Search results for: bus service quality

Authors: Noor A. Hakim

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Several studies in the developed countries investigated the prevalence of diabetes and obesity among individuals from different socioeconomic levels and suggested lower rates among the higher socioeconomic groups. However, studies evaluating diabetes risk and prevalence of obesity among the population of middle- to high-income status in developing countries are limited. The aim of this study is to evaluate the risk of developing type-2 diabetes mellitus (T2DM) and the weight status of female students in private universities in Jeddah City, Saudi Arabia. This is a cross-sectional study of 121 female students aged ≤ 25 years old was conducted; participants were recruited from two private universities. Diabetes risk was evaluated using the Finnish Diabetes Risk Score. Anthropometric measurements were assessed, and body-mass-index (BMI) was calculated. Diabetes risk scores indicated that 35.5% of the female students had a slightly elevated risk, and 10.8% had a moderate to high risk to develop T2DM. One-third of the females (29.7%) were overweight or obese. The majority of the normal weight and underweight groups were classified to have a low risk of diabetes, 22.2% of the overweight participants were classified to have moderate to high risk, and over half of the obese participants (55.5%) were classified to be at the moderate to high-risk category. Conclusions: Given that diabetes risk is alarming among the population in Saudi Arabia, healthcare providers should utilize a simple screening tool to identify high-risk individuals and initiate diabetes preventive strategies to prevent, or delay, the onset of T2DM and improve the quality of life.

Keywords: risk of type 2 diabetes, weight status, college students, socioeconomic status

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Authors: Maria C. Almario, Pam Remer, Jeff Resse, Kathy Moran, Linda Theander Adam

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The identification of victims of human trafficking and consequential service provision is characterized by a significant disconnection between the estimated prevalence of this issue and the number of cases identified. This poses as tremendous problem for human rights advocates as it prevents data collection, information sharing, allocation of resources and opportunities for international dialogues. The current paper introduces the Inclusive Human Trafficking Checklist (IHTC) as a measurement methodology with theoretical underpinnings derived from dialectic theory. The presence of human trafficking in a person’s life is conceptualized as a dynamic and dialectic interaction between vulnerability and exploitation. The current papers explores the operationalization of exploitation and vulnerability, evaluates the metric qualities of the instrument, evaluates whether there are differences in assessment based on the participant’s profession, level of knowledge, and training, and assesses if users of the instrument perceive it as useful. A total of 201 participants were asked to rate three vignettes predetermined by experts to qualify as a either human trafficking case or not. The participants were placed in three conditions: business as usual, utilization of the IHTC with and without training. The results revealed a statistically significant level of agreement between the expert’s diagnostic and the application of the IHTC with an improvement of 40% on identification when compared with the business as usual condition While there was an improvement in identification in the group with training, the difference was found to have a small effect size. Participants who utilized the IHTC showed an increased ability to identify elements of identity-based vulnerabilities as well as elements of fraud, which according to the results, are distinctive variables in cases of human trafficking. In terms of the perceived utility, the results revealed higher mean scores for the groups utilizing the IHTC when compared to the business as usual condition. These findings suggest that the IHTC improves appropriate identification of cases and that it is perceived as a useful instrument. The application of the IHTC as a multidisciplinary instrumentation that can be utilized in legal and human services settings is discussed as a pivotal piece of helping victims restore their sense of dignity, and advocate for legal, physical and psychological reparations. It is noteworthy that this study was conducted with a sample in the United States and later re-tested in Colombia. The implications of the instrument for treatment conceptualization and intervention in human trafficking cases are discussed as opportunities for enhancement of victim well-being, restoration engagement and activism. With the idea that what is personal is also political, we believe that the careful observation and data collection in specific cases can inform new areas of human rights activism.

Keywords: exploitation, human trafficking, measurement, vulnerability, screening

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Authors: M. Thuanthong, W. Youravong, N. Sirinupong

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Nile tilapia (Oreochromis niloticus) is one of fish species cultured in Thailand with a high production volume. A lot of skin is generated during fish processing. In addition, there are many research reported that fish skin contains abundant of collagen. Thus, the use of Nile tilapia skin as collagen source can increase the benefit of industrial waste. In this study, Acid soluble collagen (ASC) was extracted at 5, 15 or 25 ˚C with 0.5 M acetic acid then the acid was removed out and collagen was concentrated by ultrafiltration-diafiltration (UFDF). The triple helix collagen from UFDF process was used as substrate to produce collagen peptides by alcalase hydrolysis in an enzymatic membrane reactor (EMR) coupling with 1 kDa molecular weight cut off (MWCO) polysulfone hollow fiber membrane. The results showed that ASC extracted at high temperature (25 ˚C) with 0.5 M acetic acid for 5 h still preserved triple helix structure. In the UFDF process, the acid removal was higher than 90 % without any effect on ASC properties, particularly triple helix structure as indicated by circular dichroism spectrum. Moreover, Collagen from UFDF was used to produce collagen peptides by EMR. In EMR, collagen was pre-hydrolyzed by alcalase for 60 min before introduced to membrane separation. The EMR operation was operated for 10 h and provided a good of protein conversion stability. The results suggested that there is a successfulness of UF in application for acid removal to produce ASC with desirable preservation of its quality. In addition, the EMR was proven to be an effective process to produce low molecular weight peptides with ACE-inhibitory activity properties.

Keywords: acid soluble collagen, ultrafiltration-diafiltration, enzymatic membrane reactor, ace-inhibitory activity

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Authors: Ajay Kumar Singh, Arvind Kumar, S. P. Singh

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Cellulose nanofibrils (CNF) have shown potential of their extensive use in various fields, including papermaking, due to their unique characteristics. In this study, CNF’s were prepared by fibrillating the pulp obtained from raw materials e.g. bagasse, hardwood and softwood using enzymatic pretreatment followed by mechanical refining. These nanofibrils, when examined under FE-SEM, show that partial fibrillation on fiber surface has resulted in production of nanofibers. Mixing these nanofibers with the unrefined and normally refined fibers show their reinforcing effect. This effect is manifested in observing the improvement in the physical and mechanical properties e.g. tensile index and burst index of paper. Tear index, however, was observed to decrease on blending with nanofibers. The optical properties of paper sheets made from blended fibers showed no significant change in comparison to those made from only mechanically refined pulp. Mixing of normal pulp fibers with nanofibers show increase in ºSR and consequent decrease in drainage rate. These changes observed in mechanical, optical and other physical properties of the paper sheets made from nanofibrils blended pulp have been tried to explain considering the distribution of the nanofibrils alongside microfibrils in the fibrous network. Since usually, paper/boards with higher strength are observed to have diminished optical properties which is a drawback in their quality, the present work has the potential for developing paper/boards having improved strength alongwith undiminished optical properties utilising the concepts of nanoscience and nanotechnology.

Keywords: enzymatic pretreatment, mechanical refining, nanofibrils, paper properties

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Authors: Syeda Fahria Hoque Mimmi, Aparna Islam

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Genetically engineered (GE) plants are the need of time for increased demand for food. A complete set of regulations need to be followed from the development of a GE plant to its release into the environment. The whole regulation system is categorized into separate stages for maintaining the proper biosafety. Environmental risk assessment (ERA) is one of such crucial stages in the whole process. ERA identifies potential risks and their impacts through science-based evaluation where it is done in a case-by-case study. All the countries which deal with GE plants follow specific guidelines to conduct a successful ERA. In this study, ERA guidelines of 4 developing and 4 developed countries, including Bangladesh, were compared. ERA guidelines of countries such as India, Canada, Australia, the European Union, Argentina, Brazil, and the US were considered as a model to conduct the comparison study with Bangladesh. Initially, ten parameters were detected to compare the required data and information among all the guidelines. Surprisingly, an adequate amount of data and information requirements (e.g., if the intended modification/new traits of interest has been achieved or not, the growth habit of GE plants, consequences of any potential gene flow upon the cultivation of GE plants to sexually compatible plant species, potential adverse effects on the human health, etc.) matched between all the countries. However, a few differences in data requirement (e.g., agronomic conventions of non-transformed plants, applicants should clearly describe experimental procedures followed, etc.) were also observed in the study. Moreover, it was found that only a few countries provide instructions on the quality of the data used for ERA. If these similarities are recognized in a more framed manner, then the approval pathway of GE plants can be shared.

Keywords: GE plants, ERA, harmonization, ERA guidelines, Information and data requirements

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Authors: Rajkumar Ghosh

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The study presents an overview of the many uses and approaches for estimating out-of-sequence thrust movement in earthquake mitigation. The study investigates how knowing and forecasting thrust movement during seismic occurrences might assist to effective earthquake mitigation measures. The review begins by discussing out-of-sequence thrust movement and its importance in earthquake mitigation strategies. It explores how typical techniques of estimating thrust movement may not capture the full complexity of seismic occurrences and emphasizes the benefits of include out-of-sequence data in the analysis. A thorough review of existing research and studies on out-of-sequence thrust movement estimates for earthquake mitigation. The study demonstrates how to estimate out-of-sequence thrust movement using multiple data sources such as GPS measurements, satellite imagery, and seismic recordings. The study also examines the use of out-of-sequence thrust movement estimates in earthquake mitigation measures. It investigates how precise calculation of thrust movement may help improve structural design, analyse infrastructure risk, and develop early warning systems. The potential advantages of using out-of-sequence data in these applications to improve the efficiency of earthquake mitigation techniques. The difficulties and limits of estimating out-of-sequence thrust movement for earthquake mitigation. It addresses data quality difficulties, modelling uncertainties, and computational complications. To address these obstacles and increase the accuracy and reliability of out-of-sequence thrust movement estimates, the authors recommend topics for additional study and improvement. The study is a helpful resource for seismic monitoring and earthquake risk assessment researchers, engineers, and policymakers, supporting innovations in earthquake mitigation measures based on a better knowledge of thrust movement dynamics.

Keywords: earthquake mitigation, out-of-sequence thrust, satellite imagery, seismic recordings, GPS measurements

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Authors: Mewa Singh

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Nanomedicine, a fusion of nanotechnology and medicine, is an emerging technology ideally suited to the targeted therapies. Nanoparticles overcome the low selectivity of anti-cancer drugs toward the tumor as compared to normal tissue and hence result-in less severe side-effects. Our new technology, HYBRID-NANOENGINEERING™, uses a new molecule (MR007) in the creation of nanoparticles that not only helps in nanonizing the medicine but also provides synergy to the medicine. The simplified manufacturing process will result in reduced manufacturing costs. Treatment is made more convenient because hybrid nanomedicines can be produced in oral, injectable or transdermal formulations. The manufacturing process uses no protein, oil or detergents. The particle size is below 180 nm with a narrow distribution of size. Importantly, these properties confer great stability of the structure. The formulation does not aggregate in plasma and is stable over a wide range of pH. The final hybrid formulation is stable for at least 18 months as a powder. More than 97 drugs, including paclitaxel, docetaxel, tamoxifen, doxorubicinm prednisone, and artemisinin have been nanonized in water soluble formulations. Preclinical studies on cell cultures of tumors show promising results. Our HYBRID-NANOENGINEERING™ platform enables the design and development of hybrid nano-pharmaceuticals that combine efficacy with tolerability, giving patients hope for both extended overall survival and improved quality of life. This study would discuss or present this new discovery of HYBRID-NANOENGINEERING™ which targets drug delivery, synergistic, and potentiating effects, and barriers of drug delivery and advanced drug delivery systems.

Keywords: nano-medicine, nano-particles, drug delivery system, pharmaceuticals

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Authors: Lojaine Okacha

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In the past half-century, researchers started paying attention to enhancing the performance of urban spaces. Their idea of performance comprised urban climate performance, space synthesis, economic performance, and enhancing the quality of life in space. However, they all agreed that the key to achieving any of the previously mentioned development projects is good governance. Having good governance allows citizens to participate freely in the urbanization or development projects within cities. Consequently, using the city resources and assets as efficiently as possible, and ensures the fulfillment of the users’ needs and requests. This paper aims to propose an effective participation framework to help citizens have their voices heard and participate in the decisions that will affect their living situation. The framework allows governments to use their public resources to their best. However, this study focuses on public participation in third-world countries with unitary decentralized governance systems such as Egypt. It summarizes the challenges facing the participation practices, identifies the keys to a successful participation process, and draws on dominant effective participation practice lying on the relationship between the levels of participation, stakeholders participating, the urban development stages, the city-systems, and participation process. These components are integrated to create a real-world effective participation Framework. The results of the analysis were incredible and produced a functional and progressive approach for effective public participation to introduce to the governments. The model itself is combined with additional principles allowing the best practice to the process. The framework is finally compared with a real case of urban development.

Keywords: public participation, good governance, urban development, city systems

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Authors: Nathalia Andrea Calderon Lesmes, Eduardo Barragan Parada, Diego Fernando Villegas Bermudez

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Spasticity in the plantiflexor muscles as a product of stroke (CVA-Cerebrovascular accident) restricts the mobility and independence of the affected people. Commonly, physiotherapists are in charge of manually performing the rehabilitation therapy known as Sustained Mechanical Stretching, rotating the affected foot of the patient in the sagittal plane. However, this causes a physical wear on the professional because it is a fatiguing movement. In this article, a mechanical device is developed to implement this rehabilitation therapy more efficiently. The device consists of a worm-crown mechanism that is driven by a crank to gradually rotate a platform in the sagittal plane of the affected foot, in order to achieve dorsiflexion. The device has a range of sagittal rotation up to 150° and has velcro located on the footplate that secures the foot. The design of this device was modeled by using CAD software and was checked structurally with a general purpose finite element software to be sure that the device is safe for human use. As a measurement system, a goniometer is used in the lateral part of the device and load cells are used to measure the force in order to determine the opposing torque exerted by the muscle. Load cells sensitivity is 1.8 ± 0.002 and has a repeatability of 0.03. Validation of the effectiveness of the device is measured by reducing the opposition torque and increasing mobility for a given patient. In this way, with a more efficient therapy, an improvement in the recovery of the patient's mobility and therefore in their quality of life can be achieved.

Keywords: biomechanics, mechanical device, plantiflexor muscles, rehabilitation, spastic hemiplegia, sustained mechanical stretching

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Authors: Ayoola Adekunle Dada, Tolulope Omolola Fateropa

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There is no gain saying the fact that the Nigerian correctional services lack rehabilitation reformation. Owing to this, some so many inmates, including the female, become more emotionally bruised and hardened instead of coming out of the prison reformed. Although female inmates constitute only a small percentage worldwide, the challenges resulting from women falling under the provision of the penal system have prompted ficial and humanitarian bodies to consider female inmateas as vulnerable persons who need particular social work measures that meet their specific needs. Female inmates’condition may become worseinprisondue to the absence of the standard living condition. A survey of 100 female inmates will be used to determine the assessment of the living condition of the female inmates within the contexts in which they occur. Employing field methods from Medical Sociology and Law, the study seeks to make use of the collaboration of both disciplines for a comprehensive understanding of the scenario. Its specific objectives encompassed: (1) To examine access and use of health facilities among the female inmates;(2) To examine the effect of officers/warders attitude towards female inmates;(3)To investigate the perception of the female inmates towards the housing facilities in the centre and; (4) To investigate the feeding habit of the female inmates. Due to the exploratory nature of the study, the researchers will make use of mixed-method, such qualitative methods as interviews will be undertaken to complement survey research (quantitative). By adopting the above-explained inter-method triangulation, the study will not only ensure that the advantages of both methods are exploited but will also fulfil the basic purposes of research. The sampling for this study will be purposive. The study aims at sampling two correctional centres (Ado Ekiti and Akure) in order to generate representative data for the female inmates in South West Nigeria. In all, the total number of respondents will be 100. A cross-section of female inmates will be selected as respondents using a multi-stage sampling technique. 100 questionnaires will be administered. A semi structured (in-depth) interviews will be conducted among workers in the two selected correctional centres, respectively, to gain further insight on the living conditions of female inmates, which the survey may not readily elicit. These participants will be selected purposively in respect to their status in the organisation. Ethical issues in research on human subjects will be given due consideration. Such issues rest on principles of beneficence, non-maleficence, autonomy/justice and confidentiality. In the final analysis, qualitative data will be analyzed using manual content analysis. Both the descriptive and inferential statistics will be used for analytical purposes. Frequency, simple percentage, pie chart, bar chart, curve and cross-tabulations will form part of the descriptive analysis.

Keywords: assessment, health facilities, inmates, perception, living conditions

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Authors: B. O. Diyaolu, E. A. Okebanjo

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Children in today’s world need attention and care even with their physique as obesity is also at the increased. Several factors can be responsible for obesity in children and adequate attention is paramount in other not to accommodate it into adolescent period. This study investigated perceived determinants of obesity among primary school pupils in Eti Osa Local Government area of Lagos State. Descriptive survey research design was used and population was all obese pupils in Eti Osa Local Government Area of Lagos State. 92 pupils were selected from randomly picked 12 primary schools while purposive sampling technique was used to pick primary 4-6 pupils. With the aid of body mass index (BMI) and age percentile chart the obese pupils were selected. The instrument for the study was a self-developed and structured questionnaire on perceived determinant of obesity. The questionnaire was divided into three sections. The Cronbach’s Alpha reliability coefficient of 0.74 was obtained. The hypotheses were tested at 0.05 significant levels. The completed questionnaire was collated coded and analyzed using descriptive statistics of frequency counts and percentage and inferential statistics of chi-square (X²). Findings of this study revealed that physical activities and parental influences were determinant of obesity. Physical activity is essential in reducing the rate of obesity in Eti Osa Local Government Area both at home and within the school environment. Primary schools need to create more playing ground for pupils to exercise themselves. Parents need to cater for their children diet ensuring not just the quantity but the quality as well.

Keywords: feeding pattern, obese pupils, parental influence, physical activities

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Authors: Veli Durmus, Mert Uydaci

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Every patient who needs to get a medical treatment should share health-related personal data with healthcare providers. Therefore, personal health data plays an important role to make health decisions and identify health threats during every encounter between a patient and caregivers. In other words, health data can be defined as privacy and sensitive information which is protected by various health laws and regulations. In many cases, the data are an outcome of the confidential relationship between patients and their healthcare providers. Globally, almost all nations have own laws, regulations or rules in order to protect personal data. There is a variety of instruments that allow authorities to use the health data or to set the barriers data sharing across international borders. For instance, Directive 95/46/EC of the European Union (EU) (also known as EU Data Protection Directive) establishes harmonized rules in European borders. In addition, the General Data Protection Regulation (GDPR) will set further common principles in 2018. Because of close policy relationship with EU, this study provides not only information on regulations, directives but also how they play a role during the legislative process in Turkey. Even if the decision is controversial, the Board has recently stated that private or public healthcare institutions are responsible for the patient call system, for doctors to call people waiting outside a consultation room, to prevent unlawful processing of personal data and unlawful access to personal data during the treatment. In Turkey, vast majority private and public health organizations provide a service that ensures personal data (i.e. patient’s name and ID number) to call the patient. According to the Board’s decision, hospital or other healthcare institutions are obliged to take all necessary administrative precautions and provide technical support to protect patient privacy. However, this application does not effectively and efficiently performing in most health services. For this reason, it is important to draw a legal framework of personal health data by stating what is the main purpose of this regulation and how to deal with complicated issues on personal health data in Turkey. The research is descriptive on data protection law for health care setting in Turkey. Primary as well as secondary data has been used for the study. The primary data includes the information collected under current national and international regulations or law. Secondary data include publications, books, journals, empirical legal studies. Consequently, privacy and data protection regimes in health law show there are some obligations, principles and procedures which shall be binding upon natural or legal persons who process health-related personal data. A comparative approach presents there are significant differences in some EU member states due to different legal competencies, policies, and cultural factors. This selected study provides theoretical and practitioner implications by highlighting the need to illustrate the relationship between privacy and confidentiality in Personal Data Protection in Health Law. Furthermore, this paper would help to define the legal framework for the health law case studies on data protection and privacy.

Keywords: data protection, personal data, privacy, healthcare, health law

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Authors: Thi Phuong Lan Nguyen

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Vietnamese English Language Teacher Education (ELTE) has been changing a lot in response to the rapidly evolving socio-economic context requirements. The Vietnamese government assigns the Ministry of Education and Training (MOET) primary tasks to have policy changes to prepare for ELTE development in the globalization and socialization process. Many educational policies have been made to develop ELTE, however, they seem not to address the new global or social demands. The issue is that there are still significant disparities between the national policy and the institutional implementation. This study is to investigate the alignment between ELTE institutional curriculum, pedagogies, and MOET standards. This study used a mixed-method with the data sources from policy documents, a survey, and 33 interviews conducted with the lecturers and administrators from eleven Vietnamese ELTE institutions. The data have been analysed to understand the gap between policy and practice. The initial findings are (i) a low alignment of curriculum and language proficiency standards and (ii) a moderate alignment between curriculum and future-career skills standards. Many pedagogical challenges have been found. In order to address these gaps, it is necessary for the curriculum to be standards-based designed. It is also vital for professional development in order to improve the quality teaching. The study offers multiple perspectives on a complex issue. The study is meaningful not only to educational governance, but also to teaching practitioners, English language researchers, and English language learners. The significance lies in its relevance to English teaching careers across all parts of Vietnam, it yet remains relevant to ELTE in other countries teaching English as a foreign language.

Keywords: alignment, curriculum, educational policy, English language teaching, pedagogy, standards

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Authors: Vladyslav Povoroznyuk, Larysa Martynyuk, Iryna Syzonenko, Liliya Martynyuk

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Osteoporosis is one of the important problems in postmenopausal women due to an increased risk of sudden and unexpected fractures. This study is aimed to determine the connection between bone mineral density (BMD) and trabecular bone score (TBS) in Ukrainian women suffering from metabolic syndrome. Participating in the study, 566 menopausal women aged 50-79 year-old were examined and divided into two groups: Group A included 336 women with no obesity (BMI ≤ 29.9 kg/m²), and Group B – 230 women with metabolic syndrome (diagnosis according to IDF criteria, 2005). Dual-energy X-ray absorptiometry was used for measuring of lumbar spine (L1-L4), femoral neck, total body and forearm BMD and bone quality indexes (last according to Med-Imaps installation). Data were analyzed using Statistical Package 6.0. A significant increase of lumbar spine (L1-L4), femoral neck, total body and ultradistal radius BMD was found in women with metabolic syndrome compared to those without obesity (p < 0.001) both in their totality and in groups of 50-59 years, 60-69 years, and 70-79 years. TBS was significantly higher in non-obese women compared to metabolic syndrome patients of 50-59 years and in the general sample (p < 0.05). Analysis showed significant positive correlation between body mass index (BMI) and BMD at all levels. Significant negative correlation between BMI and TBS (L1-L4) was established. Despite the fact that BMD indexes were significantly higher in women with metabolic syndrome, the frequency of vertebral and non-vertebral fractures did not differ significantly in the groups of patients.

Keywords: bone mineral density, trabecular bone score, metabolic syndrome, fracture

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Authors: Suwarsono, Ario S. Baskoro, Gandjar Kiswanto, Budiono

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Friction Stir Welding (FSW) is a relatively new technique for joining metal. In some cases on aluminum joining, FSW gives better results compared with the arc welding processes, including the quality of welds and produces less distortion.FSW welding process for a light structure and thin materials requires small forces as possible, to avoid structure deflection. The joining process on FSW occurs because of melting temperature and compressive forces, the temperature generation of caused by material deformation and friction between the cutting tool and material. In this research, High speed rotation of spindle was expected to reduce the force required for deformation. The welding material was Aluminum A1100, with thickness of 0.4 mm. The tool was made of HSS material which was shaped by micro grinding process. Tool shoulder diameter is 4 mm, and the length of pin was 0.6 mm (with pin diameter= 1.5 mm). The parameters that varied were the plunge speed (2 mm/min, 3 mm/min, 4 mm/min). The tool speed is fixed at 33,000 rpm. Responses of FSSW parameters to analyze were Axial Force (Z-Force), Temperature and the Shear Strength of welds. Research found the optimum µFSSW parameters, it can be concluded that the most important parameters in the μFSSW process was plunge speed. lowest plunge speed (2 mm / min) causing the lowest axial force (110.40 Newton). The increases of plunge speed will increase the axial force (maximum Z-Farce= 236.03 Newton), and decrease the shear strength of welds.

Keywords: friction stir spot welding, aluminum A1100, plunge speed, axial force, shear strength

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Authors: Hedi Dghim, Ahmed El-Naggar, Istvan Erlich

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Power electronic converters are being introduced in low voltage (LV) grids at an increasingly rapid rate due to the growing adoption of power electronic-based home appliances in residential grid. Photovoltaic (PV) systems are considered one of the potential installed renewable energy sources in distribution power systems. This trend has led to high distortion in the supply voltage which consequently produces harmonic currents in the network and causes an inherent voltage unbalance. In order to investigate the effect of harmonic distortions, a case study of a typical LV grid configuration with high penetration of 3-phase and 1-phase rooftop mounted PV from southern Germany was first considered. Electromagnetic transient (EMT) simulations were then carried out under the MATLAB/Simulink environment which contain detailed models for power electronic-based loads, ohmic-based loads as well as 1- and 3-phase PV. Note that, the switching patterns of the power electronic circuits were considered in this study. Measurements were eventually performed to analyze the distortion levels when PV operating under different solar irradiance. The characteristics of the load-side harmonic impedances were analyzed, and their harmonic contributions were evaluated for different distortion levels. The effect of the high penetration of PV on the harmonic distortion of both positive and negative sequences was also investigated. The simulation results are presented based on case studies. The current distortion levels are in agreement with relevant standards, otherwise the Total Harmonic Distortion (THD) increases under low PV power generation due to its inverse relation with the fundamental current.

Keywords: harmonic distortion analysis, power quality, PV systems, residential distribution system

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Authors: An-Na Li, Ying-Yu Chen, Yu-Lung Lin

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Food tourism is one of the growing industries in the tourism industry today. The Destination Marketing Organizations (DMOs) are aware of the importance of gastronomy to stimulate local and regional economic development. From the heritage and cultural aspects, gastronomy is becoming a more important part of the cultural heritage of the region. Heritage destinations provide culinary heritage, which fits the current interest in traditional food, and cuisine is a part of a general desire for authentic experience. However, few studies have empirically examined antecedents of food tourists’ behavioral intentions. This study examined the effects of cuisine experience; emotions, place attachment and tourists’ revisit behavioral intentions. A total of 408 individuals responded to the on-site survey in the historic town of Lu-Kang in Taiwan. The results indicated that tourists’ cuisine experience include place flavor, media recommendation, local learning, life transfer and interpersonal share. In addition, cuisine experience had significant impacts on emotions and place attachment, emotions had significant effects on place attachment, furthermore, which in turn place attachment had significant effects on tourists’ revisit behavioral intentions. The findings suggested that the cuisine experience is a multi-dimensions construct. On the other hands, the good quality of cuisine experience could evoke tourists’ positive emotions and it could play a significant role in promoting tourist revisit intentions or word of mouth. Implications for theory and practice are discussed.

Keywords: culinary tourism, cuisine experiences, emotions, revisit intentions

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Authors: Mehrnaz Mostafavi

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The assessment and categorization of incidental lung nodules present a considerable challenge in healthcare, often necessitating resource-intensive multiple computed tomography (CT) scans for growth confirmation. This research addresses this issue by introducing a distinct computational approach leveraging radiomics and deep-learning methods. However, understanding local services is essential before implementing these advancements. With diverse tracking methods in place, there is a need for efficient and accurate identification approaches, especially in the context of managing lung nodules alongside pre-existing cancer scenarios. This study explores the integration of text-based algorithms in medical data curation, indicating their efficacy in conjunction with machine learning and deep-learning models for identifying lung nodules. Combining medical images with text data has demonstrated superior data retrieval compared to using each modality independently. While deep learning and text analysis show potential in detecting previously missed nodules, challenges persist, such as increased false positives. The presented research introduces a Structured-Query-Language (SQL) algorithm designed for identifying pulmonary nodules in a tertiary cancer center, externally validated at another hospital. Leveraging natural language processing (NLP) and machine learning, the algorithm categorizes lung nodule reports based on sentence features, aiming to facilitate research and assess clinical pathways. The hypothesis posits that the algorithm can accurately identify lung nodule CT scans and predict concerning nodule features using machine-learning classifiers. Through a retrospective observational study spanning a decade, CT scan reports were collected, and an algorithm was developed to extract and classify data. Results underscore the complexity of lung nodule cohorts in cancer centers, emphasizing the importance of careful evaluation before assuming a metastatic origin. The SQL and NLP algorithms demonstrated high accuracy in identifying lung nodule sentences, indicating potential for local service evaluation and research dataset creation. Machine-learning models exhibited strong accuracy in predicting concerning changes in lung nodule scan reports. While limitations include variability in disease group attribution, the potential for correlation rather than causality in clinical findings, and the need for further external validation, the algorithm's accuracy and potential to support clinical decision-making and healthcare automation represent a significant stride in lung nodule management and research.

Keywords: lung cancer diagnosis, structured-query-language (SQL), natural language processing (NLP), machine learning, CT scans

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Authors: Hamda M. Al-Ali

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From addressing fundamental questions about the history of the solar system to exploring other planets for any signs of life have always been the core of human space exploration. This triggered humans to explore whether other planets such as Mars could support human life on them. Therefore, many planned space missions to other planets have been designed and conducted to examine the feasibility of human survival on them. However, space missions are expensive and consume a large number of various resources to be successful. To overcome these problems, material efficiency shall be maximized through the use of reusable launch vehicles (RLV) rather than disposable and expendable ones. Material efficiency is defined as a way to achieve service requirements using fewer materials to reduce CO2 emissions from industrial processes. Materials such as aluminum-lithium alloys, steel, Kevlar, and reinforced carbon-carbon composites used in the manufacturing of spacecrafts could be reused in closed-loop cycles directly or by adding a protective coat. Material efficiency is a fundamental principle of a circular economy. The circular economy aims to cutback waste and reduce pollution through maximizing material efficiency so that businesses can succeed and endure. Five strategies have been proposed to improve material efficiency in the space industry, which includes waste minimization, introduce Key Performance Indicators (KPIs) to measure material efficiency, and introduce policies and legislations to improve material efficiency in the space sector. Another strategy to boost material efficiency is through maximizing resource and energy efficiency through material reusability. Furthermore, the environmental effects associated with the rapid growth in the number of space missions include black carbon emissions that lead to climate change. The levels of emissions must be tracked and tackled to ensure the safe utilization of space in the future. The aim of this research paper is to examine and suggest effective methods used to improve material efficiency in space missions so that space and Earth become more environmentally and economically sustainable. The objectives used to fulfill this aim are to identify the materials used in space missions that are suitable to be reused in closed-loop cycles considering material efficiency indicators and circular economy concepts. An explanation of how spacecraft materials could be re-used as well as propose strategies to maximize material efficiency in order to make RLVs possible so that access to space becomes affordable and reliable is provided. Also, the economic viability of the RLVs is examined to show the extent to which the use of RLVs has on the reduction of space mission costs. The environmental and economic implications of the increase in the number of space missions as a result of the use of RLVs are also discussed. These research questions are studied through detailed critical analysis of the literature, such as published reports, books, scientific articles, and journals. A combination of keywords such as material efficiency, circular economy, RLVs, and spacecraft materials were used to search for appropriate literature.

Keywords: access to space, circular economy, material efficiency, reusable launch vehicles, spacecraft materials

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Authors: Rui Lança, Elisa Silva, Fátima Farinha, Miguel José Oliveira, Manuel Duarte Pinheiro, Cátia Miguel

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Tourism has a great potential to bring up progress across the Sustainable Development Goals (SDGs). If well managed and monitored, the tourism sector can create quality jobs, reduce poorness and offer incentives for environmental preservation, helping on the transition towards more inclusive and resilient economies. However, without proper safeguards and investments, expansion of the tourism market will increase pressure on biodiversity and the ecosystems on which the livelihoods of local communities depend. Competitivity is a key dimension in tourism, sustainable tourism challenge new dimensions to competitivity, namely environmental, social, institutional and economic achieve a medium and long-term competitivity. It is undoubtedly clear on the tourism sector, the importance of the region sustainability in the current touristic destinations offer. The basis of a tourism region prosperity will depend on /of it. The OBSERVE project intends to be an instrument for monitoring and evaluating the sustainability levels of the Algarve region. Its main objective is to provide environmental, economic, social-cultural and institutional indicators to support the decision-making process for a sustainable growth of the region. The project´s main goal is a digital portal with the most relevant indicators to allow evaluating and communicating the performance of the region in a sustainable growth perspective. This paper presents the OBSERVE project and highlights the potential contribution to a broad perspective of competitivity and its contribution for different stakeholders and the touristic value chain. Limitations and opportunities are also discussed.

Keywords: sustainable tourism, competitivity, OBSERVE project, Algarve region

Procedia PDF Downloads 138

Authors: I. Hilia, C. Hange, F. Hakala, M. Matheus, C. Jansen, J. Hidinwa, O. Awofolu

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The article reports on the occurrences, level, and mobility of selected trace metals in environmental samples. The conceptual basis was to examine the possible influence of anthropogenic activities and the impact on human and environmental health. Environmental samples (soil, plant and lower animal) were randomly collected from stratified study/sampling areas, preserved and pre-treated before analysis. Mineral acid digestion procedure was employed for the isolation of metallic contents in samples, and elemental qualitative and quantitative analysis was by ICP-OES. Analytical protocol was validated through the quality assurance process and was found acceptable with quantitative metallic recoveries in the range of 85-90%; hence considered applicable for the analyses of environmental samples. The mean concentration of analysed metals in soil samples ranged from 53.2- 2532.8 mg/kg (Cu); 59.5- 2020.1 mg/kg (Zn); 1.80 – 21.26 mg/kg (Cd) and 19.6- 140.9 mg/kg (Pb). The mean level in grass samples ranged from 9.33 – 38.63 mg/kg (Cu); 64.20-105.18 mg/kg (Zn); 0.28–0.73 mg/kg (Cd) and 0.53 -16.26 mg/kg (Pb) while the mean level in lower animal sample (beetle) varied from 9.6 - 105.3 mg/kg (Cu); 134.1-297.2 mg/kg (Zn); 0.63 – 3.78 (Cd) and 8.0 – 29.1 mg/kg (Pb) across sample collection points (SCPs) 1-4 respectively. Metallic transfer factors (TFs) were in the order Zn >Cd > Cu > Pb with metal Pollution Indices (MPIs) in the order SCP1 > SCP2 > SCP3 > SCP4. About 60-70 % of analysed metals were above the maximum allowable limits (MALs) in soil and plant samples. Results obtained revealed the general prevalence of analysed metals at all sampled sites with indication of metallic mobility across the food chain which portrayed dire consequences for environmental and human health. Systematic environmental remediation and pollution abatement strategies are recommended.

Keywords: trace metals, pollution, human health, Incidences, ICP-OES

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Authors: Fangfei Li

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This research was conducted to explore how Chinese overseas students, who rarely received teacher feedback during their undergraduate studies in China, engaged in a different feedback provision context in the UK universities. In particular, this research provides some insights into Chinese students’ perspectives on how they made sense of the teacher feedback they obtained and how they took it on board in their assignments. Research questions in this study are 1) What are Chinese overseas students’ perceptions of teacher feedback on courses in UK higher education? 2) How do they respond to the teacher feedback they obtained? 3) What factors might influence their engagement with teacher feedback? Multiple case studies of five Chinese overseas students in a UK university have been carried out to address the research questions. The main data collection instruments are various types of semi-structured interviews, consisting of background interviews, scenario-based activities, stimulated recall sessions and retrospective interviews. Research findings indicate that student engagement with teacher feedback is a complex learning process incorporating several stages: from initial teacher input to ultimate transformational learning. Apart from students interpreting teachers’ comments/suggestions by themselves, students’ understandings of and responses to teacher feedback could also be influenced by pre-submission guidance, peer discussion, use of exemplars and post-submission discussion with teachers. These are key factors influencing students to make use of teacher feedback. Findings also reveal that the level of students’ reflections on tutor feedback influences the quality of their assignments and even their future learning. To sum up, this paper will discuss the current concepts of teacher feedback in existing studies and research findings of this study from which reconceptualization of teacher feedback has occurred.

Keywords: Chinese students, student engagement, teacher feedback, the UK higher education

Procedia PDF Downloads 336

Authors: Ryan C. Igama

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The complexity of disaster risk reduction management paved the way for various innovations and approaches to mitigate the loss of lives and casualties during disaster-related situations. The efficiency of doing response operations during disasters relies on the timely and organized deployment of search, rescue and retrieval teams. Indeed, the assistance provided by the search, rescue, and retrieval teams during disaster operations is a critical service needed to further minimize the loss of lives and casualties. The Armed Forces of the Philippines was mandated to provide humanitarian assistance and disaster relief operations during calamities and disasters. Thus, this study “Interoperability of 505TH Search and Rescue Group and the 205TH Tactical Helicopter Wing of the Philippine Air Force in Search and Rescue Operations: An Assessment” was intended to provide substantial information to further strengthen and promote the capabilities of search and rescue operations in the Philippines. Further, this study also aims to assess the interoperability of the 505th Search and Rescue Group of the Philippine Air Force and the 205th Tactical Helicopter Wing Philippine Air Force. This study was undertaken covering the component units in the Philippine Air Force of the Armed Forces of the Philippines – specifically the 505th SRG and the 205th THW as the involved units who also acted as the respondents of the study. The qualitative approach was the mechanism utilized in the form of focused group discussions, key informant interviews, and documentary analysis as primary means to obtain the needed data for the study. Essentially, this study was geared towards the evaluation of the effectiveness of the interoperability of the two (2) involved PAF units during search and rescue operations. Further, it also delved into the identification of the impacts, gaps, and challenges confronted regarding interoperability as to training, equipment, and coordination mechanism vis-à-vis the needed measures for improvement, respectively. The result of the study regarding the interoperability of the two (2) PAF units during search and rescue operations showed that there was a duplication in terms of functions or tasks in HADR activities, specifically during the conduct of air rescue operations in situations like calamities. In addition, it was revealed that there was a lack of equipment and training for the personnel involved in search and rescue operations which is a vital element during calamity response activities. Based on the findings of the study, it was recommended that a strategic planning workshop/activity must be conducted regarding the duties and responsibilities of the personnel involved in the search and rescue operations to address the command and control and interoperability issues of these units. Additionally, the conduct of intensive HADR-related training for the personnel involved in search and rescue operations of the two (2) PAF Units must also be conducted so they can be more proficient in their skills and sustainably increase their knowledge of search and rescue scenarios, including the capabilities of the respective units. Lastly, the updating of existing doctrines or policies must be undertaken to adapt advancement to the evolving situations in search and rescue operations.

Keywords: interoperability, search and rescue capability, humanitarian assistance, disaster response

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Authors: J. Y. Ijato, A. Adewumi, H. O Yakubu, O. O. Olajide, B. O. Ojo, B. A. Adanikin

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Post-harvest fruit rot pathogens are one of the major factors that are responsible for food security challenges in developing countries like Nigeria. These pathogens also cause fruit food poisoning. Biocidal effects of ethanolic extracts of Khaya grandifoliola, Hyptis suaveolens, Zingiber officinale, Calophyllum inophyllum, Datura stramonium on the mycelia growth of fungal rot pathogens of pineapple fruit was investigated, the ethanolic extracts of these test plants exhibited high significant inhibitory effects on the rot pathogens, the highest ethanolic extract inhibition of Zingiber officinale was on Aspergillus flavus (38.40%) at 1.0g/ml while the least inhibitory effect was on Aspergillus fumigatus (23.10%) at 1.0g/ml, the highest ethanol extract inhibition of Datura stramonium was on Aspergillus tubingensis (24.00%) at 1.0g/ml while the least inhibitory effect was 10.00% on Colletotrichum fruticola at 1.0g/ml, the highest ethanol extract inhibition of Calophyllum inophyllum was on Trichoderma harzianum (18.50%) at 1.0g/ml while the least inhibitory effect was on Aspergillus flavus (15.00%) at 1.0g/ml, the highest ethanol extract inhibition of Hyptis suaveolens was on Aspergillus fumigatus (35.00%) at 1.0g/ml while the least inhibitory effect was on Aspergillus niger (20.00%) at 1.0g/ml, the highest ethanol extract inhibition of Khaya grandifoliola was on Aspergillus flavus (35.00%) at 1.00g/ml while the least inhibitory effect was on Aspergillus fumigates (22.00%) at 1.0g/ml, the antifungal capacity of these test plant extracts on rot causing fungi on pineapple fruit reveals the possibility of their use by farmers and fruit traders as alternative to chemical fungicide that portends great threat to human and environmental health.

Keywords: fruit rot, pathogens, plant extracts, pineapple, food poisoning

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Authors: Jhuang Jin-Jhong, Hsieh Wei-Fan

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Climate change causes natural disasters persistently. Therefore, nowadays environmental planning objective tends to the issues of respecting nature and coexisting with nature. As a result, the natural environment analysis, e.g., the analysis of topography, soil, hydrology, climate, vegetation, is highly emphasized. On the other hand, Feng Shui has been a criterion of site selection for residence in Eastern since the ancient times and has had farther influence on site selection for castles and even for temples and tombs. The primary criterion of site selection is judging the quality of Long: mountain range, Sha: nearby mountains, Shui: hydrology, Xue: foundation, Xiang: aspect, which are similar to the environmental variables of mountain range, topography, hydrology and aspect. For the reason, a lot researchers attempt to probe into the connection between the criterion of Feng Shui and environmental planning factors. Most researches only discussed with the composition and theory of space of Feng Shui, but there is no research which explained Feng Shui through the environmental field. Consequently, this study reviewed the theory of Feng Shui through the environmental planning viewpoint and assembled essential composition factors of Feng Shui. The results of this study point. From literature review and comparison of theoretical meanings, we find that the ideal principles for planning the Feng Shui environment can also be used for environmental planning. Therefore, this article uses 12 ideal environmental features used in Feng Shui to contrast the natural aspects of the environment and make comparisons with previous research and classifies the environmental factors into climate, topography, hydrology, vegetation, and soil.

Keywords: the composition of Feng Shui, environmental planning, site selection, main components of the Feng Shui environment

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Authors: Vaibhav Barve

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Reversible information hiding has drawn a lot of interest as of late. Being reversible, we can restore unique computerized data totally. It is a plan where mystery data is put away in digital media like image, video, audio to maintain a strategic distance from unapproved access and security reason. By and large JPEG bit stream is utilized to store this key data, first JPEG bit stream is encrypted into all around sorted out structure and then this secret information or key data is implanted into this encrypted region by marginally changing the JPEG bit stream. Valuable pixels suitable for information implanting are computed and as indicated by this key subtle elements are implanted. In our proposed framework we are utilizing RC4 algorithm for encrypting JPEG bit stream. Encryption key is acknowledged by framework user which, likewise, will be used at the time of decryption. We are executing enhanced least significant bit supplanting steganography by utilizing genetic algorithm. At first, the quantity of bits that must be installed in a guaranteed coefficient is versatile. By utilizing proper parameters, we can get high capacity while ensuring high security. We are utilizing logistic map for shuffling of bits and utilization GA (Genetic Algorithm) to find right parameters for the logistic map. Information embedding key is utilized at the time of information embedding. By utilizing precise picture encryption and information embedding key, the beneficiary can, without much of a stretch, concentrate the incorporated secure data and totally recoup the first picture and also the original secret information. At the point when the embedding key is truant, the first picture can be recouped pretty nearly with sufficient quality without getting the embedding key of interest.

Keywords: data embedding, decryption, encryption, reversible data hiding, steganography

Procedia PDF Downloads 281

Authors: L. Masilionyte, S. Maiksteniene

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Alternative farming systems are used to cultivate high quality food products and retain the viability and fertility of soil. The field experiments of different farming systems were conducted at Joniškėlis Experimental Station of the Lithuanian Research Centre for Agriculture and Forestry in 2006–2013. The soil of the experimental site was Endocalcari-Endohypogleyic Cambisol (CMg-n-w-can). In different farming systems, farmyard manure, straw and green manure catch crops used for fertilization both in the soil low in humus and in the soil moderate in humus. In the 0–20 cm depth layer, it had a more significant effect on soil moisture than on other physical soil properties. In the agricultural systems, in which catch crops had been grown, soil physical characteristics did not differ significantly before their biomass incorporation, except for the moisture content, which was lower in rainy periods and higher in drier periods than in the soil without catch crops. Soil bulk density and porosity in the topsoil layer were more dependent on soil humus content than on agricultural measures used: in the soil moderate in humus content, compared with the soil low in humus, bulk density was by 1.4 % lower, and porosity by 1.8 % higher. The research findings create a possibility to make improvements in alternative cropping systems by choosing organic fertilizers and catch crops’ combinations that have the sustainable effect on soil and that maintain the sustainability of soil productivity parameters. Rational fertilization systems, securing the stability of soil productivity parameters and crop rotation productivity will promote a development of organic agriculture.

Keywords: agro-measures, soil physical parameters, organic farming, sustainable farming

Procedia PDF Downloads 393

Authors: Jiashu Shen

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With the increase in the prevalence of divorce, the impact of divorce on children’s sexual and reproductive health has received wide attention, while few studies have investigated parent marital relationship. This study aims to study the relation of both parent divorce and perceived parental marital relationship with children’s sexual behaviors among Chinese university or vocational college students. The study used data from “National College Student Survey on Sexual and Reproductive Health 2019”, an internet-based survey conducted from November 2019 to February 2020, in 241 universities or vocational colleges in China. Statistical analyses were conducted to assess the relationship of perceived parental marital relationship and parents’ divorce of distinct occurrence time with sexual intercourse, risky sexual behaviors, unintended health outcomes and sexual abuse. Among 51,124 university or vocational college students, those whose parents had divorced accounted for 10.72%. Better perceived parental relationship was associated with a lower likelihood to have sexual intercourse (male: OR: 0.83, 95%CI: 0.80-0.86; female: OR: 0.73, 95%CI: 0.70-0.75), sexual abuse, risky sexual behaviors and unintended health outcomes. Divorce was also found to be associated with higher risk of sexual abuse, risky sexual behaviors and unintended health outcomes. The findings highlight the importance of parental marital relationship and divorce in risky sexual behavior among young adults. The findings may provide implications on intervention programs targeting at children with divorced parents from an early stage.

Keywords: college students, divorce, family relationship, sexual behavior

Procedia PDF Downloads 121

Authors: Hsien Hua Kuo, Wen Chun Lin, Chia Chi Hsu, Hsien Wen Kuo

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Objective: Despite the high prevalence of musculoskeletal disorders (MSDs) among nurses, which has been consistently observed in the studies of Western countries, very little information regarding intensity of workload and work-related quality of life (WRQOL) related to MSDs among nurses is available in Taiwan. The objective of this study is to investigate the factors affecting musculoskeletal disorders in nurses from a hospital. Methods: 550 nurses from a hospital in Taoyuan were interviewed using a modified standardized Nordic Musculoskeletal (NMQ) questionnaire which contained the demographic information, workplace condition and musculoskeletal disorders. Results: Response rate of nurses were 92.5% from a teaching hospital. Based on medical diagnosis by physician, neck of musculoskeletal disorders had the highest percentage in nine body portions. The higher percentage of musculoskeletal disorders in nurses found from wards of internal and surgery. Severity and symptoms of musculoskeletal disorders diagnosed by self-reported questionnaire significantly correlated with WRQOL, job satisfaction and intensity of workload among nurses based on the logistic regression model. Conclusion: The severity and symptoms of musculoskeletal disorders among nurses showed a dose-dependent with WRQOL and workload. When work characteristics in hospital were modified, the severity of musculoskeletal disorders among nurses will be decreased and alleviated. Comment: Multifaceted ergonomic intervention programme to reduce the prevalence of MSDs among nurses was by encouraging nurses to do more physical activity which will make them more flexible and increase their strength. Therefore, the head nurse should encourage nurses to regularly physical activity and to modify unfitting ergonomic environment in order to reduce the prevalence of MSDs.

Keywords: musculoskeletal disorders, nurse, WRQOL, job satisfaction

Procedia PDF Downloads 323

Authors: Omkar More, Isha Saini, Gracy Mathai

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To study whether there is any clinical correlation between pterygium and dry eye and to evaluate the status of the tear film in patients with pterygium. Methods: 100 eyes with pterygium were compared with 100 control eyes without pterygium. Patients between 20 – 70 years were included in the study. A detailed history was taken and Schirmer’s test and TBUT were performed on all to evaluate the status of dry eye. Schirmer’s test ˂ 10 mm and TBUT ˂10 seconds was considered abnormal. Results: Maximum number (52) of patients affected by dry eye in both the groups were in the age group 31-40 years which statistically showed age as a significant factor of association for both pterygium and dry eye (P < 0.01).Schirmer’s test was slightly reduced in patients with pterygium(18.73±5.69 mm). TBUT was significantly reduced in the case group (12.26±2.24sec).TBUT decreased maximally in 51-60 yrs age group (13.00±2.77sec) with pterygium showing a tear film instability. On comparison of pterygia and controls with normal and abnormal tear film, Odd’s Ratio was 1.14 showing a risk of dry eye in pterygia patients to be 1.14 times higher than controls. Conclusion: Whether tear dysfunction is a precursor to pterygium growth or pterygium causes tear dysfunction is still not clear. Research and clinical evidence, however, suggest that there is a relationship between the two. This study is, therefore, undertaken to investigate the correlation between pterygium and dry eye. The patients with pterygia were compared with normals to evaluate their status regarding dryness. A close relationship exists between ocular irritation symptoms and functional evidence of tear instability. Schirmer’s test and TBUT should routinely be used in the outpatient department to diagnose dry eye in patients with pterygium and these patients should be promptly treated to prevent any sight-threatening complications.

Keywords: footfall, nursing assessment, quality improvement, six sigma

Procedia PDF Downloads 346