Search results for: outpatient department

Authors: M. Safiqul Islam, Md Arafat Hossain Sarkar

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Brachytherapy is one of the most important cancer treatment management systems in radiotherapy department. Brachytherapy treatment is moved into High Dose Rate (HDR) after loader from Low Dose Rate (LDR) after loader due to radiation protection advantage. HDR Brachytherapy is a highly multipurpose system for enhancing cure and achieving palliation in many common cancers disease of developing countries. High-dose rate (HDR) Brachytherapy is a type of internal radiation therapy that delivers radiation from implants placed close to or inside, the tumor(s) in the body. This procedure is very effective at providing localized radiation to the tumor site while minimizing the patient’s whole body dose. Brachytherapy has proven to be a highly successful treatment for cancers of the prostate, cervix, endometrium, breast, skin, bronchus, esophagus, and head and neck, as well as soft tissue sarcomas and several other types of cancer. For the time being in our country we have 10 new HDR Remote after loading Brachytherapy. Right now 4 HDR Brachytherapy is already installed and running for patient’s treatment out of 10 HDR Brachytherapy. Ir-192 source is more comfortable than Co-60. In that case people or expert personnel prefer Ir-192 source for different kind of cancer patients. Ir-192 are economically, more flexible and familiar in our country.

Keywords: Ir-192, brachytherapy, cancer treatment, prostate, cervix, endometrium, breast, skin, bronchus, esophagus, soft tissue sarcomas

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Authors: Miju Choi, Ava Seo

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Japan has been positioned as a major inbound market to Korea, accounting for about 31% of total inbound visitors until 2012. The percentage has sharply dropped each year since and remained in second place, reaching 13.33% in 2016. Meanwhile, China has been boosted as a major inbound market, reaching 46.79% in 2016. Chinese tourists mainly visit Korea with the major purpose of shopping. They consume Korean cosmetic/beauty products and clothes while Japanese tourists prefer to purchase healthy food such as ginseng and seaweed. This study aims to investigate and compare tourist shopping patterns across two major inbound markets, China and Japan. A quantitative approach using survey was applied from 2009 to 2016. Findings suggest Chinese visit Korea due to quality of product, value for money, and accessibility, and trust. Meanwhile, Japanese choose Korea as a shopping destination mainly due to convenience, affordability, and tourist attractions. Also, there were significant differences in shopping venues. For example, Japanese tourists prefer shopping at department stores while Chinese tourists prefer retail outlets and local markets. This study contributes to deeper understanding on two major inbound markets to Korea and suggests future marketing strategies.

Keywords: tourist shopping patterns, Korea, China, Japan, historical data

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Authors: Dana Christensen

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Undergraduate students, particularly in the environmental sciences, have difficulty displaying quantitative skills in their laboratory courses. Students spend time sampling in the field, often using new methods, and are expected to make sense of the data they collect. Computational thinking may be used to navigate these new experiences. We developed a curriculum for the marine science department at a small liberal arts college in the Northeastern United States based on previous computational thinking frameworks. This curriculum incorporates marine science data sets with specific objectives and topics selected by the faculty at the College. The curriculum was distributed to all students enrolled in introductory marine science classes as a mandatory module. Two pre-tests and post-tests will be used to quantitatively assess student progress on both content-based and computational principles. Student artifacts are being collected with each lesson to be coded for content-specific and computational-specific items in qualitative assessment. There is an overall gap in marine science education research, especially curricula that focus on computational thinking and associated quantitative assessment. The curricula itself, the assessments, and our results may be modified and applied to other environmental science courses due to the nature of the inquiry-based laboratory components that use quantitative skills to understand nature.

Keywords: marine science, computational thinking, curriculum assessment, quantitative skills

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Authors: Mohammad Khattak, Bikash Adhikari, Sambodh Adhikari

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This research deals with the physical, microstructural, mechanical, and shrinkage characteristics of flyash-based soil-geopolymer mixtures. Medium and high plastic soils were obtained from local construction projects. Class F flyash was used with a mixture of sodium silicate and sodium hydroxide solution to develop soil-geopolymer mixtures. Several mixtures were compacted, cured at different curing conditions, and tested for unconfined compressive strength (UCS), linear shrinkage, and observed under scanning electron microscopy (SEM). The results of the study demonstrated that the soil-geopolymer mixtures fulfilled the UCS criteria of cement treated design (CTD) and cement stabilized design (CSD) as recommended by the department of transportation for pavement base and subbase layers. It was found that soil-geopolymer demonstrated either similar or better UCS and shrinkage characteristics relative to conventional soil-cement mixtures. The SEM analysis revealed that microstructure of soil-geopolymer mixtures exhibited development and steady growth of geopolymerization during the curing period. Based on mechanical, shrinkage, and microstructural characteristics it was suggested that the soil-geopolymer mixtures, has an immense potential to be used as pavement subgrade, subbase, and base layers.

Keywords: soil-geopolymer, pavement base, soil stabilization, unconfined compressive strength, shrinkage, microstructure, and morphology

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Authors: Celeste Labuschagne, Sam Ramaila, Thasmai Dhurumraj

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Although formative assessment is acknowledged as crucial for teachers to gauge students’ understanding of subject content, applying formative assessment in an online context is more challenging than in a traditional Physical Sciences classroom. This study examines challenges experienced by Grade 10 Physical Sciences teachers when enacting online formative assessment. The empirical investigation adopted a generic qualitative design and involved three purposively selected Grade 10 Physical Sciences teachers from three different schools and quintiles within the Tshwane North District in South Africa. Data were collected through individual and focus group interviews. Technological, pedagogical, and content knowledge (TPACK) was utilised as a theoretical framework underpinning the study. The study identified a myriad of challenges experienced by Grade 10 Physical Sciences teachers when enacting online formative assessment. These challenges include the utilisation of Annual Teaching Plans, lack of technological knowledge, and internet connectivity. The Department of Basic Education faces the key imperative to provide continuous teacher professional development and concomitant online learning materials that can facilitate meaningful enactment of online formative assessment in various educational settings.

Keywords: COVID-19, challenges, online formative assessment, physical sciences, TPACK

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Authors: Ozlem Senyigit, Nur Yilmaz

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Throughout the architectural education, it is aimed to provide students with the ability to find original solutions to current problems. In this sense, workshops that provide creative thinking within the action, experiencing the environment, and finding instant solutions to problems have an important place in the education process. Parasitic architecture, which is a contemporary design approach in the architectural agenda, includes small scale designs integrated into the carrier system of existing structures in spaces of the existing urban fabric which resembles the host-parasite relationship in the biology field. The scope of this study consists of a 12-weeks long experimental workshop of the 'parasitic architecture', which was designed within the scope of Basic Design 2 course of the Department of Architecture of Çukurova University in the 2017-2018 academic year. In this study, parasitic architecture was discussed as a space design method. Students analyzed the campus of the Çukurova University and drew sketches to identify gaps in it. During the workshop, the function-form-context relationship was discussed. The output products were evaluated within the context of urban spaces/gaps, functional requirements, and students gained awareness not just about the urban occupancy but also gaps.

Keywords: design approach, parasitic architecture, experimental workshop, architectural education

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Authors: Manjunath A. P., Al-Ajmi G. M., Al Shukri M., Girija S

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Introduction: This study aimed to compare the ability of hysteroscopy and ultrasonography to diagnose uterine polyps. To correlate the ultrasonography and hystroscopic findings with various clinical factors and histopathology of uterine polyps. Methods: This is a retrospective study conducted at the Department of Obstetrics and Gynaecology at Sultan Qaboos University Hospital from 2014 to 2019. All women undergoing hysteroscopy for suspected uterine polyps were included. All relevant data were obtained from the electronic patient record and analysed using SPSS. Results: A total of 77 eligible women were analysed. The mean age of the patients was 40 years. The clinical risk factors; obesity, hypertension, and diabetes mellitus, showed no significant statistical association with the presence of uterine polyps (p-value>0.005). Although 20 women (52.6%) with uterine polyps had thickened endometrium (>11 mm), however, there is no statistical association (p-value>0.005). The sensitivity and specificity of ultrasonography in the detection of uterine polyp were 39% and 65%, respectively. Whereas for hysteroscopy, it was 89% and 20%, respectively. The prevalence of malignant and premalignant lesions were 1.85% and 7.4%, respectively. Conclusion: This study found that obesity, hypertension, and diabetes mellitus were not associated with the presence of uterine polyps. There was no association between thick endometrium and uterine polyps. The sensitivity is higher for hysteroscopy, whereas the specificity is higher for sonography in detecting uterine polyps. The prevalence of malignancy was very low in uterine polyps.

Keywords: endometrial polyps, hysteroscopy, ultrasonography, premalignant, malignant

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Authors: Wipada Chaiwchan, Patcharee Klinhom

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This research is aimed to develop the online-class scheduling management system and improve as a complex problem solution, this must take into consideration in various conditions and factors. In addition to the number of courses, the number of students and a timetable to study, the physical characteristics of each class room and regulations used in the class scheduling must also be taken into consideration. This system is developed to assist management in the class scheduling for convenience and efficiency. It can provide several instructors to schedule simultaneously. Both lecturers and students can check and publish a timetable and other documents associated with the system online immediately. It is developed in a web-based application. PHP is used as a developing tool. The database management system was MySQL. The tool that is used for efficiency testing of the system is questionnaire. The system was evaluated by using a Black-Box testing. The sample was composed of 2 groups: 5 experts and 100 general users. The average and the standard deviation of results from the experts were 3.50 and 0.67. The average and the standard deviation of results from the general users were 3.54 and 0.54. In summary, the results from the research indicated that the satisfaction of users was in a good level. Therefore, this system could be implemented in an actual workplace and satisfy the users’ requirement effectively

Keywords: timetable, schedule, management system, online

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Authors: L. P. K. Liyanage, N. R. P. Withana, A. L. Sandika

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The purpose of this study was to determine tourist and community perception-based sustainable tourism indicators as well as Human Pressure Index (HPI) and Tourist Activity Index (TAI). Study was carried out in Sinharaja forest which is considered as one of the major eco-tourism destination in Sri Lanka. Data were gathered using a pre-tested semi-structured questionnaire as well as records from Forest department. Convenient sampling technique was applied. For the majority of issues, the responses were obtained on multi-point Likert-type scales. Visual portrayal was used for display analyzed data. The study revealed that the host community of the Kudawa gets many benefits from tourism. Also, tourism has caused negative impacts upon the environment and community. The study further revealed the need of proper waste management and involvement of local cultural events for the tourism business in the Kudawa conservation center. The TAI, which accounted to be 1.27 and monthly evolution of HPI revealed that congestion can be occurred in the Sinharaja rainforest during peak season. The results provide useful information to any party involved with tourism planning anywhere, since such attempts would be more effective once the people’s perceptions on these aspects are taken into account.

Keywords: Kudawa Conservation Center, Sinharaja World Heritage Rainforest, sustainability indicators, community perception

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Authors: S. A. Che Osmi, W. M. F. Wan Ishak, H. Kim, M. A. Azman, M. A. Ramli

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River is one of important water sources for many activities including industrial and domestic usage such as daily usage, transportation, power supply and recreational activities. However, increasing activities in a river has grown the sources of pollutant enters the water bodies, and degraded the water quality of the river. It becomes a challenge to develop an effective river management to ensure the water sources of the river are well managed and regulated. In Malaysia, several approaches for river management have been implemented such as Integrated River Basin Management (IRBM) program for coordinating the management of resources in a natural environment based on river basin to ensure their sustainability lead by Department of Drainage and Irrigation (DID), Malaysia. Nowadays, Total Maximum Daily Load (TMDL) is one of the best approaches for river management in Malaysia. TMDL implementation is regulated and implemented in the United States. A study on the development of TMDL in Malacca River has been carried out by doing water quality monitoring, the development of water quality model by using Environmental Fluid Dynamic Codes (EFDC), and TMDL implementation plan. The implementation of TMDL will help the stakeholders and regulators to control and improve the water quality of the river. It is one of the good approaches for river management in Malaysia.

Keywords: EFDC, river management, TMDL, water quality modelling

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Authors: Amani K. Abu-Shaheen, Abdullah Nofal, Humariya Heena

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Introduction: Parental perceptions and practices are important for improving the asthma outcomes in children; indeed, evidence shows that parents of asthmatic children harbor considerable misperceptions of the disease. Objective: To identify the prevalence of asthma and to investigate the perceptions and practices of parents toward asthma and its management in Saudi children. Methods: A two-stage cross-sectional survey of 2000 parents of children aged 3–15 years from schools located in all five districts of Riyadh province located in central Saudi Arabia, was conducted. Data collection was accomplished using a self-administered questionnaire based on information obtained from the literature. Results: Of 1450 children whose parents participated in the study, 600 had asthma, dyspnea, or chest allergy. The overall number of children with parental reports of ever having been diagnosed with asthma was 478 (32.9%). The majority of parents (321, 53.5%) believed that asthma was a hereditary disease. Of these parents, 361 (60.3%) were concerned about side effects of inhaled steroids, and 192 (32%) about development of dependency on asthma medications. Three hundred sixty seven (61.2%) parents reported that they could treat the asthma attack at home and almost 76% of parents went to pediatric emergency department during asthma attack. Conclusions: In this study, the overall prevalence of children whose parents reported that they were diagnosed with asthma was high (32.9%). Furthermore, parents of children with asthma had misperceptions regarding asthma and exhibited ineffective practices in its management. To improve asthma care and compliance, adequate education should be provided to parents.

Keywords: asthma, management, parents, quality of life

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Authors: Maha Rashid Al-Azib, Almuzn Qasem Alqathradi, Amal Munir Alshahrani, Bilqis Mohammed Assiri, Ali Almuflih

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The Occupational Safety and Health Management System in one of the largest Saudi companies has been experiencing in the last 10 years extensive direct and indirect expenses due to lack of proactive leading indicators and safety leadership effective procedures. And since there are no studies that are associated with this department of safety in the company, this research has been conducted. In this study we used a mixed method approach containing a literature review and experts input, then a qualitative questionnaire provided by Institute for Work and Health related to determining the company’s occupational safety and health management system level out from three levels (Compliance - Improvement - Continuous Learning) and the output regarding the company’s level was in Continuous Learning. After that Deming cycle was employed to create a set of proactive leading indicators and analyzed using the SMART method to make sure of its effectiveness and suitability to the company. The objective of this research is to provide a set of proactive indicators to contribute in making an efficient occupational safety and health management system that has less accidents which results in less expenses. Therefore, we provided the company with a prototype of an APP, designed and empowered with our final results to contribute in supporting decisions making processes.

Keywords: proactive leading indicators, OSH MS, safety leadership, accidents reduction

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Authors: Mejbri Sami, Zhani Khalifa, Zarzoum Kamel, Ben Bacha Habib, Koschikowski Joachim, Pfeifle Daniel

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Many places worldwide, especially arid and semi-arid remote regions, are suffering from the lack of drinkable water and the situation will be aggravated in the near future. Furthermore, remote areas are characterised by lack of conventional energy sources, skilled personnel and maintenance facilities. Therefore, the development of small to medium size, stand-alone and robust solar desalination systems is needed to provide independent fresh water supply in remote areas. This paper is focused on experimental studies on compact membrane distillation (MD) solar desalination prototype located at the Mechanical Engineering Department site, Kairouan University, Kairouan, Tunisia. The pilot system is designed and manufactured as a part of a research and development project funded by the MESRS/BMBF. The pilot system is totally autonomous. The electrical energy required to operate the unit is generated through a field of 4 m² of photovoltaic panels, and the heating of feed water is provided by a field of 6 m² of solar collectors. The Kairouan plant performance of the first few months of operation is presented. The highest freshwater production of 150 L/d is obtained on a sunny day in July of 633 W/m²d.

Keywords: experimental, membrane distillation, solar desalination, Permeat gap

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Authors: Novutry Siregar, Afdal, Emilzon Taslim

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Hyaline Membrane Disease (HMD) is the main cause of respiratory failure in preterm neonates caused by surfactant deficiency. Nasal Continuous Positive Airway Pressure (NCPAP) is the therapy for HMD. The success of therapy is determined by gestational age, birth weight, HMD grade, time of NCAP administration, and time of breathing frequency recovery. The aim of this research is to identify the predictive factor of NCPAP therapy success in preterm neonates with HMD. This study used a cross-sectional design by using medical records of patients who were treated in the Perinatology of the Pediatric Department of Dr. M. Djamil Padang Central Hospital from January 2015 to December 2017. The samples were eighty-two neonates that were selected by using the total sampling technique. Data analysis was done by using the Chi-Square Test and the Multiple Logistic Regression Prediction Model. The results showed the success rate of NCPAP therapy reached 53.7%. Birth weight (p = 0.048, OR = 3.34 95% CI 1.01-11.07), HMD grade I (p = 0.018, OR = 4.95 CI 95% 1.31-18.68), HMD grade II (p = 0.044, OR = 5.52 95% CI 1.04-29.15), and time of breathing frequency recovery (p = 0,000, OR = 13.50 95% CI 3.58-50, 83) are the predictive factors of NCPAP therapy success in preterm neonates with HMD. The most significant predictive factor is the time of breathing frequency recovery.

Keywords: predictive factors, the success of therapy, NCPAP, preterm neonates, HMD

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Authors: Shaherah Jordan, Paula Vandergert

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The discussion on public charging infrastructure is usually framed around the ‘chicken-egg’ challenge of consumers feeling reluctant to purchase without the necessary infrastructure and policymakers reluctant to invest in the infrastructure without the demand. However, public charging infrastructure may be more crucial to electric vehicle (EV) adoption than previously thought. Historically, access to residential charging was thought to be a major factor in potential for growth in the EV market as it offered a guaranteed place for a vehicle to be charged. The purpose of this study is to understand how the built environment may encourage uptake of EVs by seeking a correlation between EV ownership and public charging points in an urban and densely populated city such as London. Using a statistical approach with data from the Department for Transport and Zap-Map, a statistically significant correlation was found between the total (slow, fast and rapid) number of public charging points and a number of EV registrations per borough – with the strongest correlation found between EV registrations and rapid chargers. This research does not explicitly prove that there is a cause and effect relationship between public charging points EVs but challenges some of the previous literature which indicates that public charging infrastructure is not as important as home charging. Furthermore, the study provides strong evidence that public charging points play a functional and psychological role in the adoption of EVs and supports the notion that the built environment can influence human behaviour.

Keywords: behaviour change, electric vehicles, public charging infrastructure, transportation

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Authors: Nam Sze Cheng, P. C. Janita Chau

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Background: Eczema is a chronic inflammatory disease with high global prevalence rates in many childhood populations. It is also the most common paediatric skin problem. Although eczema education and proper skin care were effective in controlling eczema symptoms, the lack of both sufficient time for patient consultation and structured eczema education programme hindered the transferability of knowledge to patients and their parents. As a result, these young patients and their families suffer from a significant physical disability and psychological distress, which can substantially impair their quality of life. Objectives: This integrative review is to examine the effects of educational interventions for children with eczema and identify the core elements associated with an effective intervention. Methods: This integrative review targeted all articles published in 10 databases between May 2016 and February 2017 that reported the outcomes of disease interventions of any format for children and adolescents with the clinical diagnosis of eczema who were under 18 years of age. Five randomized controlled trials (RCT) and one systematic review of 10 RCTs were identified for review. All these publications had high methodological quality, except one study of web-based eczema education that was limited by selection bias and poor subject blinding. Findings: This review found that most studies adopted nurse-led or multi-disciplinary parental eczema education programme at the outpatient clinic setting. The format of these programmes included individual lectures, demonstration and group sharing, and the educational materials covered basic eczema knowledge and management as well as methods to interrupt itch-scratch cycle. The main outcome measures of these studies included severity of eczema symptoms, treatment adherence and quality of life of both patients and their families. Nine included studies reported statistically significant improvement in the primary outcome of symptom severity of these eczematous children. On the other hand, all these reviews failed to identify an effective dosage of intervention under these educational programmes that was attributed to the heterogeneity of the interventions. One study that was designed based on the social cognitive theory to guide the interventional content yielded statistically significant results. The systematic review recommended the importance of measuring parental self-efficacy. Implication: This integrative review concludes that structured educational programme can help nurses understand the theories behind different health interventions. They can then deliver eczema education to their patients in a consistent manner. These interventions also result in behavioral changes through patient education. Due to the lack of validated educational programmes in Chinese, it is imperative to conduct an RCT of eczema educational programme to investigate its effects on eczema severity, quality of life and treatment adherence in Hong Kong children as well as to promote the importance of parental self-efficacy.

Keywords: children, eczema, education, intervention

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Authors: Mary Luna Mancao Ninal

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This study aimed to determine the performance of the kindergarten teachers and its relation to pupils’ achievement in different learning areas in the Division of Kabankalan City. Using the standardized assessment and evaluation of the Department of Education secondary data, 100 kinder teachers and 2901 kinder pupils were investigated to determine the performance of the kindergarten teachers based on their Competency–Based Performance Appraisal System for Teachers and the periodic assessment of kinder pupils collected as secondary data. Weighted mean, Pearson–r, chi-square, Analysis of Variance were used in the study. Findings revealed that the kindergarten teacher respondents were 26-31 years old and most of them were female and married; they spent teaching for two years and less and passed the Licensure Examination for Teachers. They were very satisfactory as to instructional competences, school, and home and community involvement, personal, social, and professional characteristics. It also revealed that performance of the kindergarten pupils on their period of assessment shows that they were slightly advanced in their development. It also shows that domain as to performance of the kindergarten pupils were average overall development. Based on the results, it is recommended that Kindergarten teacher must augment their educational qualification and pursue their graduate studies and must develop the total personality of the children for them to achieve high advanced development to become productive individual.

Keywords: performance, kindergarten teacher, learning areas, professional, pupil

Procedia PDF Downloads 357

Authors: Adnan Z. Mkhelif

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The production of number forms in English tends to be problematic for Iraqi learners of English as a foreign language (EFL), even at the undergraduate level. To help better understand and consequently address this problem, it is important to identify its sources. This study aims at: (1) statistically analysing Iraqi EFL undergraduates' performance in the production of number forms in English; (2) classifying learners' errors in terms of their possible major causes; and (3) outlining some pedagogical recommendations relevant to the teaching of number forms in English. It is hypothesized in this study that (1) Iraqi EFL undergraduates still face problems in the production of number forms in English and (2) errors pertaining to the context of learning are more numerous than those attributable to the other possible causes. After reviewing the literature available on the topic, a written test comprising 50 items has been constructed and administered to a randomly chosen sample of 50 second-year college students from the Department of English, College of Education, Wasit University. The findings of the study showed that Iraqi EFL undergraduates still face problems in the production of number forms in English and that the possible major sources of learners’ errors can be arranged hierarchically in terms of the percentages of errors to which they can be ascribed as follows: (1) context of learning (50%), (2) intralingual transfer (37%), and (3) interlingual transfer (13%). It is hoped that the implications of the study findings will be beneficial to researchers, syllabus designers, as well as teachers of English as a foreign/second language.

Keywords: L2 number forms, L2 vocabulary learning, productive knowledge, proficiency

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Authors: Shraddha Gopal, Jayam Lazarus

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Aims: To study the referral practice and impact of DAT-scan in the diagnosis or exclusion of Parkinson’s disease. Settings and Designs: A retrospective study Materials and methods: A retrospective study of the results of 60 patients who were referred for a DAT scan over a period of 2 years from the Department of Neurology at Northern Lincolnshire and Goole NHS trust. The reason for DAT scan referral was noted under 5 categories against Parkinson’s disease; drug-induced Parkinson’s, essential tremors, diagnostic dilemma, not responding to Parkinson’s treatment, and others. We assessed the number of patients who were diagnosed with Parkinson’s disease against the number of patients in whom Parkinson’s disease was excluded or an alternative diagnosis was made. Statistical methods: Microsoft Excel was used for data collection and statistical analysis, Results: 30 of the 60 scans were performed to confirm the diagnosis of early Parkinson’s disease, 13 were done to differentiate essential tremors from Parkinsonism, 6 were performed to exclude drug-induced Parkinsonism, 5 were done to look for alternative diagnosis as the patients were not responding to anti-Parkinson medication and 6 indications were outside the recommended guidelines. 55% of cases were confirmed with a diagnosis of Parkinson’s disease. 43.33% had Parkinson’s disease excluded. 33 of the 60 scans showed bilateral abnormalities and confirmed the clinical diagnosis of Parkinson’s disease. Conclusion: DAT scan provides valuable information in confirming Parkinson’s disease in 55% of patients along with excluding the diagnosis in 43.33% of patients aiding an alternative diagnosis.

Keywords: DATSCAN, Parkinson's disease, diagnosis, essential tremors

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Authors: Berrak Yildiz, Hinal Shah, Justine Fernandez, Nazje James, Anna Brown

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Cervical ectopic pregnancy, a rare type of ectopic pregnancies, is defined by blastocyst implantation within the cervical canal rather than the endometrium. Its rarity and potential for severe hemorrhage make cervical ectopic pregnancy a diagnostic and therapeutic challenge. A 39-year-old woman, G5P2022, with a history of two cesarean sections and two elective terminations, presented to the emergency department with vaginal bleeding and pelvic pain. Initial assessment showed a beta-hCG level of 2,853 mIU/mL, and transvaginal ultrasound revealed a small, irregular gestational sac at the level of the internal cervical os. Serial betahCG measurements over subsequent visits showed a declining trend, consistent with a nonviable pregnancy. The patient was ultimately treated with methotrexate at a dose of 50 mg/m² (total 100 mg), following which she reported no further symptoms. On follow-up, her beta-hCG level returned to the normal non-pregnant range, with no additional intervention needed. This case highlights the importance of early diagnosis in cervical ectopic pregnancy to avoid complications like hysterectomy. Methotrexate is an effective first-line treatment in hemodynamically stable patients, offering a conservative approach that can preserve fertility. The success in this patient underscores the role of prompt diagnosis and careful management in achieving resolution while minimizing invasive procedures.

Keywords: beta-hCG, cervical, ectopic, methotrexate

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Authors: Sautma Ronni Basana, Zeplin Jiwa Husada Tarigan, Widjojo Suprapto

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Companies have already implemented the Enterprise Resource Planning (ERP) system to increase the data integration so that they can improve their business performance. Although some companies have managed to implement the ERP well, they still need to improve gradually so that the ERP functions can be optimized. To obtain a faster and more accurate data, the key users and IT department have to customize the process to suit the needs of the company. In reality, sustaining the ERP technology system requires soft and hard ERP so it enables to improve the business performance of the company. Soft and hard ERP are needed to build a tough system to ensure the integration among departments running smoothly. This research has three questions. First, is the soft ERP bringing impacts to the hard ERP and system integration. Then, is the hard ERP having impacts to the system integration. Finally, is the business performance of the manufacturing companies is affected by the soft ERP, hard ERP, and system integration. The questionnaires are distributed to 100 manufacturing companies in East Java, and are collected from 90 companies which have implemented the ERP, with the response rate of 90%. From the data analysis using PLS program, it is obtained that the soft ERP brings positive impacts to the hard ERP and system integration for the companies. Then, the hard ERP brings also positive impacts to the system integration. Finally, the business process performance of the manufacturing companies is affected by the system integration, soft ERP, and hard ERP simultaneously.

Keywords: soft ERP, hard ERP, system integration, business performance

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Authors: Lu Yu Jyun

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Background: Health education is important nursing work aiming to strengthen patients’ self-caring ability and family members. Our department educates through three methods, including speech education, flyer and demonstration video education. The satisfaction rate of health education tool use is 54.3% in nursing staff. The main reason is there hadn’t been a storage area for flyers, causing extra workload in assessing flyers. The satisfaction rate of health education in patients and families is 70.7%. We aim to improve this situation between 13th April and 6th June 2021. Method: We introduce the ECRS method to erase repetitive and redundant actions. We redesign the health education tool usage workflow to improve nursing staffs’ efficiency and further enhance nursing staffs care quality and working satisfaction. Result: The satisfaction rate of health education tool usage in nursing staff elevated from 54.3% to 92.5%. The satisfaction rate of health education in patients and families elevated from 70.7% to 90.2%. Conclusion: The assessment time of health care tools dropped from 10minutes to 3minutes. This significantly reduced the nursing staffs’ workload. 1213 paper is saved in one month and 14,556 a year in the estimate; we save the environment via this action. Health education map implemented in other nursing departments since October due to its’ high efficiency and makes health care tools more humanize.

Keywords: health, education tools, satisfaction, nursing staff

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Authors: Orawan Vichiansan, J. Kraipoj, K.Phandech, P. Sirasaporn

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Generally, frozen shoulder will improve over time, although it may take a long time up to year. The symptoms of frozen shoulder present by pain around shoulder and consequently limit range of motions. The effect of frozen shoulder leads to limit activities daily living life and high medical care cost. Physiotherapy is well known treatment for frozen shoulder but there was no data about the treatment of physiotherapy in frozen shoulder and length of follow up. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder on range of motion and length of follow up. A retrospective study design was conducted. 469 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of range of motions and length of follow up was recorded. The medical record of 183 males and 286 females with average aged 57.82±12.32 years were reviewed in this study. There was a statistically significant increase in shoulder flexion [mean difference 30.24 with 95%CI were [24.37-36.12], shoulder abduction [mean difference 34.93 with 95%CI were 27.8-42.0], shoulder internal rotation [mean difference 17.25 with 95%CI were 12.55-21.95] and shoulder external rotation [mean difference 17.71 with 95%CI were [13.07-22.36] respectively. In addition, the length of follow up averaged 84 days. In summary, the retrospective study show physiotherapy program likely to be benefit for patients with frozen shoulder in term of range of motion and short length of follow up.

Keywords: frozen shoulder, physiotherapy, range of motions, length of follow up

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Authors: Modi Alsubaie, Chris Dickens, Barnaby Dunn, Andy Gibson, Obioha Ukoumunned, Alison Evans, Rachael Vicary, Manish Gandhi, Willem Kuyken

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Background: Depression co-occurs in 20% of people with cardiovascular disorders, can persist for years and predicts worse physical health outcomes. While psychosocial treatments have been shown to effectively treat acute depression in those with comorbid cardiovascular disorders, to date there has been no evaluation of approaches aiming to prevent relapse and treat residual depression symptoms in this group. Therefore, the current study aimed to examine the feasibility and acceptability of a randomised controlled trial design evaluating an adapted version of mindfulness-based cognitive therapy (MBCT) designed specifically for people with co-morbid depression and cardiovascular disorders. Methods: A 3-arm feasibility randomised controlled trial was conducted, comparing MBCT adapted for people with cardiovascular disorders plus treatment as usual (TAU), mindfulness-based stress reduction (MBSR) plus TAU, and TAU alone. Participants completed a set of self-report measures of depression severity, anxiety, quality of life, illness perceptions, mindfulness, self-compassion and affect and had their blood pressure taken immediately before, immediately after, and three months following the intervention. Those in the adapted-MBCT arm additionally underwent a qualitative interview to gather their views about the adapted intervention. Results: 3400 potentially eligible participants were approached when attending an outpatient appointment at a cardiology clinic or via a GP letter following a case note search. 242 (7.1%) were interested in taking part, 59 (1.7%) were screened as being suitable, and 33 (<1%) were eventually randomised to the three groups. The sample was heterogeneous in terms of whether they reported current depression or had a history of depression and the time since the onset of cardiovascular disease (one to 25 years). Of 11 participants randomised to adapted MBCT seven completed the full course, levels of home mindfulness practice were high, and positive qualitative feedback about the intervention was given. Twenty-nine out of 33 participants randomised completed all the assessment measures at all three-time points. With regards to the primary outcome (depression), five out of the seven people who completed the adapted MBCT and three out of five under MBSR showed significant clinical change, while in TAU no one showed any clinical change at the three-month follow-up. Conclusions: The adapted MBCT intervention was feasible and acceptable to participants. However, aspects of the trial design were not feasible. In particular, low recruitment rates were achieved, and there was a high withdrawal rate between screening and randomisation. Moreover, the heterogeneity in the sample was high meaning the adapted intervention was unlikely to be well tailored to all participants needs. This suggests that if the decision is made to move to a definitive trial, study recruitment procedures will need to be revised to more successfully recruit a target sample that optimally matches the adapted intervention.

Keywords: mindfulness-based cognitive therapy (MBCT), depression, cardiovascular disorders, feasibility, acceptability

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Authors: Inayatullah Khan, Afzal Khan, Hamzullah Khan, Afzal Khan

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Objectives: The objective of this study was to compare different statistical variables for vaccinated and unvaccinated children in measles cases. Material and Methods: This cross sectional comparative study was conducted at Isolation ward, Department of Paediatrics, Lady Reading Hospital (LRH), Peshawar, from April 2012 to March 2013. A total of 566 admitted cases of measles were enrolled. Data regarding age, sex, address, vaccination status, measles contact, hospital stay and outcome was collected and recorded on a proforma. History of measles vaccination was ascertained either by checking the vaccination cards or on parental recall. Result: In 566 cases of measles, 211(39%) were vaccinated and 345 (61%) were unvaccinated. Three hundred and ten (54.80%) patients were males and 256 (45.20%) were females with a male to female ratio of 1.2:1.The age range was from 1 year to 14 years with mean age with SD of 3.2 +2 years. Majority (371, 65.5%) of the patients were 1-3 years old. Mean hospital stay was 3.08 days with a range of 1-10 days and a standard deviation of ± 1.15. History of measles contact was present in 393 (69.4%) cases. Fourty eight patients were expired with a mortality rate of 8.5%. Conclusion: Majority of the children in Khyber Pukhtunkhwa are unvaccinated and unprotected against measles. Among vaccinated children, 39% of children attracted measles which indicate measles vaccine failure. This figure is clearly higher than that accepted for measles vaccine (2-10%).

Keywords: measles, vaccination, immunity, population

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Authors: Arup K. Sarma, Jayshree Hazarika

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The North-eastern part of India, which receives heavier rainfall than other parts of the subcontinent, is of great concern now-a-days with regard to climate change. High intensity rainfall for short duration and longer dry spell, occurring due to impact of climate change, affects river morphology too. In the present study, an attempt is made to delineate the North-Eastern region of India into some homogeneous clusters based on the Fuzzy Clustering concept and to compare the resulting clusters obtained by using conventional methods and non conventional methods of clustering. The concept of clustering is adapted in view of the fact that, impact of climate change can be studied in a homogeneous region without much variation, which can be helpful in studies related to water resources planning and management. 10 IMD (Indian Meteorological Department) stations, situated in various regions of the North-east, have been selected for making the clusters. The results of the Fuzzy C-Means (FCM) analysis show different clustering patterns for different conditions. From the analysis and comparison it can be concluded that non conventional method of using GCM data is somehow giving better results than the others. However, further analysis can be done by taking daily data instead of monthly means to reduce the effect of standardization.

Keywords: climate change, conventional and nonconventional methods of clustering, FCM analysis, homogeneous regions

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Authors: A. Alssbaiheen, S. Love

Abstract:

Mobile government (m-government) is one of the promising technologies for developing the governance of developing countries. While developing countries often have less advanced internet infrastructure compared to the developed world, mobile phone penetration is very high in the Gulf Cooperation Council (GCC) countries and mobile internet use offers a means to transcend traditional logistical barriers to accessing government services. The study explores the challenges and opportunities of the mobile government in Saudi Arabia. Semi-structured interviews were conducted with a diverse cohort of Saudi mobile users. A total of 77 semi-structured interviews were collected and subsequently analysed using open, axial, and selective coding. The participants’ responses revealed that many opportunities exist for the development of m-government in Saudi Arabia, including high popular awareness of government initiatives in e-government, and willingness to use such services, largely due to the time-saving and convenience aspects it offers compared with traditional bureaucratic services. However, numerous barriers were identified, including the low quality and speed of the internet, service customization, and concerns about privacy data security. It was also felt that in addition to infrastructure challenges, the traditional bureaucratic attitude of government department would itself hinder the effective deployment and utilization of m-government services.

Keywords: awareness, barriers, challenges, government services, mobile government, m-government, opportunities

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Authors: Robin Lok-Wang Ma

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The Center/Unit for Industry Engagement and Collaboration, as well as Internship, play a significant role at university. In general, the Center serves as the official interface between the industry and the School or Department to cultivate students’ early exposure to professional experience. The missions of the Center are not limited to provide a communication channel and collaborative platform for the industries and the university but also to assist students to build up their career paths early while still in the university. In recent years, a cooperative education experience (commonly known as a co-op) has been strongly advocated for students to make the school-to-work transition. The nature of the co-op program is not only consistent with the internships/final year design projects, but it is also more industrial-oriented with academic support from faculty at the university. The purpose of this paper is to describe an approach to how cooperative education experience can be integrated into Engineering Curriculum. It provides a mutual understanding and exchange of ideas for the approach between the university and the industry. A suggested format in terms of timeline, duration, selection of candidates, students, and companies’ expectations for the co-op program is described. Also, feedbacks from employers/industries show that a longer-term co-op program is well suited for students compared with a short-term internship. To this end, it provides a new insight into collaboration and/or partnership between the university and the industries to prepare professional work-ready graduates.

Keywords: cooperative education, industry, engagement, collaboration

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Authors: Satoshi Furukawa, Satomu Morita, Katsuji Nishi, Masahito Hitosugi

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We experience the autopsy cases that the deceased was alive in emergency room on arrival. Bleeding is the leading cause of preventable death after injury. This retrospective study aimed to characterize opportunities for performance improvement identified in patients who died from traffic trauma and were considered by the quality improvement of education system. The Japan Advanced Trauma Evaluation and Care (JATEC) education program was introduced in 2002. We focused the abdominal traffic trauma injury. An autopsy-based cross-sectional study conducted. A purposive sampling technique was applied to select the study sample of 41 post-mortems of road traffic accident between April 1999 and March 2014 subjected to medico-legal autopsy at the department of Forensic Medicine, Shiga University of Medical Science. 16 patients (39.0%) were abdominal trauma injury. The mean period of survival after meet with accident was 13.5 hours, compared abdominal trauma death was 27.4 hours longer. In road traffic accidents, the most injured abdominal organs were liver followed by mesentery. We thought delayed treatment was associated with immediate diagnostic imaging, and so expected to expand trauma management examination.

Keywords: abdominal traffic trauma, preventable death, autopsy, emergency medicine

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Authors: Omid Kalatpour, Mohammadreza Ajdari

Abstract:

This article studied the possible causes of human error-induced incidents in the petrochemical industry maintenance activities by using Human Factors Analysis and Classification System (HFACS). The purpose of the study was anticipating and identifying these causes and proposing corrective and preventive actions. Maintenance department in a petrochemical company was selected for research. A checklist of human error-induced incidents was developed based on four HFACS main levels and nineteen sub-groups. Hierarchical task analysis (HTA) technique was used to identify maintenance activities and tasks. The main causes of possible incidents were identified by checklist and recorded. Corrective and preventive actions were defined depending on priority. Analyzing the worksheets of 444 activities in four levels of HFACS showed 37.6% of the causes were at the level of unsafe actions, 27.5% at the level of unsafe supervision, 20.9% at the level of preconditions for unsafe acts and 14% of the causes were at the level of organizational effects. The HFACS sub-groups showed errors (24.36%) inadequate supervision (14.89%) and violations (13.26%) with the most frequency. According to findings of this study, increasing the training effectiveness of operators and supervision improvement respectively are the most important measures in decreasing the human error-induced incidents in petrochemical industry maintenance.

Keywords: human error, petrochemical industry, maintenance, HFACS

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