Search results for: human resources department

Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

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Authors: Hsiao-Chuan Huang, King-Lung Kuo, Mei-Hsin Lo, Hsiao-Yun Chou, Yusen Lin

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The most robust and economical method for laboratory diagnosis of TB is to identify mycobacterial bacilli (AFB) under acid-fast staining despite its disadvantages of low sensitivity and labor-intensive. Though digital pathology becomes popular in medicine, an automated microscopic system for microbiology is still not available. A new AI-assisted automated microscopic system, consisting of a microscopic scanner and recognition program powered by big data and deep learning, may significantly increase the sensitivity of TB smear microscopy. Thus, the objective is to evaluate such an automatic system for the identification of AFB. A total of 5,930 smears was enrolled for this study. An intelligent microscope system (TB-Scan, Wellgen Medical, Taiwan) was used for microscopic image scanning and AFB detection. 272 AFB smears were used for transfer learning to increase the accuracy. Referee medical technicians were used as Gold Standard for result discrepancy. Results showed that, under a total of 1726 AFB smears, the automated system's accuracy, sensitivity and specificity were 95.6% (1,650/1,726), 87.7% (57/65), and 95.9% (1,593/1,661), respectively. Compared to culture, the sensitivity for human technicians was only 33.8% (38/142); however, the automated system can achieve 74.6% (106/142), which is significantly higher than human technicians, and this is the first of such an automated microscope system for TB smear testing in a controlled trial. This automated system could achieve higher TB smear sensitivity and laboratory efficiency and may complement molecular methods (eg. GeneXpert) to reduce the total cost for TB control. Furthermore, such an automated system is capable of remote access by the internet and can be deployed in the area with limited medical resources.

Keywords: TB smears, automated microscope, artificial intelligence, medical imaging

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Authors: L. P. K. Liyanage, N. R. P. Withana, A. L. Sandika

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The purpose of this study was to determine tourist and community perception-based sustainable tourism indicators as well as Human Pressure Index (HPI) and Tourist Activity Index (TAI). Study was carried out in Sinharaja forest which is considered as one of the major eco-tourism destination in Sri Lanka. Data were gathered using a pre-tested semi-structured questionnaire as well as records from Forest department. Convenient sampling technique was applied. For the majority of issues, the responses were obtained on multi-point Likert-type scales. Visual portrayal was used for display analyzed data. The study revealed that the host community of the Kudawa gets many benefits from tourism. Also, tourism has caused negative impacts upon the environment and community. The study further revealed the need of proper waste management and involvement of local cultural events for the tourism business in the Kudawa conservation center. The TAI, which accounted to be 1.27 and monthly evolution of HPI revealed that congestion can be occurred in the Sinharaja rainforest during peak season. The results provide useful information to any party involved with tourism planning anywhere, since such attempts would be more effective once the people’s perceptions on these aspects are taken into account.

Keywords: Kudawa Conservation Center, Sinharaja World Heritage Rainforest, sustainability indicators, community perception

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Authors: Florentina Hahaianu, Mihaela Negrescu

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The analysis of the positive and negative effects of technology use and abuse in Generation Z comes as a necessity in order to understand their ever-changing emotional development needs. The article quantitatively analyzes the findings of a sociological questionnaire on a group of students in social sciences. It aimed to identify the changes generated by the use of digital resources in the emotional intelligence development. Among the outcomes of our study we include a predilection for IT related activities – be they social, learning, entertainment, etc. which undermines the manifestation of emotional intelligence, especially the reluctance to face-to-face interaction. In this context, the issue of emotional intelligence development comes into focus as a solution to compensate for the undesirable effects that contact with technology has on this generation.

Keywords: digital resources, emotional intelligence, generation Z, students

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Authors: Elizabeth Latham

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The notion that women were created as innately inferior to men has yet to be expelled completely from the theological system of humankind. This question and the biblical exegesis it requires are of paramount importance to feminist philosophy—after all, the study can bear little fruit if we cannot even agree on equality within the theological roots of humanity. Augustine’s “Duality of Man” gives new context to the two creation stories in Genesis, texts especially relevant given the billions of people worldwide that ascribe to them as philosophical realities. Each creation story describes the origin of human beings and is matched with one of Augustine’s two orders of mankind. The first story describes the absolute origin of the human soul and is paired with Augustine’s notion of the “spiritual order” of a human being: divine and eternal, fulfilling the biblical idea that human beings were created in the image and likeness of God. The second creation story, in contrast, depicts those aspects of humanity that distinguish and separate us from God: doubt, fear, and sin. It also introduces gender as a concept for the first time in the Bible. This story is better matched with Augustine’s idea of the “natural order” of humanity, that by which he believes women, in fact, are inferior. In the synthesis of the two sources, one can see that the natural order and any inferiority that it implies are incidental and not intended in our creation. Gender inequality is introduced with and belongs in the category of human imperfection and to cite the Bible as encouraging it constitutes a gross misunderstanding of scripture. This is easy to see when we divide human nature into “spiritual” and “natural” and look carefully at where scripture falls.

Keywords: augustine, bible, duality of man, feminism, genesis

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Authors: Sophia El Ouazzani, Amer M. Burhan, Mary Wickenden

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Background: Despite improvements in recent years, the Moroccan mental healthcare system still face disparity between available resources and the current population’sneeds. The societal stigma, and limited economic, political, and human resources are all factors in shaping the psychiatric system, exacerbating the discontinuity of services for users after discharged from the hospital. As a result, limited opportunities for social inclusion and meaningful community engagement undermines human rights and recovery potential for people with mental health problems, especially those with psychiatric disabilities from serious mental illness (SMI). Recovery-oriented practice, such as mental health rehabilitation, addresses the complex needs of patients with SMI and support their community inclusion. The cultural acceptability of recovery-oriented practice is an important notion to consider for a successful implementation. Exploring the extent to which recovery-oriented practices are used in Morocco is a necessary first step to assess the cultural relevance of such a practice model. Aims: This study aims to explore understanding and knowledge, perception, and perspective about core concepts in mental health rehabilitation, including psychiatric disability, recovery, and engagement in meaningful occupations for people with SMI in Morocco. Methods: A pilot qualitative study was undertaken. Data was collected via semi-structured interviews and focusgroup discussions with healthcare professional students. Questions were organised around the following themes: 1) students’ perceptions, understanding, and expectations around concepts such as SMI, mental health disability, and recovery, and 2) changes in their views and expectations after starting their professional training. Further analysis of students’ perspectives on the concept of ‘meaningful occupation’ and how is this viewed within the context of the research questions was done. The data was extracted using an inductive thematic analysis approach. This is a pilot stage of a doctoral project, further data will be collected and analysed until saturation is reached. Results: A total of eight students were included in this study which included occupational therapy and mental health nursing students receiving training in Morocco. The following themes emerged as influencing students’ perceptions and views around the main concepts: 1) Stigma and discrimination, 2) Fatalism and low expectations, 3) Gendered perceptions, 4) Religious causation, 5) Family involvement, 6) Professional background, 7) Inaccessibility of services and treatment. Discussion/Contribution: Preliminary analysis of the data suggests that students’ perceptions changed after gaining more clinical experiences and being exposed to people with psychiatric disabilities. Prior to their training, stigma shaped greatly how they viewed people with SMI. The fear, misunderstanding, and shame around SMI and their functional capacities may contribute to people with SMI being stigmatizedand marginalised from their family and their community. Religious causations associated to SMIsare understood as further deepening the social stigma around psychiatric disability. Perceptions are influenced by gender, with women being doubly discriminated against in relation to recovery opportunities. Therapeutic pessimism seems to persist amongst students and within the mental healthcare system in general and regarding the recovery potential and opportunities for people with SMI. The limited resources, fatalism, and stigma all contribute to the low expectations for recovery and community inclusion. Implications and future directions will be discussed.

Keywords: disability, mental health rehabilitation, recovery, serious mental illness, transcultural psychiatry

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Authors: Sayed Amir Hamzeh Mirkheshti

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Offshore wind energy as a strategic renewable energy, has been growing rapidly due to availability, abundance and clean nature of it. On the other hand, budget of this project is incredibly higher in comparison with other renewable energies and it takes more duration. Accordingly, precise estimation of time and cost is needed in order to promote awareness in the developers and society and to convince them to develop this kind of energy despite its difficulties. Occurrence risks during on project would cause its duration and cost constantly changed. Therefore, to develop offshore wind power, it is critical to consider all potential risks which impacted project and to simulate their impact. Hence, knowing about these risks could be useful for the selection of most influencing strategies such as avoidance, transition, and act in order to decrease their probability and impact. This paper presents an evaluation of the feasibility of 500 MV offshore wind project in the Persian Gulf and compares its situation with uncertainty resources and risk. The purpose of this study is to evaluate time and cost of offshore wind project under risk circumstances and uncertain resources by using Monte Carlo simulation. We analyzed each risk and activity along with their distribution function and their effect on the project.

Keywords: wind energy project, uncertain resources, risks, Monte Carlo simulation

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Authors: Yiqiao Yin

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Many scholars and educators have dedicated their lives in K12 education system and there has been an exploding amount of attention to implement technical foundations for Artificial Intelligence Education for high school and precollege level students. This paper focuses on the development and use of resources to support K-12 education in Artificial Intelligence (AI). The author and his team have more than three years of experience coaching students from pre-college level age from 15 to 18. This paper is a culmination of the experience and proposed online tools, software demos, and structured activities for high school students. The paper also addresses a portfolio of AI concepts as well as the expected learning outcomes. All resources are provided with online videos and Github repositories for immediate use.

Keywords: K12 education, AI4ALL, pre-college education, pre-college AI

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Authors: Shaherah Jordan, Paula Vandergert

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The discussion on public charging infrastructure is usually framed around the ‘chicken-egg’ challenge of consumers feeling reluctant to purchase without the necessary infrastructure and policymakers reluctant to invest in the infrastructure without the demand. However, public charging infrastructure may be more crucial to electric vehicle (EV) adoption than previously thought. Historically, access to residential charging was thought to be a major factor in potential for growth in the EV market as it offered a guaranteed place for a vehicle to be charged. The purpose of this study is to understand how the built environment may encourage uptake of EVs by seeking a correlation between EV ownership and public charging points in an urban and densely populated city such as London. Using a statistical approach with data from the Department for Transport and Zap-Map, a statistically significant correlation was found between the total (slow, fast and rapid) number of public charging points and a number of EV registrations per borough – with the strongest correlation found between EV registrations and rapid chargers. This research does not explicitly prove that there is a cause and effect relationship between public charging points EVs but challenges some of the previous literature which indicates that public charging infrastructure is not as important as home charging. Furthermore, the study provides strong evidence that public charging points play a functional and psychological role in the adoption of EVs and supports the notion that the built environment can influence human behaviour.

Keywords: behaviour change, electric vehicles, public charging infrastructure, transportation

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Authors: Muhammad Farid, Jen Der Day

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The purpose of this study is to explore the construct of service innovation model for Small and medium-sized enterprises (SMEs) in automotive service industries. A case study of repair shop of the motorcycle at Makassar city illustrates measure innovation implementation, the degree of innovation, and identifies the type of innovation by the service innovation model for SMEs. In this paper, we interview 10 managers of SMEs and analyze their answers. We find that innovation implementation has been slowly; only producing new service innovation 0.62 unit average per year. Incremental innovation is the present option for SMEs, because they choose safer roads to improve service continuously. If want to create radical innovation, they still consider the aspect of cost, system, and readiness of human resources.

Keywords: service innovation, incremental innovation, SMEs, automotive service industries

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Authors: Prapin Nuchpiam

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Sustainable Development Goals (SDGs) have become a global agenda for all. The role of the business sector is significant in promoting sustainable development, particularly to prevent, address, and remedy human rights abuses committed in business operations. Modern slavery is one of the complex issues of human rights. The paper aims to study the UK Modern Slavery Act (MSA) 2015, whose main purpose is to tackle modern slavery in all its forms: human trafficking, slavery, forced labor, and domestic servitude. The Act has a great significance in its approach to involving businesses in combating modern slavery without imposing stricter regulations on them. In doing so, Section 54 of the MSA requires commercial organizations to disclose a statement confirming the transparency in their corporate supply chains. Even though the statement is required by law, in practice, it is rather similar to the ‘comply or explain’ scheme. In other words, compliance is mainly enforced due to fear of reputational risk, rather than of lawbreaking. Thailand has been reported a number of modern slavery cases, particularly in the production stage of supply chains. With desperate attempts to solve modern slavery, the Thai government tends to seek stricter regulation and stronger punishment as the main approach. The paper will analyze the effective implementation of section 54and conclude whether and to what extent the MSA can be applied to the case of Thailand.

Keywords: human rights, responsible business, SDGs, the UK modern slavery act 2015

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Authors: Vincent Murray

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The glycopeptide bleomycin is used in the treatment of testicular cancer, Hodgkin's lymphoma, and squamous cell carcinoma. Bleomycin damages and cleaves DNA in human cells, and this is considered to be the main mode of action for bleomycin's anti-tumor activity. In particular, double-strand breaks are thought to be the main mechanism for the cellular toxicity of bleomycin. Using Illumina next-generation DNA sequencing techniques, the genome-wide sequence specificity of bleomycin-induced double-strand breaks was determined in human cells. The degree of bleomycin cleavage was also assessed at the transcription start sites (TSSs) of actively transcribed genes and compared with non-transcribed genes. It was observed that bleomycin preferentially cleaved at the TSSs of actively transcribed human genes. There was a correlation between the degree of this enhanced cleavage at TSSs and the level of transcriptional activity. Bleomycin cleavage is also affected by chromatin structure and at TSSs, the peaks of bleomycin cleavage were approximately 200 bp apart. This indicated that bleomycin was able to detect phased nucleosomes at the TSSs of actively transcribed human genes. The genome-wide cleavage pattern of the bleomycin analogues 6′-deoxy-BLM Z and zorbamycin was also investigated in human cells. As found for bleomycin, these bleomycin analogues also preferentially cleaved at the TSSs of actively transcribed human genes. The cytotoxicity (IC₅₀ values) of these bleomycin analogues was determined. It was found that the degree of enhanced cleavage at TSSs was inversely correlated with the IC₅₀ values of the bleomycin analogues. This suggested that the level of cleavage at the TSSs of actively transcribed human genes was important for the cytotoxicity of bleomycin and analogues. Hence this study provided a deeper understanding of the cellular processes involved in the cancer chemotherapeutic activity of bleomycin.

Keywords: anti-tumour activity, bleomycin analogues, chromatin structure, genome-wide study, Illumina DNA sequencing

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Authors: Anima Ashraf

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Over the past few decades biodiversity has become the issue of global concern for its rapid reduction worldwide. Bangladesh is no exception. The country is exceptionally endowed with a vast variety of flora and fauna, but due to tremendous population pressure, rural poverty and unemployment it has been decreased alarmingly. Since, both biodiversity and sustainable development are the part of human life in modern era and both work together to make our life safer and comfortable therefore balance should be kept in development and biodiversity conservation and priority should be given to alternative and sustainable development paths. This paper is based on study of two projects undertaken by Arannayk Foundation jointly with its local NGO partners. The aim was to understand previous, current and future scenarios for the hilly biodiversity of Khagrachari in the Chittagong Hill Tracts (CHT) of Bangladesh. It is also observed how alternative income generating activities (AIGA) improve livelihood of the tribal inhabitants of the area, decrease their dependency on forest resources and also aid conservation activities. Intensive field visits were made and interviews were conducted with key informants to see the progress and achievements of local NGOs working with the tribal community for the past seven years to restore the denuded hills of Khagrachari. The paper also covers the impacts and interventions of the projects and the methods used to aid conservation activities. Raising awareness among the villagers has reduced extraction of forests resources by 47% and granting funds and access to microcredit to adopt AIGAs have increased their average annual income by 25%. Finally, the paper concludes that effective community-based conservation practices are fundamental to ensure biodiversity conservation in the Chittagong Hill Tracts. In order to conserve biodiversity and restore the forests of CHT, livelihood development of the villagers has to be considered as the main component of the projects undertaken by all NGOs and the Government.

Keywords: biodiversity, conservation, forests, livelihood

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Authors: Mohammad U. A. Khan, Md. D. Hossain

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Background: Department of Physiology finds difficulty in managing ‘subjects’ in practical procedure. To avoid this difficulty fellow examinees of other group may be used as subjects. Objective: To find out the merits and demerits of using fellow examinees as subjects in the practical procedure. Method: This cross-sectional descriptive study was conducted in the Department of Physiology, Noakhali Medical College, Bangladesh during May-June’14. Forty-two 1st year undergraduate medical students from a selected public medical college of Bangladesh were enrolled for the study purposively. Consent of students and authority was taken. Eighteen of them were selected as subjects and designated as subject-examinees. Other fellow examinees (non-subject) examined their blood pressure and pulse as part of ‘observed structured practical examination’ (OSPE). The opinion of all examinees regarding the merits and demerits of using fellow examinee as subjects in the practical procedure was recorded. Result: Examinees stated that they could perform their practical procedure without nervousness (24/42, 57.14%), accurately and comfortably (14/42, 33.33%) and subjects were made available without wasting time (2/42, 4.76%). Nineteen students (45.24%) found no disadvantage and 2 (4.76%) felt embracing when the subject was of opposite sex. The subject-examinees narrated that they could learn from the errors done by their fellow examinee (11/18, 61.1%). 75% non-subject examinees expressed their willingness to be subject so that they can learn from their fellows’ error. Conclusion: Using fellow examinees as subjects is beneficial for both the non-subject and subject examinees. Funding sources: Navana, Beximco, Unihealth, Square & Acme Pharma, Bangladesh Ltd.

Keywords: physiology, teaching, practical, OSPE

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Authors: M. Sasajima, T. Yamaguchi, Y. Hu, Y. Koike

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In this paper, we discuss the propagation of sound in the narrow pathways of an occluded-ear simulator typically used for the measurement of insert-type earphones. The simulator has a standardized frequency response conforming to the international standard (IEC60318-4). In narrow pathways, the speed and phase of sound waves are modified by viscous air damping. In our previous paper, we proposed a new finite element method (FEM) to consider the effects of air viscosity in this type of audio equipment. In this study, we will compare the results from the ear simulator FEM model, and those from a three dimensional human ear canal FEM model made from computed tomography images, with the measured frequency response data from the ear canals of 18 people.

Keywords: ear simulator, FEM, viscosity, human ear canal

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Authors: Jan Ceselsky

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Construction and reconstruction of settlements and individual municipalities, environmental management and the creation, deployment of the forces of production and building transport and technical equipment requires a large expenditure of material and human resources. That is why the economic aspects of the majority decision in these planes built in the foreground and are often decisive. Thereby but more serious is that the economic aspects of the settlement, the creation and function remain in their whole, unprocessed, and can not speak of a set of individual techniques and methods traditional indicators and experiments with new approaches. This is true both at the level of the national economy, and in their own urban designs. Still a few remain identified specific economic shaping patterns of settlement and the less it is possible to speak of their control. Also practical assessing economics of specific solutions are often used non-apt indicators in addition to economics usually identifies with the lowest acquisition cost or high-intensity land use with little regard for functional efficiency and little studied much higher operating and maintenance costs.

Keywords: investment, municipal engineering, value for money, construction

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Authors: Mutshinye Manguvhewa, Maria Florence, Mansoo Yu, Elize Koch, Kamal Kamaloodien

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Substance use among pregnant women is a perennial problem in the Western Cape Province of South Africa. There are many influential factors are associated with substance use among women of childbearing age. The study explored factors associated with substance use among pregnant women using a qualitative research design and the bio-ecological theoretical framework to explore and guide the researcher throughout the study. Participants were selected using purposive sampling. Only participants accessed from the Department of Social Development meeting the inclusion criteria of the study were interviewed using semi structured interviews. Immediate referral for psychological intervention during the interview was available for participants who needed it. Braun and Clarke's six phases of thematic analysis were utilised to analyse the data. The study adheres to ethical guidelines for the participants' protection. Participants were informed about the study before the initiation of the interviews and the details of their voluntary participation were explained. The key findings from this study illustrate that socio-cultural factors, personal factors, emotional response and intimate relationships are the major contributing factors to substance use among pregnant women in this sample. The results outline the preventative measures that pregnant women implement. Lastly, the study reveals the positive and negative perceptions of substance use programmes that participants share. Some of the study findings are similar to the existing literature and some of the findings differed. Recommendations emanating from the study include that the stakeholders, rehabilitation centres, Department of Health and future researchers should act proactively against substance use during pregnancy.

Keywords: substance addiction, antenatal care, pregnancy, substance use

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Authors: Amina Sa'id Muhammad, Asmau Ishaq Alhassan, Beba Raymond, Fatima Bello

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Severe acute malnutrition (SAM) remains a major killer of children under five years of age. Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 percent of children under five. An estimated 2 million children in Nigeria suffer from severe acute malnutrition (SAM), and 3.9% of children in northwest Nigeria suffer from SAM, which is significantly higher than the national average of 2.1%. Community-Based Management of Acute Malnutrition (CMAM) has proven to be an effective intervention in the treatment of SAM in children using Ready-to-Use Therapeutic Food (RUTF). Ready-to-use therapeutic food (RUTF) is a key component for the treatment of Severe Acute Malnutrition. It contains all the energy and nutrients required for rapid catch-up growth and used particularly in the treatment of children over 6 months of age with SAM without medical complications. However, almost all RUTFs are currently imported to Nigeria from other countries. Shortages of RUTF due to logistics (shipping costs, delays, donor fatigue etc) and funding issues present a threat to the achievement of the 2030 World Health Assembly (WHA) targets for reducing malnutrition in addition to 2030 SDGs 2 (Zero Hunger), 3 (Good Health and Wellbeing), 12 (Responsible Consumption and Production), and 17 (Partnerships for the Goals), thus undermining its effectiveness in combating malnutrition On the other hand, the availability of human and material resources that will aid local production of RUTF presents an opportunity to fill in the gap in regular RUTF supply. About one thousand Nigerian children die of malnutrition-related causes every day, reaching a total of 361,000 each year. Owing to the high burden of malnutrition in Nigeria, the local production of RUTF is a logical step, that will ensure increased availability, acceptability, access, and efficiency in supply, and at lower costs. Objective(s): The objectives of this study were therefore, to formulate RUTF from locally available resources and to determine its energy and nutrients composition, incommensurate with the standard/commercial RUTF. Methods: Three samples of RUTF were formulated using locally available resources (soya beans, wheat, rice, baobab, brown-sugar, date palm and soya oil); which were subjected to various analysis to determine their energy/proximate composition, vitamin and mineral contents and organoleptic properties were also determined using sensory evaluation. Results: The energy values of the three samples of locally produced RUTF were found to be in conformity with WHO recommendation of ≥ 500 kcal per 100g. The energy values of the three RUTF samples produced in the current study were found to be 563.08, 503.67 and 528.98 kcal respectively. Sample A, B and C had protein content of 13.56% 16.71% and 14.62% respectively, which were higher than that of commercial RUTF (10.9%). Conclusions/recommendations: The locally formulated RUTF samples had energy value of more than 500 kcal per 100g; with an appreciable amount of macro and micro nutrients. The appearance, taste, flavor and general acceptability of the formulated RUTF samples were also commendable.

Keywords: energy, malnutrition, nutrients, RUTF

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Authors: Gagandeep Kaur, Sonal Chawla

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In a Cloud Computing environment, resource provisioning, resource allocation and resource scheduling is the most complex issues these days. Cloud User expects the best resource utilization and Cloud Provider expects revenue maximization by considering budget and time constraints. In this research paper, Resource Management Framework has been proposed to allocate the resources to Cloud Users and Cloud Providers in Cloud environment. The main aim of the proposed work is to provide the resources and services to Cloud Providers and Cloud Users in an efficient and effective manner. The proposed framework has been simulated and tested using the CloudSim simulator tool.

Keywords: cloud computing, resource allocation, auction, provisioning

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Authors: Liron Hoch

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Traditional religious and spiritual texts offer a surprising wealth of relevant theoretical and practical knowledge about human behavior. This wellspring may contribute significantly to expanding our current body of knowledge in the social sciences and criminology in particular. In Jewish religious texts, specifically by Maimonides, we can find profound analyses of human traits and guidelines for a normative way of life. Among other things, modern criminological literature attempts to link certain character traits and divergent behaviors. Using the hermeneutic phenomenological approach, we analyzed the writings of Maimonides, mainly Laws of Human Dispositions, in order to understand Moses ben Maimon's (1138–1204) view of character traits. The analysis yielded four themes: (1) Human personality between nature and nurture; (2) The complexity of human personality, imbalance and criminality; (3) Extremism as a way to achieve balance; and (4) The Middle Way, flexibility and common sense. These themes can serve therapeutic purposes, as well as inform a rehabilitation model. Grounded in a theoretical rationale about the nature of humans, this model is designed to direct individuals to balance their traits by self-reflection and constant practice of the Middle Way. The proposal we will present is that implementing this model may promote normative behavior and thus contribute to rehabilitating offenders.

Keywords: rehabilitation, traits, offenders, maimonides, middle way

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Authors: Samaneh Abedini, Diana Urajnik, Nicole Naccarato

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A high prevalence of mental health problems was observed in marginalized youth living in underserved regions of Ontario during the COVID-19 pandemic. To address this issue, a growing number of community-based traditional mental health services are offering digital mental health resources due to their accessibility, affordability, and scalability. The feasibility of providing these resources in underserved regions has been examined by researchers rather than by representatives of effective services within a mental health system. Indeed, digitalized mental health contents are not routinely embedded within local mental health organizations' services in Northern Ontario, where they can make a substantial impact. To date, many technology-based mental health initiatives have not been effectively implemented in this region. The obstacles associated with implementing digitalized mental health resources in Northern Ontario may be unique to that region. Thus, specific context-based considerations might need to be applied for developing and implementing digital resources by regional mental health organizations in Northern Ontario. The target population was child-serving organizations situated in northeastern Ontario, specifically within Greater Sudbury and the Sudbury District. A sample of six organizations were selected with representation from the mental health, social, and healthcare sectors. The project supervisor was in a unique position to access the organizations by virtue of existing relationships with the practice and lay communities at large. Thus, recruitment was conducted through professional outreach in partnership with the Center for Rural and Northern Health Research (CRaNHR). Semi-structured interviews were conducted with 1-2 key personnel (e.g., administrator, clinician) from participating organizations. Audio recordings from the semi-structured interviews were transcribed verbatim and thematically analyzed supported by NVivo. Thematic analysis of the data resulted in a total of 13 excerpts which were categorized into two major themes including 1) digital mental health services as a valuable resource for organizations both during and after the pandemic, and 2) barriers and facilitators to a successful implementation of digital mental health resources in northern Ontario. Four secondary themes were identified: 1) perceived barriers to implementation of digital mental health resources to the offered services by mental health agencies; 2) acceptability and feasibility of digital health sources for people living in northern Ontario; 3) data security, safety, and risk; and 4) connecting with clients. The employees of mental health organizations in northern Ontario considered digital mental health resources as generally acceptable to youth. However, they raised several concerns that may affect their implementation into routine practice and service delivery. The implementation of digital systems should be simple and straightforward and should enhance rather than hinder clinical workflows for staff. A clear plan for implementing technological services is also required for the successful adoption of digital systems. For successful adoption and implementation of digital systems, staff views must be considered.

Keywords: COVID-19 pandemic, digital mental health resources, Ontario, underserved

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Authors: Mary Carmen Peloche Barrera

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Since its early years as an independent nation, the United States has been one of the main promoters regarding the recognition, legislation, and protection of human rights. In the matter of freedom, the founding father Thomas Jefferson envisioned the role of the U.S. as a defender of freedom and equality throughout the world. This founding ideal shaped America’s domestic and foreign policy in the 19th and the 20th century and became an aspiration of the ideals of the country to expand its values and institutions. The history of the emergence of human rights cannot be studied without making reference to leaders such as Woodrow Wilson, Franklin, and Eleanor Roosevelt, as well as Martin Luther King. Throughout its history, this country has proclaimed that the protection of the freedoms of men, both inside and outside its borders, is practically the reason for its existence. Although the United States was one of the first countries to recognize the existence of inalienable rights for individuals, as well as the main promoter of the Universal Declaration of Human Rights of 1948, the country has gone through critical moments that had led to questioning its commitment to the issue. Racial segregation, international military interventions, national security strategy, as well as national legislation on immigration, are some of the most controversial issues related to decisions and actions driven by the United States, which at the same time mismatched with its role as an advocate of human rights, both in the Americas and in the rest of the world. The aim of this paper is to study the swinging of the efforts and commitments of the United States towards human rights. The paper will analyze the history and evolution of human rights in the United States, to study the greatest challenges for the country in this matter. The paper will focus on both the domestic policy (related to demographic issues) and foreign policy (about its role in a post-war world). Currently, more countries are joining the multilateral efforts for the promotion and protection of human rights. At the same time, the United States is one of the least committed countries in this respect, having ratified only 5 of the 18 treaties emanating from the United Nations. The last ratification was carried out in 2002 and, since then, the country has been losing ground, in an increasingly vertiginous way, in its credibility and, even worse, in its role as leader of 'the free world'. With or without the United States, the protection of human rights should remain the main goal of the international community.

Keywords: United States, human rights, foreign policy, domestic policy

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Authors: Omar Alsetoohy, Mohamed Ezzat, Mahmoud Abou Kamar

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The success of a restaurant or hotel depends very much on the quality and quantity of its human resources. Thus, establishing a competitive edge through human assets requires careful attention to the practices that best leverage these assets. Usually, hotel or restaurant employees recognize customer defection as an unfavorable or unpleasant occurrence associated with failure. These failures could be in handling, communication, learning, or encouragement. Besides, employees could be afraid of blame from their colleagues and managers, which prevents them from freely discussing these mistakes with them. Such behaviors, in turn, would push employees to withdraw from the workplace. However, we have a good knowledge of the leadership outcomes, but less is known about how and why these effects occur. Accordingly, mindful leaders usually analyze the causes and underlying mechanisms of failures for work improvement. However, despite the excessive literature in the field of leadership and employee behaviors, to date, no research studies had investigated the impact of a failure-tolerant restaurant culture on the employees’ withdrawal behaviors considering the moderating role of psychological empowerment and mindful leadership. Thus, this study seeks to investigate the impact of a failure-tolerant culture on the employees’ withdrawal behaviors in fast-food restaurants in Egypt considering the moderating effects of employee empowerment and mindful leaders. This study may contribute to the existing literature by filling the gap between failure-tolerant cultures and employee withdrawal behaviors in the hospitality literature. The study may also identify the best practices for restaurant operators and managers to deal with employees' failures as an improvement tool for their performance.

Keywords: failure-tolerant culture, employees’ withdrawal behaviors psychological empowerment, mindful leadership, restaurants

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Authors: Waqas Ahmad, Eisha Tahir, Shahper Aqeel, Imran Khalid Niazi, Amjad Iqbal

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Background: Breast conservation surgery applies a number of techniques for accurate localization of lesions. Wire localization remains the method of choice in non-palpable breast cancers post-neoadjuvant chemotherapy. Objective: The aim of our study was to determine the accuracy of wire localization procedures in our department and compare it with internationally set protocols as per the Royal College of Radiologists. Post wire mammography, as well as the margin status of the postoperative specimen, assessed the accuracy of the procedure. Methods: We retrospectively reviewed the data of 225 patients who presented to our department from May 2014 to June 2015 post neoadjuvant chemotherapy with non-palpable cancers. These patients are candidates for wire localized lumpectomies either under ultrasound or stereotactic guidance. Metallic marker was placed in all the patients at the time of biopsy. Post wire mammogram was performed in all the patients and the distance of the wire tip from the marker was calculated. The presence or absence of the metallic clip in the postoperative specimen, as well as the marginal status of the postoperative specimen, was noted. Results: 157 sonographic and 68 stereotactic wire localization procedures were performed. 95% of the wire tips were within 1 cm of the metallic marker. Marginal status was negative in 94% of the patients in histopathological specimen. Conclusion: Our audit report declares more than 95% accuracy of image guided wire localization in successful excision of non-palpable breast lesions.

Keywords: breast, cancer, non-palpable, wire localization

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Authors: Azmawati Mohammed Nawi, Siok-Fong Chin, Shamsul Azhar Shah, Rahman Jamal

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In recent years, trace elements have gained importance as biomarkers in many chronic diseases. Unfortunately, the requirement for sample volume increases according to the extent of investigation for diagnosis or elucidating the mechanism of the disease. Here, we describe the method development and validation for simultaneous determination of 25 trace elements (lithium (Li), beryllium (Be), magnesium (Mg), aluminium (Al), vanadium (V), chromium (Cr), manganese (Mn), iron (Fe), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), gallium (Ga), arsenic (As), selenium (Se), rubidium (Rb), strontium (Sr), silver (Ag), cadmium (Cd), caesium (Cs), barium (Ba), mercury (Hg), thallium (Tl), lead (Pb), uranium (U)) using just 20 µL of human serum. Serum samples were digested with nitric acid and hydrochloric acid (ratio 1:1, v/v) and analysed using inductively coupled plasma–mass spectrometry (ICP-MS). Seronorm®, a human-derived serum control material was used as quality control samples. The intra-day and inter-day precisions were consistently < 15% for all elements. The validated method was later applied to 30 human serum samples to evaluate its suitability. In conclusion, we have successfully developed and validated a precise and accurate analytical method for determining 25 trace elements requiring very low volume of human serum.

Keywords: acid digestion, ICP-MS, trace element, serum

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Authors: Mehmet Balci, Sakir Tasdemir, Mustafa Altin, Ozlem Bozok

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Our globalizing world has become almost a small village and everyone can access any information at any time. Everyone lets each other know who does whatever in which place. We can learn which social events occur in which place in the world. From the perspective of education, the course notes that a lecturer use in lessons in a university in any state of America can be examined by a student studying in a city of Africa or the Far East. This dizzying communication we have mentioned happened thanks to fast developments in computer technologies and in parallel with this, internet technology. While these developments in the world, has a very large young population and a rapidly evolving electronic communications infrastructure Turkey has been affected by this situation. Researches has shown that almost all young people in Turkey has an account in a social network. Especially becoming common of mobile devices causes data traffic in social networks to increase. In this study, has been surveyed on students in the different age groups and at the Selcuk University Vocational School of Technical Sciences Department of Computer Technology. Student’s opinions about the use of internet and social media has been gotten. Using the Internet and social media skills, purposes, operating frequency, access facilities and tools, social life and effects on vocational education etc. have been explored. Both internet and use of social media positive and negative effects on this department students results have been obtained by the obtained findings evaluating from various aspects. Relations and differences have been found out with statistic.

Keywords: computer technologies, internet use, social network, higher vocational school

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Authors: Dirk V. H. K. Franco

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For many of us a lot of phenomena are considered a risk. Examples are: climate change, decrease of biodiversity, amount of available, clean water and the decreasing variety of living organism in the oceans. On the other hand a lot of people perceive the following trends as catastrophic: the sea level, the melting of the pole ice, the numbers of tornado’s, floods and forest fires, the national security and the potential of 192 million climate migrants in 2060. The interest for climate, health and the possible solutions is large and common. The 5th IPCC states that the last decades especially human activities (and in second order natural emissions) have caused large, mainly negative impacts on our ecological environments. Chris Stringer stated that we represent, nowadays after evolution, the only one version of the possible humanity. At this very moment we are faced with an (over) crowded planet together with global climate changes and a strong demand for energy and material resources. Let us hope that we can counter these difficulties either with better application of existing technologies or by inventing new (applications of) clean technologies together with new business models.

Keywords: clean technologies, catastrophic, climate, possible solutions

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Authors: Erkan Rehber, Hasan Vural, Sule Turhan

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It is a fact that food is a vital need of human beings. As a consumer, everyone has the right to access adequate and safe food. There are considerable development to establish quality standards and schemes to have safe foods and sustainable agriculture alternatives to protect natural resources and environment to reach this target. Recently, there is also a remarkable development in integration and combination of these efforts. Food Safety and Sustainable Agriculture Forum organized in 2014, Beijing shows that it is a global awareness more than being an individual view. Eventually, quality standards, assurance systems applied to conventional agriculture has to be applied to sustainable agriculture alternatives to have a holistic sustainable food chain from seed to fork. All actors of the whole food system from farmer to ultimate consumers, along with the state, have to work together meeting this big challenge.

Keywords: integrated safe, food safety, sustainable food system, consumer

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Authors: Hasibe Caballero-Gomez, Richard Pepino

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Childhood lead poisoning is an issue that continues to plague major U.S. cities. Lead poisoning has been linked to decreases in academic achievement and IQ at levels as low as 5 ug/dL. Despite efforts from the Philadelphia Health Department to curtail systemic childhood lead poisoning, children continue to be identified with elevated blood lead levels (EBLLs) above the CDC reference level for diagnosis. This problem disproportionately affects low-income Black communities. At the moment, remediation is costly, and with the current policies in place, comprehensive remediation seems unrealistic. This research investigates community engagement policy and the ways pre-exisiting resources in target communities can be adjusted to decrease childhood lead poisoning. The study was done with two methods: content analysis and case studies. The content analysis includes 12 interviews from stakeholders and five published policy recommendations. The case studies focus on Baltimore, Chicago, Rochester, and St. Louis, four cities with significant childhood lead poisoning. Target communities were identified by mapping five factors that indicate a higher risk for lead poisoning. Seven priority zipcodes were identified for the model developed in this study. For these urban centers, 28 policy solutions and suggestions were identified, with three being identified at least four times in the content analysis and case studies. These three solutions create an interdependent model that offers increased community awareness and engagement with the issue that could potentially improve health and social outcomes for at-risk children.

Keywords: at-risk populations, community engagement, environmental justice, policy translation

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Authors: Rishana Bilimoria, Selina Tang, Sajni Shah, Marianne Henien, Christopher Sproat

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Temporomandibular disorders (TMD) may affect up to a third of the general population, and there is evidence demonstrating the majority of Myofascial TMD cases improve after education and conservative measures. In 2015 our department implemented a modified care pathway for myofascial TMD patients in an attempt to improve the patient journey. This involved the use of an interactive group therapy approach to deliver education, reinforce conservative measures and promote self-management. Patient reported experience measures from the new group clinic revealed 71% patient satisfaction. This service is efficient in improving aspects of health status while reducing health-care costs and redistributing clinical time. Since its’ establishment, 52 hours of clinical time, resources and funding have been redirected effectively. This Quality Improvement Project was initiated because it was felt that this new service was being underutilised by our surgical teams. The ‘Plan-Do-Study-Act cycle’ (PDSA) framework was employed to analyse utilisation of the service: The ‘plan’ stage involved outlining our aims: to raise awareness amongst clinicians of the unified care pathway and to increase referral to this clinic. The ‘do’ stage involved collecting data from a sample of 96 patients over 4 month period to ascertain the proportion of Myofascial TMD patients who were correctly referred to the designated clinic. ‘Suitable’ patients who weren’t referred were identified. The ‘Study’ phase involved analysis of results, which revealed that 77% of suitable patients weren’t referred to the designated clinic. They were reviewed on other clinics, which are often overbooked, or managed by junior staff members. This correlated with our original prediction. Barriers to referral included: lack of awareness of the clinic, individual consultant treatment preferences and patient, reluctance to be referred to a ‘group’ clinic. The ‘Act’ stage involved presenting our findings to the team at a clinical governance meeting. This included demonstration of the clinical effectiveness of the care-pathway and explaining the referral route and criteria. In light of the evaluation results, it was decided to keep the group clinic and maximize utilisation. The second cycle of data collection following these changes revealed that of 66 Myofascial TMD patients over a 4 month period, only 9% of suitable patients were not seen via the designated pathway; therefore this QIP was successful in meeting the set objectives. Overall, employing the PDSA cycle in this QIP resulted in appropriate utilisation of the modified care pathway for patients with myofascial TMD in Guy’s Oral Surgery Department. In turn, this leads to high patient satisfaction with the service and effectively redirected 52 hours of clinical time. It permitted adoption of a collaborative working style with oral surgery colleagues to investigate problems, identify solutions, and collectively raise standards of clinical care to ensure we adopt a unified care pathway in secondary care management of Myofascial TMD patients.

Keywords: myofascial, quality Improvement, PDSA, TMD

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