Search results for: residents' satisfaction

Authors: Susan Evans, Janna Gordon-Elliott, Katarzyna Wyka, Virginia Mutch

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During the rise of the COVID-19 pandemic, healthcare workers needed an intervention that could address their profound acute stress. Mindfulness-based stress reduction (MBSR) is a program that has long established effectiveness for mental and physical health outcomes. In recent years, MBSR has been modified such that the duration of both class time and number of sessions has been abbreviated, and its delivery has been adapted for online dissemination, thus increasing the likelihood that individuals who could most benefit from the program would do so. We sought to investigate whether a brief, online version of MBSR could be feasible and acceptable for health care workers (HCW) in acute stress in response to the COVID-19 pandemic. Participants were recruited via an email sent to all hospital employees, which spans residents, physicians, nurses, housekeeping, lab technicians, administrators, and others. Participating HCW were asked about their previous experience with mindfulness and asked to commit to a minimum of 3 sessions. They were then provided with four weekly 1-hour sessions online that included the major mindfulness exercises taught during traditional MBSR programs (i.e., body scan, sitting meditation, mindful eating, and yoga). Participants were provided with supporting slides, videos, demonstrations and asked to track their practice. Hospital staff enrolled in the program; by the end of the first day of recruitment, 40 had applied; by the start date, about 100 were enrolled, and n attended a minimum of 3 sessions, supporting feasibility. Hospital staff also participated and practiced the mindfulness exercises (n=42), thus supporting acceptability. Participants reported that the program was logical, successful, and worth recommending both before starting the program and after completing it (M= 22.02 and M=21.76, respectively, possible range 0-27). There was a slight decline in the belief in improvement in health and well-being due to the program (ES=.37, p=.021). Secondary hypotheses regarding participants’ self-reported stress and levels of mindfulness were also supported, such that participants reported improvements in perceived stress (ES=.45, p=.006), compassion satisfaction, burnout, and secondary traumatic stress (ES=.41, ES=.31, ES=.35, respectively, p<.05). Participants reported significant improvements in the describing facet of mindfulness (ES=.49, p=.004), while all other facets (observing, acting with awareness, nonjudging of inner experience, nonreactivity to inner experience) remained unchanged pre- to post-program. Results from this study suggest that an abridged, online version of MBSR is feasible and accessible to health care workers in acute stress and provides benefits expected from traditional MBSR programs. The lack of a randomized control group limits generalizability. We intend to provide a structure, framework, and lessons learned to hospital administrators and clinical staff seeking to support their employees in acute stress.

Keywords: acute stress, health care workers, mindfulness, online interventions

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Authors: Dorcas Matowe

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Inequality in health care for racial and ethnic minorities continues to be a growing concern for many Americans. Some of the barriers hindering the elimination of health disparities include lack of insurance, socioeconomic status (SES), and racism. This study will specifically focus on the association between some of these factors- health care access, which includes insurance coverage and frequency of doctor visits, race, ethnicity, and health status. The purpose of this study will be to address the following questions: is having health insurance associated with increased doctor visits? Are racial and ethnic minorities with health insurance more or less likely to see a doctor? Is the association between having health insurance moderated by being an ethnic minority? Given the current implications of the 2010 Affordable Care Act, this study will highlight the need to prioritize health care access for minorities and confront institutional racism. Critical Race Theory (CRT) will demonstrate how racism has reinforced these health disparities. This quantitative study design will analyze secondary data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, a telephone survey conducted annually in all 50 states and three US territories by state health departments in conjunction with the Center for Disease Control (CDC). Non-identifying health-related data is gathered annually from over 400,000 adults 18 years and above about their health status and use of preventative services. Through Structural Equation Modeling (SEM), the relationship between the predictor variables of health care access, race, and ethnicity, the criterion variable of health status, and the latent variables of emotional support and life satisfaction will be examined. It is hypothesized that there will be an interaction between certain racial and ethnic minorities who went to see a doctor, had insurance coverage, experienced racism, and the quality of their health status, emotional support, and life satisfaction.

Keywords: ethnic minorities, health disparities, health access, racism

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Authors: Glauberto S. Quirino, Emanuelly V. Pereira, Amana S. Figueiredo, Antonia T. F. Santos, Paulo R. A. Firmino, Denise F. F. Barbosa, Caroline B. Q. Aquino, Eveliny S. Martins, Cinthia G. P. Calou, Ana K. B. Pinheiro

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Introduction: During pregnancy there are adjustments in the physical, emotional, existential and sexual areas, which may contribute to changes in sexual behavior. The objective was to analyze the sexual behavior of pregnant women. Methods: Quantitative, exploratory-descriptive study, approved by the Ethics and Research Committee of the Regional University of Cariri. For data collection, it was used the Sexuality Questionnaire in Gestation and Sexual Quotient - Female Version. It was carried out in public institutions in the urban and rural areas of three municipalities of the Metropolitan Region of Cariri, south of Ceará, Brazil from February to September 2016. The sampling was proportional stratified by convenience. A total of 815 pregnant women who were literate and aged 20 years or over were broached. 461 pregnant women were excluded because of high risk, adolescence, saturation of the extract, incomplete filling of the instrument, mental and physical handicap, without sexual partner, and the sample was 354 pregnant. The data were grouped, organized and analyzed in the statistical program R Studio (version 386 3.2.4). Descriptive frequency statistics and non-parametric tests were used to analyze the variables, and the results were shown in graphs and tables. Results: The women presented a minimum age of 20, maximum 35 and average of 26.9 years, predominantly urban area residents, with a monthly income of up to one minimum wage (US$ 275,00), high school, catholic, with fixed partner, heterosexuals, multiparous, multiple sexual partners throughout life and with the beginning of sexual life in adolescence (median age 17 years). There was a reduction in sexual practices (67%) and when they were performed, they were more frequent in the first trimester (79.7%) and less frequent in the third trimester (30.5%). Preliminary sexual practices did not change and were more frequent in the second trimester (46.6%). Throughout the gestational trimesters, the partner was referred as the main responsible for the sexual initiative. The women performed vaginal sex (97.7%) and provided greater pleasure (42.8%) compared to non-penetrative sex (53.9%) (oral sex and masturbation). There was also a reduction in the sexual disposition of pregnant women (90.7%) and partner (72.9%), mainly in the first trimester (78.8%), and sexual positions. Sexual performance ranged from regular to good (49.7%). Level of schooling, marital status, sexual orientation of the pregnant woman and the partner, sexual practices and positions, preliminaries, frequency of sexual practices and importance attributed to them were variables that influenced negatively sexual performance and satisfaction. It is concluded that pregnancy negatively changes the sexual behavior of the women and it is suggested to further investigations and approach of the partner, in order to clarify the influence of these variables on the sexual function and subsidize intervention strategies, with a view to the integrality of sexual and reproductive health.

Keywords: obstetric nursing, pregnant women, sexual behavior, women's health

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Authors: Chueh Chi-An, Chan Hui-Ya

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Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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Authors: Tomas O. Ortega, Cecilia T. Reyes, Cecile O. Legaspi, Cylde G. Abayon, Anna Mae C. Relingo, Mary Eden M. Teruel

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A study was conducted to evaluate the performance in the delivery of environmental management programs of the local government of Malay, Aklan, Philippines. The samples were determined by adopting the Multi-Stage Random Probability Sampling technique. The 150 respondents were drawn from barangays with larger shares of the population based on the Philippine Statistical Authority’s Data on Census Population and Housing for the year 2015. The qualified sample respondents were selected using the Kish Grid. Female respondents were targeted for even numbered questionnaires while male respondents were targeted for odd numbers. The four major core concepts namely awareness, availment, satisfaction and need for action were used in measuring the rating of the respondents and presented in frequency and percentage distributions. The reasons for their response were likewise gathered. The study inferred that a large portion of the respondents was profoundly aware of the environmental management programs implemented by their local government unit especially the solid waste management and the clean-up programs/projects. Programs to control air pollution and waste water management obtained the least awareness ratings from the respondents. A high percentage of respondents had availed of environmental management programs, particularly solid waste management. Overall, majority of the respondents were satisfied with the environmental management programs rendered by the local government unit and therefore needs less action. It is recommended that the local government unit must strengthen air pollution control program. Appropriate action must be taken to support the people’s interest in this program most particularly to the individuals who burn their garbage. Seminars and training-workshops about appropriate waste disposal will most likely help settle this issue.

Keywords: availment, awareness, environmental management, need for action, satisfaction

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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Authors: Soyele Esther Kelechi

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The study examined assessing student level of utilization of library books and electronic resources: a case study of Gani Belo library, Federal College of Education, Osiele, Abeokuta, Ogun State, Nigeria. A mixed research method was adopted for the study, a purposive sampling method was used in selecting 1,000 students, with 200 students from each of the five schools in the college. Data were collected through a survey questionnaire designed by the researcher, which assessed library book usage, satisfaction with electronic services, and the extent of library automation. Additionally, face-to-face interviews were conducted with 10 library staff and 10 faculty members. The data collected were analyzed using the descriptive statistics of frequency distributions and percentages, and content analysis was used for the interviews. The findings reveal that more than half of the library clientele visit the library once a month, and this is because they see the library primarily for reading and assignments. Respondents expressed satisfaction with the library collections and general services, not with electronic services. The study also identified that the library's automation is only partially complete, primarily due to the lack of a Local Area Network (LAN) connection. However, measures are underway to achieve full automation. The study concluded that rapid adaptation to technological advancements is crucial for maximizing the use of librariess ICT facilities and electronic services, and the study recommends libraries should prioritize the implementation of electronic services and ICT facilities to ensure uninterrupted access to e-library and automated services, thereby attracting and retaining more users.

Keywords: academic libraries, changing needs of user's electronic services, library collections, library services

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Authors: Morgan Cheng, Wilson Ho, Max Yiu, Dragon Tsui, Wylog Wong, Richard Kwan, K. C. Lam, Hannah Lo, C. L. Wong

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Hong Kong has been known worldwide for its ability to thrive under trying circumstances. The 7.5 million residents of this mature and busy metropolis are living in a primarily high-rise city whereby development and renewal of the cityscape are taking place unceasingly. Hong Kong residents are therefore affected by the virtually continuous and numerous construction activities. In 2020, the Hong Kong environmental protection department (EPD) completed a feasibility study on managing construction noise, including those associated with the renovation of domestic premises. Part of the study was the review of management and control of construction noise in other metropolitan cities globally. As far as the authors are aware of, such worldwide and extensive review of best practices on construction noise control has not been conducted for over 20 years. In order to benefit from international best practices, the extensive review is to identify possible areas for improvement in Hong Kong. The consultant of the study first referred to the United Nations Report ‘The World’s Cities in 2016’ and examined the top 100 cities therein. The 20 most suitable cities were then chosen for further review. Upon screening of each of these 20 cities, 12 cities with the more relevant management practices were selected for further scrutiny. These 12 cities were: Asia – Tokyo, Seoul, Taipei, Guangzhou, Singapore; Europe – City of Westminster (London), Berlin; North America – Toronto, New York City, San Francisco; Oceania – Sydney, Melbourne. Afterwards, three cities, namely Sydney, City of Westminster, and New York City, were selected for in-depth review. These cities were chosen primarily because of the maturity, success, and effectiveness of their construction noise management and control measures, as well as their similarity to Hong Kong in key and selected aspects. One of the more important findings of the review is the usefulness of early focus, with the aim of designing the noise issues away wherever practicable. The consultant examined the similar yet different construction noise early focus mechanisms of the three cities. This paper describes this landmark worldwide and extensive review of international best practices on construction noise management and control. The methodology, approach, and key findings are presented to give readers a succinct yet comprehensive view. The authors shared the findings with the acoustics professionals worldwide with the hope of global advancement of more mature construction noise management while welcoming sustainable development and construction.

Keywords: construction noise, international best practices, noise control, noise management

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Authors: Kwok W. Mui, Ling T. Wong, Chin T. Cheung, Ho C. Yu

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Based on an indoor environmental quality (IEQ) index established by previous work that indicates the overall IEQ acceptance from the prospect of an occupant in residential buildings in terms of four IEQ factors - thermal comfort, indoor air quality, visual and aural comforts, this study develops a user-friendly IEQ calculator for iOS and Android users to calculate the occupant acceptance and compare the relative performance of IEQ in apartments. The calculator allows the prediction of the best IEQ scenario on a quantitative scale. Any indoor environments under the specific IEQ conditions can be benchmarked against the predicted IEQ acceptance range. This calculator can also suggest how to achieve the best IEQ acceptance among a group of residents.

Keywords: calculator, indoor environmental quality (IEQ), residential buildings, 5-star benchmarks

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Authors: Zichun Chu

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The issue of tribal poverty has always attracted attentions. Due to social and economic difficulties, the indigenous people's personal development and tribal development have been greatly restricted. Past studies have pointed out that poverty may come from a lack of education. The United Nations Sustainable Development Goals (SDGs) also stated that if we are to solve the poverty problem, providing education widely is an important key. According to the theory of intellectual capital adaptation, “being capable” and “willing to do” are the keys of development. Therefore, we can say that the "ability" and "will" of tribal residents for their tribal development is the core concern of the tribal development. This research was designed to investigate the career choice development model of indigenous tribe people by investigating the current status of human capital, social capital, and cultural capital of tribal residents. This study collected 327 questionnaires (70% of total households) from Truku tribe to answer the research question: Did education help them for job choosing decisions from the aspects of human capital, social capital, and cultural capital in tribal status. This project highlighted the ‘single tribal research approach’ to gain an in-depth understanding of the human capital formed under the unique culture of the tribe (Truku tribe). The results show that the education level of most research participants was high school, very few high school graduates chose to further their education to college level; due to the lack of education of their parents, the social capital was limited to support them for jobs choice, most of them work for labor and service industries; however, their culture capital was comparably rich for works, the sharing culture of Taiwanese indigenous people made their work status stable. The results suggested that we should emphasize more on the development of vocational education based on the tribe’s location and resources. The self-advocacy of indigenous people should be developed so that they would gain more power on making career decisions. This research project is part of a pilot project called “INDIGENOUS PEOPLES, POVERTY, AND DEVELOPMENT,” sponsored by the National Science and Technology Council of Taiwan. If this paper were accepted to present in the 2023 ICIP, it would be lovely if a panel is formed for me and other co-researchers (Chuanju Cheng, Chih-Yuan Weng, and YiXuan Chen), for the audience will be able to get a full picture of this pilot project.

Keywords: career choices, career model, indegenous career development, indigenous education, tribe

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Authors: Mahshid Asadollahi, Mohammad Akbari Asl

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The restaurant industry is highly competitive, and restaurants are constantly looking for ways to attract new customers and retain their existing ones. Nonverbal communication is an important factor in creating a positive customer experience and can play a significant role in attracting customers to restaurants. Nonverbal communication can include body language, facial expressions, tone of voice, and physical proximity, among other things. The present study aimed to investigate the impact of nonverbal communication between restaurant employees and customers on attracting customers in food courts in Tehran. The research method was descriptive-correlational, and the statistical population of this study included all customers of food court restaurants in Tehran, which was about 30 restaurants. The research sample was selected through probability sampling, and 440 customers completed emotional response, customer satisfaction, and nonverbal communication questionnaires in person. The data obtained were analyzed using multiple regression analysis. The results showed that vocal language, employee proximity, physical appearance, and speech movements, as components of nonverbal communication of restaurant employees, had an impact on attracting customers. Additionally, positive and negative emotions of customers have a significant relationship with customer attraction in Food Court restaurants. The study shows that various nonverbal communication factors can play a significant role in attracting customers, and that positive and negative customer emotions can affect customer satisfaction. Therefore, restaurant owners and managers should pay attention to nonverbal communication and train their employees accordingly to create a positive and welcoming atmosphere for customers.

Keywords: verbal language, proximity of employees, physical appearance, speech gestures, nonverbal communication, customer emotions, customer attraction

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Authors: Lee Cahaner, Nissim Leon

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The segregation of populations is one of the main axes in the research of urban geography, which refers to the spatial and functional relationships between settlements. In Israel, this phenomenon has its unique expression in the spatial processes concerning the ultra-orthodox population. This population holds a set of interactions within itself as well as with the non-orthodox surrounding population because of historical and contemporary motivations on its which strength depends on its homogeneousness and separation. Its demographic growth rate and the internal social processes that the ultra-orthodox society undergoes create a new image of the ultra-orthodox concentration and its location in the Israeli space. The goals of the present study have also been defined with the express intention of filling the scholarly vacuum noted above: firstly, to discuss the development of the Israeli ultra-Orthodox sector’s hierarchical and spatial structure as of 2015, in light of the principles and mechanisms that guide it and vis-à-vis the general population’s hierarchical locality system; secondly, to map Israel’s ultra-Orthodox population, with attention to its physical boundaries, its subdivisions (Hassidic, Lithuanian, Sephardic) and the geographical and demographic processes that have characterized it in recent years; and thirdly, to shed light on the interactions between ultra-Orthodox localities via several different parameters, e.g. migration, education, transportation, employment, consumerism and community services. In order to understand the changes in ultra-Orthodox geographic distribution and the social processes that these changes have generated, a number of research activities were conducted during the course of this study− notably, gathering and assembling material from earlier academic studies, newspaper advertisements, state and private archives; in-depth interviews with major figures in the ultra-Orthodox community and others who come into contact with it; tours of the core areas of ultra-Orthodox settlement; and gathering quantitative and qualitative data from the statistical reports of governmental and other bodies. In addition, a multi-participant (2400-respondent) quantitative survey was conducted among residents of the new ultra-Orthodox cities, designed to elucidate the attributes and spatial attitudes of the residents− as a means of tracing and understanding this new settlement pattern within ultra-Orthodox space. A major portion of the quantitative and qualitative material was processed to form a system of maps that visually describe the distribution of Israel’s ultra-Orthodox population.

Keywords: migration, new cities, segregation, ultra-orthodox

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Authors: Seetanah Boopen, Padachi Kesseven, R. Juwaheer , R. V. Sannassee, M. L. Lamport

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This study aims primarily at investigating the importance of soft infrastructure in tourism development for the case of an island economy namely Mauritius. The study in the first place assesses the level of perceived and actual satisfaction of the present state of the different types of soft tourism infrastructure and the allied services provided by tourism stakeholders in Mauritius and address the identified gaps. In order to address the study objectives, a rigorous survey analysis among 1741 international tourists at the departure lounge of the Sir Seewoosagur International Airport of Mauritius was carried out. The respondents placed significant emphasis on the different elements of the soft infrastructure dimension, where many of the elements falling under this dimension were rated with a high mean score. In particular the visitors rated communication, both internet and telephone services, and security to be most important. Significant gap has been found in the categories of ‘Health’ and ‘Security’. This indicates that the tourists ascribe high importance to the soft infrastructure dimension. The link between the respondent profile and the key variables which influence the tourist choice of the island as a destination are found to be equally important for most of the international tourists. However, these were deemed to be more critical for tourists travelling with family members. Although the survey instrument attempted to measure any gap between on the one hand, the importance of the infrastructure dimension and on the other hand, the level of satisfaction with the infrastructure dimension, overall the results do not show any statistically significant gap among the different elements of the infrastructural dimension. The study dwells into further analysis by engaging into an econometric framework related to a Probit Model, using the data collected, to gauge the effect of soft infrastructure on tourist intention to repeat or recommend the destination. The results confirm that soft infrastructure is found to be sensible to tourists, although relatively less sensitive as compared to tourism and transport and hotel infrastructure.

Keywords: tourism development, soft infrastructure, Mauritius, hotel infrastructure

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Authors: D. S. Jaya, G. P. Deepthi

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Groundwater is vital to the livelihoods and health of the majority of the people since it provides almost the entire water resource for domestic, agricultural and industrial uses. Groundwater quality comprises the physical, chemical, and bacteriological qualities. The present investigation was carried out to determine the physicochemical and bacteriological quality of the ground water sources in the residential areas of Karakulam Grama Panchayath in Thiruvananthapuram district, Kerala state in India. Karakulam is located in the eastern suburbs of Thiruvananthapuram city. The major drinking water source of the residents in the study area are wells. The present study aims to assess the portability and irrigational suitability of groundwater in the study area. The water samples were collected from randomly selected dug wells and bore wells in the study area during post monsoon and pre-monsoon seasons of the year 2014 after a preliminary field survey. The physical, chemical and bacteriological parameters of the water samples were analysed following standard procedures. The concentration of heavy metals (Cd, Pb, and Mn) in the acid digested water samples were determined by using an Atomic Absorption Spectrophotometer. The results showed that the pH of well water samples ranged from acidic to the alkaline level. In the majority of well water samples ( > 54%) the iron and magnesium content were found high in both the seasons studied, and the values were above the permissible limits of WHO drinking water quality standards. Bacteriological analyses showed that 63% of the wells were contaminated with total coliforms in both the seasons studied. Irrigational suitability of groundwater was assessed by determining the chemical indices like Sodium Percentage (%Na), Sodium Adsorption Ratio (SAR), Residual Sodium Carbonate (RSC), Permeability Index (PI), and the results indicate that the well water in the study area is good for irrigation purposes. Therefore, the study reveals the degradation of drinking water quality groundwater sources in Karakulam Grama Panchayath in Thiruvananthapuram District, Kerala in terms of its chemical and bacteriological characteristics and is not potable without proper treatment. In the study, more than 1/3rd of the wells tested were positive for total coliforms, and the bacterial contamination may pose threats to public health. The study recommends the need for periodic well water quality monitoring in the study area and to conduct awareness programs among the residents.

Keywords: bacteriological, groundwater, irrigational suitability, physicochemical, portability

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Authors: Anilkumar L. Rathod

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This paper examines event tourism as a field of study and area of professional practice updating the previous review article published in 2015. In this substantially extended review, a deeper analysis of the field's evolution and development is presented, charting the growth of the literature, focusing both chronologically and thematically. A framework for understanding and creating knowledge about events and tourism is presented, forming the basis which signposts established research themes and concepts and outlines future directions for research. In addition, the review article focuses on constraining and propelling forces, ontological advances, contributions from key journals, and emerging themes and issues. It also presents a roadmap for research activity in event tourism. Published scholarly studies within this period are examined through content analysis, using such keywords as knowledge management, organizational learning, hospitality, tourism, tourist destinations, travel industry, hotels, lodging, motels, hotel industry, gaming, casino hotel and convention to search scholarly research journals. All contributions found are then screened for a hospitality and tourism theme. Researchers mostly discuss knowledge management approach in improving information technology, marketing and strategic planning in order to gain competitive advantage. Overall, knowledge management research is still limited. Planned events in tourism are created for a purpose, and what was once the realm of individual and community initiatives has largely become the realm of professionals and entrepreneurs provides a typology of the four main categories of planned events within an event-tourism context, including the main venues associated with each. It also assesses whether differences exist between socio-demographic groupings. An analysis using primarily descriptive statistics indicated both sub-samples had similar viewpoints although Maharashtra residents tended to have higher scores pertaining to the consequences of gambling. It is suggested that the differences arise due to the greater exposure of Maharashtra residents to the influences of casino development.

Keywords: organizational learning, hospitality, tourism, tourist destinations, travel industry, hotels, lodging, motels, hotel industry, gaming, casino hotel and convention to search scholarly research journals

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Authors: Suparpit von Bormann, Winai Sayorwan, Sirichai Channim, Sararat Rungruangkhanarak, Premchai Suksamran, Piyaporn Srisuk, Piyatida Phosri

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The best medicine will not work if the patient does not take them. There are several methods developed to help patients to be adherent to medicine. However, non-adherent rate still high: 24% in physically ill and 42% in mentally ill patients. Moreover, patients might feel less confident when carrying medicine around. Normal medicine box has no alarm; whereas the one with alarm is not handy and might be left at home. Therefore, Medication Reminder (MR) was invented. MR is a medicine pocket that has an alarm clock to remind the patient when it is the time to take medicine. It also has a small light indicating the medicine the patient has to take. This pocket is attached within a purse or wallet because most people forget medicine but do not forget to take their money. This research was conducted to develop innovation assisting patients to take their medicine on time. Samples were 24 volunteers who went out to work every day. Uncoated tablets, coated tablets, and capsules were filled in three types of containers: MR, plastic bag with ziplock, and normal plastic box. Each volunteer carried three types of containers everywhere during day time. After three days, medicines were tested for physical quality (appearance, odor, color, hardness, and weight) in laboratory. Medication adherence and satisfaction questionnaires were completed by participants. The results showed that MR showed significant improvement in participants’ adherence than plastic bag with ziplock, and normal plastic box at p < .001 (x̄(SD) = 11.16(0.75), 7.83(0.98), 8.83(1.32), respectively). Based on the quality test, MR and normal plastic box significantly better protected medicine than plastic bag with zip lock at p < .001 (x̄(SD) = 4(0.00), 4(0.00), 2.5(0.54), respectively). Most participants were satisfied with the innovation in highest level (4.50 out of 5). MR has a potential to improve adherent rates of participants and therefore to be an innovation that helps reducing the cost of treatment due to non-adherence. MR also has a potential in commercial aspect due to its effects in preserving quality of medicine. MR can be integrated with local products such as silk purse that can increase income for local people.

Keywords: medication, reminder, adherence, satisfaction

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Authors: Beata Wentura-Dudek

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In the United States in 2007-2010 before the crisis, the US labour market policy focused mainly on providing residents with unemployment insurance, after the recession this policy changed. The aim of the article was to present quantitative research presenting the most effective labor market instruments contributing to reducing unemployment during the crisis in the USA. The article presents research based on the analysis of available documents and statistical data. The results of the conducted research show that the most effective forms of counteracting unemployment at that time were: direct job creation, job search assistance, subsidized employment, training and employment promotion using new technologies, including social media.

Keywords: lotteries, loyalty programs, competitions, bonus sales, rebate campaigns

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Authors: Kazuhiro Tateda, Elisa Gonzalez, Shuhei Ito, Kirstin Heinrich, Kevin Sweetland, Pingping Zhang, Catia Ferreira, Michael Pride, Jennifer Moisi, Sharon Gray, Bennett Lee, Fred Angulo

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Clostridium difficile (C. difficile) is the most common cause of antibiotic-associated diarrhea and infectious diarrhea in healthcare settings. Japan has an aging population; the elderly are at increased risk of hospitalization, antibiotic use, and C. difficile infection (CDI). Little is known about the population-based incidence and disease burden of CDI in Japan although limited hospital-based studies have reported a lower incidence than the United States. To understand CDI disease burden in Japan, CLOUD (Clostridium difficile Infection Burden of Disease in Adults in Japan) was developed. CLOUD will derive population-based incidence estimates of the number of CDI cases per 100,000 population per year in Ota-ku (population 723,341), one of the districts in Tokyo, Japan. CLOUD will include approximately 14 of the 28 Ota-ku hospitals including Toho University Hospital, which is a 1,000 bed tertiary care teaching hospital. During the 12-month patient enrollment period, which is scheduled to begin in November 2018, Ota-ku residents > 50 years of age who are hospitalized at a participating hospital with diarrhea ( > 3 unformed stools (Bristol Stool Chart 5-7) in 24 hours) will be actively ascertained, consented, and enrolled by study surveillance staff. A stool specimen will be collected from enrolled patients and tested at a local reference laboratory (LSI Medience, Tokyo) using QUIK CHEK COMPLETE® (Abbott Laboratories). which simultaneously tests specimens for the presence of glutamate dehydrogenase (GDH) and C. difficile toxins A and B. A frozen stool specimen will also be sent to the Pfizer Laboratory (Pearl River, United States) for analysis using a two-step diagnostic testing algorithm that is based on detection of C. difficile strains/spores harboring toxin B gene by PCR followed by detection of free toxins (A and B) using a proprietary cell cytotoxicity neutralization assay (CCNA) developed by Pfizer. Positive specimens will be anaerobically cultured, and C. difficile isolates will be characterized by ribotyping and whole genomic sequencing. CDI patients enrolled in CLOUD will be contacted weekly for 90 days following diarrhea onset to describe clinical outcomes including recurrence, reinfection, and mortality, and patient reported economic, clinical and humanistic outcomes (e.g., health-related quality of life, worsening of comorbidities, and patient and caregiver work absenteeism). Studies will also be undertaken to fully characterize the catchment area to enable population-based estimates. The 12-month active ascertainment of CDI cases among hospitalized Ota-ku residents with diarrhea in CLOUD, and the characterization of the Ota-ku catchment area, including estimation of the proportion of all hospitalizations of Ota-ku residents that occur in the CLOUD-participating hospitals, will yield CDI population-based incidence estimates, which can be stratified by age groups, risk groups, and source (hospital-acquired or community-acquired). These incidence estimates will be extrapolated, following age standardization using national census data, to yield CDI disease burden estimates for Japan. CLOUD also serves as a model for studies in other countries that can use the CLOUD protocol to estimate CDI disease burden.

Keywords: Clostridium difficile, disease burden, epidemiology, study protocol

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Authors: Şeyda Akçalı

Abstract:

This study explores the concept of social sustainability and its characteristics in terms of neighborhood (mahalle) which is a social phenomenon in Turkish urban life. As social sustainability indicators that moving away traditional themes toward multi-dimensional measures, the solutions for urban strategies may be achieved through learning lessons from historical precedents. It considers the inherent values of traditional urban forms contribute to the evolution of the city as well as the social functions of it. The study aims to measure non-tangible issues in order to evaluate social sustainability in historic urban environments and how they could contribute to the current urban planning strategies. The concept of neighborhood (mahalle) refers to a way of living that represents the organization of Turkish social and communal life rather than defining an administrative unit for the city. The distinctive physical and social features of neighborhood illustrate the link between social sustainability and historic urban environment. Instead of having a nostalgic view of past, it identifies both the failures and successes and extract lessons of traditional urban environments and adopt them to modern context. First, the study determines the aspects of social sustainability which are issued as the key themes in the literature. Then, it develops a model by describing the social features of mahalle which show consistency within the social sustainability agenda. The model is used to analyze the performance of traditional housing area in the historical city center of Bursa, Turkey whether it meets the residents’ social needs and contribute collective functioning of the community. Through a questionnaire survey exercised in the historic neighborhoods, the residents are evaluated according to social sustainability criteria of neighborhood. The results derived from the factor analysis indicate that social aspects of neighborhood are social infrastructure, identity, attachment, neighborliness, safety and wellbeing. Qualitative evaluation shows the relationship between key aspects of social sustainability and demographic and socio-economic factors. The outcomes support that inherent values of neighborhood retain its importance for the sustainability of community although there must be some local arrangements for few factors with great attention not to compromise the others. The concept of neighborhood should be considered as a potential tool to support social sustainability in national political agenda and urban policies. The performance of underlying factors in historic urban environment proposes a basis for both examining and improving traditional urban areas and how it may contribute to the overall city.

Keywords: historical city center, mahalle, neighborhood, social sustainability, traditional urban environment, Turkey

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Authors: A. Ham, A. Kuckert-Wostheinrich

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Demographic changes, like the ageing population in European countries and shortage of nursing staff, the increasing number of people with severe cognitive impairment, and elderly socially isolated people raise important questions about who will provide long-term care for ageing citizens. Due to the so-called refugee crisis in 2015, some health care institutions for ageing citizens in Europe invited first generation immigrants to start a nursing career and providing them language skills, nursing training, and internships. The aim of this ethnographic research was to explore the social processes affecting workforce integration and how newcomers enact good care in ageing citizens in a German nursing home. By ethnographic fieldwork, 200 hours of participant observations, 25 in-depth interviews with immigrants and established staff, 2 focus groups with 6 immigrants, and 6 established staff members, data were analysed. The health care institution provided the newcomers a nursing program on psychogeriatric theory and nursing skills in the psychogeriatric field and professional oriented language skills. Courses of health prevention and theater plays accompanied the training. The knowledge learned in education could be applied in internships on the wards. Additionally, diversity and inclusivity courses were given to established personal for cultural awareness and sensitivity. They learned to develop a collegial attitude of respect and appreciation, regardless of gender, nationality, ethnicity, religion or belief, age sexual orientation, or disability and identity. The qualitative data has shown that social processes affected workforce integration, like organizational constraints, staff shortages, and a demanding workload. However, zooming in on the interactions between newcomers and residents, we noticed how they tinkered to enact good care by embodied caring, playing games, singing and dancing. By situational acting and practical wisdom in nursing care, the newcomers could meet the needs of ageing residents. Thus, when health care institutions open up nursing programs for newcomers with refugees’ backgrounds and focus on talent instead of shortcomings, we might as well stimulate the unknown competencies, attitudes, skills, and expertise of newcomers and create excellent nurses for excellent care.

Keywords: established staff, Germany, nursing, refugees

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Authors: Julia Brudzinski, Ashley Croswell, Jade Mardin, Hannah Shilling, Jennifer Berg-Carnegie

Abstract:

Adults with brain injuries and mental illnesses commonly experience cognitive impairments that interfere with their participation in activities of daily living (ADLs). Prior research states that electronic reminder systems can support adults with cognitive impairments; however, previous studies focus primarily on one-way reminder systems. Research on adults with chronic diseases reported that two-way reminder systems yield better health outcomes and disease self-management compared to one-way reminder systems. Literature was identified through systematically searching 7 databases and hand-searching relevant reference lists. Retrieved studies were independently screened and reviewed by at least two members of the research team. Data was extracted on study design, participant characteristics, intervention details, study objectives, outcome measures, and important results. 574 articles were screened and reviewed. Nine articles met all inclusion criteria and were included. The literature focused on three main areas: system feasibility (n=8), stakeholder satisfaction (n=6), and efficacy of the two-way reminder systems (n=6). Participants in eight of the studies had brain injuries, with participants in only one study having a mental illness (i.e., schizophrenia). Two-way reminder systems were used to support participation in a wide range of ADLs. The current literature on two-way reminder systems to support ADLs for adults with cognitive impairments focuses on feasibility, stakeholder satisfaction, and system efficacy. Future research should focus on addressing the barriers to accessing and implementing two-way reminder systems and identifying specific client characteristics that would benefit most from using these systems.

Keywords: brain injury, digital health, occupational therapy, activities of daily living, two-way reminder systems

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Authors: Lolwa Alansari, Abdelhamid Azhaghdani, Sufia Athar, Hanen Mrabet, Annaliza Cruz, Tamara Alshadafat, Almunzer Zakaria

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Introduction: Improving the patient experience is a fundamental pillar of healthcare's quadruple aims. Recognizing the importance of patient experiences and perceptions in healthcare interactions is pivotal for driving quality improvement. This abstract centers around the Patient Experience Program, an endeavor crafted with the purpose of comprehending and elevating the experiences of patients in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). Methodology: This comprehensive endeavor unfolded through a structured sequence of phases following Plan-Do-Study-Act (PDSA) model, spanning over 12 months, focused on enhancing patient experiences in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). The study meticulously examined the journeys of patients with acute obstetrics and gynecological conditions, collecting data from over 100 participants monthly. The inclusive approach covered patients of different priority levels (1-5) admitted for acute conditions, with no exclusions. Historical data from March and April 2022 serves as a benchmark for comparison, strengthening causality claims by providing a baseline understanding of OB/GYN ED performance before interventions. Additionally, the methodology includes the incorporation of staff engagement surveys to comprehensively understand the experiences of healthcare professionals with the implemented improvements. Data extraction involved administering open-ended questions and comment sections to gather rich qualitative insights. The survey covered various aspects of the patient journey, including communication, emotional support, timely access to care, care coordination, and patient-centered decision-making. The project's data analysis utilized a mixed-methods approach, combining qualitative techniques to identify recurring themes and extract actionable insights and quantitative methods to assess patient satisfaction scores and relevant metrics over time, facilitating the measurement of intervention impact and longitudinal tracking of changes. From the themes we discovered in both the online and in-person patient experience surveys, several key findings emerged that guided us in initiating improvements, including effective communication and information sharing, providing emotional support and empathy, ensuring timely access to care, fostering care coordination and continuity, and promoting patient-centered decision-making. Results: The project yielded substantial positive outcomes, significantly improving patient experiences in the OB/GYN ED. Patient satisfaction levels rose from 62% to a consistent 98%, with notable improvements in satisfaction with care plan information and physician care. Waiting time satisfaction increased from 68% to a steady 97%. The project positively impacted nurses' and midwives' job satisfaction, increasing from 64% to an impressive 94%. Operational metrics displayed positive trends, including a decrease in the "left without being seen" rate from 3% to 1%, the discharge against medical advice rate dropping from 8% to 1%, and the absconded rate reducing from 3% to 0%. These outcomes underscore the project's effectiveness in enhancing both patient and staff experiences in the healthcare setting. Conclusion: The use of a patient experience questionnaire has been substantiated by evidence-based research as an effective tool for improving the patient experience, guiding interventions, and enhancing overall healthcare quality in the OB/GYN ED. The project's interventions have resulted in a more efficient allocation of resources, reduced hospital stays, and minimized unnecessary resource utilization. This, in turn, contributes to cost savings for the healthcare facility.

Keywords: patient experience, patient survey, person centered care, quality initiatives

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Authors: Hocine Benabid, M. F. Ghorab

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The exploration of open pit mines and quarries has always been important resources that provide many valuable needed minerals but very often accompanied by large amounts of dust rejected into the air and also many other negative environmental impacts. The dust remains suspended in the atmosphere before being deposited on soils, on forest trees, on plants and also on water, causing at long term allergic and respiratory diseases for residents living in the vicinity or even far away from the mines and quarries. As a consequence of this activity, dust can also disturb the photosynthetic activity of plants and affect water quality. It is for these reasons and because of the intensification of these activities that our motivations have become larger to deal with this kind of topic, which is becoming nowadays an environmental and health concern for almost every country in the world.

Keywords: mines, dust, environmental impacts, environmental concern

Procedia PDF Downloads 384

Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini, Omid Seyed Esmaeili, Rouzbeh Kezemi, Noushin Mehrbod, Nazanin Vahed, Tahereh Hajiahmad, Noureddin Nakhostin Ansari

Abstract:

Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of VR beside conventional rehabilitation versus conventional rehabilitation alone on spasticity and motor function in stroke patients. Materials and Methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran, in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were modified Ashworth scale, recovery stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in the combination group (P=0.003). Only wrist extension was varied between groups and was better in the combination group. The variables generally had a statistically significant difference (P < 0.05). Conclusion: Virtual reality plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: stroke, virtual therapy, rehabilitation, treatment

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Authors: Perpetual Onyejelem, Kenichi Matsui

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Solid waste management is one essential area for urban administration to achieve environmental sustainability. Proper solid waste management (SWM) improves the environment by reducing diseases and increasing public health. On the other way, improper SWM practices negatively impact public health and environmental sustainability. This article evaluates SWM in Port Harcourt, Nigeria, with the goal of determining the current solid waste management practices and their health implications. This study used secondary data, which relies on existing published literature and official documents. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and its four-stage inclusion/exclusion criteria were utilized as part of a systematic literature review technique to locate the literature that concerns SWM practices and the implementation of solid waste management policies between 2014-2023 in PortHarcourt and its health effects from specific databases (Scopus and Google Scholar). The results found that despite the existence and implementation of the Rivers State Waste Management Policy and the formulation of the National Policy on Solid Waste Management in Port Harcourt, residents continued to dump waste in drainages. They were unaware of waste sorting and dumped waste haphazardly. This trend has persisted due to a lack of political commitment to the effective implementation and monitoring of policies and strategies and a lack of training provided to waste collectors regarding the SWM approach, which involves sorting and separating waste. In addition, inadequate remuneration for waste collectors, the absence of community participation in policy formulation, and insufficient awareness among residents regarding the 3R approach are also contributory factors. This caused the emergence of vector-borne diseases such as malaria, lassa fever, and cholera in Port Harcourt, increasing the expense of healthcare for locals, particularly low-income households. The study urges the government to prioritize protecting the health of its citizens by studying the methods other nations have taken to address the problem of solid waste management and adopting those that work best for their region. The bottom-up strategy should be used to include locals in developing solutions. However, citizens who are always the most impacted by this issue should launch initiatives to address it and put pressure on the government to assist them when they have limitations.

Keywords: health effects, solid waste management practices, environmental pollution, Port-Harcourt

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Authors: Huynh Viet Khai, Mitsuyasu Yabe

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The study investigated the economic value of biodiversity attributes that could provide policy-makers reliable information to estimate welfare losses due to biodiversity reductions and analyse the trade-off between biodiversity and economics. In order to obtain the non-market benefits of biodiversity conservation, an indirect utility function and willingness to pay for biodiversity attributes were applied using the approach of choice modelling with the analysis of conditional logit model. The study found that Mekong Delta residents accepted their willingness to pay for VND 913 monthly for a one percent increase in healthy vegetation, VND 360 for an additional mammal species and VND 2,440 to avoid the welfare losses of 100 local farmers.

Keywords: choice modelling, genetic resources, wetland conservation, marginal willingness to pay

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Authors: Shahnaz Haque, Anand Shukla, Sunita Singh, Anil Kem

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Introduction: Diabetes Mellitus is a chronic metabolic disease affecting millions worldwide. Metformin is the most commonly prescribed first line oral hypoglycemic drug for type 2 diabetes mellitus, but due to progressive worsening of blood glucose control during the natural history of type 2 diabetes, combination therapy usually becomes necessary. Objective: This study was designed to assess the treatment satisfaction between Sitagliptin versus Pioglitazone added to Metformin in patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a prospective, open label, randomized, parallel group study in SIMS, Hapur, U.P. Eligible patients fulfilling inclusion criteria were randomized into two groups having 25 patients in each group using tab Sitagliptin 100mg, tab Pioglitazone 30mg added to ongoing tab Metformin (500mg) therapy for 16 weeks. The follow-up visits were on weeks 4,12 and 16. Result: 16 weeks later, addition of Sitagliptin 100mg compared to that of Pioglitazone 30 mg to ongoing Metformin therapy provided similar glycosylated hemoglobin (HbA1c) lowering efficacy in patients with T2DM with inadequate glycemic control on metformin monotherapy. Change in HbA1c in group1 was -0.656±0.21%(p<0.0001) whereas in group2 was -0.748±0.35%(p<0.0001). Hence decrease in HbA1c from baseline was more in group2. Both treatments were well tolerated with negligible risk of hypoglycaemia. Weight loss was observed with Sitagliptin in contrast to weight gain seen in Pioglitazone. Conclusion: In this study, Sitagliptin 100 mg along with metformin therapy in comparison to pioglitazone 30 mg plus metformin therapy was both effective, well-tolerated and improved glycemic control in both the groups. Addition of pioglitazone had cause oedema and weight gain to the patients whereas sitagliptin caused weight loss in its patients.

Keywords: sitagliptin, pioglitazone, metformin, type 2 diabetes mellitus

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Authors: N. Gharbi

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Constraint Satisfaction problems are mathematical problems that are often used to model many real-world problems for which we look if there exists a solution satisfying all its constraints. Table constraints are important for modeling parts of many problems since they list all combinations of allowed or forbidden values. However, they admit practical limitations because they are sometimes too large to be represented in a direct way. In this paper, we present a survey of the different categories of the proposed approaches to compress table constraints in order to reduce both space and time complexities.

Keywords: constraint programming, compression, data mining, table constraints

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Authors: Outokesh Fatemeh, Jourabchi Keivan, Talebi Maryam, Nikbakht Fatemeh

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Mayamei is a small town in Iran that is located between Shahrud and Sabzevar cities, on the Silk Road. It enjoys a history of approximately 1000 years. An alley entitled ‘Aghayan’ exists in this town that comprises residential buildings of a famous family. Bathhouse, mosque, telegraph center, cistern are all related to this alley. This architectural complex belongs to Sadat Mousavi, who is one of the Mayamei's major grandees and religious household. The alley after construction has been inherited from generation to generation within the family masters. The purpose of this study, which was conducted on Aghayan alley and its associated complex, was to elucidate Iranian vernacular domestic architecture of Qajar era in small towns and villages. We searched for large, medium, and small architectural patterns in the contemplated complex, and tried to elaborate their evolution from past to the present. The other objective of this project was finding a correlation between changes in the lifestyle of the alley’s inhabitants with the form of the building's architecture. Our investigation methods included: literature review especially in regard to historical travelogues, peer site visiting, mapping, interviewing of the elderly people of the Mousavi family (the owners), and examining the available documents especially the 4 meters’ scroll-type testament of 150 years ago. For the analysis of the aforementioned data, an effort was made to discover (1) the patterns of placing of different buildings in respect of the others, (2) finding the relation between function of the buildings with their relative location in the complex, as was considered in the original design, and (3) possible changes of functions of the buildings during the time. In such an investigation, special attention was paid to the chronological changes of lifestyles of the residents. In addition, we tried to take all different activities of the residents into account including their daily life activities, religious ceremonies, etc. By combining such methods, we were able to obtain a picture of the buildings in their original (construction) state, along with a knowledge of the temporal evolution of the architecture. An interesting finding is that the Aghayan complex seems to be a big structure of the horizontal type apartments, which are placed next to each other. The houses made in this way are connected to the adjacent neighbors both by the bifacial rooms and from the roofs.

Keywords: Iran, Qajar period, vernacular domestic architecture, life style, residential complex

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Authors: Lucila T. Magalong

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The hotel industry has been using their corporate image and reputation to maintain service quality, customer satisfaction, and customer loyalty and to leverage themselves against competitors and facilitate their growth strategies. With the increasing pressure to perform, hotels have even created hybrid service strategy to fight in the niche markets across pricing and level-off service parameters.

Keywords: corporate image, hotel industry, service quality, customer expectations

Procedia PDF Downloads 466