Search results for: alternative and complementary healthcare
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5677

Search results for: alternative and complementary healthcare

4717 Assessing Impacts of Climate Change on Rural Water Resources

Authors: Ntandoyenkosi Moyo

Abstract:

Majority of rural Eastern Cape villages of South Africa households do not have access to safe water supply. Due to changes in climatic conditions for example higher temperatures, these sources become not reliable in supplying adequate and safe water to the population. These rural populations due to the drying up of water resources have to find other alternative ways to get water. Climate change has an impact on the reliability of water resources and this has an impact on rural communities. This study seeks to establish what alternative ways do people use when affected by unfavorable conditions like less rainfall and increased temperatures. The study also seeks to investigate any local and provincial intervention in the provision of water to the village. Interventions can be in the form of programmes or initiatives that involve water supply strategies. The community should participate fully in making sure that their place is serviced. The study will identify households with improved sources (JOJO tanks) and those with unimproved sources (rivers) and investigate what alternatives they resort to when their sources dry up. The study also investigates community views on whether they have any challenges of water supply (reliability and adequacy) as required by section 27(1) (b) of the constitution which states that everyone should have access to safe and clean water.

Keywords: rural water resources, temperature, improved sources, unimproved sources

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4716 Automated Driving Deep Neural Networks Model Accuracy and Performance Assessment in a Simulated Environment

Authors: David Tena-Gago, Jose M. Alcaraz Calero, Qi Wang

Abstract:

The evolution and integration of automated vehicles have become more and more tangible in recent years. State-of-the-art technological advances in the field of camera-based Artificial Intelligence (AI) and computer vision greatly favor the performance and reliability of the Advanced Driver Assistance System (ADAS), leading to a greater knowledge of vehicular operation and resembling human behavior. However, the exclusive use of this technology still seems insufficient to control vehicular operation at 100%. To reveal the degree of accuracy of the current camera-based automated driving AI modules, this paper studies the structure and behavior of one of the main solutions in a controlled testing environment. The results obtained clearly outline the lack of reliability when using exclusively the AI model in the perception stage, thereby entailing using additional complementary sensors to improve its safety and performance.

Keywords: accuracy assessment, AI-driven mobility, artificial intelligence, automated vehicles

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4715 An Exploratory Survey Questionnaire to Understand What Emotions Are Important and Difficult to Communicate for People with Dysarthria and Their Methodology of Communicating

Authors: Lubna Alhinti, Heidi Christensen, Stuart Cunningham

Abstract:

People with speech disorders may rely on augmentative and alternative communication (AAC) technologies to help them communicate. However, the limitations of the current AAC technologies act as barriers to the optimal use of these technologies in daily communication settings. The ability to communicate effectively relies on a number of factors that are not limited to the intelligibility of the spoken words. In fact, non-verbal cues play a critical role in the correct comprehension of messages and having to rely on verbal communication only, as is the case with current AAC technology, may contribute to problems in communication. This is especially true for people’s ability to express their feelings and emotions, which are communicated to a large part through non-verbal cues. This paper focuses on understanding more about the non-verbal communication ability of people with dysarthria, with the overarching aim of this research being to improve AAC technology by allowing people with dysarthria to better communicate emotions. Preliminary survey results are presented that gives an understanding of how people with dysarthria convey emotions, what emotions that are important for them to get across, what emotions that are difficult for them to convey, and whether there is a difference in communicating emotions when speaking to familiar versus unfamiliar people.

Keywords: alternative and augmentative communication technology, dysarthria, speech emotion recognition, VIVOCA

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4714 Investigating Best Strategies Towards Creating Alternative Assessment in Literature

Authors: Sandhya Rao Mehta

Abstract:

As ChatGpt and other Artificial Intelligence (AI) forms are becoming part of our regular academic world, the consequences are being gradually discussed. The extent to which an essay written by a student is itself of any value if it has been downloaded by some form of AI is perhaps central to this discourse. A larger question is whether writing should be taught as an academic skill at all. In literature classrooms, this has major consequences as writing a traditional paper is still the single most preferred form of assessment. This study suggests that it is imperative to investigate alternative forms of assessment in literature, not only because the existing forms can be written by AI, but in a larger sense, students are increasingly skeptical of the purpose of such work. The extent to which an essay actually helps the students professionally is a question that academia has not yet answered. This paper suggests that using real-world tasks like creating podcasts, video tutorials, and websites is a far better way to evaluate students' critical thinking and application of ideas, as well as to develop digital skills which are important to their future careers. Using the example of a course in literature, this study will examine the possibilities and challenges of creating digital projects as a way of confronting the complexities of student evaluation in the future. The study is based on a specific university English as a Foreign Language (EFL) context.

Keywords: assessment, literature, digital humanities, chatgpt

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4713 Impact of Primary Care Telemedicine Consultations On Health Care Resource Utilisation: A Systematic Review

Authors: Anastasia Constantinou, Stephen Morris

Abstract:

Background: The adoption of synchronous and asynchronous telemedicine modalities for primary care consultations has exponentially increased since the COVID-19 pandemic. However, there is limited understanding of how virtual consultations influence healthcare resource utilization and other quality measures including safety, timeliness, efficiency, patient and provider satisfaction, cost-effectiveness and environmental impact. Aim: Quantify the rate of follow-up visits, emergency department visits, hospitalizations, request for investigations and prescriptions and comment on the effect on different quality measures associated with different telemedicine modalities used for primary care services and primary care referrals to secondary care Design and setting: Systematic review in primary care Methods: A systematic search was carried out across three databases (Medline, PubMed and Scopus) between August and November 2023, using terms related to telemedicine, general practice, electronic referrals, follow-up, use and efficiency and supported by citation searching. This was followed by screening according to pre-defined criteria, data extraction and critical appraisal. Narrative synthesis and metanalysis of quantitative data was used to summarize findings. Results: The search identified 2230 studies; 50 studies are included in this review. There was a prevalence of asynchronous modalities in both primary care services (68%) and referrals from primary care to secondary care (83%), and most of the study participants were females (63.3%), with mean age of 48.2. The average follow-up for virtual consultations in primary care was 28.4% (eVisits: 36.8%, secure messages 18.7%, videoconference 23.5%) with no significant difference between them or F2F consultations. There was an average annual reduction of primary care visits by 0.09/patient, an increase in telephone visits by 0.20/patient, an increase in ED encounters by 0.011/patient, an increase in hospitalizations by 0.02/patient and an increase in out of hours visits by 0.019/patient. Laboratory testing was requested on average for 10.9% of telemedicine patients, imaging or procedures for 5.6% and prescriptions for 58.7% of patients. When looking at referrals to secondary care, on average 36.7% of virtual referrals required follow-up visit, with the average rate of follow-up for electronic referrals being higher than for videoconferencing (39.2% vs 23%, p=0.167). Technical failures were reported on average for 1.4% of virtual consultations to primary care. When using carbon footprint estimates, we calculate that the use of telemedicine in primary care services can potentially provide a net decrease in carbon footprint by 0.592kgCO2/patient/year. When follow-up rates are taken into account, we estimate that virtual consultations reduce carbon footprint for primary care services by 2.3 times, and for secondary care referrals by 2.2 times. No major concerns regarding quality of care, or patient satisfaction were identified. 5/7 studies that addressed cost-effectiveness, reported increased savings. Conclusions: Telemedicine provides quality, cost-effective, and environmentally sustainable care for patients in primary care with inconclusive evidence regarding the rates of subsequent healthcare utilization. The evidence is limited by heterogeneous, small-scale studies and lack of prospective comparative studies. Further research to identify the most appropriate telemedicine modality for different patient populations, clinical presentations, service provision (e.g. used to follow-up patients instead of initial diagnosis) as well as further education for patients and providers alike on how to make best use of this service is expected to improve outcomes and influence practice.

Keywords: telemedicine, healthcare utilisation, digital interventions, environmental impact, sustainable healthcare

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4712 Alternative Housing Systems: Influence on Blood Profile of Egg-Type Chickens in Humid Tropics

Authors: Olufemi M. Alabi, Foluke A. Aderemi, Adebayo A. Adewumi, Banwo O. Alabi

Abstract:

General well-being of animals is of paramount interest in some developed countries and of global importance hence the shift onto alternative housing systems for egg-type chickens as replacement for conventional battery cage system. However, there is paucity of information on the effect of this shift on physiological status of the hens to judge their health via the blood profile. Therefore, investigation was carried out on two strains of hen kept in three different housing systems in humid tropics to evaluate changes in their blood parameters. 108, 17-weeks old super black (SBL) hens and 108, 17-weeks old super brown (SBR) hens were randomly allotted to three different intensive systems Partitioned Conventional Cage (PCC), Extended Conventional Cage (ECC) and Deep Litter System (DLS) in a randomized complete block design with 36 hens per housing system, each with three replicates. The experiment lasted 37 weeks during which blood samples were collected at 18th week of age and bi-weekly thereafter for analyses. Parameters measured are packed cell volume (PCV), hemoglobin concentration (Hb), red blood counts (RBC), white blood counts (WBC) and serum metabolites such as total protein (TP), albumin (Alb), globulin (Glb), glucose, cholesterol, urea, bilirubin, serum cortisol while blood indices such as mean corpuscular hemoglobin (MCH), mean cell volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) were calculated. The hematological values of the hens were not significantly (p>0.05) affected by the housing system and strain, so also the serum metabolites except for the serum cortisol which was significantly (p<0.05) affected by the housing system only. Hens housed on PCC had higher values (20.05 ng/ml for SBL and 20.55 ng/ml for SBR) followed by hens on ECC (18.15ng/ml for SBL and 18.38ng/ml for SBL) while hens on DLS had the lowest value (16.50ng/ml for SBL and 16.00ng/ml for SBR) thereby confirming indication of stress with conventionally caged birds. Alternative housing systems can also be adopted for egg-type chickens in the humid tropics from welfare point of view with the results of this work confirming stress among caged hens.

Keywords: blood, housing, humid-tropics, layers

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4711 Investigation on the Fire Resistance of Ultra-High Performance Concrete with Natural Fibers

Authors: Dong Zhang, Kang Hai Tan, Aravind Dasari

Abstract:

Increasing concern on environmental sustainability and waste management has driven the construction and building sector towards renewable materials. In this work, we have explored the usage of natural fibers as an alternative to synthetic fibers like polypropylene (PP) in ultra-high performance concrete (UHPC). PP fibers are incorporated into concrete to resist explosive thermal spalling of UHPC during a fire exposure scenario. Experimental studies on the effect of natural fiber on the mechanical properties and spalling resistance of UHCP were conducted. The residual mechanical properties of UHPC with natural fibers were tested after heating to different temperatures. Spalling behavior of UHPC with natural fibers is also assessed by heating the samples according to ISO 834 fire curve. A range of analytical, physical and microscopic characterization techniques was also used on the concrete samples before and after being subjected to elevated temperature to investigate the phase and microstructural change of the sample. The findings show that natural fibers are able to improve fire resistance of UHPC. Adding natural fibers can prevent UHPC from spalling at high temperature. This study provides an alternative, which is at low cost and environmentally friendly, to prevent spalling of UHPC.

Keywords: high temperature, natural fiber, spalling, ultra-high performance concrete

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4710 Energy Potential of Organic Fraction of Municipal Solid Waste - Colombian Housing

Authors: Esteban Hincapie

Abstract:

The growing climate change, global warming and population growth have contributed to the energy crisis, aggravated by the generation of organic solid waste, as a material with high energy potential. From the context of waste generation in the Metropolitan Area of the Aburrá Valley, was evaluated the potential of energy content in organic solid waste generated in La Herradura housing complex, through anaerobic digestion process in batch reactors, with mixtures of substrate, water and inoculum 1: 3: 0.2 and 1: 3: 0, reaching a total biogas production of 0,2 m³/Kg y 0,14 m³/Kg respectively, in a period of 38 days under temperature conditions of 24°C. The volume of biogas obtained was equivalent to the monthly consumption of natural gas for 75 apartments or 1.856 Kw of electric power. For the Metropolitan Area of the Aburrá Valley, a production of 7.152Kw of electric power was estimated for a month, from the treatment of 22.319 tons of organic solid waste that would not be taken to the landfill. The results indicate that the treatment of organic waste from anaerobic digestion is a sustainable option to reduce pollution, contribute to the production of alternative energies and improve the efficiency of urban metabolism.

Keywords: alternative energies, anaerobic digestion, solid waste, sustainable construction, urban metabolism, waste management

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4709 Conventional and Islamic Perspective in Accounting: Potential for Alternative Reporting Framework

Authors: Shibly Abdullah

Abstract:

This paper provides an overview of fundamental philosophical and functional differences in conventional and Islamic accounting. The aim of this research is to undertake a detailed analysis focus on specific illustrations drawn from both these systems and highlight how these differences implicate in recording financial transactions and preparation of financial reports for a range of stakeholders. Accounting as being universally considered as a platform for providing a ‘true and fair’ view of corporate entities can be challenged in the current world view, as the business environment has evolved and transformed significantly. Growth of the non-traditional corporate entity such as Islamic financial institutions, fundamentally questions the applicability of conventional accounting standards in preparation of Shariah-compliant financial reporting. Coupled with this, there are significant concerns about the wider applicability of Islamic accounting standards and framework in order to achieve reporting practices satisfying the information needs generally. Against the backdrop of such a context, this paper raises fundamental question as to how potential convergence could be achieved between these two systems in order to provide users’ a transparent and comparable state of financial information resulting in an alternative framework of financial reporting.

Keywords: accounting, conventional accounting, corporate reporting, Islamic accounting

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4708 Ethical Leadership: A Theological and Ethical Alternative to the Culture of Greed in South African Government

Authors: Mookgo Solomon Kgatle

Abstract:

Introductory Statement: The effect of corruption in South Africa has seriously constrained development of the national economy and has significantly inhibited good governance in the country. The significance of this paper is a demonstration that Corruption in a South African government is greatly influenced by the culture of greed by leaders in government. Many leaders in government are not satisfied with what they receive on monthly basis in the form of salaries and allowances. Thus, the quest to accumulate, as many material possessions by cabinet ministers and public servants is what is crippling the annual budget and disadvantaging the poor masses of our people including women, children and the elderly. Basic Methodology: In order to deal with this dilemma, this paper proposes ethical leadership as a theological and ethical alternative and antidote to the culture of greed in government. Research Findings: Ethical leadership is proposed because unlike the culture of greed, it is a leadership that is based on respect for ethical principles and standards and for the dignity and privileges of others. Ethical leadership is synonymous with principles like trust, morality, consideration, equality, and justice. Conclusion: The conclusion is that ethical leadership is one of the solutions that can assist the South African government to deal with the root causes of corruption, that is, the culture of greed.

Keywords: ethical leadership, theological ethics, culture of greed, corruption, governance

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4707 Public-Private Partnership in Tourism Development: Kuwait Experience within 2035 Vision

Authors: Obaid Alotaibi

Abstract:

Tourism and recreation have become one of the important and influential sectors in most of the modern economies. This sector has been accepted as one of the alternative sources of national income, employment, and foreign exchange. Kuwait has many potentialities in tourism and recreation, and exploitation of this leads to more diversification of the economy besides augmenting its contribution to the GDP. It is an import-oriented economy; it requires hard currencies (foreign exchange) to meet the import costs as well as to maintain stability in the international market. To compensate for the revenue fall stemmed from fluctuations in oil prices -where the agriculture, fisheries, and industrial sectors are too immune and inelastic- the only alternative solution is the regeneration of the tourism and recreation to surface. This study envisages the characteristics of tourism and recreation, the economic and social importance for the society, the physical and human endowments, as well as the tourist pattern and plans for promoting and sustaining tourism in the country. The study summarizes many recommendations, including the necessity of establishing authority or a council for tourism, linking the planning of tourism development with the comprehensive planning for economic and social development in Kuwait in the shadow of 2035 vision, and to encourage the investors to develop new tourist and recreation projects.

Keywords: Kuwait, public-private, partnership, tourism, 2035 vision

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4706 Maternal Review: Challenges Experienced by Midwives in Malawi

Authors: Mercy D. Chirwa, Juliet Nyasulu, Lebisti Modiba, Makombo Ganga-Limando

Abstract:

Maternal death review is an initiative that provides a deeper understanding of the causes and circumstances sorounding of maternal deaths in Malawi and globally. Midwives are frontline members of the healthcare team and have stories about what pregnant women go through as such they are better placed to contribute to these reviews. Despite midwives’ participation as members of the facility-based maternal death review team, maternal deaths continues to occur. A lot has been documented around processes involved in maternal review, however, not much has been written around challenges experienced by midwives in maternal death review. This study explored the challenges faced by midwives in the implementation of maternal death reviews in the context of the healthcare system in Malawi. Methodology: This was a qualitative exploratory study design. Focus group discussions and individual face-to-face interviews were used to collect data in the study. A total of 40 midwives, who met the inclusion criteria, participated in the study. Data was analysed manually using a thematic content procedure. Findings: The four major challenges identified were: knowledge and skill gaps; lack of leadership and accountability; lack of institutional political will and inconsistency in conducting FBMDR, impeding midwives’ effective contribution to the implementation of maternal death review. The practical solutions and recommendations that emerged were: need-based knowledge and skills updates, supportive leadership, effective and efficient interdisciplinary work ethics, and sustained availability of material and human resources. Conclusion: Midwives have the highest potential to contribute to the reduction of maternal deaths. Practice development strategies are required to improve their practice in all the areas they are challenged with.

Keywords: facility-based maternal death review, maternal deaths, midwife, midwife challenges

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4705 Biofungicides in Nursery Production

Authors: Miroslava Markovic, Snezana Rajkovic, Ljubinko Rakonjac, Aleksandar Lucic

Abstract:

Oak powdery mildew is a serious problem on seedlings in nurseries as well as on naturally and artificially introduced progeny. The experiments were set on oak seedlings in two nurseries located in Central Serbia, where control of oak powdery mildew Microsphaera alphitoides Griff. et Maubl. had been conducted through alternative protection measures by means of various dosages of AQ-10 biofungicide, with and without added polymer (which has so far never been used in this country for control of oak powdery mildew). Simultaneous testing was conducted on the efficiency of a chemical sulphur-based preparation (used in this area for many years as a measure of suppression of powdery mildews, without the possibility of developing resistance of the pathogen to the active matter). To date, the Republic of Serbia has registered no fungicides for suppression of pathogens in the forest ecosystems. In order to introduce proper use of new disease-fighting agents into a country, certain relevant principles, requirements and criteria prescribed by the Forest Stewardship Council (FSC) must be observed, primarily with respect to measures of assessment and mitigation of risks, the list of dangerous and highly dangerous pesticides with the possibility of alternative protection. One of the main goals of the research was adjustment of the protective measures to the FSC policy through selection of eco-toxicologically favourable fungicides, given the fact that only preparations named on the list of permitted active matters are approved for use in certified forests. The results of the research have demonstrated that AQ-10 biofungicide can be used as a part of integrated disease management programmes as an alternative, through application of several treatments during vegetation and combination with other active matters registered for these purposes, so as to curtail the use of standard fungicides for control of powdery mildews on oak seedlings in nurseries. The best results in suppression of oak powdery mildew were attained through use of AQ-10 biofungicide (dose 50 or 70g/ha) with added polymer Nu Film-17 (dose 1.0 or 1.5 l/ha). If the treatment is applied at the appropriate time, even fewer number of treatments and smaller doses will be just as efficient.

Keywords: oak powdery mildew, biofungicides, polymers, Microsphaera alphitoides

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4704 A Settlement Strategy for Health Facilities in Emerging Countries: A Case Study in Brazil

Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Piero Favino, Luca Preis

Abstract:

A settlement strategy is to anticipate and respond the needs of existing and future communities through the provision of primary health care facilities in marginalized areas. Access to a health care network is important to improving healthcare coverage, often lacking, in developing countries. The study explores that a good sanitary system strategy of rural contexts brings advantages to an existing settlement: improving transport, communication, water and social facilities. The objective of this paper is to define a possible methodology to implement primary health care facilities in disadvantaged areas of emerging countries. In this research, we analyze the case study of Lauro de Freitas, a municipality in the Brazilian state of Bahia, part of the Metropolitan Region of Salvador, with an area of 57,662 km² and 194.641 inhabitants. The health localization system in Lauro de Freitas is an integrated process that involves not only geographical aspects, but also a set of factors: population density, epidemiological data, allocation of services, road networks, and more. Data were collected also using semi-structured interviews and questionnaires to the local population. Synthesized data suggest that moving away from the coast where there is the greatest concentration of population and services, a network of primary health care facilities is able to improve the living conditions of small-dispersed communities. Based on the health service needs of populations, we have developed a methodological approach that is particularly useful in rural and remote contexts in emerging countries.

Keywords: healthcare, settlement strategy, urban health, rural

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4703 The Invaluable Contributions of Radiography and Radiotherapy in Modern Medicine

Authors: Sahar Heidary

Abstract:

Radiography and radiotherapy have emerged as crucial pillars of modern medical practice, revolutionizing diagnostics and treatment for a myriad of health conditions. This abstract highlights the pivotal role of radiography and radiotherapy in favor of healthcare and society. Radiography, a non-invasive imaging technique, has significantly advanced medical diagnostics by enabling the visualization of internal structures and abnormalities within the human body. With the advent of digital radiography, clinicians can obtain high-resolution images promptly, leading to faster diagnoses and informed treatment decisions. Radiography plays a pivotal role in detecting fractures, tumors, infections, and various other conditions, allowing for timely interventions and improved patient outcomes. Moreover, its widespread accessibility and cost-effectiveness make it an indispensable tool in healthcare settings worldwide. On the other hand, radiotherapy, a branch of medical science that utilizes high-energy radiation, has become an integral component of cancer treatment and management. By precisely targeting and damaging cancerous cells, radiotherapy offers a potent strategy to control tumor growth and, in many cases, leads to cancer eradication. Additionally, radiotherapy is often used in combination with surgery and chemotherapy, providing a multifaceted approach to combat cancer comprehensively. The continuous advancements in radiotherapy techniques, such as intensity-modulated radiotherapy and stereotactic radiosurgery, have further improved treatment precision while minimizing damage to surrounding healthy tissues. Furthermore, radiography and radiotherapy have demonstrated their worth beyond oncology. Radiography is instrumental in guiding various medical procedures, including catheter placement, joint injections, and dental evaluations, reducing complications and enhancing procedural accuracy. On the other hand, radiotherapy finds applications in non-cancerous conditions like benign tumors, vascular malformations, and certain neurological disorders, offering therapeutic options for patients who may not benefit from traditional surgical interventions. In conclusion, radiography and radiotherapy stand as indispensable tools in modern medicine, driving transformative improvements in patient care and treatment outcomes. Their ability to diagnose, treat, and manage a wide array of medical conditions underscores their favor in medical practice. As technology continues to advance, radiography and radiotherapy will undoubtedly play an ever more significant role in shaping the future of healthcare, ultimately saving lives and enhancing the quality of life for countless individuals worldwide.

Keywords: radiology, radiotherapy, medical imaging, cancer treatment

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4702 Comparative Analysis of Medical Tourism Industry among Key Nations in Southeast Asia

Authors: Nur A. Azmi, Suseela D. Chandran, Fadilah Puteh, Azizan Zainuddin

Abstract:

Medical tourism has been associated as a global phenomenon in developed and developing countries in the 21st century. Medical tourism is defined as an activity in which individuals who travel from one country to another country to seek or receive medical healthcare. Based on the global trend, the number of medical tourists is increasing annually, especially in the Southeast Asia (SEA) region. Since the establishment of Association of Southeast Asian Nations (ASEAN) in 1967, the SEA nations have worked towards regional integration in medical tourism. The medical tourism in the SEA has become the third-largest sector that contributes towards economic development. Previous research has demonstrated several factors that affect the development of medical tourism. However, despite the already published literature on SEA's medical tourism in the last ten years there continues to be a scarcity of research on niche areas each of the SEA countries. Hence, this paper is significant in enriching the literature in the field of medical tourism particularly in showcasing the niche market of medical tourism among the SEA best players namely Singapore, Thailand, Malaysia and Indonesia. This paper also contributes in offering a comparative analysis between the said nations whether they are complementing or competing with each other in the medical tourism sector. This then, will increase the availability of information in SEA region on medical tourism. The data was collected through an in-depth interview with various stakeholders and private hospitals. The data was then analyzed using two approaches namely thematic analysis (interview data) and document analysis (secondary data). The paper concludes by arguing that the ASEAN countries have specific niche market to promote their medical tourism industry. This paper also concludes that these key nations complement each other in the industry. In addition, the medical tourism sector in SEA region offers greater prospects for market development and expansion that witnessed the emerging of new key players from other nations.

Keywords: healthcare services, medical tourism, medical tourists, SEA region, comparative analysis

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4701 Intermodal Strategies for Redistribution of Agrifood Products in the EU: The Case of Vegetable Supply Chain from Southeast of Spain

Authors: Juan C. Pérez-Mesa, Emilio Galdeano-Gómez, Jerónimo De Burgos-Jiménez, José F. Bienvenido-Bárcena, José F. Jiménez-Guerrero

Abstract:

Environmental cost and transport congestion on roads resulting from product distribution in Europe have to lead to the creation of various programs and studies seeking to reduce these negative impacts. In this regard, apart from other institutions, the European Commission (EC) has designed plans in recent years promoting a more sustainable transportation model in an attempt to ultimately shift traffic from the road to the sea by using intermodality to achieve a model rebalancing. This issue proves especially relevant in supply chains from peripheral areas of the continent, where the supply of certain agrifood products is high. In such cases, the most difficult challenge is managing perishable goods. This study focuses on new approaches that strengthen the modal shift, as well as the reduction of externalities. This problem is analyzed by attempting to promote intermodal system (truck and short sea shipping) for transport, taking as point of reference highly perishable products (vegetables) exported from southeast Spain, which is the leading supplier to Europe. Methodologically, this paper seeks to contribute to the literature by proposing a different and complementary approach to establish a comparison between intermodal and the “only road” alternative. For this purpose, the multicriteria decision is utilized in a p-median model (P-M) adapted to the transport of perishables and to a means of shipping selection problem, which must consider different variables: transit cost, including externalities, time, and frequency (including agile response time). This scheme avoids bias in decision-making processes. By observing the results, it can be seen that the influence of the externalities as drivers of the modal shift is reduced when transit time is introduced as a decision variable. These findings confirm that the general strategies, those of the EC, based on environmental benefits lose their capacity for implementation when they are applied to complex circumstances. In general, the different estimations reveal that, in the case of perishables, intermodality would be a secondary and viable option only for very specific destinations (for example, Hamburg and nearby locations, the area of influence of London, Paris, and the Netherlands). Based on this framework, the general outlook on this subject should be modified. Perhaps the government should promote specific business strategies based on new trends in the supply chain, not only on the reduction of externalities, and find new approaches that strengthen the modal shift. A possible option is to redefine ports, conceptualizing them as digitalized redistribution and coordination centers and not only as areas of cargo exchange.

Keywords: environmental externalities, intermodal transport, perishable food, transit time

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4700 Organ Transplantation in Pakistan from an Anthropological Perspectives

Authors: Qurratulain Faheem

Abstract:

The human body often serves as a reference point to analyse the notions of self and society. Situating on Merleau-Ponty and Bourdieu theories of embodiments, this research explores the notions around the human body and its influence on the ethical considerations in regards to organ transplantation among the Muslim communities in Pakistan. The context of Pakistan makes an intriguing case study as cadaveric organ transplantation is not in practise. Whereas living organ transplantation is commonly is practised between family membersonly. These contradictory practices apparently rests on the ideologies around the human body and religious beliefs as well the personal judgements and authority of healthcare professionals. This research is a year-long ethnographic study carried out as part of doctoral studies. An anthropological approach towards organ transplantation in Pakistan brought forward various socio-cultural notions around the human body and selfhood that serve as a framework around biomedical ethical issues in various societies. Further, it surface the contradictions and issues associated with organ transplantation that makes it a dilemma situated in a nexus of various socio-cultural and political factors rather seeing it as an isolated health concern. This research is a novel study on the subject of organ transplantation in the context of Pakistan but also put forward ethnographic data that could serve as a reference in other religious societies. Further, the ethnographic data bring forward experiences and stories of organ receivers, organ donors, religious leaders, healthcare professionals, and the general public, which aspire to encourage biomedical ethicists and social-scientists to consider ethnography as a research methodology and rely upon people’s lived experiences while establishing policies and practices around biomedical ethical issues.

Keywords: organ transplantation, ethics, pakistan, gender, islam, muslims, living organ donation

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4699 Intensifying Approach for Separation of Bio-Butanol Using Ionic Liquid as Green Solvent: Moving Towards Sustainable Biorefinery

Authors: Kailas L. Wasewar

Abstract:

Biobutanol has been considered as a potential and alternative biofuel relative to the most popular biodiesel and bioethanol. End product toxicity is the major problems in commercialization of fermentation based process which can be reduce to some possible extent by removing biobutanol simultaneously. Several techniques have been investigated for removing butanol from fermentation broth such as stripping, adsorption, liquid–liquid extraction, pervaporation, and membrane solvent extraction. Liquid–liquid extraction can be performed with high selectivity and is possible to carry out inside the fermenter. Conventional solvents have few drawbacks including toxicity, loss of solvent, high cost etc. Hence alternative solvents must be explored for the same. Room temperature ionic liquids (RTILs) composed entirely of ions are liquid at room temperature having negligible vapor pressure, non-flammability, and tunable physiochemical properties for a particular application which term them as “designer solvents”. Ionic liquids (ILs) have recently gained much attention as alternatives for organic solvents in many processes. In particular, ILs have been used as alternative solvents for liquid–liquid extraction. Their negligible vapor pressure allows the extracted products to be separated from ILs by conventional low pressure distillation with the potential for saving energy. Morpholinium, imidazolium, ammonium, phosphonium etc. based ionic liquids have been employed for the separation biobutanol. In present chapter, basic concepts of ionic liquids and application in separation have been presented. Further, type of ionic liquids including, conventional, functionalized, polymeric, supported membrane, and other ionic liquids have been explored. Also the effect of various performance parameters on separation of biobutanol by ionic liquids have been discussed and compared for different cation and anion based ionic liquids. The typical methodology for investigation have been adopted such as contacting the equal amount of biobutanol and ionic liquids for a specific time say, 30 minutes to confirm the equilibrium. Further, biobutanol phase were analyzed using GC to know the concentration of biobutanol and material balance were used to find the concentration in ionic liquid.

Keywords: biobutanol, separation, ionic liquids, sustainability, biorefinery, waste biomass

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4698 Attitudes Towards Homosexuality, Bisexuality and Transgenderism among Medical Students of a Sri Lankan University

Authors: Rajapaksha J. S. R. L., Rajapaksha R. G. D. T., Ranawaka A. U. R., Rangalla R. D. M. P., Ranwala R. D. E. B., Chandratilake M. N.

Abstract:

Introduction: Lesbian, gay, bisexual, and transgender (LGBT) patients experience discrimination, insensitivity, and ignorance about LGBT-specific health needs among healthcare providers. Developing the correct attitudes among medical students towards LGBT may help provide them with optimal healthcare. Objectives: This study aimed at assessing the attitudes of medical students towards the LBGT community. Methodology: A cross-sectional descriptive study was among all the medical students in the Faculty of Medicine, University of Kelaniya, Sri Lanka, using a validated online questionnaire. The questionnaire focused on eight areas. The data were descriptively analyzed, and the demographic groups were compared. Results: 358 students completed the survey. The response rate was 34.26%. Their attitudes on traditional gender roles and comfortability in interacting with LGBT people were moderate, and they disagreed with negative LGBT social beliefs. They knew less about the origin of sexuality/gender of LGBT. Although they accepted LGBT as a part of diversity, they discouraged normalizing the social practices of LGBT people. Their acceptance and association of LGBT were moderately positive. A minority has encountered LGBT in close social circles, and the majority of them were batch-mates. Although males’ knowledge about the origin of LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of attitudes towards LGBT reflected respondents’ political ideology. Conclusion: Although medical students’ knowledge on the sexuality/gender basis of LGBT is poor, they have moderately favourable attitudes towards them. They accept LGBT as a part of social diversity but not their social practices. Poor knowledge, lack of encounters, cultural influences, and political ideology may have influenced their attitudes.

Keywords: medical students, attitude, LGBT, diversity

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4697 Technical Analysis of Combined Solar Water Heating Systems for Cold Climate Regions

Authors: Hossein Lotfizadeh, André McDonald, Amit Kumar

Abstract:

Renewable energy resources, which can supplement space and water heating for residential buildings, can have a noticeable impact on natural gas consumption and air pollution. This study considers a technical analysis of a combined solar water heating system with evacuated tube solar collectors for different solar coverage, ranging from 20% to 100% of the total roof area of a typical residential building located in Edmonton, Alberta, Canada. The alternative heating systems were conventional (non-condensing) and condensing tankless water heaters and condensing boilers that were coupled to solar water heating systems. The performance of the alternative heating systems was compared to a traditional heating system, consisting of a conventional boiler, applied to houses of various gross floor areas. A comparison among the annual natural gas consumption, carbon dioxide (CO2) mitigation, and emissions for the various house sizes indicated that the combined solar heating system can reduce the natural gas consumption and CO2 emissions, and increase CO2 mitigation for all the systems that were studied. The results suggest that solar water heating systems are potentially beneficial for residential heating system applications in terms of energy savings and CO2 mitigation.

Keywords: CO2 emissions, CO2 mitigation, natural gas consumption, solar water heating system

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4696 Perception of Nurses and Caregivers on Fall Preventive Management for Hospitalized Children Based on Ecological Model

Authors: Mirim Kim, Won-Oak Oh

Abstract:

Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

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4695 Two-Stage Hospital Efficiency Analysis Including Qualitative Evidence: A Greek Case

Authors: Panos Xenos, Milton Nektarios, John Yfantopoulos

Abstract:

Background: Policy makers, professional organizations and payers have introduced a variety of initiatives and reforms for the health systems worldwide, aimed at improving hospital efficiency. Their efforts are concentrated in two main categories: to constrain increasing healthcare costs and to enhance quality of services provided. Research Objectives: This study examines the efficiency of 112 Greek public hospitals for the year 2009, evaluates the importance of bootstrapping techniques and investigates the effect of contextual factors on hospital efficiency. Furthermore, the effect of qualitative evidence, on hospital efficiency is explored using data from 28 large hospitals. Methods: We applied Data Envelopment Analysis, augmented by bootstrapping techniques, to estimate efficiency scores. In order to measure the effect of environmental factors on hospital efficiency we used Tobit regression analysis. The significance of our models is evaluated using statistical tests to compare distributions. Results: The Kolmogorov-Smirnov test between the original and the bootstrap-corrected efficiency indicates that their distributions are significantly different (p-value<0.01). The environmental factors, that seem to influence efficiency, are Occupancy Rating and the ratio between Outpatient Visits and Inpatient Days. Results indicate that the inclusion of the quality variable in DEA modelling generates statistically significant variations in efficiency scores (p-value<0.05). Conclusions: The inclusion of quality variables and the use of bootstrap resampling in efficiency analysis impose a statistically significant effect on the distribution of efficiency scores. As a policy conclusion we highlight the importance of these methods on hospital efficiency analysis and, by implication, on healthcare resource allocation.

Keywords: hospitals, efficiency, quality, data envelopment analysis, Greek public hospital sector

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4694 Harnessing the Power of Large Language Models in Orthodontics: AI-Generated Insights on Class II and Class III Orthopedic Appliances: A Cross-Sectional Study

Authors: Laiba Amin, Rashna H. Sukhia, Mubassar Fida

Abstract:

Introduction: This study evaluates the accuracy of responses from ChatGPT, Google Bard, and Microsoft Copilot regarding dentofacial orthopedic appliances. As artificial intelligence (AI) increasingly enhances various fields, including healthcare, understanding its reliability in specialized domains like orthodontics becomes crucial. By comparing the accuracy of different AI models, this study aims to shed light on their effectiveness and potential limitations in providing technical insights. Materials and Methods: A total of 110 questions focused on dentofacial orthopedic appliances were posed to each AI model. The responses were then evaluated by five experienced orthodontists using a modified 5-point Likert scale to ensure a thorough assessment of accuracy. This structured approach allowed for consistent and objective rating, facilitating a meaningful comparison between the AI systems. Results: The results revealed that Google Bard demonstrated the highest accuracy at 74%, followed by Microsoft Copilot, with an accuracy of 72.2%. In contrast, ChatGPT was found to be the least accurate, achieving only 52.2%. These results highlight significant differences in the performance of the AI models when addressing orthodontic queries. Conclusions: Our study highlights the need for caution in relying on AI for orthodontic insights. The overall accuracy of the three chatbots was 66%, with Google Bard performing best for removable Class II appliances. Microsoft Copilot was more accurate than ChatGPT, which, despite its popularity, was the least accurate. This variability emphasizes the importance of human expertise in interpreting AI-generated information. Further research is necessary to improve the reliability of AI models in specialized healthcare settings.

Keywords: artificial intelligence, large language models, orthodontics, dentofacial orthopaedic appliances, accuracy assessment.

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4693 Dynamic Properties of Recycled Concrete Aggregate from Resonant Column Tests

Authors: Wojciech Sas, Emil Soból, Katarzyna Gabryś, Andrzej Głuchowski, Alojzy Szymański

Abstract:

Depleting of natural resources is forcing the man to look for alternative construction materials. One of them is recycled concrete aggregates (RCA). RCA from the demolition of buildings and crushed to proper gradation can be a very good replacement for natural unbound granular aggregates, gravels or sands. Physical and the mechanical properties of RCA are well known in the field of basic civil engineering applications, but to proper roads and railways design dynamic characteristic is need as well. To know maximum shear modulus (GMAX) and the minimum damping ratio (DMIN) of the RCA dynamic loads in resonant column apparatus need to be performed. The paper will contain literature revive about alternative construction materials and dynamic laboratory research technique. The article will focus on dynamic properties of RCA, but early studies conducted by the authors on physical and mechanical properties of this material also will be presented. The authors will show maximum shear modulus and minimum damping ratio. Shear modulus and damping ratio degradation curves will be shown as well. From exhibited results conclusion will be drawn at the end of the article.

Keywords: recycled concrete aggregate, shear modulus, damping ratio, resonant column

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4692 Cotton Crops Vegetative Indices Based Assessment Using Multispectral Images

Authors: Muhammad Shahzad Shifa, Amna Shifa, Muhammad Omar, Aamir Shahzad, Rahmat Ali Khan

Abstract:

Many applications of remote sensing to vegetation and crop response depend on spectral properties of individual leaves and plants. Vegetation indices are usually determined to estimate crop biophysical parameters like crop canopies and crop leaf area indices with the help of remote sensing. Cotton crops assessment is performed with the help of vegetative indices. Remotely sensed images from an optical multispectral radiometer MSR5 are used in this study. The interpretation is based on the fact that different materials reflect and absorb light differently at different wavelengths. Non-normalized and normalized forms of these datasets are analyzed using two complementary data mining algorithms; K-means and K-nearest neighbor (KNN). Our analysis shows that the use of normalized reflectance data and vegetative indices are suitable for an automated assessment and decision making.

Keywords: cotton, condition assessment, KNN algorithm, clustering, MSR5, vegetation indices

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4691 Heterogeneous Catalytic Hydroesterification of Soybean Oil to Develop a Biodiesel Formation

Authors: O. Mowla, E. Kennedy, M. Stockenhuber

Abstract:

Finding alternative renewable resources of energy has attracted the attentions in consequence of limitation of the traditional fossil fuel resources, increasing of crude oil price and environmental concern over greenhouse gas emissions. Biodiesel (or Fatty Acid Methyl Esters (FAME)), an alternative energy source, is synthesised from renewable sources such as vegetable oils and animal fats and can be produced from waste oils. FAME can be produced via hydroesterification of oils. The process involves two stages. In the first stage of this process, fatty acids and glycerol are being obtained by hydrolysis of the feed stock oil. In the second stage, the recovered fatty acids are then esterified with an alcohol to methyl esters. The presence of a catalyst accelerates the rate of the hydroesterification reaction of oils. The overarching aim of this study is to find the effect of using zeolite as a catalyst in the heterogeneous hydroesterification of soybean oil. Both stages of the catalytic hydroesterification of soybean oil had been conducted at atmospheric and high-pressure conditions using reflux glass reactor and Parr reactor, respectively. The effect of operating parameters such as temperature and reaction time on the overall yield of biodiesel formation was also investigated.

Keywords: biodiesel, heterogeneous catalytic hydroesterification, soybean oil, zeolite

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4690 Rheometer Enabled Study of Tissue/biomaterial Frequency-Dependent Properties

Authors: Polina Prokopovich

Abstract:

Despite the well-established dependence of cartilage mechanical properties on the frequency of the applied load, most research in the field is carried out in either load-free or constant load conditions because of the complexity of the equipment required for the determination of time-dependent properties. These simpler analyses provide a limited representation of cartilage properties thus greatly reducing the impact of the information gathered hindering the understanding of the mechanisms involved in this tissue replacement, development and pathology. More complex techniques could represent better investigative methods, but their uptake in cartilage research is limited by the highly specialised training required and cost of the equipment. There is, therefore, a clear need for alternative experimental approaches to cartilage testing to be deployed in research and clinical settings using more user-friendly and financial accessible devices. Frequency dependent material properties can be determined through rheometry that is an easy to use requiring a relatively inexpensive device; we present how a commercial rheometer can be adapted to determine the viscoelastic properties of articular cartilage. Frequency-sweep tests were run at various applied normal loads on immature, mature and trypsinased (as model of osteoarthritis) cartilage samples to determine the dynamic shear moduli (G*, G′ G″) of the tissues. Moduli increased with increasing frequency and applied load; mature cartilage had generally the highest moduli and GAG depleted samples the lowest. Hydraulic permeability (KH) was estimated from the rheological data and decreased with applied load; GAG depleted cartilage exhibited higher hydraulic permeability than either immature or mature tissues. The rheometer-based methodology developed was validated by the close comparison of the rheometer-obtained cartilage characteristics (G*, G′, G″, KH) with results obtained with more complex testing techniques available in literature. Rheometry is relatively simpler and does not require highly capital intensive machinery and staff training is more accessible; thus the use of a rheometer would represent a cost-effective approach for the determination of frequency-dependent properties of cartilage for more comprehensive and impactful results for both healthcare professional and R&D.

Keywords: tissue, rheometer, biomaterial, cartilage

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4689 Isolation and Molecular Characterization of Lytic Bacteriophage against Carbapenem Resistant Klebsiella pneumoniae

Authors: Guna Raj Dhungana, Roshan Nepal, Apshara Parajuli, , Archana Maharjan, Shyam K. Mishra, Pramod Aryal, Rajani Malla

Abstract:

Introduction: Klebsiella pneumoniae is a well-known opportunistic human pathogen, primarily causing healthcare-associated infections. The global emergence of carbapenemase-producing K. pneumoniaeis a major public health burden, which is often extensively multidrug resistant.Thus, because of the difficulty to treat these ‘superbug’ and menace and some term as ‘apocalypse’ of post antibiotics era, an alternative approach to controlling this pathogen is prudent and one of the approaches is phage mediated control and/or treatment. Objective: In this study, we aimed to isolate novel bacteriophage against carbapenemase-producing K. pneumoniaeand characterize for potential use inphage therapy. Material and Methods: Twenty lytic phages were isolated from river water using double layer agar assay and purified. Biological features, physiochemical characters, burst size, host specificity and activity spectrum of phages were determined. One most potent phage: Phage TU_Kle10O was selected and characterized by electron microscopy. Whole genome sequences of the phage were analyzed for presence/absence of virulent factors, and other lysin genes. Results: Novel phage TU_Kle10O showed multiple host range within own genus and did not induce any BIM up to 5th generation of host’s life cycle. Electron microscopy confirmed that the phage was tailed and belonged to Caudovirales family. Next generation sequencing revealed its genome to be 166.2 Kb. bioinformatical analysis further confirmed that the phage genome ‘did not’ contain any ‘bacterial genes’ within phage genome, which ruled out the concern for transfer of virulent genes. Specific 'lysin’ enzyme was identified phages which could be used as 'antibiotics'. Conclusion: Extensively multidrug resistant bacteria like carbapenemase-producing K. pneumoniaecould be treated efficiently by phages.Absence of ‘virulent’ genes of bacterial origin and presence of lysin proteins within phage genome makes phages an excellent candidate for therapeutics.

Keywords: bacteriophage, Klebsiella pneumoniae, MDR, phage therapy, carbapenemase,

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4688 Minimizing Learning Difficulties in Teaching Mathematics

Authors: Hari Sharan Pandit

Abstract:

Mathematics teaching in Nepal has been centralized and guided by the notion of transfer of knowledge and skills from teachers to students. The overemphasis on an algorithm-centric approach of mathematics teaching and the focus on ‘rote–learning’ as the ultimate way of solving mathematical problems since the early years of schooling have been creating severe problems in school-level mathematics in Nepal. In this context, the author argues that students should learn real-world mathematical problems through various interesting, creative and collaborative, as well as artistic and alternative ways of knowing. The collaboration-incorporated pedagogy is an distinct pedagogical approach that offers a better alternative as an integrated and interdisciplinary approach to learning that encourages students to think more broadly and critically about real-world problems. The paper, as a summarized report of action research designed, developed and implemented by the author, focuses on the needs and usefulness of collaboration-incorporated pedagogy in the Nepali context to make mathematics teaching more meaningful for producing creative and critical citizens. This paper is useful for mathematics teachers, teacher educators and researchers who argue on arts integration in mathematics teaching.

Keywords: algorithm-centric, rote-learning, collaboration - incorporated pedagogy, action research

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