Search results for: Risk management

Authors: Eda Ozkara San

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Nurse educators have been charged by several nursing organizations and accrediting bodies to provide innovative and evidence-based educational experiences, both didactic and clinical, to help students to develop the knowledge, skills, and attitudes needed to provide culturally competent nursing care to patients. Clinical simulation, which offers the opportunity for students to practice nursing skills in a risk-free, controlled environment and helps develop self-efficacy (confidence) within the nursing role. As one simulation method, the standardized patients (SPs) simulation helps educators to teach nursing students variety of skills in nursing, medicine, and other health professions. It can be a helpful tool for nurse educators to enhance cultural competence of nursing students. An alarming gap exists within the literature concerning the effectiveness of SP strategy to enhance cultural competence development of diverse student groups, who must work with patients from various backgrounds. This grant-supported, longitudinal, one-group, pretest and post-test educational intervention study aimed to examine the effect of the Diverse Standardized Patient Simulation (DSPS) cultural competence education strategy on students’ (n = 53) transcultural self-efficacy (TSE). The researcher-developed multidimensional DSPS strategy involved careful integration of transcultural nursing skills guided by the Cultural Competence and Confidence (CCC) model. As a carefully orchestrated teaching and learning strategy by specifically utilizing the SP pedagogy, the DSPS also followed international guidelines and standards for the design, implementation, evaluation, and SP training; and had content validity review. The DSPS strategy involved two simulation scenarios targeting underrepresented patient populations (Muslim immigrant woman with limited English proficiency and Irish-Italian American gay man with his partner (Puerto Rican) to be utilized in a second-semester, nine-credit, 15-week medical-surgical nursing course at an urban public US university. Five doctorally prepared content experts reviewed the DSPS strategy for content validity. The item-level content validity index (I-CVI) score was calculated between .80-1.0 on the evaluation forms. Jeffreys’ Transcultural Self-Efficacy Tool (TSET) was administered as a pretest and post-test to assess students’ changes in cognitive, practical, and affective dimensions of TSE. Results gained from this study support that the DSPS cultural competence education strategy assisted students to develop cultural competence and caused statistically significant changes (increase) in students’ TSE perceptions. Results also supported that all students, regardless of their background, benefit (and require) well designed cultural competence education strategies. The multidimensional DSPS strategy is found to be an effective way to foster nursing students’ cultural competence development. Step-by-step description of the DSPS provides an easy adaptation of this strategy with different student populations and settings.

Keywords: cultural competence development, the cultural competence and confidence model, CCC model, educational intervention, transcultural self-efficacy, TSE, transcultural self-efficacy tool, TSET

Procedia PDF Downloads 149

Authors: A. K. Tekile, I. L. Kim, J. Y. Lee

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Human activities put freshwater quality under risk, mainly due to expansion of agriculture and industries, damming, diversion and discharge of inadequately treated wastewaters. The rapid human population growth and climate change escalated the problem. External controlling actions on point and non-point pollution sources are long-term solution to manage water quality. To have a holistic approach, these mechanisms should be coupled with the in-water control strategies. The available in-lake or river methods are either costly or they have some adverse effect on the ecological system that the search for an alternative and effective solution with a reasonable balance is still going on. This study aimed at the physical and chemical water quality improvement in a stagnant Yeo-cheon River reach (Korea), which has recently shown sign of water quality problems such as scum formation and fish death. The river water quality was monitored, for the duration of three months by operating only water flow generator in the first two weeks and then ultrasonic irradiation device was coupled to the flow unit for the remaining duration of the experiment. In addition to assessing the water quality improvement, the correlation among the parameters was analyzed to explain the contribution of the ultra-sonication. Generally, the combined strategy showed localized improvement of water quality in terms of dissolved oxygen, Chlorophyll-a and dissolved reactive phosphate. At locations under limited influence of the system operation, chlorophyll-a was highly increased, but within 25 m of operation the low initial value was maintained. The inverse correlation coefficient between dissolved oxygen and chlorophyll-a decreased from 0.51 to 0.37 when ultrasonic irradiation unit was used with the flow, showing that ultrasonic treatment reduced chlorophyll-a concentration and it inhibited photosynthesis. The relationship between dissolved oxygen and reactive phosphate also indicated that influence of ultra-sonication was higher than flow on the reactive phosphate concentration. Even though flow increased turbidity by suspending sediments, ultrasonic waves canceled out the effect due to the agglomeration of suspended particles and the follow-up settling out. There has also been variation of interaction in the water column as the decrease of pH and dissolved oxygen from surface to the bottom played a role in phosphorus release into the water column. The variation of nitrogen and dissolved organic carbon concentrations showed mixed trend probably due to the complex chemical reactions subsequent to the operation. Besides, the intensive rainfall and strong wind around the end of the field trial had apparent impact on the result. The combined effect of water flow and ultrasonic irradiation was a cumulative water quality improvement and it maintained the dissolved oxygen and chlorophyll-a requirement of the river for healthy ecological interaction. However, the overall improvement of water quality is not guaranteed as effectiveness of ultrasonic technology requires long-term monitoring of water quality before, during and after treatment. Even though, the short duration of the study conducted here has limited nutrient pattern realization, the use of ultrasound at field scale to improve water quality is promising.

Keywords: stagnant, ultrasonic irradiation, water flow, water quality

Procedia PDF Downloads 193

Authors: Denis Constantin Topa, Irina Gabriela Cara, Gerard Jitareanu

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Tillage is a fundamental soil practice with different soil disturbance intensities and unique implications in soil organic carbon, soil structure, and nutrient dynamics. However, the implication of tillage practice on soil organic carbon and soil health is complex and specific to the context. it study evaluated soil health status based on soil carbon sequestration and pools, soil aggregation, and nutrient use under two different tillage practices: conventional and minimum tillage. The results of our study are consistent with the hypothesis that, over time, minimum tillage typically boosts soil health in the 0-10 cm soil layer. Compared to the conventional practice (19.36 t C ha-1) there was a significant accumulation of soil organic carbon (0-30 cm) in the minimum-tillage practice (23.21 t C ha-1). Below 10 cm depth, the soil organic carbon stocks are close to that of the conventional layer (0-30 cm). Soil aggregate stability was improved under conservative tillage, due to soil carbon improvement which facilitated a greater volume of mesopores and micropores. Total nitrogen (TN), available potassium (AK) and phosphorus (AP) content in 0-10 cm depth under minimum-tillage practice were 26%, 6% and 32%, greater respectively, compared to the conventional treatment. Overall, the TN, AP and AK values decreased with depth within the soil profiles as a consequence of soil practice and minimum disturbance. The data show that minimum tillage is a sustainable and effective management practice that maintain soil health with soil carbon increase and efficient nutrient use.

Keywords: minimum tillage, conventional tillage, soil organic carbon, nutrients, soil aggregation, soil health

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Authors: Ariyaratna Athugala

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Mass media play a significant role in democratic societies. The Political Economy of the Mass Media postulates that elite media interlock with other institutional sectors in ownership, and editorial management effectively circumscribing their ability to remain analytically detached from other dominant institutional sectors. The production of meaning in news discourse is not valued neutral, but part of a larger process of presenting a hegemonic understanding of the world to audiences as the “production of consent.” The horse race model argues that “the raw material of news” pressures six bands that ultimately shape the news audiences receive. The six bands are as follows: Crown piece (raw material), brow band (professionalism), throat latch (gatekeeper), a bit (construction), nose band (perception), and reins (ownership). dThe horse race model suggests that media ultimately serve to “manufacture consent” for a range of self-serving elite opinion options. These bands determine what events are deemed newsworthy, how they are covered, where they are placed within the media and how much coverage they receive. Highly descriptive in nature, the horse race model of communication is concerned with the question of whether media can be seen to play a hegemonic role in the society oriented towards legitimization, hegemonic pressures and ideological construction.

Keywords: hegemonic pressures, horse race, ideological construction, six bands

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Authors: Theophilius Adekunle Tinuoye

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Trade unions are groups formed essentially to promote, articulate and enhance the welfare of workers. They are expected to defend the workers interests and participate actively in workplace exchanges. But for trade unions to function effectively and actualize their lofty aspirations in the context of the current dynamic and ever-changing industrial relations context, they must not only have qualified and competent leaders, but also flexible and effective structure, systems, organograms, constitution, and administrative processes in place to compliment their policies and programmes. An important aspect of industrial relations is the existence of cordial tripartite or bipartite interactions between stakeholders and other social partners that are indispensable to the creation of positive and mutually beneficial exchanges and outcomes. This paper canvassed that unions must be structurally viable and administratively cohesive in order to be effective, pragmatic, functional and remain relevant. It also argued that weak, structurally deficient and less organized unions often find it immensely difficult to actualize workers goals. Finally, it outlined basic principles that will enhance union administration, guarantee that unions will continue to satisfy the yearnings of its members in these trying times and finally foster peaceful industrial relations climate and cordial labor relations between trade unions, employers /management and government.

Keywords: governance, labor relations, trade unions, workers

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Authors: Shizra Waris, Bilal Shoaib, Munib Ahmad

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Background; The using of clinical decision support systems (CDSSs) may recover unceasing disease organization, which requires regular visits to multiple health professionals, treatment monitoring, disease control, and patient behavior modification. The objective of this survey is to determine if these CDSSs improve the processes of unceasing care including diagnosis, treatment, and monitoring of diseases. Though artificial intelligence is not a new idea it has been widely documented as a new technology in computer science. Numerous areas such as education business, medical and developed have made use of artificial intelligence Methods: The survey covers articles extracted from relevant databases. It uses search terms related to information technology and viral hepatitis which are published between 2000 and 2016. Results: Overall, 80% of studies asserted the profit provided by information technology (IT); 75% of learning asserted the benefits concerned with medical domain;25% of studies do not clearly define the added benefits due IT. The CDSS current state requires many improvements to hold up the management of liver diseases such as HCV, liver fibrosis, and cirrhosis. Conclusion: We concluded that the planned model gives earlier and more correct calculation of hepatitis B and it works as promising tool for calculating of custom hepatitis B from the clinical laboratory data.

Keywords: detection, hapataties, observation, disesese

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Authors: Y. N. Fung, R. Liu, T. M. Choi

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Over the past decades, previous studies have explored different consumers’ attitudes towards sustainable fashion and how these attitudes affect consumer behaviors. Researchers have attempted to provide solutions for product suppliers (e.g., retailers, designers, developers, and manufacturers) through studying consumers’ attitudes towards sustainable fashion. However, based on the studies of consumer attitudes, investigations on the sales and market share of sustainable sportswear products remain under-explored. Gaps may exist between the consumers’ expectations and the developed sustainable sportswear products. In this study, a novel study has been carried out to examine the attitude gaps existing between the sustainable sportswear suppliers’ (SSSs) and the sustainable sportswear consumers (SSCs). This study firstly identifies the key attitudes towards sustainable sportswear product development. It analyses how sustainable attitudes affect the products being developed, as well as the effects of the attitude’s difference between the SSSs and the SSCs on the consumers’ satisfaction towards sportswear product consumption. A gap analysis research framework is adopted with the use of collected questionnaire survey data. The results indicate that a significant difference exists between SSSs and SSCs’ attitudes towards sustainable design, manufacture, product features, and branding. Based on in-depth interviews, the major causes of the difference in attitudes are studied to provide managerial insights for sustainable sportswear product management and business development.

Keywords: sustainability, sportswear, attitude, gap analysis, suppliers, consumers

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Authors: Noorh Albadi, Salha Khayyat

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People's moods and well-being are affected by their environment. The built environment impacts one's level of activity and health. In order to enhance users' physical health, sustainable design strategies have been developed for the physical environment to improve users' health. This study aimed to determine whether adult resorts in Saudi Arabia meet standards that ensure physical wellness to identify the needed requirements. It will be significant to the Ministry of Tourism, Sports, developers, and designers. Physical activity affects human health physically and mentally. In Saudi Arabia, the percentage of people who practiced sports in the Kingdom in 2019 was 20.04% - males and females older than 15. On the other hand, there is a lack of physical activity in Saudi Arabia; 90% of the Kingdom's population spends more than two hours sitting down without moving, which puts them at risk of contracting a non-communicable disease. The lack of physical activity and movement led to an increase in the rate of obesity among Saudis by 59% in 2020 and consequently could cause chronic diseases or death. The literature generally endorses that leading an active lifestyle improves physical health and affects mental health. Therefore, the United Nations has set 17 sustainable development goals (SDGs) to ensure healthy lives and promote well-being for all ages. One of SDG3's targets is reducing mortality, which can be achieved by raising physical activity. In order to support sustainable design, many rating systems and strategies have been developed, such as WELL building, Leadership in Energy and Environmental Design, (LEED), Active design strategies, and RIPA plan of work. The survey was used to gather qualitative and quantitative information. It was designed based on the Active Design and WELL building theories targeting beach resorts visitors, professional and beginner athletes, and non-athletics to ask them about the beach resorts they visited in the Kingdom and whether they met the criteria of sports resorts and healthy and active design theories, in addition to gathering information about the preferences of physical activities in the Saudi society in terms of the type of activities that young people prefer, where they prefer to engage in and under any thermal and light conditions. The final section asks about the design of residential units in beach sports resorts, the data collected from 127 participants. Findings revealed that participants prefer outdoor activities in moderate weather and sunlight or the evening with moderate and sufficient lighting and that no beach sports resorts in the country are constructed to support sustainable design criteria for physical activity. Participants agreed that several measures that lessen tension at beach resorts and enhance movement and activity are needed by Saudi society. The study recommends designing resorts that meet the sustainable design criteria regarding physical activity in Saudi Arabia to increase physical activity to achieve psychological and physical benefits and avoid psychological and physical diseases related to physical inactivity.

Keywords: sustainable design, SDGs, active design strategies, well building, beach resort design

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Authors: Rudolph Carl Barrientos, Juwaln Diego Descallar, Rainer James Palmiano

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Household Appliance Scheduling Systems (HASS) coupled with a Time-of-Use (TOU) pricing scheme, a form of Demand Side Management (DSM), is not widely utilized in the Philippines’ residential electricity sector. This paper’s goal is to encourage distribution utilities (DUs) to adopt HASS and TOU by analyzing the effect of household schedulers on the electricity price and load profile in a residential environment. To establish this, a city based on an implemented survey is generated using Monte Carlo Analysis (MCA). Then, a Binary Particle Swarm Optimization (BPSO) algorithm-based HASS is developed considering user satisfaction, electricity budget, appliance prioritization, energy storage systems, solar power, and electric vehicles. The simulations were assessed under varying levels of user compliance. Results showed that the average electricity cost, peak demand, and peak-to-average ratio (PAR) of the city load profile were all reduced. Therefore, the deployment of the HASS and TOU pricing scheme is beneficial for both stakeholders.

Keywords: appliance scheduling, DSM, TOU, BPSO, city-wide simulation, electric vehicle, appliance prioritization, energy storage system, solar power

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Authors: Duncan Wallace, M-Tahar Kechadi

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In recent years, Machine Learning (ML) approaches have been successfully applied to an analysis of patient symptom data in the context of disease diagnosis, at least where such data is well codified. However, much of the data present in Electronic Health Records (EHR) are unlikely to prove suitable for classic ML approaches. Furthermore, as scores of data are widely spread across both hospitals and individuals, a decentralized, computationally scalable methodology is a priority. The focus of this paper is to develop a method to predict outliers in an out-of-hours healthcare provision center (OOHC). In particular, our research is based upon the early identification of patients who have underlying conditions which will cause them to repeatedly require medical attention. OOHC act as an ad-hoc delivery of triage and treatment, where interactions occur without recourse to a full medical history of the patient in question. Medical histories, relating to patients contacting an OOHC, may reside in several distinct EHR systems in multiple hospitals or surgeries, which are unavailable to the OOHC in question. As such, although a local solution is optimal for this problem, it follows that the data under investigation is incomplete, heterogeneous, and comprised mostly of noisy textual notes compiled during routine OOHC activities. Through the use of Deep Learning methodologies, the aim of this paper is to provide the means to identify patient cases, upon initial contact, which are likely to relate to such outliers. To this end, we compare the performance of Long Short-Term Memory, Gated Recurrent Units, and combinations of both with Convolutional Neural Networks. A further aim of this paper is to elucidate the discovery of such outliers by examining the exact terms which provide a strong indication of positive and negative case entries. While free-text is the principal data extracted from EHRs for classification, EHRs also contain normalized features. Although the specific demographical features treated within our corpus are relatively limited in scope, we examine whether it is beneficial to include such features among the inputs to our neural network, or whether these features are more successfully exploited in conjunction with a different form of a classifier. In this section, we compare the performance of randomly generated regression trees and support vector machines and determine the extent to which our classification program can be improved upon by using either of these machine learning approaches in conjunction with the output of our Recurrent Neural Network application. The output of our neural network is also used to help determine the most significant lexemes present within the corpus for determining high-risk patients. By combining the confidence of our classification program in relation to lexemes within true positive and true negative cases, with an inverse document frequency of the lexemes related to these cases, we can determine what features act as the primary indicators of frequent-attender and non-frequent-attender cases, providing a human interpretable appreciation of how our program classifies cases.

Keywords: artificial neural networks, data-mining, machine learning, medical informatics

Procedia PDF Downloads 131

Authors: Z. I Jeeva

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The establishment of municipalities in South Africa has been a long and difficult process; 25 years later, it still appears to be evolving. In 1994, the new democratic government undertook to restructure the country’s racially segregated administrative structure by integrating areas to form cohesive municipal entities that would allow for the more efficient administration management of the regions. It planned to achieve this within a short seven-year period from 1993 to 2000, which was to be divided into three phases, namely, the pre-interim phase from 1994 to1995, the interim phase from 1996 to 1999, and the post-interim phase from 2000 onwards. However, the extensive integrated municipal approach was easier to pen on paper than to implement in practice. This paper seeks to explore the South African spatial reform process from 1993 to 2020, by analyzing policy documents and literature in order to determine how exactly the government attempted to achieve this. The study found that the spatial restructuring process was particularly complex since the democratic government inherited an unequal society located on a fragmented spatial landscape of which there was limited knowledge with many unresolved issues. Furthermore, the study found that there is a lack of literature on the topic from an urban planning perspective and calls for further research to ensure the formation of more efficient administrative regions.

Keywords: categorization, demarcation, municipalities, racial integration, spatial reform

Procedia PDF Downloads 107

Authors: Tharsinithevy Kirupananthan, Thivahary Geretharan

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Since creation of agricultural enterprises going to reflect the micro and macro level development of Sri Lanka, it is vey important to study the entrepreneurial trends of Agricultural Undergraduates. Likert scale scoring method was used to assess the responses of involvement, Role model effect, aware of demands, confidence and willingness. 37.8% were strongly agreed to do full time business. The average score for to do agriculture businesses were between agree and strongly agree. The average scores for role model effects were less than agree. Average score for aware of needs of society was less than agree. 75.7% of them were able to identify the demands of the society. The demands identified were human capital, self sufficient domestic production, safe and nutritional foods. The confidence of having enough skills score was less than agree. 64.1% of them were owned special skills to carry out entrepreneurial activities. Such skills were possession of different human capitals management skills. The willingness responses scores were more than agree. 61.5% of them were discussed their business plan. Their dream plans were development of new food products, Quality planting materials, harmless method of cultivation and floricultural industry. Those were supported by government policies and other related organizations.

Keywords: agricultural undergraduates, entrepreneurial trends, likert scale Sri Lanka

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Authors: Mateusz Janas

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Innovative implementations in the micro, small, and medium-sized enterprises (MSME) sector are among the essential activities considering the current market realities, technological advancements, and digitization trends. MSMEs play a crucial role and significantly influence the economic conditions of countries, as their competitiveness directly impacts the global economy. Business development and investment in innovation and technology are integral parts of every modern enterprise's strategy, seeking to maintain and achieve a desired competitive position. The instability of the socio-economic environment, along with contemporary changes in artificial intelligence implementation and digitization, requires businesses to adopt increasingly newer solutions and actions. Enterprises must strive to survive in the global market and build competitive positions, especially in uncertain conditions. Being aware of the significance of innovative actions is crucial for MSMEs as it enables them to enhance their operations and expand their scope. It is essential for managers and executives of MSMEs to be focused on development and innovation, as their approach will also impact their employees, emphasizing results and maximizing the company's value. Managers of MSMEs must be aware of various threats, costs, opportunities, and gains that can arise from implementing new technical and organizational solutions. Businesses must view development as an integral part of their strategy and continuously strive for improvement.

Keywords: innovation, SME, develop, management

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Authors: A. Kourou, A. Ioakeimidou, V. Avramea

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Planning for natural disasters and emergencies is something every school or educational institution must consider, regardless of its size or location. Preparedness is the key to save lives if a disaster strikes. School disaster management mirrors individual and family disaster prevention, and wider community disaster prevention efforts. This paper presents the usage of E-PreS System as a helpful, managerial tool during the school earthquake drill, in order to support schools in developing effective disaster and emergency plans specific to their local needs. The project comes up with a holistic methodology using real-time evaluation involving different categories of actors, districts, steps and metrics. The main outcomes of E-PreS project are the development of E-PreS web platform that host the needed data of school emergency planning; the development of E-PreS System; the implementation of disaster drills using E-PreS System in educational premises and local schools; and the evaluation of E-PreS System. Taking into consideration that every disaster drill aims to test and valid school plan and procedures; clarify and train personnel in roles and responsibilities; improve interagency coordination; identify gaps in resources; improve individual performance; and identify opportunities for improvement, E-PreS Project was submitted and approved by the European Commission (EC).

Keywords: disaster drills, earthquake preparedness, E-PreS System, school emergency plans

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Authors: Kenneth A. Rostowsky, Alexander S. Maher, Nahian F. Chowdhury, Andrei Irimia

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The clinical significance of cerebral microbleeds (CMBs) due to mild traumatic brain injury (mTBI) remains unclear. Here we use magnetic resonance imaging (MRI), diffusion tensor imaging (DTI) and connectomic analysis to investigate the statistical association between mTBI-related CMBs, post-TBI changes to the human connectome and neurological/cognitive deficits. This study was undertaken in agreement with US federal law (45 CFR 46) and was approved by the Institutional Review Board (IRB) of the University of Southern California (USC). Two groups, one consisting of 26 (13 females) mTBI victims and another comprising 26 (13 females) healthy control (HC) volunteers were recruited through IRB-approved procedures. The acute Glasgow Coma Scale (GCS) score was available for each mTBI victim (mean µ = 13.2; standard deviation σ = 0.4). Each HC volunteer was assigned a GCS of 15 to indicate the absence of head trauma at the time of enrollment in our study. Volunteers in the HC and mTBI groups were matched according to their sex and age (HC: µ = 67.2 years, σ = 5.62 years; mTBI: µ = 66.8 years, σ = 5.93 years). MRI [including T1- and T2-weighted volumes, gradient recalled echo (GRE)/susceptibility weighted imaging (SWI)] and gradient echo (GE) DWI volumes were acquired using the same MRI scanner type (Trio TIM, Siemens Corp.). Skull-stripping and eddy current correction were implemented. DWI volumes were processed in TrackVis (http://trackvis.org) and 3D Slicer (http://www.slicer.org). Tensors were fit to DWI data to perform DTI, and tractography streamlines were then reconstructed using deterministic tractography. A voxel classifier was used to identify image features as CMB candidates using Microbleed Anatomic Rating Scale (MARS) guidelines. For each peri-lesional DTI streamline bundle, the null hypothesis was formulated as the statement that there was no neurological or cognitive deficit associated with between-scan differences in the mean FA of DTI streamlines within each bundle. The statistical significance of each hypothesis test was calculated at the α = 0.05 level, subject to the family-wise error rate (FWER) correction for multiple comparisons. Results: In HC volunteers, the along-track analysis failed to identify statistically significant differences in the mean FA of DTI streamline bundles. In the mTBI group, significant differences in the mean FA of peri-lesional streamline bundles were found in 21 out of 26 volunteers. In those volunteers where significant differences had been found, these differences were associated with an average of ~47% of all identified CMBs (σ = 21%). In 12 out of the 21 volunteers exhibiting significant FA changes, cognitive functions (memory acquisition and retrieval, top-down control of attention, planning, judgment, cognitive aspects of decision-making) were found to have deteriorated over the six months following injury (r = -0.32, p < 0.001). Our preliminary results suggest that acute post-TBI CMBs may be associated with cognitive decline in some mTBI patients. Future research should attempt to identify mTBI patients at high risk for cognitive sequelae.

Keywords: traumatic brain injury, magnetic resonance imaging, diffusion tensor imaging, connectomics

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Authors: Ana L. M. Pavan, Guilherme Giacomini, Allan F. F. Alves, Marcela De Oliveira, Fernando A. B. Neto, Maria E. D. Rosa, Andre P. Trindade, Diana R. De Pina

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Mammography is a worldwide image modality used to diagnose breast cancer, even in asymptomatic women. Due to its large availability, mammograms can be used to measure breast density and to predict cancer development. Women with increased mammographic density have a four- to sixfold increase in their risk of developing breast cancer. Therefore, studies have been made to accurately quantify mammographic breast density. In clinical routine, radiologists perform image evaluations through BIRADS (Breast Imaging Reporting and Data System) assessment. However, this method has inter and intraindividual variability. An automatic objective method to measure breast density could relieve radiologist’s workload by providing a first aid opinion. However, pectoral muscle is a high density tissue, with similar characteristics of fibroglandular tissues. It is consequently hard to automatically quantify mammographic breast density. Therefore, a pre-processing is needed to segment the pectoral muscle which may erroneously be quantified as fibroglandular tissue. The aim of this work was to develop an automatic algorithm to segment and extract pectoral muscle in digital mammograms. The database consisted of thirty medio-lateral oblique incidence digital mammography from São Paulo Medical School. This study was developed with ethical approval from the authors’ institutions and national review panels under protocol number 3720-2010. An algorithm was developed, in Matlab® platform, for the pre-processing of images. The algorithm uses image processing tools to automatically segment and extract the pectoral muscle of mammograms. Firstly, it was applied thresholding technique to remove non-biological information from image. Then, the Hough transform is applied, to find the limit of the pectoral muscle, followed by active contour method. Seed of active contour is applied in the limit of pectoral muscle found by Hough transform. An experienced radiologist also manually performed the pectoral muscle segmentation. Both methods, manual and automatic, were compared using the Jaccard index and Bland-Altman statistics. The comparison between manual and the developed automatic method presented a Jaccard similarity coefficient greater than 90% for all analyzed images, showing the efficiency and accuracy of segmentation of the proposed method. The Bland-Altman statistics compared both methods in relation to area (mm²) of segmented pectoral muscle. The statistic showed data within the 95% confidence interval, enhancing the accuracy of segmentation compared to the manual method. Thus, the method proved to be accurate and robust, segmenting rapidly and freely from intra and inter-observer variability. It is concluded that the proposed method may be used reliably to segment pectoral muscle in digital mammography in clinical routine. The segmentation of the pectoral muscle is very important for further quantifications of fibroglandular tissue volume present in the breast.

Keywords: active contour, fibroglandular tissue, hough transform, pectoral muscle

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Authors: Mastawal Melese, Yismaw Assefa

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This study aims to identify household-level determinants of solid waste disposal (SWD) practices in Bure Town, north-western Ethiopia. Using a cross-sectional design and a mixed-methods approach, data were collected from 238 randomly selected households through structured interviews, focus group discussions, and field observations. Descriptive analysis revealed that 14.7% of households used composting as a primary SWD method, 37.4% practiced open dumping, 25.6% used burning, and 22.3% resorted to burial. Multinomial logistic regression showed that factors such as monthly income, age, family size, length of residence, sex, home ownership, solid waste sorting procedures, and education significantly influenced the choice of disposal method. Households with lower education, income, home ownership, and shorter residence times were more likely to use improper disposal methods. Females were found to be more likely to engage in better waste disposal practices than males. These findings underscore the need for context-specific interventions in newly developing towns to enhance household-level SWM systems by addressing key socio-economic factors.

Keywords: multinomial logistic regression, solid waste management, solid waste disposal, urban household

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Authors: Jolanta Brodowska-Szewczuk

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The article includes the results and conclusions from empirical researches that had been done. The research focuses on the impact of investments made in small and medium-sized enterprises financed from EU funds on the competitiveness of these companies. The researches includes financial results in sales revenue and net income, expenses, and many other new products/services on offer, higher quality products and services, more modern methods of production, innovation in management processes, increase in the number of customers, increase in market share, increase in profitability of production and provision of services. The main conclusions are that, companies with direct investments under this measure shall apply the modern methods of production. The consequence of this is to increase the quality of our products and services. Furthermore, both small and medium-sized enterprises have introduced new products and services. Investments were carried out, thus enabling better work organization in enterprises. Entrepreneurs would guarantee higher quality of service, which would result in better relationships with their customers, what is more, noting the rise in number of clients. More than half of the companies indicated that the investments contributed to the increase in market share. Same thing as for market reach and brand recognition of particular company. An interesting finding is that, investments in small enterprises were more effective than medium-sized enterprises.

Keywords: competitiveness, efficiency, EU funds, small and medium-sized enterprises

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Authors: E. Elgohary, R. Abdelazyz

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The research aims to clarify the effect of the marketing culture on improving the e-service quality for foreign and domestic information technology companies in the Arab Republic of Egypt. So the researcher sought to include the dimensions of the marketing culture, which are (customer service, management style, sales mission, internal communications, technology, wages and rewards, innovation) as measures of marketing culture for its effect on improving the e-service quality in this research. The research population consists of employees and customers of the companies under study. The research problem was the following question: What is the effect of the actual application of marketing culture on improving the e-service quality? To answer that, three main hypotheses were adopted, and they were tested by statistical means for the data collected through a questionnaire prepared and distributed for this purpose. Accordingly, the research presented a set of results, the most important of which are: the need to pay attention to the dimensions of the marketing culture to improve the e-service quality, foreign companies were the most popular companies in applying the marketing culture compared to local companies. The research also recommends designing a system to continuously measure the performance of electronic service providers and work on spreading the culture of innovation among employees, linking reward programs to the extent of commitment to applying the elements of marketing culture while doing business.

Keywords: marketing culture, e-service quality, measurement models, quality measurements

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Authors: Alice Carter, Lucy Dumbell, Lorna Cameron, Victoria Lewis

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The Olympic discipline of eventing is the triathlon of equestrian sport, consisting of dressage, cross-country and show jumping. Falls on the cross-country are common and can be serious even causing death to rider. Research identifies an increased risk of a fall with an increasing number of obstacles and for jumping efforts later in the course suggesting fatigue maybe a contributing factor. Advice based on anecdotal evidence suggests riders undertake strength and conditioning programs to improve their ‘core’, thus improving their ability to maintain and control their riding position. There is little empirical evidence to support this advice. Therefore, the aim of this study is to investigate truck muscle fatigue and cognitive function during a simulated jumping test. Eight adult riders participated in a riding test on a Racewood Event simulator for 10 minutes, over a continuous jumping programme. The SEMG activity of six trunk muscles were bilaterally measured at every minute, and normalised root mean squares (RMS) and median frequencies (MDF) were computed from the EMG power spectra. Visual analogue scales (VAS) measuring Fatigue and Pain levels and Cognitive Function ‘tapping’ tests were performed before and after the riding test. Average MDF values for all muscles differed significantly between each sampled minute (p = 0.017), however a consistent decrease from Minute 1 and Minute 9 was not found, suggesting the trunk muscles fatigued and then recovered as other muscle groups important in maintaining the riding position during dynamic movement compensated. Differences between the MDF and RMS of different muscles were highly significant (H=213.01, DF=5, p < 0.001), supporting previous anecdotal evidence that different trunk muscles carry out different roles of posture maintenance during riding. RMS values were not significantly different between the sampled minutes or between riders, suggesting the riding test produced a consistent and repeatable effect on the trunk muscles. MDF values differed significantly between riders (H=50.8, DF = 5, p < 0.001), suggesting individuals may experience localised muscular fatigue of the same test differently, and that other parameters of physical fitness should be investigated to provide conclusions. Lumbar muscles were shown to be important in maintaining the position, therefore physical training program should focus on these areas. No significant differences were found between pre- and post-riding test VAS Pain and Fatigue scores or cognitive function test scores, suggesting the riding test was not significantly fatiguing for participants. However, a near significant correlation was found between time of riding test and VAS Pain score (p = 0.06), suggesting somatic pain may be a limiting factor to performance. No other correlations were found between the factors of participant riding test time, VAS Pain and Fatigue, however a larger sample needs to be tested to improve statistical analysis. The findings suggest the simulator riding test was not sufficient to provoke fatigue in the riders, however foundations for future studies have been laid to enable methodologies in realistic eventing settings.

Keywords: eventing, fatigue, horse-rider, surface EMG, trunk muscles

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Authors: A. Luft, S. Bremen, N. Balc

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The task of flexibility planning and design, just like factory planning, for example, is to create the long-term systemic framework that constitutes the restriction for short-term operational management. This is a strategic challenge since, due to the decision defect character of the underlying flexibility problem, multiple types of flexibility need to be considered over the course of various scenarios, production programs, and production system configurations. In this context, an evaluation model has been developed that integrates both conventional and additive resources on a basic task level and allows the quantification of flexibility enhancement in terms of mix and volume flexibility, complexity reduction, and machine capacity. The model helps companies to decide in early decision-making processes about the potential gains of implementing additive manufacturing technologies on a strategic level. For companies, it is essential to consider both additive and conventional manufacturing beyond pure unit costs. It is necessary to achieve an integrative view of manufacturing that incorporates both additive and conventional manufacturing resources and quantifies their potential with regard to flexibility and manufacturing complexity. This also requires a structured process for the strategic production systems design that spans the design of various scenarios and allows for multi-dimensional and comparative analysis. A respective guideline for the planning of additive resources on a strategic level is being laid out in this paper.

Keywords: additive manufacturing, production system design, flexibility enhancement, strategic guideline

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Authors: Duaa Al Maani, Andrew Roberts

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Students in higher education are expected to learn actively and independently. Whilst quite work has been done to understand the perceptions of students’ learning transition regarding independent learning, to author’s best knowledge, it seems relatively few published research on independent learning in studio-based subjects such as architecture. Another major issue in independent learning research concerned the inconsistency in terminology; there appears to be a paucity of research on its definition, challenges, and tools within the UK university sector. It is not always clear how independent learning works in practice, or what are the challenges that face students toward being independent learners. Accordingly, this paper seeks to highlight these problems by analyzing previous and current literature of independent learning, in addition, to measure students’ independence at the very begging of their first academic year and compare it with their level of learning independence at the end of the same year. Eighty-seven student enrolled in 2017/2018 at Cardiff University completed the Autonomous Learning Questionnaire in order to measure their level of learning independence. Students’ initial responses were very positive and showed high level of learning independence. Interestingly, these responses significantly decreased at the end of the year. Time management was the most obvious challenge facing students transition into higher education, and contrary to expectations, we found no effect of student maturity on their level of independence. Moreover, we found no significant differences among students’ gender, but we did find differences among nationalities.

Keywords: autonomous learning, first year, learning independence, transition

Procedia PDF Downloads 146

Authors: Carin Chuang, Kuan-Chou Chen

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An Enterprise Resource Planning (ERP) system is an integrated information system that supports the seamless integration of all the business processes of a company. Implementing an ERP system can increase efficiencies and decrease the costs while helping improve productivity. Many organizations including large, medium and small-sized companies have already adopted an ERP system for decades. Although ERP system can bring competitive advantages to organizations, the lack of proper training approach in ERP implementation is still a major concern. Organizations understand the importance of ERP training to adequately prepare managers and users. The low return on investment, however, for the ERP training makes the training difficult for knowledgeable workers to transfer what is learned in training to the jobs at workplace. Inadequate and inefficient ERP training limits the value realization and success of an ERP system. That is the need to call for a profound change and innovation for ERP training in both workplace at industry and the Information Systems (IS) education in academia. The innovated ERP training approach can improve the users’ knowledge in business processes and hands-on skills in mastering ERP system. It also can be instructed as educational material for IS students in universities. The purpose of the study is to examine the use of ERP simulation games via the ERPsim system to train the IS students in learning ERP implementation. The ERPsim is the business simulation game developed by ERPsim Lab at HEC Montréal, and the game is a real-life SAP (Systems Applications and Products) ERP system. The training uses the ERPsim system as the tool for the Internet-based simulation games and is designed as online student competitions during the class. The competitions involve student teams with the facilitation of instructor and put the students’ business skills to the test via intensive simulation games on a real-world SAP ERP system. The teams run the full business cycle of a manufacturing company while interacting with suppliers, vendors, and customers through sending and receiving orders, delivering products and completing the entire cash-to-cash cycle. To learn a range of business skills, student needs to adopt individual business role and make business decisions around the products and business processes. Based on the training experiences learned from rounds of business simulations, the findings show that learners have reduced risk in making mistakes that help learners build self-confidence in problem-solving. In addition, the learners’ reflections from their mistakes can speculate the root causes of the problems and further improve the efficiency of the training. ERP instructors teaching with the innovative approach report significant improvements in student evaluation, learner motivation, attendance, engagement as well as increased learner technology competency. The findings of the study can provide ERP instructors with guidelines to create an effective learning environment and can be transferred to a variety of other educational fields in which trainers are migrating towards a more active learning approach.

Keywords: business simulations, ERP implementation training, ERPsim, game-based learning, instructional strategy, training innovation

Procedia PDF Downloads 139

Authors: Davit Pipoyan, Meline Beglaryan, Nicolò Merendino

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Mining industry is one of the priority sectors of Armenian economy. Along with the solution of some socio-economic development, it brings about numerous environmental problems, especially toxic element pollution, which largely influences the safety of agricultural products. In addition, accumulation of toxic elements in agricultural products, mainly in edible parts of plants represents a direct pathway for their penetration into the human food chain. In Armenia, the share of plant origin food in overall diet is significantly high, so estimation of dietary intakes of toxic trace elements via consumption of selected fruits and vegetables are of great importance for observing the underlying health risks. Therefore, the present study was aimed to assess dietary exposure of potentially toxic trace elements through the intake of locally grown fruits and vegetables in Akhtala community (Armenia), where not only mining industry is developed, but also cultivation of fruits and vegetables. Moreover, this investigation represents one of the very first attempts to estimate human dietary exposure of potentially toxic trace elements in the study area. Samples of some commonly grown fruits and vegetables (fig, cornel, raspberry, grape, apple, plum, maize, bean, potato, cucumber, onion, greens) were randomly collected from several home gardens located near mining areas in Akhtala community. The concentration of Cu, Mo, Ni, Cr, Pb, Zn, Hg, As and Cd in samples were determined by using an atomic absorption spectrophotometer (AAS). Precision and accuracy of analyses were guaranteed by repeated analysis of samples against NIST Standard Reference Materials. For a diet study, individual-based approach was used, so the consumption of selected fruits and vegetables was investigated through food frequency questionnaire (FFQ). Combining concentration data with contamination data, the estimated daily intakes (EDI) and cumulative daily intakes were assessed and compared with health-based guidance values (HBGVs). According to the determined concentrations of the studied trace elements in fruits and vegetables, it can be stressed that some trace elements (Cu, Ni, Pb, Zn) among the majority of samples exceeded maximum allowable limits set by international organizations. Meanwhile, others (Cr, Hg, As, Cd, Mo) either did not exceed these limits or still do not have established allowable limits. The obtained results indicated that only for Cu the EDI values exceeded dietary reference intake (0.01 mg/kg/Bw/day) for some investigated fruits and vegetables in decreasing order of potato > grape > bean > raspberry > fig > greens. In contrast to this, for combined consumption of selected fruits and vegetables estimated cumulative daily intakes exceeded reference doses in the following sequence: Zn > Cu > Ni > Mo > Pb. It may be concluded that habitual and combined consumption of the above mentioned fruits and vegetables can pose a health risk to the local population. Hence, further detailed studies are needed for the overall assessment of potential health implications taking into consideration adverse health effects posed by more than one toxic trace element.

Keywords: daily intake, dietary exposure, fruits, trace elements, vegetables

Procedia PDF Downloads 300

Authors: Hyunsik Park

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Objective: To provide information of charged nursing care facility for helping to establish geriatric health care policy, and to figure out which factors would be the main determinants for the choice of it. Method: 46 males and 53 females, and the same number of their caregivers admitted into the charged nursing care facility were recruited for intensive interview including personal information, disease information, and economic, familial, marital and emotional statuses. This is a cross-sectional study and we analyzed the data qualitatively. Results: Patients had 3.2 diseases and a hospitalization for 2.3 years on average. They were consists of 46 singles (46.9%), 8 unmarried (8.2%), 5 divorced (5.1%) and 32 married (32.7%). More than two third (70.1%) were supported by their eldest son or daughter. Mostly, the family caregivers decided to admit into the facilities by the doctor’s recommendation (68.4%). When they made a choice for a facility, most of them (42.9%) considered environmental and sanitary conditions. According to their expectation for management in nursing care facility, most caregivers (59.2%) wanted simple-staying for the duration, but most patients (61.3%) expected to be home after taking comprehensive rehabilitation. Three-quarter of the caregivers would agree to use nursing care facilities in the future, if they would be the same situation. Conclusion: Life style and environment are rapidly changing. In the near future, we need lots of the charged nursing care facilities for the old, thus this study can be the good reference for the preparing upcoming aged and super-aged society.

Keywords: nursing care facility, aged society, qualitative analysis, health

Procedia PDF Downloads 474

Authors: Dennis Glen G. Ramos, Angelica S. Mendoza, Juliene Marie A. Alvarez, Claudette A. Nagal, Kayzee C. Blanza, Jayson M. Narbonita, John Anthony D. Dayot, Rebecca M. Reduca, Jermaine Jem M. Flojo, Michael E. Resultan, Clyde C. Fomocod, Cindy A. Vinluan, Jeffrie Aleona Mari C. Maclang

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RN HEALS, an acronym for Registered Nurses for Health Enhancement and Local Service, is expected to address the shortage of skilled and experienced nurses in 1,221 rural and unserved or underserved communities for one year. The study would like to explore the lived experiences of the nurses deployed under this program.The study is a Descriptive Qualitative Research. Interview was utilized as a data gathering tool. Six community nurses who are deployed under the RN HEALS program are included in the study. Van Kaam method was used as data management. Data gathering was done from October to December 2013.Two themes emerged in the study; Value and Challenge. Under Value, it had three sub-themes; Job Satisfaction, Upholding Competency, including Personal Development and Professional Growth, and Employability. While under Challenge, it had one sub-theme, Job Stress. The study concludes that nurses adapt to strategies to pursue personal and professional competence and an evolutionary journey. The researchers recommend that Health Administrators improve the work environment of nurses to lessen the challenges experienced by nurses.

Keywords: lived experience, RN HEALS, health enhancement, local service

Procedia PDF Downloads 512

Authors: Melliti Rihab, Zaeid Sonia, Khechine Wiem, Daldoul Amira

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Introduction: Lung cancer is the leading cause of cancer death. Its incidence is increasing, and its prognosis remains pejorative. We present the clinical, pathological, and therapeutic characteristics of bronchopulmonary cancer (BPC) in Tunisia. Methods: Retrospective study including patients followed in the oncology department of the University Hospital of Monastir between April 2014 and December 2021 suffering from lung cancer. Results: These are 117 patients, including 86.3% men and 13.7% women (sex ratio 6.3). The average age was 64 years ± 9 (37-83), with 95.7% being over 50 years old. Patients were smokers in 82% of cases. The clinical signs were dominated by chest pain (27.5%) and dyspnea in 21.1% of cases. In 6 patients, an episode of COVID-19 infection revealed the diagnosis. Half of the patients had a PS between 0 and 1. Small cell lung cancer was present in 18 patients (15.4%). The majority of non small cell lung cancer was of the adenocarcinoma type (68.7%). The diagnosis was late (stage IV) in 62.4% of cases. BPC was metastatic to bone (52%), contralateral lung (25.9%), and brain (27.3%). Patients were oligometastatic in 26% of cases. Surgery and radiotherapy were performed respectively in 14.5% and 23.1% of cases. Three-quarters of the patients had had nutrition (75.2%). The ROS1 mutation was present in 1 patient. PDL-1 expression was >40% in 2 patients. Survival was mean eight months ± 7.4. Conclusion: Lung cancer is diagnosed at a late stage in Tunisia. The lack of molecular study for non-small cell PBC and the lack of marketing authorization for tyrosine kinase inhibitors in Tunisia make the management incomplete.

Keywords: SCLC, NCSLC, ROS1, PDL1

Procedia PDF Downloads 79

Authors: Dimitrios Ntardas, Alexandros Tzanetos, Georgios Dounias

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High Voltage Substations (HVS) are the intermediate step between production of power and successfully transmitting it to clients, making them one of the most important checkpoints in power grids. Nowadays - renewable resources and consequently distributed generation are growing fast, the construction of HVS is of high importance both in terms of quality and time completion so that new energy producers can quickly and safely intergrade in power grids. The resources needed, such as machines and workers, should be carefully allocated so that the construction of a HVS is completed on time, with the lowest possible cost (e.g. not spending additional cost that were not taken into consideration, because of project delays), but in the highest quality. In addition, there are milestones and several checkpoints to be precisely achieved during construction to ensure the cost and timeline control and to ensure that the percentage of governmental funding will be granted. The management of such a demanding project is a NP-hard problem that consists of prerequisite constraints and resource limits for each task of the project. In this work, a hybrid meta-heuristic method is implemented to solve this problem. Meta-heuristics have been proven to be quite useful when dealing with high-dimensional constraint optimization problems. Hybridization of them results in boost of their performance.

Keywords: hybrid meta-heuristic methods, substation construction, resource allocation, time-cost efficiency

Procedia PDF Downloads 152

Authors: Jung Yoon Kim

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Introduction: Wounds inevitably cause patients to experience discomfort, distress, and consequentially reduced quality of life due to entailed pain, maceration, and foul odor. The dressing has been a universal wound care method in which wounds are covered and protected, and an optimum environment for healing is provided. This study aimed to investigate Korean nurses’ level of awareness of pain and skin tearing in wound beds and/or peri-wound skin at dressing change. Methods: A descriptive study was performed. Convenience sampling was employed, and registered nurses were recruited from attendees of continuing education program. A total of 399 participants (RN) completed the questionnaire. Data were collected from September to November 2022. Results: Many of them perceived skin tearing and wound-related pain associated with dressing changes, but most of them did not assess and record pain and skin tearing at dressing change. More than half of the respondents reported that they did not provide nursing intervention to prevent pain and skin tearing. Many of them reported that a systematic educational program for preventing pain and skin tearing at dressing changes was needed. Discussion: Many of the respondents were aware of pain and skin tearing at dressing change but did not take any further necessary measures, including nursing intervention, for the most appropriate, systematic pain and skin tearing management. Therefore, this study suggested that a systematic and comprehensive educational program for Korean healthcare professionals needs to be developed and implemented in Korea’s hospital settings.

Keywords: skin tearing, pain, dressing change, nurses

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Authors: B. Shukir, L. Szivos, D. Kis, P. Barzo

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Glioblastoma is the most malignant brain tumor. In general, the survival rate varies between (14-18) months. Glioblastoma consists a solid and infiltrative part. The standard therapeutic management of glioblastoma is maximum safe resection followed by chemo-radiotherapy. It’s hypothesized that the pretumoral hyperintense region in fluid attenuated inversion recovery (FLAIR) images includes both vasogenic edema and infiltrated tumor cells. In our study, we aimed to define the sensitivity and specificity of hyperintense FLAIR images preoperatively to examine how well it can define the true extent of glioblastoma. (16) glioblastoma patients included in this study. Hyperintense FLAIR region were delineated preoperatively as tumor mask. The infiltrative part of glioblastoma considered the regions where the tumor recurred on the follow up MRI. The recurrence on the CE-T1 images was marked as the recurrence masks. According to (AAL3) and (JHU white matter labels) atlas, the brain divided into cortical and subcortical regions respectively. For calculating specificity and sensitivity, the FLAIR and the recurrence masks overlapped counting how many regions affected by both . The average sensitivity and specificity was 83% and 85% respectively. Individually, the sensitivity and specificity varied between (31-100)%, and (100-58)% respectively. These results suggest that despite FLAIR being as an effective radiologic imaging tool its prognostic value remains controversial and probabilistic tractography remain more reliable available method for identifying the true extent of glioblastoma.

Keywords: brain tumors, glioblastoma, MRI, FLAIR

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