manufacture, resulting in ‘mass customised’ furniture with virtually no setup requirements. These generatively designed products can be manufactured using the robot based additive manufacturing. Essentially, the 3D printing robot is already functional; some initial goals have been achieved and are also presented in this paper.

Keywords: additive manufacturing, generative design, robot, sustainability

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Authors: Dujrudee Chinwong, Chanida Prompantakorn, Ubonphan Chaichana, Surarong Chinwong

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Objective: Understanding the university students’ perceptions on smoking caused lung cancer based on the Health Belief Model should help health care providers in assisting them to quit smoking. Thus, this study aimed to investigate the University students’ health belief in smoking behaviors caused lung cancer, which based on the Health Belief Model. Methods: Data were collected from voluntary participants using a self-administered questionnaire. Participants were students studying at a University in northern Thailand who were current smokers; they were selected using snowball sampling. Results: Of 361 students, 84% were males; 78% smoked not more than 10 cigarettes a day; 68% intended to quit smoking. Our findings, based on the health belief model, showed that 1) perceived susceptibility: participants strongly believed that if they did not stop smoking, they were at high risk of lung cancer (88%); 2) perceived severity: they strongly believed that they had a high chance of death from lung cancer if they continued smoking (84%); 3) perceived benefits: they strongly believed that quitting smoking could reduce the chance of developing lung cancer; 4) perceived barriers of quitting smoking: they strongly believed in the difficulty of quitting smoking because it needed a high effort and strong intention (69%); 5) perceived self-efficacy: however, they strongly believed that they can quit smoking right away if they had a strong intention to quit smoking (70%); 6) cues to action: they strongly believed in the support of parents (85%) and lovers (78%) in helping them to quit smoking. Further, they believed that limitation on smoking area in the University and smoking cessation services provided by the University can assist them to quit smoking. Conclusion: The Health Belief Model helps us to understand students’ smoking behaviors caused lung cancer. This could lead to designing a smoking cessation program to assist students to quit smoking.

Keywords: health belief model, lung cancer, smoking, Thailand

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Authors: Pavani K. Sree, Ragahava Reddy Chandri

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Independent living and living with dignity have been the hallmarks of the movement of the persons with disabilities across the globe against the oppression perpetuated by society in the form of social and physical structural barriers. Advancements in assistive technologies have been providing a new lease of life to persons with disabilities. However, access to these technologies is marred by the issues of affordability and availability. Poor from the developing countries find it difficult to make independent living or live with dignity because of lack of access and inability to afford the advance technologies. Class and gender appear to be key factors influencing the access to modern assistive technologies. The present paper attempts to understand the dynamics of class and gender in accessing advanced technologies in the Indian context. Based on an empirical study in which data were collected from persons with locomotor disabilities and service providers, the paper finds that the advance technologies are expensive and inaccessible to all persons with disabilities. The paper also finds that men with disabilities are prioritized by the members of the family for the use of advance technologies while women with disabilities are forced to live with not so advanced technologies. The paper finds that the state institutions working in the field of prosthetics and assistive technologies fail to deliver to the requirements of the poor. It was found that because of lack of facilities at the state institutions the cost of prosthetics, in the case of orthopedically challenged, is expensive and unaffordable for the poor. It was found that while rich male access the private services the poor women depend on the state institutions. It may be said that the social, cultural stereotypes extend not only to the state organizations but also to the use of prosthetics. Thus the notions of independent living and living with dignity in third world countries context are still elusive.

Keywords: accessibility, assistive technology, class, gender, state

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Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

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Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

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Authors: Vladimir Littva, Peter Kutis

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Based on common practice, we know that an empathic approach to a patient is one of the characteristics of a physiotherapist. Although empathy is regarded as an essential condition of the psychotherapeutic relationship, it has taken quite a while for attention to be paid to it in clinical practice. Patients who are experiencing a sense of understanding from health care providers are more willing to cooperate, and treatment within the optimistic attunes a more comfortable framework of care. Age, experience, family, education and the working environment may have an impact on the degree of empathy for paramedics. Within the KEGA project no. 003KU-4-2021, we decided to investigate the level of empathy in the work of physiotherapists in Slovakia. Research sample and Methods: The sample comprised 194 respondents – physiotherapists working on the territory of Slovakia. 112 were men and 82 women. The age of respondents was between 21 and 64 years of age. 133 were married, 51 were single and ten were divorced. 98 were living in the countryside and 96 in towns. Twenty-two grew up without siblings, 95 with one sibling and 77 with two and more siblings. In the survey, we used the Empathy Assessment Questionnaire (EAQ) with 18 questions with four possible answers: strongly disagree, disagree, agree; and strongly agree, which we validated linguistically and psychometrically. All data were statistically processed by SPSS 25. Results: We evaluated the intrinsic reliability of the questionnaire EAQ using Cronbach's Alpha and the coefficient is 0.756 in the whole set. This means that the questionnaire is a quite strong and reliable measurement tool. The mean for individual questions ranged from 2.39 to 3.74 (maximum was 4). In Pearson's correlations, we confirmed the significant differences between the groups regarding sex in 8 questions out of 18, regarding age in 5 questions, regarding family status in 4 questions and regarding siblings in 4 questions out of 18 at the level 5% (p <0.05). Conclusion: The results obtained during the research show the importance of adequate communication with the patient due to his health and well-being. Empathy in the physiotherapists’ profession is very important. It would be worthwhile if the students of physiotherapy would receive a course during their study that would deal exclusively with empathy, empathic approach, burnout, or psycho-emotional hygiene.

Keywords: empathy, approach, clinical practice, physiotherapists

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Authors: Kalaashini Ramachandran, Maznah Dahlui, Nik Daliana Nik Farid

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WHO recommends all babies to be exclusively breastfed and donor milk is the next best alternative in the absence of mother’s own milk. The establishment of a human milk bank (HMB) is still being debated due to religious concerns in Malaysia leading to informal milk sharing practices, but little is known on the knowledge, attitude and perception of women towards HMB and its benefits. This study hypothesizes that there is no association between knowledge and attitude and the acceptance towards the establishment of human milk bank among Malaysian women and healthcare providers. The aim of this study is to determine the drivers and barriers among Malaysian towards the acceptance of an HMB. A cross-sectional study with 367 participants was enrolled within a period of 3 months to answer an online self-administered questionnaire. Data on sociodemographic, knowledge on breastfeeding benefits, knowledge and attitude on HMB and its specific issues were analyzed in terms of frequency and then proceed to multiple logistic regression. Majority of the respondents are of Islamis religion (73.3%), have succeesfully completed their tertiary education (82.8%), and are employed (70.8%). Only 55.9% of respondents have heard of an HMB stating internet as their main source of information but a higher prevalence is agreeable to the establishment of a human milk bank (67.8%). Most respondents have a good score on knowledge of breastfeeding benefits and on HMB specific issues (70% and 54.2% respectively) while 63.8% of them have a positive attitude towards HMB. In the multivariate analysis, mothers with a good score on general knowledge of breastfeeding (AOR: 1.715) were more likely to accept the establishment of an HMB while Islamic religion was negatively associated with its establishment (AOR:0.113). This study has found a high prevalence rate of mothers who are willing to accept the establishment of an HMB. This action can be potentially shaped by educating mothers on the benefits of breastfeeding as well as addressing their religious concerns so the establishment of a religiously abiding HMB in Malaysia may be accepted without compromising their belief or the health benefit of donor milk.

Keywords: acceptability, attitude, human milk bank, knowledge

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Authors: Naridchaya Aberdour, Joanna Kao, Anne Miller, Timothy Shore, Richard Maher, Zhixin Liu

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Background: COVID-19 has and continues to be a strain on healthcare globally, with the number of patients requiring hospitalization exceeding the level of medical support available in many countries. As chest x-rays are the primary respiratory radiological investigation, the Radiological Assessment of Lung Edema (RALE) score was used to quantify the extent of pulmonary infection on baseline imaging. Assessment of RALE score's reproducibility and associations with clinical outcome parameters were then evaluated to determine implications for patient management and prognosis. Methods: A retrospective study was performed with the inclusion of patients testing positive for COVID-19 on nasopharyngeal swab within a single Local Health District in Sydney, Australia and baseline x-ray imaging acquired between January to June 2020. Two independent Radiologists viewed the studies and calculated the RALE scores. Clinical outcome parameters were collected and statistical analysis was performed to assess RALE score reproducibility and possible associations with clinical outcomes. Results: A total of 78 patients met inclusion criteria with the age range of 4 to 91 years old. RALE score concordance between the two independent Radiologists was excellent (interclass correlation coefficient = 0.93, 95% CI = 0.88-0.95, p<0.005). Binomial logistics regression identified a positive correlation with hospital admission (1.87 OR, 95% CI= 1.3-2.6, p<0.005), oxygen requirement (1.48 OR, 95% CI= 1.2-1.8, p<0.005) and invasive ventilation (1.2 OR, 95% CI= 1.0-1.3, p<0.005) for each 1-point increase in RALE score. For each one year increased in age, there was a negative correlation with recovery (0.05 OR, 95% CI= 0.92-1.0, p<0.01). RALE scores above three were positively associated with hospitalization (Youden Index 0.61, sensitivity 0.73, specificity 0.89) and above six were positively associated with ICU admission (Youden Index 0.67, sensitivity 0.91, specificity 0.78). Conclusion: The RALE score can be used as a surrogate to quantify the extent of COVID-19 infection and has an excellent inter-observer agreement. The RALE score could be used to prognosticate and identify patients at high risk of deterioration. Threshold values may also be applied to predict the likelihood of hospital and ICU admission.

Keywords: chest radiography, coronavirus, COVID-19, RALE score

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Authors: Amit Syal, Madeline Grade, Alister Martin

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Background: Cross-sectional and longitudinal studies demonstrate an association between health and voting. Furthermore, voting enables populations to support policies that impact their health via social determinants like income, education, housing, and healthcare access. Unfortunately, many barriers exist which disproportionately affect the civic participation of certain minority groups. Health professionals have an important role to play in addressing the civic health of all patients and empowering underrepresented communities. Description: Vot-ER is a non-partisan, nonprofit organization that aims to reduce barriers to civic participation by helping patients register to vote while in healthcare settings. The initial approach involved iPad-based kiosks in the emergency department waiting rooms, allowing patients to register themselves while waiting. After the COVID-19 pandemic began, Vot-ER expanded its touchless digital approaches. Vot-ER provides healthcare workers across the country with “Healthy Democracy Kits” consisting of badge backers, posters, discharge paperwork, and other resources. These contain QR and text codes that direct users to an online platform for registering to vote or requesting a mail-in ballot, available in English or Spanish. Outcomes: From May to November 2020, Vot-ER helped prepare 46,320 people to vote. 13,192 individual healthcare providers across all 50 states signed up for and received Healthy Democracy Kits. 80 medical schools participated in the Healthy Democracy Campaign competition. Over 500 institutions ordered site-based materials. Conclusions: A healthy democracy is one in which all individuals in a community have equal and fair opportunities for their voices to be heard. Healthcare settings, such as hospitals, are appropriate and effective venues for increasing both voter registration and education.

Keywords: civic health, enfranchisement, physician, voting

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Authors: Kehabtimer Shiferaw Kotiso, Getachew Hailemariam, Abiy Seifu Estifanos

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Introduction: Despite the highest share of low birth weight (LBW) for neonatal mortality and morbidity, predicting births with LBW for better intervention preparation is challenging. This study aims to predict LBW using a dataset encompassing 53,637 birth cohorts collected from 36 primary hospitals across seven regions in Ethiopia from February 2022 to June 2024. Methods: We identified ten explanatory variables related to maternal and neonatal characteristics, including maternal education, age, residence, history of miscarriage or abortion, history of preterm birth, type of pregnancy, number of livebirths, number of stillbirths, antenatal care frequency, and sex of the fetus to predict LBW. Using WEKA 3.8.2, we developed and compared seven machine learning algorithms. Data preprocessing included handling missing values, outlier detection, and ensuring data integrity in birth weight records. Model performance was evaluated through metrics such as accuracy, precision, recall, F1-score, and area under the Receiver Operating Characteristic curve (ROC AUC) using 10-fold cross-validation. Results: The results demonstrated that the decision tree, J48, logistic regression, and gradient boosted trees model achieved the highest accuracy (94.5% to 94.6%) with a precision of 93.1% to 93.3%, F1-score of 92.7% to 93.1%, and ROC AUC of 71.8% to 76.6%. Conclusion: This study demonstrates the effectiveness of machine learning models in predicting LBW. The high accuracy and recall rates achieved indicate that these models can serve as valuable tools for healthcare policymakers and providers in identifying at-risk newborns and implementing timely interventions to achieve the sustainable developmental goal (SDG) related to neonatal mortality.

Keywords: low birth weight, machine learning, classification, neonatal mortality, Ethiopia

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Authors: Obadiah Nwabueze

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Bodija market is classified as Central Business District (CBD) of Ibadan North Local Government Area of Oyo State (Nigeria) because of socio economic activities, so Crime is a peculiar social issue that causes insecurity. The law enforcement agencies tasked with crime prevention and control such as the Nigerian Police have insufficient manpower, and a resultant effect is the emergence of Vigilante groups as citizen’s response to crime control and prevention (self-help). The research design adopted for this study is a case study design exploring Vigilante activities in Bodija Market. The study utilizes both quantitative and qualitative approach, sources of data includes primary and secondary sources. A sample of 127 respondents randomly picked from the 4 sections of Bodija Market through questionnaire, comprising of 50 male and 77 females which alienates issues of gender bias in addition to the 4 in-depth interview, making a total of 131 respondents. Statistical package for Social Sciences (SPSS) was used. The descriptive statistics of simple frequency, percentage, charts and graphs were computed for the analysis. Finding in the study shows that the market vigilante is able to deter and disrupt criminal activities through strategic spiritual intelligence (SSI), use of charm and juju, physical presence in strategic locations vulnerable to crime occurrence. Findings in the study also show that vigilantes collaborate with the police by assisting them in surveillance, tracking down criminals, identifying black spots, acting as informants to the police, arrest and handover criminal to police. Their challenges include poor equipment, motivation, unhealthy rivalry between the vigilante and the police. The study recommends that the government should support vigilantes with logistics and training, including patrol vehicle and radio communication. The study also recommends the integration of the informal mechanism (juju and charm) of crime detection and prevention into the formal policing strategy, an office should be created in the force commands for use of SSI.

Keywords: central business district, CBD, charm, Juju, strategic spiritual intelligence, SSI

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Authors: Jiri Beranovsky, Jaroslav Knapek, Tomas Kralik, Kamila Vavrova

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The paper deals with the results of research focused on the complex aspects of the use of intentionally grown biomass on agricultural land for the production of solid biofuels as an alternative for individual household heating. . The study primarily deals with the analysis of CO2 emissions of the logistics cycle of biomass for the production of energy pellets. Growing, harvesting, transport and storage are evaluated in the pellet production cycle. The aim is also to take into account the consumption profile during the year in terms of heating of common family houses, which are typical end-market segment for these fuels. It is assumed that in family houses, bio-pellets are able to substitute typical fossil fuels, such as brown coal and old wood burning heating devices and also electric boilers. One of the competing technology with the pellets are heat pumps. The results show the CO2 emissions related with considered fuels and technologies for their utilization. Comparative analysis is aimed biopellets from intentionally grown biomass, brown coal, natural gas and electricity used in electric boilers and heat pumps. Analysis combines CO2 emissions related with individual fuels utilization with costs of these fuels utilization. Cost of biopellets from intentionally grown biomass is derived from the economic models of individual energy crop plantations. At the same time, the restrictions imposed by EU legislation on Ecodesign's fuel and combustion equipment requirements and NOx emissions are discussed. Preliminary results of analyzes show that to achieve the competitiveness of pellets produced from specifically grown biomass, it would be necessary to either significantly ecological tax on coal (from about 0.3 to 3-3.5 EUR/GJ), or to multiply the agricultural subsidy per area. In addition to the Czech Republic, the results are also relevant for other countries, such as Bulgaria and Poland, which also have a high proportion of solid fuels for household heating.

Keywords: CO2 emissions, heating costs, energy crop, pellets, brown coal, heat pumps, economical evaluation

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Authors: Salah Al-Ali

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The role of technology transfer in technical and vocational education is significant since lecturers, trainers, and students can obtain the updated knowledge, skills, and attitudes that are currently being practiced by local and international businesses and industries. Technology transfer can indeed close the gap between what is being learned and practiced in technical and vocational institutions and the world of work. However, the success of technology transfer in technical and vocational education perspectives would depend entirely on the quality of management. It is their responsibility when signing an agreement with internal or external providers of technology, to include calluses that enable academic staff in related specialty to interact positively and freely with the supplier of technology. In other terms, ensuring no clear or hidden restriction is imposed by the supplier of technology to acquire the know-how and know-why that are embedded in the agreement. In this paper, I present some of the empirical results and observations which describe the interactions between the supplier of technology (Electrical Engineering System) and the recipient of the technology (PAAE&T) in the field of technology transfer. In another word, whether the PAAE&T have taken the opportunity while building its new headquarter, the transfer of technology from the supplier of an electrical engineering system to its academic staff in its various Electrical Engineering Academic Departments at the PAAE&T colleges and institutions. The paper argues that, for effective and efficient transfer of technology, the recipient (PAAE&T) must ensure that the agreement with the supplier of the Electrical Engineering System must include calluses that would allow the PAAE&T academic staff in its various Electrical Engineering Academic Departments in its various colleges and institutions to acquire the technology embedded in the agreement. The paper concludes that the transfer of technology and the building of a local scientific and technical infrastructure must be viewed by Kuwaiti decision-makers as complementary to one another. Thus, reducing, to great extent, the level of dependence on expatriates, particularly in the essential sectors of the economy.

Keywords: vocational and technical education, technology transfer, enhancing indigenous capabilities, Kuwait

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Authors: Somayeh Abedian, Pirhossein Kolivand, Hamid Reza Lornejad, Amin Karampour, Ebrahim Keshavarz Safari

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For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Keywords: response time, geographic location inquiry service (GLIS), location-based service (LBS), emergency medical services information system (EMSIS)

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Authors: Sarieh Poortaghi, Zakiyeh Jafaryparvar, Marzieh Hasanpour, Reza Negarandeh

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Aim: This article aims to discuss how violence against health care workers especially nurses affects health care systems and the quality of care of the patients. In this paper causes of violence and strategies to reduce it have been discussed. Methods: Discourse of the literature considering the violence against nurses during the COVID-19 pandemic and its reasons and outcomes. Results: The COVID-19 pandemic has led to a significant increase in violence against healthcare providers. The attacker against nurses may be among patients, companions, visitors, colleagues such as doctors and other nurses, supervisors, and managers. Many individuals who experience violence in healthcare environments refrain from reporting it. The causes of violence against nurses include spending long periods with patients, perceiving nursing as a low-status profession, gender of nurses, direct and frequent contact with patients and their companions, inadequate facilities and high workload, weak healthcare delivery systems in public hospitals and inequality in health, nature of the department and shift type of personnel, work shifts and staff shortages, forcing nurses to work in non-standard conditions during the COVID-19 pandemic, prohibition of patient visits during the pandemic, patient death and nurses' sense of incompetence, and expressing stress through aggression. Workplace violence leads to a decrease in job satisfaction and an increase in continuous psychological stress, which has a negative impact on the personal and professional lives of nurses. Potential strategies for reducing workplace violence include protecting healthcare workers through laws, improving communication with patients and their families, critically analyzing information in social media, facilitating patient access through remote medical strategies, and improving access to primary healthcare services.

Keywords: nurses, health care workers, Covid-19, nursing

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Authors: Kyngäs Helvi, Patala-Pudas, Kaakinen Pirjo

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It has been reported that COPD -patients may experience much emotional distress, which can compromise positive health outcomes. The aim of this study was to explore disease-related uncertainty as reported by Chronic Obstructive Pulmonary Disease (COPD) patients. Uncertainty was defined as a lack of confidence; negative feelings; a sense of confidence; and awareness of the sources of uncertainty. Research design was a non-experimental cross-sectional survey. The data (n=141) was collected by validated questionnaire during COPD -patients’ visits or admissions to a tertiary hospital. The response rate was 62%. The data was analyzed by statistical methods. Around 70% of the participants were male with COPD diagnosed many years ago. Fifty-four percent were under 65 years and used an electronic respiratory aid apparatus (52%) (oxygen concentrator, ventilator or electronic inhalation device). Forty-one percent of the participants smoked. Disease-related uncertainty was widely reported. Seventy-three percent of the participants had uncertainty about their knowledge of the disease, the pulmonary medication and nutrition. One-quarter (25%) did not feel sure about managing COPD exacerbation. About forty percent (43%) reported that they did not have a written exacerbation decision aid indicating how to act in relation to COPD symptoms. Over half of the respondents were uncertain about self-management behavior related to health habits such as exercise and nutrition. Over a third of the participants (37%) felt uncertain about self-management skills related to giving up smoking. Support from the care providers was correlated significantly with the patients’ sense of confidence. COPD -patients who felt no confidence stated that they received significantly less support in care. Disease-related uncertainty should be considered more closely and broadly in the patient care context, and those strategies within patient education that enhance adherence should be strengthened and incorporated into standard practice.

Keywords: adherence, COPD, disease-management, uncertainty

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Authors: Niloofar Mobasem, Kambiz Heidarzadeh Hanzaee

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Purpose: The study aimed to measure the customer satisfaction with service recovery through the conflict management framework, especially assessing the role of pre-existing attitudes for measuring the customer response to the service failure. Design/ methodology/ approach: The study is based on the experimental research method. The factorial designs are used in the research that measures the variables in two separate studies. In the first study, the factorial design is 3 conflict management style: cooperative, competitive, avoiding; - 3 service performance: exceed expectation, meet expectation, fail to meet expectation; and in the second study includes: - 3 conflict management style: cooperative, competitive, avoiding; - 2 service performance: exceed expectation, fail to meet expectation; - 2 pre-existing attitude: positive, negative. Finding: The results of study based on a scenario indicate that the conflict management style affected on customer satisfaction by service recovery efforts as well as the pre-existing attitudes affected the customer interpretation for service providers (conflict management style) and those who have positive pre-existing attitudes are interested to response to the cooperative approach in dealing with service failure. Research limitation/ implication: According to all researches, the study has several limitations. The nature of scenario in this study may cause to hit the reality of life. Although, the similar scenario approaches commonly are used for such researches, but the approaches are not without criticism. Practical implications: Given the importance of service recovery, companies can understand the importance of creating customer satisfaction achieved by the positive results due to the service recovery during the shortness or service failure by the mentioned companies. Originality/ value: The study highlights the importance of service failure and providing the education in relation to the service recovery.

Keywords: service recovery, pre-existing attitude, service failure, customer satisfaction

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Authors: Sewe Silvanus Odhiambo

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Globally, many governments have publicly recognized private security firms as essential services providers. The private security firms face a lot of challenges, but the COVID-19 situation also has exacerbated them to another level. This paper locates its relevance in the post-coronavirus era. The COVID-19 pandemic has redefined the world operation, which shows a higher impact on the security field. Accordingly, the purpose of the study was to examine the role of corporate governance on the performance of private security firms in a post-covid pandemic era in Kenya. The study employed a descriptive research design, which included a quantitative approach and secondary data. The study was carried in the month of July 2021 from the registered private security firms. After targeting all private security firms, only 54 firms had disclosed their annual report by the time of conducting the study. The results depicted that pandemic has affected the performance of private security firms measures unfavorably. Further, boards of directors show a positive association with security firm performance. The study recommends that there is need board of directors to enhance management’s risk assessments in the midst of COVID-19; ensure that there are business continuity plans; there is organizational resilience; there is need for the development of new digital strategies; enabling the digital workforce in the firms and have effective communication plans with both internal and external stakeholders to deal with uncertainties and develop more post-COVID practices for boards of directors to improve performance of private security firms in Kenya. The practical implications of the study are that the research outcomes might assist regulatory bodies, investors, policymakers, and the security sector in general in their formulation of public and corporate governance strategies concerning future emergency preparedness and responses. This study also provides a unique contribution to the literature of COVID-19 and security firm performance in emerging economies context.

Keywords: COVID-19, corporate governance, firm performance, private security firms

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Authors: Sarinra Thongmee, Krittaporn Prakobsaeng, Adithep Mingsuan, Chanyapak Polkhet, Supattra Wongsuk

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The purposes of this research and developmentwasto develop and evaluation of the clinical nursingpractice guideline (CNPG) for the prevention infection during intubation in patient with suspected or confirmedCOVID-19 patient. This study was developed by using the evidencebased practice model of Soukup (2000) asa conceptual framework. The study consisted of 4 steps: 1) situational analysis of intubation service in patientswith confirmed COVID-19; 2) development of the CNPG; 3) apply the NPG to trial; and 4) evaluation of the CNPG. The sample consisted of 52 nurse anesthetists and 25 infected or suspected COVID-19 patients. The research instrument consisted of 1) the CNPG, which was developed by the researchers; 2) the nurses anesthetist opinion questionnaire to the guideline; 3) the evaluation practice form; and 4) the nurse anesthetist knowledge test on nursing care of patients infected with COVID-19. Data were analyzed by using descriptive statistics, and Wilcoxon matched-pairs signed rank test. The results revealed this developed CNPG consists of 4 sections: 1)the CNPG for airborne precautions2) the preparation of anesthetic and intubation equipments3) the roles and duties of the intubation team, 4) the guidelines for intubation in suspected or confirmed COVID-19 patients. The results of CNPG use found that 1)the provider: using NPG in providers revealed that nurse anesthetist had a higher mean of knowledge scores than before using CNPG statistically significant at the 0.05 level (p<0.01) and able to follow the NPG 100% inall activities. The anesthetic team was not infected with COVID-19 from intubation outside the operating room. 2)the client: the patient was safe, with no complications from intubation. Summary CNPG to prevent infection during reintubation of suspected or confirmedCOVID-19patient was appropriate and applicable to practice.

Keywords: clinical nursing practice guideline, prevention of infection, endotracheal intubation, COVID-19

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Authors: Aria Teimourzadeh, Marc Favier, Samaneh Kakavand

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The emergence of social networks has revolutionized the exchange of information. Every behavior on these platforms contributes to the generation of data known as social network data that are processed, stored and published by the social network service providers. Hence, it is vital to investigate the role of these platforms in user data by considering the privacy measures, especially when we observe the increased number of individuals and organizations engaging with the current virtual platforms without being aware that the data related to their positioning, connections and behavior is uncovered and used by third parties. Performing analytics on social network datasets may result in the disclosure of confidential information about the individuals or organizations which are the members of these virtual environments. Analyzing separate datasets can reveal private information about relationships, interests and more, especially when the datasets are analyzed jointly. Intentional breaches of privacy is the result of such analysis. Addressing these privacy concerns requires an understanding of the nature of data being accumulated and relevant data privacy regulations, as well as motivations for disclosure of personal information on social network platforms. Some significant points about how user's online information is controlled by the influence of social factors and to what extent the users are concerned about future use of their personal information by the organizations, are highlighted in this paper. Firstly, this research presents a short literature review about the structure of a network and concept of privacy in Online Social Networks. Secondly, the factors of user behavior related to privacy protection and self-disclosure on these virtual communities are presented. In other words, we seek to demonstrates the impact of identified variables on user information disclosure that could be taken into account to explain the privacy preservation of individuals on social networking platforms. Thirdly, a few research directions are discussed to address this topic for new researchers.

Keywords: information disclosure, privacy measures, privacy preservation, social network analysis, user experience

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Authors: M. S. Maglasang, S. O. Palacio, L. P. Ogdoc

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Business Process Outsourcing has been one of the fastest growing and emerging industry in the Philippines today. Unlike most of the contact service centers, more popularly known as "call centers", The BPO Industry’s primary outsourced service is performing audits of the global clients' logistics. As a service industry, manpower is considered as the most important yet the most expensive resource in the company. Because of this, there is a need to maximize the human resources so people are effectively and efficiently utilized. The main purpose of the study is to optimize the current manpower resources through effective distribution and assignment of different types of bills to the different skill-level of data entry operators. The assignment model parameters include the average observed time matrix gathered from through time study, which incorporates the learning curve concept. Subsequently, a simulation model was made to duplicate the arrival rate of demand which includes the different batches and types of bill per day. Next, a mathematical linear programming model was formulated. Its objective is to minimize direct labor cost per bill by allocating the different types of bills to the different skill-levels of operators. Finally, a hypothesis test was done to validate the model, comparing the actual and simulated results. The analysis of results revealed that the there’s low utilization of effective capacity because of its failure to determine the product-mix, skill-mix, and simulated demand as model parameters. Moreover, failure to consider the effects of learning curve leads to overestimation of labor needs. From 107 current number of operators, the proposed model gives a result of 79 operators. This results to an increase of utilization of effective capacity to 14.94%. It is recommended that the excess 28 operators would be reallocated to the other areas of the department. Finally, a manpower capacity planning model is also recommended in support to management’s decisions on what to do when the current capacity would reach its limit with the expected increasing demand.

Keywords: optimization modelling, linear programming, simulation, time and motion study, capacity planning

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Authors: Shu-Lien Chou, Chung-Feng Liu

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Self-health management of chronic illnesses plays an important part in chronic illness treatments. However, various kinds of health information (health education materials) which government or healthcare institutions provide for patients may not achieve the expected outcome. One of the critical reasons affecting patients’ use intention could be patients’ perceived Information overload regarding the health information. This study proposed an extended model of Theory of Planned Behavior, which integrating perceived information overload as another construct to explore patients’ use intention of the health information for self-health management. The independent variables are attitude, subject norm, perceived behavior control and perceived information overload while the dependent variable is behavior intention to use the health information. The cross-sectional study used a structured questionnaire for data collection, focusing on the chronic patients with coronary artery disease (CAD), who are the potential users of the health information, in a medical center in Taiwan. Data were analyzed using descriptive statistics of the basic information distribution of the questionnaire respondents, and the Partial Least Squares (PLS) structural equation model to study the reliability and construct validity for testing our hypotheses. A total of 110 patients were enrolled in this study and 106 valid questionnaires were collected. The PLS analysis result indicates that the patients’ perceived information overload of health information contributes the most critical factor influencing the behavioral intention. Subjective norm and perceived behavioral control of TPB constructs had significant effects on patients’ intentions to use health information also, whereas the attitude construct did not. This study demonstrated a comprehensive framework, which extending perceived information overload into TPB model to predict patients’ behavioral intention of using heath information. We expect that the results of this study will provide useful insights for studying health information from the perspectives of academia, governments, and healthcare providers.

Keywords: chronic patients, health information, information overload, theory of planned behavior

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Authors: Mustafa Eruyar, Ersoy Pehlivan, Fatih Kafalı, Fatih Gundogan

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All megacities are not only under the pressure of common urbanization and growth problems but also dealing with different challenges according to their specific circumstances. However, the majority of cities focuses mainly on popular smart city projects, which are usually driven by strong private sector, regardless of their characteristics, each city needs to develop customized projects within a tailor-made smart city roadmap to be able to solve its own challenges. Smart city manifest, helps citizens to feel the action better than good reading smart city vision statements, which consists of five elements; namely purpose, values, mission, vision, and strategy. This study designs a methodology for smart city roadmap based on a top-down approach, breaking down of smart city manifest to feasible projects for a systematic smart city transformation. This methodology was implemented in Istanbul smart city transformation program which includes smart city literature review, current state analysis, roadmap, and architecture projects, respectively. Istanbul smart city roadmap project followed an extensive literature review of certain leading smart cities around the world and benchmarking of the city’s current state using well known smart city indices. In the project, needs of citizens and service providers of the city were identified via stakeholder, persona and social media analysis. The project aimed to develop smart city projects targeting fulfilling related needs by implementing a gap analysis between current state and foreseen plans. As a result, in 11 smart city domains and enablers; 24 strategic objectives, 50 programs, and 101 projects were developed with the support of 183 smart city stakeholder entities and based on 125 citizen persona profiles and last one-year social media analysis. In conclusion, the followed methodology helps cities to identify and prioritize their needs and plan for long-term sustainable development, despite limited resources.

Keywords: needs-based, manifest, roadmap, smart city, top-down approach

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Authors: Esmeralda Hysenbelliu

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The aim of this paper is to present the QoE (Quality of Experience) IPTV SDN-based media streaming server enhanced architecture for configuring, controlling, management and provisioning the improved delivery of IPTV service application with low cost, low bandwidth, and high security. Furthermore, it is given a virtual QoE IPTV SDN-based topology to provide an improved IPTV service based on QoE Control and Management of multimedia services functionalities. Inside OpenFlow SDN Controller there are enabled in high flexibility and efficiency Service Load-Balancing Systems; based on the Loading-Balance module and based on GeoIP Service. This two Load-balancing system improve IPTV end-users Quality of Experience (QoE) with optimal management of resources greatly. Through the key functionalities of OpenFlow SDN controller, this approach produced several important features, opportunities for overcoming the critical QoE metrics for IPTV Service like achieving incredible Fast Zapping time (Channel Switching time) < 0.1 seconds. This approach enabled Easy and Powerful Transcoding system via FFMPEG encoder. It has the ability to customize streaming dimensions bitrates, latency management and maximum transfer rates ensuring delivering of IPTV streaming services (Audio and Video) in high flexibility, low bandwidth and required performance. This QoE IPTV SDN-based media streaming architecture unlike other architectures provides the possibility of Channel Exchanging between several IPTV service providers all over the word. This new functionality brings many benefits as increasing the number of TV channels received by end –users with low cost, decreasing stream failure time (Channel Failure time < 0.1 seconds) and improving the quality of streaming services.

Keywords: improved quality of experience (QoE), OpenFlow SDN controller, IPTV service application, softwarization

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Authors: Kristine Joy Y. Sumanga, Clarissa Mae D. Derecho

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Telemedicine is providing health care services using electronic means at a distance, including the diagnosis, treatment, and prevention of diseases as well as the research and evaluation and education of health care providers. The role of telemedicine in this time of the COVID-19 pandemic is vital, especially in the practice of medicine. General Objective: To determine the extent of knowledge, preparedness and perception of telemedicine among Family Medicine Resident Physicians in different training institutions in Cebu City during the Coronavirus Disease 19 pandemic. Methods: A descriptive, cross-sectional survey research study was conducted in four hospital training institutions in Cebu City. A total of 41 respondents gave their consent and were given the online survey questionnaire pertaining to the extent of knowledge, preparedness and perceptions on telemedicine, including respondents’ demographic data and problems encountered in Telemedicine. Results: Out of the 41 respondents, 56.10% were young adults (26 to 30 years old), mostly females (70.73%), single (68.29%), first-year residents (43.90%), employed at a government hospital (70.73%) and are in the traditional residency pathway (82.93%). On relevant experience, 82.93% experienced telemedicine during residency, with 100% on follow-up consultations, and 95% were consulted due to infections. Respondents’ extent of knowledge was average, while the extent of preparedness and perception were great. Problems with low connectivity (80.48%) were noted by most of the respondents. Conclusion: Resident physicians moderately understood the information about telemedicine but with a great extent of preparedness and perception. They are always prepared for telemedicine modality because they are fully aware of its existence and need in the delivery of health care services among their patients at the time of the pandemic. Challenges to low connectivity and handling patients’ data privacy were the major concerns met by the resident physicians in the use of telemedicine.

Keywords: telemedicine, knowledge, preparedness, perception, family medicine, residents, COVID 19

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Authors: Virakti Dhaval Shah

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Advances in technology and the changes in lifestyle and work expectations amid the COVID-19 pandemic are requiring changes to vocational assessment, provision of vocational training, and identification of job matches for individuals with intellectual disability. Vocational assessment involves the assessment of interests, skills, abilities, and strengths/weaknesses, as well as a detailed understanding of healthcare, familial, social, community, workplace-related and policy-level protective and risk factors impacting the individual. In India, vocational assessment procedures such as interviews play a major role in vocational placement today. Unfortunately, many of the most widely used vocational assessment instruments in India were developed in the 1970s to 2000s and have not been revised since. Hence, there is a dire need to update existing tools and prepare a structured approach for vocational service providers to meet the unique employment needs of individuals with intellectual disabilities. To address this need, this project designed a multi-domain assessment toolkit for a structured approach to vocational assessment, training, and job placement for individuals with intellectual disabilities in India. Methods included conducting an empirical review of the available tools currently in use in India for the vocational assessment of persons with intellectual disabilities. Domains addressed in the instrument review were organized into a structured system, and additional items related to contemporary technology, pandemic-related experiences of persons with disabilities, and changes in lifestyle and work expectations due to the pandemic were added. Items assessing behaviors, provision of vocational training, and identification of job matches for individuals with intellectual disabilities were developed. The proposed tool has the potential to benefit organizations working with and preparing individuals with intellectual disabilities to find successful employment by undertaking a structured approach to vocational assessment, rehabilitation, training, and placement. It can be particularly useful for guiding new professionals doing vocational rehabilitation in India.

Keywords: intellectual disability, rehabilitation, vocational assessment, vocational rehabilitation

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Authors: Akiode Ayobami, Akiode Akinsewa, Odeku Mojisola, Salako Busola, Odutolu Omobola, Nuhu Khadija

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Purpose: Evidence exists that family planning use can contribute to reduction in infant and maternal mortality in any country. Despite these benefits, contraceptive use in Nigeria still remains very low, only 10% among married women. Understanding factors that predict contraceptive use is very important in order to improve the situation. In this paper, we analysed data from the 2013 Nigerian Demographic and Health Survey (NDHS) to better understand predictors of contraceptive use in Nigeria. The use of logistics regression and other traditional models in this type of situation is not appropriate as they do not account for social structure influence brought about by the hierarchical nature of the data on response variable. We therefore used multilevel modelling to explore the determinants of contraceptive use in order to account for the significant variation in modern contraceptive use by socio-demographic, and other proximate variables across the different Nigerian states. Method: This data has a two-level hierarchical structure. We considered the data of 26, 403 married women of reproductive age at level 1 and nested them within the 36 states and the Federal Capital Territory, Abuja at level 2. We modelled use of modern contraceptive against demographic variables, being told about FP at health facility, heard of FP on TV, Magazine or radio, husband desire for more children nested within the state. Results: Our results showed that the independent variables in the model were significant predictors of modern contraceptive use. The estimated variance component for the null model, random intercept, and random slope models were significant (p=0.00), indicating that the variation in contraceptive use across the Nigerian states is significant, and needs to be accounted for in order to accurately determine the predictors of contraceptive use, hence the data is best fitted by the multilevel model. Only being told about family planning at the health facility and religion have a significant random effect, implying that their predictability of contraceptive use varies across the states. Conclusion and Recommendation: Results showed that providing FP information at the health facility and religion needs to be considered when programming to improve contraceptive use at the state levels.

Keywords: multilevel modelling, family planning, predictors, Nigeria

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Authors: Mohanad Al-Behadili, Xiang Song, Djamila Ouelhadj, Alex Fraess-Ehrfeld

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In off-shore wind farms, turbine blade inspection accessibility under various sea states is very challenging and greatly affects the downtime of wind turbines. Maintenance of any offshore system is not an easy task due to the restricted logistics and accessibility. The multirotor unmanned helicopter is of increasing interest in inspection applications due to its manoeuvrability and payload capacity. These advantages increase when many of them are deployed simultaneously in a swarm. Hence this paper proposes a drone swarm framework for inspecting offshore wind turbine blades and nacelles so as to reduce downtime. One of the big challenges of this task is that when operating a drone swarm, an individual drone may not have enough power to fly and communicate during missions and it has no capability of refueling due to its small size. Once the drone power is drained, there are no signals transmitted and the links become intermittent. Vessels equipped with 5G masts and small power units are utilised as platforms for drones to recharge/swap batteries. The research work aims at designing a smart energy management system, which provides automated vessel and drone routing and recharging plans. To achieve this goal, a novel mathematical optimisation model is developed with the main objective of minimising the number of drones and vessels, which carry the charging stations, and the downtime of the wind turbines. There are a number of constraints to be considered, such as each wind turbine must be inspected once and only once by one drone; each drone can inspect at most one wind turbine after recharging, then fly back to the charging station; collision should be avoided during the drone flying; all wind turbines in the wind farm should be inspected within the given time window. We have developed a real-time Ant Colony Optimisation (ACO) algorithm to generate real-time and near-optimal solutions to the drone swarm routing problem. The schedule will generate efficient and real-time solutions to indicate the inspection tasks, time windows, and the optimal routes of the drones to access the turbines. Experiments are conducted to evaluate the quality of the solutions generated by ACO.

Keywords: drone swarm, routing, scheduling, optimisation model, ant colony optimisation

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Authors: Mahmoud T. Alwidyan, Ahmad Alrawashdeh, Alaa O. Oteir

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Background: Emergency medical service (EMS) providers, oftentimes, use the lights and sirens (L&S) of their ambulances to warn road users, navigate through traffic, and expedite transport to save lives of ill and injured patients. Despite the contribution of road users in the effectiveness of reducing transport time of EMS ambulances using L&S, there is a lack of empirical assessments exploring the road user’s attitude and behavior in such situations. This study, therefore, aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use. Methods: This was a cross-sectional survey developed and distributed to adult road users in Northern Jordan. The questionnaire included 20 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants’ responses and assessed the association between demographics and attitude statements using logistic regression. Results: A total of 1302 questionnaires were complete and appropriate for analysis. The mean age was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) in our sample would perform inappropriate action in response to EMS ambulances with L&S in use. The multivariate logistic regression model show that being female (OR, 0.63; 95% CI = 0.48-0.81), more educated (OR, 0.68; 95% CI = 0.53-0.86), or public transport driver (OR, 0.55; 95% CI = 0.34-0.90) is significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as crossing red traffic lights or following the passing by EMS ambulances, which would, in turn, increase the risk on ambulances and other road users. Conclusions: A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances, and many engage in risky driving behaviors due perhaps to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior, which, in turn, improves the efficiency of ambulance services.

Keywords: EMS ambulances, lights and sirens, road users, attitude and behavior

Procedia PDF Downloads 90

Authors: Natividad Natalia Angeles Manuel

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In the Dominican Republic, American-Dominican veterans face unique challenges due to their dual identities and wartime experiences. This case study examines an 85-year-old veteran with memory impairments and emotional distress linked to military service. A neuropsychological assessment using standardized tools evaluated cognitive domains and functional abilities. Significant deficits in memory, orientation, semantic memory, and executive functions, alongside symptoms of Post-Traumatic Stress Disorder and depression, were identified. A six-month cognitive stimulation program included tailored interventions to enhance memory, attention, and executive skills through weekly sessions and group activities. Medical and physical therapy support aimed to improve overall cognitive, functional, and emotional outcomes. Follow-up evaluations showed improvements in memory retention, attention, task proficiency, and reduced depressive symptoms, highlighting the program's effectiveness in promoting emotional well-being and quality of life. Despite ongoing memory challenges and military-related nightmares, the veteran responded positively to interventions, demonstrating resilience and motivation. This study emphasizes the importance of personalized neuropsychological interventions for American-Dominican veterans in the Dominican Republic. Through assessment tools and focused cognitive stimulation strategies, healthcare providers can successfully alleviate cognitive and emotional challenges stemming from traumatic experiences in elderly veterans. Overall, integrated neuropsychological assessment and stimulation programs are shown to enhance cognitive resilience and emotional well-being, thus contributing to an enhanced quality of life for aging American-Dominican veterans.

Keywords: neuropsychology, cognitive stimulation, American-Dominican veterans, Dominican Republic, PTSD, memory deficits

Procedia PDF Downloads 37