Search results for: public hospital
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7570

Search results for: public hospital

6220 Analyzing Competition in Public Construction Projects

Authors: Khaled Hesham Hyari, Amjad Almani

Abstract:

Construction projects in the public sector are commonly awarded through competitive bidding. In the last decade, the Construction projects environment in the Middle East went through many changes. These changes have been caused by different factors including the economic crisis, delays in monthly payments, international competition and reduced number of projects. These factors had a great impact on the bidding behaviors of contractors and their pricing strategies. This paper examines the competition characteristics in public construction projects through an analysis of bidding results of contractors in public construction projects over a period of 6 years (2006-2011) in Jordan. The analyzed projects include all categories of projects such as infrastructure, buildings, transportation and engineering services (design and supervision contracts). Data for the projects were obtained from the General Tender’s Directorate in Jordan and includes 462 projects. The analysis performed in this projects includes, studying the bid spread in all projects as it is an indication of the level of competition in the analyzed bids. The analysis studied the factors that affect bid spread such as number of bidders, Value of the project, Project category and years. It also studying the “Signal to Noise Ratio” in all projects as it is an indication of the accuracy of cost estimating performed by competing bidders and bidder´s evaluation of project risks. The analysis performed includes the relationship between signal to noise ratio and different parameters such as project category, number of bidders and changes over years. Moreover, the analysis includes determining the bidder´s aggressiveness in bidding as it is an indication of competition level in such projects. This was performed by determining the pack price which can be considered as the true value of the project and comparing it with the lowest bid submitted for each project to determine the level of aggressiveness in submitted bids. The analysis performed in this project should prove to be useful to owners in understanding bidding behaviors of contractors and pointing out areas that needs improvement in preparing bidding documents. Also the project should be useful to contractors in understanding the competitive bidding environment and should help them to improve their bidding strategies to maximize the success rate in obtaining contracts.

Keywords: construction projects, competitive bidding, public construction, competition

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6219 When the Rubber Hits the Road: The Enactment of Well-Intentioned Language Policy in Digital vs. In Situ Spaces on Washington, DC Public Transportation

Authors: Austin Vander Wel, Katherin Vargas Henao

Abstract:

Washington, DC, is a city in which Spanish, along with several other minority languages, is prevalent not only among tourists but also those living within city limits. In response to this linguistic diversity and DC’s adoption of the Language Access Act in 2004, the Washington Metropolitan Area Transit Authority (WMATA) committed to addressing the need for equal linguistic representation and established a five-step plan to provide the best multilingual information possible for public transportation users. The current study, however, strongly suggests that this de jure policy does not align with the reality of Spanish’s representation on DC public transportation–although perhaps doing so in an unexpected way. In order to investigate Spanish’s de facto representation and how it contrasts with de jure policy, this study implements a linguistic landscapes methodology that takes critical language-policy as its theoretical framework (Tollefson, 2005). Specifically concerning de facto representation, it focuses on the discrepancies between digital spaces and the actual physical spaces through which users travel. These digital vs. in situ conditions are further analyzed by separately addressing aural and visual modalities. In digital spaces, data was collected from WMATA’s website (visual) and their bilingual hotline (aural). For in situ spaces, both bus and metro areas of DC public transportation were explored, with signs comprising the visual modality and recordings, driver announcements, and interactions with metro kiosk workers comprising the aural modality. While digital spaces were considered to successfully fulfill WMATA’s commitment to representing Spanish as outlined in the de jure policy, physical spaces show a large discrepancy between what is said and what is done, particularly regarding the bus system, in addition to the aural modality overall. These discrepancies in situ spaces place Spanish speakers at a clear disadvantage, demanding additional resources and knowledge on the part of residents with limited or no English proficiency in order to have equal access to this public good. Based on our critical language-policy analysis, while Spanish is represented as a right in the de jure policy, its implementation in situ clearly portrays Spanish as a problem since those seeking bilingual information can not expect it to be present when and where they need it most (Ruíz, 1984; Tollefson, 2005). This study concludes with practical, data-based steps to improve the current situation facing DC’s public transportation context and serves as a model for responding to inadequate enactment of de jure policy in other language policy settings.

Keywords: Urban landscape, language access, critical-language policy, spanish, public transportation

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6218 Symptom Burden and Quality of Life in Advanced Lung Cancer Patients

Authors: Ammar Asma, Bouafia Nabiha, Dhahri Meriem, Ben Cheikh Asma, Ezzi Olfa, Chafai Rim, Njah Mansour

Abstract:

Despite recent advances in treatment of the lung cancer patients, the prognosis remains poor. Information is limited regarding health related quality of life (QOL) status of advanced lung cancer patients. The purposes of this study were: to assess patient reported symptom burden, to measure their QOL, and to identify determinant factors associated with QOL. Materials/Methods: A cross sectional study of 60 patients was carried out from over the period of 03 months from February 1st to 30 April 2016. Patients were recruited in two department of health care: Pneumology department in a university hospital in Sousse and an oncology unit in a University Hospital in Kairouan. Patients with advanced stage (III and IV) of lung cancer who were hospitalized or admitted in the day hospital were recruited by convenience sampling. We used a questionnaire administrated and completed by a trained interviewer. This questionnaire is composed of three parts: demographic, clinical and therapeutic information’s, QOL measurements: based on the SF-36 questionnaire, Symptom’s burden measurement using the Lung Cancer Symptom Scale (LCSS). To assess Correlation between symptoms burden and QOL, we compared the scores of two scales two by two using the Pearson correlation. To identify factors influencing QOL in Lung cancer, a univariate statistical analysis then, a stepwise backward approach, wherein the variables with p< 0.2, were carried out to determine the association between SF-36 scores and different variables. Results: During the study period, 60 patients consented to complete symptom and quality of life questionnaires at a single point time (72% were recruited from day hospital). The majority of patients were male (88%), age ranged from 21 to 79 years with a mean of 60.5 years. Among patients, 48 (80%) were diagnosed as having non-small cell lung carcinoma (NSCLC). Approximately, 60 % (n=36) of patients were in stage IV, 25 % in stage IIIa and 15 % in stage IIIb. For symptom burden, the symptom burden index was 43.07 (Standard Deviation, 21.45). Loss of appetite and fatigue were rated as the most severe symptoms with mean scores (SD): 49.6 (25.7) and 58.2 (15.5). The average overall score of SF36 was 39.3 (SD, 15.4). The physical and emotional limitations had the lowest scores. Univariate analysis showed that factors which influence negatively QOL were: married status (p<0.03), smoking cessation after diagnosis (p<0.024), LCSS total score (p<0.001), LCSS symptom burden index (p<0.001), fatigue (p<0.001), loss of appetite (p<0.001), dyspnea (p<0.001), pain (p<0.002), and metastatic stage (p<0.01). In multivariate analysis, unemployment (p<0.014), smoking cessation after diagnosis (p<0.013), consumption of analgesic (p<0.002) and the indication of an analgesic radiotherapy (p<0.001) are revealed as independent determinants of QOL. The result of the correlation analyses between total LCSS scores and the total and individual domain SF36 scores was significant (p<0.001); the higher total LCSS score is, the poorer QOL is. Conclusion: A built in support of lung cancer patients would better control the symptoms and promote the QOL of these patients.

Keywords: quality of life, lung cancer, metastasis, symptoms burden

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6217 Factors Influencing Public Attitudes Towards Mental Illness in the Togolese Population

Authors: Myriam Roy

Abstract:

The perspectives of the Togolese public towards mental illness were assessed, looking at religious affiliation, personal knowledge of someone with a mental illness, and education level as influencers. The goal was to observe which factors influenced most strongly the general public’s attitudes towards mental illness. The Togolese population was surveyed within the context of mental health awareness workshops and involved college and university students, rural community members, and company employees. Taylor and Dear’s Community Attitudes towards the Mentally Ill (CAMI) questionnaire was used to assess these influencers and includes four dimensions of community attitudes towards mental illness: authoritarianism, benevolence, social restrictiveness, and community mental health ideology (CMHI). Demographic questions were also included, tailored to the various realities of the Togolese population. These questions looked, among others, at religious, ethnical (region of origin within Togo), and educational background. It was found that religious affiliation and personal knowledge did not correlate significantly with changes in the four dimensions of the CAMI scale. It suggests that public perspectives towards mental illness might not be as associated with these variables as was previously thought. The dimensions, however, did correlate with themselves as was expected. Authoritarianism was associated positively with social restrictiveness, benevolence was associated negatively with social restrictiveness and positively with CMHI, and CMHI was associated negatively with social restrictiveness, indicating the CAMI did not suffer from reliability and validity issues when used with this population. Interestingly, level of education significantly impacted authoritarianism level, with higher education associated with a decrease in authoritarianism. This finding would support the notion that education is likely to provide access to a wide array of information as well as interaction with people from various backgrounds and situations. Providing increased awareness regarding mental health and illness in schools could be beneficial to favor the impact that education appears to have on public perspectives towards mental illness in Togo. Future studies could assess which mental health interventions in schools would be the most useful in Togo.

Keywords: CAMI questionnaire, cross-cultural psychology, stigma towards mental illness, West African psychology

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6216 Evaluating the Perception of Roma in Europe through Social Network Analysis

Authors: Giulia I. Pintea

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The Roma people are a nomadic ethnic group native to India, and they are one of the most prevalent minorities in Europe. In the past, Roma were enslaved and they were imprisoned in concentration camps during the Holocaust; today, Roma are subject to hate crimes and are denied access to healthcare, education, and proper housing. The aim of this project is to analyze how the public perception of the Roma people may be influenced by antiziganist and pro-Roma institutions in Europe. In order to carry out this project, we used social network analysis to build two large social networks: The antiziganist network, which is composed of institutions that oppress and racialize Roma, and the pro-Roma network, which is composed of institutions that advocate for and protect Roma rights. Measures of centrality, density, and modularity were obtained to determine which of the two social networks is exerting the greatest influence on the public’s perception of Roma in European societies. Furthermore, data on hate crimes on Roma were gathered from the Organization for Security and Cooperation in Europe (OSCE). We analyzed the trends in hate crimes on Roma for several European countries for 2009-2015 in order to see whether or not there have been changes in the public’s perception of Roma, thus helping us evaluate which of the two social networks has been more influential. Overall, the results suggest that there is a greater and faster exchange of information in the pro-Roma network. However, when taking the hate crimes into account, the impact of the pro-Roma institutions is ambiguous, due to differing patterns among European countries, suggesting that the impact of the pro-Roma network is inconsistent. Despite antiziganist institutions having a slower flow of information, the hate crime patterns also suggest that the antiziganist network has a higher impact on certain countries, which may be due to institutions outside the political sphere boosting the spread of antiziganist ideas and information to the European public.

Keywords: applied mathematics, oppression, Roma people, social network analysis

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6215 Identifying the Barriers Facing Chinese Small and Medium-Sized Enterprises and Evaluating the Effectiveness of Public Supports

Authors: A. Yongsheng Guo, B. Obedat. Abdulazeez, C. Xiaoxian Zhu

Abstract:

This study aimed to identify the barriers to the development of small and medium-sized enterprises (SMEs) in China and build a theoretical framework to evaluate the support provided by the authorities and institutions. A grounded theory approach was adopted to collect and analyze data. 32 interviews were conducted with SME managers, and open, axial and selective coding was utilized to develop themes. Based on institutional theory, grounded theory models were used to present findings. The findings showed that the main barriers in the business environment were defaulting on contracts, bureaucracy in procedures, lack of financial and legal support, limited intermediaries and channels, and poor quality of products and services. This study found that many programs were provided to support SMEs. A theoretical framework was developed to evaluate the performance of the programs from the managers’ perspective. The concepts of economy, efficiency and effectiveness were used to evaluate the perceived value of the programs. This study suggests that specialized programs are needed to suit sector-specific requirements, and creative packages are helpful in supporting SMEs' growth.

Keywords: business support, public economics, public programme, SME

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6214 Yoga as a Tool for Public Health

Authors: Divya Kanchibhotla

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Of all the major health threats to emerge, none has challenged the very foundation of public health so profoundly as the rise of non-communicable diseases (NCD). Encouraging a holistic health approach encompasses the community’s well-being. Competent public health grounded with holistic health approach can lay a better foundation in the modern world. Yoga has been increasingly explored as an adjunct therapy to major disorders. This study explores the efficacy of Yoga as a tool for public health. A survey was administered to 5500 adults, and 300 teens were selected from 25 states of India. The study explored the differences in health, happiness, and sustainable living between Yoga-practitioners and Non-yoga practitioners. The study also explored the practice and habits of yoga practitioners (frequency, place, reasons to practice) and Health, Happiness, and Sustainable Living. The subjects were grouped based on age, education, experience in yoga (years of practice), and occupational background. The study population comprised of 54% males and 46% females. Majority of the respondents (59%) were from 18 to 30 years age group. The study indicated that 96.4% of the total respondents have heard of Yoga. However, only 46.8% of the total study population practice yoga (YP) and the rest 53.2% were non-practitioners (NP). From a perspective of how Yoga and health, 72.7% yoga practitioners asserted a peaceful and happy life, 71.9% yoga practitioners felt satisfaction in life, and 70.2 % yoga practitioners had satisfactory health. 61.9% of yoga practitioners report being vegetarian, not eating junk food, and not drinking alcohol than 38.1% Non-Practitioners population. 47% of yoga practitioners found themselves to be more sensitive to the environment compared to only 40% of non-practitioners. India has been witnessing an unprecedented rise in the NCDs, accounting for 61% deaths. The importance of yoga as an adjunct therapy for various disorders and diseases is gaining momentum across the globe. There are various studies on yoga that have indicated benefits of yoga as a unique holistic approach towards lifestyle and a consistent, complementary solution that could be adopted for long-term viability for a well being. The comprehensive study is the first of its kind that takes a holistic look at the prevalence of Yoga for public health in India. Our study is unique and stands out as it is detailed in its outlook with extensive coverage of almost the whole country (surveying 25 out of 29 states) and contemplates on the benefits to an individual at the grass-root level – physical, mental and social outlook. The insights from the study will enable the health care systems and grassroots organizations to make the holistic practice of Yoga accessible to spread sustainable living for a healthy community.

Keywords: non-communicable disease (NCD), sustainable development goal (SDG 3), public health, healthy living

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6213 Awareness regarding Radiation Protection among the Technicians Practicing in Bharatpur, Chitwan, Nepal

Authors: Jayanti Gyawali, Deepak Adhikari, Mukesh Mallik, Sanjay Sah

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Radiation is defined as an emission or transmission of energy in form of waves or particles through space or material medium. The major imaging tools used in diagnostic radiology is based on the use of ionizing radiation. A cross-sectional study was carried out during July- August, 2015 among technicians in 15 different hospitals of Bharatpur, Chitwan, Nepal to assess awareness regarding radiation protection and their current practice. The researcher was directly engaged for data collection using self-administered semi-structured questionnaire. The findings of the study are presented in socio-demographic characteristics of respondents, current practice of respondents and knowledge regarding radiation protection. The result of this study demonstrated that despite the importance of radiation and its consequent hazards, the level of knowledge among technicians is only 60.23% and their current practice is 76.84%. The difference in the mean score of knowledge and practice might have resulted due to technicians’s regular work and lack of updates. The study also revealed that there is no significant (p>0.05) difference in knowledge level of technicians practicing in different hospitals. But the mean difference in practice scores of different hospital is significant (p<0.05) i.e. i.e. the cancer hospital with large volumes of regular radiological cases and radiation therapies for cancer treatment has better practice in comparison to other hospitals. The deficiency in knowledge of technicians might alter the expected benefits, compared to the risk involved, and can cause erroneous medical diagnosis and radiation hazard. Therefore, this study emphasizes the need for all technicians to update themselves with the appropriate knowledge and current practice about ionizing and non-ionizing radiation.

Keywords: technicians, knowledge, Nepal, radiation

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6212 Comparison of Incidence and Risk Factors of Early Onset and Late Onset Preeclampsia: A Population Based Cohort Study

Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

Abstract:

Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

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6211 Anti-Graft Instruments and Their Role in Curbing Corruption: Integrity Pact and Its Impact on Indian Procurement

Authors: Jot Prakash Kaur

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The paper aims to showcase that with the introduction of anti-graft instruments and willingness of the governments towards their implementation, a significant change can be witnessed in the anti-corruption landscape of any country. Since the past decade anti-graft instruments have been introduced by several international non-governmental organizations with the vision of curbing corruption. Transparency International’s ‘Integrity Pact’ has been one such initiative. Integrity Pact has been described as a tool for preventing corruption in public contracting. Integrity Pact has found its relevance in a developing country like India where public procurement constitutes 25-30 percent of Gross Domestic Product. Corruption in public procurement has been a cause of concern even though India has in place a whole architecture of rules and regulations governing public procurement. Integrity Pact was first adopted by a leading Oil and Gas government company in 2006. Till May 2015, over ninety organizations had adopted Integrity Pact, of which majority of them are central government units. The methodology undertaken to understand impact of Integrity Pact on Public procurement is through analyzing information received from important stakeholders of the instrument. Government, information was sought through Right to Information Act 2005 about the details of adoption of this instrument by various government organizations and departments. Contractor, Company websites and annual reports were used to find out the steps taken towards implementation of Integrity Pact. Civil Society, Transparency International India’s resource materials which include publications and reports on Integrity Pact were also used to understand the impact of Integrity Pact. Some of the findings of the study include organizations adopting Integrity pacts in all kinds of contracts such that 90% of their procurements fall under Integrity Pact. Indian State governments have found merit in Integrity Pact and have adopted it in their procurement contracts. Integrity Pact has been instrumental in creating a brand image of companies. External Monitors, an essential feature of Integrity Pact have emerged as arbitrators for the bidders and are the first line of procurement auditors for the organizations. India has cancelled two defense contracts finding it conflicting with the provisions of Integrity Pact. Some of the clauses of Integrity Pact have been included in the proposed Public Procurement legislation. Integrity Pact has slowly but steadily grown to become an integral part of big ticket procurement in India. Government’s commitment to implement Integrity Pact has changed the way in which public procurement is conducted in India. Public Procurement was a segment infested with corruption but with the adoption of Integrity Pact a number of clean up acts have been performed to make procurement transparent. The paper is divided in five sections. First section elaborates on Integrity Pact. Second section talks about stakeholders of the instrument and the role it plays in its implementation. Third section talks about the efforts taken by the government to implement Integrity Pact in India. Fourth section talks about the role of External Monitor as Arbitrator. The final section puts forth suggestions to strengthen the existing form of Integrity Pact and increase its reach.

Keywords: corruption, integrity pact, procurement, vigilance

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6210 Prediction Factor of Recurrence Supraventricular Tachycardia After Adenosine Treatment in the Emergency Department

Authors: Welawat Tienpratarn, Chaiyaporn Yuksen, Rungrawin Promkul, Chetsadakon Jenpanitpong, Pajit Bunta, Suthap Jaiboon

Abstract:

Supraventricular tachycardia (SVT) is an abnormally fast atrial tachycardia characterized by narrow (≤ 120 ms) and constant QRS. Adenosine was the drug of choice; the first dose was 6 mg. It can be repeated with the second and third doses of 12 mg, with greater than 90% success. The study found that patients observed at 4 hours after normal sinus rhythm was no recurrence within 24 hours. The objective of this study was to investigate the factors that influence the recurrence of SVT after adenosine in the emergency department (ED). The study was conducted retrospectively exploratory model, prognostic study at the Emergency Department (ED) in Faculty of Medicine, Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand. The study was conducted for ten years period between 2010 and 2020. The inclusion criteria were age > 15 years, visiting the ED with SVT, and treating with adenosine. Those patients were recorded with the recurrence SVT in ED. The multivariable logistic regression model developed the predictive model and prediction score for recurrence PSVT. 264 patients met the study criteria. Of those, 24 patients (10%) had recurrence PSVT. Five independent factors were predictive of recurrence PSVT. There was age>65 years, heart rate (after adenosine) > 100 per min, structural heart disease, and dose of adenosine. The clinical risk score to predict recurrence PSVT is developed accuracy 74.41%. The score of >6 had the likelihood ratio of recurrence PSVT by 5.71 times. The clinical predictive score of > 6 was associated with recurrence PSVT in ED.

Keywords: supraventricular tachycardia, recurrance, emergency department, adenosine

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6209 Causes of Non-Compliance With Public Procurement Act, 2007 Among Some Selected State Own Public Tertiary Education Institutions in Southwest, Nigeria

Authors: Ibitoye Olabode Clement

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The huge amount of grants for infrastructures development in Tertiary Institutions in Nigeria calls for transparency and accountability in the procurement process. However, questions have been raised concerning the judicious and appropriate use of the funds, and it was doubtful if the institutions complied with due process. This paper examined the causes of non-compliance with the Public Procurement Act (2007) in the procurement of Goods, Works, and Services through either direct or indirect processes of procurement, mostly in Tertiary Institutions of State government subvention institutions in Nigeria. Nigeria has over 120 public universities, polytechnics, and colleges of Education. This paper will take samples of some selected Institutions in southwest Nigeria. The institutions comprise 5 Universities, 5 Polytechnics, and 5 Colleges of Education / Health and Technology. The opinions of the institutions’ Procurement Officers on the tremendous investment through grants and interventions for infrastructure development in Tertiary Education Institutions (TEI) in Nigeria call for transparency and accountability in the procurement process. However, there are a lot of questions have been raised as to the judicious use of the funds, and it was doubtful if the institutions complied with due process. This study examined the causes of non-compliance with the Public Procurement Act (2007) in the procurement of Goods, Works, and Services in most State Government Public Institutions in Southwest Nigeria. Over, 120 public institutions comprising 5 Universities, 5 Polytechnics, and 5 Colleges of Education / Health and Technology were used for the study. The opinions of the institutions’ Procurement Officers on the causes of non-compliance with the Act in their procurement process were sought using a structured questionnaire. The results revealed that non-independent of Procurement Officers, non-compliance with the Act by some at the managerial level, claiming inadequate knowledge of the Act, non-employment of qualified and experienced Procurement officers, insufficient publicity of the Act, and non-existence of corporate governance led to poor management of procurement record and non-provision of incentive, Inability to separate the duties of Internal Auditors and Procurement Officers, Inability to translate procurement entity at large which makes nearly all at departmental level believe they procurement officers. Conclusively, on taking the Procurement Officers through interviewing having it that: the right educational and professional qualifications, understanding of the Act, sufficient cognate working experience, recruiting most professionals needed if not all, and occupying management position will enhance compliance. Hence, in addition, adopting an external empowered department from the Bureau should raise for monitoring the compliance mostly in State Government Tertiary Education Institution. Also, an organizational culture with a corporate governance structure that supports the engagement of the right and qualified personnel to handle procurement, encourages them to perform at their best and rewards excellent service by giving incentives, and operates within an administrative environment devoid of corruption.

Keywords: non compliance of procurement act, tertiary education institution, university, polytechnic and college of education/ health science and technology, Nigeria

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6208 Comparison of the Common Factors of the Top Academic Elementary Schools to the Average Elementary Schools in California: Looking beyond School Leadership

Authors: Lindy Valdez, Daryl Parker

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Introduction: There has been much research on academic achievement in elementary schools. Most of the research has been on school leadership. While research has focused on the role of leadership on school improvement, little research has examined what variables the top elementary schools have in common. To undertake school improvement, it is important to understand what factors the best schools share. The purpose of this study was to examine data of the “Best Elementary Schools in California,” based on academic achievement as rated by three prominent websites and determine if these schools had any common factors which were different than the statewide averages. The variables examined included access to subject matter specialists (physical education, art, and music), librarians, after school programs, class size, socioeconomic status, and diversity. The participants consisted of the top public elementary schools in California based on the websites i)https://www.niche.com/k12/search/best-schools/, ii)https://www.finder.com/best-schools-california,and iii)https://www.schooldigger.com/go/CA/schoolrank.aspx. The data for subject matter specialists (physical education, art, and music), librarians, after school programs, class size, socioeconomic status, and diversity were collected from these top schools and compared to California statewide averages. Results indicate that top public elementary schools in California have a high number of subject matter specialists that teach physical education, art, and music. These positions are on the decline in the average public elementary school in California, but the top schools have abundant access to these specialists. The physical education specialist has the highest statistically significant difference between the nationwide average and the top schools—librarians, and after school programs are also most commonly high in top public elementary schools in California. The high presence of these programs may be aiding academic achievement in less visible ways. Class size is small, socio-economic status is high, and diversity is low among top public elementary schools in California when compared to the statewide average public elementary schools in California. The single largest area of discrepancy was between physical education specialists in a top school and their state and nationwide averages. The socioeconomic status of schools and parents may be an underlining factor affecting several other variables. This affluence could explain how these schools were able to have access to subject matter specialists, after-school activities, and, therefore, more opportunities for physical activity and greater learning opportunities affecting academic achievement.

Keywords: academic achievement, elementary education, factors, schools

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6207 Keys of Success in Regional Entrepreneurial Media Collaboration Linked With a New Concept of Citizenship

Authors: Rianne Voet

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This paper uses a literature review to search for keys of success for entrepreneurial regional media collaborations in the Netherlands and elsewhere. It specifies keys on general aspects: a digital-first strategy, innovation, a particular journalistic mission and a new role for the public. It outlines keys in practicalities: competencies, revenue model, legal structure, communication structure and organization structure. The paper elaborates on a new public function and a new concept of citizenship which, according to several authors in the literature, are required in order to be successful. Finally, it offers a model of keys for success in regional entrepreneurial media collaboration.

Keywords: media collaboration, factors of success, keys of success, regional media cooperation

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6206 The Role of Citizen Journalism on the Rising of Public Awareness in the Kurdistan Region Government-Iraq

Authors: Abdulsamad Qadir Hussien

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The development of new technology in recent years has offered ordinary people various online digital platform tools and internet access to provide news stories, information, and subjects of public interest in the Kurdistan Region Government-Iraq (KRI). This shifting aspect has offered more chances for ordinary people to engage with other individuals on many issues in order to discuss and argue matters relating to their everyday lives. The key purpose of this research project will examine the role of citizen journalism in the increase of public awareness in the Kurdish community in the KRi; particularly, citizen journalism provides a new opportunity for ordinary people to raise their voices about problems and public matters in the KRI. The sample of this research project encompasses ordinary people who use social media platforms as sources of information and news concerning the KRI government policy. In the research project, the focus is on the ordinary people who are interacting with the blogs, posts, and footage that are produced by citizen journalism. The questionnaire was sent to more than 1,000 participants in the Kurdish community; this aspect produces statistically acceptable numbers to obtain a significant result for this research project. The sampling process is mainly based on the survey method in this study. The online questionnaire form includes many sections, which are divided into four key sections. The first section contains socio-demographic questions, including gender, age, and level of education. The research project applied the survey method in order to gather data and information surrounding the role of citizen journalism in increasing awareness of individuals in the Kurdish community. For this purpose, the researcher designed a questionnaire as the primary tool for the data collection process from ordinary people who use social media as a source of news and information. During the research project, online questionnaires were mailed in two ways – via Facebook and email – to participants in the Kurdish community, and this questionnaire looked for answers to questions from ordinary people, such as to what extent citizen journalism helps users to obtain information and news about public affairs and government policy. The research project found that citizen journalism has an essential role in increasing awareness of the Kurdish community, especially mainstream journalism has helped ordinary people to raise their voices in the KRI. Furthermore, citizen journalism carries more advantages as digital sources of news, footage, and information related to public affairs. This study provides useful tools to fore the news stories that are unreachable to professional journalists in the KRI.

Keywords: citizen journalism, public awareness, demonstration and democracy, social media news

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6205 Impacts of Opium Addiction on Patterns of Angiographic Findings in Patients with Coronary Artery Syndrome

Authors: Alireza Abdiardekani, Maryam Salimi, Shirin Sarejloo, Mehdi Bazrafshan, Amir Askarinejad, Amirhossein Salimi, Hanieh Bazrafshan, Salar Javanshir, Armin Attar, Shokoufeh Khanzadeh, Mohsen Esmaeili, Hamed Bazrafshan Drissi

Abstract:

Background: Opium, after tobacco, is the most abused substance in the Middle East. The effects of opium use on coronary artery disease are indeed unclear. This study aimed to assess the association between opium use and angiographic findings in patients with acute coronary syndrome (ACS) diagnosis at Al-Zahra Heart Hospital, Shiraz, Iran. Methods: In this case-control study, 170 patients admitted for coronary angiography were enrolled from 2019 to 2020. They were categorized into two groups based on their history: "non-opium" and "opium." SPSS (Version 26) was used to investigate the correlation between opioid addiction and the severity of coronary artery disease. Results: The results of our study reveal that the mean age of the participants was 61.63±9.07. This study indicated that 49 (28.82%) patients were female, and 121 (71.17%) were male. Our findings revealed that three-vessel disease was more frequent in non-opium (40; 47.05%) and opium (45; 52.94%) groups. There was a significant correlation between the severity of the second diagonal artery(D2) and right coronary artery(RCA) involvement and opium consumption. There was a strong positive correlation between the location of the vascular lesion in the left circumflex artery and opium consumption. Conclusion: Opium, as an independent risk factor for cardiovascular diseases, can have specific effects on angiographic findings in patients with coronary artery disease. Public health officials and politicians should arrange several programs to increase the general population’s consciousness about opioid use and its consequences.

Keywords: acute coronary syndrome, opium, coronary artery disease, angiography

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6204 Platelet Indices among the Cases of Vivax Malaria

Authors: Mirza Sultan Ahmad, Mubashra Ahmad, Ramlah Mehmood, Nazia Mahboob, Waqar Nasir

Abstract:

Objective: To ascertain the prevalence of thrombocytopenia and study changes in MPV and PDW among cases of vivax malaria. Design: Descriptive analytic study. Place and duration of study: Department of pediatrics, Fazle Omar Hospital, from January to December 2012. Methodology: All patients from birth to 16 years age, who presented in Fazle- Omar hospital, Rabwah from January to December 2012 were included in this study. Hundred patients with other febrile illnesses were taken as control. Full blood counts were checked by Madonic CA 620 analyzer. Name, age, sex, weight, platelet counts. MPV, PDW, any evidence of bleeding, outcome of cases included in this study and taken as control were recorded on data sheets. Results: One hundred and forty-two patients were included in this study. There was no incidence of death or active bleeding. Median platelet count was 109000/mm3. Thrombocytopenia was present in 108 (76.1%) patients. Severe thrombocytopenia was present in 10(7%) patients. Minimum count was 27000/mm3 and maximum was 341000/mm3. Platelet counts of control group was significantly more as compared with study group.(p<.001) Median MPV was 8.70. Minimum value was 6.40 and maximum was 11.90. MPV of study group was significantly more than control group.(p<.001) Median PDW was 11.30. Minimum value was 8.5 and maximum was 16.70. There was no difference between PDW of study and control groups (p=0.246). Conclusions: Thrombocytopenia is a common complication among pediatric cases of vivax malaria. MPV of cases of vivax malaria is higher than control group.

Keywords: malaria vivax, platelet, mean platelet volume, thrombocytopenia

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6203 The Effect of Organizational Justice on Management by Values Perception and Intention to Leave: A Study among Nurses

Authors: Arzu K. Harmanci Seren, Burcu Alacam, Serap Altuntas, Ulku Baykal

Abstract:

Organizational justice has been evaluated as a concept related to rules developed with regards to distributing gains and making decisions of distribution such as duty, goods, service, reward, punishment, fee, organizational position, opportunity or role among those working in that organization, and to social norms on which these rules are based. Studies of organizational justice are crucial for analyzing the organizational life. It is considered that organization justice will be positively influential upon organizational behaviours such as employees’ level of work satisfaction, their performance, and behaviours of organization citizenship, management by values perception, tendency towards cooperation, and towards quitting their jobs. However, when the literature related to health and nurse management is examined, authors could not reach enough findings related to the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values. For that reason, this study has been carried out with the purpose of determining the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values. The study has been carried out with 176 nurses working in a university hospital in Istanbul and a private hospital who accepted to take part in the study, and it is definitive and relation-seeking. Before the data has been collected, ethics committee approval and institutional permissions have been taken, Organizational Justice Scale, Management by Values, Intention to Leave Scale with a questionnaire including 8 questions that aims at defining the personal and professional characteristics of the nurses have been used as a means of data collection. The data collected between 1 May and 20 June 2016 have been evaluated by the researchers in a computer via definitive, relation-seeking and psychometric statistic. As a result of the study, it has been determined that most of the nurses are working in a university hospital (70.5%), that they are 30 and over (49.4%), women (91.5%), single (52.8%) and have a Bachelor’s Degree (48.3%), working in a surgery unit (17.6), have 5 year or less institutional experience (44.9%), 11 year or more professional experience. Cronbach alpha values of the scales used in this study are .94, .95 and .56. Nurses’ average scores of Organizational Justice Scale is M= 3.35±.96, Management by Values Scale is M=3.30±.74, Intention to Leave Scale is M=8.36±3.14. As a result of the analysis carried out in order to determine the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values, it has been pointed out that the Perception of Organizational Justice influenced the perception of Management by Values positively, Intention to Leave negatively.

Keywords: intention to leave, management by values, nursing, organizational justice

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6202 Reliability Analysis of a Life Support System in a Public Aquarium

Authors: Mehmet Savsar

Abstract:

Complex Life Support Systems (LSS) are used in all large commercial and public aquariums in order to keep the fish alive. Reliabilities of individual equipment, as well as the complete system, are extremely important and critical since the life and safety of important fish depend on these life support systems. Failure of some critical device or equipment, which do not have redundancy, results in negative consequences and affects life support as a whole. In this paper, we have considered a life support system in a large public aquarium in Kuwait Scientific Center and presented a procedure and analysis to show how the reliability of such systems can be estimated by using appropriate tools and collected data. We have also proposed possible improvements for systems reliability. In particular, addition of parallel components and spare parts are considered and the numbers of spare parts needed for each component to achieve a required reliability during specified lead time are calculated. The results show that significant improvements in system reliability can be achieved by operating some LSS components in parallel and having certain numbers of spares available in the spare parts inventories. The procedures and the results presented in this paper are expected to be useful for aquarium engineers and maintenance managers dealing with LSS.

Keywords: life support systems, aquariums, reliability, failures, availability, spare parts

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6201 An Application for Risk of Crime Prediction Using Machine Learning

Authors: Luis Fonseca, Filipe Cabral Pinto, Susana Sargento

Abstract:

The increase of the world population, especially in large urban centers, has resulted in new challenges particularly with the control and optimization of public safety. Thus, in the present work, a solution is proposed for the prediction of criminal occurrences in a city based on historical data of incidents and demographic information. The entire research and implementation will be presented start with the data collection from its original source, the treatment and transformations applied to them, choice and the evaluation and implementation of the Machine Learning model up to the application layer. Classification models will be implemented to predict criminal risk for a given time interval and location. Machine Learning algorithms such as Random Forest, Neural Networks, K-Nearest Neighbors and Logistic Regression will be used to predict occurrences, and their performance will be compared according to the data processing and transformation used. The results show that the use of Machine Learning techniques helps to anticipate criminal occurrences, which contributed to the reinforcement of public security. Finally, the models were implemented on a platform that will provide an API to enable other entities to make requests for predictions in real-time. An application will also be presented where it is possible to show criminal predictions visually.

Keywords: crime prediction, machine learning, public safety, smart city

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6200 Effectiveness of Clinical Practice Guidelines for Jellyfish Stings Treatment at the Emergency Room of Songkhla Hospital Thailand

Authors: Prataksitorn Chonlakan, Tiparat Wongsilarat

Abstract:

The traditional clinical practice guideline used at the emergency room at Songkhla Hospital in caring for patients who come in contact with jellyfish venom took a long time for the pain to reduce to the level that patients can cope with. To investigate the effectiveness of clinical practice guidelines by comparing the effectiveness of a newly developed clinical practice guideline with the traditional clinical practice guideline in the following aspects: 1) pain reduction, 2) length of pain, 3) the rate of patient’s re-visit, 4) the rate of severe complications such as anaphylactic shock, and cardiac arrest, and death, and 5) patient satisfaction. This study employed a quasi-experimental research design. Thirty subjects were selected with purposive sampling from jellyfish-sting patients who came for treatment at the Emergency Room of Songkhla Hospital. The subjects were divided using random assignment into two groups of 15 each: an experimental group, and the control group. The control group was treated using the traditional clinical practice guideline consisting of rinsing the affected area with 0.9% normal saline, using a cloth soaked with vinegar to press against the affected area, and controlling pain using tramadol or diclofenac intramuscular injection. The data were analyzed using descriptive statistics and paired t-test at the significance level p < 0.05. The results of the study revealed the following. The pain level in the experimental group was significantly lower than that of the control group (the average pain score of the experimental group was 3.46 while that of the control group was 6.33) (p < 0.05).The length of pain in the experimental group was significantly lower than that of the control group (the average length of pain in the experimental group was 48.67 minutes while that of the control group was 105.35 minutes) (p < 0.05). The rate of re-visit within 12 hours in the experimental group was significantly lower than that of the control group (the rate of re-visit within 12 hours of the experimental group was 0.07 while that of the control group was 0.00) (p < 0.05).No severe complications such as anaphylactic shock, and cardiac arrest were found in the two groups of subjects.The rate of satisfaction among the subjects in the experimental group was significantly higher than that of the control group (the rate of satisfaction among the subjects of the experimental group was 90.00 percent while that among the control group was 66.33 percent) (p < 0.05). The newly develop clinical practice guideline could reduce pain and increase satisfaction among jellyfish-sting patients better than the traditional clinical practice guideline.

Keywords: effectiveness, clinical practice guideline, jellyfish-sting patients, cardiac arrest

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6199 Criticality of Socio-Cultural Factors in Public Policy: A Study of Reproductive Health Care in Rural West Bengal

Authors: Arindam Roy

Abstract:

Public policy is an intriguing terrain, which involves complex interplay of administrative, social political and economic components. There is hardly any fit-for all formulation of public policy as Lindbloom has aptly categorized it as a science of muddling through. In fact, policies are both temporally and contextually determined as one the proponents of policy sciences Harold D Lasswell has underscored it in his ‘contextual-configurative analysis’ as early as 1950s. Though, a lot of theoretical efforts have been made to make sense of this intricate dynamics of policy making, at the end of the day the applied area of public policy negates any such uniform, planned and systematic formulation. However, our policy makers seem to have learnt very little of that. Until recently, policy making was deemed as an absolutely specialized exercise to be conducted by a cadre of professionally trained seasoned mandarin. Attributes like homogeneity, impartiality, efficiency, and neutrality were considered as the watchwords of delivering common goods. Citizen or clientele was conceptualized as universal political or economic construct, to be taken care of uniformly. Moreover, policy makers usually have the proclivity to put anything into straightjacket, and to ignore the nuances therein. Hence, least attention has been given to the ground level reality, especially the socio-cultural milieu where the policy is supposed to be applied. Consequently, a substantial amount of public money goes in vain as the intended beneficiaries remain indifferent to the delivery of public policies. The present paper in the light of Reproductive Health Care policy in rural West Bengal has tried to underscore the criticality of socio-cultural factors in public health delivery. Indian health sector has traversed a long way. From a near non-existent at the time of independence, the Indian state has gradually built a country-wide network of health infrastructure. Yet it has to make a major breakthrough in terms of coverage and penetration of the health services in the rural areas. Several factors are held responsible for such state of things. These include lack of proper infrastructure, medicine, communication, ambulatory services, doctors, nursing services and trained birth attendants. Policy makers have underlined the importance of supply side in policy formulation and implementation. The successive policy documents concerning health delivery bear the testimony of it. The present paper seeks to interrogate the supply-side oriented explanations for the failure of the delivery of health services. Instead, it identified demand side to find out the answer. The state-led and bureaucratically engineered public health measures fail to engender demands as these measures mostly ignore socio-cultural nuances of health and well-being. Hence, the hiatus between supply side and demand side leads to huge wastage of revenue as health infrastructure, medicine and instruments remain unutilized in most cases. Therefore, taking proper cognizance of these factors could have streamlined the delivery of public health.

Keywords: context, policy, socio-cultural factor, uniformity

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6198 Towards Improved Public Information on Industrial Emissions in Italy: Concepts and Specific Issues Associated to the Italian Experience in IPPC Permit Licensing

Authors: C. Mazziotti Gomez de Teran, D. Fiore, B. Cola, A. Fardelli

Abstract:

The present paper summarizes the analysis of the request for consultation of information and data on industrial emissions made publicly available on the web site of the Ministry of Environment, Land and Sea on integrated pollution prevention and control from large industrial installations, the so called “AIA Portal”. However, since also local Competent Authorities have been organizing their own web sites on IPPC permits releasing procedures for public consultation purposes, as a result, a huge amount of information on national industrial plants is already available on internet, although it is usually proposed as textual documentation or images. Thus, it is not possible to access all the relevant information through interoperability systems and also to retrieval relevant information for decision making purposes as well as rising of awareness on environmental issue. Moreover, since in Italy the number of institutional and private subjects involved in the management of the public information on industrial emissions is substantial, the access to the information is provided on internet web sites according to different criteria; thus, at present it is not structurally homogeneous and comparable. To overcome the mentioned difficulties in the case of the Coordinating Committee for the implementation of the Agreement for the industrial area in Taranto and Statte, operating before the IPPC permit granting procedures of the relevant installation located in the area, a big effort was devoted to elaborate and to validate data and information on characterization of soil, ground water aquifer and coastal sea at disposal of different subjects to derive a global perspective for decision making purposes. Thus, the present paper also focuses on main outcomes matured during such experience.

Keywords: public information, emissions into atmosphere, IPPC permits, territorial information systems

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6197 The Effects of the Introduction of a One-day Waiting Period on Absences for Ordinary Illness of Public Employees

Authors: Mohamed Ali Ben Halima, Malik Koubi, Joseph Lanfranchi, Yohan Wloczysiak

Abstract:

This article assesses the consequences on the frequency and duration of ordinary sick leave of the January 2012 and 2018 reforms modifying the scope of sick leave reimbursement in the French civil service. These reforms introduce a one-day waiting period which removes the compensation for the first day of ordinary sick leave. In order to evaluate these reforms, we use an administrative database from the National Pension Fund for local public employees (FPT). The first important result of our data analysis is that the one-day waiting period was not introduced at the same time in the French Local Public Service establishments, or even never in some. This peculiarity allows for an identification strategy using a difference-in-differences method based on the definition at each date of groups of employees treated and not treated by the reform, since establishments that apply the one-day waiting period coexist with establishments that do not apply it. Two types of estimators are used for this evaluation: individual and time fixed effects estimators and DIDM estimators which correct for the biases of the Two Way Fixed Effects one. The results confirm that the change in the sick pay system decreases the probability of having at least one ordinary sick leave as well as the number and duration of these episodes. On the other hand, the estimates show that longer leave episodes are not less affected than shorter ones. Finally, the validity tests of the estimators support the results obtained for the second period of 2018-2019, but suggest estimation biases for the period 2012-2013. The extent to which the endogeneity of the choices of implementation of the reform at the local level impact these estimates needs to be further tested.

Keywords: sick leave, one-day waiting period, territorial civil service, public policy evaluation

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6196 The Effect of Organizational Virtuousness on Nurses' Organizational Identification Level and Performance: The Mediating Role of Perceived Organizational Support

Authors: Feride Eskin Bacaksiz, Aytolan Yildirim

Abstract:

Practices voluntarily performed by organizations for their employees well-being, create an emotional imperative for employees in accordance with reciprocity norm. Changes in desired course occur in organizational outputs and attitudes towards organization among employees perceiving their organizations as virtuous and supportive. The aim of this study was to examine the effect of organizational virtuousness on performance and organizational identification levels of employees and mediating role of perceived organizational support in this relationship. The data of this descriptive and methodological study were collected from 336 nurses working in a public university hospital in 2015. Participant information form, Organizational Virtuousness, Perceived Organizational Support, Organizational Identification, and Employee Performance scales were used to collect the data. Descriptive, correlative, psychometric analyses and Structural Equation Modeling were performed for the data analysis. Most of the participants were female, under 30 years of age, graduated degrees and staff nurse. Mean scores obtained by the participants from scales were calculated as 3.43(SD=.99) for organizational virtuousness, 2.99 (SD=1.16) for perceived organizational support, 3.18 (SD=1.03) for organizational identification and 3.84 (SD=0.66) for employee performance. It was found that correlation between organizational virtuousness and employee performance regressed from r=0.64 to r=-0.01 and correlation between organizational virtuousness and organizational identification regressed from r=0.55 to r=-0.16 and became statistically non-significant (p < 0.05) via mediating role of perceived organizational support. According to the results, perceived organizational support assumes full mediation on the impact of organizational virtues of employee performance and organizational identification levels. Therefore, organizations, which intend to positively affect employees attitudes towards organization and their performance, should both extend organizational virtuous activities and affect perceptions of employees; whereas, employees should perceive that they are supported by their organization.

Keywords: employee performance, organizational identification, organizational virtuousness, perceived organizational support

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6195 Association of Transforming Growth Factor-β1 Gene 1800469 C > T and 1982073 C > T Polymorphism with Type 2 Diabetic Foot Ulcer Patient in Cipto Mangunkusumo National Hospital Jakarta

Authors: Dedy Pratama, Akhmadu Muradi, Hilman Ibrahim, Patrianef Darwis, Alexander Jayadi Utama, Raden Suhartono, D. Suryandari, Luluk Yunaini, Tom Ch Adriani

Abstract:

Objective: Diabetic Foot Ulcer (DFU) is one of the complications of Type 2 Diabetes Mellitus (T2DM) that can lead to disability and death. Inadequate vascularization condition will affect healing process of DFU. Therefore, we investigated the expression of polymorphism TGF- β1 in the relation of the occurrence of DFU in T2DM. Methods: We designed a case-control study to investigate the polymorphism TGF- β1 gene 1800469 C > T and 1982073 C > T in T2DM in Cipto Mangunkusumo National Hospital (RSCM) Jakarta from June to December 2016. We used PCR techniques and compared the results in a group of T2DM patients with DFU as the case study and without DFU as the control group. Results: There were 203 patients, 102 patients with DFU and 101 patients control without DFU. 49,8% is male and 50,2% female with mean age about 56 years. Distribution of wild-type genotype TGF-B1 1800469 C > T wild type CC was found in 44,8%, the number of mutant heterozygote CT was 10,8% and mutant homozygote is 11,3%. Distribution of TGF-B1 1982073 C>T wild type CC was 32,5%, mutant heterozygote is 38,9% and mutant homozygote 25,1%. Conclusion: Distribution of alleles from TGF-B1 1800469 C > T is C 75% and T 25% and from TGF-B1 1982073 C > T is C53,8% and T 46,2%. In the other word polymorphism TGF- β1 plays a role in the occurrence and healing process of the DFU in T2DM patients.

Keywords: diabetic foot ulcers, diabetes mellitus, polymorphism, TGF-β1

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6194 Incidence, Pattern and Risk Factors of Congenial Heart Diseases in Neonates in a Tertiary Care Hospital, Egyptian Study

Authors: Gehan Hussein, Hams Ahmad, Baher Matta, Yasmeen Mansi, Mohamad Fawzi

Abstract:

Background: Congenital heart disease (CHD) is a common problem worldwide with variable incidence in different countries. The exact etiology is unknown, suggested to be multifactorial. We aimed to study the incidence of various CHD in a neonatal intensive care unit (NICU) in a tertiary care hospital in Egypt and the possible associations with variable risk factors. Methods: Prospective study was conducted over a period of one year (2013 /2014) at NICU KasrAlAini School of Medicine, Cairo University. Questionnaire about possible maternal and/or paternal risk factors for CHD, clinical examination, bedside echocardiography were done. Cases were classified into groups: group 1 without CHD and group 2 with CHD. Results: from 723 neonates admitted to NICU, 180 cases were proved to have CHD, 58 % of them were males. patent ductus arteriosus(PDA) was the most common CHD (70%), followed by an atrial septal defect (ASD8%), while Fallot tetralogy and single ventricle were the least common (0.45 %) for each. CHD was found in 30 % of consanguineous parents Maternal age ≥ 35 years at the time of conception was associated with increased incidence of PDA (p= 0.45 %). Maternal diabetes and insulin intake were significantly associated with cases of CHD (p=0.02 &0.001 respectively), maternal hypertension and hypothyroidism were both associated with VSD, but the difference did not reach statistical significance (P=0.36 &0.44respectively). Maternal passive smoking was significantly associated with PDA (p=0.03). Conclusion: The most frequent CHD in the studied population was PDA, followed by ASD. Maternal conditions as diabetes was associated with VSD occurrence.

Keywords: NICU, risk factors, congenital heart disease, echocardiography

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6193 The Grand Technological Promise in Norwegian Child Welfare Services: Social Workers’ Experiences and Expectations

Authors: Ida Bruheim Jensen, Hulda Mjöll Gunnarsdottir, Ingunn T. Ellingsen

Abstract:

Digital government is often seen as an enabler or even driver of transformation of public administration, with the objective of creating public value. The increasing use of digital solutions in public services comes with great expectations of new and/or more efficient service provision. Digitalizing public sector services involve multi-level implementation. It involves national policy negotiations and decisions of digital government solutions. It involves co-creation/-production of ideas where planning, design, and implementation involves several groups of actors targeting end-users. Norway is among the most digitalised countries in the world, and Government spendings on digital technologies in public services are high compared to other OECD countries. This contribution studies an ongoing digital transformation in the Norwegian child welfare services. DigiBarnevern (Digi child welfare) is a nationwide project promising better and more efficient child welfare services through various digital technologies. The digitalization process, which is managed by the state and municipalities, is still in its early stages, and as of 2022, only a few services are operative. Digital technologies such as DigiBarnevern are implemented with promises of qualitatively improving child protection work, making the services more effective, foster user participation, and increase availability. There is limited research on the implications of using digital technologies in child protection work. We aim to present findings from an ongoing research project (2022-2024). Drawing on data from focus group interviews with social workers in 5 municipal child welfare services in Norway, we explore social workers’ experiences and expectations towards using digital technologies in child welfare services. Technological solutions may change the services and child protection work in numerous ways. Potential points of departure for discussion are how technologies may change the relationships between social workers, children, youth, and their families, how technologies can alter and obscure responsibilities, and how technologies may demand digital competence among social workers and service recipients.

Keywords: child welfare, social work, technology, digitalisation

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6192 Prevalence and Genetic Determinant of Drug Resistant Tuberculosis among Patients Completing Intensive Phase of Treatment in a Tertiary Referral Center in Nigeria

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

Abstract:

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

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

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6191 The Prevalence of Intubation Induced Dental Complications among Hospitalized Patients

Authors: Dorsa Rahi, Arghavan Tonkanbonbi, Soheila Manifar, Behzad Jafvarnejad

Abstract:

Background and Aim: Intraoral manipulation is performed during endotracheal intubation for general anesthesia, which can traumatize the soft and hard tissue in the oral cavity and cause postoperative pain and discomfort. Dental trauma is the most common complication of intubation. This study aimed to assess the prevalence of dental complications due to intubation in patients hospitalized in Imam Khomeini Hospital during 2018-2019. Materials and Methods: A total of 805 patients presenting to the Cancer Institute of Imam Khomeini Hospital for preoperative anesthesia consultation were randomly enrolled. A dentist interviewed the patients and performed a comprehensive clinical oral examination preoperatively. The patients underwent clinical oral examination by another dentist postoperatively. Results: No significant correlation was found between dental trauma (tooth fracture, tooth mobility, or soft tissue injury) after intubation with the age or gender of patients. According to the Wilcoxon test and McNemar-Bowker Test, the rate of mobility before the intubation was significantly different from that after the intubation (P=0.000). Maxillary central incisors, maxillary left canine and mandibular right and left central incisors had the highest rate of fracture. Conclusion: Mobile teeth before the intubation are at higher risk of avulsion and aspiration during the procedure. Patients with primary temporomandibular joint disorders are more susceptible to post-intubation trismus.

Keywords: oral trauma, dental trauma, intubation, anesthesia

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