Search results for: public health management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 19954

Search results for: public health management

10444 Implementing Quality Improvement Projects to Enhance Contraception and Abortion Care Service Provision and Pre-Service Training of Health Care Providers

Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie

Abstract:

Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.

Keywords: abortion, contraception, quality improvement, service provision

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10443 Offline Parameter Identification and State-of-Charge Estimation for Healthy and Aged Electric Vehicle Batteries Based on the Combined Model

Authors: Xiaowei Zhang, Min Xu, Saeid Habibi, Fengjun Yan, Ryan Ahmed

Abstract:

Recently, Electric Vehicles (EVs) have received extensive consideration since they offer a more sustainable and greener transportation alternative compared to fossil-fuel propelled vehicles. Lithium-Ion (Li-ion) batteries are increasingly being deployed in EVs because of their high energy density, high cell-level voltage, and low rate of self-discharge. Since Li-ion batteries represent the most expensive component in the EV powertrain, accurate monitoring and control strategies must be executed to ensure their prolonged lifespan. The Battery Management System (BMS) has to accurately estimate parameters such as the battery State-of-Charge (SOC), State-of-Health (SOH), and Remaining Useful Life (RUL). In order for the BMS to estimate these parameters, an accurate and control-oriented battery model has to work collaboratively with a robust state and parameter estimation strategy. Since battery physical parameters, such as the internal resistance and diffusion coefficient change depending on the battery state-of-life (SOL), the BMS has to be adaptive to accommodate for this change. In this paper, an extensive battery aging study has been conducted over 12-months period on 5.4 Ah, 3.7 V Lithium polymer cells. Instead of using fixed charging/discharging aging cycles at fixed C-rate, a set of real-world driving scenarios have been used to age the cells. The test has been interrupted every 5% capacity degradation by a set of reference performance tests to assess the battery degradation and track model parameters. As battery ages, the combined model parameters are optimized and tracked in an offline mode over the entire batteries lifespan. Based on the optimized model, a state and parameter estimation strategy based on the Extended Kalman Filter (EKF) and the relatively new Smooth Variable Structure Filter (SVSF) have been applied to estimate the SOC at various states of life.

Keywords: lithium-ion batteries, genetic algorithm optimization, battery aging test, parameter identification

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10442 Variability Management of Contextual Feature Model in Multi-Software Product Line

Authors: Muhammad Fezan Afzal, Asad Abbas, Imran Khan, Salma Imtiaz

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Software Product Line (SPL) paradigm is used for the development of the family of software products that share common and variable features. Feature model is a domain of SPL that consists of common and variable features with predefined relationships and constraints. Multiple SPLs consist of a number of similar common and variable features, such as mobile phones and Tabs. Reusability of common and variable features from the different domains of SPL is a complex task due to the external relationships and constraints of features in the feature model. To increase the reusability of feature model resources from domain engineering, it is required to manage the commonality of features at the level of SPL application development. In this research, we have proposed an approach that combines multiple SPLs into a single domain and converts them to a common feature model. Extracting the common features from different feature models is more effective, less cost and time to market for the application development. For extracting features from multiple SPLs, the proposed framework consists of three steps: 1) find the variation points, 2) find the constraints, and 3) combine the feature models into a single feature model on the basis of variation points and constraints. By using this approach, reusability can increase features from the multiple feature models. The impact of this research is to reduce the development of cost, time to market and increase products of SPL.

Keywords: software product line, feature model, variability management, multi-SPLs

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10441 A Basic Concept for Installing Cooling and Heating System Using Seawater Thermal Energy from the West Coast of Korea

Authors: Jun Byung Joon, Seo Seok Hyun, Lee Seo Young

Abstract:

As carbon dioxide emissions increase due to rapid industrialization and reckless development, abnormal climates such as floods and droughts are occurring. In order to respond to such climate change, the use of existing fossil fuels is reduced, and the proportion of eco-friendly renewable energy is gradually increasing. Korea is an energy resource-poor country that depends on imports for 93% of its total energy. As the global energy supply chain instability experienced due to the Russia-Ukraine crisis increases, countries around the world are resetting energy policies to minimize energy dependence and strengthen security. Seawater thermal energy is a renewable energy that replaces the existing air heat energy. It uses the characteristic of having a higher specific heat than air to cool and heat main spaces of buildings to increase heat transfer efficiency and minimize power consumption to generate electricity using fossil fuels, and Carbon dioxide emissions can be minimized. In addition, the effect on the marine environment is very small by using only the temperature characteristics of seawater in a limited way. K-water carried out a demonstration project of supplying cooling and heating energy to spaces such as the central control room and presentation room in the management building by acquiring the heat source of seawater circulated through the power plant's waterway by using the characteristics of the tidal power plant. Compared to the East Sea and the South Sea, the main system was designed in consideration of the large tidal difference, small temperature difference, and low-temperature characteristics, and its performance was verified through operation during the demonstration period. In addition, facility improvements were made for major deficiencies to strengthen monitoring functions, provide user convenience, and improve facility soundness. To spread these achievements, the basic concept was to expand the seawater heating and cooling system with a scale of 200 USRT at the Tidal Culture Center. With the operational experience of the demonstration system, it will be possible to establish an optimal seawater heat cooling and heating system suitable for the characteristics of the west coast ocean. Through this, it is possible to reduce operating costs by KRW 33,31 million per year compared to air heat, and through industry-university-research joint research, it is possible to localize major equipment and materials and develop key element technologies to revitalize the seawater heat business and to advance into overseas markets. The government's efforts are needed to expand the seawater heating and cooling system. Seawater thermal energy utilizes only the thermal energy of infinite seawater. Seawater thermal energy has less impact on the environment than river water thermal energy, except for environmental pollution factors such as bottom dredging, excavation, and sand or stone extraction. Therefore, it is necessary to increase the sense of speed in project promotion by innovatively simplifying unnecessary licensing/permission procedures. In addition, support should be provided to secure business feasibility by dramatically exempting the usage fee of public waters to actively encourage development in the private sector.

Keywords: seawater thermal energy, marine energy, tidal power plant, energy consumption

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10440 Continuance Intention to Use E-administration Information Portal by Non-teaching Staff in Selected Universities, Southwest, Nigeria

Authors: Adebayo Muritala Adegbore

Abstract:

The e-administration is increasingly being recognized as an important phenomenon in this 21st century and its place in society both at the public and private levels cannot be downplayed. Of close attention is how these platforms are adopted and used in academia due to academia’s role in shaping the overall development of the society, particularly the administrative activities of the non-teaching staff in universities since much has not been done to find out the continuance intention to use e-administration information portal by non-teaching staff in universities. This study, therefore, investigates the continuance intention to use e-administration of information portals of senior non-teaching staff in selected universities in southwest Nigeria. The study’s design was a correlational survey using simple random sampling to select three hundred and fifty-two (352) senior non-teaching staff in the selected universities. A standardized questionnaire was used for data capturing while data were analyzed using the descriptive statistics of frequency counts, percentages, means, and standard deviation for the research questions and the Pearson Product Moment Correlation was used for the hypothesis. Findings revealed that the continuance intention of senior non-teaching staff to use e-administration information portal is positive (x = 3.13), the university portal is one of the most utilized e-administration tools (83.4%), while there was an inversely significant relationship between continuance intention to use and use of e-administration information portal (r = -.254; p< 0.05; N = 320).

Keywords: e-administration, e-portal, non-teaching staff, information systems, continuance intention, use of e-administration portals

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10439 Influence and Depiction of Power in an Urban Space

Authors: Kalpeshkumar Patel, Nikita Manvi

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The paper is an attempt to understand the influence and depiction of power in an urban space by throwing light across a few examples across the architectural timeline. Power has been the medium through which ideologies function, as witnessed across the timeline. The center to understand this ideology is to apprehend how power is formed, captured, owned, traded, and distorted. Every urban space has power embedded in it, either for the people who are imposing it or for the public who are receiving it. The most fundamental question in the issue of power is who – who will judge, whose tastes will matter and whose interests are being served. Power is expressed and reinforced by regular means, a boundary and gates, a parade route, a dominant landmark, play of shape or scale in elevation, ceremonial axis, boulevards and avenues, the vista, bilateral symmetry, or regular order. Even if people accept the psychological efficacy of these forms, the way they perceive them may vary depending on the subject. They are cold devices of power used to make some people submit to others. Yet it is also true that these symbolic forms are attractive because they speak to the deep emotions of people. They do indeed give us a sense of security, stability and continuity, awe and pride. The Urban Space for mass assembly is an idea that continues to seduce dictators and democracies. It is a tradition as old as an agora and as manipulative as Baroque Rome.

Keywords: urban space, aggrandization, city planning, landscape, supremacy, democratic

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10438 Reinventing Urban Governance: Sustainable Transport Solutions for Mitigating Climate Risks in Smart Cities

Authors: Jaqueline Nichi, Leila Da Costa Ferreira, Fabiana Barbi Seleguim, Gabriela Marques Di Giulio, Mariana Barbieri

Abstract:

The transport sector is responsible for approximately 55% of global greenhouse gas (GHG) emissions, in addition to pollution and other negative externalities, such as road accidents and congestion, that impact the routine of those who live in large cities. The objective of this article is to discuss the application and use of distinct mobility technologies such as climate adaptation and mitigation measures in the context of smart cities in the Global South. The documentary analysis is associated with 22 semi structured interviews with managers who work with mobility technologies in the public and private sectors and in civil society organizations to explore solutions in multilevel governance for smart and low-carbon mobility based on the case study from the city of São Paulo, Brazil. The hypothesis that innovation and technology to mitigate and adapt to climate impacts are not yet sufficient to make mobility more sustainable has been confirmed. The results indicate four relevant aspects for advancing a climate agenda in smart cities: integrated planning, coproduction of knowledge, experiments in governance, and new means of financing to guarantee the sustainable sociotechnical transition of the sector.

Keywords: urban mobility, climate change, smart cities, multilevel governance

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10437 The Role of Zakat on Sustainable Economic Development by Rumah Zakat

Authors: Selamat Muliadi

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This study aimed to explain conceptual the role of Zakat on sustainable economic development by Rumah Zakat. Rumah Zakat is a philanthropic institution that manages zakat and other social funds through community empowerment programs. In running the program, including economic empowerment and socio health services are designed for these recipients. Rumah Zakat's connection with the establisment of Sustainable Development Goals (SDGs) which is to help impoverished recipients economically and socially. It’s an important agenda that the government input into national development, even the region. The primary goal of Zakat on sustainable economic development, not only limited to economic variables but based on Islamic principles, has comprehensive characteristics. The characteristics include moral, material, spiritual, and social aspects. In other words, sustainable economic development is closely related to improving people’s living standard (Mustahiq). The findings provide empiricial evidence regarding the positive contribution and effectiveness of zakat targeting in reducing poverty and improve the welfare of people related with the management of zakat. The purpose of this study was to identify the role of Zakat on sustainable economic development, which was applied by Rumah Zakat. This study used descriptive method and qualitative analysis. The data source was secondary data collected from documents and texts related to the research topic, be it books, articles, newspapers, journals, or others. The results showed that the role of zakat on sustainable economic development by Rumah Zakat has been quite good and in accordance with the principle of Islamic economics. Rumah Zakat programs are adapted to support intended development. The contribution of the productive program implementation has been aligned with four goals in the Sustainable Development Goals, i.e., Senyum Juara (Quality Education), Senyum Lestari (Clean Water and Sanitation), Senyum Mandiri (Entrepreneur Program) and Senyum Sehat (Free Maternity Clinic). The performance of zakat in the sustainable economic empowerment community at Rumah Zakat is taking into account dimensions such as input, process, output, and outcome.

Keywords: Zakat, social welfare, sustainable economic development, charity

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10436 SWOT Analysis on the Prospects of Carob Use in Human Nutrition: Crete, Greece

Authors: Georgios A. Fragkiadakis, Antonia Psaroudaki, Theodora Mouratidou, Eirini Sfakianaki

Abstract:

Research: Within the project "Actions for the optimal utilization of the potential of carob in the Region of Crete" which is financed-supervised by the Region, with collaboration of Crete University and Hellenic Mediterranean University, a SWOT (strengths, weaknesses, opportunities, threats) survey was carried out, to evaluate the prospects of carob in human nutrition, in Crete. Results and conclusions: 1). Strengths: There exists a local production of carob for human consumption, based on international reports, and local-product reports. The data on products in the market (over 100 brands of carob food), indicates a sufficiency of carob materials offered in Crete. The variety of carob food products retailed in Crete indicates a strong demand-production-consumption trend. There is a stable number (core) of businesses that invest significantly (Creta carob, Cretan mills, etc.). The great majority of the relevant food stores (bakery, confectionary etc.) do offer carob products. The presence of carob products produced in Crete is strong on the internet (over 20 main professionally designed websites). The promotion of the carob food-products is based on their variety and on a few historical elements connected with the Cretan diet. 2). Weaknesses: The international prices for carob seed affect the sector; the seed had an international price of €20 per kg in 2021-22 and fell to €8 in 2022, causing losses to carob traders. The local producers do not sort the carobs they deliver for processing, causing 30-40% losses of the product in the industry. The occasional high price triggers the collection of degraded raw material; large losses may emerge due to the action of insects. There are many carob trees whose fruits are not collected, e.g. in Apokoronas, Chania. The nutritional and commercial value of the wild carob fruits is very low. Carob trees-production is recorded by Greek statistical services as "other cultures" in combination with prickly pear i.e., creating difficulties in retrieving data. The percentage of carob used for human nutrition, in contrast to animal feeding, is not known. The exact imports of carob are not closely monitored. We have no data on the recycling of carob by-products in Crete. 3). Opportunities: The development of a culture of respect for carob trade may improve professional relations in the sector. Monitoring carob market and connecting production with retailing-industry needs may allow better market-stability. Raw material evaluation procedures may be implemented to maintain carob value-chain. The state agricultural services may be further involved in carob-health protection. The education of farmers on carob cultivation/management, can improve the quality of the product. The selection of local productive varieties, may improve the sustainability of the culture. Connecting the consumption of carob with health-food products, may create added value in the sector. The presence and extent of wild carob threes in Crete, represents, potentially, a target for grafting. 4). Threats: The annual fluctuation of carob yield challenges the programming of local food industry activities. Carob is a forest species also - there is danger of wrong classification of crops as forest areas, where land ownership is not clear.

Keywords: human nutrition, carob food, SWOT analysis, crete, greece

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10435 A Cluster Randomised Controlled Trial Investigating the Impact of Integrating Mass Drug Administration Treating Soil Transmitted Helminths with Mass Dog Rabies Vaccination in Remote Communities in Tanzania

Authors: Felix Lankester, Alicia Davis, Safari Kinung'hi, Catherine Bunga, Shayo Alkara, Imam Mzimbiri, Jonathan Yoder, Sarah Cleaveland, Guy H. Palmer

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Achieving the London Declaration goal of a 90% reduction in neglected tropical diseases (NTDs) by 2030 requires cost-effective strategies that attain high and comprehensive coverage. The first objective of this trial was to assess the impact on cost and coverage of employing a novel integrative One Health approach linking two NTD control programs: mass drug administration (MDA) for soil-transmitted helminths in humans (STH) and mass dog rabies vaccination (MDRV). The second objective was to compare the coverage achieved by the MDA, a community-wide deworming intervention, with that of the existing national primary school-based deworming program (NSDP), with particular focus on the proportion of primary school-age children reached and their school enrolment status. Our approach was unconventional because, in line with the One Health approach to disease control, it coupled the responsibilities and resources of the Ministries responsible for human and animal health into one program with the shared aim of preventing multiple NTDs. The trial was carried out in hard-to-reach pastoral communities comprising 24 villages of the Ngorongoro District, Tanzania, randomly allocated to either Arm A (MDA and MDRV), Arm B (MDA only) or Arm C (MDRV only). Objective one: The percentage of people in each target village that received treatment through MDA in Arms A and B was 63% and 65%, respectively (χ2 = 1, p = 0.32). The percentage of dogs vaccinated in Arm A and C was 70% and 81%, respectively (χ2 =9, p = 0.003). It took 33% less time for a single person and a dog to attend the integrated delivery than two separate events. Cost per dose (including delivery) was lower under the integrated strategy, with delivery of deworming and rabies vaccination reduced by $0.13 (54%) and $0.85 (19%) per dose, respectively. Despite a slight reduction in the proportion of village dogs vaccinated in the integrated event, both the integrated and non-integrated strategies achieved the target threshold of 70% required to eliminate rabies. Objective two: The percentages of primary school age children enrolled in school that was reached by this trial (73%) and the existing NSDP (80%) were not significantly different (F = 0.9, p = 0.36). However, of the primary school age children treated in this trial, 46% were not enrolled in school. Furthermore, 86% of the people treated would have been outside the reach of the NSDP because they were not primary school age or were primary school age children not enrolled in school. The comparable reach, the substantial reductions in cost per dose delivered and the decrease in participants’ time support this integrated One Health approach to control multiple NTDs. Further, the recorded level of non-enrolment at primary school suggests that, in remote areas, school-based delivery strategies could miss a large fraction of school-age children and that programs that focus delivery solely at the level of the primary school will miss a substantial proportion of both primary school age children as well as other individuals from the community. We have shown that these populations can be effectively reached through extramural programs.

Keywords: canine mediated human rabies, integrated health interventions, mass drug administration, neglected tropical disease, One Health, soil-transmitted helminths

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10434 Blood Chemo-Profiling in Workers Exposed to Occupational Pyrethroid Pesticides to Identify Associated Diseases

Authors: O. O. Sufyani, M. E. Oraiby, S. A. Qumaiy, A. I. Alaamri, Z. M. Eisa, A. M. Hakami, M. A. Attafi, O. M. Alhassan, W. M. Elsideeg, E. M. Noureldin, Y. A. Hobani, Y. Q. Majrabi, I. A. Khardali, A. B. Maashi, A. A. Al Mane, A. H. Hakami, I. M. Alkhyat, A. A. Sahly, I. M. Attafi

Abstract:

According to the Food and Agriculture Organization (FAO) Pesticides Use Database, pesticide use in agriculture in Saudi Arabia has more than doubled from 4539 tons in 2009 to 10496 tons in 2019. Among pesticides, pyrethroids is commonly used in Saudi Arabia. Pesticides may increase susceptibility to a variety of diseases, particularly among pesticide workers, due to their extensive use, indiscriminate use, and long-term exposure. Therefore, analyzing blood chemo-profiles and evaluating the detected substances as biomarkers for pyrethroid pesticide exposure may assist to identify and predicting adverse effects of exposure, which may be used for both preventative and risk assessment purposes. The purpose of this study was to (a) analyze chemo-profiling by Gas Chromatography-Mass Spectrometry (GC-MS) analysis, (b) identify the most commonly detected chemicals in a time-exposure-dependent manner using a Venn diagram, and (c) identify their associated disease among pesticide workers using analyzer tools on the Comparative Toxicogenomics Database (CTD) website, (250 healthy male volunteers (20-60 years old) who deal with pesticides in the Jazan region of Saudi Arabia (exposure intervals: 1-2, 4-6, 6-8, more than 8 years) were included in the study. A questionnaire was used to collect demographic information, the duration of pesticide exposure, and the existence of chronic conditions. Blood samples were collected for biochemistry analysis and extracted by solid-phase extraction for gas chromatography-mass spectrometry (GC-MS) analysis. Biochemistry analysis reveals no significant changes in response to the exposure period; however, an inverse association between the albumin level and the exposure interval was observed. The blood chemo-profiling was differentially expressed in an exposure time-dependent manner. This analysis identified the common chemical set associated with each group and their associated significant occupational diseases. While some of these chemicals are associated with a variety of diseases, the distinguishing feature of these chemically associated disorders is their applicability for prevention measures. The most interesting finding was the identification of several chemicals; erucic acid, pelargonic acid, alpha-linolenic acid, dibutyl phthalate, diisobutyl phthalate, dodecanol, myristic Acid, pyrene, and 8,11,14-eicosatrienoic acid, associated with pneumoconiosis, asbestosis, asthma, silicosis and berylliosis. Chemical-disease association study also found that cancer, digestive system disease, nervous system disease, and metabolic disease were the most often recognized disease categories in the common chemical set. The hierarchical clustering approach was used to compare the expression patterns and exposure intervals of the chemicals found commonly. More study is needed to validate these chemicals as early markers of pyrethroid insecticide-related occupational disease, which might assist evaluate and reducing risk. The current study contributes valuable data and recommendations to public health.

Keywords: occupational, toxicology, chemo-profiling, pesticide, pyrethroid, GC-MS

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10433 Integration of an Innovative Complementary Approach Inspired by Clinical Hypnosis into Oncology Care: Nurses’ Perception of Comfort Talk

Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

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Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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10432 Factors Influencing Disclosure and CSR Spending in Indian Companies: An Econometric Analysis

Authors: Shekar Babu, Amalendu Jyothishi

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The New Companies Bill-2013 in India has mandated all the companies with a certain profit to spend on Corporate Social Responsibility (CSR). Despite the Corporate Governance (CG) compliances at the strategic level the firms have to engage in social good. For both the Central Public Sector Enterprises (CPSE) and the private companies in India the need for strategic CSR focus through operational efficiency measures are mandated. In this paper the focus is to find out if the Indian companies understand their responsibility towards the society despite government making CSR mandatory. Analyzing both the CPSEs and Private companies the researchers find out which set of companies behave responsibly towards the society. Does any particular industry group(s) impact the society by disclosing their CSR spending activities. The key financial and non-financial parameters that influence CSR spending were identified and through econometric analysis methodologies (logistic regression and OLS models) the results were analyzed. The innovative methods were developed to identify if the firms operate efficiently and at the same time complying with the new CSR laws. An innovative matrix was developed to explain how companies could operate efficiently and be compliant in parallel how some of the companies can strategically realign their spending by operating efficiently.

Keywords: corporate social responsibility(CSR), corporate governance(CG), India, logit function, ordinary least squares (OLS)

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10431 The Right of Taiwanese Individuals with Mental Illnesses to Participate in Medical Decision-Making

Authors: Ying-Lun Tseng Chiu-Ying Chen

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Taiwan's Mental Health Act was amended at the end of 2022; they added regulations regarding refusing compulsory treatment by patients with mental illnesses. In addition, not only by an examination committee, the judge must also assess the patient's need for compulsory treatment. Additionally, the maximum of compulsory hospitalization has been reduced from an unlimited period to a maximum of 60 days. They aim to promote the healthcare autonomy of individuals with mental illnesses in Taiwan and prevent their silenced voice in medical decision-making while they still possess rationality. Furthermore, they plan to use community support and social care networks to replace the current practice of compulsory treatment in Taiwan. This study uses qualitative research methodology, utilizing interview guidelines to inquire about the experiences of Taiwanese who have undergone compulsory hospitalization, compulsory community treatment, and compulsory medical care. The interviews aimed to explore their feelings when they were subjected to compulsory medical intervention, the inside of their illness, their opinions after treatments, and whether alternative medical interventions proposed by them were considered. Additionally, participants also asked about their personal life history and their support networks in their lives. We collected 12 Taiwanese who had experienced compulsory medical interventions and were interviewed 14 times. The findings indicated that participants still possessed rationality during the onset of their illness. However, when they have other treatments to replace compulsory medical, they sometimes diverge from those of the doctors and their families. Finally, doctors prefer their professional judgment and patients' families' option. Therefore, Taiwanese mental health patients' power of decision-making still needs to improve. Because this research uses qualitative research, so difficult to find participants, and the sample size rate was smaller than Taiwan's population, it may have biases in the analysis. So, Taiwan still has significant progress in enhancing the decision-making rights of participants in the study.

Keywords: medical decision making, compulsory treatment, medical ethics, mental health act

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10430 Risk Assessment of Lead Element in Red Peppers Collected from Marketplaces in Antalya, Southern Turkey

Authors: Serpil Kilic, Ihsan Burak Cam, Murat Kilic, Timur Tongur

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Interest in the lead (Pb) has considerably increased due to knowledge about the potential toxic effects of this element, recently. Exposure to heavy metals above the acceptable limit affects human health. Indeed, Pb is accumulated through food chains up to toxic concentrations; therefore, it can pose an adverse potential threat to human health. A sensitive and reliable method for determination of Pb element in red pepper were improved in the present study. Samples (33 red pepper products having different brands) were purchased from different markets in Turkey. The selected method validation criteria (linearity, Limit of Detection, Limit of Quantification, recovery, and trueness) demonstrated. Recovery values close to 100% showed adequate precision and accuracy for analysis. According to the results of red pepper analysis, all of the tested lead element in the samples was determined at various concentrations. A Perkin- Elmer ELAN DRC-e model ICP-MS system was used for detection of Pb. Organic red pepper was used to obtain a matrix for all method validation studies. The certified reference material, Fapas chili powder, was digested and analyzed, together with the different sample batches. Three replicates from each sample were digested and analyzed. The results of the exposure levels of the elements were discussed considering the scientific opinions of the European Food Safety Authority (EFSA), which is the European Union’s (EU) risk assessment source associated with food safety. The Target Hazard Quotient (THQ) was described by the United States Environmental Protection Agency (USEPA) for the calculation of potential health risks associated with long-term exposure to chemical pollutants. THQ value contains intake of elements, exposure frequency and duration, body weight and the oral reference dose (RfD). If the THQ value is lower than one, it means that the exposed population is assumed to be safe and 1 < THQ < 5 means that the exposed population is in a level of concern interval. In this study, the THQ of Pb was obtained as < 1. The results of THQ calculations showed that the values were below one for all the tested, meaning the samples did not pose a health risk to the local population. This work was supported by The Scientific Research Projects Coordination Unit of Akdeniz University. Project Number: FBA-2017-2494.

Keywords: lead analyses, red pepper, risk assessment, daily exposure

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10429 Climate Change Effects on Western Coastal Groundwater in Yemen (1981-2020)

Authors: Afrah S. M. Al-Mahfadi

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Climate change is a global issue that has significant impacts on water resources, resulting in environmental, economic, and political consequences. Groundwater reserves, particularly in coastal areas, are facing depletion, leading to serious problems in regions such as Yemen. This study focuses on the western coastal region of Yemen, which already faces risks such as water crises, food insecurity, and widespread poverty. Climate change exacerbates these risks by causing high temperatures, sea level rise, inadequate sea level rise, and inadequate environmental policies. Research Aim: The aim of this research is to provide a comprehensive overview of the impact of climate change on the western coastal region of Yemen. Specifically, the study aims to analyze the relationship between climate change and the loss of fresh groundwater resources in this area. Methodology: The research utilizes a combination of a literature review and three case studies conducted through site visits. Arch-GIS mapping is employed to analyze and visualize the relationship between climate change and the depletion of fresh groundwater resources. Additionally, data on precipitation from 1981 to 2020 and scenarios of projected sea level rise (SLR) are considered. Findings: The study reveals several future issues resulting from climate change. It is projected that the annual temperature will increase while the rainfall rate will decrease. Furthermore, the sea level is expected to rise by approximately 0.30 to 0.72 meters by 2100. These factors contribute to the loss of wetlands, the retreat of shorelines and estuaries, and the intrusion of seawater into the coastal aquifer, rendering drinking water from wells increasingly saline. Data Collection and Analysis Procedures: Data for this research are collected through a literature review, including studies on climate change impacts in coastal areas and the hydrogeology of the study region. Furthermore, three case studies are conducted through site visits. Arch-GIS mapping techniques are utilized to analyze the relationship between climate change and the loss of fresh groundwater resources. Historical precipitation data from 1981 to 2020 and scenarios of projected sea level rise are also analyzed. Questions Addressed: (1) What is the impact of climate change on the western coastal region of Yemen? (2) How does climate change affect the availability of fresh groundwater resources in this area? Conclusion: The study concludes that the western coastal region of Yemen is facing significant challenges due to climate change. The projected increase in temperature, decrease in rainfall, and rise in sea levels have severe implications, such as the loss of wetlands, shorelines, and estuaries. Additionally, the intrusion of seawater into the coastal aquifer further exacerbates the issue of saline drinking water. Urgent measures are needed to address climate change, including improving water management, implementing integrated coastal zone planning, raising awareness among stakeholders, and implementing emergency projects to mitigate the impacts. Recommendations: To mitigate the adverse effects of climate change, several recommendations are provided. These include improving water management practices, developing integrated coastal zone planning strategies, raising awareness among all stakeholders, improving health and education, and implementing emergency projects to combat climate change. These measures aim to enhance adaptive capacity and resilience in the face of future climate change impacts.

Keywords: climate change, groundwater, coastal wetlands, Yemen

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10428 Access to Higher Education in Nigeria: The University of Calabar Pre-Degree Programme Experience

Authors: Eni I. Eni, James Okon, Ashang J. Ashang

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The pre-degree programme of the University of Calabar was introduced to help increase access to tertiary Education in science related courses. This has become necessary due to population increase and public awareness. Its main objective was to provide access to candidates from educationally less developed states (ELDS) and states within its catchment area. To find out if this objective of the programme has been achieved, an impact evaluation of the programme was conducted, from where the aspect of providing access to University Education was reported here. It was reasoned that if this objective of the programme was properly implemented, there should be an evidence of increase in the access to University Education. To achieve the purpose of this study, two research questions were formulated; expost-facto research design and purposive sampling technique were adopted for the study. Data was collected from the Faculty of Science and analyzed using descriptive statistics in terms of frequencies and percentages. The result of data analysis showed that the pre-degree programme of the University of Calabar has provided educational access to Nigerians especially those from educationally less developed states in science related courses. It was therefore recommended that the programme be sustained and further be improved upon to facilitate its continued provision of access to University Education in Nigeria.

Keywords: higher education, pre-degree programme, University of Calabar, educationally less developed states

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10427 The Future of the Architect's Profession in France with the Emergence of Building Information Modelling

Authors: L. Mercier, D. Beladjine, K. Beddiar

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The digital transition of building in France brings many changes which some have been able to face very quickly, while others are struggling to find their place and the interest that BIM can bring in their profession. BIM today is already adopted or initiated by construction professionals. However, this change, which can be drastic for some, prevents them from integrating it definitively. This is the case with architects. The profession is shared on the practice of BIM in its exercise. The risk of not adopting this new working method now and of not wanting to switch to its new digital tools leads us to question the future of the profession in view of the gap that is likely to be created within project management. In order to deal with the subject efficiently, our work was based on a documentary watch on BIM and then on the profession of architect, which allowed us to establish links on these two subjects. The observation of the economic model towards which the agencies tend and the trend of the sought after profiles made it possible to develop the opportunities and the brakes likely to impact the future of the profession of architect. The centralization of research directs work towards the conclusion that the model implemented by companies does not allow to integrate BIM within their structure. A solution hypothesis was then issued, focusing on the development of agencies through the diversity of profiles, skills to be integrated internally with the aim of diversifying their skills, and their business practices. In order to address this hypothesis of a multidisciplinary agency model, we conducted a survey of architectural firms. It is built on the model of Anglo-Saxon countries, which do not have the same functioning in comparison to the French model. The results obtained showed a risk of gradual disappearance on the market from small agencies in favor of those who will have and could take this BIM working method. This is why the architectural profession must, first of all, look at what is happening within its training before absolutely wanting to diversify the profiles to integrate into its structure. This directs the study on the training of architects. The schools of French architects are generally behind schedule if we allow the comparison to the schools of engineers. The latter is currently experiencing a slight improvement with the emergence of masters and BIM options during the university course. If the training of architects develops towards learning BIM and the agencies have the desire to integrate different but complementary profiles, then they will develop their skills internally and therefore open their profession to new functions. The place of BIM Management on projects will allow the architect to remain in control of the project because of their overall vision of the project. In addition, the integration of BIM and more generally of the life cycle analysis of the structure will make it possible to guarantee eco-design or eco-construction by approaching the constraints of sustainable development omnipresent on the planet.

Keywords: building information modelling, BIM, BIM management, BIM manager, BIM architect

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10426 Proactive SoC Balancing of Li-ion Batteries for Automotive Application

Authors: Ali Mashayekh, Mahdiye Khorasani, Thomas weyh

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The demand for battery electric vehicles (BEV) is steadily increasing, and it can be assumed that electric mobility will dominate the market for individual transportation in the future. Regarding BEVs, the focus of state-of-the-art research and development is on vehicle batteries since their properties primarily determine vehicles' characteristic parameters, such as price, driving range, charging time, and lifetime. State-of-the-art battery packs consist of invariable configurations of battery cells, connected in series and parallel. A promising alternative is battery systems based on multilevel inverters, which can alter the configuration of the battery cells during operation via semiconductor switches. The main benefit of such topologies is that a three-phase AC voltage can be directly generated from the battery pack, and no separate power inverters are required. Therefore, modular battery systems based on different multilevel inverter topologies and reconfigurable battery systems are currently under investigation. Another advantage of the multilevel concept is that the possibility to reconfigure the battery pack allows battery cells with different states of charge (SoC) to be connected in parallel, and thus low-loss balancing can take place between such cells. In contrast, in conventional battery systems, parallel connected (hard-wired) battery cells are discharged via bleeder resistors to keep the individual SoCs of the parallel battery strands balanced, ultimately reducing the vehicle range. Different multilevel inverter topologies and reconfigurable batteries have been described in the available literature that makes the before-mentioned advantages possible. However, what has not yet been described is how an intelligent operating algorithm needs to look like to keep the SoCs of the individual battery strands of a modular battery system with integrated power electronics balanced. Therefore, this paper suggests an SoC balancing approach for Battery Modular Multilevel Management (BM3) converter systems, which can be similarly used for reconfigurable battery systems or other multilevel inverter topologies with parallel connectivity. The here suggested approach attempts to simultaneously utilize all converter modules (bypassing individual modules should be avoided) because the parallel connection of adjacent modules reduces the phase-strand's battery impedance. Furthermore, the presented approach tries to reduce the number of switching events when changing the switching state combination. Thereby, the ohmic battery losses and switching losses are kept as low as possible. Since no power is dissipated in any designated bleeder resistors and no designated active balancing circuitry is required, the suggested approach can be categorized as a proactive balancing approach. To verify the algorithm's validity, simulations are used.

Keywords: battery management system, BEV, battery modular multilevel management (BM3), SoC balancing

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10425 The Motivating and Limiting Factors of Learners’ Engagement in an Online Discussion Forum

Authors: K. Durairaj, I. N. Umar

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Lately, asynchronous discussion forum is integrated in higher educational institutions as it may increase learning process, learners’ understanding, achievement and knowledge construction. Asynchronous discussion forum is used to complement the traditional, face-to-face learning session in hybrid learning courses. However, studies have proven that students’ engagement in online forum are still unconvincing. Thus, the aim of this study is to investigate the motivating factors and obstacles that affect the learners’ engagement in asynchronous discussion forum. This study is carried out in one of the public higher educational institutions in Malaysia with 18 postgraduate students as samples. The authors have developed a 40-items questionnaire based on literature review. The results indicate several factors that have encouraged or limited students’ engagement in asynchronous discussion forum: (a) the practices or behaviors of peers, or instructors, (b) the needs for the discussions, (c) the learners’ personalities, (d) constraints in continuing the discussion forum, (e) lack of ideas, (f) the level of thoughts, (g) the level of knowledge construction, (h) technical problems, (i) time constraints and (j) misunderstanding. This study suggests some recommendations to increase the students’ engagement in online forums. Finally, based upon the findings, some implications are proposed for further research.

Keywords: asynchronous discussion forum, engagement, factors, motivating, limiting

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10424 The Trend of Epidemics in Population and Body Regulation in Iran (1850-1920)

Authors: Seyedfateh Moradi

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Medical issues mark the beginning of a new form of epistemology in nineteenth-century Iran. The emergence of epidemic diseases led to the formation of a medical discourse and conflict over the body which displayed itself in the concept of health progress and development. The discourse attributed to this development in the health system defines the general structure of the given period. This discourse manifested itself in the conflict between the traditional and new medicine. The regulation and classification of body and population reveal the nature of this period. The government attempted to adapt itself to the modern and progressive discourse. This paper seeks to reveal part of this rupture and adaptation around epidemics and modern medical discourse. Also, accepting part of the traditional discourse in the new era, or adapting and integrating parts of it indicate a delegation of part of the power of traditional authorities. The delegation of power arose in the context of the discursive hegemony of Western modernism from which there was no escape. This provided the ground for the acceptance of government and emergence of other discourses. Finally, during the reign of Reza Shah (1922-1942), body and population planning changed into the key issues of government, which created serious tensions in society.

Keywords: epidemic, population, body, cholera, plague

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10423 Imaging Spectrum of Central Nervous System Tuberculosis on Magnetic Resonance Imaging: Correlation with Clinical and Microbiological Results

Authors: Vasundhara Arora, Anupam Jhobta, Suresh Thakur, Sanjiv Sharma

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Aims and Objectives: Intracranial tuberculosis (TB) is one of the most devastating manifestations of TB and a challenging public health issue of considerable importance and magnitude world over. This study elaborates on the imaging spectrum of neurotuberculosis on magnetic resonance imaging (MRI) in 29 clinically suspected cases from a tertiary care hospital. Materials and Methods: The prospective hospital based evaluation of MR imaging features of neuro-tuberculosis in 29 clinically suspected cases was carried out in Department of Radio-diagnosis, Indira Gandhi Medical Hospital from July 2017 to August 2018. MR Images were obtained on a 1.5 T Magnetom Avanto machine and were analyzed to identify any abnormal meningeal enhancement or parenchymal lesions. Microbiological and Biochemical CSF analysis was performed in radio-logically suspected cases and the results were compared with the imaging data. Clinical follow up of the patients started on anti-tuberculous treatment was done to evaluate the response to treatment and clinical outcome. Results: Age range of patients in the study was between 1 year to 73 years. The mean age of presentation was 11.5 years. No significant difference in the distribution of cerebral tuberculosis was noted among the two genders. Imaging findings of neuro-tuberculosis obtained were varied and non specific ranging from lepto-meningeal enhancement, cerebritis to space occupying lesions such as tuberculomas and tubercular abscesses. Complications presenting as hydrocephalus (n= 7) and infarcts (n=9) was noted in few of these patients. 29 patients showed radiological suspicion of CNS tuberculosis with meningitis alone observed in 11 cases, tuberculomas alone were observed in 4 cases, meningitis with parenchymal tuberculomas in 11 cases. Tubercular abscess and cerebritis were observed in one case each. Tuberculous arachnoiditis was noted in one patient. Gene expert positivity was obtained in 11 out of 29 radiologically suspected patients; none of the patients showed culture positivity. Meningeal form of the disease alone showed higher positivity rate of gene Xpert (n=5) followed by combination of meningeal and parenchymal forms of disease (n=4). The parenchymal manifestation of disease alone showed least positivity rates (n= 3) with gene xpert testing. All 29 patients were started on anti tubercular treatment based on radiological suspicion of the disease with clinical improvement observed in 27 treated patients. Conclusions: In our study, higher incidence of neuro- tuberculosis was noted in paediatric population with predominance of the meningeal form of the disease. Gene Xpert positivity obtained was low due to paucibacillary nature of cerebrospinal fluid (CSF) with even lower positivity of CSF samples in parenchymal form of the manifestation. MRI showed high accuracy in detecting CNS lesions in neuro-tuberculosis. Hence, it can be concluded that MRI plays a crucial role in the diagnosis because of its inherent sensitivity and specificity and is an indispensible imaging modality. It caters to the need of early diagnosis owing to poor sensitivity of microbiological tests more so in the parenchymal manifestation of the disease.

Keywords: neurotuberculosis, tubercular abscess, tuberculoma, tuberculous meningitis

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10422 Neural Network Analysis Applied to Risk Prediction of Early Neonatal Death

Authors: Amanda R. R. Oliveira, Caio F. F. C. Cunha, Juan C. L. Junior, Amorim H. P. Junior

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Children deaths are traumatic events that most often can be prevented. The technology of prevention and intervention in cases of infant deaths is available at low cost and with solid evidence and favorable results, however, with low access cover. Weight is one of the main factors related to death in the neonatal period, so the newborns of low birth weight are a population at high risk of death in the neonatal period, especially early neonatal period. This paper describes the development of a model based in neural network analysis to predict the mortality risk rating in the early neonatal period for newborns of low birth weight to identify the individuals of this population with increased risk of death. The neural network applied was trained with a set of newborns data obtained from Brazilian health system. The resulting network presented great success rate in identifying newborns with high chances of death, which demonstrates the potential for using this tool in an integrated manner to the health system, in order to direct specific actions for improving prognosis of newborns.

Keywords: low birth weight, neonatal death risk, neural network, newborn

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10421 Examination of Indoor Air Quality of Naturally Ventilated Dwellings During Winters in Mega-City Kolkata

Authors: Tanya Kaur Bedi, Shankha Pratim Bhattacharya

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The US Environmental Protection Agency defines indoor air quality as “The air quality within and around buildings, especially as it relates to the health and comfort of building occupants”. According to the 2021 report by the Energy Policy Institute at Chicago, Indian residents, a country which is home to the highest levels of air pollution in the world, lose about 5.9 years from life expectancy due to poor air quality and yet has numerous dwellings dependent on natural ventilation. Currently the urban population spends 90% of the time indoors, this scenario raises a concern for occupant health and well-being. The built environment can affect health directly and indirectly through immediate or long-term exposure to indoor air pollutants. Health effects associated with indoor air pollutants include eye/nose/throat irritation, respiratory diseases, heart disease, and even cancer. This study attempts to demonstrate the causal relationship between the indoor air quality and its determining aspects. Detailed indoor air quality audits were conducted in residential buildings located in Kolkata, India in the months of December and January 2021. According to the air pollution knowledge assessment city program in India, Kolkata is also the second most polluted mega-city after Delhi. Although the air pollution levels are alarming year-long, the winter months are most crucial due to the unfavorable environmental conditions. While emissions remain typically constant throughout the year, cold air is denser and moves slower than warm air, trapping the pollution in place for much longer and consequently is breathed in at a higher rate than the summers. The air pollution monitoring period was selected considering environmental factors and major pollution contributors like traffic and road dust. This study focuses on the relationship between the built environment and the spatial-temporal distribution of air pollutants in and around it. The measured parameters include, temperature, relative humidity, air velocity, particulate matter, volatile organic compounds, formaldehyde, and benzene. A total of 56 rooms were audited, selectively targeting the most dominant middle-income group. The data-collection was conducted using a set of instruments positioned in the human breathing-zone. The study assesses indoor air quality based on factors determining natural ventilation and air pollution dispersion such as surrounding environment, dominant wind, openable window to floor area ratio, windward or leeward side openings, and natural ventilation type in the room: single side or cross-ventilation, floor height, residents cleaning habits, etc.

Keywords: indoor air quality, occupant health, urban housing, air pollution, natural ventilation, architecture, urban issues

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10420 The Need for a Tool to Support Users of E-Science Infrastructures in a Virtual Laboratory Environment

Authors: Hashim Chunpir

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Support processes play an important role to facilitate researchers (users) to accomplish their research activities with the help of cyber-infrastructure(s). However, the current user-support process in cyber-infrastructure needs a feasible tool to support users. This tool must enable the users of a cyber-infrastructure to communicate efficiently with the staffs of a cyber-infrastructure in order to get technical and scientific assistance, whilst saving resources at the same time. This research paper narrates the real story of employing various forms of tools to support the user and staff communication. In addition, this paper projects the lessons learned from an exploration of the help-desk tools in the current state of user support process in Earth System Grid Federation (ESGF) from support staffs’ perspective. ESGF is a climate cyber-infrastructure that facilitates Earth System Modeling (ESM) and is taken as a case study in this paper. Finally, this study proposes a need for a tool, a framework or a platform that not only improves the user support process to address support servicing needs of end-users of e-Science infrastructures but also eases the life of staffs in providing assistance to the users. With the help of such a tool; the collaboration between users and the staffs of cyber-infrastructures is made easier. Consequently, the research activities of the users of e-Science infrastructure will thrive as the scientific and technical support will be available to users. Finally, this results into painless and productive e-Research.

Keywords: e-Science User Services, e-Research in Earth Sciences, Information Technology Services Management (ITSM), user support process, service desk, management of support activities, help desk tools, application of social media

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10419 Application of Analytic Hierarchy Process Model to Weight and Prioritize Challenges and Barriers to Strategic Approach

Authors: Mohammad Mehdi Mohebi, Nima Kazempour, Mohammad Naeim Kazempour

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Strategic thinking enables managers to find out what factors are effective in achieving the desired goals and how these factors create value for the customer. Strategic thinking can be interpreted as a form of mental and inner strength in the manager, who by utilizing it, while considering the conditions of the environment and unstable global environment changes, takes decisions, and plans actions, and designs the strategy of his organization in today's changing and unsustainable business environment. Strategic thinking is very important in today’s business world, because without this thinking, the organization's efforts to achieve developed strategies will not be effective. In this study, through a detailed study of the challenges and barriers to strategic thinking that is carried out by various scholars and experts theoretically and experimentally, 7 major factors were identified. Then, based on these main factors of challenges and related elements, a tool in the form of a questionnaire was developed in order to determine their importance and priority from the perspective of strategic management experts. Using statistical tests the reliability and validity of this instrument, including its structural validity, has been examined and approved using factor analysis. These factors are weighted and prioritized using AHP techniques and the opinions of scholars and experts. Prioritization of barriers to strategic thinking include: lack of participatory management, lack of a systematic approach, difficulty in aligning the organization members, lack of incentive organizational culture, behavioural and internal barriers of managers, lack of key managers and lack of access to timely and accurate information.

Keywords: strategic thinking, challenges and barriers to strategic thinking, EN bank, AHP method

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10418 Attention Based Fully Convolutional Neural Network for Simultaneous Detection and Segmentation of Optic Disc in Retinal Fundus Images

Authors: Sandip Sadhukhan, Arpita Sarkar, Debprasad Sinha, Goutam Kumar Ghorai, Gautam Sarkar, Ashis K. Dhara

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Accurate segmentation of the optic disc is very important for computer-aided diagnosis of several ocular diseases such as glaucoma, diabetic retinopathy, and hypertensive retinopathy. The paper presents an accurate and fast optic disc detection and segmentation method using an attention based fully convolutional network. The network is trained from scratch using the fundus images of extended MESSIDOR database and the trained model is used for segmentation of optic disc. The false positives are removed based on morphological operation and shape features. The result is evaluated using three-fold cross-validation on six public fundus image databases such as DIARETDB0, DIARETDB1, DRIVE, AV-INSPIRE, CHASE DB1 and MESSIDOR. The attention based fully convolutional network is robust and effective for detection and segmentation of optic disc in the images affected by diabetic retinopathy and it outperforms existing techniques.

Keywords: attention-based fully convolutional network, optic disc detection and segmentation, retinal fundus image, screening of ocular diseases

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10417 Assessing the Survival Time of Hospitalized Patients in Eastern Ethiopia During 2019–2020 Using the Bayesian Approach: A Retrospective Cohort Study

Authors: Chalachew Gashu, Yoseph Kassa, Habtamu Geremew, Mengestie Mulugeta

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Background and Aims: Severe acute malnutrition remains a significant health challenge, particularly in low‐ and middle‐income countries. The aim of this study was to determine the survival time of under‐five children with severe acute malnutrition. Methods: A retrospective cohort study was conducted at a hospital, focusing on under‐five children with severe acute malnutrition. The study included 322 inpatients admitted to the Chiro hospital in Chiro, Ethiopia, between September 2019 and August 2020, whose data was obtained from medical records. Survival functions were analyzed using Kaplan‒Meier plots and log‐rank tests. The survival time of severe acute malnutrition was further analyzed using the Cox proportional hazards model and Bayesian parametric survival models, employing integrated nested Laplace approximation methods. Results: Among the 322 patients, 118 (36.6%) died as a result of severe acute malnutrition. The estimated median survival time for inpatients was found to be 2 weeks. Model selection criteria favored the Bayesian Weibull accelerated failure time model, which demonstrated that age, body temperature, pulse rate, nasogastric (NG) tube usage, hypoglycemia, anemia, diarrhea, dehydration, malaria, and pneumonia significantly influenced the survival time of severe acute malnutrition. Conclusions: This study revealed that children below 24 months, those with altered body temperature and pulse rate, NG tube usage, hypoglycemia, and comorbidities such as anemia, diarrhea, dehydration, malaria, and pneumonia had a shorter survival time when affected by severe acute malnutrition under the age of five. To reduce the death rate of children under 5 years of age, it is necessary to design community management for acute malnutrition to ensure early detection and improve access to and coverage for children who are malnourished.

Keywords: Bayesian analysis, severe acute malnutrition, survival data analysis, survival time

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10416 Sustainability through Resilience: How Emergency Responders Cope with Stressors

Authors: Sophie Kroeling, Agnetha Schuchardt

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Striving for sustainability brings a lot of challenges for different fields of interest, e. g. security or health concerns. In Germany, civil protection is predominantly carried out by emergency responders who perform essential tasks of civil protection. Based on theoretical concepts of different psychological stress theories this contribution focuses on the question, how the resilience of emergency responders can be improved. The goal is to identify resources and successful coping strategies that help to prevent and reduce negative outcomes during or after stressful events. The paper will present results from a qualitative analysis of semi-structured qualitative interviews with 20 emergency responders. These results provide insights into the complexity of coping processes (e. g. controlling the situation, downplaying perceived personal threats through humor) and show the diversity of stressors (like complexity of the disastrous situation, intrusive press and media, or lack of social support within the organization). Self-efficacy expectation was a very important resource for coping with stressful situations. The results served as a starting point for a quantitative survey (that was conducted in March 2017), the development of education and training tools for emergency responders and the improvement of critical incident stress management processes. First results from the quantitative study with more than 700 participants show that, e. g., the emergency responders use social coping within their private social network and also within their aid organization and that both are correlated to resilience. Moreover, missing information, bureaucratic problems and social conflicts within the organization are events that the majority of the participants considered very onerous. Further results from regression analysis will be presented. The proposed paper will combine findings from the qualitative study with the quantitative results, illustrating figures and correlations with respective statements from the interviews. At the end, suggestions for the improvement of the emergency responder’s resilience are given and it is discussed how this can make a contribution to strive for civil security and furthermore a sustainable development.

Keywords: civil security, emergency responders, stress, resilience, resources

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10415 Coexistence and Conservation of Sympatric Large Carnivores in Gir Protected Area, Gujarat, Western India

Authors: Nazneen Zehra

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Gir Protected Area (PA) is home to two sympatric large carnivores, the Asiatic lion and the common leopard, which share the same habitat. Understanding their interactions and coexistence is crucial for effective conservation management. From 2009 to 2012, we studied the availability and consumption of prey by these two carnivores to understand the dynamics of their interactions and coexistence. Ungulates provided approximately 3634.45 kg/km² of prey biomass, primarily composed of chital (ca. 2711.25 kg/km²), sambar (ca. 411.78 kg/km²), and nilgai (ca. 511.52 kg/km²). Other prey included peafowl (75.76 kg/km²) and langur (ca. 158.72 kg/km²). Both carnivores prioritized chital as their key prey species. The diet of Asiatic lions was predominantly composed of ungulates, with biomass contributions of chital (301.14 kg), sambar (378.75 kg), and nilgai (291.42 kg). Other prey species, such as peafowl and langur, contributed 1.36 kg and 2.40 kg, respectively, to the lions' diet. For leopards, the diet also heavily relied on chital (311.49 kg), followed by sambar (44.03 kg) and nilgai (172.78 kg). The biomass of other prey species in the leopards' diet included peafowl (2.08 kg) and langur (36.07 kg). Both species were found to primarily utilize teak-mixed forest, followed by riverine forest and teak-acacia-zizyphus habitats. The similarities in diet composition and habitat use indicate competition between these sympatric species. This competition may require one predator species to bear certain costs for the benefit of the other, which can influence conservation and management strategies. Effective conservation strategies are necessary to ensure the long-term survival of both the Asiatic lion and the common leopard equally and to maintain ecological balance in Gir PA.

Keywords: large carnivores, Gir PA, coexistence, resource utilization

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