Search results for: educational data mining
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 26646

Search results for: educational data mining

16506 The role of Financial Development and Institutional Quality in Promoting Sustainable Development through Tourism Management

Authors: Hashim Zameer

Abstract:

Effective tourism management plays a vital role in promoting sustainability and supporting ecosystems. A common principle that has been in practice over the years is “first pollute and then clean,” indicating countries need financial resources to promote sustainability. Financial development and the tourism management both seems very important to promoting sustainable development. However, without institutional support, it is very difficult to succeed. In this context, it seems prominently significant to explore how institutional quality, tourism development, and financial development could promote sustainable development. In the past, no research explored the role of tourism development in sustainable development. Moreover, the role of financial development, natural resources, and institutional quality in sustainable development is also ignored. In this regard, this paper aims to investigate the role of tourism development, natural resources, financial development, and institutional quality in sustainable development in China. The study used time-series data from 2000–2021 and employed the Bayesian linear regression model because it is suitable for small data sets. The robustness of the findings was checked using a quantile regression approach. The results reveal that an increase in tourism expenditures stimulates the economy, creates jobs, encourages cultural exchange, and supports sustainability initiatives. Moreover, financial development and institution quality have a positive effect on sustainable development. However, reliance on natural resources can result in negative economic, social, and environmental outcomes, highlighting the need for resource diversification and management to reinforce sustainable development. These results highlight the significance of financial development, strong institutions, sustainable tourism, and careful utilization of natural resources for long-term sustainability. The study holds vital insights for policy formulation to promote sustainable tourism.

Keywords: sustainability, tourism development, financial development, institutional quality

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16505 Online Teacher Professional Development: An Extension of the Unified Theory of Acceptance and Use of Technology Model

Authors: Lovemore Motsi

Abstract:

The rapid pace of technological innovation, along with a global fascination with the internet, continues to result in a dominating call to integrate internet technologies in institutions of learning. However, the pressing question remains – how can online in-service training for teachers, support quality and success in professional development programmers. The aim of this study was to examine an integrated model that extended the Unified Theory of Acceptance and Use of Technology (UTAUT) with additional constructs – including attitude and behaviour intention – adopted from the Theory of Planned Behaviour (TPB) to answer the question. Data was collected from secondary school teachers at 10 selected schools in the Tshwane South district by means of the Statistical Package for Social Scientists (SPSS v 23.0), and the collected data was analysed quantitatively. The findings are congruent with model testing under conditions of volitional usage behaviour. In this regard, the role of facilitating condition variables is insignificant as a determinant of usage behaviour. Social norm variables also proved to be a weak determinant of behavioural intentions. Findings demonstrate that effort expectancy is the key determinant of online INSET usage. Based on these findings, the variable social influence and facilitating conditions are important factors in ensuring the acceptance of online INSET among teachers in selected secondary schools in the Tshwane South district.

Keywords: unified theory of acceptance and use of technology (UTAUT), teacher professional development, secondary schools, online INSET

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16504 The Correlation between Three-Dimensional Implant Positions and Esthetic Outcomes of Single-Tooth Implant Restoration

Authors: Pongsakorn Komutpol, Pravej Serichetaphongse, Soontra Panmekiate, Atiphan Pimkhaokham

Abstract:

Statement of Problem: The important parameter of esthetic assessment in anterior maxillary implant include pink esthetic of gingiva and white esthetic of restoration. While the 3 dimensional (3D) implant position are recently concerned as a key for succeeding in implant treatment. However, to our knowledge, the authors did not come across any publication that demonstrated the relations of esthetic outcome and 3D implant position. Objectives: To investigate the correlation between positional accuracy of single-tooth implant restoration (STIR) in all 3 dimensions and their esthetic outcomes. Materials and Methods: 17 patients’ data who had a STIR at central incisor with pristine contralateral tooth were included in this study. Intraoral photographs, dental models, and cone beam computed tomography (CBCT) images were retrieved. The esthetic outcome was assessed in accordance with pink esthetic score and white esthetic score (PES/WES). While the number of correct position in each dimension (mesiodistal, labiolingual, apicocoronal) of the implant were evaluated and defined as 'right' or 'wrong' according to ITI consensus conference by one investigator using CBCT data. The different mean score between right and wrong position in all dimensions was analyzed by Mann-Whitney U test with 0.05 was the significant level of the study. Results: The average score of PES/WES was 15.88 ± 1.65 which was considered as clinically acceptable. The average PES/WES score in 1, 2 and 3 right dimension of the implant position were 16.71, 15.75 and 15.17 respectively. None of the implants placed wrongly in all three dimensions. Statistically significant difference of the PES/WES score was found between the implants that placed right in 3 dimensions and 1 dimension (p = 0.041). Conclusion: This study supported the principle of 3D position of implant. The more properly implant was placed, the higher esthetic outcome was found.

Keywords: accuracy, dental implant, esthetic, 3D implant position

Procedia PDF Downloads 157
16503 Mob Justice in Ghana: Implication for Peace

Authors: Ishaq Alhassan Meriga

Abstract:

This study examined the phenomenon of mob violence and its implication for peace in Ghana. The study used the archival study of media reports and content analysis of other secondary data as well as eyewitness accounts. The study examined trends and patterns of vigilante violence within the Ghanaian context. Results showed a considerable increase in the occurrence of mob violence within the last 10 years. Theft and robbery emerged as the most frequently suspected crimes for which victims were attacked, while the LGBT community is not left out. Cases of mob violence were most frequently reported in urban areas. This study has shown that the patterns, scope, nature, and implication of mob justice in Ghana are fairly and comparatively similar to those found in other parts of Africa and the globe. Mob violence is identified as undermining the rule of law and thereby infringing on the fundamental human rights of the victims. It is confirmed to have a cycle of effects that is an impediment to the peace of the country. The study underscores the implications of mob violence in terms of disdaining human life and dignity, revisiting our justice systems and punishment procedures, resourcing, and empowering law enforcers to fight the menace of vigilantism. First, the archival study had a limitation regarding missing data. The majority of the cases used for the study lack information mostly on perpetrators and the steps taken by public authorities and security agencies after reports of a mob attack have been lodged with them. The study recommends for further research to be undertaken on the perpetrators and survivors of mob actions in order to get a holistic understanding of the phenomenon. This will give a more comprehensive view of the issue of mob violence in Ghana. From the findings, it can be concluded that mob justice is a social canker in Ghanaian communities, which has a great impact on the peace of the country.

Keywords: LGBT, mob justice, peace, vigilantism

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16502 Gender Responsiveness of Water, Sanitation Policies and Legal Frameworks at Makerere University

Authors: Harriet Kebirungi, Majaliwa Jackson-Gilbert Mwanjalolo, S. Livingstone Luboobi, Richard Joseph Kimwaga, Consolata Kabonesa

Abstract:

This paper assessed gender responsiveness of water and sanitation policies and legal frameworks at Makerere University, Uganda. The objectives of the study were to i) examine the gender responsiveness of water and sanitation related policies and frameworks implemented at Makerere University; and ii) assess the challenges faced by the University in customizing national water and sanitation policies and legal frameworks into University policies. A cross-sectional gender-focused study design was adopted. A checklist was developed to analyze national water and sanitation policies and legal frameworks and University based policies. In addition, primary data was obtained from Key informants at the Ministry of Water and Environment and Makerere University. A gender responsive five-step analytical framework was used to analyze the collected data. Key findings indicated that the policies did not adequately address issues of gender, water and sanitation and the policies were gender neutral consistently. The national policy formulation process was found to be gender blind and not backed by situation analysis of different stakeholders including higher education institutions like Universities. At Makerere University, due to lack of customized and gender responsive water and sanitation policy and implementation framework, there were gender differences and deficiencies in access to and utilization of water and sanitation facilities. The University should take advantage of existing expertise within them to customize existing national water policies and gender, and water and sanitation sub-sector strategy. This will help the University to design gender responsive, culturally acceptable and environmental friendly water and sanitation systems that provide adequate water and sanitation facilities that address the needs and interests of male and female students.

Keywords: gender, Makerere University, policies, water, sanitation

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16501 The Effect of Geographical Differentials of Epidemiological Transition on Health-Seeking Behavior in India

Authors: Sumit Kumar Das, Laishram Ladusingh

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Aim: The aim of the study is to examine the differential of epidemiological transition across fifteen agro-climatic zones of India and its effect on health-seeking behavior. Data and Methods: Unit level data on consumption expenditure on health of India from three decadal rounds conducted by National Sample Survey Organization are used for the analysis. These three rounds are 52nd (1995-96), 60th (2004-05) and 71st (2014-15). The age-adjusted prevalence rate for communicable diseases and non-communicable diseases are estimated for fifteen agro-climatic zones of India for three time periods. Bivariate analysis is used to find out determinants of health-seeking behavior. Multilevel logistic regression is used to examine factors effecting on household health-seeking behavior. Result: The prevalence of communicable diseases is increasing in most of the zones of India. Every South Indian zones, Gujarat plains, and lower Gangetic plain are facing the severe attack of dual burden of diseases. Demand for medical advice has increased in southern zones, and east zones, reliance on private healthcare facilities are increasing in most of the zone. Demographic characteristics of the household head have a significant impact on health-seeking behavior. Conclusion: Proper program implementation is required considering the disease prevalence and differential in the pattern of health seeking behavior. Along with initiation and strengthening of programs for non-communicable, existing programs for communicable diseases need to monitor and supervised strictly.

Keywords: agro-climatic zone, epidemiological transition, health-seeking behavior, multilevel regression

Procedia PDF Downloads 169
16500 An Evaluation of Cognitive Function Level, Depression, and Quality of Life of Elderly People Living in a Nursing Home

Authors: Ayse Inel Manav, Saliha Bozdogan Yesilot, Pinar Yesil Demirci, Gursel Oztunc

Abstract:

Introduction: This study was conducted with a view to evaluating cognitive function level, depression, and quality of life of elderly people living in a nursing home. Methods: This study, which is cross-sectional and descriptive in nature, was conducted in the Nursing and Rehabilitation Center for the Elderly in Adana/Turkey between 1st of May and 1st of August, 2016. The participants included 118 elderly people who were chosen using simple random sampling method. The data were collected using the Personal Information Form, the Standardized Mini Mental State Exam (SMMSE), the Geriatric Depression Scale (GDS), and the World Health Organization Quality of Life-OLD (WHOQOL-OLD) module. The data were analyzed using IBM SPSS Statistics 22 (IBM, SPSS, Turkey) program. Results: Of all the participants, 36,4% (n=43) were female, 63,6% (n=75) were male, and average age was 74,08 ± 8,23 years. The participants’ SMMSE mean score was found 20,37 ± 7,08, GDS mean score was 14,92 ± 4,29, and WHOQOL-OLD module mean score was 69,76 ± 11,54. There was a negative, significant relationship between SMMSE and GDS scores, a positive relationship between WHOQOL-OLD module total scores and a negative, significant relationship between GDS scores and WHOQOL-OLD module total scores. Discussıon and Conclusion: Results showed that more than half of the elderly people living in the nursing home experienced cognitive deterioration and depression; and cognitive state, depression, and quality of life were found to be significantly related to each other.

Keywords: depression, cognitive function level, quality of life

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16499 Environment-Friendly Biogas Technology: Comparative Analysis of Benefits as Perceived by Biogas Users and Non-User Livestock Farmers of Tehsil Jhang

Authors: Anees Raza, Liu Chunyan

Abstract:

Renewable energy technologies are need of the time and are already making the big impact in the climatic outlook of the world. Biogas technology is one of those, and it has a lot of benefits for its users. It is cost effective because it is produced from the raw material which is available free of cost to the livestock farmers. Bio-slurry, a by-product of biogas, is being used as fertilizer for the crops production and increasing soil fertility. There are many other household benefits of technology. Research paper discusses the benefits of biogas as perceived by the biogas users as well as non-users of Tehsil Jhang. Data were collected from 60 respondents (30 users and 30 non-users) selected purposively through validated and pre-tested interview schedule from the respondents. Collected data were analyzed by using Statistical Package for Social Sciences (SPSS). Household benefits like ‘makes cooking easy,’ ‘Less breathing issues for working women in kitchens’ and ‘Use of bio-slurry as organic fertilizer’ had the highly significant relationship between them with t-values of 3.24, 4.39 and 2.80 respectively. Responses of the respondents about environmental benefits of biogas technology showed that ‘less air pollution’ had a significant relationship between them while ‘less temperature rise up than due to the burning of wood /dung’ had the non-significant relationship in the responses of interviewed respondents. It was clear from the research that biogas users were becoming influential in convincing non-users to adopt this technology due to its noticeable benefits. Research area where people were depending on wood to be used as fire fuel could be helped in reduction of cutting of trees which will help in controlling deforestation and saving the environment.People should be encouraged in using of biogas technology through providing them subsidies and low mark up loans.

Keywords: biogas technology, deforestation, environmental benefits, renewable energy

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16498 Motherhood Factors Influencing the Business Growth of Women-Owned Sewing Businesses in Lagos, Nigeria: A Mixed Method Study

Authors: Oyedele Ogundana, Amon Simba, Kostas Galanakis, Lynn Oxborrow

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The debate about factors influencing the business growth of women-owned businesses has been a topical issue in business management. Currently, scholars have identified the issues of access to money, market, and management as canvasing factors influencing the business growth of women-owned businesses. However, the influence of motherhood (household/family context) on business growth is inconclusive in the literature; despite that women are more family-oriented than their male counterparts. Therefore, this research study considers the influence of motherhood factor (household/family context) on the business growth of women-owned sewing businesses (WOSBs) in Lagos, Nigeria. The sewing business sector is chosen as the fashion industry (which includes sewing businesses) currently accounts for the second largest number of jobs in Sub-Saharan Africa, following agriculture. Thus, sewing businesses provide a rich ground for contributing to existing scholarly work. Research questions; (1) In what way does the motherhood factor influence the business growth of WOSBs in Lagos? (2) To what extent does the motherhood factor influence the business growth of WOSBs in Lagos? For the method design, a pragmatic approach, a mixed-methods technique and an abductive form of reasoning are adopted. The method design is chosen because it fits, better than other research perspectives, with the research questions posed in this study. For instance, using a positivist approach will not sufficiently answer research question 1, neither will an interpretive approach sufficiently answer research question 2. Therefore, the research method design is divided into 2 phases, and the results from one phase are used to inform the development of the subsequent phases (only phase 1 has been completed at the moment). The first phase uses qualitative data and analytical method to answer research question 1. While the second phase of the research uses quantitative data and analytical method to answer research question 2. For the qualitative phase, 5 WOSBs were purposefully selected and interviewed. The sampling technique is selected as it was not the intention of the researcher to make any statistical inferences, at this phase, rather the purpose was just exploratory. Therefore, the 5 sampled women comprised of 2 unmarried women, 1 married woman with no child, and 2 married women with children. A 40-60 minutes interview was conducted per participants. The interviews were audio-recorded and transcribed. Thereafter, the data were analysed using thematic analysis in order to unearth patterns and relationships. Findings for the first phase of this research reveals that motherhood (household/family context) directly influences (positively/negatively) the performance of WOSBs in Lagos. Apart from a direct influence on WOSBs, motherhood also moderates (positively/negatively) other factors–e.g., access to money, management/human resources and market/opportunities– influencing WOSBs in Lagos. To further strengthen this conclusion, a word frequency query result shows that ‘family,’ ‘husband’ and ‘children’ are among the 10 words used frequently in all the interview transcripts. This first phase contributes to existing studies by showing the various forms by which motherhood influences WOSBs. The second phase (which data are yet to be collected) would reveal the extent to which motherhood influence the business growth of WOSBs in Lagos.

Keywords: women-owned sewing businesses, business growth, motherhood, Lagos

Procedia PDF Downloads 151
16497 Impacts of Computer Assisted Instruction and Gender on High-Flyers Pre-Service Teachers' Attitude towards Agricultural Economics in Southwest Nigeria

Authors: Alice Morenike Olagunju, Olufemi A. Fakolade, Abiodun Ezekiel Adesina, Olufemi Akinloye Bolaji, Oriyomi Rabiu

Abstract:

The use of computer-assisted instruction(CAI) has been suggested as a way out of the problem of Colleges of Education (CoE) in Southwest, Nigeria persistent high failure rate in and negative attitude towards Agricultural Economics (AE).The impacts of this are yet unascertained on high-flyers. This study, therefore, determined the impacts of CAI onhigh-flyers pre-service teachers’ attitude towards AE concepts in Southwest, Nigeria. The study adopted pretest-posttest, control group, quasi-experimental design. Six CoE with e-library facilities were purposively selected. Fourty-nine 200 level Agricultural education students offering introduction to AE course across the six CoE were participants. The participants were assigned to two groups (CAI, 22 and control, 27). Treatment lasted eight weeks. The AE Attitude Scale(r=0.80), Instructional guides and Teacher Performance Assessment Sheets were used for data collection. Data were analysed using t-test. The participants were 62.8% male with mean age of 22 years. Treatment had significant effects on high-flyers pre-service teachers’ attitude (t = 17.44; df = 47, p < .5). Participants in CAI ( =71.03) had higher post attitude mean score compared to those in control ( = 64.92) groups. Gender had no significant effect on attitude (t= 3.06; df= 47, p > .5). The computer assisted instructional mode enhanced students’ attitude towards Agricultural Economics concepts. Therefore, CAI should be adopted for improved attitude towards agricultural economics concepts among high-flyers pre-service teachers.

Keywords: attitude towards agricultural economics concepts, colleges of education in southwest Nigeria, computer-assisted instruction, high-flyers pre-service teachers

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16496 Optimization Modeling of the Hybrid Antenna Array for the DoA Estimation

Authors: Somayeh Komeylian

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The direction of arrival (DoA) estimation is the crucial aspect of the radar technologies for detecting and dividing several signal sources. In this scenario, the antenna array output modeling involves numerous parameters including noise samples, signal waveform, signal directions, signal number, and signal to noise ratio (SNR), and thereby the methods of the DoA estimation rely heavily on the generalization characteristic for establishing a large number of the training data sets. Hence, we have analogously represented the two different optimization models of the DoA estimation; (1) the implementation of the decision directed acyclic graph (DDAG) for the multiclass least-squares support vector machine (LS-SVM), and (2) the optimization method of the deep neural network (DNN) radial basis function (RBF). We have rigorously verified that the LS-SVM DDAG algorithm is capable of accurately classifying DoAs for the three classes. However, the accuracy and robustness of the DoA estimation are still highly sensitive to technological imperfections of the antenna arrays such as non-ideal array design and manufacture, array implementation, mutual coupling effect, and background radiation and thereby the method may fail in representing high precision for the DoA estimation. Therefore, this work has a further contribution on developing the DNN-RBF model for the DoA estimation for overcoming the limitations of the non-parametric and data-driven methods in terms of array imperfection and generalization. The numerical results of implementing the DNN-RBF model have confirmed the better performance of the DoA estimation compared with the LS-SVM algorithm. Consequently, we have analogously evaluated the performance of utilizing the two aforementioned optimization methods for the DoA estimation using the concept of the mean squared error (MSE).

Keywords: DoA estimation, Adaptive antenna array, Deep Neural Network, LS-SVM optimization model, Radial basis function, and MSE

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16495 The Lived Experience of Risk and Protective Contexts of Blind Successful University Students in Sidist Kilo Campus

Authors: Zelalem Markos Borko

Abstract:

The quality of life of people with blindness is significantly influenced by the level of resilience they possess. A qualitative approach of the descriptive phenomenological design was employed to address basic study objectives. The researcher purposely selected three blind graduate students from Sidist Kilo Campus and conducted a semi-structured interview to gather data. Data were analyzed by using thematic coding techniques. The present study found that personal characteristics such as commitment, living hope, motivation, positive self-esteem, self-confidence, and communication have shaped resiliency for successful university students with visual disabilities. The finding showed that the school environment is the place in which blind students had developed/experienced social, psychological, and economical competency and hope for their academic and entire life success. Furthermore, the finding showed that blind students had experienced individual, family, school, and community-related risks in the success track. Therefore, governmental and non-governmental organizations should provide training for students with visual impairments that focus on the individual traits that shape resilience for academic success, such as commitment, living hope, motivation, positive self-esteem, self-confidence, and communication and also community-oriented training should be to break the social stigma and discriminations for the individuals with the visual impairment.

Keywords: blind students, risk and protective factors, lived experience, success

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16494 Prevalence and Genetic Determinant of Drug Resistant Tuberculosis among Patients Completing Intensive Phase of Treatment in a Tertiary Referral Center in Nigeria

Authors: Aminu Bashir Mohammad, Agwu Ezera, Abdulrazaq G. Habib, Garba Iliyasu

Abstract:

Background: Drug resistance tuberculosis (DR-TB) continues to be a challenge in developing countries with poor resources. Routine screening for primary DR-TB before commencing treatment is not done in public hospitals in Nigeria, even with the large body of evidence that shows a high prevalence of primary DR-TB. Data on drug resistance and its genetic determinant among follow up TB patients is lacking in Nigeria. Hence the aim of this study was to determine the prevalence and genetic determinant of drug resistance among follow up TB patients in a tertiary hospital in Nigeria. Methods: This was a cross-sectional laboratory-based study conducted on 384 sputum samples collected from consented follow-up tuberculosis patients. Standard microbiology methods (Zeil-Nielsen staining and microscopy) and PCR (Line Probe Assay)] were used to analyze the samples collected. Person’s Chi-square was used to analyze the data generated. Results: Out of three hundred and eighty-four (384) sputum samples analyzed for mycobacterium tuberculosis (MTB) and DR-TB twenty-five 25 (6.5%) were found to be AFB positive. These samples were subjected to PCR (Line Probe Assay) out of which 18(72%) tested positive for DR-TB. Mutations conferring resistance to rifampicin (rpo B) and isoniazid (katG, and or inhA) were detected in 12/18(66.7%) and 6/18(33.3%), respectively. Transmission dynamic of DR-TB was not significantly (p>0.05) dependent on demographic characteristics. Conclusion: There is a need to strengthened the laboratory capacity for diagnosis of TB and drug resistance testing and make these services available, affordable, and accessible to the patients who need them.

Keywords: drug resistance tuberculosis, genetic determinant, intensive phase, Nigeria

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16493 Automated End of Sprint Detection for Force-Velocity-Power Analysis with GPS/GNSS Systems

Authors: Patrick Cormier, Cesar Meylan, Matt Jensen, Dana Agar-Newman, Chloe Werle, Ming-Chang Tsai, Marc Klimstra

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Sprint-derived horizontal force-velocity-power (FVP) profiles can be developed with adequate validity and reliability with satellite (GPS/GNSS) systems. However, FVP metrics are sensitive to small nuances in data processing procedures such that minor differences in defining the onset and end of the sprint could result in different FVP metric outcomes. Furthermore, in team-sports, there is a requirement for rapid analysis and feedback of results from multiple athletes, therefore developing standardized and automated methods to improve the speed, efficiency and reliability of this process are warranted. Thus, the purpose of this study was to compare different methods of sprint end detection on the development of FVP profiles from 10Hz GPS/GNSS data through goodness-of-fit and intertrial reliability statistics. Seventeen national team female soccer players participated in the FVP protocol which consisted of 2x40m maximal sprints performed towards the end of a soccer specific warm-up in a training session (1020 hPa, wind = 0, temperature = 30°C) on an open grass field. Each player wore a 10Hz Catapult system unit (Vector S7, Catapult Innovations) inserted in a vest in a pouch between the scapulae. All data were analyzed following common procedures. Variables computed and assessed were the model parameters, estimated maximal sprint speed (MSS) and the acceleration constant τ, in addition to horizontal relative force (F₀), velocity at zero (V₀), and relative mechanical power (Pmax). The onset of the sprints was standardized with an acceleration threshold of 0.1 m/s². The sprint end detection methods were: 1. Time when peak velocity (MSS) was achieved (zero acceleration), 2. Time after peak velocity drops by -0.4 m/s, 3. Time after peak velocity drops by -0.6 m/s, and 4. When the integrated distance from the GPS/GNSS signal achieves 40-m. Goodness-of-fit of each sprint end detection method was determined using the residual sum of squares (RSS) to demonstrate the error of the FVP modeling with the sprint data from the GPS/GNSS system. Inter-trial reliability (from 2 trials) was assessed utilizing intraclass correlation coefficients (ICC). For goodness-of-fit results, the end detection technique that used the time when peak velocity was achieved (zero acceleration) had the lowest RSS values, followed by -0.4 and -0.6 velocity decay, and 40-m end had the highest RSS values. For intertrial reliability, the end of sprint detection techniques that were defined as the time at (method 1) or shortly after (method 2 and 3) when MSS was achieved had very large to near perfect ICC and the time at the 40 m integrated distance (method 4) had large to very large ICCs. Peak velocity was reached at 29.52 ± 4.02-m. Therefore, sport scientists should implement end of sprint detection either when peak velocity is determined or shortly after to improve goodness of fit to achieve reliable between trial FVP profile metrics. Although, more robust processing and modeling procedures should be developed in future research to improve sprint model fitting. This protocol was seamlessly integrated into the usual training which shows promise for sprint monitoring in the field with this technology.

Keywords: automated, biomechanics, team-sports, sprint

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16492 Incidence and Causes of Elective Surgery Cancellations in Songklanagarind Hospital, Thailand

Authors: A. Kaeotawee, N. Bunmas, W. Chomthong

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Background: The cancellation of elective surgery is a major indicator of poor operating room efficiency. Furthermore, it is recognized as a major cause of emotional trauma to patients as well as their families. This study was carried out to assess the incidence and causes of elective surgery cancellation in our setting and to find the appropriate solutions for better quality management. Objective: To determine the incidence and causes of elective surgery cancellations in Songklanagarind Hospital. Material and Method: A prospective survey was conducted from September to November 2012. All patients who had their scheduled elective operations cancelled were assessed. Data was collected on the following 2 components: (1) patient demographics;(2) main reasons for cancellations, which were grouped into patient-related factors and organizational-related factors. Data are reported as a percentage of patients whose operations were cancelled. The association between cancellation status and patient demographics was assessed using univariate logistic regression. Results: 2,395 patients were scheduled for elective surgery and of these 343 (14.3%) had their operations cancelled. Cardiothoracic surgery had the highest rate of cancellations (28.7%) while the least number of cancellations occurred in ophthalmology (10.1%). The main reasons for cancellations were related to the unit's organization (53.6%), due to the surgeon (48.4%). Patient related causes (46.4%), due to non medical reasons (32.1%). The most common cause of cancellation by the surgeon was lack of theater time (21.3%), by patients due to the patient’s nonappearance (25.1%). Cancellation was significantly associated with type of patient, health insurance, type of anesthesia and specialties (p<0.05). Conclusion: Surgery cancellations by surgeons relating to a lack of theater time was a significant problem in our setting. Appropriate solutions for better quality improvement are needed.

Keywords: elective cases, surgery cancellation, quality management, appropriate solutions

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16491 Measuring Stakeholder Engagement and Drivers of Success in Ethiopian Tourism Sector

Authors: Gezahegn Gizaw

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The FDRE Tourism Training Institute organizes forums for debates, best practices exchange and focus group discussions to forge a sustainable and growing tourism sector while minimizing negative impacts on the environment, communities, and cultures. This study aimed at applying empirical research method to identify and quantify relative importance of success factors and individual engagement indicators that were identified in these forums. Response to the 12-question survey was collected from a total of 437 respondents in academic training institutes (212), business executive and employee (204) and non-academic government offices (21). Overall, capacity building was perceived as the most important driver of success for stakeholder engagement. Business executive and employee category rated capacity building as the most important driver of success (53%), followed by decision-making process (27%) and community participation (20%). Among educators and students, both capacity building and decision-making process were perceived as the most important factors (40% of respondents), whereas community participation was perceived as the most important success factor only by 20% of respondents. Individual engagement score in capacity building, decision-making process and community participation showed highest variability by educational level of participants (variance of 3.4% - 5.2%, p<0.001). Individual engagement score in capacity building was highly correlated to perceived benefit of training on improved efficiency, job security, higher customer satisfaction and self-esteem. On the other hand, individual engagement score in decision making process was highly correlated to its perceived benefit on lowering business costs, improving ability to meet the needs of a target market, job security, self-esteem and more teamwork. The study provides a set of recommendations that help educators, business executives and policy makers to maximize the individual and synergetic effect of training, decision making process on sustainability and growth of the tourism sector in Ethiopia.

Keywords: engagement score, driver of success, capacity building, tourism

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16490 Pre-Transformation Phase Reconstruction for Deformation-Induced Transformation in AISI 304 Austenitic Stainless Steel

Authors: Manendra Singh Parihar, Sandip Ghosh Chowdhury

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Austenitic stainless steels are widely used and give a good combination of properties. When this steel is plastically deformed, a phase transformation of the metastable Face Centred Cubic Austenite to the stable Body Centred Cubic (α’) or to the Hexagonal close packed (ԑ) martensite may occur, leading to the enhancement in the mechanical properties like strength. The work was based on variant selection and corresponding texture analysis for the strain induced martensitic transformation during deformation of the parent austenite FCC phase to form the product HCP and the BCC martensite phases separately, obeying their respective orientation relationships. The automated method for reconstruction of the parent phase orientation using the EBSD data of the product phase orientation is done using the MATLAB and TSL-OIM software. The method of triplets was used which involves the formation of a triplet of neighboring product grains having a common variant and linking them using a misorientation-based criterion. This led to the proper reconstruction of the pre-transformation phase orientation data and thus to its microstructure and texture. The computational speed of current method is better compared to the previously used methods of reconstruction. The reconstruction of austenite from ԑ and α’ martensite was carried out for multiple samples and their IPF images, pole figures, inverse pole figures and ODFs were compared. Similar type of results was observed for all samples. The comparison gives the idea for estimating the correct sequence of the transformation i.e. γ → ε → α’ or γ → α’, during deformation of AISI 304 austenitic stainless steel.

Keywords: variant selection, reconstruction, EBSD, austenitic stainless steel, martensitic transformation

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16489 The Effects of Six Weeks Endurance Training and Aloe Vera on COX-2 and VEGF Levels in Mice with Breast Cancer

Authors: Alireza Barari, Ahmad Abdi

Abstract:

The aim of this study was to determine the effects of the effects of six weeks endurance training and Aloe Vera on cyclooxygenase 2 (COX-2) and VEGF levels in mice with breast cancer. For this purpose, 35 rats were randomly divided into 5 groups: control (healthy), control (cancer), training (cancer), Aloe Vera (cancer) and Aloe Vera + training (cancer). Induction of breast cancer tumors were done in mice by planting method. The training program includes six weeks of swimming training was done in three sessions per week. Training time from 10 minutes on the first day increased to 60 minutes in second week, and by stabilizing this time, the water flow rate was increased from 7 to 15 liters per minute. 300 mg per kg body weight of Aloe Vera extract was injected into the peritoneal. Sampling was done 48 hours after the last exercise session. K-S test to determine the normality of the data and analysis of variance for repeated measures and Tukey test was used to analyze the data. A significant difference in the p<0.05 accepted. The results showed that induction of cancer cells significantly increased levels of COX-2 in aloe group and VEGF in training and Aloe Vera + training groups. The results suggest that swimming exercise and Aloe Vera can reduce levels of COX-2 and VEGF in mice with breast cancer.The results of this study, Induction of cancer cells significantly increased levels of COX-2 and MMP-9 in the control group compared with the cancer control group. The results suggest that Aloe Vera can probably inhibit the cyclooxygenase pathway and thus production of prostaglandin E2 decrease of arachidonic acid.

Keywords: endurance training, aloe vera, COX-2, VEGF

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16488 Simulation of Solar Assisted Absorption Cooling and Electricity Generation along with Thermal Storage

Authors: Faezeh Mosallat, Eric L. Bibeau, Tarek El Mekkawy

Abstract:

Availability of a wide variety of renewable resources, such as large reserves of hydro, biomass, solar and wind in Canada provides significant potential to improve the sustainability of energy uses. As buildings represent a considerable portion of energy use in Canada, application of distributed solar energy systems for heating and cooling may increase the amount of renewable energy use. Parabolic solar trough systems have seen limited deployments in cold northern climates as they are more suitable for electricity production in southern latitudes. Heat production by concentrating solar rays using parabolic troughs can overcome the poor efficiencies of flat panels and evacuated tubes in cold climates. A numerical dynamic model is developed to simulate an installed parabolic solar trough facility in Winnipeg. The results of the numerical model are validated using the experimental data obtained from this system. The model is developed in Simulink and will be utilized to simulate a tri-generation system for heating, cooling and electricity generation in remote northern communities. The main objective of this simulation is to obtain operational data of solar troughs in cold climates as this is lacking in the literature. In this paper, the validated Simulink model is applied to simulate a solar assisted absorption cooling system along with electricity generation using organic Rankine cycle (ORC) and thermal storage. A control strategy is employed to distribute the heated oil from solar collectors among the above three systems considering the temperature requirements. This modeling provides dynamic performance results using real time minutely meteorological data which are collected at the same location the solar system is installed. This is a big step ahead of the current models by accurately calculating the available solar energy at each time step considering the solar radiation fluctuations due to passing clouds. The solar absorption cooling is modeled to use the generated heat from the solar trough system and provide cooling in summer for a greenhouse which is located next to the solar field. A natural gas water heater provides the required excess heat for the absorption cooling at low or no solar radiation periods. The results of the simulation are presented for a summer month in Winnipeg which includes the amount of generated electric power from ORC and contribution of solar energy in the cooling load provision

Keywords: absorption cooling, parabolic solar trough, remote community, validated model

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16487 Wildlife Habitat Corridor Mapping in Urban Environments: A GIS-Based Approach Using Preliminary Category Weightings

Authors: Stefan Peters, Phillip Roetman

Abstract:

The global loss of biodiversity is threatening the benefits nature provides to human populations and has become a more pressing issue than climate change and requires immediate attention. While there have been successful global agreements for environmental protection, such as the Montreal Protocol, these are rare, and we cannot rely on them solely. Thus, it is crucial to take national and local actions to support biodiversity. Australia is one of the 17 countries in the world with a high level of biodiversity, and its cities are vital habitats for endangered species, with more of them found in urban areas than in non-urban ones. However, the protection of biodiversity in metropolitan Adelaide has been inadequate, with over 130 species disappearing since European colonization in 1836. In this research project we conceptualized, developed and implemented a framework for wildlife Habitat Hotspots and Habitat Corridor modelling in an urban context using geographic data and GIS modelling and analysis. We used detailed topographic and other geographic data provided by a local council, including spatial and attributive properties of trees, parcels, water features, vegetated areas, roads, verges, traffic, and census data. Weighted factors considered in our raster-based Habitat Hotspot model include parcel size, parcel shape, population density, canopy cover, habitat quality and proximity to habitats and water features. Weighted factors considered in our raster-based Habitat Corridor model include habitat potential (resulting from the Habitat Hotspot model), verge size, road hierarchy, road widths, human density, and presence of remnant indigenous vegetation species. We developed a GIS model, using Python scripting and ArcGIS-Pro Model-Builder, to establish an automated reproducible and adjustable geoprocessing workflow, adaptable to any study area of interest. Our habitat hotspot and corridor modelling framework allow to determine and map existing habitat hotspots and wildlife habitat corridors. Our research had been applied to the study case of Burnside, a local council in Adelaide, Australia, which encompass an area of 30 km2. We applied end-user expertise-based category weightings to refine our models and optimize the use of our habitat map outputs towards informing local strategic decision-making.

Keywords: biodiversity, GIS modeling, habitat hotspot, wildlife corridor

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16486 Impact of Out-Of-Pocket Payments on Health Care Finance and Access to Health Care Services: The Case of Health Transformation Program in Turkey

Authors: Bengi Demirci

Abstract:

Out-of-pocket payments have become one of the common models adopted by health care reforms all over the world, and they have serious implications for not only the financial set-up of the health care systems in question but also for the people involved in terms of their access to the health care services provided. On the one hand, out-of-pocket payments are used in raising resources for the finance of the health care system and in decreasing non-essential health care expenses by having a deterrent role on the patients. On the other hand, out-of-pocket payment model causes regressive distribution effect by putting more burdens on the lower income groups and making them refrain from using health care services. Being a relatively incipient country having adopted the out-of-pocket payment model within the context of its Health Transformation Program which has been ongoing since the early 2000s, Turkey provides a good case for re-evaluating the pros and cons of this model in order not to sacrifice equality in access to health care for raising revenue for health care finance and vice versa. Therefore this study aims at analyzing the impact of out-of-pocket payments on the health finance system itself and on the patients’ access to healthcare services in Turkey where out-of-pocket payment model has been in use for a while. In so doing, data showing the revenue obtained from out-of-pocket payments and their share in health care finance are analyzed. In addition to this, data showing the change in the amount of expenditure made by patients on health care services after the adoption of out-of-pocket payments and the change in the use of various health care services in the meanwhile are examined. It is important for the incipient countries like Turkey to be careful in striking the right balance between the objective of cost efficiency and that of equality in accessing health care services while adopting the out-of-pocket payment model.

Keywords: health care access, health care finance, health reform, out-of-pocket payments

Procedia PDF Downloads 359
16485 Metformin Protects Cardiac Muscle against the Pro-Apoptotic Effects of Hyperglycaemia, Elevated Fatty Acid and Nicotine

Authors: Christopher R. Triggle, Hong Ding, Khaled Machaca, Gnanapragasam Arunachalam

Abstract:

The antidiabetic drug, metformin, has been in clinical use for over 50 years and remains the first choice drug for the treatment of type two diabetes. In addition to its effectiveness as an oral anti-hyperglycaemic drug metformin also possesses vasculoprotective effects that are assumed to be secondary to its ability to reduce insulin resistance and control glycated hemoglobin levels; however, recent data from our laboratory indicate that metformin also has direct vasoprotective effects that are mediated, at least in part, via the anti-ageing gene, SIRT1. Diabetes is a major risk factor for the development of cardiovascular disease (CVD) and it is also well established that tobacco use further enhances the risk of CVD; however, it is not known whether treatment with metformin can offset the negative effects of diabetes and tobacco use on cardiac function. The current study was therefore designed to investigate 1: the effects of hyperglycaemia (HG) either alone or in the presence of elevated fatty acids (palmitate) and nicotine on the protein expression levels of the deacetylase sirtuin 1 (the protein product of SIRT1), anti-apoptotic Bcl-2, pro-apoptotic BIM and the pro-apoptotic, tumour suppressor protein, acetylated p53 in cardiomyocytes. 2: the ability of metformin to prevent the detrimental effects of HG, palmitate and nicotine on cardiomyocyte survival. Cell culture protocols were designed using a rat cardiomyocyte cell line, H9c2, either under normal glycaemic (NG) conditions of 5.5mM glucose, or hyperglycaemic conditions (HG) of 25mM glucose with, or without, added palmitate (250μM) or nicotine (1.0mM) for 24h. Immuno-blotting was used to detect the expression of sirtuin 1, Bcl-2, BIM, acetylated (Ac)-p53, p53 with β-actin used as the reference protein. Exposure to HG, palmitate, or nicotine alone significantly reduced expression of sirtuin1, Bcl-2 and raised the expression levels of acetylated p53 and BIM; however, the combination of HG, palmitate and nicotine had a synergistic effect to significantly suppress the expression levels of sirtuin 1 and Bcl-2, but further enhanced the expression of Ac-p53, and BIM. The inclusion of 1000μM, but not 50μM, metformin in the H9c2 cell culture protocol prevented the effects of HG, palmitate and nicotine on the pro-apoptotic pathways. Collectively these data indicate that metformin, in addition to its anti-hyperglycaemic and vasculoprotective properties, also has direct cardioprotective actions that offset the negative effects of hyerglycaemia, elevated free fatty acids and nicotine on cardiac cell survival. These data are of particular significance for the treatment of patients with diabetes who are also smokers as the inclusion of metformin in their therapeutic treatment plan should help reduce cardiac-related morbidity and mortality.

Keywords: apoptosis, cardiac muscle, diabetes, metformin, nicotine

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16484 The Effort of Nutrition Status Improvement through Partnership with Early Age Education Institution on Urban Region, City of Semarang, Indonesia

Authors: Oktia Woro Kasmini Handayani, Sri Ratna Rahayu, Efa Nugroho, Bertakalswa Hermawati

Abstract:

In Indonesia, from 2007 until 2013, the prevalence of overnutrition in children under five years and school age tends to increase. Clean and Health Life Behavior of school children supporting nutrition status still below the determined target. On the other side, school institution is an ideal place to educate and form health behavior, that should be initiated as early as possible (Early Age Education/PAUD level). The objective of this research was to find out the effectivity of education model through partnership with school institution in urban region, city of Semarang, Central Java Province, Indonesia. The research used quantitative approach supported with qualitative data. The population consist of all mother having school children of ages 3-5 years within the research region; sampling technique was purposive sampling, as many as 237 mothers. Research instrument was Clean and Health Life Behavior evaluation questionaire, and video as education media. The research used experimental design. Data analysis used effectivity criteria from Sugiyono and 2 paired sampel t test. Education model optimalization in the effort to improve nutrition status indicates t test result with signification < 0.05 (there was significant effect before and after model intervention), with effectivity test result of 79% (effective), but still below expected target which is 80%. Education model need to be utilized and optimallized the implementation so that expected target reached.

Keywords: nutrition status, early age education, clean dan health life behavior, education model

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16483 Examining Awareness, Foresight and Expectations about Fatih Project Increasing the Occasions and Normalizing the Technology Movement

Authors: Agah Tugrul Korucu, Mustafa Mucahit Gundogdu, Tarık Gencturk, Ahmet Yucel

Abstract:

Countries are developing big projects and supplying financial resource for developing technological substructure and integrating technology into the education. In Turkey, the Ministry of Education, with the aim of integrating ICT into learning and teaching processes, created a project named increasing occasions and normalizing the technology movement. FATIH Project with this project, the aim is to create teaching environments which are enriched with technology. In orientating people with the technology and integrating technology into the education, teacher and teacher candidates have a big responsibility. While teachers are using technology in lesson, the devices in class and the methods developed are important factors. The aim of this research is to examine awareness, and foresight about FATIH Project in different aspects. This study was conducted during the practice period of the second semester in the 2014-2015 academic years. The working group of the research was created from 209 teacher candidates which are from different teaching departments in the Ahmet Kelesoglu Education Faculty of Necmettin Erbakan University. Scanning model was used in this research. In research, as a getting data tool evaluation of “opinion about FATIH Project: awareness, foresight and expectation scale” which was developed by Karal et. al.; personal information form which was developed by researchers were used. Cronbach coefficient which is the reliability of the scale is 0.91. In analyzing the data, statistical package program average, standard deviation, percentage, correlation, t-test and variance analysis test were used.

Keywords: Fatih Project, information and communication technologies, information technology integration, views on the Fatih Project, technology integration in education

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16482 Organizational Culture and Its Internalization of Change in the Manufacturing and Service Sector Industries in India

Authors: Rashmi Uchil, A. H. Sequeira

Abstract:

Post-liberalization era in India has seen an unprecedented growth of mergers, both domestic as well as cross-border deals. Indian organizations have slowly begun appreciating this inorganic method of growth. However, all is not well as is evidenced in the lowering value creation of organizations after mergers. Several studies have identified that organizational culture is one of the key factors that affects the success of mergers. But very few studies have been attempted in this realm in India. The current study attempts to identify the factors in the organizational culture variable that may be unique to India. It also focuses on the difference in the impact of organizational culture on merger of organizations in the manufacturing and service sectors in India. The study uses a mixed research approach. An exploratory research approach is adopted to identify the variables that constitute organizational culture specifically in the Indian scenario. A few hypotheses were developed from the identified variables and tested to arrive at the Grounded Theory. The Grounded Theory approach used in the study, attempts to integrate the variables related to organizational culture. Descriptive approach is used to validate the developed grounded theory with a new empirical data set and thus test the relationship between the organizational culture variables and the success of mergers. Empirical data is captured from merged organizations situated in major cities of India. These organizations represent significant proportions of the total number of organizations which have adopted mergers. The mix of industries included software, banking, manufacturing, pharmaceutical and financial services. Mixed sampling approach was adopted for this study. The first phase of sampling was conducted using the probability method of stratified random sampling. The study further used the non-probability method of judgmental sampling. Adequate sample size was identified for the study which represents the top, middle and junior management levels of the organizations that had adopted mergers. Validity and reliability of the research instrument was ensured with appropriate tests. Statistical tools like regression analysis, correlation analysis and factor analysis were used for data analysis. The results of the study revealed a strong relationship between organizational culture and its impact on the success of mergers. The study also revealed that the results were unique to the extent that they highlighted a marked difference in the manner of internalization of change of organizational culture after merger by the organizations in the manufacturing sector. Further, the study reveals that the organizations in the service sector internalized the changes at a slower rate. The study also portrays the industries in the manufacturing sector as more proactive and can contribute to a change in the perception of the said organizations.

Keywords: manufacturing industries, mergers, organizational culture, service industries

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16481 Nurse-Reported Perceptions of Medication Safety in Private Hospitals in Gauteng Province.

Authors: Madre Paarlber, Alwiena Blignaut

Abstract:

Background: Medication administration errors remains a global patient safety problem targeted by the WHO (World Health Organization), yet research on this matter is sparce within the South African context. Objective: The aim was to explore and describe nurses’ (medication administrators) perceptions regarding medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province of South Africa, and to determine any relationships between perceived variables concerned with medication safety (safety culture, incidences, causes, reporting of incidences, and reasons for non-reporting). Method: A quantitative research design was used through which self-administered online surveys were sent to 768 nurses (medication administrators) (n=217). The response rate was 28.26%. The survey instrument was synthesised from the Agency of Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture, the Registered Nurse Forecasting (RN4CAST) survey, a survey list prepared from a systematic review aimed at generating a comprehensive list of medication administration error causes and the Medication Administration Error Reporting Survey from Wakefield. Exploratory and confirmatory factor analyses were used to determine the validity and reliability of the survey. Descriptive and inferential statistical data analysis were used to analyse quantitative data. Relationships and correlations were identified between items, subscales and biographic data by using Spearmans’ Rank correlations, T-Tests and ANOVAs (Analysis of Variance). Nurses reported on their perceptions of medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province. Results: Units’ teamwork deemed satisfactory, punitive responses to errors accentuated. “Crisis mode” working, concerns regarding mistake recording and long working hours disclosed as impacting patient safety. Overall medication safety graded mostly positively. Work overload, high patient-nurse ratios, and inadequate staffing implicated as error-inducing. Medication administration errors were reported regularly. Fear and administrative response to errors effected non-report. Non-report of errors’ reasons was affected by non-punitive safety culture. Conclusions: Medication administration safety improvement is contingent on fostering a non-punitive safety culture within units. Anonymous medication error reporting systems and auditing nurses’ workload are recommended in the quest of improved medication safety within Gauteng Province private hospitals.

Keywords: incidence, medication administration errors, medication safety, reporting, safety culture

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16480 Modulation of Alternative Respiration Pathyway under Salt Stress in Exogenous Estrogen-Treated Maize Seedlings

Authors: Farideh K. Khosroushahi, Serkan Erdal, Mucip Geni̇şel

Abstract:

Soil salinity is one of the major abiotic stress factors that restricts arable land and reduces crop productivity worldwide. High salt concentration adversely affects plant growth and development inducing water deficit, ionic toxicity, nutrient imbalance, and lead to oxidative stress. Although the stimulating role of mammalian sex hormones on various biological and biochemical processes under normal and stress condition have been proven, there is no study regarding with these hormone's effect on modulation of the alternative respiration pathway and AOX gene expression. In this study, changes in alternative respiration pathway in leaves of maize seedlings under salinity and the possible modulating effect of estrogen on these changes were investigated. Maize seedlings were grown in a hydroponic media for 11 days and then were exposed to salt stress for 3 days after being sprayed estrogen. The data obtained from oxygen consumption revealed that salt stress elevated cellular respiration value in the leaves. In addition, a marked increase was observed at alternative respiration level in salt-stressed seedlings. Compared to salt application alone, supplementation with estrogen resulted in a significant rise in alternative oxidase (AOX) activities. Similarly, while salt stress caused to rise in expressions of AOX gene compared to control seedlings, estrogen application resulted in further activation of these genes’ expression compared to stressed-seedlings alone. These data revealed that mitigating role of estrogen against the detrimental effects of salt stress is linked to modulation of alternative respiration pathway.

Keywords: alternative oxidase, estrogen, Ssalt stress, AOX, maize

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16479 The Comparison between Public's Social Distances against Syrian Refugees and Perceptions of Access to Healthcare Services: Istanbul Sample

Authors: Pinar Dogan, Merve Tarhan, Ahu Kurklu

Abstract:

Syrian refugees who sheltering due to war has protected by the Government of Turkey since 2011. Since Syria was a medium-low income country prior to the war, it is known that chronic health problems weren’t common among citizens. However, it is also known that they frequently use health services in our country because of the spread of infectious and acute diseases due to insufficient sanitation and crowding after the war. This study was planned to compare the social distances of the community against the Syrian refugees and the perceptions of accessing health care services. The descriptive-cross sectional study was carried out on 1262 individuals living in Istanbul. A questionnaire form consisted of Personal Information Form, The Bogardus Social Distance Scale (BSDS) and The Survey of Access to Healthcare Services (AHS) was used as data collection tool. Descriptive tests and chi-square test were used for statistical analysis. It was found that the majorities of participants was satisfied with the health services and were waiting for more than 40 minutes to be examined. It was determined that participants have high scores from BSDS. At the same time, the majority of participants stated that their level of access to health care is diminishing due to refugees. Participants who experienced disruption in access to health services due to refugees were found to have higher scores from BSDS. The data collection process in the study will continue until 2400 individuals are reached. With these conclusions, it is considered necessary that the effect of the presence of the refugees in reaching the health services and nursing care of the society should be revealed through extensive researches to be conducted in Turkey.

Keywords: health care services, nursing care, social distances, Syrian refugees

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16478 Predicting Resistance of Commonly Used Antimicrobials in Urinary Tract Infections: A Decision Tree Analysis

Authors: Meera Tandan, Mohan Timilsina, Martin Cormican, Akke Vellinga

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Background: In general practice, many infections are treated empirically without microbiological confirmation. Understanding susceptibility of antimicrobials during empirical prescribing can be helpful to reduce inappropriate prescribing. This study aims to apply a prediction model using a decision tree approach to predict the antimicrobial resistance (AMR) of urinary tract infections (UTI) based on non-clinical features of patients over 65 years. Decision tree models are a novel idea to predict the outcome of AMR at an initial stage. Method: Data was extracted from the database of the microbiological laboratory of the University Hospitals Galway on all antimicrobial susceptibility testing (AST) of urine specimens from patients over the age of 65 from January 2011 to December 2014. The primary endpoint was resistance to common antimicrobials (Nitrofurantoin, trimethoprim, ciprofloxacin, co-amoxiclav and amoxicillin) used to treat UTI. A classification and regression tree (CART) model was generated with the outcome ‘resistant infection’. The importance of each predictor (the number of previous samples, age, gender, location (nursing home, hospital, community) and causative agent) on antimicrobial resistance was estimated. Sensitivity, specificity, negative predictive (NPV) and positive predictive (PPV) values were used to evaluate the performance of the model. Seventy-five percent (75%) of the data were used as a training set and validation of the model was performed with the remaining 25% of the dataset. Results: A total of 9805 UTI patients over 65 years had their urine sample submitted for AST at least once over the four years. E.coli, Klebsiella, Proteus species were the most commonly identified pathogens among the UTI patients without catheter whereas Sertia, Staphylococcus aureus; Enterobacter was common with the catheter. The validated CART model shows slight differences in the sensitivity, specificity, PPV and NPV in between the models with and without the causative organisms. The sensitivity, specificity, PPV and NPV for the model with non-clinical predictors was between 74% and 88% depending on the antimicrobial. Conclusion: The CART models developed using non-clinical predictors have good performance when predicting antimicrobial resistance. These models predict which antimicrobial may be the most appropriate based on non-clinical factors. Other CART models, prospective data collection and validation and an increasing number of non-clinical factors will improve model performance. The presented model provides an alternative approach to decision making on antimicrobial prescribing for UTIs in older patients.

Keywords: antimicrobial resistance, urinary tract infection, prediction, decision tree

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16477 Performance the SOFA and APACHEII Scoring System to Predicate the Mortality of the ICU Cases

Authors: Yu-Chuan Huang

Abstract:

Introduction: There is a higher mortality rate for unplanned transfer to intensive care units. It also needs a longer length of stay and makes the intensive care unit beds cannot be effectively used. It affects the immediate medical treatment of critically ill patients, resulting in a drop in the quality of medical care. Purpose: The purpose of this study was using SOFA and APACHEII score to analyze the mortality rate of the cases transferred from ED to ICU. According to the score that should be provide an appropriate care as early as possible. Methods: This study was a descriptive experimental design. The sample size was estimated at 220 to reach a power of 0.8 for detecting a medium effect size of 0.30, with a 0.05 significance level, using G-power. Considering an estimated follow-up loss, the required sample size was estimated as 242 participants. Data were calculated by medical system of SOFA and APACHEII score that cases transferred from ED to ICU in 2016. Results: There were 233 participants meet the study. The medical records showed 33 participants’ mortality. Age and sex with QSOFA , SOFA and sex with APACHEII showed p>0.05. Age with APCHHII in ED and ICU showed r=0.150, 0,268 (p < 0.001**). The score with mortality risk showed: ED QSOFA is r=0.235 (p < 0.001**), exp(B)=1.685(p = 0.007); ICU SOFA 0.78 (p < 0.001**), exp(B)=1.205(p < 0.001). APACHII in ED and ICU showed r= 0.253, 0.286 (p < 0.001**), exp(B) = 1.041,1.073(p = 0.017,0.001). For SOFA, a cutoff score of above 15 points was identified as a predictor of the 95% mortality risk. Conclusions: The SOFA and APACHE II were calculated based on initial laboratory data in the Emergency Department, and during the first 24 hours of ICU admission. In conclusion, the SOFA and APACHII score is significantly associated with mortality and strongly predicting mortality. Early predictors of morbidity and mortality, which we can according the predicting score, and provide patients with a detail assessment and proper care, thereby reducing mortality and length of stay.

Keywords: SOFA, APACHEII, mortality, ICU

Procedia PDF Downloads 136